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Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics

We investigated the ability of time-warping-based ECG-derived markers of T-wave morphology changes in time ([Formula: see text] ) and amplitude ([Formula: see text] ), as well as their non-linear components ([Formula: see text] and [Formula: see text] ), and the heart rate corrected counterpart ([Fo...

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Autores principales: Palmieri, Flavio, Gomis, Pedro, Ferreira, Dina, Ruiz, José Esteban, Bergasa, Beatriz, Martín-Yebra, Alba, Bukhari, Hassaan A., Pueyo, Esther, Martínez, Juan Pablo, Ramírez, Julia, Laguna, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887245/
https://www.ncbi.nlm.nih.gov/pubmed/33594135
http://dx.doi.org/10.1038/s41598-021-82935-5
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author Palmieri, Flavio
Gomis, Pedro
Ferreira, Dina
Ruiz, José Esteban
Bergasa, Beatriz
Martín-Yebra, Alba
Bukhari, Hassaan A.
Pueyo, Esther
Martínez, Juan Pablo
Ramírez, Julia
Laguna, Pablo
author_facet Palmieri, Flavio
Gomis, Pedro
Ferreira, Dina
Ruiz, José Esteban
Bergasa, Beatriz
Martín-Yebra, Alba
Bukhari, Hassaan A.
Pueyo, Esther
Martínez, Juan Pablo
Ramírez, Julia
Laguna, Pablo
author_sort Palmieri, Flavio
collection PubMed
description We investigated the ability of time-warping-based ECG-derived markers of T-wave morphology changes in time ([Formula: see text] ) and amplitude ([Formula: see text] ), as well as their non-linear components ([Formula: see text] and [Formula: see text] ), and the heart rate corrected counterpart ([Formula: see text] ), to monitor potassium concentration ([Formula: see text] ) changes ([Formula: see text] ) in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We compared the performance of the proposed time-warping markers, together with other previously proposed [Formula: see text] markers, such as T-wave width ([Formula: see text] ) and T-wave slope-to-amplitude ratio ([Formula: see text] ), when computed from standard ECG leads as well as from principal component analysis (PCA)-based leads. 48-hour ECG recordings and a set of hourly-collected blood samples from 29 ESRD-HD patients were acquired. Values of [Formula: see text] , [Formula: see text] , [Formula: see text] , [Formula: see text] and [Formula: see text] were calculated by comparing the morphology of the mean warped T-waves (MWTWs) derived at each hour along the HD with that from a reference MWTW, measured at the end of the HD. From the same MWTWs [Formula: see text] and [Formula: see text] were also extracted. Similarly, [Formula: see text] was calculated as the difference between the [Formula: see text] values at each hour and the [Formula: see text] reference level at the end of the HD session. We found that [Formula: see text] and [Formula: see text] showed higher correlation coefficients with [Formula: see text] than [Formula: see text] —Spearman’s ([Formula: see text] ) and Pearson’s (r)—and [Formula: see text] —Spearman’s ([Formula: see text] )—in both SL and PCA approaches being the intra-patient median [Formula: see text] and [Formula: see text] in SL and [Formula: see text] and [Formula: see text] in PCA respectively. Our findings would point at [Formula: see text] and [Formula: see text] as the most suitable surrogate of [Formula: see text] , suggesting that they could be potentially useful for non-invasive monitoring of ESRD-HD patients in hospital, as well as in ambulatory settings. Therefore, the tracking of T-wave morphology variations by means of time-warping analysis could improve continuous and remote [Formula: see text] monitoring of ESRD-HD patients and flagging risk of [Formula: see text] -related cardiovascular events.
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spelling pubmed-78872452021-02-18 Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics Palmieri, Flavio Gomis, Pedro Ferreira, Dina Ruiz, José Esteban Bergasa, Beatriz Martín-Yebra, Alba Bukhari, Hassaan A. Pueyo, Esther Martínez, Juan Pablo Ramírez, Julia Laguna, Pablo Sci Rep Article We investigated the ability of time-warping-based ECG-derived markers of T-wave morphology changes in time ([Formula: see text] ) and amplitude ([Formula: see text] ), as well as their non-linear components ([Formula: see text] and [Formula: see text] ), and the heart rate corrected counterpart ([Formula: see text] ), to monitor potassium concentration ([Formula: see text] ) changes ([Formula: see text] ) in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We compared the performance of the proposed time-warping markers, together with other previously proposed [Formula: see text] markers, such as T-wave width ([Formula: see text] ) and T-wave slope-to-amplitude ratio ([Formula: see text] ), when computed from standard ECG leads as well as from principal component analysis (PCA)-based leads. 48-hour ECG recordings and a set of hourly-collected blood samples from 29 ESRD-HD patients were acquired. Values of [Formula: see text] , [Formula: see text] , [Formula: see text] , [Formula: see text] and [Formula: see text] were calculated by comparing the morphology of the mean warped T-waves (MWTWs) derived at each hour along the HD with that from a reference MWTW, measured at the end of the HD. From the same MWTWs [Formula: see text] and [Formula: see text] were also extracted. Similarly, [Formula: see text] was calculated as the difference between the [Formula: see text] values at each hour and the [Formula: see text] reference level at the end of the HD session. We found that [Formula: see text] and [Formula: see text] showed higher correlation coefficients with [Formula: see text] than [Formula: see text] —Spearman’s ([Formula: see text] ) and Pearson’s (r)—and [Formula: see text] —Spearman’s ([Formula: see text] )—in both SL and PCA approaches being the intra-patient median [Formula: see text] and [Formula: see text] in SL and [Formula: see text] and [Formula: see text] in PCA respectively. Our findings would point at [Formula: see text] and [Formula: see text] as the most suitable surrogate of [Formula: see text] , suggesting that they could be potentially useful for non-invasive monitoring of ESRD-HD patients in hospital, as well as in ambulatory settings. Therefore, the tracking of T-wave morphology variations by means of time-warping analysis could improve continuous and remote [Formula: see text] monitoring of ESRD-HD patients and flagging risk of [Formula: see text] -related cardiovascular events. Nature Publishing Group UK 2021-02-16 /pmc/articles/PMC7887245/ /pubmed/33594135 http://dx.doi.org/10.1038/s41598-021-82935-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Palmieri, Flavio
Gomis, Pedro
Ferreira, Dina
Ruiz, José Esteban
Bergasa, Beatriz
Martín-Yebra, Alba
Bukhari, Hassaan A.
Pueyo, Esther
Martínez, Juan Pablo
Ramírez, Julia
Laguna, Pablo
Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title_full Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title_fullStr Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title_full_unstemmed Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title_short Monitoring blood potassium concentration in hemodialysis patients by quantifying T-wave morphology dynamics
title_sort monitoring blood potassium concentration in hemodialysis patients by quantifying t-wave morphology dynamics
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887245/
https://www.ncbi.nlm.nih.gov/pubmed/33594135
http://dx.doi.org/10.1038/s41598-021-82935-5
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