126750 20241125101133.0 doi 10.1016/j.bspc.2023.105056 sideral 134124 ART-2023-134124 eng Pérez, Cristina Universidad de Zaragoza (orcid)0000-0002-8334-4786 QT interval time lag in response to heart rate changes during stress test for Coronary Artery Disease diagnosis 2023 Access copy available to the general public Unrestricted Background: Slow adaptation of the QT interval to abrupt changes in heart rate (HR) can enhance ventricular heterogeneity and has been suggested as a marker of arrhythmic risk. Most investigations on QT rate adaptation lag have been performed in response to step-like HR changes. However, abrupt HR changes are difficult to induce or observe in ECG recordings under ambulatory conditions. Objective: We aim to evaluate the power of indices related to the QT lag in response to ramp-like HR changes in stress test to assess CAD risk. Methods: We quantified the lag between the actual QT series and the memoryless expected QT series, which was obtained by fitting a hyperbolic regression model to the instantaneous QT and HR measurements in stages where their behavior could be assumed stationary. The proposed methodology was applied to analyze ECG stress tests of a subset of 448 patients presenting different risk levels for Coronary Artery Disease (CAD). The QT lag was estimated separately in the exercise and recovery phases. Results: An increase in the estimated QT lag during exercise (from 25 to 36 s) and a decrease during recovery (from 57 to 39 s) were associated with higher CAD risk. The difference between these lags showed significant capacity for CAD risk stratification. Conclusion: The QT lag in response to HR changes can be quantified from a stress test. QT lag values in response to ramp-like HR changes are in ranges comparable to those quantified from abrupt HR changes and show clinical significance to stratify CAD risk. info:eu-repo/grantAgreement/ES/DGA-IIU/796-2019 info:eu-repo/grantAgreement/ES/DGA/LMP94_21 info:eu-repo/grantAgreement/ES/DGA/T39-23R info:eu-repo/grantAgreement/EUR/ERC-2014-StG-638284 info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-104881RB-I00 info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-105674RB-I00 info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00 info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 4.9 2023 ENGINEERING, BIOMEDICAL 30 / 123 = 0.244 2023 Q1 T1 1.284 2023 Biomedical Engineering 2023 Q1 Signal Processing 2023 Q1 Health Informatics 2023 Q1 9.8 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Pueyo, Esther Universidad de Zaragoza (orcid)0000-0002-1960-407X Martínez, Juan Pablo Universidad de Zaragoza (orcid)0000-0002-7503-3339 Viik, Jari Laguna, Pablo Universidad de Zaragoza (orcid)0000-0003-3434-9254 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 86 (2023), 105056 [13 pp.] Biomed. signal proces. control Biomedical Signal Processing and Control 1746-8094 1865813 http://zaguan.unizar.es/record/126750/files/texto_completo.pdf Versión publicada 2530449 http://zaguan.unizar.es/record/126750/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:126750 articulos driver 2024-11-22-11:59:31 ARTICLE