Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, 28942 Madrid, Spain.
Department of Signal Theory and Communications, Carlos III University, 28912 Madrid, Spain.
Int J Environ Res Public Health. 2018 Mar 1;15(3):428. doi: 10.3390/ijerph15030428.
Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT)), and a complex-domain (heart rate variability (HRV)). Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages) and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT). The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain.
许多从心电图信号处理的心血管风险分层的指数已经被提出，但在临床实践中的应用仍然有限。我们创建了一个系统，将心电图的心脏风险亚域的临床定义与各种信号处理技术结合起来。从技术和临床观点的联合分析中定义了三个亚域。一个亚域专门用于人口统计学和临床数据。另外两个亚域旨在从心电图监测中获得广泛定义的风险指数：一个简单域（心率震荡（HRT））和一个复杂域（心率变异性（HRV））。三个亚域提供的数据允许生成不同强度和性质的警报，以及根据既定的处理和风险阈值标准对患者进行分组和审查。通过连接来自真实世界的住院电子健康记录和心电图监测的数据，并考虑语法（HL7 消息）和语义互操作性（基于 CEN/ISO EN13606 和 SNOMED-CT 的原型）标准，对实施的系统进行了测试。该系统能够在健康记录中提供风险指数并生成警报，以支持决策。总的来说，该系统允许在基于动态心电图的心脏风险领域中进行研究和临床实践的敏捷交互。
