RESUMO
PURPOSE: Electronic noses represent a technique for the measurement of exhaled breath volatile compound pattern which can discriminate patients with obstructive sleep apnoea (OSA) from control subjects. Although overnight changes in circulating biomarkers were reported, this effect on the exhaled volatile compound pattern has not been studied before. We aimed to compare breath patterns in the evening and in the morning in patients with OSA and to study the ability of the electronic nose to distinguish patients from controls based on these exhaled volatile patterns. METHODS: Exhaled breath volatile compound pattern was measured before and after night in 26 patients with suspected sleep-disordered breathing (53 ± 15 years) who underwent polysomnography and in ten control subjects (37 ± 15 years), by whom sleep-disordered breathing was excluded with a home apnoea screening device. Breath measurements were also performed in the morning in 26 healthy, non-smoking age-matched controls (48 ± 10 years) with no complaints about disturbed sleep. Exhaled volatile compound pattern was processed with a Cyranose 320 electronic nose, and principal component analysis was used for statistical analysis. RESULTS: Exhaled volatile compound patterns recorded in the evening and in the morning were different in patients with OSA (p = 0.01) but not in non-OSA habitual snorers (p = 0.49) or in control subjects (p = 0.23). The electronic nose distinguished patients with OSA from control subjects based on the breath samples collected in the morning (p < 0.001, classification accuracy 77 %) but not in the evening (p > 0.05). CONCLUSIONS: Evening and morning exhaled volatile compound patterns are different in OSA. This might affect the ability of electronic noses to identify this disorder. Overnight alterations in volatile substances need to be taken into account during exhaled breath measurements in OSA.
Assuntos
Testes Respiratórios , Ritmo Circadiano/fisiologia , Nariz Eletrônico , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Compostos Orgânicos Voláteis/análise , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Valores de ReferênciaRESUMO
BACKGROUND: Electronic noses are composites of nanosensor arrays. Numerous studies showed their potential to detect lung cancer from breath samples by analysing exhaled volatile compound pattern ("breathprint"). Expiratory flow rate, breath hold and inclusion of anatomic dead space may influence the exhaled levels of some volatile compounds; however it has not been fully addressed how these factors affect electronic nose data. Therefore, the aim of the study was to investigate these effects. METHODS: 37 healthy subjects (44 ± 14 years) and 27 patients with lung cancer (60 ± 10 years) participated in the study. After deep inhalation through a volatile organic compound filter, subjects exhaled at two different flow rates (50 ml/sec and 75 ml/sec) into Teflon-coated bags. The effect of breath hold was analysed after 10 seconds of deep inhalation. We also studied the effect of anatomic dead space by excluding this fraction and comparing alveolar air to mixed (alveolar + anatomic dead space) air samples. Exhaled air samples were processed with Cyranose 320 electronic nose. RESULTS: Expiratory flow rate, breath hold and the inclusion of anatomic dead space significantly altered "breathprints" in healthy individuals (p < 0.05), but not in lung cancer (p > 0.05). These factors also influenced the discrimination ability of the electronic nose to detect lung cancer significantly. CONCLUSIONS: We have shown that expiratory flow, breath hold and dead space influence exhaled volatile compound pattern assessed with electronic nose. These findings suggest critical methodological recommendations to standardise sample collections for electronic nose measurements.
Assuntos
Testes Respiratórios/métodos , Nariz Eletrônico , Neoplasias Pulmonares/diagnóstico , Adulto , Idoso , Suspensão da Respiração , Feminino , Fluxo Expiratório Forçado , Voluntários Saudáveis , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Espaço Morto Respiratório , Fumar , Compostos Orgânicos Voláteis/análiseRESUMO
Összefoglaló. Bevezetés: Az affektív temperamentumok (depresszív, cyclothym, hyperthym, ingerlékeny, szorongó) a személyiségnek olyan genetikailag meghatározott, felnottkorban stabil részei, amelyekkel jellemezhetok a környezeti ingerekre adott érzelmi válaszok. Az artériás érfalmerevségi index megmutatja, hogy az adott egyénnek a valóságban mért és az elvárt pulzushullám-terjedési sebessége (PWV) milyen arányban áll egymással; pozitív értéke számít kórosnak. Célkituzés: Célunk az volt, hogy az affektív temperamentumok kapcsolatát vizsgáljuk az artériás érfalmerevségi indexszel krónikus hypertoniás betegekben. Módszer: A bevont betegeknél tonometriás eszközzel (PulsePen) mértük a carotis-femoralis PWV-t, mely az artériás érfalmerevség legelfogadottabb markere. Az artériás érfalmerevségi indexet a mért és az elvárt PWV arányában határoztuk meg. Az affektív temperamentumokat a Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire kérdoív (TEMPS-A) segítségével objektivizáltuk. Eredmények: Vizsgálatunkba 185 beteget vontunk be, életkoruk 61,6 (49,5-69,8) év volt. Kortól, nemtol, diabetestol, alkoholfogyasztástól, dohányzástól, BMI-tol, systolés vérnyomástól, összkoleszterinszinttol és GFR-tol független kapcsolatot találtunk az artériás érfalmerevségi index és a depresszív (B = 0,009, 95% CI: 0,002-0,017, p = 0,018), a cyclothym (B = 0,009, 95% CI: 0,002-0,016, p = 0,012), az ingerlékeny (B = 0,013, 95% CI: 0,005-0,021, p<0,001) és a szorongó (B = 0,008, 95% CI: 0,003-0,013, p<0,001) temperamentum között. Következtetés: Újabb kapcsolatot sikerült kimutatni egy cardiovascularis rizikót jelzo paraméter és az affektív temperamentumok között, ami megerosíti ezen személyiségjegyek meghatározásának jelentoségét cardiovascularis prevenciós szempontból is az ismert pszichopatológiai vonatkozások mellett. Orv Hetil. 2022; 163(8): 312-318. INTRODUCTION: Affective temperaments (depressive, anxious, cyclothymic, hyperthymic, irritable) are genetically determined, adult-stable parts of the personality that characterize emotional responses to environmental stimuli. The arterial stiffness index demonstrates the ratio of the actually measured and expected pulse wave velocity (PWV) of a given individual. The positive value is considered to be abnormal. OBJECTIVE: The aim of this study was to investigate the relationship between affective temperaments and arterial stiffness index in chronic hypertensive patients. METHOD: Carotid-femoral PWV, the most accepted marker of arterial stiffness, was measured using a tonometric device (PulsePen). The arterial stiffness index was determined as the ratio of measured and expected PWVs. Affective temperaments were evaluated by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). RESULTS: The study included 185 patients, with a mean age of 61.6 (49.5-69.8) years. We found association between arterial stiffness index and depressive (B = 0.009, 95% CI: 0.009-0.017, p = 0.018), cyclothymic (B = 0.009, 95% CI: 0.002-0.016, p = 0.012), irritable (B = 0.013, 95% CI: 0.005-0.021, p = 0.001), and anxious (B = 0.008, 95% CI: 0.003-0.013, p = 0.001) temperaments independent of age, sex, diabetes, alcohol consumption, smoking, BMI, systolic blood pressure, total cholesterol, and GFR. CONCLUSION: An additional relationship between a cardiovascular risk measure and affective temperaments has been demonstrated, confirming the importance of determining these personality traits aiming cardiovascular prevention in addition to their known psychopathological aspects. Orv Hetil. 2022; 163(8): 312-318.
Assuntos
Hipertensão , Rigidez Vascular , Adulto , Humanos , Pessoa de Meia-Idade , Análise de Onda de Pulso , TemperamentoRESUMO
Electronic noses can distinguish various disorders by analyzing exhaled volatile organic compound (VOC) pattern; however it is unclear how hereditary and environmental backgrounds affect the exhaled VOC pattern. A twin study enrolling monozygotic (MZ) and dizygotic (DZ) twins is an ideal tool to separate the influence of these factors on the exhaled breath pattern. Exhaled breath samples were collected in duplicates from 28 never smoking twin pairs (in total 112 samples) without lung diseases and processed with an electronic nose (Cyranose 320). Univariate quantitative hereditary modeling (ACE analysis) adjusted for age and gender was performed to decompose the phenotypic variance of the exhaled volatile compound pattern (assessing principal components (PCs) derived from electronic nose data) into hereditary (A), shared (C), and unshared (E) environmental effects. Exhaled VOC pattern showed good intra-subject reproducibility as assessed with the Bland-Altman plot. Significant correlations were found between exhaled VOC patterns of both MZ and DZ twins. The hereditary background did not influence the VOC pattern. The shared environmental effect on PC 1, 2 and 3 was estimated to be 93%, 94% and 54%, respectively. The unshared (unique) environmental influence explained a smaller variance (7%, 6% and 46%). For the first time using the twin design, we have shown that the environmental background largely affects the exhaled volatile compound pattern in never smoking volunteers without respiratory disorders. Further studies should identify these environmental factors and also assess their influence on exhaled breath patterns in patients with lung diseases.