Methods of observing autonomic neural stimulation and diagnosing cardiac dynamical dysfunction using heartbeat interval data to analyze cardioventilatory interactions

• US 4,960,129 A
• Filed: 12/05/1988
• Issued: 10/02/1990
• Est. Priority Date: 12/05/1988
• Status: Expired due to Fees

• Current Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Original Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Inventors: Ostlund, Stellan, dePaola, Robert
• Primary Examiner(s): Jaworski, Francis
• Assistant Examiner(s): Manuel, George
• Application Number:
  US07/280,138
• Time in Patent Office: 666 Days
• Field of Search: 128/670, 128/695, 128/696, 128/700, 128/716, 128/723, 364/413.03, 364/413.04, 364/413.06
• US Class Current: 600/508
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system

Abstract

Methods of isolating individual neural impulses are disclosed. In a preferred embodiment, methods of observing the response of the heart to autonomic neural control are presented. The present invention is used to observe cardioventilatory phase-locking. The noninvasive technique disclosed are a useful clinical tool for observing phase locking as diagnostic of physiological disorders which result from autonomic neural dysfunction. The methods of observation disclosed also are applicable to the isolation of other neural impulses. An understanding of cardioventilatory interaction is obtained by plotting highly accurate heartbeat-interval (hbi) time series data versus ventilator phase. The data displays created by the methods of the present invention show structure whose features are reproducible over time and across subjects. These structures are attributable to the effect of individual neural impulses from the autonomic nervous system which influence the cardiac pacemaker. The absence of neural function has been correlated to various physiological dysfunctions.

Claims

1. A method of determining the occurrence of a neural stimulus to a cyclic physiological function which occurs in a subject, comprising the steps of:

(a) determining the time interval between successive heartbeats of said subject and generating data representative of said time intervals;

(b) determining the phase of said cyclic physiological function over a predetermined interval concurrent with said time interval determination, said interval having a duration of more than one heartbeat, and generating data representative of said phase;

(c) combining said heartbeat interval and physiological phase data as a data set;

(d) processing said data set to identify pronounced variations in said heartbeat interval data within a portion of said cycle of said physiological function;

whereby the presence of said repetitive pronounced variation is indicative of the occurrence of neural stimulus.

2. The method of claim 1, further comprising the steps of:

(e) further processing said time interval data to remove substantially all of said variations having a duration less than about five percent (5%) of said cycle;

(f) further processing said time interval data to collect all of said variations having a duration greater than about one percent (1%) of said cycle;

(g) storing time interval data processed according to steps (e)-(f) as a final data set;

(h) collecting a plurality of said final data sets, taken successively from said subject; and

(i) displaying said plurality of final data sets in a manner to indicate the presence of a repetitive pronounced variation within an identified portion of said physiological cycle;

whereby the neural stimulation of said physiological cycle is indicated.

3. The method of claim 2, wherein:

(a) said further processing of step (e) comprises performing a 150 point running average on said data set; and

(b) said further processing of step (f) comprises performing a 30 point running average to obtain a final data set.

4. The method of claim 1, wherein said physiological cycle is the ventilatory cycle of said subject.

5. A method of observing cardiac neural stimulus in a subject, comprising the steps of:

(a) determining the time interval between successive heartbeats of said subject and generating data representative of said time intervals;

(b) determining the frequency of a cycle of a physiological function of said subject over a predetermined interval concurrent with said time interval determination, said interval having a duration of more than one heartbeat, and generating data representative of said frequency;

(c) combining said heartbeat interval and physiological frequency data as a data set;

(d) processing said data set through a band pass filter, wherein said band pass filter is designed to operate at frequencies between about 1/20 and about 1/100 of said physiological cycle to obtain a final data set;

(e) collecting a plurality of said final data sets, taken successively in time from said subject; and

(f) displaying said plurality of final data sets in a manner to indicate the presence of a repetitive pronounced variation within a particular portion of said physiological cycle.

6. The method of claim 5, wherein said physiological cycle is the ventilatory cycle of said subject.

7. A method of identifying cardiac neurological dysfunction in a subject, comprising the steps of:

(a) determining the time interval between successive heartbeats of said subject and generating data representative of said time intervals;

(b) determining the frequency of ventilation of said subject over a predetermined interval concurrent with said time interval determination which coincides with a plurality of said heartbeats, and generating data representative of said frequency;

(c) combining said heartbeat interval and ventilatory frequency data as a data set;

(d) processing said data set to determine the presence or absence of cardioventilatory phase locking; and

(e) displaying said data in a manner to indicate the presence or absence of said phase locking, the presence of phase locking being indicative of neural dysfunction.

8. The method of claim 7 further comprising the steps of:

(f) converting said frequency to a ventilatory phase related to said interval between beats of a heart; and

(g) calculating the difference between successive heartbeat intervals.

9. The method of claim 8 further comprising the step of:

(h) displaying said ventilatory phase and said difference between successive heartbeat intervals upon a coordinate system, having at least two axes, wherein said ventilatory phase is displayed upon one of said axes as the dependent variable, said data being displayed in a manner to indicate the presence or absence of group of closely spaced data points wherein said groups form substantially straight, substantially parallel lines when interconnected.

10. The method of claim 7 wherein steps (a)-(e) are performed in real time.

11. A method for determining the presence of cardioventilatory phase locking in a subject, comprising the steps of:

(a) acquiring data representing the respective time intervals between successive heartbeats of said subject;

(b) concurrently acquiring data representing the phase of the ventilatory cycle of said subject related to said heartbeat interval data;

(c) determining whether said data acquired in steps (a) and (b) are substantially linearly correlated at substantially the same point in the ventilatory cycle of said subject over a discrete period of time;

whereby the existence of said substantial linear correlation is indicative of cardioventilatory phase locking.

12. The method of claim 11, wherein the step of determining whether substantial linear correlation described in step (c) is present is comprised of creating an observable representation of a display of said data and visually inspecting said observable representation.

13. In a patient having a heart and at least one other organ exhibiting a regularly recurring physiological cycle, apparatus for observing cardiac neural stimulus in the patient comprising:

(a) means for determining heartbeat data representative of the time interval between successive heartbeats of said patient;

(b) means for determining frequency data representative of the frequency of said regularly recurring physiological cycle of said at least one other organ of said patient over a period of time concurrent with said successive heartbeats; and

(c) computing means for combining said heartbeat data and said frequency data and for processing said combined data to determine the presence of a repetitive pronounced variation of said regularly recurring physiological cycle and identify the a particular portion of said physiological cycle said pronounced variation occurs.

14. The apparatus of claim 13, further comprising display means for displaying said data and indicating the presence of said repetitive pronounced variation within a particular portion of said physiological cycle.

15. Apparatus for cardiac and ventilatory monitoring of a patient, comprising:

(a) means for determining data representative of the time interval between successive heartbeats of said patient;

(b) means for determining data representative of the frequency of ventilation of said patient over a period of time including said successive heartbeats; and

(c) computing means for combining said heartbeat data and said ventilation data to create a combined data set and means for processing said combined data set to determine the presence and/or absence of cardioventilatory phase locking.

16. The apparatus of claim 15, further comprising means for displaying said combined data set so as to indicate the presence and/or absence of said phase locking.

17. A method of analyzing data collected from rhythmic systems, comprising the steps of:

(a) collecting first data representative of a first non-periodic rhythmic activity;

(b) collecting second data representative of a second rhythmic activity concurrently with said first data;

said second activity having an interrelationship with said first activity;

(c) processing said first and second data to relate said first activity to the phase of said second activity; and

(d) determining the existence of ordered data structures indicative of the interrelationship between said first and second activities.

18. The method of claim 17, wherein said first activity is the ventilatory activity of a subject and said second activity is the cardiac activity of a subject.

19. The method of claim 18, wherein said ordered data structures comprise substantially repetitive data points representing said cardiac activity said data points occurring at plurality of distinct locations within the phase of said ventilatory activity;

whereby said data structures are indicative of cardioventilatory phase locking.

20. The method of claim 18, wherein said ordered data structures comprise data values within a region of the phase of said ventilatory activity exhibiting a substantially greater variation in the maximum and minimum data points representing cardiac activity than all other regions of said ventilatory phase;

whereby said data structures represent the existence of neural activity.