Comparison of linear-stochastic and nonlinear-deterministic algorithms in the analysis of 15-minute clinical ECGs to predict risk of arrhythmic death.
Comparison of linear-stochastic and nonlinear-deterministic algorithms in the analysis of 15-minute clinical ECGs to predict risk of arrhythmic death.
复制标题
在分析15分钟的临床ECG中，线性缝隙和非线性确定性算法的比较，以预测心律不齐的死亡风险。
DOI：
10.2147/tcrm.s5568
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发表时间：
2009-06
影响因子：
2.8
通讯作者：
Dalsey WC
中科院分区：
文献类型：
--
作者：
Skinner JE;Meyer M;Nester BA;Geary U;Taggart P;Mangione A;Ramalanjaona G;Terregino C;Dalsey WC
低至高风险心脏病患者心跳序列的比较算法评估，用于前瞻性预测心脏病死亡（AD）风险。心率变异反映心脏自主神经功能和AD风险。基于线性随机模型的指数是心肌梗死后（MI后）队列中AD的独立危险因素。基于非线性确定性模型的指数在回顾性数据中具有上级可预测性。患者（N = 397）在出现胸痛时被纳入三个急诊科，并被确定为急性MI的低至高风险（>7%）。记录简要ECG（15分钟），并通过三种非线性算法（PD 2 i、DFA和ApEn）和四种常规线性随机测量（SDNN、MNN、1/f斜率、LF/HF）评估R-R间期。采用改良Hinkle-Thaler标准确定院外AD。1年随访时的全因死亡率为10.3%，其中7.7%被裁定为AD。非线性PD 2 i算法预测AD的灵敏度和相对风险在所有时间点均最高（p ≤0.001）。30天时的敏感性为100%，特异性为58%，相对风险>100（p ≤0.001）; 360天时的敏感性为95%，特异性为58%，相对风险>11.4（p ≤0.001）。通过时间依赖的非线性PD 2 i算法的心跳分析是比较上级的测试。
Comparative algorithmic evaluation of heartbeat series in low-to-high risk cardiac patients for the prospective prediction of risk of arrhythmic death (AD). Heartbeat variation reflects cardiac autonomic function and risk of AD. Indices based on linear stochastic models are independent risk factors for AD in post-myocardial infarction (post-MI) cohorts. Indices based on nonlinear deterministic models have superior predictability in retrospective data. Patients were enrolled (N = 397) in three emergency departments upon presenting with chest pain and were determined to be at low-to-high risk of acute MI (>7%). Brief ECGs were recorded (15 min) and R-R intervals assessed by three nonlinear algorithms (PD2i, DFA, and ApEn) and four conventional linear-stochastic measures (SDNN, MNN, 1/f-Slope, LF/HF). Out-of-hospital AD was determined by modified Hinkle–Thaler criteria. All-cause mortality at one-year follow-up was 10.3%, with 7.7% adjudicated to be AD. The sensitivity and relative risk for predicting AD was highest at all time-points for the nonlinear PD2i algorithm (p ≤0.001). The sensitivity at 30 days was 100%, specificity 58%, and relative risk >100 (p ≤0.001); sensitivity at 360 days was 95%, specificity 58%, and relative risk >11.4 (p ≤0.001). Heartbeat analysis by the time-dependent nonlinear PD2i algorithm is comparatively the superior test.