Novel Bloodless Potassium Determination Using a Signal-Processed Single-Lead ECG.

Autor: Attia ZI; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.) Electrical and Computer Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel (Z.I.A., Y.S., D.S., A.B.G.)., DeSimone CV; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Dillon JJ; Nephrology and Hypertension, Mayo Clinic, Rochester, MN (J.J.D.)., Sapir Y; Electrical and Computer Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel (Z.I.A., Y.S., D.S., A.B.G.)., Somers VK; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Dugan JL; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Bruce CJ; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Ackerman MJ; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Asirvatham SJ; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Striemer BL; Center for Advanced Imaging, Mayo Clinic, Rochester, MN (B.L.S.)., Bukartyk J; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.)., Scott CG; Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN (C.G.S.)., Bennet KE; Department of Engineering, Mayo Clinic, Rochester, MN (K.E.B.)., Ladewig DJ; Mayo Clinic Ventures, Mayo Clinic, Rochester, MN (D.J.L., E.J.G.)., Gilles EJ; Mayo Clinic Ventures, Mayo Clinic, Rochester, MN (D.J.L., E.J.G.)., Sadot D; Electrical and Computer Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel (Z.I.A., Y.S., D.S., A.B.G.)., Geva AB; Electrical and Computer Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel (Z.I.A., Y.S., D.S., A.B.G.)., Friedman PA; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (Z.I.A., C.V.D.S., V.K.S., J.L.D., C.J.B., M.J.A., S.J.A., J.B., P.A.F.).
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2016 Jan 25; Vol. 5 (1). Date of Electronic Publication: 2016 Jan 25.
DOI: 10.1161/JAHA.115.002746
Abstrakt: Background: Hyper- and hypokalemia are clinically silent, common in patients with renal or cardiac disease, and are life threatening. A noninvasive, unobtrusive, blood-free method for tracking potassium would be an important clinical advance.
Methods and Results: Two groups of hemodialysis patients (development group, n=26; validation group, n=19) underwent high-resolution digital ECG recordings and had 2 to 3 blood tests during dialysis. Using advanced signal processing, we developed a personalized regression model for each patient to noninvasively calculate potassium values during the second and third dialysis sessions using only the processed single-channel ECG. In addition, by analyzing the entire development group's first-visit data, we created a global model for all patients that was validated against subsequent sessions in the development group and in a separate validation group. This global model sought to predict potassium, based on the T wave characteristics, with no blood tests required. For the personalized model, we successfully calculated potassium values with an absolute error of 0.36±0.34 mmol/L (or 10% of the measured blood potassium). For the global model, potassium prediction was also accurate, with an absolute error of 0.44±0.47 mmol/L for the training group (or 11% of the measured blood potassium) and 0.5±0.42 for the validation set (or 12% of the measured blood potassium).
Conclusions: The signal-processed ECG derived from a single lead can be used to calculate potassium values with clinically meaningful resolution using a strategy that requires no blood tests. This enables a cost-effective, noninvasive, unobtrusive strategy for potassium assessment that can be used during remote monitoring.
(© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)
Databáze: MEDLINE
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