000131453 001__ 131453
000131453 005__ 20240319080950.0
000131453 0247_ $$2doi$$a10.1109/TBME.2022.3153791
000131453 0248_ $$2sideral$$a128397
000131453 037__ $$aART-2022-128397
000131453 041__ $$aeng
000131453 100__ $$aPalmieri, Flavio
000131453 245__ $$aWeighted Time Warping Improves T-wave Morphology Markers Clinical Significance; 35196223
000131453 260__ $$c2022
000131453 5060_ $$aAccess copy available to the general public$$fUnrestricted
000131453 5203_ $$aBackground: 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
000131453 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000131453 590__ $$a4.6$$b2022
000131453 591__ $$aENGINEERING, BIOMEDICAL$$b34 / 96 = 0.354$$c2022$$dQ2$$eT2
000131453 592__ $$a1.167$$b2022
000131453 593__ $$aBiomedical Engineering$$c2022$$dQ1
000131453 594__ $$a9.5$$b2022
000131453 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000131453 700__ $$aGomis, Pedro
000131453 700__ $$aFerreira, Dina
000131453 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo, Esther$$uUniversidad de Zaragoza
000131453 700__ $$0(orcid)0000-0002-7503-3339$$aMartinez, Juan Pablo$$uUniversidad de Zaragoza
000131453 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, Pablo$$uUniversidad de Zaragoza
000131453 700__ $$0(orcid)0000-0003-4130-5866$$aRamirez, Julia$$uUniversidad de Zaragoza
000131453 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000131453 773__ $$g69, 9 (2022), 2787-2796$$pIEEE trans. biomed. eng.$$tIEEE Transactions on Biomedical Engineering$$x0018-9294
000131453 8564_ $$s1739153$$uhttps://zaguan.unizar.es/record/131453/files/texto_completo.pdf$$yPostprint
000131453 8564_ $$s3582201$$uhttps://zaguan.unizar.es/record/131453/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000131453 909CO $$ooai:zaguan.unizar.es:131453$$particulos$$pdriver
000131453 951__ $$a2024-03-18-12:58:09
000131453 980__ $$aARTICLE