Rivolo Simone, Nagel Eike, Smith Nicolas P, Lee Jack
Annu Int Conf IEEE Eng Med Biol Soc. 2014;2014:5056-9. doi: 10.1109/EMBC.2014.6944761.
Coronary Wave Intensity Analysis (cWIA) is a technique capable of separating the effects of proximal arterial haemodynamics from cardiac mechanics. The cWIA ability to establish a mechanistic link between coronary haemodynamics measurements and the underlying pathophysiology has been widely demonstrated. Moreover, the prognostic value of a cWIA-derived metric has been recently proved. However, the clinical application of cWIA has been hindered due to the strong dependence on the practitioners, mainly ascribable to the cWIA-derived indices sensitivity to the pre-processing parameters. Specifically, as recently demonstrated, the cWIA-derived metrics are strongly sensitive to the Savitzky-Golay (S-G) filter, typically used to smooth the acquired traces. This is mainly due to the inability of the S-G filter to deal with the different timescale features present in the measured waveforms. Therefore, we propose to apply an adaptive S-G algorithm that automatically selects pointwise the optimal filter parameters. The newly proposed algorithm accuracy is assessed against a cWIA gold standard, provided by a newly developed in-silico cWIA modelling framework, when physiological noise is added to the simulated traces. The adaptive S-G algorithm, when used to automatically select the polynomial degree of the S-G filter, provides satisfactory results with ≤ 10% error for all the metrics through all the levels of noise tested. Therefore, the newly proposed method makes cWIA fully automatic and independent from the practitioners, opening the possibility to multi-centre trials.
冠状动脉波强度分析(cWIA)是一种能够将近端动脉血流动力学的影响与心脏力学分离的技术。cWIA在冠状动脉血流动力学测量与潜在病理生理学之间建立机制联系的能力已得到广泛证实。此外,最近已证明cWIA衍生指标的预后价值。然而,cWIA的临床应用受到阻碍,因为它强烈依赖于从业者,这主要归因于cWIA衍生指标对预处理参数的敏感性。具体而言,正如最近所证明的,cWIA衍生指标对Savitzky-Golay(S-G)滤波器高度敏感,该滤波器通常用于平滑采集的波形。这主要是由于S-G滤波器无法处理测量波形中存在的不同时间尺度特征。因此,我们建议应用一种自适应S-G算法,该算法能逐点自动选择最佳滤波器参数。当向模拟波形添加生理噪声时,针对新开发的计算机模拟cWIA建模框架提供的cWIA金标准,评估新提出算法的准确性。当自适应S-G算法用于自动选择S-G滤波器的多项式次数时,在所有测试噪声水平下,所有指标的误差≤10%,能提供令人满意的结果。因此,新提出的方法使cWIA完全自动化且独立于从业者,为多中心试验开辟了可能性。