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Diagnosis of mitral insufficiency using impedance cardiography technique ICG

Souhir Chabchoub
Souhir Chabchoub
, 
Sofienne Mansouri
Sofienne Mansouri
 e 
Ridha B. Salah
Ridha B. Salah
   | 31 ott 2016
Journal of Electrical Bioimpedance's Cover Image
INFORMAZIONI SU QUESTO ARTICOLO
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Article Category: Articles
Pubblicato online: 31 ott 2016
Pagine: 28 - 34
Ricevuto: 21 apr 2016
DOI: https://doi.org/10.5617/jeb.2872
Parole chiave
© 2016 Souhir Chabchoub, Sofienne Mansouri, Ridha B. Salah, Published by sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig.1

Electrodes configuration for the measurement of the ICG signal.
Electrodes configuration for the measurement of the ICG signal.

Fig.2

A typical ICG signal.
A typical ICG signal.

Fig.3

Impedance Cardiography traces recorded in (a) a control subject and (b) a patient with mitral insufficiency and the detection of the characteristic points (C-waves: red triangles, O-waves: green triangles, A-waves: yellow triangles, X-waves: blue squares, B-waves: pink circles).
Impedance Cardiography traces recorded in (a) a control subject and (b) a patient with mitral insufficiency and the detection of the characteristic points (C-waves: red triangles, O-waves: green triangles, A-waves: yellow triangles, X-waves: blue squares, B-waves: pink circles).

Fig.4

Difference between patients with mitral insufficiency (red) and control subjects (blue): (A) Histogram of the A-wave amplitude, (B) Histogram of the O-wave amplitude, (C) Histogram of the determined parameter “I”.
Difference between patients with mitral insufficiency (red) and control subjects (blue): (A) Histogram of the A-wave amplitude, (B) Histogram of the O-wave amplitude, (C) Histogram of the determined parameter “I”.

Fig.4

Difference between patients with mitral insufficiency (red) and control subjects (blue): (A) Histogram of stroke volume, (B) Histogram of cardiac output.
Difference between patients with mitral insufficiency (red) and control subjects (blue): (A) Histogram of stroke volume, (B) Histogram of cardiac output.

Fig.5

ROC curves for O- wave amplitude (AUC=0.96, p<0.0001), A- wave amplitude (AUC=1, p<0.0001), and the diagnosis parameter “I” (AUC=1, p<0.0001).
ROC curves for O- wave amplitude (AUC=0.96, p<0.0001), A- wave amplitude (AUC=1, p<0.0001), and the diagnosis parameter “I” (AUC=1, p<0.0001).

ICG wave amplitudes for control subjects and patients with mitral insufficiency (mean± SD)

ICG wavesControl subjectsPatients with MIt–values
O (Ohm/s)∙10-31.2±1.25.3±0.414.4*
A (Ohm/s)∙10-3-1.5 ± 0.2-20±0.004403.5*
I (Ohm/s)∙10-32.7 ± 1.525.3 ± 0.463.24*

Characteristic points on the ICG signal

Characteristic pointsDescription
AIs the beginning of electromechanical systole. It is associated with the atrial contraction.
BAppears simultaneously with the opening of the aortic valve. The precise identification of a B point is important for accurate calculation of stroke volume and cardiac output [33]. It denotes the beginning of the ejection time. It has been reported that the marker of this point is not always apparent [34] and it may occur at any point on the ascending portion of the signal before the (dZ/dt) max [35, 36].
CIs taken at the peak of the ICG signal and it corresponds to the ventricular contraction. The amplitude of this point is used to calculate the stroke volume and cardiac output.
XIs the lowest point after the peak and it is associated with the closure of the aortic valve. It indicates the end of the systole [37].
OIs associated with changing of the volume during the diastolic phase of the cycle and the maximal opening of the mitral valve [37].

The computed hemodynamic parameters for control subjects and patients with mitral insufficiency (mean± SD)

ICG wavesControl subjectsPatients with MIt–values
HR (bpm)58±358±7n/s
LVET (ms)270 ± 110500±767.50*
SV (ml)113.8 ± 17.570.7 ± 12.28.81*
CO (l/min)6.6±0.84.1±1.18.07*

ROC curve analysis of O-wave amplitude, A-wave amplitude, and the characteristic parameter “I”

Amplitude (Ohm/s)AUCPOptimum cut-offSe (%)Sp (%)PPV (%)NPV (%)
O0.96<0.0001>3.647010010096.8
A1<0.0001≤ -20100100100100
I1<0.0001>5.44100100100100
eISSN:
1891-5469
Lingua:
Inglese
Frequenza di pubblicazione:
Volume Open
Argomenti della rivista:
Engineering, Bioengineering and Biomedical Engineering, Biomedical Electronics, Life Sciences, Biophysics, Medicine, Biomedical Engineering, Physics, Spectroscopy and Metrology
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