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Systematic variability in ICG recordings results in ICG complex subtypes – steps towards the enhancement of ICG characterization Cover

Systematic variability in ICG recordings results in ICG complex subtypes – steps towards the enhancement of ICG characterization

Open Access
|Dec 2018

Figures & Tables

Fig. 1

Typical model of dZ/dt waveform recorded simultaneously with an ECG signal. Each signal is marked by characteristic points.

Fig. 2

Electrode positions. a) Electrode positions for measurements obtained with Respimon. b) Electrode positions for measurements obtained with the Z-RPI device.

Fig. 3

Flowchart of the data processing stages.

Fig. 4

Observed waveform morphology changes (ABEXYOZ types) of the dZ/dt signal.

Fig. 5

Distribution of ABEXYOZ complexes with different morphologies. a) Order of percentages of ABEXYOZ complexes, from the most to the least abundant. b) Percentage of ABEXYOZ complexes.

Fig. 6

Five consecutive ABEXYOZ complexes with different morphologies.

Fig. 7

Total percentage of missing points in both groups.

Characteristic points of the dZ/dt signal_

The pointsDescription
AAtrial contraction
BAortic valve opening, which is often calculated as a 15% response from the baseline [14]. The B point may also be calculated from an equation that relates the R peak of the electrocardiography (ECG) signal and the E peak of the dZ/dt signal; RB = 1.233RE -0.0032RE2 - 31.59 [11].
E (or C)Maximum amplitude of dZ/dt from the baseline (dZ/dtmax). It represents the maximum aortic flow.
XAortic valve closing, which is calculated as the first turning point valley after the E point (d1) or the lowest minimum after the E point (d2) [22]. In the time domain, aortic valve closing occurs at the end of the T wave of the ECG signal.
YPulmonic valve closing. It is the minimum notched between the X and O points [6].
OMitral valve opening, the maximum positive point after the E wave [6].
ZMitral regurgitation, which is the minimum notch after the O point [6].

Percentage of missing points of each characteristic point in each volunteer for both groups

Group 1Group 2
V 1V 2V 3V 4V 5V 1V 2V 3V 4V 5
A, B, E (%)21.307.635.706.349.500.014.107.700.000.0
X (%)23.579.397.39796.613.664.281.746.672.0
Y, O, Z (%)25.668.0100.098.5100.097.346.280.098.797

Hemodynamic parameters calculated using ICG characteristic points_

ParametersDescriptionCalculation
PEPPre-ejection periodThe Q-B segment is required.
ET (or LVET)Ventricular ejection timeThe X-B segment is required.
IVRTIsovolumic relaxation timeThe X-O segment is required.
FTVentricular filling timeThe Y-Z segment is required.
SVStroke volume; the volume of blood ejected from the leftBoth the E point and X-B are required [8].
ventricular in one cycleSV=VCEZ0ET$SV={{V}_{C}}\sqrt{\frac{E}{{{Z}_{0}}}}\,\text{ET}$
COAmount of blood pumped during 1 min [8]CO = SV × HR (2)
Heather indexCardiac contractility index is the ratio between theNoted E point and the Q-E time interval.
maximum amplitude of the dZ/dt signal.HeatherIndex=EQE$\text{Heather}\,\,\text{Index}=\frac{E}{\left( \text{Q}-E \right)}$

Percentage of ABEXYOZ complexes contained in each recording per volunteer with the average heart-rate (mean ± SD) for group 2

Waveform Group type 2012345uHR
V 1-86.402.702.708.1--52 ± 4
V 229.406.423.010.215.301.214.175 ± 5
V 307.610.712.335.326.1-07.666 ± 7
V 4-53.401.328.716.4--69 ± 4
V 502.225.8-10.161.8--87 ± 4

Characteristic pattern of ABEXYOZ waveforms

ABEXYOZ sDescription of ABEXYOZ complex
ABEXYOZ 0Typical ABEXYOZ complex of the dZ/dt waveform containing all characteristic ICG points
ABEXYOZ 1ABEXYOZ complex of the dZ/dt waveform with X but without YOZ are unidentified in one slope
ABEXYOZ 2ABEXYOZ complex of the dZ/dt waveform with typical characteristic points, except the X point, which is a not a clear X (noted X2)
ABEXYOZ 3ABEXYOZ complex of the dZ/dt waveform with an unpronounced X point (X2) and no well-defined YOZ points
ABEXYOZ 4ABEXYOZ complex of the dZ/dt waveform without well-defined XYOZ points that are almost time contained in one slope after the E wave
ABEXYOZ 5The ABEXYOZ complex of the dZ/dt waveform that have all of the typical characteristic points, except the X point, which may be a true X or X2, and the dZ/dt waveform has a skirt shape.
ABEXYOZ uThe ABEXYOZ complex of the dZ/dt waveform that is characterized by a high percentage of noise or missing points

Percentage of ABEXYOZ complexes in each recording per volunteer with the average heart-rate (mean ± SD) for group 1

Waveform for group type 1012345uHR
V 172.304.202.1---21.255 ± 5
V 211.309.415.041.509.405.607.560 ± 3
V 3-02.7-08.253.4-35.676 ± 5
V 401.501.5--90.6-06.266 ± 2
V 5-03.4--47.1-49.490 ± 6
Language: English
Page range: 72 - 82
Submitted on: Jul 30, 2018
Published on: Dec 19, 2018
Published by: University of Oslo
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2018 Sara Benouar, Abdelakram Hafid, Mokhtar Attari, Malika Kedir-Talha, Fernando Seoane, published by University of Oslo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.