Coupling analysis of heart rate variability and cortical arousal using a deep learning algorithm
Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activit...
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| Vydáno v: | PloS one Ročník 18; číslo 4; s. e0284167 |
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06.04.2023
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| Abstract | Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects’ full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death. |
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| AbstractList | Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects’ full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death. Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects' full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death.Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects' full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death. |
| Audience | Academic |
| Author | Quan, Stuart F. Li, Ao Roveda, Janet Huo, Jiayan |
| AuthorAffiliation | 5 BIO5 Institute, The University of Arizona, Tucson, AZ, United States of America 4 Electrical and Computer Engineering, The University of Arizona, Tucson, AZ, United States of America 1 Biomedical Engineering, The University of Arizona, Tucson, AZ, United States of America 3 Asthma and Airway Disease Research Center, College of Medicine, The University of Arizona, Tucson, AZ, United States of America 2 Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America Charite Medical University Berlin, GERMANY |
| AuthorAffiliation_xml | – name: 1 Biomedical Engineering, The University of Arizona, Tucson, AZ, United States of America – name: 5 BIO5 Institute, The University of Arizona, Tucson, AZ, United States of America – name: Charite Medical University Berlin, GERMANY – name: 2 Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America – name: 3 Asthma and Airway Disease Research Center, College of Medicine, The University of Arizona, Tucson, AZ, United States of America – name: 4 Electrical and Computer Engineering, The University of Arizona, Tucson, AZ, United States of America |
| Author_xml | – sequence: 1 givenname: Jiayan surname: Huo fullname: Huo, Jiayan – sequence: 2 givenname: Stuart F. orcidid: 0000-0002-9474-7679 surname: Quan fullname: Quan, Stuart F. – sequence: 3 givenname: Janet orcidid: 0000-0001-6210-2633 surname: Roveda fullname: Roveda, Janet – sequence: 4 givenname: Ao orcidid: 0000-0002-1927-8606 surname: Li fullname: Li, Ao |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37023117$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_2147_NSS_S435918 crossref_primary_10_1038_s44220_024_00206_4 crossref_primary_10_1016_j_bspc_2023_105633 crossref_primary_10_54691_epgcyy04 crossref_primary_10_1016_j_bspc_2025_108524 |
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| Copyright | Copyright: © 2023 Huo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. COPYRIGHT 2023 Public Library of Science 2023 Huo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2023 Huo et al 2023 Huo et al 2023 Huo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: S.F.Q. is a consultant for Bryte Bed, Guidepoint Global, Cowen Services, Whispersom, DR Capital and Best Doctors and is a member of the Hypopnea Taskforce of the American Academy of Sleep Medicine. Other authors have nothing to disclose. |
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| Title | Coupling analysis of heart rate variability and cortical arousal using a deep learning algorithm |
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