Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study

Palmieri, Flavio; Gomis, Pedro; Ruiz, José Esteban; Ferreira, Dina; Martín-Yebra, Alba; Pueyo, Esther; Martínez, Juan Pablo; Ramírez, Julia; Laguna, Pablo

doi:10.3390/s21082710

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Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study

^1,2,3

^1,4

⁵,

³,

^2,6

^2,6

^2,6

⁷

and

Pablo Laguna

^2,6,*

Centre de Recerca en Enginyeria Biomèdica, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain

CIBER en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain

Laboratorios Rubió, Castellbisbal, 08755 Barcelona, Spain

⁴

Escuela Superior de Ingeniería, Ciencia y Tecnología, Universidad Internacional de Valencia, 46002 Valencia, Spain

⁵

Nephrology Ward, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain

⁶

BSICoS Group, I3A, IIS Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain

⁷

William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK

Author to whom correspondence should be addressed.

Academic Editor: Piotr Augustyniak

Sensors 2021, 21(8), 2710; https://doi.org/10.3390/s21082710

Received: 25 January 2021 / Revised: 16 March 2021 / Accepted: 30 March 2021 / Published: 12 April 2021

(This article belongs to the Special Issue Advances in ECG Sensing and Monitoring)

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Abstract

Background: End-stage renal disease patients undergoing hemodialysis (ESRD-HD) therapy are highly susceptible to malignant ventricular arrhythmias caused by undetected potassium concentration ([

K^{+}

]) variations (

Δ [K^{+}]

) out of normal ranges. Therefore, a reliable method for continuous, noninvasive monitoring of [

K^{+}

] is crucial. The morphology of the T-wave in the electrocardiogram (ECG) reflects

Δ [K^{+}]

and two time-warping-based T-wave morphological parameters,

d_{w}

and its heart-rate corrected version

d_{w, c}

, have been shown to reliably track

Δ [K^{+}]

from the ECG. The aim of this study is to derive polynomial models relating

d_{w}

and

d_{w, c}

with

Δ [K^{+}]

, and to test their ability to reliably sense and quantify

Δ [K^{+}]

values. Methods: 48-hour Holter ECGs and [

K^{+}

] values from six blood samples were collected from 29 ESRD-HD patients. For every patient,

d_{w}

and

d_{w, c}

were computed, and linear, quadratic, and cubic fitting models were derived from them. Then, Spearman’s (

ρ

) and Pearson’s (r) correlation coefficients, and the estimation error (

e_{d}

) between

Δ [K^{+}]

and the corresponding model-estimated values (

\hat{Δ} [K^{+}]

) were calculated. Results and Discussions: Nonlinear models were the most suitable for

Δ [K^{+}]

estimation, rendering higher Pearson’s correlation (median 0.77

\leq r \leq

0.92) and smaller estimation error (median 0.20

\leq e_{d} \leq

0.43) than the linear model (median 0.76

\leq r \leq

0.86 and 0.30

\leq e_{d} \leq

0.40), even if similar Spearman’s

ρ

were found across models (median 0.77

\leq ρ \leq

0.83). Conclusion: Results support the use of nonlinear T-wave-based models as

Δ [K^{+}]

sensors in ESRD-HD patients. View Full-Text

Keywords: electrocardiogram; periodic component analysis; T-wave morphology; time warping; noninvasive potassium sensing; personalised medicine

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MDPI and ACS Style

Palmieri, F.; Gomis, P.; Ruiz, J.E.; Ferreira, D.; Martín-Yebra, A.; Pueyo, E.; Martínez, J.P.; Ramírez, J.; Laguna, P. Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study. Sensors 2021, 21, 2710. https://doi.org/10.3390/s21082710

AMA Style

Palmieri F, Gomis P, Ruiz JE, Ferreira D, Martín-Yebra A, Pueyo E, Martínez JP, Ramírez J, Laguna P. Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study. Sensors. 2021; 21(8):2710. https://doi.org/10.3390/s21082710

Chicago/Turabian Style

Palmieri, Flavio, Pedro Gomis, José E. Ruiz, Dina Ferreira, Alba Martín-Yebra, Esther Pueyo, Juan P. Martínez, Julia Ramírez, and Pablo Laguna. 2021. "Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study" Sensors 21, no. 8: 2710. https://doi.org/10.3390/s21082710

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Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study

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