Weighted Time Warping Improves T-wave Morphology Markers Clinical Significance; 35196223

Palmieri, Flavio ; Gomis, Pedro ; Ferreira, Dina ; Pueyo, Esther (Universidad de Zaragoza) ; Martinez, Juan Pablo (Universidad de Zaragoza) ; Laguna, Pablo (Universidad de Zaragoza) ; Ramirez, Julia (Universidad de Zaragoza)

Resumen: Background: T-wave (TW) morphology indices based on time-warping (dw) have shown significant cardiovascular risk stratification value. However, errors in the location of TW boundaries may impact their prognostic power. Our aim was to test the hypothesis that a weighted time-warping function (WF) would reduce the sensitivity of dw to these errors and improve their clinical significance. Methods: The WFs were proportional to (i) the reference TW (T), and (ii) the absolute value of its derivative (D). The index dw was recalculated using these WFs, and its performance was compared to the unweighted control case (C) in four different scenarios: 1) robustness against simulated TW boundaries location errors; 2) ability to retain physiological information in an electrophysiological cardiac model; 3) ability to monitor blood potassium concentration changes (K+]) in 29 hemodialysis (HD) patients; 4) and the sudden cardiac death (SCD) risk stratification value of the TW morphology restitution (TMR) index, derived from dw, in 651 chronic heart failure (CHF) patients. Results and Discussion: The WFs led to a reduced sensitivity (R) of dw to TW boundary location errors as compared to C (median R=0.19 and 0.22 and 0.35 for T, D and C, respectively). They also preserved the physiological relationship between dw and repolarization dispersion changes at ventricular level. No improvements in K+] tracking were observed for the HD patients (Pearsons median correlation r] between K+] and dw was 0.86r0.90 for T, D and C). In CHF patients, the SCD risk stratification value of TMR was improved by applying T (hazard ratio, HAR, of 2.80), followed by D (HAR=2.32) and C (HAR=2.23). Conclusions and Significance: The proposed WFs, with T showing the best performance, increased the robustness of time-warping based markers against TW location errors preserving their physiological information content and boosting their SCD risk stratification value. Results from this work support the use of T when deriving dw for future clinical applications. IEEE

Idioma: Inglés

DOI: 10.1109/TBME.2022.3153791

Año: 2022

Publicado en: IEEE Transactions on Biomedical Engineering 69, 9 (2022), 2787-2796
ISSN: 0018-9294

Factor impacto JCR: 4.6 (2022)

Categ. JCR: ENGINEERING, BIOMEDICAL rank: 34 / 96 = 0.354 (2022) - Q2 - T2

Factor impacto CITESCORE: 9.5 - Engineering (Q1)

Factor impacto SCIMAGO: 1.167 - Biomedical Engineering (Q1)

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)