The deep breathing test: median-based expiration-inspiration difference is the measure of choice. 2009

Deborah Löllgen, and Michael Müeck-Weymann, and Reinhard D Beise
Biocomfort Diagnostics GmbH & Co. KG, Bernhäuser Strasse 17, 73765 Neuhausen, Germany. loellgen@biocomfort.de

Heart rate variability (HRV) has become an important parameter for the assessment of autonomic function in many areas of medicine. In particular, respiratory sinus arrhythmia measured during the deep breathing test (DBT) is often used. Results are usually expressed in common time-domain parameters. A "most preferred measure" has not yet been identified. We investigated the sensitivity of the DBT to the following anomalies: in-test variance; shifts of mean heart rate; premature ventricular contractions; and breathing rate deviations. Frequency and magnitude of the anomalies were determined in a set of real DBTs (n=514) and transferred to computer simulations to mimic realistic conditions. The sensitivity of standard deviation, mean circular resultant (MCR), root mean square of successive differences (RMSSD), and four types of expiration-inspiration (E-I) difference were quantified statistically. Median-based E-I differences, E-I ratio, and MCR were most resistant to the anomalies. E-I difference derived by median values should be used preferentially, providing the highest precision and independence from heart rate.

UI MeSH Term Description Entries
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D002320 Cardiovascular Physiological Phenomena Processes and properties of the CARDIOVASCULAR SYSTEM as a whole or of any of its parts. Cardiovascular Physiologic Processes,Cardiovascular Physiological Processes,Cardiovascular Physiology,Cardiovascular Physiological Concepts,Cardiovascular Physiological Phenomenon,Cardiovascular Physiological Process,Physiology, Cardiovascular,Cardiovascular Physiological Concept,Cardiovascular Physiological Phenomenas,Concept, Cardiovascular Physiological,Concepts, Cardiovascular Physiological,Phenomena, Cardiovascular Physiological,Phenomenon, Cardiovascular Physiological,Physiologic Processes, Cardiovascular,Physiological Concept, Cardiovascular,Physiological Concepts, Cardiovascular,Physiological Phenomena, Cardiovascular,Physiological Phenomenon, Cardiovascular,Physiological Process, Cardiovascular,Physiological Processes, Cardiovascular,Process, Cardiovascular Physiological,Processes, Cardiovascular Physiologic,Processes, Cardiovascular Physiological
D003198 Computer Simulation Computer-based representation of physical systems and phenomena such as chemical processes. Computational Modeling,Computational Modelling,Computer Models,In silico Modeling,In silico Models,In silico Simulation,Models, Computer,Computerized Models,Computer Model,Computer Simulations,Computerized Model,In silico Model,Model, Computer,Model, Computerized,Model, In silico,Modeling, Computational,Modeling, In silico,Modelling, Computational,Simulation, Computer,Simulation, In silico,Simulations, Computer
D003943 Diagnostic Techniques, Neurological Methods and procedures for the diagnosis of diseases of the nervous system, central and peripheral, or demonstration of neurologic function or dysfunction. Diagnostic Technic, Neurological,Diagnostic Technics, Neurologic,Diagnostic Technics, Neurological,Diagnostic Technique, Neurological,Diagnostic Techniques, Neurologic,Neurological Diagnostic Technic,Neurological Diagnostic Technics,Neurological Diagnostic Technique,Neurological Diagnostic Techniques,Technic, Neurological Diagnostic,Technics, Neurological Diagnostic,Technique, Neurological Diagnostic,Techniques, Neurological Diagnostic,Diagnostic Technic, Neurologic,Diagnostic Technique, Neurologic,Neurologic Diagnostic Technic,Neurologic Diagnostic Technics,Neurologic Diagnostic Technique,Neurologic Diagnostic Techniques,Technic, Neurologic Diagnostic,Technics, Neurologic Diagnostic,Technique, Neurologic Diagnostic,Techniques, Neurologic Diagnostic
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001146 Arrhythmia, Sinus Irregular HEART RATE caused by abnormal function of the SINOATRIAL NODE. It is characterized by a greater than 10% change between the maximum and the minimum sinus cycle length or 120 milliseconds. Sinus Arrhythmia,Arrhythmia, Sinoatrial,Sinoatrial Arrhythmia,Arrhythmias, Sinoatrial,Arrhythmias, Sinus,Sinoatrial Arrhythmias,Sinus Arrhythmias
D001239 Inhalation The act of BREATHING in. Inhaling,Inspiration, Respiratory,Respiratory Inspiration
D001342 Autonomic Nervous System Diseases Diseases of the AUTONOMIC NERVOUS SYSTEM, including sympathetic, parasympathetic, and enteric nervous systems. Autonomic Disorders,Central Autonomic Nervous System Diseases,Disorders of the Autonomic Nervous System,Dysautonomia,Nervous System Diseases, Autonomic,Nervous System Diseases, Parasympathetic,Nervous System Diseases, Sympathetic,Non-Familial Dysautonomia,Parasympathetic Nervous System Diseases,Peripheral Autonomic Nervous System Diseases,Sympathetic Nervous System Diseases,ANS (Autonomic Nervous System) Diseases,ANS Diseases,Autonomic Central Nervous System Diseases,Autonomic Diseases,Autonomic Nervous System Disorders,Autonomic Peripheral Nervous System Diseases,Segmental Autonomic Dysfunction,ANS Disease,Autonomic Disease,Autonomic Disorder,Autonomic Dysfunction, Segmental,Autonomic Dysfunctions, Segmental,Disorder, Autonomic,Dysautonomia, Non-Familial,Dysautonomias,Non Familial Dysautonomia,Non-Familial Dysautonomias,Segmental Autonomic Dysfunctions
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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