Cardiovascular diseases are one of the most common causes of death; however, the early detection of patients at high risk of sudden cardiac death (SCD) remains an issue. The aim of this study was to analyze the cardio-vascular couplings based on heart rate variability (HRV) and blood pressure variability (BPV) analyses in order to introduce new indices for noninvasive risk stratification in idiopathic dilated cardiomyopathy patients (IDC). High-resolution electrocardiogram (ECG) and continuous noninvasive blood pressure (BP) signals were recorded in 91 IDC patients and 49 healthy subjects (CON). The patients were stratified by their SCD risk as high risk (IDCHR) when after two years the subject either died or suffered life-threatening complications, and as low risk (IDCLR) when the subject remained stable during this period. Values were extracted from ECG and BP signals, the beat-to-beat interval, and systolic and diastolic blood pressure, and analyzed using the segmented Poincaré plot analysis (SPPA), the high-resolution joint symbolic dynamics (HRJSD) and the normalized short time partial directed coherence methods. Support vector machine (SVM) models were built to classify these patients according to SCD risk. IDCHR patients presented lowered HRV and increased BPV compared to both IDCLR patients and the control subjects, suggesting a decrease in their vagal activity and a compensation of sympathetic activity. Both, the cardio -systolic and -diastolic coupling strength was stronger in high-risk patients when comparing with low-risk patients. The cardio-systolic coupling analysis revealed that the systolic influence on heart rate gets weaker as the risk increases. The SVM IDCLR vs. IDCHR model achieved 98.9% accuracy with an area under the curve (AUC) of 0.96. The IDC and the CON groups obtained 93.6% and 0.94 accuracy and AUC, respectively. To simulate a circumstance in which the original status of the subject is unknown, a cascade model was built fusing the aforementioned models, and achieved 94.4% accuracy. In conclusion, this study introduced a novel method for SCD risk stratification for IDC patients based on new indices from coupling analysis and non-linear HRV and BPV. We have uncovered some of the complex interactions within the autonomic regulation in this type of patient.
Physiological records are one of the most relevant elements to obtain objective information from the patients. The presence of artifacts in biomedical signals can give misleading in the analysis of information that these signals give. The blood pressure signal is one of the records clearly affected by different artifacts, especially the ones due from the calibration episodes. We propose a method to reconstruct different episodes of artifacts in these signals. This method is sustained on the detection of the events of the signal, differentiating between to the physiological cycles and the artifacts. The performance of the method is based on the detection of the cycles and artifact's position, the identification of the number of cycles to reconstruct, and the prediction of the cycle model used to generate the missing cycles. The parameter θ E represents the difference between the area under the curve when two events are compared. The value of this parameter is low when two similar events are compared like the physiological cycles, whereas it is high comparing a cycle with an artifact. An adaptive threshold is defined to identify the artifact episodes. The number of cycles to reconstruct is generated considering the same number of their neighbours physiological cycles, to left and right, of the original signal. Finally, the performance of the method has been analyzed comparing the number of events and artifacts detected and their correct reconstruction. According to the results, the reconstruction error was less than 1% in all cases.
Patients with Chronic Heart Failure (CHF) often develop oscillatory breathing patterns. This work proposes the characterization of respiratory pattern by Wavelet Transform (WT) technique to identify Periodic Breathing pattern (PB) and Non-Periodic Breathing pattern (nPB) through the respiratory flow signal. A total of 62 subjects were analyzed: 27 CHF patients and 35 healthy subjects. Respiratory time series were extracted, and statistical methods were applied to obtain the most relevant information to classify patients. Support Vector Machine (SVM) were applied using forward selection technique to discriminate patients, considering four kernel functions. Differences between these parameters are assessed by investigating the following four classification issues: healthy subjects versus CHF patients, PB versus nPB patients, PB patients versus healthy subjects, and nPB patients versus healthy subjects. The results are presented in terms of average accuracy for each kernel function, and comparison groups.
Las enfermedades cardiovasculares son una de las principales causas de muerte en países desarrollados. Se han analizado 42 pacientes con cardiomiopatía isquémica (ICM) o dilatada (DCM), clasificados en función de la fracción de eyección ventricular izquierda (LVEF), en grupos de alto riesgo (HR: LVEF
Analyzing the pore-size distribution of porous materials, made up of an aggregation of interconnected pores, is a demanding task. Mercury intrusion porosimetry (MIP) is a physical method that intrudes mercury into a sample at increasing pressures to obtain a pore-size histogram. This method has been simulated in-silice with several approaches requiring prior computation of a skeleton. We present a new approach to simulate MIP that does not require skeleton computation. Our method is an iterative process that considers the diameters corresponding to pressures. At each iteration, geometric tests detect throats for the corresponding diameter and a CCL process collects the region invaded by the mercury. Additionally, a new decomposition model called CUDB, is used. This is suitable for computing the throats and performs better with the CCL algorithm than a voxel model. Our approach obtains the pore-size distribution of the porous medium, and the corresponding pore graph.
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