Abstract
Objective: In this study we aimed to predict the time to syncope occurrence (TSO) in patients with vasovagal syncope (VVS), solely based on measurements recorded during the supine position of the head-up tilt (HUT) testing protocol.
Methods: We extracted various time and frequency domain features related to morphological aspects of arterial blood pressure (ABP) and the electrocardiogram (ECG) raw signals as well as to dynamic interactions between beat-to-beat ABP, heart rate, and cerebral blood flow velocity. From these we identified the most predictive features related to TSO.
Results: Specifically, when no orthostatic stress is involved, TSO in VVS patients can be predicted with high accuracy from a set of only five ECG features.
References
Kenny RA, Bayliss J, Ingram A, Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet. 1986;327(8494):1352–5.
van Lieshout JJ, Wieling W, Karemaker JM, Eckberg DL. The vasovagal response. Clin Sci (London 1979). 1991;81(5):575–86.
Mallat Z, Vicaut E, Sangaré A, Verschueren J, Fontaine G, Frank R. Prediction of head-up tilt test result by analysis of early heart rate variations. Circulation. 1997;96(2):581–4.
Virag N, Sutton R, Vetter R, Markowitz T, Erickson M. Prediction of vasovagal syncope from heart rate and blood pressure trend and variability: experience in 1,155 patients. Hear Rhythm. 2007;4(11):1375–82.
Pruvot E, Vesin JM, Schlaepfer J, Eromer M, Kappenberger L. Autonomic imbalance assessed by heart rate variability analysis in vasovagal syncope. Pacing Clin Electrophysiol. 1994;17(11):2201–6.
Bellard E, Fortrat J-O, Vielle B, Dupuis J-M, Victor J, Lefthériotis G. Early predictive indexes of head-up tilt table testing outcomes utilizing heart rate and arterial pressure changes. Am J Cardiol. 2001;88(8):903–6.
Avolio AP, Butlin M, Walsh A. Arterial blood pressure measurement and pulse wave analysis—their role in enhancing cardiovascular assessment. Physiol Meas. 2009;31(1):R1.
Simek J, Wichterle D, Melenovsky V, Malik J, Svobodova J, Svacina S. Pulse wave analysis during supine rest may identify subjects with recurrent vasovagal syncope. Clin Sci. 2005;109(2):165–70.
Pecha S, Hakmi S, Wilke I, Yildirim Y, Hoffmann B, Reichenspurner H, Willems S, von Kodolitsch Y, Aydin A. Pulse wave analysis of the aortic pressure waveform in patients with vasovagal syncope. Heart Vessel. 2016;31(1):74–9.
Bellard E, Fortrat J-O, Schang D, Dupuis J-M, Victor J, Lefthériotis G. Changes in the transthoracic impedance signal predict the outcome of a 70 head-up tilt test. Clin Sci. 2003;104(2):119–26.
Schang D, Feuilloy M, Plantier G, Fortrat J-O, Nicolas P. Early prediction of unexplained syncope by support vector machines. Physiol Meas. 2006;28(2):185.
Schang D, Bellard E, Plantier G, Dupuis JM, Victor J, Leftheriotis G. Comparison of computational algorithms applied on transthoracic impedance waveforms to predict head-up tilt table testing outcome. Comput Biol Med. 2006;36:225–40.
Hamilton JD. Time series analysis, vol. 2. Princeton, NJ: Princeton University Press; 1994.
Zhang R, Zuckerman JH, Giller CA, Levine BD. Transfer function analysis of dynamic cerebral autoregulation in humans. Am J Physiol Circ Physiol. 1998;274(1):H233–41.
Schondorf R, Stein R, Roberts R, Benoit J, Cupples W. Dynamic cerebral autoregulation is preserved in neurally mediated syncope. J Appl Physiol. 2001;91(6):2493–502.
Lütkepohl H. New introduction to multiple time series analysis. New York, NY: Springer Science & Business Media; 2005.
Faes L, Porta A, Nollo G. Testing frequency-domain causality in multivariate time series. IEEE Trans Biomed Eng. 2010;57(8):1897–906.
Mitsis GD, Zhang R, Levine BD, Marmarelis VZ. Cerebral hemodynamics during orthostatic stress assessed by nonlinear modeling. J Appl Physiol. 2006;101:354–66.
Breiman L. Random forests. Mach Learn. 2001;45(1):5–32.
Kostoglou K, Michmizos KP, Stathis P, Sakas D, Nikita KS, Mitsis GD. Prediction of the Unified Parkinson’s disease rating scale improvement in deep brain stimulation. IEEE Trans Biomed Engin. 2017;64(5):1123–30.
Guyon I, Elisseeff A. An introduction to variable and feature selection. J Mach Learn Res. 2003;3:1157–82.
Conflicts of interest statement
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this paper
Cite this paper
Kostoglou, K., Schondorf, R., Benoit, J., Balegh, S., Mitsis, G.D. (2018). Prediction of the Time to Syncope Occurrence in Patients Diagnosed with Vasovagal Syncope. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_61
Download citation
DOI: https://doi.org/10.1007/978-3-319-65798-1_61
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-65797-4
Online ISBN: 978-3-319-65798-1
eBook Packages: MedicineMedicine (R0)