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Ribeiro M, Monteiro-Santos J, Castro L, Antunes L, Costa-Santos C, Teixeira A, Henriques TS. Non-linear Methods Predominant in Fetal Heart Rate Analysis: A Systematic Review. Front Med (Lausanne) 2021; 8:661226. [PMID: 34917624 PMCID: PMC8669823 DOI: 10.3389/fmed.2021.661226] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
The analysis of fetal heart rate variability has served as a scientific and diagnostic tool to quantify cardiac activity fluctuations, being good indicators of fetal well-being. Many mathematical analyses were proposed to evaluate fetal heart rate variability. We focused on non-linear analysis based on concepts of chaos, fractality, and complexity: entropies, compression, fractal analysis, and wavelets. These methods have been successfully applied in the signal processing phase and increase knowledge about cardiovascular dynamics in healthy and pathological fetuses. This review summarizes those methods and investigates how non-linear measures are related to each paper's research objectives. Of the 388 articles obtained in the PubMed/Medline database and of the 421 articles in the Web of Science database, 270 articles were included in the review after all exclusion criteria were applied. While approximate entropy is the most used method in classification papers, in signal processing, the most used non-linear method was Daubechies wavelets. The top five primary research objectives covered by the selected papers were detection of signal processing, hypoxia, maturation or gestational age, intrauterine growth restriction, and fetal distress. This review shows that non-linear indices can be used to assess numerous prenatal conditions. However, they are not yet applied in clinical practice due to some critical concerns. Some studies show that the combination of several linear and non-linear indices would be ideal for improving the analysis of the fetus's well-being. Future studies should narrow the research question so a meta-analysis could be performed, probing the indices' performance.
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Affiliation(s)
- Maria Ribeiro
- Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal.,Computer Science Department, Faculty of Sciences, University of Porto, Porto, Portugal
| | - João Monteiro-Santos
- Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luísa Castro
- Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,School of Health of Polytechnic of Porto, Porto, Portugal
| | - Luís Antunes
- Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal.,Computer Science Department, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Cristina Costa-Santos
- Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Teixeira
- Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Teresa S Henriques
- Centre for Health Technology and Services Research, Faculty of Medicine University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
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Ponsiglione AM, Cosentino C, Cesarelli G, Amato F, Romano M. A Comprehensive Review of Techniques for Processing and Analyzing Fetal Heart Rate Signals. SENSORS (BASEL, SWITZERLAND) 2021; 21:6136. [PMID: 34577342 PMCID: PMC8469481 DOI: 10.3390/s21186136] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023]
Abstract
The availability of standardized guidelines regarding the use of electronic fetal monitoring (EFM) in clinical practice has not effectively helped to solve the main drawbacks of fetal heart rate (FHR) surveillance methodology, which still presents inter- and intra-observer variability as well as uncertainty in the classification of unreassuring or risky FHR recordings. Given the clinical relevance of the interpretation of FHR traces as well as the role of FHR as a marker of fetal wellbeing autonomous nervous system development, many different approaches for computerized processing and analysis of FHR patterns have been proposed in the literature. The objective of this review is to describe the techniques, methodologies, and algorithms proposed in this field so far, reporting their main achievements and discussing the value they brought to the scientific and clinical community. The review explores the following two main approaches to the processing and analysis of FHR signals: traditional (or linear) methodologies, namely, time and frequency domain analysis, and less conventional (or nonlinear) techniques. In this scenario, the emerging role and the opportunities offered by Artificial Intelligence tools, representing the future direction of EFM, are also discussed with a specific focus on the use of Artificial Neural Networks, whose application to the analysis of accelerations in FHR signals is also examined in a case study conducted by the authors.
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Affiliation(s)
- Alfonso Maria Ponsiglione
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (A.M.P.); (F.A.)
| | - Carlo Cosentino
- Department of Experimental and Clinical Medicine ‘Gaetano Salvatore’, University Magna Graecia of Catanzaro, Viale Tommaso Campanella 185, 88100 Catanzaro, Italy;
| | - Giuseppe Cesarelli
- Department of Chemical, Materials and Production Engineering (DICMaPI), University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy;
| | - Francesco Amato
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (A.M.P.); (F.A.)
| | - Maria Romano
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (A.M.P.); (F.A.)
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Complexity of Cardiotocographic Signals as A Predictor of Labor. ENTROPY 2020; 22:e22010104. [PMID: 33285878 PMCID: PMC7516409 DOI: 10.3390/e22010104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/06/2020] [Accepted: 01/13/2020] [Indexed: 11/17/2022]
Abstract
Prediction of labor is of extreme importance in obstetric care to allow for preventive measures, assuring that both baby and mother have the best possible care. In this work, the authors studied how important nonlinear parameters (entropy and compression) can be as labor predictors. Linear features retrieved from the SisPorto system for cardiotocogram analysis and nonlinear measures were used to predict labor in a dataset of 1072 antepartum tracings, at between 30 and 35 weeks of gestation. Two groups were defined: Group A—fetuses whose traces date was less than one or two weeks before labor, and Group B—fetuses whose traces date was at least one or two weeks before labor. Results suggest that, compared with linear features such as decelerations and variability indices, compression improves labor prediction both within one (C-Statistics of 0.728) and two weeks (C-Statistics of 0.704). Moreover, the correlation between compression and long-term variability was significantly different in groups A and B, denoting that compression and heart rate variability look at different information associated with whether the fetus is closer to or further from labor onset. Nonlinear measures, compression in particular, may be useful in improving labor prediction as a complement to other fetal heart rate features.
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Sung YL, Wu CE, Syu JY, Kuo TBJ, Li JY, Chen CW, Weng CH, Hsu WH, Chen SA, Hu YF, Lin SF. Effects of long-term exercise on arrhythmogenesis in aged hypertensive rats. Comput Biol Med 2018; 102:390-395. [PMID: 30144936 DOI: 10.1016/j.compbiomed.2018.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/24/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
Chronic hypertension is a multifactorial disease that is highly associated with cardiovascular disorders. Physical activity, such as long-term exercise, is advocated as a treatment for hypertension, but the responses of different age groups to long-term exercise are unknown. We used aged spontaneous hypertensive rats (SHRs, 80 weeks old) to test the hypothesis that long-term exercise compensated for deficient autonomic control and reduced susceptibility to ventricular tachycardia (VT) and ventricular fibrillation (VF) in this animal model. The aged SHRs were divided into control and voluntary exercise groups. Ambulatory electrocardiography was recorded for the heart rate variability (HRV) analysis. Programmed stimulation was applied to exposed hearts to induce ventricular arrhythmia in situ. Then, the hearts were isolated for an optical mapping study. The results showed that increased HRV indices were broadly related to vagal dominance in the high-intensity exercise group. Exercise altered the electrical propagation dynamic properties, such as the action potential duration restitution (APDR). Furthermore, the VF inducibility decreased with increased exercise intensity. Taken together, our results suggest that long-term exercise reduces the risk of arrhythmogenesis in aged SHRs through enhanced vagal control and stabilized electrical dynamics.
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Affiliation(s)
- Yen-Ling Sung
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Chih-En Wu
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Jhen-Yang Syu
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Terry B J Kuo
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | - Jai-Yi Li
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Chieh-Wen Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Hui Weng
- Division of Cardiology, Department of Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
| | - Wei-Hsuan Hsu
- Division of Cardiology, Department of Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
| | - Shih-Ann Chen
- Division of Cardiology, Department of Medicine, Taipei Veteran General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Feng Hu
- Division of Cardiology, Department of Medicine, Taipei Veteran General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Shien-Fong Lin
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
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Schneider U, Bode F, Schmidt A, Nowack S, Rudolph A, Doelcker EM, Schlattmann P, Götz T, Hoyer D. Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability. PLoS One 2018; 13:e0200799. [PMID: 30016343 PMCID: PMC6049949 DOI: 10.1371/journal.pone.0200799] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 07/03/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Fetal heart rate variability (fHRV) of normal-to-normal (NN) beat intervals provides high-temporal resolution access to assess the functioning of the autonomic nervous system (ANS). AIM To determine critical periods of fetal autonomic maturation. The developmental pace is hypothesized to change with gestational age (GA). STUDY DESIGN Prospective longitudinal observational study. SUBJECTS 60 healthy singleton fetuses were followed up by fetal magnetocardiographic heart rate monitoring 4-11 times (median 6) during the second half of gestation. OUTCOME MEASURE FHRV parameters, accounting for differential aspects of the ANS, were studied applying linear mixed models over four predefined pregnancy segments of interest (SoI: <27; 27+0-31+0; 31+1-35+0; >35+1 weeks GA). Periods of fetal active sleep and quiescence were accounted for separately. RESULTS Skewness of the NN interval distribution VLF/LF band power ratio and complexity describe a saturation function throughout the period of interest. A decreasing LF/HF ratio and an increase in pNN5 indicate a concurrent shift in sympathovagal balance. Fluctuation amplitude and parameters of short-term variability (RMSSD, HF band) mark a second acceleration towards term. In contrast, fetal quiescence is characterized by sequential, but low-margin transformations; ascending overall variability followed by an increase of complexity and superseded by fluctuation amplitude. CONCLUSIONS An increase in sympathetic activation, connected with by a higher ability of parasympathetic modulation and baseline stabilization, is reached during the transition from the late 2nd into the early 3rd trimester. Pattern characteristics indicating fetal well-being saturate at 35 weeks GA. Pronounced fetal breathing efforts near-term mirror in fHRV as respiratory sinus arrhythmia.
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Affiliation(s)
- Uwe Schneider
- Department of Obstetrics, Division of Prenatal Diagnostics and Fetal Physiology, Jena University Hospital, Jena, Germany
- * E-mail:
| | - Franziska Bode
- Department of Obstetrics, Division of Prenatal Diagnostics and Fetal Physiology, Jena University Hospital, Jena, Germany
| | - Alexander Schmidt
- Hans Berger Clinic of Neurology, Biomagnetic Center, Jena University Hospital, Jena, Germany
| | - Samuel Nowack
- Hans Berger Clinic of Neurology, Biomagnetic Center, Jena University Hospital, Jena, Germany
| | - Anja Rudolph
- Department of Obstetrics, Division of Prenatal Diagnostics and Fetal Physiology, Jena University Hospital, Jena, Germany
| | - Eva-Maria Doelcker
- Hans Berger Clinic of Neurology, Biomagnetic Center, Jena University Hospital, Jena, Germany
- Institute of Biomedical Engineering and Informatics, Technical University, Ilmenau, Germany
| | - Peter Schlattmann
- Institute for Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Theresa Götz
- Hans Berger Clinic of Neurology, Biomagnetic Center, Jena University Hospital, Jena, Germany
- Institute for Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Dirk Hoyer
- Hans Berger Clinic of Neurology, Biomagnetic Center, Jena University Hospital, Jena, Germany
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Spyridou K, Chouvarda I, Hadjileontiadis L, Maglaveras N. Linear and nonlinear features of fetal heart rate on the assessment of fetal development in the course of pregnancy and the impact of fetal gender. Physiol Meas 2018; 39:015007. [PMID: 29185994 DOI: 10.1088/1361-6579/aa9e3c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This work aims to investigate the impact of gestational age and fetal gender on fetal heart rate (FHR) tracings. APPROACH Different linear and nonlinear parameters indicating correlation or complexity were used to study the influence of fetal age and gender on FHR tracings. The signals were recorded from 99 normal pregnant women in a singleton pregnancy at gestational ages from 28 to 40 weeks, before the onset of labor. There were 56 female fetuses and 43 male. MAIN RESULTS Analysis of FHR shows that the means as well as measures of irregularity of FHR, such as approximate entropy and algorithmic complexity, decrease as gestation progresses. There were also indications that mutual information and multiscale entropy were lower in male fetuses in early pregnancy. SIGNIFICANCE Fetal age and gender seem to influence FHR tracings. Taking this into consideration would improve the interpretation of FHR monitoring.
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Affiliation(s)
- K Spyridou
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, The Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece. Author to whom any correspondence should be addressed
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Al-Angari HM, Kimura Y, Hadjileontiadis LJ, Khandoker AH. A Hybrid EMD-Kurtosis Method for Estimating Fetal Heart Rate from Continuous Doppler Signals. Front Physiol 2017; 8:641. [PMID: 28912727 PMCID: PMC5582307 DOI: 10.3389/fphys.2017.00641] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Abstract
Monitoring of fetal heart rate (FHR) is an important measure of fetal wellbeing during the months of pregnancy. Previous works on estimating FHR variability from Doppler ultrasound (DUS) signal mainly through autocorrelation analysis showed low accuracy when compared with heart rate variability (HRV) computed from fetal electrocardiography (fECG). In this work, we proposed a method based on empirical mode decomposition (EMD) and the kurtosis statistics to estimate FHR and its variability from DUS. Comparison between estimated beat-to-beat intervals using the proposed method and the autocorrelation function (AF) with respect to RR intervals computed from fECG as the ground truth was done on DUS signals from 44 pregnant mothers in the early (20 cases) and late (24 cases) gestational weeks. The new EMD-kurtosis method showed significant lower error in estimating the number of beats in the early group (EMD-kurtosis: 2.2% vs. AF: 8.5%, p < 0.01, root mean squared error) and the late group (EMD-kurtosis: 2.9% vs. AF: 6.2%). The EMD-kurtosis method was also found to be better in estimating mean beat-to-beat with an average difference of 1.6 ms from true mean RR compared to 19.3 ms by using the AF method. However, the EMD-kurtosis performed worse than AF in estimating SNDD and RMSSD. The proposed EMD-kurtosis method is more robust than AF in low signal-to-noise ratio cases and can be used in a hybrid system to estimate beat-to-beat intervals from DUS. Further analysis to reduce the estimated beat-to-beat variability from the EMD-kurtosis method is needed.
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Affiliation(s)
- Haitham M Al-Angari
- Department of Biomedical Engineering, Khalifa University of Science and TechnologyAbu Dhabi, United Arab Emirates
| | | | - Leontios J Hadjileontiadis
- Department of Electrical and Computer Engineering, Khalifa University of Science and TechnologyAbu Dhabi, United Arab Emirates.,Department of Electrical and Computer Engineering, Aristotle University of ThessalonikiThessaloniki, Greece
| | - Ahsan H Khandoker
- Department of Biomedical Engineering, Khalifa University of Science and TechnologyAbu Dhabi, United Arab Emirates
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Murta LO, Guzo MG, Moraes ER, Baffa O, Wakai RT, Comani S. Segmented independent component analysis for improved separation of fetal cardiac signals from nonstationary fetal magnetocardiograms. ACTA ACUST UNITED AC 2017; 60:235-44. [PMID: 25781658 DOI: 10.1515/bmt-2014-0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 01/27/2015] [Indexed: 11/15/2022]
Abstract
Fetal magnetocardiograms (fMCGs) have been successfully processed with independent component analysis (ICA) to separate the fetal cardiac signals, but ICA effectiveness can be limited by signal nonstationarities due to fetal movements. We propose an ICA-based method to improve the quality of fetal signals separated from fMCG affected by fetal movements. This technique (SegICA) includes a procedure to detect signal nonstationarities, according to which the fMCG recordings are divided in stationary segments that are then processed with ICA. The first and second statistical moments and the signal polarity reversal were used at different threshold levels to detect signal transients. SegICA effectiveness was assessed in two fMCG datasets (with and without fetal movements) by comparing the signal-to-noise ratio (SNR) of the signals extracted with ICA and with SegICA. Results showed that the SNR of fetal signals affected by fetal movements improved with SegICA, whereas the SNR gain was negligible elsewhere. The best measure to detect signal nonstationarities of physiological origin was signal polarity reversal at threshold level 0.9. The first statistical moment also provided good results at threshold level 0.6. SegICA seems a promising method to separate fetal cardiac signals of improved quality from nonstationary fMCG recordings affected by fetal movements.
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Sriram B, Mencer MA, McKelvey S, Siegel ER, Vairavan S, Wilson JD, Preissl H, Eswaran H, Govindan RB. Differences in the sleep states of IUGR and low-risk fetuses: An MCG study. Early Hum Dev 2013; 89:815-9. [PMID: 23907090 PMCID: PMC3816553 DOI: 10.1016/j.earlhumdev.2013.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/28/2013] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Intrauterine growth restriction (IUGR) is a fetal condition characterized by growth-rate reduction. Afflicted fetuses tend to display abnormalities in heart rate. OBJECTIVE To study the differences in the heart-rate variability of low-risk fetuses and IUGR fetuses during different behavioral states. METHODS A total of 40 fetal magnetocardiograms were analyzed from 20 low-risk and 20 IUGR fetuses recorded using a 151-sensor SQUID-array system. The maternal cardiac signals were attenuated using signal-space projection. Fetal R waves were identified using an adaptive Hilbert transform approach and fetal heart rate was calculated. In each three-minute window, the heart rate was classified into patterns reflective of quiet sleep (pattern A) and active sleep (pattern B) using the criteria of Nijhuis. Two adjacent 3-min windows exhibiting the same pattern were selected for analysis from every dataset. Heart-rate variability in that 6-min window was characterized using three measures, standard deviation of normal to normal (SDNN), root mean square of successive differences (RMSSD) and phase plane area (PPA). RESULTS All three measures tended to be lower in the IUGR group compared to the low-risk group. However, when the measures were analyzed in patterns, only PPA showed significant difference between the risk groups in pattern A, whereas both PPA and SDNN showed highly significant risk-group differences in pattern B. RMSSD did not show any significant risk-group difference. CONCLUSION The result signifies that the heart-rate variability of IUGR fetuses is different from that of low-risk fetuses, and only PPA was able to capture the HRV differences in both quiet and active states. The difference between these two groups of fetuses shows that the fetal-activity states are potential confounders when characterizing heart-rate variability.
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Affiliation(s)
- Bhargavi Sriram
- Graduate Institute of Technology, University of Arkansas at Little Rock, AR 72205, USA.
| | - Margret A Mencer
- SARA Research Center, Department of Ob/Gyn, University of Arkansas for Medical Sciences, 4301 West Markham Street, #518, Little Rock, Arkansas 72205-7199, USA
| | - Samantha McKelvey
- SARA Research Center, Department of Ob/Gyn, University of Arkansas for Medical Sciences, 4301 West Markham Street, #518, Little Rock, Arkansas 72205-7199, USA
| | - Eric R Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Srinivasan Vairavan
- Graduate Institute of Technology, University of Arkansas at Little Rock, 2801 South University Ave, Little Rock, AR 72205, USA,Division of Fetal and Transitional Medicine, Children’s National Medical Center, 111 Michigan Avenue, N.W., Washington, DC 20010, USA
| | - James D. Wilson
- Graduate Institute of Technology, University of Arkansas at Little Rock, 2801 South University Ave, Little Rock, AR 72205, USA
| | - Hubert Preissl
- SARA Research Center, Department of Ob/Gyn, University of Arkansas for Medical Sciences, 4301 West Markham Street, #518, Little Rock, Arkansas 72205-7199, USA,MEG-Center, University of Tubingen, Tubingen 72074, Germany
| | - Hari Eswaran
- SARA Research Center, Department of Ob/Gyn, University of Arkansas for Medical Sciences, 4301 West Markham Street, #518, Little Rock, Arkansas 72205-7199, USA
| | - Rathinaswamy B. Govindan
- Division of Fetal and Transitional Medicine, Children’s National Medical Center, 111 Michigan Avenue, N.W., Washington, DC 20010, USA
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Ortiz MR, Echeverría JC, Alvarez-Ramírez J, Martínez A, Peña MA, García MT, Vargas-García C, González-Camarena R. Effects of fetal respiratory movements on the short-term fractal properties of heart rate variability. Med Biol Eng Comput 2012; 51:441-8. [PMID: 23242783 DOI: 10.1007/s11517-012-1012-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 12/01/2012] [Indexed: 11/25/2022]
Abstract
We evaluated the effect of fetal respiratory movements (RM) on the heart rate (HR) fractal dynamics.Abdominal ECG recordings were collected from low-middle-risk pregnant woman at rest. Mean gestational age was 34.8 ± 3.7 weeks. Ultrasound images were simultaneously acquired determining if RM were exhibited by fetuses. 13 pairs of HR series were compared. Each pair included 5 min of data from the same fetus either during the manifestation of RM or when there was no persistent indication of them. Detrended fluctuation analysis was applied to these series for obtaining the scaling exponent α1. HR series were also assessed using the conventional parameters RMSSD and HF power.The main findings of this contribution were the lack of significant changes in the scaling exponent α1 of fetal HR fluctuations as a result of RM. By contrast, HF power and RMSSD did show significant changes associated with the manifestation of fetal RM (p < 0.001 and p < 0.05, respectively). Yet the scaling exponent was the only parameter showing a significant relationship with the particular frequency of fetal RM (r s = 0.6, p < 0.03). Given the invariability of α1 regarding the manifestation of fetal RM, we consider that the HR short-term fractal properties are convenient for assessing the cardiovascular prenatal regulation.
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Affiliation(s)
- M R Ortiz
- Basic Science and Engineering Division, Universidad Autónoma Metropolitana-Izt., Mexico City, Mexico
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