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用于心脏性猝死风险分层的RR-QT间期趋势协变性

RR-QT interval trend covariability for sudden cardiac death risk stratification.

作者信息

Nishibe Toshihiro, Sato Kei, Yoshino Kunihiro, Seki Ryota, Yana Kazuo, Ono Takuya

机构信息

Graduate School of Engineering, Hosei University, Tokyo 184-8584 Japan.

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:4287-90. doi: 10.1109/EMBC.2012.6346914.

Abstract

This paper examines the feasibility of the trend covariability between QT and RR Intervals (QTIs and RRIs) be a novel mean of the sudden cardiac death (SCD) risk stratification. Twenty four hour beat to beat QTIs and RRIs are measured from Holter ECG recordings of 25 normal control subjects (SCD-C), 14 low SCD risk patients (SCD-L) with high blood pressure or light cardiac arrhythmia and 11 SCD high risk patients (SCD-H) with heart attack history. The Kalman filtering technique has been applied to decompose 24 hour short term mean QTIs and RRIs sequences into trend components and additive random variations. The correlation coefficients (TC-QT/RR) and cross entropies (TE-QT/RR) between the QT and RR trend signals are estimated. Cross entropy TE-QT/RR achieved the best stratification of subject groups. TE-QT/RR distribution for SCD-C, -L -H subject groups were 1.697 ± 0.058, 1.160 ± 0.099, 0.920 ± 0.067. The differences in entropy values are statistically significant for all classes pairs (SCD-H and -C (p<0.00001); -L and -C (p<0.001); -H and -L (p<0.05) The result indicates that the TE-QT/RR could be a novel index for the SCD risk stratification.

摘要

本文探讨了QT间期与RR间期(QTIs和RRIs)之间的趋势协变性作为心脏性猝死(SCD)风险分层新方法的可行性。从25名正常对照受试者(SCD-C)、14名患有高血压或轻度心律失常的低SCD风险患者(SCD-L)以及11名有心脏病发作史的高SCD风险患者(SCD-H)的动态心电图记录中测量24小时逐搏QTIs和RRIs。应用卡尔曼滤波技术将24小时短期平均QTIs和RRIs序列分解为趋势成分和加性随机变化。估计QT和RR趋势信号之间的相关系数(TC-QT/RR)和交叉熵(TE-QT/RR)。交叉熵TE-QT/RR实现了受试者组的最佳分层。SCD-C、-L、-H受试者组的TE-QT/RR分布分别为1.697±0.058、1.160±0.099、0.920±0.067。所有类别对的熵值差异具有统计学意义(SCD-H和-C(p<0.00001);-L和-C(p<0.001);-H和-L(p<0.05))。结果表明TE-QT/RR可能是SCD风险分层的一个新指标。

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