Categorizing the Role of Respiration in Cardiovascular and Cerebrovascular Variability Interactions.

Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Ranucci M, Faes L. Categorizing the Role of Respiration in Cardiovascular and Cerebrovascular Variability Interactions. IEEE Trans Biomed Eng. 2022 Jun;69(6):2065-2076. doi: 10.1109/TBME.2021.3135313. Epub 2022 May 19. PMID: 34905489.

Abstract

Objective: Respiration disturbs cardiovascular and cerebrovascular controls but its role is not fully elucidated.

Methods: Respiration can be classified as a confounder if its observation reduces the strength of the causal relationship from source to target. Respiration is a suppressor if the opposite situation holds. We prove that a confounding/suppression (C/S) test can be accomplished by evaluating the sign of net redundancy/synergy balance in the predictability framework based on multivariate autoregressive modelling. In addition, we suggest that, under the hypothesis of Gaussian processes, the C/S test can be given in the transfer entropy decomposition framework as well. Experimental protocols: We applied the C/S test to variability series of respiratory movements, heart period, systolic arterial pressure, mean arterial pressure, and mean cerebral blood flow recorded in 17 pathological individuals (age: 64±8 yrs; 17 males) before and after induction of propofol-based general anesthesia prior to coronary artery bypass grafting, and in 13 healthy subjects (age: 27±8 yrs; 5 males) at rest in supine position and during head-up tilt with a table inclination of 60°.

Results: Respiration behaved systematically as a confounder for cardiovascular and cerebrovascular controls. In addition, its role was affected by propofol-based general anesthesia but not by a postural stimulus of limited intensity.

Conclusion: The C/S test can be fruitfully exploited to categorize the role of respiration over causal variability interactions.

Significance: The application of the C/S test could favor the comprehension of the role of respiration in cardiovascular and cerebrovascular regulations.