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PURPOSE: Compressed Sensing Magnetic Resonance Imaging (CS-MRI) is a promising technique to accelerate dynamic cardiac MR imaging (DCMRI). For DCMRI, the CS-MRI usually exploits image signal sparsity and low-rank property to reconstruct dynamic images from the undersampled k-space data. In this paper, a novel CS algorithm is investigated to improve dynamic cardiac MR image reconstruction quality under the condition of minimizing the k-space recording. METHODS: The sparse representation of 3D cardiac magnetic resonance data is implemented by synergistically integrating 3D total generalized variation (3D-TGV) algorithm and high order singular value decomposition (HOSVD) based Tensor Decomposition, termed k-t TGV-TD method. In the proposed method, the low rank structure of the 3D dynamic cardiac MR data is performed with the HOSVD method, and the localized image sparsity is achieved by the 3D-TGV method. Moreover, the Fast Composite Splitting Algorithm (FCSA) method, combining the variable splitting with operator splitting techniques, is employed to solve the low-rank and sparse problem. Two different cardiac MR datasets (cardiac perfusion and cine MR datasets) are used to evaluate the performance of the proposed method. RESULTS: Compared with the state-of-art methods, such as k-t SLR, 3D-TGV, HOSVD based tensor decomposition and low-rank plus sparse method, the proposed k-t TGV-TD method can offer improved reconstruction accuracy in terms of higher peak SNR (PSNR) and structural similarity index (SSIM). The proposed k-t TGV-TD method can achieve significantly better and stable reconstruction results than state-of-the-art methods in terms of both PSNR and SSIM, especially for cardiac perfusion MR dataset. CONCLUSIONS: This work proved that the k-t TGV-TD method was an effective sparse representation way for DCMRI, which was capable of significantly improving the reconstruction accuracy with different acceleration factors.
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Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Algoritmos , Coração/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodosRESUMO
Recently, deep neural networks (DNNs) have been widely used in the field of electrocardiogram (ECG) signal classification, but the previous models have limited ability to extract features from raw ECG data. In this paper, a deep residual network model based on pyramidal convolutional layers (PC-DRN) was proposed to implement ECG signal classification. The pyramidal convolutional (PC) layer could simultaneously extract multi-scale features from the original ECG data. And then, a deep residual network was designed to train the classification model for arrhythmia detection. The public dataset provided by the physionet computing in cardiology challenge 2017(CinC2017) was used to validate the classification experiment of 4 types of ECG data. In this paper, the harmonic mean F 1 of classification accuracy and recall was selected as the evaluation indexes. The experimental results showed that the average sequence level F 1 ( SeqF 1) of PC-DRN was improved from 0.857 to 0.920, and the average set level F 1 ( SetF 1) was improved from 0.876 to 0.925. Therefore, the PC-DRN model proposed in this paper provided a promising way for the feature extraction and classification of ECG signals, and provided an effective tool for arrhythmia classification.
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Eletrocardiografia , Arritmias Cardíacas , Progressão da Doença , Humanos , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: One of the major limitations of MRI is its slow acquisition speed. To accelerate data acquisition, partially parallel imaging (PPI) methods have been widely used in clinical applications such as sensitivity encoding (SENSE) and generalized autocalibrating partially parallel acquisitions (GRAPPA). SENSE is a popular image-domain partially parallel imaging method, which suffers from residual aliasing artifacts when the reduction factor goes higher. Undersampling the k-space data and then reconstruct images with artificial sparsity is an efficient way to accelerate data acquisition. By exploiting artificial sparsity with a high-pass filter, an improved SENSE method is proposed in this work, termed high-pass filtered SENSE (HF-SENSE). METHODS: First, a high-pass filter was applied to the raw k-space data, the result of which was used as the inputs of sensitivity estimation and undersampling process. Second, the adaptive array coil combination method was adopted to calculate sensitivity maps on a block-by-block basis. Third, Tikhonov regularized SENSE was then used to reconstruct magnetic resonance images. Fourth, the reconstructed images were transformed into k-space data, which was filtered with the corresponding inverse filter. RESULTS: Both simulation and in vivo experiments demonstrate that HF-SENSE method significantly reduces noise level of the reconstructed images compared with SENSE. Furthermore, it is found that HF-SENSE can achieve lower normalized root-mean-square error value than SENSE. CONCLUSIONS: The proposed method explores artificial sparsity with a high-pass filter. Experiments demonstrate that the proposed HF-SENSE method can improve the image quality of SENSE reconstruction. The high-pass filter parameters can be predefined. With this image reconstruction method, high acceleration factors can be achieved, which will improve the clinical applicability of SENSE. This retrospective study (HF-SENSE: an improved partially parallel imaging using a high-pass filter) was approved by Institute Review Board of 2nd Affiliated Hospital of Zhejiang University (ethical approval number 2018-314). Participant for all images have informed consent that he knew the risks and agreed to participate in the research.
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Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Algoritmos , Artefatos , Humanos , Imagens de Fantasmas , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
Many kinds of fibrosis are related to the content of pyridinoline cross-linking in type 1 collagen. In this study, ZIF-8 (zeolitic imidazolate framework), a metal organic framework (MOF), and ZIF8-hypocrellin B (ZIF8-HB), which combined the merits of hypocrellin B and the properties of ZIF-8, were prepared and applied to the photodegradation of the pyridinoline cross-linking. The effects of O2 and H2O2 in the photodynamic action were investigated. The results indicate that ZIF8-HB is an efficient photosensitizer to decompose pyridinoline cross-linking in collagen.
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Aminoácidos/química , Colágeno Tipo I/química , Complexos de Coordenação/química , Compostos Organometálicos/química , Perileno/análogos & derivados , Fármacos Fotossensibilizantes/química , Quinonas/química , Espectrometria de Fluorescência , Aminoácidos/efeitos da radiação , Colágeno Tipo I/efeitos da radiação , Peróxido de Hidrogênio/química , Modelos Químicos , Oxigênio/química , Perileno/química , Fotólise , Proteólise , Fatores de TempoRESUMO
The first derivatives of gelatin and type I collagen fluorescence spectra were characterized in order to describe the effect of free radicals on pyridinoline (PYD) cross-links. The different gas saturation conditions were used to investigate the effect of different free radicals. An analysis of first derivative fluorescence spectra suggests that PYD cross-link fluorescence emission is composed of three peaks in gelatin, but only two in type I collagen. The PYD cross-link was photo-degraded more than other gases in the presence of O2. This suggests that the singlet oxygen ((1)O2) plays a key role when using photodynamic therapy to treat skin fibrosis disease with Hypocrellin B (HB).
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Aminoácidos/química , Colágeno Tipo I/química , Gelatina/química , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/química , Oxigênio Singlete/química , Dermatopatias/tratamento farmacológico , Pele/efeitos dos fármacos , Aminoácidos/efeitos da radiação , Colágeno Tipo I/efeitos da radiação , Fibrose , Gelatina/efeitos da radiação , Humanos , Radical Hidroxila/química , Fotólise , Fármacos Fotossensibilizantes/farmacologia , Proteólise , Pele/metabolismo , Pele/patologia , Dermatopatias/metabolismo , Dermatopatias/patologia , Espectrometria de FluorescênciaRESUMO
As a tumor thermal ablation technology in cancer therapy, HIFU (High Intensity Focused Ultrasound) has been developed rapidly in recent years. With the technology becoming more and more mature, it's clinical application is becoming more and more widely. In HIFU therapy, the high-intensity ultrasound energy is focused in the target tumor tissue, generating heat within very short time, causing coagulation necrosis, so that the effect of the treatment is achieved. To ensure safe and therapeutic efficacy, HIFU therapy needs to be properly monitored by medical imaging, and temperature in the target has to be precisely measured, this article is based on the current domestic and foreign detection methods of the focal region temperature.
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Ablação por Ultrassom Focalizado de Alta Intensidade , Neoplasias/terapia , Temperatura , Diagnóstico por Imagem , Humanos , Terapia por UltrassomRESUMO
OBJECTIVE: To establish the solid three-dimensional fluorescence fingerprint spectra for the main root and branch root of Panax notoginseng. METHODS: With the Xuesaitong power as a control, the solid three-dimensional fluorescence technique was employed to establish the fingerprint spectra. RESULTS: The fluorescence peaks of Xuesaitong power were at 230 nm/330 nm,280 nm/660 nm,300 nm/340 nm, 370 nm/590 nm, 440 nm/550 nm, and 490 nm/610 nm. Among of them, the 300 nm/340 nm peak was the strongest. The fluorescence peaks of Panax notoginseng main root power were at 230 nm/340 nm,290 nm/340 nm,370 nm/480 nm,and 430 nm/540 nm. Among of them, the peak at 290 nm/340 nm was the strongest. The branch root of Panax notoginseng was at 280 nm/450 nm,290 nm/350 nm and 350 nm/440 nm,and the peak at 350 nm/440 nm was the strongest. All of them had the peak at 290-300 nm/340-350 nm, this peak was the strongest in Xuesaitong and Panax notoginseng main root power, but 350 nm/440 nm was the strongest in the branch root of Panax notoginseng. Only the peak at 230 nm/330-340 nm was not detected in the branch root of Panax notoginseng. CONCLUSION: The solid three-dimensional fluorescence fingerprints spectra are established. Using peaks at 290-300 nm/340-350 nm and 230 nm/330-340 nm as characteristics of the fluorescence peak can efficiently identify main root and branch root of Panax notoginseng.
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Panax notoginseng/química , Fluorescência , Imageamento Tridimensional , Raízes de Plantas , Controle de QualidadeRESUMO
Objective.Myocardial infarction (MI) is one of the most threatening cardiovascular diseases. This paper aims to explore a method for using an algorithm to autonomously classify MI based on the electrocardiogram (ECG).Approach.A detection method of MI that fuses continuous T-wave area (C_TWA) feature and ECG deep features is proposed. This method consists of three main parts: (1) The onset of MI is often accompanied by changes in the shape of the T-wave in the ECG, thus the area of the T-wave displayed on different heartbeats will be quite different. The adaptive sliding window method is used to detect the start and end of the T-wave, and calculate the C_TWA on the same ECG record. Additionally, the coefficient of variation of C_TWA is defined as the C_TWA feature of the ECG. (2) The multi lead fusion convolutional neural network was implemented to extract the deep features of the ECG. (3) The C_TWA feature and deep features of the ECG were fused by soft attention, and then inputted into the multi-layer perceptron to obtain the detection result.Main results.According to the inter-patient paradigm, the proposed method reached a 97.67% accuracy, 96.59% precision, and 98.96% recall on the PTB dataset, as well as reached 93.15% accuracy, 93.20% precision, and 95.14% recall on the clinical dataset.Significance.This method accurately extracts the feature of the C_TWA, and combines the deep features of the signal, thereby improving the detection accuracy and achieving favorable results on clinical datasets.
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Eletrocardiografia , Infarto do Miocárdio , Processamento de Sinais Assistido por Computador , Eletrocardiografia/métodos , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , Redes Neurais de Computação , AlgoritmosRESUMO
Two new bicyclic sesquiterpenes,Δ9-2, 5, 11-trihydroxyl-ß-cis-bergamotene (3) and Nigrohydroin A (4), together with ten known compounds (1, 2 and 5-12) were obtained from endophytic fungus Nigrospora sp. E121. The structures were elucidated on the basis of their 1D and 2D NMR spectra and mass spectrometric data. The possible biosynthetic pathway of compounds 1, 2, 3 and 4 in Nigrospora sp. E121were reported according to literature. The phytotoxic assay results indicated that the acetyl fragment in α-acetylorcinol may contribute to the phytotoxic activity of this compound.
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OBJECTIVE: In recent years, the early diagnosis and treatment of coronary microvascular dysfunction (CMD) have become crucial for preventing coronary heart disease. This paper aims to develop a computer-assisted autonomous diagnosis method for CMD by using ECG features and expert features. APPROACH: Clinical electrocardiogram (ECG), myocardial contrast echocardiography (MCE), and coronary angiography (CAG) are used in our method. Firstly, morphological features, temporal features, and T-wave features of ECG are extracted by multi-channel residual network with BiLSTM (MCResnet-BiLSTM) model and the multi-source T-wave features (MTF) extraction model, respectively. And these features are fused to form ECG features. In addition, the CFR[Formula: see text] is calculated based on the parameters related to the MCE at rest and stress state, and the Angio-IMR is calculated based on CAG. The combination of CFR[Formula: see text] and Angio-IMR is termed as expert features. Furthermore, the hybrid features, fused from the ECG features and the expert features, are input into the multilayer perceptron to implement the identification of CMD. And the weighted sum of the soft maximum loss and center loss is used as the total loss function for training the classification model, which optimizes the classification ability of the model. RESULT: The proposed method achieved 93.36% accuracy, 94.46% specificity, 92.10% sensitivity, 95.89% precision, and 93.95% F1 score on the clinical dataset of the Second Affiliated Hospital of Zhejiang University. CONCLUSION: The proposed method accurately extracts global ECG features, combines them with expert features to obtain hybrid features, and uses weighted loss to significantly improve diagnostic accuracy. It provides a novel and practical method for the clinical diagnosis of CMD.
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Coronary artery centerline extraction in cardiac computed tomography angiography (CTA) is an effectively non-invasive method to diagnose and evaluate coronary artery disease (CAD). The traditional method of manual centerline extraction is time-consuming and tedious. In this study, we propose a deep learning algorithm that continuously extracts coronary artery centerlines from CTA images using a regression method. In the proposed method, a CNN module is trained to extract the features of CTA images, and then the branch classifier and direction predictor are designed to predict the most possible direction and lumen radius at the given centerline point. Besides, a new loss function is developed for associating the direction vector with the lumen radius. The whole process starts from a point manually placed at the coronary artery ostia, and terminates until tracking the vessel endpoint. The network was trained using a training set consisting of 12 CTA images and the evaluation was performed using a testing set consisting of 6 CTA images. The extracted centerlines had an average overlap (OV) of 89.19%, overlap until first error (OF) of 82.30%, and overlap with clinically relevant vessel (OT) of 91.42% with manually annotated reference. Our proposed method can efficiently deal with multi-branch problems and accurately detect distal coronary arteries, thereby providing potential help in assisting CAD diagnosis.
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Doença da Artéria Coronariana , Interpretação de Imagem Radiográfica Assistida por Computador , Humanos , Angiografia Coronária/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Doença da Artéria Coronariana/diagnóstico por imagem , AlgoritmosRESUMO
Arrhythmia is one of the common cardiovascular diseases. Nowadays, many methods identify arrhythmias from electrocardiograms (ECGs) by computer-aided systems. However, computer-aided systems could not identify arrhythmias effectively due to various the morphological change of abnormal ECG data. This paper proposes a deep method to classify ECG samples. Firstly, ECG features are extracted through continuous wavelet transform. Then, our method realizes the arrhythmia classification based on the new lightweight context transform blocks. The block is proposed by improving the linear content transform block by squeeze-and-excitation network and linear transformation. Finally, the proposed method is validated on the MIT-BIH arrhythmia database. The experimental results show that the proposed method can achieve a high accuracy on arrhythmia classification.
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Arritmias Cardíacas , Análise de Ondaletas , Humanos , Arritmias Cardíacas/diagnóstico , Eletrocardiografia/métodos , Bases de Dados Factuais , AlgoritmosRESUMO
Myocardial contrast echocardiography (MCE) has been proposed as a method to assess myocardial perfusion for the detection of coronary artery diseases in a non-invasive way. As a critical step of automatic MCE perfusion quantification, myocardium segmentation from the MCE frames faces many challenges due to the low image quality and complex myocardial structure. In this paper, a deep learning semantic segmentation method is proposed based on a modified DeepLabV3+ structure with an atrous convolution and atrous spatial pyramid pooling module. The model was trained separately on three chamber views (apical two-chamber view, apical three-chamber view, and apical four-chamber view) on 100 patients' MCE sequences, divided by a proportion of 7:3 into training and testing datasets. The results evaluated by using the dice coefficient (0.84, 0.84, and 0.86 for three chamber views respectively) and Intersection over Union(0.74, 0.72 and 0.75 for three chamber views respectively) demonstrated the better performance of the proposed method compared to other state-of-the-art methods, including the original DeepLabV3+, PSPnet, and U-net. In addition, we conducted a trade-off comparison between model performance and complexity in different depths of the backbone convolution network, which illustrated model application feasibility.
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Aprendizado Profundo , Humanos , Semântica , Processamento de Imagem Assistida por Computador/métodos , Ecocardiografia/métodos , MiocárdioRESUMO
Coronary microvascular dysfunction (CMD) is one of the basic mechanisms of myocardial ischemia. Myocardial contrast echocardiography (MCE) is a bedside technique that utilises microbubbles which remain entirely within the intravascular space and denotes the status of microvascular perfusion within that region. Some pilot studies suggested that MCE may be used to diagnose CMD, but without further validation. This study is aimed to investigate the diagnostic performance of MCE for the evaluation of CMD. MCE was performed at rest and during adenosine triphosphate stress. ECG triggered real-time frames were acquired in the apical 4-chamber, 3-chamber, 2-chamber, and long-axis imaging planes. These images were imported into Narnar for further processing. Eighty-two participants with suspicion of coronary disease and absence of significant epicardial lesions were prospectively investigated. Thermodilution was used as the gold standard to diagnose CMD. CMD was present in 23 (28%) patients. Myocardial blood flow reserve (MBF) was assessed using MCE. CMD was defined as MBF reserve < 2. The MCE method had a high sensitivity (88.1%) and specificity (95.7%) in the diagnosis of CMD. There was strong agreement with thermodilution (Kappa coefficient was 0.727; 95% CI: 0.57-0.88, p < 0.001). However, the correlation coefficient (r = 0.376; p < 0.001) was not high.
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Doença da Artéria Coronariana , Isquemia Miocárdica , Humanos , Ecocardiografia sob Estresse , Miocárdio , Ecocardiografia , Doença da Artéria Coronariana/diagnóstico por imagem , Diagnóstico PrecoceRESUMO
PURPOSE: Coronary microvascular dysfunction (CMD) is emerging as an important cause of myocardial ischemia, but there is a lack of a non-invasive method for reliable early detection of CMD. AIM: To develop an electrocardiogram (ECG)-based machine learning algorithm for CMD detection that will lay the groundwork for patient-specific non-invasive early detection of CMD. METHODS: Vectorcardiography (VCG) was calculated from each 10-second ECG of CMD patients and healthy controls. Sample entropy (SampEn), approximate entropy (ApEn), and complexity index (CI) derived from multiscale entropy were extracted from ST-T segments of each lead in ECGs and VCGs. The most effective entropy subset was determined using the sequential backward selection algorithm under the intra-patient and inter-patient schemes, separately. Then, the corresponding optimal model was selected from eight machine learning models for each entropy feature based on five-fold cross-validations. Finally, the classification performance of SampEn-based, ApEn-based, and CI-based models was comprehensively evaluated and tested on a testing dataset to investigate the best one under each scheme. RESULTS: ApEn-based SVM model was validated as the optimal one under the intra-patient scheme, with all testing evaluation metrics over 0.8. Similarly, ApEn-based SVM model was selected as the best one under the intra-patient scheme, with major evaluation metrics over 0.8. CONCLUSIONS: Entropies derived from ECGs and VCGs can effectively detect CMD under both intra-patient and inter-patient schemes. Our proposed models may provide the possibility of an ECG-based tool for non-invasive detection of CMD.
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Doença da Artéria Coronariana , Isquemia Miocárdica , Humanos , Entropia , Eletrocardiografia/métodos , Algoritmos , Isquemia Miocárdica/diagnósticoRESUMO
Objective.With the improvement of living standards, heart disease has become one of the common diseases that threaten human health. Electrocardiography (ECG) is an effective way of diagnosing cardiovascular diseases. With the rapid growth of ECG examinations and the shortage of cardiologists, accurate and automatic arrhythmias classification has become a research hotspot. The main purpose of this paper is to improve accuracy in detecting abnormal ECG patterns.Approach.A hybrid 1D Resnet-GRU method, consisting of the Resnet and gated recurrent unit (GRU) modules, is proposed to implement classification of arrhythmias from 12-lead ECG recordings. In addition, the focal Loss function is used to solve the problem of unbalanced datasets. Based on the proposed 1D Resnet-GRU model, we use class-discriminative visualization to improve interpretability and transparency as an additional step. In this paper, the Grad-CAM++ mechanism has been employed to the trained network model and generate thermal images superimposed on raw signals to explore underlying explanations of various ECG segments.Main results.The experimental results show that the proposed method can achieve a high score of 0.821 (F1-score) in classifying 9 kinds of arrythmias, and Grad-CAM++ not only provides insight into the predictive power of the model, but is also consistent with the diagnostic approach of the arrhythmia classification.Significance.The proposed method can effectively select and integrate ECG features to achieve the goal of end-to-end arrhythmia classification by using 12-lead ECG signals, which can serve a promising and useful way for automatic arrhythmia classification, and can provide an explainable deep leaning model for clinical diagnosis.
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Aprendizado Profundo , Processamento de Sinais Assistido por Computador , Algoritmos , Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Humanos , Redes Neurais de ComputaçãoRESUMO
Automatic and accurate classification of Alzheimer's disease is a challenging and promising task. Fully Convolutional Network (FCN) can classify images at the pixel level. Adding an attention mechanism to the Fully Convolutional Network can effectively improve the classification performance of the model. However, the self-attention mechanism ignores the potential correlation between different samples. Aiming at this problem, we propose a new method for image classification of Alzheimer's disease based on the external-attention mechanism. The external-attention module is added after the fourth convolutional block of the fully convolutional network model. At the same time, the double normalization method of Softmax and L1 norm is introduced to obtain a better classification performance and richer feature information of the disease probability map. The activation function Softmax can increase the degree of fitting of the neural network to the training set, which transforms linearity into nonlinearity, thereby increasing the flexibility of the neural network. The L1 norm can avoid the attention map being affected by especially large (especially small) eigenvalues. The experiments in this paper use 550 three-dimensional MRI images and use five-fold cross-validation. The experimental results show that the proposed image classification method for Alzheimer's disease, combining the external-attention mechanism with double normalization, can effectively improve the classification performance of the model. With this method, the accuracy of the MLP-A model is 92.36%, the accuracy of the MLP-B model is 98.55%, and the accuracy of the fusion model MLP-C is 98.73%. The classification performance of the model is higher than similar models without adding any attention mechanism, and it is better than other comparison methods.
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BACKGROUND: Invasively measured fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) are gold standards for the diagnosis of coronary artery disease (CAD) and coronary microcirculatory dysfunction (CMD). However, the interaction between CAD and CMD has not been comprehensively investigated. We aim to non-invasively investigate hemodynamic effect of CMD in nonobstructive CAD cases using computational fluid dynamics (CFD) simulation. METHOD: This study employed CFD simulations on six cases with nonobstructive CAD and CMD in left anterior descending artery (LAD) territories. Two microcirculatory situations were simulated: normal microcirculatory resistance (MR) situation; CMD situation where MR at the outlets of LAD branches were multiplied by the ratio of clinically measured IMR to the cutoff value. Blood flow, translesional pressure drop (Δptl), and simulated FFR (FFRCT) of LAD and non-culprit branches were compared between the two microcirculatory situations using Wilcoxon signed rank test. RESULTS: The results are in accordance with existing studies and clinical measurements. Compared with normal MR, there were significant decreases in outlet flow velocity and increases in FFRCT (p < 0.01 for both in Wilcoxon signed rank tests) in LAD branches with CMD, with minor decreases (0.63-5.64 mmHg) in Δptl. There was no significant influence on outlet flow velocity (< 2%) and FFRCT (< 0.02) in non-culprit branches (p > 0.05 for both). CONCLUSION: IMR-based CFD simulation could estimate hemodynamic effects of CMD. CMD in a coronary artery branch can decrease its blood flow and Δptl, increase its FFR, with little effect on non-culprit branches.
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Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Hemodinâmica , Humanos , Hidrodinâmica , Microcirculação/fisiologia , Projetos Piloto , Valor Preditivo dos TestesRESUMO
Background: Myocardial ischemia is a common early symptom of cardiovascular disease (CVD). Reliable detection of myocardial ischemia using computer-aided analysis of electrocardiograms (ECG) provides an important reference for early diagnosis of CVD. The vectorcardiogram (VCG) could improve the performance of ECG-based myocardial ischemia detection by affording temporal-spatial characteristics related to myocardial ischemia and capturing subtle changes in ST-T segment in continuous cardiac cycles. We aim to investigate if the combination of ECG and VCG could improve the performance of machine learning algorithms in automatic myocardial ischemia detection. Methods: The ST-T segments of 20-second, 12-lead ECGs, and VCGs were extracted from 377 patients with myocardial ischemia and 52 healthy controls. Then, sample entropy (SampEn, of 12 ECG leads and of three VCG leads), spatial heterogeneity index (SHI, of VCG) and temporal heterogeneity index (THI, of VCG) are calculated. Using a grid search, four SampEn and two features are selected as input signal features for ECG-only and VCG-only models based on support vector machine (SVM), respectively. Similarly, three features (S I , THI, and SHI, where S I is the SampEn of lead I) are further selected for the ECG + VCG model. 5-fold cross validation was used to assess the performance of ECG-only, VCG-only, and ECG + VCG models. To fully evaluate the algorithmic generalization ability, the model with the best performance was selected and tested on a third independent dataset of 148 patients with myocardial ischemia and 52 healthy controls. Results: The ECG + VCG model with three features (S I ,THI, and SHI) yields better classifying results than ECG-only and VCG-only models with the average accuracy of 0.903, sensitivity of 0.903, specificity of 0.905, F1 score of 0.942, and AUC of 0.904, which shows better performance with fewer features compared with existing works. On the third independent dataset, the testing showed an AUC of 0.814. Conclusion: The SVM algorithm based on the ECG + VCG model could reliably detect myocardial ischemia, providing a potential tool to assist cardiologists in the early diagnosis of CVD in routine screening during primary care services.
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In recent years, coronary heart disease (CHD) has become one of the main diseases that endanger human health, with a high mortality and disability rate. Myocardial ischemia (MI) is the main symptom in the development of CHD. Continuous and severe myocardial ischemia will lead to myocardial infarction. The clinical manifestations of MI are mainly the changes of ST-T segment of ECG, that is, ST segment and T wave. Nearly one third of patients with CHD, however, has no obvious ECG changes. In this paper, a new method for detecting MI based on the T-wave area curve (TWAC) was proposed. Through observation and analysis of clinical data, it was found that there exist significant correlation between the morphology of TWAC and MI. The TWAC morphology of normal subject is smooth and gentle, while the TWAC morphology of patients with coronary stenosis is mostly jagged, and the curve becomes more severe with more severe stenosis. The preliminary test results show that the sensitivity, specificity, and accuracy of the proposed method for detecting MI are 84.3, 83.6, and 84%, respectively. This study shows that the TWAC based approach may be an effective method for detecting MI, especially for the CHD patients with no obvious ECG changes.