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Article

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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Centre de Recerca en Enginyeria Biomèdica, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain
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CIBER en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain
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Laboratorios Rubió, Castellbisbal, 08755 Barcelona, Spain
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Escuela Superior de Ingeniería, Ciencia y Tecnología, Universidad Internacional de Valencia, 46002 Valencia, Spain
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Nephrology Ward, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
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BSICoS Group, I3A, IIS Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain
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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)
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, dw and its heart-rate corrected version dw,c, have been shown to reliably track Δ[K+] from the ECG. The aim of this study is to derive polynomial models relating dw and dw,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, dw and dw,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 (ed) between Δ[K+] and the corresponding model-estimated values (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 r 0.92) and smaller estimation error (median 0.20 ed 0.43) than the linear model (median 0.76 r 0.86 and 0.30 ed 0.40), even if similar Spearman’s ρ were found across models (median 0.77 ρ 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 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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