Can fractal analysis on heart rate variability reflect physiological causes for cardiorespiratory interaction?

Abstract

It is well accepted that Heart Rate Variability (HRV) is a result from complex cardiorespiratory dynamics including heart rate, blood pressure, and respiration rate. Respiratory Sinus Arrhythmia (RSA) is a well-known phenomenon due to cardiorespiratory interaction [1]. Obstructive Sleep Apnea (OSA), one of RSA-related disorders, is the repeated, temporary cessation of breathing during sleep caused by intermittent airway obstruction, and OSA is considered as an independent risk factor for hypertension, ischemic heart attacks, and stroke [2-4]. The underlying mechanisms leading to cardiovascular disease in OSA are complex and not fully understood. However, it is believed that changes of the cardiac autonomic regulation should be involved in the development of cardiovascular disease for OSA patients [5]. In this Editorial, I would like to comment on the understanding of complex cardiorespiratory interaction through sophisticated math like fractal analysis must be careful in clinical applications