Distance to healthy cardiovascular dynamics from fetal heart rate scale-dependent features in pregnant sheep model of human labor predicts cardiovascular decompensation
| Autor: | Roux, Stéphane, Garnier, Nicolas, Abry, Patrice, Gold, N, Frasch, Martin |
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| Přispěvatelé: | Laboratoire de Physique de l'ENS Lyon (Phys-ENS), École normale supérieure - Lyon (ENS Lyon)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Department of Mathematics and Statistics, York University, Departments of Obstetrics and Gynecology, University of Washington [Seattle], Center on Human Development and Disability (CHDD), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), École normale supérieure de Lyon (ENS de Lyon)-Université de Lyon-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
cardiovascular
entropy rate FOS: Physical sciences sliding-window analysis fetal heart rate [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics Physics - Medical Physics Quantitative Biology - Quantitative Methods distance to healthy cardiovascular decompensation time-scales dependent features animal model of human labor FOS: Biological sciences embryonic structures [PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph] Medical Physics (physics.med-ph) Quantitative Methods (q-bio.QM) [PHYS.PHYS.PHYS-DATA-AN]Physics [physics]/Physics [physics]/Data Analysis Statistics and Probability [physics.data-an] |
| Zdroj: | Frontiers in Pediatrics Frontiers in Pediatrics, Frontiers, 2021, 9, pp.710 Frontiers in Pediatrics, 2021, 9, pp.710 |
| ISSN: | 2296-2360 |
| DOI: | 10.3389/fped.2021.660476 |
| Popis: | The overarching goal of the present work is to contribute to the understanding of the relations between fetal heart rate (FHR) temporal dynamics and the well-being of the fetus, notably in terms of predicting cardiovascular decompensation (CVD). It makes uses of an established animal model of human labor, where fourteen near-term ovine fetuses subjected to umbilical cord occlusions (UCO) were instrumented to permit regular intermittent measurements of metabolites, pH, and continuous recording of electrocardiogram (ECG) and systemic arterial blood pressure (to identify CVD) during UCO. ECG-derived FHR was digitized at the sampling rate of 1000 Hz and resampled to 4Hz, as used in clinical routine. We focused on four FHR variability features which are tunable to temporal scales of FHR dynamics, robustly computable from FHR sampled at $4$Hz and within short-time sliding windows, hence permitting a time-dependent, or local, analysis of FHR which helps dealing with signal noise. Results show the sensitivity of the proposed features for early detection of CVD, correlation to metabolites and pH, useful for early acidosis detection and the importance of coarse time scales (2.5 to 8 seconds) which are not disturbed by the low FHR sampling rate. Further, we introduce the performance of an individualized self-referencing metric of the distance to healthy state, based on a combination of the four features. We demonstrate that this novel metric, applied to clinically available FHR temporal dynamics alone, accurately predicts the time occurrence of CVD which heralds a clinically significant degradation of the fetal health reserve to tolerate the trial of labor. 34 pages (preprint version) 10 figures |
| Databáze: | OpenAIRE |
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