1
|
Prats-Boluda G, Martinez-de-Juan JL, Nieto-Del-Amor F, Termenon M, Varón C, Ye-Lin Y. Vectorgastrogram: dynamic trajectory and recurrence quantification analysis to assess slow wave vector movement in healthy subjects. Phys Eng Sci Med 2024; 47:663-677. [PMID: 38436885 PMCID: PMC11166836 DOI: 10.1007/s13246-024-01396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 01/21/2024] [Indexed: 03/05/2024]
Abstract
Functional gastric disorders entail chronic or recurrent symptoms, high prevalence and a significant financial burden. These disorders do not always involve structural abnormalities and since they cannot be diagnosed by routine procedures, electrogastrography (EGG) has been proposed as a diagnostic alternative. However, the method still has not been transferred to clinical practice due to the difficulty of identifying gastric activity because of the low-frequency interference caused by skin-electrode contact potential in obtaining spatiotemporal information by simple procedures. This work attempted to robustly identify the gastric slow wave (SW) main components by applying multivariate variational mode decomposition (MVMD) to the multichannel EGG. Another aim was to obtain the 2D SW vectorgastrogram VGGSW from 4 electrodes perpendicularly arranged in a T-shape and analyse its dynamic trajectory and recurrence quantification (RQA) to assess slow wave vector movement in healthy subjects. The results revealed that MVMD can reliably identify the gastric SW, with detection rates over 91% in fasting postprandial subjects and a frequency instability of less than 5.3%, statistically increasing its amplitude and frequency after ingestion. The VGGSW dynamic trajectory showed a statistically higher predominance of vertical displacement after ingestion. RQA metrics (recurrence ratio, average length, entropy, and trapping time) showed a postprandial statistical increase, suggesting that gastric SW became more intense and coordinated with a less complex VGGSW and higher periodicity. The results support the VGGSW as a simple technique that can provide relevant information on the "global" spatial pattern of gastric slow wave propagation that could help diagnose gastric pathologies.
Collapse
Affiliation(s)
- Gema Prats-Boluda
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain.
| | - Jose L Martinez-de-Juan
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain
| | - Felix Nieto-Del-Amor
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain
| | - María Termenon
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain
| | - Cristina Varón
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain
| | - Yiyao Ye-Lin
- Centro de Investigación e Innovación en Bioingeniería (CI2B), Universitat Politècnica de València (UPV), Valencia, Spain
| |
Collapse
|
2
|
Aydeniz E, van Rosmalen F, de Kok J, Martens B, Mingels AMA, Canakci ME, Mihl C, Vernooy K, Prinzen FW, Wildberger JE, van der Horst ICC, van Bussel BCT, Driessen RGH. The association between coronary artery calcification and vectorcardiography in mechanically ventilated COVID-19 patients: the Maastricht Intensive Care COVID cohort. Intensive Care Med Exp 2024; 12:26. [PMID: 38451350 PMCID: PMC10920503 DOI: 10.1186/s40635-024-00611-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Coronary artery calcification (CAC) is associated with poor outcome in critically ill patients. A deterioration in cardiac conduction and loss of myocardial tissue could be an underlying cause. Vectorcardiography (VCG) and cardiac biomarkers provide insight into these underlying causes. The aim of this study was to investigate whether a high degree of CAC is associated with VCG-derived variables and biomarkers, including high-sensitivity troponin-T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). METHODS Mechanically ventilated coronavirus-19 (COVID-19) patients with an available chest computed tomography (CT) and 12-lead electrocardiogram (ECG) were studied. CAC scores were determined using chest CT scans. Patients were categorized into 3 sex-specific tertiles: low, intermediate, and high CAC. Daily 12 leads-ECGs were converted to VCGs. Daily hs-cTnT and NT-proBNP levels were determined. Linear mixed-effects regression models examined the associations between CAC tertiles and VCG variables, and between CAC tertiles and hs-cTnT or NT-proBNP levels. RESULTS In this study, 205 patients (73.2% men, median age 65 years [IQR 57.0; 71.0]) were included. Compared to the lowest CAC tertile, the highest CAC tertile had a larger QRS area at baseline (6.65 µVs larger [1.50; 11.81], p = 0.012), which decreased during admission (- 0.27 µVs per day [- 0.43; - 0.11], p = 0.001). Patients with the highest CAC tertile also had a longer QRS duration (12.02 ms longer [4.74; 19.30], p = 0.001), higher levels of log hs-cTnT (0.79 ng/L higher [0.40; 1.19], p < 0.001) and log NT-proBNP (0.83 pmol/L higher [0.30; 1.37], p = 0.002). CONCLUSION Patients with a high degree of CAC had the largest QRS area and higher QRS amplitude, which decreased more over time when compared to patients with a low degree of CAC. These results suggest that CAC might contribute to loss of myocardial tissue during critical illness. These insights could improve risk stratification and prognostication of patients with critical illness.
Collapse
Affiliation(s)
- Eda Aydeniz
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
| | - Frank van Rosmalen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jip de Kok
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Bibi Martens
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Alma M A Mingels
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Central Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Mustafa Emin Canakci
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Emergency Department, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Casper Mihl
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Kevin Vernooy
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Frits W Prinzen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Physiology, Maastricht University, Maastricht, The Netherlands
| | - Joachim E Wildberger
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Bas C T van Bussel
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Rob G H Driessen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center +, Maastricht, The Netherlands
| |
Collapse
|
3
|
Continuous monitoring of acute myocardial infarction with a 3-Lead ECG system. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
4
|
Martinek R, Ladrova M, Sidikova M, Jaros R, Behbehani K, Kahankova R, Kawala-Sterniuk A. Advanced Bioelectrical Signal Processing Methods: Past, Present and Future Approach-Part I: Cardiac Signals. SENSORS 2021; 21:s21155186. [PMID: 34372424 PMCID: PMC8346990 DOI: 10.3390/s21155186] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
Advanced signal processing methods are one of the fastest developing scientific and technical areas of biomedical engineering with increasing usage in current clinical practice. This paper presents an extensive literature review of the methods for the digital signal processing of cardiac bioelectrical signals that are commonly applied in today’s clinical practice. This work covers the definition of bioelectrical signals. It also covers to the extreme extent of classical and advanced approaches to the alleviation of noise contamination such as digital adaptive and non-adaptive filtering, signal decomposition methods based on blind source separation and wavelet transform.
Collapse
Affiliation(s)
- Radek Martinek
- FEECS, Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava, 708 00 Ostrava, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
- Correspondence: (R.M.); (A.K.-S.)
| | - Martina Ladrova
- FEECS, Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava, 708 00 Ostrava, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Michaela Sidikova
- FEECS, Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava, 708 00 Ostrava, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Rene Jaros
- FEECS, Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava, 708 00 Ostrava, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Khosrow Behbehani
- College of Engineering, The University of Texas in Arlington, Arlington, TX 76019, USA;
| | - Radana Kahankova
- FEECS, Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava, 708 00 Ostrava, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Aleksandra Kawala-Sterniuk
- Faculty of Electrical Engineering, Automatic Control and Informatics, Opole University of Technology, 45-758 Opole, Poland
- Correspondence: (R.M.); (A.K.-S.)
| |
Collapse
|
5
|
Ladrova M, Martinek R, Nedoma J, Hanzlikova P, Nelson MD, Kahankova R, Brablik J, Kolarik J. Monitoring and Synchronization of Cardiac and Respiratory Traces in Magnetic Resonance Imaging: A Review. IEEE Rev Biomed Eng 2021; 15:200-221. [PMID: 33513108 DOI: 10.1109/rbme.2021.3055550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Synchronization of human vital signs, namely the cardiac cycle and respiratory excursions, is necessary during magnetic resonance imaging of the cardiovascular system and the abdominal cavity to achieve optimal image quality with minimized artifacts. This review summarizes techniques currently available in clinical practice, as well as methods under development, outlines the benefits and disadvantages of each approach, and offers some unique solutions for consideration.
Collapse
|
6
|
Jaros R, Martinek R, Danys L. Comparison of Different Electrocardiography with Vectorcardiography Transformations. SENSORS (BASEL, SWITZERLAND) 2019; 19:E3072. [PMID: 31336798 PMCID: PMC6678609 DOI: 10.3390/s19143072] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/04/2019] [Accepted: 07/09/2019] [Indexed: 12/01/2022]
Abstract
This paper deals with transformations from electrocardiographic (ECG) to vectorcardiographic (VCG) leads. VCG provides better sensitivity, for example for the detection of myocardial infarction, ischemia, and hypertrophy. However, in clinical practice, measurement of VCG is not usually used because it requires additional electrodes placed on the patient's body. Instead, mathematical transformations are used for deriving VCG from 12-leads ECG. In this work, Kors quasi-orthogonal transformation, inverse Dower transformation, Kors regression transformation, and linear regression-based transformations for deriving P wave (PLSV) and QRS complex (QLSV) are implemented and compared. These transformation methods were not yet compared before, so we have selected them for this paper. Transformation methods were compared for the data from the Physikalisch-Technische Bundesanstalt (PTB) database and their accuracy was evaluated using a mean squared error (MSE) and a correlation coefficient (R) between the derived and directly measured Frank's leads. Based on the statistical analysis, Kors regression transformation was significantly more accurate for the derivation of the X and Y leads than the others. For the Z lead, there were no statistically significant differences in the medians between Kors regression transformation and the PLSV and QLSV methods. This paper thoroughly compared multiple VCG transformation methods to conventional VCG Frank's orthogonal lead system, used in clinical practice.
Collapse
Affiliation(s)
- Rene Jaros
- Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 17. listopadu 15, 708 33 Ostrava, Czech Republic.
| | - Radek Martinek
- Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 17. listopadu 15, 708 33 Ostrava, Czech Republic.
| | - Lukas Danys
- Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 17. listopadu 15, 708 33 Ostrava, Czech Republic
| |
Collapse
|
7
|
Pastore CA, Samesima N, Pereira Filho HG, Tobias NMMDO, Madaloso BA, Facin ME. Applicability of the Electro-Vectorcardiogram in Current Clinical Practice. Arq Bras Cardiol 2019; 113:87-99. [PMID: 31271597 PMCID: PMC6684186 DOI: 10.5935/abc.20190095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
The electrocardiogram (ECG) has been reinvigorated by the identification of
electrical alterations that were not definitely clarified before. In this
context, and mainly regarding the definition of arrhythmogenic substrates, the
association of the ECG with the vectorcardiogram (VCG) has gathered much more
information about the cardiac electrical phenomena, thus allowing us to
differentiate potentially fatal cases from benign ones. Obtaining a VCG
concomitantly with the performance of an ECG has led to a significant gain in
the definition of extremely sophisticated pathologies, which function suffer
some type of structural or dynamic alterations, involving either the reduction
or enhancement of ionic channels and currents. The classic aspects of the ECG/VCG association in the differential diagnosis of
myocardial infarctions, conduction disorders, atrial and ventricular
hypertrophies, and the correlations between these electrical disorders are still
valid and assertive. The association of these pathologies is further clarified
when they are seen through the ECG/VCG dyad. The three-dimensional spatial orientation of both the atrial and the ventricular
activity provides a far more complete observation tool than the ECG linear form.
The modern analysis of the ECG and its respective VCG, simultaneously obtained
by the recent technique called electro-vectorcardiogram (ECG/VCG), brought a
significant gain for the differential diagnosis of some pathologies. Therefore,
we illustrate how this type of analysis can elucidate some of the most important
diagnoses found in our daily clinical practice as cardiologists.
Collapse
Affiliation(s)
- Carlos Alberto Pastore
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brazil
| | - Nelson Samesima
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brazil
| | - Horacio Gomes Pereira Filho
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brazil
| | | | - Bruna Affonso Madaloso
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brazil
| | - Mirella Esmanhotto Facin
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brazil
| |
Collapse
|
8
|
Vozda M, Cerny M. Methods for derivation of orthogonal leads from 12-lead electrocardiogram: A review. Biomed Signal Process Control 2015. [DOI: 10.1016/j.bspc.2015.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
9
|
Paukkunen M, Parkkila P, Hurnanen T, Pänkäälä M, Koivisto T, Nieminen T, Kettunen R, Sepponen R. Beat-by-Beat Quantification of Cardiac Cycle Events Detected From Three-Dimensional Precordial Acceleration Signals. IEEE J Biomed Health Inform 2015; 20:435-9. [PMID: 25594987 DOI: 10.1109/jbhi.2015.2391437] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The vibrations produced by the cardiovascular system that are coupled to the precordium can be noninvasively detected using accelerometers. This technique is called seismocardiography. Although clinical applications have been proposed for seismocardiography, the physiology underlying the signal is still not clear. The relationship of seismocardiograms of on the back-to-front axis and cardiac events is fairly well known. However, the 3-D seismocardiograms detectable with modern accelerometers have not been quantified in terms of cardiac cycle events. A major reason for this might be the degree of intersubject variability observed in 3-D seismocardiograms. We present a method to quantify 3-D seismocardiography in terms of cardiac cycle events. First, cardiac cycle events are identified from the seismocardiograms, and then, assigned a number based on the location in which the corresponding event was found. 396 cardiac cycle events from 9 healthy subjects and 120 cardiac cycle events from patients suffering from atrial flutter were analyzed. Despite the weak intersubject correlation of the waveforms (0.05, 0.27, and 0.15 for the x-, y-, and z-axes, respectively), the present method managed to find latent similarities in the seismocardiograms of healthy subjects. We observed that in healthy subjects the distribution of cardiac cycle event coordinates was centered on specific locations. These locations were different in patients with atrial flutter. The results suggest that spatial distribution of seismocardiographic cardiac cycle events might be used to discriminate healthy individuals and those with a failing heart.
Collapse
|
10
|
Pahlm O, Wagner GS. QRS, ST and T changes of acute transmural myocardial ischemia: Overview editorial. J Electrocardiol 2014; 47:397-401. [DOI: 10.1016/j.jelectrocard.2014.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|