Papers

Peer-reviewed International journal
Oct, 2018

Mortality Prediction in Severe Congestive Heart Failure Patients with Multifractal Point-Process Modeling of Heartbeat Dynamics.

IEEE transactions on bio-medical engineering
  • Gaetano Valenza
  • ,
  • Herwig Wendt
  • ,
  • Ken Kiyono
  • ,
  • Junichro Hayano
  • ,
  • Eiichi Watanabe
  • ,
  • Yoshiharu Yamamoto
  • ,
  • Patrice Abry
  • ,
  • Riccardo Barbieri

Volume
65
Number
10
First page
2345
Last page
2354
Language
English
Publishing type
DOI
10.1109/TBME.2018.2797158

Multifractal analysis of human heartbeat dynamics has been demonstrated to provide promising markers of Congestive Heart Failure (CHF). Yet, it crucially builds on the interpolation of RR intervals series, which has been generically performed with limited links to CHF pathophysiology. We devise a novel methodology estimating multifractal autonomic dynamics from heartbeat-derived series defined in the continuous time. We hypothesize that markers estimated from our novel framework are also effective for mortality prediction in severe CHF. We merge multifractal analysis within a methodological framework based on inhomogeneous point process models of heartbeat dynamics. Specifically, wavelet coefficients and wavelet leaders are computed over measures extracted from instantaneous statistics of probability density functions characterizing and predicting the time until the next heartbeat event occurs. The proposed approach is tested on data from 94 CHF patients, aiming at predicting survivor and non-survivor individuals as determined after a 4 years follow up. Instantaneous markers of vagal and sympatho-vagal dynamics display power-law scaling for a large range of scales, from s to s. Using standard SVM algorithms, the proposed inhomogeneous point-process representation based multifractal analysis achieved the best CHF mortality prediction accuracy of 79.11 % (sensitivity 90.48%, specificity 67.74%). Our results suggest that heartbeat scaling and multifractal properties in CHF patients are not generated at the sinus-node level, but rather by the intrinsic action of vagal short-term control and of sympatho-vagal fluctuations associated with circadian cardiovascular control, especially within the VLF band. These markers might provide critical information in devising a clinical tool for individualized prediction of survivor and non-survivor CHF patients.

Link information
DOI
https://doi.org/10.1109/TBME.2018.2797158
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29993522
ID information
  • DOI : 10.1109/TBME.2018.2797158
  • Pubmed ID : 29993522

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