Miguel Servet Children Hospital

Zaragoza, Spain

Miguel Servet Children Hospital

Zaragoza, Spain

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Lazaro J.,University of Zaragoza | Lazaro J.,CIBER ISCIII | Gil E.,University of Zaragoza | Gil E.,CIBER ISCIII | And 4 more authors.
Computing in Cardiology | Year: 2012

An analysis of the pulse rate variability (PRV) during decreases in the amplitude fluctuations of pulse photoplethysmographic (PPG) signal (DAP) events, and their utility in obstructive sleep apnea syndrome (OSAS) screening is presented as an alternative to heart rate variability (HRV) which will save the need of electrocardiogram (ECG) recording. 21 polysomnographic registers from children whose age was 4.47 ± 2.04 (mean ± SD) years were manually labeled as OSAS (10 children) or not (11 children) following standard clinical procedures. Then DAP events were automatically detected and classified as apneic or non apneic by a linear discriminant analysis whose features come from the PRV. Subsequently, the apneic DAP event per hour index was used to discriminate OSAS from non-OSAS children. Results show an improvement in accuracy of subject classification with respect to the HRV analysis of 6.7%, reaching a 86.7% (100% for sensitivity and 71.4% for specificity). These results suggest that PRV can be used to discriminate apneic and non-apneic DAP events without introducing any additional signal and so a decision from just the PPG with same results as if the ECG were also considered, which takes special relevance in sleep studies. © 2012 CCAL.


Gil E.,Aragon Institute of Engineering Research | Gil E.,CIBER ISCIII | Orini M.,Aragon Institute of Engineering Research | Orini M.,CIBER ISCIII | And 8 more authors.
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC'10 | Year: 2010

In this work we assessed the possibility of using the pulse rate variability (PRV) extracted from photoplethysmography signal as an alternative measurement of the HRV signal in non.stationary conditions. The study is based on the analysis of the changes observed during tilt table test in the heart rate modulation of 17 young subjects. Time.varying spectral properties of both signals were compared by time.frequency (TF) and TF coherence analysis. In addition, the effect of replacing PRV with HRV in the assessment of the changes of the autonomic modulation of the heart rate was considered. Time. frequency analysis revealed that: the TF spectra of both signals were highly correlated (0.99 ± 0.01); the difference between the instantaneous power, in LF and HF bands, obtained from HRV and PRV was small (<10-3 s -2) and their temporal patterns were highly correlated (0.98±0.04 and 0.95±0.06 in LF and HF bands respectively); TF coherence in LF and HF bands was high (0.97±0.04 and 0.89±0.08, respectively). Finally, the instantaneous power in LF band was observed to significantly increase during head.up tilt by both HRV and PRV analysis. These results suggest that, although some small differences in the time.varying spectral indices extracted from HRV and PRV exist, mainly in the HF band associated with respiration, PRV could be used as an acceptable surrogate of HRV during non. stationary conditions, at least during tilt table test. © 2010 IEEE.


Gil E.,Aragon Institute of Engineering Research | Gil E.,CIBER ISCIII | Orini M.,Aragon Institute of Engineering Research | Orini M.,CIBER ISCIII | And 8 more authors.
Physiological Measurement | Year: 2010

In this paper we assessed the possibility of using the pulse rate variability (PRV) extracted from the photoplethysmography signal as an alternative measurement of the HRV signal in non-stationary conditions. The study is based on analysis of the changes observed during a tilt table test in the heart rate modulation of 17 young subjects. First, the classical indices of HRV analysis were compared to the indices from PRV in intervals where stationarity was assumed. Second, the time-varying spectral properties of both signals were compared by timefrequency (TF) and TF coherence analysis. Third, the effect of replacing PRV with HRV in the assessment of the changes of the autonomic modulation of the heart rate was considered. Time-invariant HRV and PRV indices showed no statistically significant differences (p > 0.05) and high correlation (>0.97). Time-frequency analysis revealed that the TF spectra of both signals were highly correlated (0.99 ± 0.01); the difference between the instantaneous power, in the LF and HF bands, obtained from HRV and PRV was small (<10-3 s-2) and their temporal patterns were highly correlated (0.98 ± 0.04 and 0.95 ± 0.06 in the LF and HF bands, respectively) and TF coherence in the LF and HF bands was high (0.97 ± 0.04 and 0.89 ± 0.08, respectively). Finally, the instantaneous power in the LF band was observed to significantly increase during head-up tilt by both HRV and PRV analysis. These results suggest that although some differences in the time-varying spectral indices extracted from HRV and PRV exist, mainly in the HF band associated with respiration, PRV could be used as a surrogate of HRV during non-stationary conditions, at least during the tilt table test. © 2010 Institute of Physics and Engineering in Medicine.


Lazaro J.,Aragon Institute of Engineering Research | Gil E.,Aragon Institute of Engineering Research | Vergara J.M.,Miguel Servet Children Hospital | Laguna P.,Aragon Institute of Engineering Research
IEEE Journal of Biomedical and Health Informatics | Year: 2014

A technique for ambulatory diagnosis of the obstructive sleep apnea syndrome (OSAS) in children based on pulse photoplethysmographic (PPG) signal is presented. Decreases in amplitude fluctuations of the PPG signal (DAP) events have been proposed as OSAS discriminator, since they are related to vasoconstriction associated to apnea. Heart rate variability (HRV) analysis during these DAP events has been proposed to discriminate between DAP events related or unrelated to an apneic event. The use of HRV requires electrocardiogram (ECG) as an additional recording, meaning a disadvantage that takes more relevance in sleep studies context where the number of sensors is tried to be minimized in order not to affect the physiological sleep. This study proposes the use of pulse rate variability (PRV) extracted from the PPG signal instead of HRV. Polysomnographic registers from 21 children (aged 4.47 ± 2.04 years) were studied. The subject classification based on DAP events and PRV analysis obtained an accuracy of 86.67% which represents an improvement of 6.67% with respect to the HRV analysis. These results suggest that PRV can be used in apnea detectors based on DAP events, to discriminate apneic from nonapneic events avoiding the need for ECG recordings. © 2013 IEEE.

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