000109483 001__ 109483
000109483 005__ 20230519145457.0
000109483 0247_ $$2doi$$a10.1098/rsta.2020.0261
000109483 0248_ $$2sideral$$a125671
000109483 037__ $$aART-2021-125671
000109483 041__ $$aeng
000109483 100__ $$aGonzález del Castillo, Marta
000109483 245__ $$aQT variability unrelated to RR variability during stress testing for identification of coronary artery disease
000109483 260__ $$c2021
000109483 5060_ $$aAccess copy available to the general public$$fUnrestricted
000109483 5203_ $$aStress test electrocardiogram (ECG) analysis is widely used for coronary artery disease (CAD) diagnosis despite its limited accuracy. Alterations in autonomic modulation of cardiac electrical activity have been reported in CAD patients during acute ischemia. We hypothesized that those alterations could be reflected in changes in ventricular repolarization dynamics during stress testing that could be measured through QT interval variability (QTV). However, QTV is largely dependent on RR interval variability (RRV), which might hinder intrinsic ventricular repolarization dynamics. In this study, we investigated whether different markers accounting for low-frequency (LF) oscillations of QTV unrelated to RRV during stress testing could be used to separate patients with and without CAD. Power spectral density of QTV unrelated to RRV was obtained based on time-frequency coherence estimation. Instantaneous LF power of QTV and QTV unrelated to RRV were obtained. LF power of QTV unrelated to RRV normalized by LF power of QTV was also studied. Stress test ECG of 100 patients were analysed. Patients referred to coronary angiography were classified into non-CAD or CAD group. LF oscillations in QTV did not show significant differences between CAD and non-CAD groups. However, LF oscillations in QTV unrelated to RRV were significantly higher in the CAD group as compared with the non-CAD group when measured during the first phases of exercise and last phases of recovery. ROC analysis of these indices revealed area under the curve values ranging from 61 to 73%. Binomial logistic regression analysis revealed LF power of QTV unrelated to RRV, both during the first phase of exercise and last phase of recovery, as independent predictors of CAD. In conclusion, this study highlights the importance of removing the influence of RRV when measuring QTV during stress testing for CAD identification and supports the added value of LF oscillations of QTV unrelated to RRV to diagnose CAD from the first minutes of exercise. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
000109483 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R-BSICoS group$$9info:eu-repo/grantAgreement/EUR/ERC-2014-StG-638284$$9info:eu-repo/grantAgreement/ES/MICIU/PID2019-105674RB-I00$$9info:eu-repo/grantAgreement/ES/MICIU/RTI2018-097723-B-I00
000109483 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000109483 590__ $$a4.019$$b2021
000109483 592__ $$a0.973$$b2021
000109483 594__ $$a8.2$$b2021
000109483 591__ $$aMULTIDISCIPLINARY SCIENCES$$b24 / 74 = 0.324$$c2021$$dQ2$$eT1
000109483 593__ $$aMathematics (miscellaneous)$$c2021$$dQ1
000109483 593__ $$aEngineering (miscellaneous)$$c2021$$dQ1
000109483 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000109483 700__ $$0(orcid)0000-0002-1462-4880$$aHernando, David
000109483 700__ $$aOrini, Michele
000109483 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, Pablo$$uUniversidad de Zaragoza
000109483 700__ $$aViik, Jari
000109483 700__ $$0(orcid)0000-0003-1272-0550$$aBailón, Raquel$$uUniversidad de Zaragoza
000109483 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo, Esther$$uUniversidad de Zaragoza
000109483 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000109483 773__ $$g379, 2212 (2021)$$pPhilos. trans. - Royal Soc., Math. phys. eng. sci.$$tPhilosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences$$x1364-503X
000109483 8564_ $$s773409$$uhttps://zaguan.unizar.es/record/109483/files/texto_completo.pdf$$yVersión publicada
000109483 8564_ $$s1971991$$uhttps://zaguan.unizar.es/record/109483/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000109483 909CO $$ooai:zaguan.unizar.es:109483$$particulos$$pdriver
000109483 951__ $$a2023-05-18-14:52:14
000109483 980__ $$aARTICLE