112395 20240319080955.0 doi 10.3390/s22082951 sideral 128290 ART-2022-128290 eng Bukhari, Syed Hassaan Ahmed Universidad de Zaragoza (orcid)0000-0001-5976-0483 Monitoring of serum potassium and calcium levels in end-stage renal disease patients by ecg depolarization morphology analysis 2022 Access copy available to the general public Unrestricted Objective: Non-invasive estimation of serum potassium, [K+], and calcium, [Ca2+], can help to prevent life-threatening ventricular arrhythmias in patients with advanced renal disease, but current methods for estimation of electrolyte levels have limitations. We aimed to develop new markers based on the morphology of the QRS complex of the electrocardiogram (ECG). Methods: ECG recordings from 29 patients undergoing hemodialysis (HD) were processed. Mean warped QRS complexes were computed in two-minute windows at the start of an HD session, at the end of each HD hour and 48 h after it. We quantified QRS width, amplitude and the proposed QRS morphology-based markers that were computed by warping techniques. Reference [K+] and [Ca2+] were determined from blood samples acquired at the time points where the markers were estimated. Linear regression models were used to estimate electrolyte levels from the QRS markers individually and in combination with T wave morphology markers. Leave-one-out cross-validation was used to assess the performance of the estimators. Results: All markers, except for QRS width, strongly correlated with [K+] (median Pearson correlation coefficients, r, ranging from 0.81 to 0.87) and with [Ca2+] (r ranging from 0.61 to 0.76). QRS morphology markers showed very low sensitivity to heart rate (HR). Actual and estimated serum electrolyte levels differed, on average, by less than 0.035 mM (relative error of 0.018) for [K+] and 0.010 mM (relative error of 0.004) for [Ca2+] when patient-specific multivariable estimators combining QRS and T wave markers were used. Conclusion: QRS morphological markers allow non-invasive estimation of [K+] and [Ca2+] with low sensitivity to HR. The estimation performance is improved when multivariable models, including T wave markers, are considered. Significance: Markers based on the QRS complex of the ECG could contribute to non-invasive monitoring of serum electrolyte levels and arrhythmia risk prediction in patients with renal disease info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R-BSICoS group info:eu-repo/grantAgreement/EUR/ERC-2014-StG-638284 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 http://creativecommons.org/licenses/by/3.0/es/ 3.9 2022 CHEMISTRY, ANALYTICAL 26 / 86 = 0.302 2022 Q2 T1 INSTRUMENTS & INSTRUMENTATION 19 / 63 = 0.302 2022 Q2 T1 ENGINEERING, ELECTRICAL & ELECTRONIC 100 / 274 = 0.365 2022 Q2 T2 0.764 2022 Instrumentation 2022 Q1 Analytical Chemistry 2022 Q1 Medicine (miscellaneous) 2022 Q2 Information Systems 2022 Q2 Biochemistry 2022 Q2 Atomic and Molecular Physics, and Optics 2022 Q2 Electrical and Electronic Engineering 2022 Q2 6.8 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sánchez, Carlos Universidad de Zaragoza (orcid)0000-0003-4273-5403 Ruiz, José Esteban Universidad de Zaragoza (orcid)0000-0002-4351-8518 Potse, Mark Laguna, Pablo Universidad de Zaragoza (orcid)0000-0003-3434-9254 Pueyo, Esther Universidad de Zaragoza (orcid)0000-0002-1960-407X 5007 520 Universidad de Zaragoza Dpto. Informát.Ingenie.Sistms. Área Ingen.Sistemas y Automát. 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 22 , 8 (2022), 2951 [19 pp] Sensors Sensors 1424-8220 2523362 http://zaguan.unizar.es/record/112395/files/texto_completo.pdf Versión publicada 2712911 http://zaguan.unizar.es/record/112395/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:112395 articulos driver 2024-03-18-13:32:58 ARTICLE