Ballistocardiography and seismocardiography detection of hemodynamic changes during simulated obstructive apnea.

ABSTRACT

OBJECTIVE: To investigate if modern seismocardiography (SCG) and ballistocardiography (BCG) are useful in the detection of hemodynamic changes occurring during simulated obstructive apneic events. METHODS: Forty-seven healthy volunteers performed a voluntary maximum Mueller maneuver (MM) for 10 s, and SCG and BCG signals were simultaneously taken. The kinetic energy of a set of cardiac cycles before and during the apneic episode was automatically computed from the rotational and linear channels of the SCG and BCG waveforms and its temporal integral (i K) was derived (unit of measure: microjoules per second (µJ·s)). The estimated transmural pressure (eP TM ) was assessed as the difference between systemic blood pressure and maximal inspiratory pressure (MIP). The Wilcoxon sign-rank test was used to evaluate differences in energy measurements between normal respiration and the loaded inspiration maneuver. Cardiac kinetic energies and the MIP produced during the MM were compared by linear regression analysis following log transformation in order to assess the correlation between variables. MAIN RESULTS: The [Formula see text] during normal breathing increased from 1.1(0.8; 1.4) to 1.9(1.4; 4.3) µJ·s during MM (p < 0.001). Meanwhile, [Formula see text] increased from 54 (31; 92) to 84 (44; 153) µJ·s, (p < 0.001). The [Formula see text] and [Formula see text] of a set of cardiac cycles during the MM were negatively associated with the MIP (r -0.59, p < 0.001 and r -0.53, p = 0.001 for [Formula see text] and [Formula see text], respectively). When eP TM was considered, this association became positive (r +0.58, p < 0.001 and r+0.60, p < 0.001, for [Formula see text] and [Formula see text], respectively). When the i K LIN was considered as the comparative factor, correlations with the MIP and eP TM were weak and insignificant. Men had higher values of i K than women. SIGNIFICANCE: Simulated obstructive apnea elicits large rotational i K swings, which are related to the intensity of the inspiratory effort and, as such, to the intensity of the left ventricular afterload. Computation of cardiac kinetic energy through BCG and SCG may shed further light on the impact of obstructive respiratory events on the cardiovascular system.