Areiza-Laverde Henry, Dopierala Cindy, Senhadji Lotfi, Boucher Francois, Gumery Pierre Y, Hernández Alfredo
Univ Rennes, INSERM, LTSI - UMR 1099, Rennes, France.
SentinHealth SA, Biopolis, Grenoble, France.
Front Physiol. 2021 Nov 19;12:748367. doi: 10.3389/fphys.2021.748367. eCollection 2021.
The analysis of cardiac vibration signals has been shown as an interesting tool for the follow-up of chronic pathologies involving the cardiovascular system, such as heart failure (HF). However, methods to obtain high-quality, real-world and longitudinal data, that do not require the involvement of the patient to correctly and regularly acquire these signals, remain to be developed. Implantable systems may be a solution to this observability challenge. In this paper, we evaluate the feasibility of acquiring useful electrocardiographic (ECG) and accelerometry (ACC) data from an innovative implant located in the gastric fundus. In a first phase, we compare data acquired from the gastric fundus with gold standard data acquired from surface sensors on 2 pigs. A second phase investigates the feasibility of deriving useful hemodynamic markers from these gastric signals using data from 4 healthy pigs and 3 pigs with induced HF with longitudinal recordings. The following data processing chain was applied to the recordings: (1) ECG and ACC data denoising, (2) noise-robust real-time QRS detection from ECG signals and cardiac cycle segmentation, (3) Correlation analysis of the cardiac cycles and computation of coherent mean from aligned ECG and ACC, (4) cardiac vibration components segmentation (S1 and S2) from the coherent mean ACC data, and (5) estimation of signal context and a signal-to-noise ratio (SNR) on both signals. Results show a high correlation between the markers acquired from the gastric and thoracic sites, as well as pre-clinical evidence on the feasibility of chronic cardiovascular monitoring from an implantable cardiac device located at the gastric fundus, the main challenge remains on the optimization of the signal-to-noise ratio, in particular for the handling of some sources of noise that are specific to the gastric acquisition site.
心脏振动信号分析已被证明是一种用于跟踪涉及心血管系统的慢性疾病（如心力衰竭（HF））的有趣工具。然而，获取高质量、真实世界和纵向数据的方法仍有待开发，这些方法不需要患者参与即可正确且定期地采集这些信号。植入式系统可能是解决这一可观测性挑战的一种方法。在本文中，我们评估了从位于胃底的一种创新型植入物获取有用的心电图（ECG）和加速度计（ACC）数据的可行性。在第一阶段，我们将从胃底采集的数据与从2头猪的表面传感器采集的金标准数据进行比较。第二阶段使用来自4头健康猪和3头诱导性HF猪的纵向记录数据，研究从这些胃部信号中推导有用的血流动力学标志物的可行性。对记录应用了以下数据处理链：（1）ECG和ACC数据去噪，（2）从ECG信号中进行抗噪声实时QRS检测和心动周期分割，（3）心动周期的相关性分析以及对齐的ECG和ACC的相干均值计算，（4）从相干均值ACC数据中进行心脏振动成分分割（S1和S2），以及（5）估计两个信号的信号背景和信噪比（SNR）。结果表明，从胃部和胸部部位获取的标志物之间具有高度相关性，以及关于从位于胃底的植入式心脏设备进行慢性心血管监测可行性的临床前证据，主要挑战仍然在于信噪比的优化，特别是对于处理一些特定于胃部采集部位的噪声源。
