doi:10.1109/JBHI.2023.3310878engGómez, NeurysRamírez, JuliaMartínez, Juan PabloLaguna, PabloTime-warping analysis of the T-wave peak-to-end Interval to quantify ventricular repolarization dispersion during ischemiaART-2023-136351Variations in the dispersion of ventricular repolarization can be quantified by T-wave time-warping based index, dw . However, the early phase of the T-wave can be affected by ST-segment changes during ischemia. We hypothesized that restricting dw to the T-wave peak-to-end ( Tpe ) would circumvent this limitation while still quantifying variations in repolarization dispersion. A total of 101 ECG recordings from patients undergoing coronary occlusion, together with their control recordings, were analyzed. A series of dw values was calculated by quantifying the Tpe morphological variations between the T-waves at different occlusion stages and a baseline T-wave. We introduced a normalized version of dw , Rd , reflecting variations of dw during occlusion relative to control recordings ( Rd=1 corresponds to the same level of variation). The dw series followed a gradually increasing trend with occlusion time, reaching median [range] Rd values of 9.44 [1.01, 80.74] at the occlusion end. Rd at occlusion end was significantly higher than threshold values of 1, 2, 5, and 10 in 94.1%, 85.11%, 64.4% and 48.5% of patients, respectively. The spatial lead-wise analysis of dw showed distinct distributions depending on the occluded artery, suggesting a relation with the ischemia location. The relative variation R with ischemia of index dw (9.4) is greater than that of the T-wave amplitude (7.7), Tpe interval (2.7) and T-wave width (3.0). In conclusion, dw tracks ischemic-induced variations in repolarization dispersion in a more robust manner than classical indexes, avoiding the impact of ST segment elevation/depression or early T-wave distortions, thus warranting further clinical studies.2023http://zaguan.unizar.es/record/13005210.1109/JBHI.2023.3310878http://zaguan.unizar.es/record/130052oai:zaguan.unizar.es:130052info:eu-repo/grantAgreement/ES/AEI/PID2021-128972OA-I00info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20Rinfo:eu-repo/grantAgreement/ES/MICINN/PID2019-104881RB-I00info:eu-repo/grantAgreement/ES/MICINN/PID2019-105674RB-I00info:eu-repo/grantAgreement/ES/MICINN/RYC2021-031413-Iinfo:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00IEEE journal of biomedical and health informatics 27, 11 (2023), 5314-5325All rights reservedhttp://www.europeana.eu/rights/rr-f/info:eu-repo/semantics/openAccess