通过一种新的集群方法对心电图进行动态时间扭曲的心脏和脏器官间评估:模型开发和验证研究
Sally Zhao1, Zhan Ye2, Bhavna Adhin3
1Pfizer (United States), New York, United States.
JMIR medical informatics
|August 12, 2025
概括
这项研究表明,心电图 (ECG) 数据可以识别患有慢性脏病 (CKD) 风险较高的患有保存喷射率 (HFpEF) 心力衰竭的患者群体. 电心电图的动态时间扭曲提供了最稳定的集群,用于预测心脏与脏关系.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗信息学 医疗信息学
背景情况:
- 心脏和脏有着相互的生理关系,其中一个器官的功能障碍可能会对另一个器官产生负面影响.
- 保存喷射分数 (HFpEF) 的心力衰竭影响超过50%的心力衰竭患者,慢性病 (CKD) 的6分之一患者也患有HF.
- 预测和理解HFpEF和CKD之间的心脏脏链接对于患者管理至关重要.
研究的目的:
- 开发基于心电图 (ECG) 的模型,用于分层HFpEF患者并识别CKD丰富的子组.
- 为了获得可访问的精确诊断,推导出一组最小的显著心电图特征.
- 通过使用心电图数据来验证HFpEF和CKD之间的心脏与脏关系,以获得更好的生物学洞察力.
主要方法:
- 从FinnGen数据中对患有HFpEF (LVEF ≥50%,NT-proBNP>450 pg/mL) 的患者的ECG特征进行无监督聚类.
- 隔离重要的心电图特征 (PR间隔,QRS持续时间) 用于现象分组和风险分析.
- 集群方法的比较:k-平均值 (所有特征),k-平均值 (最小特征) 和原始心电图信号的动态时间曲线 (DTW),然后进行CKD风险评估.
主要成果:
- 动态时间扭曲 (DTW) 聚类的II心电图波形产生了最稳定的患者群.
- ANOVA分析显示,在几个HFpEF集群中,CKD风险的显著偏差,由肌素水平表明.
- DTW集群与使用肌素水平形成的基线集群的一致性最高,验证了心脏与脏之间的关系.
结论:
- 该研究使用ECG数据验证了HFpEF和CKD之间的心脏与脏关系.
- 对心电图II波形的DTW聚类在HFpEF中对临床上有意义的患者分层证明是有效的.
- 这种基于心电图的聚类方法有可能在超出HFpEF的患者分层中得到更广泛的应用.
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