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Lagged segmented Poincaré plot analysis for risk stratification in patients with dilated cardiomyopathy

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Abstract

The objectives of this study were to introduce a new type of heart-rate variability analysis improving risk stratification in patients with idiopathic dilated cardiomyopathy (DCM) and to provide additional information about impaired heart beat generation in these patients. Beat-to-beat intervals (BBI) of 30-min ECGs recorded from 91 DCM patients and 21 healthy subjects were analyzed applying the lagged segmented Poincaré plot analysis (LSPPA) method. LSPPA includes the Poincaré plot reconstruction with lags of 1–100, rotating the cloud of points, its normalized segmentation adapted to their standard deviations, and finally, a frequency-dependent clustering. The lags were combined into eight different clusters representing specific frequency bands within 0.012–1.153 Hz. Statistical differences between low- and high-risk DCM could be found within the clusters II–VIII (e.g., cluster IV: 0.033–0.038 Hz; p = 0.0002; sensitivity = 85.7 %; specificity = 71.4 %). The multivariate statistics led to a sensitivity of 92.9 %, specificity of 85.7 % and an area under the curve of 92.1 % discriminating these patient groups. We introduced the LSPPA method to investigate time correlations in BBI time series. We found that LSPPA contributes considerably to risk stratification in DCM and yields the highest discriminant power in the low and very low-frequency bands.

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Acknowledgments

The authors wish to gratefully acknowledge the financial support provided by the Deutsche Forschungsgemeinschaft (DFG: Vo 505/8-1 and Vo 505/8-2).

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Authors and Affiliations

  1. Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Carl-Zeiss-Promenade 2, 07745, Jena, Germany

    Andreas Voss, Claudia Fischer & Rico Schroeder

  2. Clinic for Internal Medicine I, Friedrich-Schiller-University Hospital Jena, Erlanger Allee 101, 07747, Jena, Germany

    Hans R. Figulla & Matthias Goernig

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  1. Andreas Voss
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  2. Claudia Fischer
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  3. Rico Schroeder
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  4. Hans R. Figulla
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Correspondence to Andreas Voss.

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Voss, A., Fischer, C., Schroeder, R. et al. Lagged segmented Poincaré plot analysis for risk stratification in patients with dilated cardiomyopathy. Med Biol Eng Comput 50, 727–736 (2012). https://doi.org/10.1007/s11517-012-0925-5

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  • DOI: https://doi.org/10.1007/s11517-012-0925-5

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