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2022 Computing in Cardiology (CinC)最新文献

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Validation of a Customized Method for Estimating Electrical Potentials in the Torso From Atrial Signals: a Computational-Clinical Study 从心房信号中估计躯干电位的定制方法的验证:一项计算临床研究
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.369
Camila R Restivo, Gabriel V Costa, I. Sandoval, M. Guillem, J. Salinet
Atrial fibrillation (AF) is a common supraventricular arrhythmia (SVA) in clinical practice and is characterized by uncoordinated electrical activity of the atria. This study aims to evaluate the influence on the forward solution of AF torso biomarkers under different levels of noise, 3D cardiorespiratory torso/atria morphologies, and number of atria electrodes. 2,048 atrial epicardium electrograms (AEGs) from 5 AF mathematical models were used to estimate 771 body surface potentials (BSPs). The BSPs and respective frequency/phase maps of are obtained after: (i) introduction of noise in the AEGs, (ii) 3D geometry torso/atria modification, and (iii) reduction in electrodes (from 2,048 to 256, 128, 64 e 32; interpolation methods: Linear/Laplacian). To reduce biomarkers disparity, a Butterworth bandpass filter (BPF) at different cut-off frequencies (0.5-30, 3–30 and HDF±1 Hz) is applied on the AEGs prior BSPs estimation. The above methodology is extended to two AF patients (EDGAR database). The estimation of AF BSPs, in different noise ranges, limits the effectiveness of the forward solution. Phase biomarkers are sensitive to the AEGs' pre-processing strategy. The BPF around HDF showed the best agreement between the different SNR levels. Due to the 3D morphological changes, HDF areas variability increased.
心房颤动(AF)是临床上常见的室上性心律失常(SVA),其特点是心房电活动不协调。本研究旨在评估不同水平的噪声、三维心肺躯干/心房形态和心房电极数量对房颤躯干生物标志物正向溶液的影响。利用5个AF数学模型的2,048张心房心外膜电图(aeg)估计771个体表电位(BSPs)。bsp和各自的频率/相位图是在以下情况下获得的:(i)在aeg中引入噪声,(ii) 3D几何躯干/心房修改,以及(iii)减少电极(从2,048减少到256、128、64 e 32;插值方法:线性/拉普拉斯)。为了减少生物标志物的差异,在不同的截止频率(0.5- 30,3 -30和HDF±1hz)下应用巴特沃斯带通滤波器(BPF)对aaegs先验BSPs估计。上述方法扩展到2例房颤患者(EDGAR数据库)。在不同噪声范围下对自动对焦BSPs的估计限制了正演解的有效性。相生物标志物对aeg的预处理策略敏感。HDF附近的BPF在不同信噪比水平之间表现出最好的一致性。由于三维形态的变化,HDF面积变异性增加。
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引用次数: 0
Model-Based Analysis of Apnea-Bradycardia events in Newborns 新生儿呼吸暂停-心动过缓事件的模型分析
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.305
O. Duport, V. Rolle, Gustavo Guerrero, A. Beuchée, Alfredo I. Hernández
In preterm infants, recurrent episodes of apnea, bradycardia and severe intermittent hypoxia are mainly related to cardiorespiratory immaturity. These episodes are associated with major risks during the first weeks of life. Cardiorespiratory data consisting of a continuous 12 hours recording of transthoracic impedance and ECG signals were acquired in 18 preterm neonates. 106 isolated apnea events (>10 sec) were manually annotated from the database, of which 19 apneas with bradycardia. A system-level physiological model of cardio-respiratory interactions in the newborn is proposed and used to reproduce simulations of mixed apneas with and without bradycardia, by modifying the functional residual capacity. A first qualitative comparison between the simulations and the clinical data shows a close match between the experimental and simulated heart rate series during apnea with bradycardia (RMSE 4.96 bpm) and without (RMSE 2.02 bpm).
在早产儿中,反复发作的呼吸暂停、心动过缓和严重间歇性缺氧主要与心肺不成熟有关。这些发作与生命最初几周的主要风险有关。对18例早产儿进行了连续12小时的经胸阻抗和心电图信号记录。从数据库中手动标注106例孤立性呼吸暂停事件(>10秒),其中19例呼吸暂停伴心动过缓。提出了新生儿心肺相互作用的系统水平生理模型,并通过修改功能剩余容量来重现伴有和不伴有心动过缓的混合性呼吸暂停的模拟。模拟与临床数据的首次定性比较显示,呼吸暂停伴心动过缓(RMSE 4.96 bpm)和不伴心动过缓(RMSE 2.02 bpm)时的实验和模拟心率序列非常吻合。
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引用次数: 0
Approximate Entropy and Densely Connected Neural Network in the Early Diagnostic of Patients with Chagas Disease 近似熵和密集连接神经网络在恰加斯病早期诊断中的应用
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.313
María Fernanda Rodríguez, A. Ravelo-García, E. Alvarez, Luz Alexandra Díaz, D. Cornejo, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo
It is estimated that in the world there are between 6 and 8 million people infected with Chagas disease, mainly in endemic areas of 21 Latin American countries, and in recent years it is slowly becoming a health problem in more urban areas and countries. In that sense, developing diagnosis methods is primordial. That is why this work used a deep neural network to classify 292 subjects (volunteers and patients) composed of 83 health volunteers (Control group); 102 asymptomatic chagasic patients (CH1 group) and 107 seropositive chagasic patients with incipient heart disease (CH2 group). Approximate Entropy ApEn was calculated from the tachograms of the circadian profiles of 24 hours every 5 minutes (288 frames) of each subject, and part of this data were used to train the network. The classification work done by the deep neural network had 98% of accuracy and 98% of precision, validated with the ROC curve, whose AUC values were approximately the unit for each group. Taking into account the good performance, we can consider this deep neural network and approximate entropy as useful tools to have a good early diagnosis about Chagas disease and its cardiac compromise.
据估计,全世界有600万至800万人感染了恰加斯病,主要是在21个拉丁美洲国家的流行地区,近年来,它正在逐渐成为更多城市地区和国家的一个健康问题。从这个意义上说,开发诊断方法是最基本的。这就是为什么这项工作使用深度神经网络对292名受试者(志愿者和患者)进行分类,其中83名健康志愿者(对照组);无症状chagasic患者102例(CH1组)和血清阳性chagasic合并早期心脏病患者107例(CH2组)。从每5分钟(288帧)24小时的昼夜节律曲线的行车图中计算出近似熵ApEn,并利用部分数据对网络进行训练。通过ROC曲线验证,深度神经网络完成的分类工作准确率为98%,精密度为98%,ROC曲线的AUC值近似为每组的单位。考虑到良好的性能,我们可以将该深度神经网络和近似熵作为对恰加斯病及其心脏损害进行早期诊断的有用工具。
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引用次数: 1
Explainable Deep Learning for Non-Invasive Detection of Pulmonary Artery Hypertension from Heart Sounds 可解释的深度学习对心音肺动脉高压的无创检测
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.295
Alex Gaudio, Miguel Coimbra, A. Campilho, A. Smailagic, S. Schmidt, F. Renna
Late diagnoses of patients affected by pulmonary artery hypertension (PH) have a poor outcome. This observation has led to a call for earlier, non-invasive PH detection. Cardiac auscultation offers a non-invasive and cost-effective alternative to both right heart catheterization and doppler analysis in analysis of PH. We propose to detect PH via analysis of digital heart sound recordings with over-parameterized deep neural networks. In contrast with previous approaches in the literature, we assess the impact of a pre-processing step aiming to separate S2 sound into the aortic (A2) and pulmonary (P2) components. We obtain an area under the ROC curve of. 95, improving over our adaptation of a state-of-the-art Gaussian mixture model PH detector by +.17. Post-hoc explanations and analysis show that the availability of separated A2 and P2 components contributes significantly to prediction. Analysis of stethoscope heart sound recordings with deep networks is an effective, low-cost and non-invasive solution for the detection of pulmonary hypertension.
肺动脉高压(PH)患者的晚期诊断预后较差。这一观察结果引发了对早期非侵入性PH检测的呼吁。在分析PH值时,心脏听诊为右心导管插入术和多普勒分析提供了一种无创且具有成本效益的替代方法。我们建议通过使用过度参数化的深度神经网络分析数字心音记录来检测PH值。与文献中先前的方法相比,我们评估了旨在将S2音分离为主动脉(A2)和肺动脉(P2)分量的预处理步骤的影响。的ROC曲线下的面积。95,比我们最先进的高斯混合模型PH检测器的适应性提高了+.17。事后解释和分析表明,分离的A2和P2组分的可用性对预测有重要贡献。深层网络听诊器心音记录分析是一种有效、低成本、无创的肺动脉高压检测方法。
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引用次数: 0
Comparison Between ECG-Derived Respiration and Respiratory Flow for the Assessment of Cardiorespiratory Coupling Before and After Cardiopulmonary Exercise Test Protocol 心电图呼吸和呼吸流量对心肺运动试验方案前后心肺耦合评价的比较
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.103
B. Cairo, V. Bari, F. Gelpi, Beatrice De Maria, Anita Mollo, F. Bandera, A. Porta
Evaluation of cardiorespiratory coupling (CRC) usually requires the simultaneous recording of heart period (HP) variability, derived from the electrocardiogram (ECG), and respiration. ECG-derived respiration (ECGDR) exploits the cardiac axis movement due to respiration to estimate respiratory activity directly from the ECG. Since CRC indexes could theoretically be computed using ECGDR, a comparison with results obtained through a more precise monitoring of respiratory activity such as the respiratory flow (RF) is warranted. Therefore, a mixed unpredictability index (MUPI) of HP variability from respiratory dynamics, computed via local k-nearest-neighbor approach, was calculated using ECGDR and RF in patients with preserved functional capacity (PFC) and with reduced functional capacity (RFC) before and after cardiopulmonary exercise test (CPET) protocol. The MUPI computed from RF was found to be significantly increased in PFC patients after CPET protocol, while no effect could be observed when considering the ECGDR. Moreover, the correlation between the two MUPI indexes was limited. We conclude that indexes of CRC might require more direct measures of respiration than ECGDR to detect pathophysiological differences.
评估心肺耦合(CRC)通常需要同时记录心期(HP)变异性,由心电图(ECG)和呼吸得出。心电图衍生呼吸(ECGDR)利用呼吸引起的心轴运动来直接从心电图估计呼吸活动。由于理论上可以使用ECGDR计算CRC指数,因此有必要将其与通过更精确地监测呼吸活动(如呼吸流量(RF))获得的结果进行比较。因此,通过局部k近邻法计算呼吸动力学HP变异性的混合不可预测性指数(MUPI),在心肺运动试验(CPET)方案前后使用ECGDR和RF计算功能容量保持(PFC)和功能容量降低(RFC)的患者。经CPET治疗后,PFC患者通过RF计算的MUPI显著增加,而考虑ECGDR时则未观察到影响。此外,两个MUPI指标之间的相关性有限。我们得出结论,CRC的指标可能需要比ECGDR更直接的呼吸测量来检测病理生理差异。
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引用次数: 0
Conduction System Pacing Versus Biventricular Pacing For Cardiac Resynchronization - Preliminary Electrocardiographic Results 传导系统起搏与双心室起搏对心脏再同步的初步心电图结果
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.297
T. Zlahtic, D. Žižek, M. Mrak, A. Z. Mežnar, V. Starc
Cardiac resynchronization therapy with biventricular pacing (BiV) is the cornerstone treatment for heart failure patients with ventricular dyssynchrony. Recently, the conduction system pacing (CSP) has being introduced as a possible alternative. We hypothesized that CSP could produce a more complete electrical resynchronization compared to conventional BIV pacing. To trace the spreading of myocardial depolarization, we assessed equivalent dipole (ED) trajectories utilizing the BEM method with a tailored human torso from the high resolution 12-lead ECG before and after device implantation in 17 patients included in our ongoing randomized CSP-SYNC study. We observed a similar relative shortening of the QRS duration (0,23 in CSP and 0,25 in BiV) and relative ED trajectory length (0,16 in CSP and 0,20 in BiV). However, a significant change of ED trajectory direction occurred after the therapy. In BiV pacing, the trajectory direction shifted more towards the base of the heart, but more apically in CSP, mimicking normal heart depolarization Resynchronization with CSP seems to restore more physiological depolarization compared to BiV pacing. The assessment of the ED trajectories provides additional insight into the electrical heart remodelling after the therapy.
心脏再同步化双心室起搏(BiV)治疗是心力衰竭伴心室非同步化患者的基础治疗。最近,传导系统起搏(CSP)作为一种可能的替代方案被引入。我们假设与传统的BIV起搏相比,CSP可以产生更完整的电再同步。为了追踪心肌去极化的扩散,我们在正在进行的随机CSP-SYNC研究中纳入了17例患者,在植入器械前后,我们使用定制的人体躯干高分辨率12导联心电图,利用BEM方法评估了等效偶极子(ED)轨迹。我们观察到QRS持续时间的相对缩短(CSP为0.23,BiV为0.25)和ED轨迹的相对缩短(CSP为0.16,BiV为0.20)。然而,治疗后ED轨迹方向发生了显著变化。在BiV起搏中,轨迹方向更偏向于心脏的底部,而在CSP中,轨迹方向更偏向于心脏的顶部,模仿正常的心脏去极化与CSP的再同步似乎比BiV起搏恢复更多的生理去极化。对ED轨迹的评估为治疗后心脏电重构提供了额外的见解。
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引用次数: 0
Assessment of Transcatheter Heart Valve Migration and Embolization Risk Following Valve-in-MAC 经导管心脏瓣膜置换术后瓣膜迁移及栓塞风险评估
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.428
S. J. Hill, Alistair A. Young, R. Rajani, A. Vecchi
Transcatheter Valve Embolization and Migration (TVEM) is a rare, but catastrophic event where the prosthesis moves due to heamodynamic forces acting on the frame. TVEM following Transcatheter Mitral Valve Replacement (TMVR) is largely undocumented. Haemodynamic forces cannot be estimated during pre-procedural planning and conventional imaging does not allow to compute them after replacement. To shed light on this issue, this study focusses on modelling haemodynamics after TMVR in 3 patients with Mitral Annular Calcification (MAC) known as Valve-in-MAC (ViMAC). Three-dimensional flow simulations are performed using the computational fluid dynamics (CFD) package STARCCM+. Results of the simulation are processed to compute the fluid forces acting on the device and pressure gradients in the left ventricular outflow tract (LVOT). Anatomical measurements are performed on CT data sets to assess the mitral valve size and shape, the extent and location of the calcification and the size of the LVOT after implantation. Our results show that the force distribution on the device is largely influenced by LVOT anatomy and contraction patterns.
经导管瓣膜栓塞和移位(TVEM)是一种罕见但灾难性的事件,其中假体由于作用在框架上的血流动力而移动。经导管二尖瓣置换术(TMVR)后的TVEM在很大程度上没有文献记载。在手术前的计划中无法估计血流动力学力,而传统的成像也不允许在置换后计算血流动力学力。为了阐明这一问题,本研究的重点是模拟3例二尖瓣环钙化(MAC)(俗称MAC中的瓣膜(ViMAC))患者TMVR后的血流动力学。使用计算流体动力学(CFD)软件包STARCCM+进行三维流动模拟。对模拟结果进行处理,计算作用在装置上的流体力和左心室流出道(LVOT)的压力梯度。在CT数据集上进行解剖测量,以评估二尖瓣的大小和形状,钙化的程度和位置以及植入后LVOT的大小。我们的研究结果表明,装置上的力分布在很大程度上受LVOT解剖和收缩模式的影响。
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引用次数: 0
Deep Learning and Permutation Entropy in the Stratification of Patients with Chagas Disease 查加斯病患者分层中的深度学习和排列熵
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.311
D. Cornejo, A. Ravelo-García, E. Alvarez, María Fernanda Rodríguez, Luz Alexandra Díaz, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo
Chagas disease is a life threatening illness that in the last decades was becoming a public health problem because of the change in the epidemiological pattern. It may be silent and asymptomatic in the chronic phase. Hence the necessity of the development of early markers. To achieve this, we propose a deep neural network architecture in order to classify 292 patients into three groups: The Control group with 83 volunteers, the CH1 group with 102 patients with positive serology and no cardiac involvement and the CH2 group with 107 patients with positive serology and incipient heart failure. The used data comes from 24-hour ECG, the RR intervals from each subject was divided in 288 frames of 5 minutes each. Then it was preprocessed using permutation entropy obtaining the circadian profile for each patient. And by applying PCA each patient ended up represented by a vector of 144 entries. This was in turn used for the training of the proposed NN architecture. The classification performed with 91% accuracy and an average of 92% precision, consisting in a great work of classification validated by the AUC in each ROC curve. As this results were obtained with a limited quantity of data, this study can be improved provided with more samples, making this model a tool for analyzing ECG in order to try to do an early evaluation and diagnosis of a cardiac compromise related to the generally silent chronic phase.
恰加斯病是一种危及生命的疾病,在过去几十年中,由于流行病学模式的变化,它已成为一个公共卫生问题。在慢性期可能是沉默和无症状的。因此,开发早期标记是必要的。为了实现这一点,我们提出了一个深度神经网络架构,将292名患者分为三组:对照组有83名志愿者,CH1组有102名血清学阳性且无心脏受累的患者,CH2组有107名血清学阳性且早期心力衰竭的患者。使用的数据来自24小时心电图,每个受试者的RR间隔被划分为288帧,每帧5分钟。然后使用排列熵对其进行预处理,获得每个患者的昼夜节律特征。通过应用PCA,每个患者最终由144个条目的向量表示。这反过来又用于训练所提出的神经网络架构。分类准确率为91%,平均精度为92%,通过各ROC曲线的AUC验证了分类的有效性。由于数据量有限,本研究可以通过更多的样本进行改进,使该模型成为心电图分析的工具,以便对与一般沉默的慢性期相关的心脏损害进行早期评估和诊断。
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引用次数: 0
Impact of Pre-Processing Decisions on Automated ECG Classification Accuracy 预处理决策对自动心电分类精度的影响
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.252
Adrian K. Cornely, Grace M. Mirsky
Electrocardiography is well established as an effective clinical tool for detection and diagnosis of cardiac arrhythmias and abnormalities. The objective of the 2021 PhysioNet/Computing in Cardiology Challenge was for teams to develop automated classification algorithms for reduced-lead ECGs. While it is well-known that proper pre-processing is very important for the success of classification algorithms, there is not universal agreement as to the appropriate pre-processing steps for automated ECG classification. Papers from the top 15 finishers in the Challenge as well as the bottom ten finishers were examined to determine what pre-processing steps were applied by each team. The most commonly used pre-processing steps included resampling to a consistent sampling rate, applying a bandpass filter, normalizing and using a fixed signal length. There were a number of similarities in the preprocessing steps used by the top 15 teams, whereas all of these steps were not applied in the majority of approaches for the bottom ten teams. In the bottom ten participants, less than half used a bandpass filter, and only three applied some type of normalization. This investigation underscores the importance of appropriate pre-processing for strong classification accuracy and the need for a universal approach to pre-processing techniques in automated ECG classification.
心电图是一种有效的检测和诊断心律失常和异常的临床工具。2021年PhysioNet/Computing in Cardiology挑战赛的目标是让团队开发用于减少导联心电图的自动分类算法。虽然众所周知,适当的预处理对于分类算法的成功是非常重要的,但对于自动心电分类的适当预处理步骤并没有普遍的共识。来自挑战赛前15名和后10名的论文将被检查,以确定每个团队应用了哪些预处理步骤。最常用的预处理步骤包括重新采样到一致的采样率,应用带通滤波器,归一化和使用固定的信号长度。在前15个团队使用的预处理步骤中有许多相似之处,而所有这些步骤并没有应用于后10个团队的大多数方法中。在最后十位参与者中,不到一半的人使用了带通滤波器,只有三个人应用了某种类型的归一化。这项研究强调了适当的预处理对强分类准确性的重要性,以及在自动心电分类中需要一种通用的预处理技术。
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引用次数: 0
Cycle Length Estimation Using Accurate Adaptive Detection of Local Activations in Atrial Intracardiac Electrograms 心房心内电局部激活的精确自适应检测周期长度估计
Pub Date : 2022-09-04 DOI: 10.22489/CinC.2022.142
Dinara Veshchezerova, C. Bars, J. Seitz
The normal electrical potential propagates throughout the atria periodically. During atrial arrhythmias its prop-agation is modified because the substrate is not homoge-neous and new sources of punctual electrical activity appear. The periodic behavior of activation remains predom-inant, but becomes local in different parts of the atria. It is characterized by cycle length (CL) which measures the frequency of activation and can be computed from intrac-ardiac bipolar electrograms (EGM) recorded by a mapping catheter during the catheter ablation procedure. The CL value of different mapped zones is an extremely important resource for physicians when performing persis-tent Atrial Fibrillation (AF) ablation because it helps to identify pathological zones and define the ablation strat-egy. Thus, a reliable estimation of the CL of atrial tissue is essential. The complexity of this task stems from the large variability in EGM morphology influenced by mul-tiple wavefronts, fragmentation and added noise. In this work, we propose a cycle length estimator that can process the complex mapping signals recorded during atrial arrhythmias ablation and reliably provide the frequency of their periodic activity.
正常电位周期性地在心房内传播。在房性心律失常期间,由于底物不均匀性和新的准时电活动源出现,其促进作用被改变。周期性的激活行为仍然占主导地位,但在心房的不同部位变得局部。它的特征是周期长度(CL),它测量了激活的频率,可以从心内双极电图(EGM)中计算出来,在导管消融过程中由测绘导管记录。不同映射区域的CL值对于医生进行持续性心房颤动(AF)消融是一个极其重要的资源,因为它有助于识别病理区域和确定消融策略。因此,一个可靠的估计心房组织的CL是必不可少的。这项任务的复杂性源于EGM形态受多个波前、碎片化和附加噪声影响的巨大变异性。在这项工作中,我们提出了一个周期长度估计器,可以处理心房心律失常消融过程中记录的复杂映射信号,并可靠地提供其周期活动的频率。
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引用次数: 0
期刊
2022 Computing in Cardiology (CinC)
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