Electrocardiogram to Determine Mitral and Aortic Valve Opening and Closure.
Electrocardiogram to Determine Mitral and Aortic Valve Opening and Closure.
复制标题
心电图确定二尖瓣和主动脉瓣的打开和关闭。
DOI：
10.1007/s13239-023-00664-4
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发表时间：
2023
影响因子：
1.8
通讯作者：
Lloyd,StevenG
中科院分区：
文献类型：
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作者：
Aufan,MRifqi;Jost,ZacharyT;Miller,NealJ;Sharifov,OlegF;Gupta,Himanshu;Perry,GilbertJ;Wells,JMichael;DenneyJr,ThomasS;Lloyd,StevenG
目的了解心脏瓣膜开闭的时间是心脏生理学的重要内容。瓣膜运动和心电图（ECG）之间的关系通常是假设的，但没有明确定义。在这里，我们调查的准确性，心脏瓣膜定时估计仅使用心电图，相比多普勒超声心动图（DE）血流成像作为金standard.MethodsDE获得37例同时心电图记录。对ECG进行数字化处理，并将可识别的特征（QRS、T、P波）作为潜在参考点进行检查，以确定与DE流出和流入测量相比主动脉瓣和二尖瓣的打开和关闭。从推导集（n = 19）测量ECG特征和DE之间心脏瓣膜打开和关闭的时间偏移。然后在验证集（n = 18）上评价所获得的平均偏移与ECG特征模型的组合。使用相同的方法，额外的测量也做了右侧valves.ResultsFrom的衍生集，我们发现了一个固定的偏移22 ± 9 ms，2 ± 13 ms，90 ± 26 ms，和− 2 ± − 27 ms时，比较S主动脉瓣开放，主动脉瓣关闭，二尖瓣打开，和R二尖瓣关闭分别。将该模型应用于验证集显示了对主动脉瓣和二尖瓣打开和关闭时间值的良好估计，模型绝对误差较低（与金标准DE测量值相比，四个事件的平均绝对误差中位数= 19 ms）。对于右侧（三尖瓣和肺动脉瓣）在我们的患者设置，有相当高的中位数的平均绝对误差为42 ms的model.ConclusionECG功能可以用来估计主动脉瓣和二尖瓣定时具有良好的准确性相比，DE，允许有用的血流动力学信息，从这个容易获得的测试。
PurposeKnowledge of the timing of cardiac valve opening and closing is important in cardiac physiology. The relationship between valve motion and electrocardiogram (ECG) is often assumed, however is not clearly defined. Here we investigate the accuracy of cardiac valve timing estimated using only the ECG, compared to Doppler echocardiography (DE) flow imaging as the gold standard.MethodsDE was obtained in 37 patients with simultaneous ECG recording. ECG was digitally processed and identifiable features (QRS, T, P waves) were examined as potential reference points to determine opening and closure of aortic and mitral valves, as compared to DE outflow and inflow measurement. Timing offset of the cardiac valves opening and closure between ECG features and DE was measured from derivation set (n = 19). The obtained mean offset in combination with the ECG features model was then evaluated on a validation set (n = 18). Using the same approach, additional measurement was also done for the right sided valves.ResultsFrom the derivation set, we found a fixed offset of 22 ± 9 ms, 2 ± 13 ms, 90 ± 26 ms, and − 2 ± − 27 ms when comparing S to aortic valve opening, Tendto aortic valve closure, Tendto mitral valve opening, and R to mitral valve closure respectively. Application of this model to the validation set showed good estimation of aortic and mitral valve opening and closure timing value, with low model absolute error (median of the mean absolute error of the four events = 19 ms compared to the gold standard DE measurement). For the right-sided (tricuspid and pulmonic) valves in our patient set, there was considerably higher median of the mean absolute error of 42 ms for the model.ConclusionECG features can be used to estimate aortic and mitral valve timings with good accuracy as compared to DE, allowing useful hemodynamic information to be derived from this easily available test.