Nonlinear Dynamics of Heart Rate Variability in Children with Asthmatic Symptoms
Asthma is a chronic lung disease that is prone to start during chilhood. Although symptoms can be usually controlled with medication, early diagnosis is crucial to reduce the risk of permanent airway obstruction. Despite the fact that origin of asthma is
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BSICoS group, I3A, IIS Arag´on, University of Zaragoza, Zaragoza, Spain 2 Centro de Investigaci´ on Biom´edica en Red (CIBER), Madrid, Spain BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland 4 Skin and Allergy Hospital, University of Helsinki, Helsinki, Finland 5 Helsinki University Hospital, Helsinki, Finland
Abstract— Asthma is a chronic lung disease that is prone to start during chilhood. Although symptoms can be usually controlled with medication, early diagnosis is crucial to reduce the risk of permanent airway obstruction. Despite the fact that origin of asthma is still uncertain, abnormal parasympathetic nervous system (PNS) activity has been pointed out to play a major role in its pathogenesis. In this work the use of nonlinear heart rate variability (HRV) indexes is proposed in order to look for differences between children classified as high- or low-risk of suffering from asthma in the future. PNS activity is assessed trough a filtered HRV signal. Correlation dimension analysis showed statistically significant differences distinguishing highand low-risk. Decreased complexity observed in high-risk group suggests that abnormal PNS activity might be related with increased risk of developing asthma. Keywords— heart rate variability, asthma, nonlinear, parasympathetic nervous system
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I. I NTRODUCTION Asthma is a chronic lung disease that inflames and narrows the airways [1], and although it affects people of any age [2] it most often starts during childhood [3]. Despite the fact that main symptoms of asthma (increase in mucus segregation, spasmodic contraction of the bronchioles or bronchial hyperresponsiveness) are usually reversible with medication, their effect can become severe in some cases [2]. Therefore, early diagnosis of asthma is crucial to prevent patients from the worsening of these symptoms, that could turn into permanent airway obstruction [4]. Although diagnosis of asthma is well defined in adults, the assessment in young children is performed through evaluation of the clinical history [5] that can be incomplete or inaccurate in some cases. © Springer Nature Singapore Pte Ltd. 2018 H. Eskola et al. (eds.), EMBEC & NBC 2017, IFMBE Proceedings 65, DOI: 10.1007/978-981-10-5122-7_204
Abnormal parasympathetic nervous system (PNS) activity has been related with the pathogenesis of asthma [6], playing a major role in the bronchoconstriction mechanisms [7] and in the control of bronchomotor tone [8]. Heart rate variability (HRV) analysis can be used for assessing PNS activity and nonlinear dynamics analysis is considered to be a powerful tool in the evaluation of cardiovascular system behavior [9]. In this way, a nonlinear analysis of HRV is proposed here in order to assess differences in the complexity of PNS activity as an indicator of increased risk of developing asthma.
II. M ATERIALS The data base analyzed in this work is composed by 34 children who were referred to the Pediatric Allergy Unit of Helsinki Universi
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