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Optimal Timing in Screening Patients with Congestive Heart Failure and Healthy Subjects During Circadian Observation

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Abstract

Congestive heart failure (CHF) is a major medical challenge in developed countries. In order to screen patients with CHF and healthy subjects during circadian observation, accurate judgment and fast response are imperative. In this study, optimal timing during circadian observation via the heart rate variability (HRV) was sought. We tested 29 CHF patients and 54 healthy subjects in the control group from the interbeat interval databases of PhysioBank. By invoking the α1 parameter in detrended fluctuation analysis of HRV, we found that it could be used as an indicator to screen the patients with CHF and subjects in normal sinus rhythm (NSR) under Kruskal–Wallis test. By invoking Fano factor, the optimal timing to screen CHF patients and healthy subjects was found to be from 7 PM to 9 PM during the circadian observation. In addition, this result is robust in a sense that the same result can be achieved by using different ECG recording lengths of 2, 5, 10, … , and 120 min, respectively. Furthermore, a support vector machine was employed to classify CHF and NSR with α1 parameter of a moving half-hour ECG recordings via leave-one-out cross validation. The results showed that the superlative screening performance was obtained in the 7 pm–9 pm period during circadian observation. It is believed that this result of optimal timing will be helpful in the non-invasive monitoring and screening of CHF patients and healthy subjects in the clinical practice.

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Abbreviations

CHF:

Congestive heart failure

CHFRRID:

Congestive heart failure RR interval database

DFA:

Detrended fluctuation analysis

HRV:

Heart rate variability

LOOCV:

Leave-one-out cross validation

NSR:

Normal sinus rhythm

NSRRRID:

Normal sinus rhythm RR interval database

ROC:

Receiver operating characteristic

SVM:

Support vector machine

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Acknowledgments

This study was supported in part by the Grant NSC94-2213-E-007-094 from National Science Council, Taiwan, and the Grant V99C1-106 from Taipei Veterans General Hospital, Taipei, Taiwan. We are grateful to the reviewers for their comments and suggestions that have improved the robustness of this article a great deal.

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Authors and Affiliations

  1. Department of Electrical Engineering, National Tsing Hua University, Hsinchu, 300, Taiwan, ROC

    Tai-Lang Jong & Ben Chang

  2. Department of Research and Education, Laboratory of Biophysics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Cheng-Deng Kuo

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  1. Tai-Lang Jong
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Correspondence to Ben Chang.

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Associate Editor Ioannis A. Kakadiaris oversaw the review of this article.

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Jong, TL., Chang, B. & Kuo, CD. Optimal Timing in Screening Patients with Congestive Heart Failure and Healthy Subjects During Circadian Observation. Ann Biomed Eng 39, 835–849 (2011). https://doi.org/10.1007/s10439-010-0180-6

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  • DOI: https://doi.org/10.1007/s10439-010-0180-6

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