000136165 001__ 136165
000136165 005__ 20240719195438.0
000136165 0247_ $$2doi$$a10.1109/TBME.2024.3404254
000136165 0248_ $$2sideral$$a139115
000136165 037__ $$aART-2024-139115
000136165 041__ $$aeng
000136165 100__ $$aGómez, Neurys
000136165 245__ $$aT-wave Peak-to-End Changes Quantified by Time-Warping Predicts Ventricular Fibrillation in a Porcine Myocardial Infarction Model
000136165 260__ $$c2024
000136165 5060_ $$aAccess copy available to the general public$$fUnrestricted
000136165 5203_ $$aBackground: The T-peak-to-T-end ( $\mathrm{T}_{pe}$ ) interval has shown potential in predicting ventricular arrhythmic risk. It is an appealing index to be measured during ischemia since it is less influenced by ST-segment changes than the early part of the T wave. A time-warping-based index, derived from a spatially transformed PCA lead, $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ , quantifying changes in the $\mathrm{T}_{pe}$ morphology, has previously demonstrated utility in tracking repolarization changes induced by a 5-minute ischemia model in humans. The value of $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ as a predictor of ventricular fibrillation (VF) episodes is assessed in a porcine model of myocardial ischemia with ischemia maintained for 40 minutes. Methods: From 32 pigs undergoing a coronary occlusion, pre-occlusion and occlusion ECG recordings from 10 pigs suffering a VF episode after 10 min of occlusion (Delayed VF) and 16 that did not had any episode during the recording were analyzed. The $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ series was measured by comparing $\mathrm{T}_{pe}$ morphologies at different stages of the occlusion relative to the peak-to-end morphology of a baseline T-wave. Results: During baseline, $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ remained stationary with an intra-recording median [IQR] value of 1.60 [1.33] ms. During artery occlusion, $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ followed a well-marked gradual increasing trend as ischemia progressed, reaching a median of 14.58 [17.72] ms. $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ averages were significantly higher ( ${p< 0.05}$ ) in the VF group than in the Non-VF group at time intervals 0-5, 5-10, 10-15, 15-20, 20-25 min after occlusion onset and at 10-15, 5-10 and 5-0 minutes prior to VF episode, with median values of 12.5, 18.8, 26.8, 24.0, 31.0, 18.6, 25.0 and 28.8 vs 6.3, 7.6, 8.0, 7.8, 7.8, 8.5, 7.2 and 6.0 ms, respectively. The $\mathrm{T}_{pe}^{\text{PCA}}$ interval was also significantly higher in the VF group at all analyzed time periods, but with a lower significance level. Pigs with maximum $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ $\geq$ 20.0 ms and $\mathrm{T}_{pe}^{\text{PCA}}$ $\geq$ 85.4 ms had significantly higher risk for VF occurring in the early 5-10 minutes interval, with 90.0%/75.0% and 80.0%/69.0% sensitivity/specificity, respectively. Univariate Cox analysis yielded hazard ratios of 12.5 for $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ vs 5.5 for $\mathrm{T}_{pe}^{\text{PCA}}$ . Conclusions and Significance: The time-warping-based index, $d^{{\kern0.28436pt}\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ , is a stronger VF predictor than $\mathrm{T}_{pe}^{\text{PCA}}$ during ischemia in a porcine model, advising for further clinical exploration studies in humans.
000136165 536__ $$9info:eu-repo/grantAgreement/ES/AEI/PID2021-128972OA-I00$$9info:eu-repo/grantAgreement/ES/DGA/MultiMetAr LMP143-21$$9info:eu-repo/grantAgreement/ES/DGA/T39-23R$$9info:eu-repo/grantAgreement/ES/MICINN/PID2019-104881RB-I00$$9info:eu-repo/grantAgreement/ES/MICINN/RYC2021-031413-I$$9info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00
000136165 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000136165 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000136165 700__ $$0(orcid)0000-0003-4130-5866$$aRamírez, Julia$$uUniversidad de Zaragoza
000136165 700__ $$0(orcid)0000-0003-0226-4950$$aMartín-Yebra, Alba$$uUniversidad de Zaragoza
000136165 700__ $$aDemidova, Marina M.
000136165 700__ $$aPlatonov, Pyotr
000136165 700__ $$0(orcid)0000-0002-7503-3339$$aMartínez, Juan Pablo$$uUniversidad de Zaragoza
000136165 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, Pablo$$uUniversidad de Zaragoza
000136165 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000136165 773__ $$g(2024), 10 pp.$$pIEEE trans. biomed. eng.$$tIEEE Transactions on Biomedical Engineering$$x0018-9294
000136165 8564_ $$s2127709$$uhttps://zaguan.unizar.es/record/136165/files/texto_completo.pdf$$yVersión publicada
000136165 8564_ $$s3640491$$uhttps://zaguan.unizar.es/record/136165/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000136165 909CO $$ooai:zaguan.unizar.es:136165$$particulos$$pdriver
000136165 951__ $$a2024-07-19-18:28:30
000136165 980__ $$aARTICLE