Electrical and Electronic Engineering - Research Publications
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ItemComplex Correlation Measure: a novel descriptor for Poincare plot(BMC, 2009-08-13)BACKGROUND: Poincaré plot is one of the important techniques used for visually representing the heart rate variability. It is valuable due to its ability to display nonlinear aspects of the data sequence. However, the problem lies in capturing temporal information of the plot quantitatively. The standard descriptors used in quantifying the Poincaré plot (SD1, SD2) measure the gross variability of the time series data. Determination of advanced methods for capturing temporal properties pose a significant challenge. In this paper, we propose a novel descriptor "Complex Correlation Measure (CCM)" to quantify the temporal aspect of the Poincaré plot. In contrast to SD1 and SD2, the CCM incorporates point-to-point variation of the signal. METHODS: First, we have derived expressions for CCM. Then the sensitivity of descriptors has been shown by measuring all descriptors before and after surrogation of the signal. For each case study, lag-1 Poincaré plots were constructed for three groups of subjects (Arrhythmia, Congestive Heart Failure (CHF) and those with Normal Sinus Rhythm (NSR)), and the new measure CCM was computed along with SD1 and SD2. ANOVA analysis distribution was used to define the level of significance of mean and variance of SD1, SD2 and CCM for different groups of subjects. RESULTS: CCM is defined based on the autocorrelation at different lags of the time series, hence giving an in depth measurement of the correlation structure of the Poincaré plot. A surrogate analysis was performed, and the sensitivity of the proposed descriptor was found to be higher as compared to the standard descriptors. Two case studies were conducted for recognizing arrhythmia and congestive heart failure (CHF) subjects from those with NSR, using the Physionet database and demonstrated the usefulness of the proposed descriptors in biomedical applications. CCM was found to be a more significant (p = 6.28E-18) parameter than SD1 and SD2 in discriminating arrhythmia from NSR subjects. In case of assessing CHF subjects also against NSR, CCM was again found to be the most significant (p = 9.07E-14). CONCLUSION: Hence, CCM can be used as an additional Poincaré plot descriptor to detect pathology.
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ItemIdentifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis(BMC, 2009-01-29)BACKGROUND: Cardiac autonomic neuropathy (CAN) in diabetes has been called a "silent killer", because so few patients realize that they suffer from it, and yet its effect can be lethal. Early sub clinical detection of CAN and intervention are of prime importance for risk stratification in preventing sudden death due to silent myocardial infarction. This study presents the usefulness of heart rate variability (HRV) and complexity analyses from short term ECG recordings as a screening tool for CAN. METHODS: A total of 17 sets of ECG recordings during supine rest were acquired from diabetic subjects with CAN (CAN+) and without CAN (CAN-) and analyzed. Poincaré plot indexes as well as traditional time and frequency, and the sample entropy (SampEn) measure were used for analyzing variability (short and long term) and complexity of HRV respectively. RESULTS: Reduced (p > 0.05)_Poincaré plot patterns and lower (p < 0.05) SampEn values were found in CAN+ group, which could be a practical diagnostic and prognostic marker. Classification Trees methodology generated a simple decision tree for CAN+ prediction including SampEn and Poincaré plot indexes with a sensitivity reaching 100% and a specificity of 75% (percentage of agreement 88.24%). CONCLUSION: Our results demonstrate the potential utility of SampEn (a complexity based estimator) of HRV in identifying asymptomatic CAN.
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ItemA comparative study on approximate entropy measure and poincare plot indexes of minimum foot clearance variability in the elderly during walking(BMC, 2008-02-02)BACKGROUND: Trip-related falls which is a major problem in the elderly population, might be linked to declines in the balance control function due to ageing. Minimum foot clearance (MFC) which provides a more sensitive measure of the motor function of the locomotor system, has been identified as a potential gait parameter associated with trip-related falls in older population. This paper proposes nonlinear indexes (approximate entropy (ApEn) and Poincaré plot indexes) of MFC variability and investigates the relationship of MFC with derived indexes of elderly gait patterns. The main aim is to find MFC variability indexes that well correlate with balance impairments. METHODS: MFC data during treadmill walking for 14 healthy elderly and 10 elderly participants with balance problems and a history of falls (falls risk) were analysed using a PEAK-2D motion analysis system. ApEn and Poincaré plot indexes of all MFC data sets were calculated and compared. RESULTS: Significant relationships of mean MFC with Poincaré plot indexes (SD1, SD2) and ApEn (r = 0.70, p < 0.05; r = 0.86, p < 0.01; r = 0.74, p < 0.05) were found in the falls-risk elderly group. On the other hand, such relationships were absent in the healthy elderly group. In contrast, the ApEn values of MFC data series were significantly (p < 0.05) correlated with Poincaré plot indexes of MFC in the healthy elderly group, whereas correlations were absent in the falls-risk group. The ApEn values in the falls-risk group (mean ApEn = 0.18 +/- 0.03) was significantly (p < 0.05) higher than that in the healthy group (mean ApEn = 0.13 +/- 0.13). The higher ApEn values in the falls-risk group might indicate increased irregularities and randomness in their gait patterns and an indication of loss of gait control mechanism. ApEn values of randomly shuffled MFC data of falls risk subjects did not show any significant relationship with mean MFC. CONCLUSION: Results have implication for quantifying gait dynamics in normal and pathological conditions, thus could be useful for the early diagnosis of at-risk gait. Further research should provide important information on whether falls prevention intervention can improve the gait performance of falls risk elderly by monitoring the change in MFC variability indexes.
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ItemInvestigating scale invariant dynamics in minimum toe clearance variability of the young and elderly during treadmill walking(IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC, 2008-08)Current research applying variability measures of gait parameters has demonstrated promise for helping to solve one of the "holy grails" of geriatric research by defining markers that can be used to prospectively identify persons at risk of falling . The minimum toe clearance (MTC) event occurs during the leg swing phase of the gait cycle and is a task highly sensitive to the spatial and balance control properties of the locomotor system. The aim of this study is to build upon the current state of research by investigating the magnitude and dynamic structure from the MTC time series fluctuations due to aging and locomotor disorder. Thirty healthy young (HY), 27 healthy elderly (HE), and 10 falls risk (FR) elderly individuals (who presented a prior history of trip-related falls) participated in treadmill walking for at least 10 min at their preferred speed. Continuous MTC data were collected and the first 512 data points were analyzed. The following variability indices were quantified: 1) MTC mean and standard deviation (SD), 2) PoincarE plot indices of MTC variability (SD1, SD2, SD1/SD2), 3) a wavelet based multiscale exponent beta to describe the dynamic structure of MTC fluctuations, and 4) detrended fluctuation analysis exponent alpha to investigate the presence of long-range correlations in MTC time series data. Results showed that stride-to-stride MTC time series has a nonlinear structure in all three groups when compared against randomly shuffled surrogate MTC data. Test on aging effects showed the MTC central tendency was significantly lower (p < 0.01) and the magnitude of the MTC variability significantly higher (p < 0.01). This trend changed when comparing FR subjects against age-matched HE as both the central tendency (p < 0.01) and magnitude of the variability (p < 0.01) increased significantly in FR. Although the magnitude of MTC variability increased with age, the nonlinear indices represented by alpha, beta, and SD1/SD2 demonstrated that the nonlinear structure of MTC does not change significantly due to aging (p > 0.05). There were, however, significant differences between HY and FR for beta (between scale 1 and 2; p < 0.01) and alpha (p < 0.05). Out of all the variability measures applied, beta(Wv2-4), SD1/SD2, SD2 of critical MTC parameter were found to be potential markers to be able to reliably identify FR from HE subjects. Further research is required to understand the mechanisms underlying the cause of MTC variability.
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ItemAutomated Scoring of Obstructive Sleep Apnea and Hypopnea Events Using Short-Term Electrocardiogram Recordings(IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC, 2009-11)Obstructive sleep apnea or hypopnea causes a pause or reduction in airflow with continuous breathing effort. The aim of this study is to identify individual apnea and hypopnea events from normal breathing events using wavelet-based features of 5-s ECG signals (sampling rate = 250 Hz) and estimate the surrogate apnea index (AI)/hypopnea index (HI) (AHI). Total 82,535 ECG epochs (each of 5-s duration) from normal breathing during sleep, 1638 ECG epochs from 689 hypopnea events, and 3151 ECG epochs from 1862 apnea events were collected from 17 patients in the training set. Two-staged feedforward neural network model was trained using features from ECG signals with leave-one-patient-out cross-validation technique. At the first stage of classification, events (apnea and hypopnea) were classified from normal breathing events, and at the second stage, hypopneas were identified from apnea. Independent test was performed on 16 subjects' ECGs containing 483 hypopnea and 1352 apnea events. The cross-validation and independent test accuracies of apnea and hypopnea detection were found to be 94.84% and 76.82%, respectively, for training set, and 94.72% and 79.77%, respectively, for test set. The Bland-Altman plots showed unbiased estimations with standard deviations of +/- 2.19, +/- 2.16, and +/- 3.64 events/h for AI, HI, and AHI, respectively. Results indicate the possibility of recognizing apnea/hypopnea events based on shorter segments of ECG signals.
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ItemSupport Vector Machines for Automated Recognition of Obstructive Sleep Apnea Syndrome From ECG Recordings(IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC, 2009-01)Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity as well as excessive daytime sleepiness and poor quality of life. In this study, we apply a machine learning technique [support vector machines (SVMs)] for automated recognition of OSAS types from their nocturnal ECG recordings. A total of 125 sets of nocturnal ECG recordings acquired from normal subjects (OSAS - ) and subjects with OSAS (OSAS +), each of approximately 8 h in duration, were analyzed. Features extracted from successive wavelet coefficient levels after wavelet decomposition of signals due to heart rate variability (HRV) from RR intervals and ECG-derived respiration (EDR) from R waves of QRS amplitudes were used as inputs to the SVMs to recognize OSAS +/- subjects. Using leave-one-out technique, the maximum accuracy of classification for 83 training sets was found to be 100% for SVMs using a subset of selected combination of HRV and EDR features. Independent test results on 42 subjects showed that it correctly recognized 24 out of 26 OSAS + subjects and 15 out of 16 OSAS - subjects (accuracy = 92.85%; Cohen's kappa value of 0.85). For estimating the relative severity of OSAS, the posterior probabilities of SVM outputs were calculated and compared with respective apnea/hypopnea index. These results suggest superior performance of SVMs in OSAS recognition supported by wavelet-based features of ECG. The results demonstrate considerable potential in applying SVMs in an ECG-based screening device that can aid a sleep specialist in the initial assessment of patients with suspected OSAS.