Reducing the effect of respiration in baroreflex sensitivity estimation with adaptive filtering.

Abstract

Cardiac baroreflex is described by baroreflex sensitivity (BRS) from blood pressure and heart rate interval (RRi) fluctuations. However, respiration affects both blood pressure and RRi via mechanisms that are not necessarily of baroreflex origin. To separate the effects of baroreflex and respiration, metronome-guided breathing in a high frequency band (HF, 0.25-0.4 Hz) and a low frequency spectral band (LF, 0.04-0.15 Hz) have therefore been commonly used for BRS estimation. The controlled breathing may, however, change the natural functioning of the autonomic system and interfere BRS estimates. To enable usage of spontaneous breathing, we propose an adaptive LMS-based filter for removing the respiration effect from the BRS estimates. ECG, continuous blood pressure and respiration were measured during 5 min spontaneous and 5 min controlled breathing at 0.25 Hz in healthy males (n = 24, 33+/-7 years). BRS was calculated with spectral methods from the LF band with and without filtering. In those subjects whose spontaneous breathing rate was <0.15 Hz, the BRS(LF) values were overestimated, whereas the adaptive filtering reduced the bias significantly. As a conclusion, the adaptive filter reduces the distorting effect of respiration on BRS values, which enables more accurate estimation of BRS and the usage of spontaneous breathing as a measurement protocol.