130851 20240912131720.0 doi 10.1016/j.jelectrocard.2015.04.002 sideral 91630 ART-2015-91630 eng Ramírez, Julia (orcid)0000-0003-4130-5866 Automatic SVM classification of sudden cardiac death and pump failure death from autonomic and repolarization ECG markers 2015 Access copy available to the general public Unrestricted Background Considering the rates of sudden cardiac death (SCD) and pump failure death (PFD) in chronic heart failure (CHF) patients and the cost-effectiveness of their preventing treatments, identification of CHF patients at risk is an important challenge. In this work, we studied the prognostic performance of the combination of an index potentially related to dispersion of repolarization restitution (Δα), an index quantifying T-wave alternans (IAA) and the slope of heart rate turbulence (TS) for classification of SCD and PFD. Methods Holter ECG recordings of 597 CHF patients with sinus rhythm enrolled in the MUSIC study were analyzed and Δα, IAA and TS were obtained. A strategy was implemented using support vector machines (SVM) to classify patients in three groups: SCD victims, PFD victims and other patients (the latter including survivors and victims of non-cardiac causes). Cross-validation was used to evaluate the performance of the implemented classifier. Results Δα and IAA, dichotomized at 0.035 (dimensionless) and 3.73 μV, respectively, were the ECG markers most strongly associated with SCD, while TS, dichotomized at 2.5 ms/RR, was the index most strongly related to PFD. When separating SCD victims from the rest of patients, the individual marker with best performance was Δα ≥ 0.035, which, for a fixed specificity (Sp) of 90%, showed a sensitivity (Se) value of 10%, while the combination of Δα and IAA increased Se to 18%. For separation of PFD victims from the rest of patients, the best individual marker was TS ≤ 2.5 ms/RR, which, for Sp = 90%, showed a Se of 26%, this value being lower than Se = 34%, produced by the combination of Δα and TS. Furthermore, when performing SVM classification into the three reported groups, the optimal combination of risk markers led to a maximum Sp of 79% (Se = 18%) for SCD and Sp of 81% (Se = 14%) for PFD. Conclusions The results shown in this work suggest that it is possible to efficiently discriminate SCD and PFD in a population of CHF patients using ECG-derived risk markers like Δα, TS and IAA. info:eu-repo/grantAgreement/ES/DGA/FSE info:eu-repo/grantAgreement/ES/DGA/Grupo Consolidado BSICoS info:eu-repo/grantAgreement/ES/MINECO/TEC2013-42140-R info:eu-repo/grantAgreement/ES/MINECO/TIN2013-41998-R info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 1.29 2015 CARDIAC & CARDIOVASCULAR SYSTEMS 93 / 124 = 0.75 2015 Q3 T3 0.559 2015 Cardiology and Cardiovascular Medicine 2015 Q2 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Monasterio, Violeta (orcid)0000-0001-5343-5671 Mincholé, Ana Llamedo, Mariano Lenis, Gustavo Cygankiewicz, Iwona Bayés de Luna, Antonio Malik, Marek Martínez, Juan Pablo Universidad de Zaragoza (orcid)0000-0002-7503-3339 Laguna, Pablo Universidad de Zaragoza (orcid)0000-0003-3434-9254 Pueyo, Esther Universidad de Zaragoza (orcid)0000-0002-1960-407X 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 48, 4 (2015), 551-557 J. electrocardiol. JOURNAL OF ELECTROCARDIOLOGY 0022-0736 https://www.sciencedirect.com/science/article/pii/S0022073615001090?via%3Dihub Texto completo de la revista 141301 http://zaguan.unizar.es/record/130851/files/texto_completo.pdf Postprint 2615852 http://zaguan.unizar.es/record/130851/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:130851 articulos driver 2024-09-12-13:15:34 ARTICLE