112087 20240319080951.0 doi 10.1016/j.compbiomed.2022.105304 sideral 128265 ART-2022-128265 eng Bukhari, Hassaan A. Estimation of potassium levels in hemodialysis patients by T wave nonlinear dynamics and morphology markers 2022 Access copy available to the general public Unrestricted Noninvasive screening of hypo- and hyperkalemia can prevent fatal arrhythmia in end-stage renal disease (ESRD) patients, but current methods for monitoring of serum potassium (K+) have important limitations. We investigated changes in nonlinear dynamics and morphology of the T wave in the electrocardiogram (ECG) of ESRD patients during hemodialysis (HD), assessing their relationship with K+ and designing a K+ estimator. Methods: ECG recordings from twenty-nine ESRD patients undergoing HD were processed. T waves in 2-min windows were extracted at each hour during an HD session as well as at 48 h after HD start. T wave nonlinear dynamics were characterized by two indices related to the maximum Lyapunov exponent (¿t, ¿wt) and a divergence-related index (¿). Morphological variability in the T wave was evaluated by three time warping-based indices (dw, reflecting morphological variability in the time domain, and da and daNL, in the amplitude domain). K+was measured from blood samples extracted during and after HD. Stage-specific and patient-specific K+ estimators were built based on the quantified indices and leave-one-out cross-validation was performed separately for each of the estimators. Results: The analyzed indices showed high inter-individual variability in their relationship with K+. Nevertheless, all of them had higher values at the HD start and 48 h after it, corresponding to the highest K+. The indices ¿ and dw were the most strongly correlated with K+ (median Pearson correlation coefficient of 0.78 and 0.83, respectively) and were used in univariable and multivariable linear K+ estimators. Agreement between actual and estimated K+ was confirmed, with averaged errors over patients and time points being 0.000 ± 0.875 mM and 0.046 ± 0.690 mM for stage-specific and patient-specific multivariable K+ estimators, respectively.ariability allow noninvasive monitoring of [K+] in ESRD patients. Significance: ECG markers have the potential to be used for hypo- and hyperkalemia screening in ESRD patients info:eu-repo/grantAgreement/ES/DGA-FSE/LMP124-18 info:eu-repo/grantAgreement/EC/H2020/764738/EU/Personalised In-Silico Cardiology/PIC This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 764738-PIC info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-104881RB-I00 info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-105674RB-I00 info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 7.7 2022 BIOLOGY 7 / 92 = 0.076 2022 Q1 T1 MATHEMATICAL & COMPUTATIONAL BIOLOGY 4 / 55 = 0.073 2022 Q1 T1 ENGINEERING, BIOMEDICAL 16 / 96 = 0.167 2022 Q1 T1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS 18 / 110 = 0.164 2022 Q1 T1 1.222 2022 Health Informatics 2022 Q1 Computer Science Applications 2022 Q1 9.2 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sánchez, Carlos Srinivasan, Sabarathinam Palmieri, Flavio Potse, Mark Laguna, Pablo Pueyo, Esther 143 (2022), 105304 [13 pp] Comput. biol. med. Computers in biology and medicine 0010-4825 6641334 http://zaguan.unizar.es/record/112087/files/texto_completo.pdf Versión publicada 2176527 http://zaguan.unizar.es/record/112087/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:112087 articulos driver 2024-03-18-13:05:03 ARTICLE