Discovery of Causal Paths in Cardiorespiratory Parameters: A Time-Independent Approach in Elite Athletes

Training of elite athletes requires regular physiological and medical monitoring to plan the schedule, intensity and volume of training, and subsequent recovery. In sports medicine, ECG-based analyses are well-established. However, they rarely consider the correspondence of respiratory and cardiac activity. Given such mutual influence, we hypothesize that athlete monitoring might be developed with causal inference and that detailed, time-related techniques should be preceded by a more general, time-independent approach that considers the whole group of participants and parameters describing whole signals. The aim of this study was to discover general causal paths among cardiac and respiratory variables in elite athletes in two body positions (supine and standing), at rest. ECG and impedance pneumography signals were obtained from 100 elite athletes. The mean heart rate, the root-mean-square difference of successive RR intervals (RMSSD), its natural logarithm (lnRMSSD), the mean respiratory rate (RR), the breathing activity coefficients, and the resulting breathing regularity (BR) were estimated. Several causal discovery frameworks were applied, comprising Generalized Correlations (GC), Causal Additive Modeling (CAM), Fast Greedy Equivalence Search (FGES), Greedy Fast Causal Inference (GFCI), and two score-based Bayesian network learning algorithms: Hill-Climbing (HC) and Tabu Search. The discovery of cardiorespiratory paths appears ambiguous. The main, still mild, rules best supported by data are: for supine - tidal volume causes heart activity variation, which causes average heart activity, which causes respiratory timing; and for standing - normalized respiratory activity variation causes average heart activity. The presented approach allows data-driven and time-independent analysis of elite athletes as a particular population, without considering prior knowledge. However, the results seem to be consistent with the medical background. Causality inference is an interesting mathematical approach to the analysis of biological responses, which are complex. One can use it to profile athletes and plan appropriate training. In the next step, we plan to expand the study using time-related causality analyses.