Why the study?
The effect of cardiac resynchronization therapy (CRT) on the relationship between cardiovascular and respiratory systems in heart failure had not been examined, and whether alterations in cardio-respiratory interactions could mark favorable CRT response was unknown.
Does cardiac resynchronization therapy improve cardio-respiratory coupling in heart failure patients?
Does cardiac resynchronization therapy improve cardio-respiratory coupling in heart failure patients?
Stability of cardio-respiratory coupling, measured by signal complexity and synchrony, is associated with successful response to cardiac resynchronization therapy.
Cardio-respiratory coupling stability may identify CRT responders; hypothesis-generating and requires prospective validation before clinical adoption.
In this study, the effect of cardiac resynchronization therapy (CRT) on the relationship between the cardiovascular and respiratory systems in heart failure subjects was examined for the first time. We hypothesized that alterations in cardio-respiratory interactions, after CRT implantation, quantified by signal complexity, could be a marker of a favorable CRT response. Sample entropy and scaling exponents were calculated from synchronously recorded cardiac and respiratory signals 20 min in duration, collected in 47 heart failure patients at rest, before and 9 months after CRT implantation. Further, cross-sample entropy between these signals was calculated. After CRT, all patients had lower heart rate and CRT responders had reduced breathing frequency. Results revealed that higher cardiac rhythm complexity in CRT non-responders was associated with weak correlations of cardiac rhythm at baseline measurement over long scales and over short scales at follow-up recording. Unlike CRT responders, in non-responders, a significant difference in respiratory rhythm complexity between measurements could be consequence of divergent changes in correlation properties of the respiratory signal over short and long scales. Asynchrony between cardiac and respiratory rhythm increased significantly in CRT non-responders during follow-up. Quantification of complexity and synchrony between cardiac and respiratory signals shows significant associations between CRT success and stability of cardio-respiratory coupling.
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Radovanović et al. (2021) studied this question.
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