Characterization of rheumatic heart disease from electrocardiogram recordings
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Melkamu Hunegnaw Asmare1,2, Amsalu Tomas Chuma1,3, Carolina Varon1,4
1eMedia Research Lab/STADIUS, Department of Electrical Engineering (ESAT), KU Leuven, Andreas Vesaliusstraat 13, B-3000 Leuven, Belgium.
Insights
Electrocardiograms (ECG) can help detect Rheumatic Heart Disease (RHD) by identifying common abnormalities like PR elongation and bradycardia. This research explores ECG
Area of Science:
- Cardiology
- Medical Diagnostics
- Biomedical Engineering
Background:
- Rheumatic Heart Disease (RHD) is a prevalent condition in developing nations, often affecting heart valves and leading to RHD endocarditis.
- Current RHD diagnosis relies on echocardiography and stethoscope, but the utility of Electrocardiograms (ECG) for RHD characterization remains underexplored.
Purpose of the Study:
- To investigate the potential of ECG recordings for characterizing cardiac abnormalities in patients with Rheumatic Heart Disease (RHD).
Main Methods:
- Collected and preprocessed an extensive ECG dataset from RHD patients and healthy controls.
- Utilized KIT-IBT MATLAB toolbox for wave delineation and computed temporal ECG parameters (PR, QRS, RR, QT, QTc intervals).
- Analyzed ECG data, including median values, age, sex, and duration since RHD diagnosis.
Main Results:
- Observed PR elongation in 47.2% of RHD cases and QRS duration elongation in 26.4%.
- QTc interval elongation was noted in 44.3% of cases, and bradycardia was present in 62.2%.
Conclusions:
- ECG analysis reveals significant temporal parameter abnormalities and bradycardia in RHD patients.
- Findings suggest ECG's potential for developing new screening tools for RHD, particularly in resource-limited settings.
Abstract:
Objective. Rheumatic Heart Disease (RHD) is one of the highly prevalent heart diseases in developing countries that can affect the pericardium, myocardium, or endocardium. Rheumatic endocarditis is a common RHD variant that gradually deteriorates the normal function of the heart valves. RHD can be diagnosed using standard echocardiography or listened to as a heart murmur using a stethoscope. The electrocardiogram (ECG), on the other hand, is critical in the study and identification of heart rhythms and abnormalities. The effectiveness of ECG to identify distinguishing signs of rheumatic heart problems, however, has not been adequately examined. This study addressed the possible use of ECG recordings for the characterization of problems of the heart in RHD patients.Approach. To this end, an extensive ECG dataset was collected from patients suffering from RHD (PwRHD), and healthy control subjects (HC). Bandpass filtering was used at the preprocessing stage. Each data was then standardized by removing its mean and dividing by its standard deviation. Delineation of the onsets and offsets of waves was performed using KIT-IBT open ECG MATLAB toolbox. PR interval, QRS duration, RR intervals, QT intervals, and QTc intervals were computed for each heartbeat. The median values of the temporal parameters were used to eliminate possible outliers due to missed ECG waves. The data were clustered in different age groups and sex. Another categorization was done based on the time duration since the first RHD diagnosis.Main results. In 47.2% of the cases, a PR elongation was observed, and in 26.4% of the cases, the QRS duration was elongated. QTc was elongated in 44.3% of the cases. It was also observed that 62.2% of the cases had bradycardia.Significance. The end product of this research can lead to new medical devices and services that can screen RHD based on ECG which could somehow assist in the detection and diagnosis of the disease in low-resource settings and alleviate the burden of the disease.
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