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Chen S, Jiang L, Xu F, Pang J, Pan C, Chen Y, Wang J, Li K. Electrical-mechanical dynamical coupling between electrocardiographic and photoplethysmographic signals during cardiopulmonary resuscitation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107809. [PMID: 37757567 DOI: 10.1016/j.cmpb.2023.107809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiac arrest (CA) remains a significant cause of death and disability. High-quality cardiopulmonary resuscitation (CPR) can improve the survival rate of CA. A challenging issue is to find physiological indicators for screening and evaluating the cardiovascular function associated with CPR. This study aimed to investigate the electrical-mechanical dynamic coupling between electrocardiographic (ECG) and photoplethysmographic (PPG) signals for indicating cardiovascular function in the progress of CPR. METHOD The ECG and PPG signals were simultaneously collected from a porcine CA model (n = 10) induced by ventricular fibrillation, and were further divided into four periods: Baseline, CA, CPR, and recovery of spontaneous circulation (ROSC). Recurrence quantitative analysis (RQA) was applied to examine the nonlinear dynamics of the ECG and PPG signals individually, and cross recurrence quantitative analysis (CRQA) was used to examine the ECG-PPG dynamical coupling. RESULTS The CA influenced the dynamic patterns of electrical and mechanical activities and the electrical-mechanical coupling, which can be observed from the reduced entropy (ENTR) (p < 0.01), reduced determinism (DET) (p < 0.01) and reduced trapping time (TT) (p < 0.01) at CA compared to Baseline. The recurrence rate (RR), ENTR, DET, and TT at CPR were significantly lower than the parameters at ROSC but higher than those at CA. CONCLUSIONS The electrical-mechanical dynamical coupling was sensitive to CPR and able to reflect the changes in cardiac function in the process of CPR.
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Affiliation(s)
- Shuxin Chen
- Institute of Intelligent Medical Engineering, School of Control Science and Engineering, Shandong University, Jinan, China
| | - Lijun Jiang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China
| | - Feng Xu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China
| | - Jiaojiao Pang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China
| | - Chang Pan
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China
| | - Yuguo Chen
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China.
| | - Jiali Wang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Shandong Key Laboratory: Magnetic Field-free Medicine & Functional Imaging, Qilu Hospital of Shandong University, Jinan, China; NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Qilu Hospital of Shandong University, Jinan, China.
| | - Ke Li
- Institute of Intelligent Medical Engineering, School of Control Science and Engineering, Shandong University, Jinan, China.
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Zhang H, Wang X, Liu C, Li Y, Liu Y, Jiao Y, Liu T, Dong H, Wang J. Discrimination of Patients with Varying Degrees of Coronary Artery Stenosis by ECG and PCG Signals Based on Entropy. ENTROPY (BASEL, SWITZERLAND) 2021; 23:823. [PMID: 34203339 PMCID: PMC8304206 DOI: 10.3390/e23070823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
Coronary heart disease (CHD) is the leading cause of cardiovascular death. This study aimed to propose an effective method for mining cardiac mechano-electric coupling information and to evaluate its ability to distinguish patients with varying degrees of coronary artery stenosis (VDCAS). Five minutes of electrocardiogram and phonocardiogram signals was collected synchronously from 191 VDCAS patients to construct heartbeat interval (RRI)-systolic time interval (STI), RRI-diastolic time interval (DTI), HR-corrected QT interval (QTcI)-STI, QTcI-DTI, Tpeak-Tend interval (TpeI)-STI, TpeI-DTI, Tpe/QT interval (Tpe/QTI)-STI, and Tpe/QTI-DTI series. Then, the cross sample entropy (XSampEn), cross fuzzy entropy (XFuzzyEn), joint distribution entropy (JDistEn), magnitude-squared coherence function, cross power spectral density, and mutual information were applied to evaluate the coupling of the series. Subsequently, support vector machine recursive feature elimination and XGBoost were utilized for feature selection and classification, respectively. Results showed that the joint analysis of XSampEn, XFuzzyEn, and JDistEn had the best ability to distinguish patients with VDCAS. The classification accuracy of severe CHD-mild-to-moderate CHD group, severe CHD-chest pain and normal coronary angiography (CPNCA) group, and mild-to-moderate CHD-CPNCA group were 0.8043, 0.7659, and 0.7500, respectively. The study indicates that the joint analysis of XSampEn, XFuzzyEn, and JDistEn can effectively capture the cardiac mechano-electric coupling information of patients with VDCAS, which can provide valuable information for clinicians to diagnose CHD.
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Affiliation(s)
- Huan Zhang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Xinpei Wang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Changchun Liu
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Yuanyang Li
- Department of Medical Engineering, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China;
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Yuanyuan Liu
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Yu Jiao
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Tongtong Liu
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Huiwen Dong
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
| | - Jikuo Wang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (H.Z.); (C.L.); (Y.L.); (Y.J.); (T.L.); (H.D.); (J.W.)
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