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20 pages, 2371 KiB  
Article
Enhanced Production and Functional Characterization of Recombinant Equine Chorionic Gonadotropin (rec-eCG) in CHO-DG44 Cells
by Munkhzaya Byambaragchaa, Sei Hyen Park, Myung-Hum Park, Myung-Hwa Kang and Kwan-Sik Min
Biomolecules 2025, 15(2), 289; https://doi.org/10.3390/biom15020289 - 14 Feb 2025
Abstract
Equine chorionic gonadotropin (eCG) hormone, comprising highly glycosylated α- and β-subunits, elicits responses similar to follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in non-equid species. This study aimed to establish a mass production of recombinant eCG (rec-eCG) using CHO DG44 cells. Single-chain rec-eCG [...] Read more.
Equine chorionic gonadotropin (eCG) hormone, comprising highly glycosylated α- and β-subunits, elicits responses similar to follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in non-equid species. This study aimed to establish a mass production of recombinant eCG (rec-eCG) using CHO DG44 cells. Single-chain rec-eCG β/α was expressed in CHO DG44 cells. FSH- and LH-like activities were evaluated in CHO-K1 and HEK 293 cells expressing the equine LH/CG receptor (eLH/CGR), rat LH/CGR (rLH/CGR), and rFSHR. pERK1/2 activation and β-arrestin 2 recruitment were assessed in PathHunter CHO-K1 cells. The expression from one, among nine isolates, peaked at 364–470 IU/mL on days 9 and 11. The molecular weight of rec-eCG β/α ranged from 40 to 47 kDa, with two distinct bands. PNGase F treatment reduced the molecular weight by 8–10 kDa, indicating N-glycosylation. Rec-eCG β/α demonstrated dose-responsive cAMP activity in cells expressing eLH/CGR, with enhanced potency in rLH/CGR and rFSHR. Phospho-ERK1/2 activation peaked at 5 min before declining rapidly. β-arrestin 2 recruitment was receptor-mediated in cells expressing hFSHR and hLH/CGR. This study provides insights into the mechanisms underlying eCG’s FSH- and LH-like activities. Stable CHO DG44 cells can produce large quantities of rec-eCG. eCG activates pERK1/2 signaling via the PKA/cAMP pathway and facilitates β-arrestin 2 recruitment. Full article
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Graphical abstract
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<p>Schematic diagram of wild-type recombinant equine chorionic gonadotropin (rec-eCG). The diagram illustrates the N- and O-glycosylation sites on eCG. The eCG α-subunit has N-linked oligosaccharides at Asn56 and Asn82, while the β-subunit has one at Asn13. Additionally, the β-subunit includes up to 12 potential O-linked oligosaccharides in the carboxyl-terminal peptide (CTP) region. Circles labeled “N” and “O” indicate N-linked and O-linked glycosylation sites, respectively. A myc-tag epitope was inserted between the first and second amino acid residues of the mature β-subunit.</p>
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<p>Quantitative analysis of rec-eCG production by ELISA following monoclonal cell isolation from CHO-DG44 cells. Nine monoclonal cell lines were isolated and evaluated for secreted rec-eCG levels. Supernatants were collected on days 0, 1, 3, 5, 7, 9, and 11 of culture in 50 mL spinner flasks. The expression levels of rec-eCG from each clone were analyzed using a sandwich enzyme-linked immunosorbent assay (ELISA). Data are presented as the mean ± standard error of the mean (SEM) from at least three independent experiments.</p>
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<p>Western blot analysis of rec-eCG proteins produced by monoclonal cells. Supernatants from nine colonies were collected on days 7 and 9 of cultivation. Rec-eCG samples (20 µL) were resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and transferred to a membrane. Proteins were detected using anti-myc-tag antibodies and horseradish peroxidase-conjugated goat anti-mouse IgG antibodies. Original images can be found in <a href="#app1-biomolecules-15-00289" class="html-app">Figure S1</a>.</p>
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<p>Western blot analysis of rec-eCG proteins over the cultivation period. Supernatants (20 µL) from four selected colonies were subjected to SDS-PAGE. Faint protein bands were first detected on day 3, with signal intensity gradually increasing over time. Two specific bands were consistently observed across all samples. Original images can be found in <a href="#app1-biomolecules-15-00289" class="html-app">Figure S2</a>.</p>
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<p>Deglycosylation analysis of rec-eCG proteins. Conditioned media from cells were treated with peptide-N-glycanase F (PNGase F) to remove N-linked oligosaccharides. Supernatants from cells No. 1 to 4 reacted with PNGase F at 37 °C for 1 h and then analyzed by SDS-PAGE. − indicates samples not treated with PNGase F, while + indicates samples treated with PNGase F. Original images can be found in <a href="#app1-biomolecules-15-00289" class="html-app">Figure S3</a>.</p>
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<p>Effect of rec-eCG on cyclic AMP (cAMP) production in cells expressing equine LH/chorionic gonadotropin receptor (eLH/CGR), rat LH/CGR (rLH/CGR), and rat FSH receptor (rFSHR). Cells transiently transfected with eLH/CGR, rLH/CGR, or rFSHR were seeded in 384-well plates (10,000 cells/well) 24 h post-transfection. Cells were incubated with rec-eCG for 30 min at room temperature. cAMP production was measured using a homogeneous time-resolved fluorescence (HTRF) assay and expressed as Delta F%. The mock-transfected control values were subtracted from each dataset (see Methods). Data are shown as mean ± SEM from triplicate experiments, with curve fitting performed using a one-phase exponential decay model in GraphPad Prism. %. (<b>A</b>) eLH/CGR. (<b>B</b>) rLH/CGR. (<b>C</b>) rFSHR.</p>
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<p>Dose- and time-dependent pERK1/2 activation by rec-eCG in cells expressing eLH/CGR. HEK293 cells transiently transfected with eLH/CGR were stimulated with rec-eCG under the following conditions: (<b>A</b>) Dose-dependent activation using 0, 50, 125, 250, and 500 ng/mL rec-eCG. (<b>B</b>) Time course of pERK1/2 activation with 50 ng/mL rec-eCG. (<b>C</b>) Time course of pERK1/2 activation with 250 ng/mL rec-eCG. Total ERK1/2 levels were assessed to normalize phosphorylated ERK1/2 (pERK1/2). Rec-eCG-stimulated HTRF ratios were normalized and expressed as fold changes relative to unstimulated cells.</p>
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<p>Dose- and time-dependent pERK1/2 activation by rec-eCG in cells expressing rLH/CGR and rFSHR. HEK293 cells transiently transfected with rLH/CGR or rFSHR were stimulated with rec-eCG under the following conditions: (<b>A</b>,<b>B</b>) pERK1/2 activation following treatment with 50 ng/mL rec-eCG. (<b>C</b>,<b>D</b>) pERK1/2 activation following treatment with 250 ng/mL rec-eCG.</p>
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<p>Comparison of pERK1/2 activation among eLH/CGR, rLH/CGR, and rFSHR. The pERK1/2 activation levels in eLH/CGR were compared with those in rLH/CGR and rFSHR at 5 min post-rec-eCG treatment. Data are presented as the mean ± standard error of the mean (SEM) from triplicate experiments. Values marked with asterisks indicate significant differences (* <span class="html-italic">p</span> &lt; 0.05). (<b>A</b>) Activation at 50 ng/mL rec-eCG. (<b>B</b>) Activation at 250 ng/mL rec-eCG.</p>
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<p>Effects of rec-eCG on pERK1/2 activation in eLH/CGR-stimulated cells. HEK293 cells transiently transfected with eLH/CGR were serum-starved for at least 6 h before stimulation. Cellular extracts (20 µg per sample) were analyzed by SDS-PAGE. (<b>A</b>) Dose-dependent pERK1/2 activation using rec-eCG concentrations of 0, 125, 250, 500, 1000, and 2000 ng/mL, to stimulate cells for 7 min. (<b>B</b>) Time course of pERK1/2 activation following treatment with 250 ng/mL rec-eCG. pERK1/2 and total ERK bands were quantified by densitometry, and pERK1/2 levels were normalized to total ERK levels. Equal protein amounts were loaded for each lane. Representative data are shown, and graphs depict the mean ± standard error (SE) from independent experiments. The maximal pERK1/2 response observed at 250 ng/mL and 5 min was designated as 100%. Original images can be found in <a href="#app1-biomolecules-15-00289" class="html-app">Figure S4</a>.</p>
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<p>pERK1/2 activation stimulated by rLH/CGR and rFSHR. HEK293 cells transiently transfected with rLH/CGR or rFSHR were serum-starved for at least 6 h and stimulated with 250 ng/mL of agonist for the indicated times. Whole-cell lysates (20 µg per sample) were analyzed for pERK1/2 and total ERK levels by SDS-PAGE. pERK1/2 levels were normalized to total ERK levels. Representative data are shown, and graphs represent the mean ± SE from independent experiments. The maximal pERK1/2 response observed at 5 min was designated as 100%. (<b>A</b>) rLH/CGR. (<b>B</b>) rFSHR. Original images can be found in <a href="#app1-biomolecules-15-00289" class="html-app">Figure S5</a>.</p>
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<p>Effects of β-arrestin 2 recruitment in PathHunter (DiscoverX) eXpress CHO-K1 cells expressing hFSHR and hLH/CGR. Cells were plated at 0.5 × 10<sup>4</sup> cells per well in 384-well plates and incubated for 24 or 48 h at 37 °C. Cells were stimulated with 2200 ng/mL of rec-eCG under dose- and time-dependent conditions. PathHunter detection reagents were added and incubated for 60 min at room temperature. Luminescence signals were measured using a plate reader. (<b>A</b>,<b>B</b>) β-arrestin 2 recruitment in CHO-K1 cells expressing hFSHR. (<b>C</b>,<b>D</b>) β-arrestin 2 recruitment in CHO-K1 cells expressing hLH/CGR.</p>
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22 pages, 19836 KiB  
Article
Assessing Cardiac Sympatho-Vagal Balance Through Wavelet Transform Analysis of Heart Rate Variability
by A.M. Nelushi, C.H. Manathunga, N.G.S. Shantha Gamage and Tadachika Nakayama
Appl. Sci. 2025, 15(4), 1687; https://doi.org/10.3390/app15041687 - 7 Feb 2025
Abstract
Heart rate variability (HRV), which is the variation between consecutive heartbeats, reflects the electrical activity of the heart and provides insight into the autonomic nervous system (ANS) function. This study uses wavelet transform-based HRV feature extraction to investigate cardiac sympatho-vagal balance. Both the [...] Read more.
Heart rate variability (HRV), which is the variation between consecutive heartbeats, reflects the electrical activity of the heart and provides insight into the autonomic nervous system (ANS) function. This study uses wavelet transform-based HRV feature extraction to investigate cardiac sympatho-vagal balance. Both the continuous wavelet transform (CWT) and discrete wavelet transform (DWT) methods were applied in different steps. DWT was used for R-peak detection and CWT and MODWT were used to generate spectrograms from RR intervals. Frequency components (HF, LF, and VLF) within 0.003–0.4 Hz were extracted, and power estimation was performed. The LF/HF ratio, indicating sympatho-vagal balance, was calculated. ECG data from 42 arrhythmia patients and 18 normal sinus rhythm subjects were analyzed. The results showed a lower LF/HF ratio in arrhythmia patients, with higher HF power in arrhythmia subjects and higher LF power in normal sinus rhythm subjects. The study suggests that the parasympathetic nervous system dominates the ANS in arrhythmia patients, while the sympathetic nervous system dominates in normal sinus rhythm patients. Full article
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Figure 1
<p>db4 and sym4 wavelets. The sym4 wavelet is from the Symlet family, and db4 is from the Daubechies family. These wavelets show similarities with the ECG signal waveform and are used in analyzing the ECG signal waveforms.</p>
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<p>(<b>a</b>) Graphical representation of multi-resolution analysis. Wider wavelets (windows) are used in multi-resolution analysis to capture lower frequencies which provide high frequency resolution, and narrow wavelets (windows) are used to capture higher frequencies which provide high time resolution. (<b>b</b>) Multilevel decomposition. The approximation coefficients are shown by “A” and detailed coefficients are shown by “D”. At each level the number of coefficients is halved.</p>
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<p>Methodology flowchart. This illustrates the multi-step process of HRV analysis.</p>
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<p>ECG signal of normal sinus rhythm recording—16,265. The Y-axis represents the voltage amplitudes of the ECG signal and the x-axis represents the time duration of the ECG signal.</p>
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<p>Reconstructed signal containing R peaks in red color annotations of record no. 16,265.</p>
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<p>The graph of RR intervals vs. the beat number. This is the representation of variation in the heart rate, HRV.</p>
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<p>The CWT spectrogram of record no. 16,265. CWT spectrum represents 3 dimensions: frequency, time, and the RR interval magnitude by each coordinate. The dashed line is the cone of influence which indicates the more accurate results inside the cone. We can observe high-magnitude events in bright colors in the spectrograms.</p>
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<p>Extracted frequency components in VLF, LF, and HF bands for record no. 16,265 from the spectrogram. This represents the variation in the magnitude of rr intervals for each band.</p>
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<p>(<b>a</b>) Located R peaks. (<b>b</b>) RR interval vs. beat no. plot. (<b>c</b>) CWT spectrogram for record: 16,786 using MODWPT.</p>
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<p>(<b>a</b>) Located R peaks. (<b>b</b>) RR interval vs. beat no. plot. (<b>c</b>) CWT spectrogram for record: 16,786 using MODWT. For recording no. 16,786, MODWPT method and MODWT method do not show any significant difference.</p>
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<p>(<b>a</b>) Located R peaks. (<b>b</b>) RR interval vs. beat no. plot. (<b>c</b>) CWT spectrogram for the record: 117 using MODWPT. When comparing these plots with the MODWT method plots, we can observe a significant difference in the HF range until the 600 beat number.</p>
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<p>(<b>a</b>) Located R peaks. (<b>b</b>) RR interval vs. beat no. plot. (<b>c</b>) CWT spectrogram for record: 117 using MODWT.</p>
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<p>Missing peaks observed in the R peaks plot of recording: (<b>a</b>) 16,420, (<b>b</b>) 16,483, (<b>c</b>) 101, (<b>d</b>) 111, (<b>e</b>) 121, and (<b>f</b>) 234. These plots show the missed R peak circled in yellow color.</p>
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<p>The RR interval plot of recording: (<b>a</b>) 16,420 observed with an incorrect higher interval between R peaks; (<b>b</b>) 16,420 obtained from the PhysioNet Database; (<b>c</b>) 121 observed with an incorrect higher interval between R peaks; (<b>d</b>) 121 obtained from the PhysioNet Database.</p>
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<p>(<b>a</b>) RR interval plot of recording 16,786 plotted using MATLAB. (<b>b</b>) RR interval plot of recording 16,786 obtained from PhysioBank ATM. (<b>c</b>) RR interval plot of recording 230 plotted using MATLAB. (<b>d</b>) RR interval plot of recording 230 obtained from PhysioBank ATM.</p>
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<p>(<b>a</b>) RR interval plot of recording 16,786 plotted using MATLAB. (<b>b</b>) RR interval plot of recording 16,786 obtained from PhysioBank ATM. (<b>c</b>) RR interval plot of recording 230 plotted using MATLAB. (<b>d</b>) RR interval plot of recording 230 obtained from PhysioBank ATM.</p>
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<p>(<b>a</b>) RR interval plot of recording no. 16,773 plotted using MATLAB. (<b>b</b>) RR interval plot of recording no. 16,773 obtained from PhysioBank ATM.</p>
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<p>CWT spectrograms of recordings no. (<b>a</b>) 19,093 and (<b>b</b>) 228.</p>
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<p>RR intervals vs. beat no. plots of recordings no. (<b>a</b>) 112, (<b>b</b>) 123, and (<b>c</b>) 222.</p>
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<p>CWT spectrograms of recordings no. (<b>a</b>) 112, (<b>b</b>) 123, and (<b>c</b>) 222.</p>
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<p>(<b>a</b>) CWT spectrograms and (<b>b</b>) RR intervals vs. beat no. plots of recording no. 16,539.</p>
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<p>CWT spectrograms of recording no. 121.</p>
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<p>CWT spectrograms of recordings no. (<b>a</b>) 122 and (<b>b</b>) 205.</p>
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<p>CWT spectrograms of recordings no. (<b>a</b>) 106, (<b>b</b>) 119, and (<b>c</b>) 233.</p>
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<p>RR intervals vs. beat number plots of recordings no. (<b>a</b>) 106, (<b>b</b>) 119, and (<b>c</b>) 233.</p>
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<p>Scatter plot of LF/HF values of (<b>a</b>) Normal Sinus Rhythm dataset and (<b>b</b>) Arrhythmia dataset.</p>
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15 pages, 568 KiB  
Article
Electrocardiographic Assessment of National-Level Triathletes: Sinus Bradycardia and Other Electrocardiographic Abnormalities
by Mike Climstein, Kenneth S. Graham, Michael Stapelberg, Joe Walsh, Mark DeBeliso, Kent Adams, Trish Sevene and Chad Harris
Sports 2025, 13(1), 25; https://doi.org/10.3390/sports13010025 - 16 Jan 2025
Viewed by 594
Abstract
Background: High-intensity endurance training induces specific cardiac adaptations, often observed through electrocardiographic (ECG) changes. This study investigated the prevalence of ECG abnormalities in national-level Australian triathletes compared to sedentary controls. Methods: A cross-sectional observational study was conducted involving 22 triathletes and 7 sedentary [...] Read more.
Background: High-intensity endurance training induces specific cardiac adaptations, often observed through electrocardiographic (ECG) changes. This study investigated the prevalence of ECG abnormalities in national-level Australian triathletes compared to sedentary controls. Methods: A cross-sectional observational study was conducted involving 22 triathletes and 7 sedentary controls. Standard 12-lead ECGs assessed resting heart rate, ECG intervals, and axis deviation. Peak oxygen consumption was evaluated in triathletes to correlate with ECG indices and left ventricular mass, derived via echocardiography. Results: Triathletes exhibited significantly lower resting heart rates (53.8 vs. 72.1 bpm, −34%, p = 0.04), shorter QRS durations (0.088 vs. 0.107 ms, −21.6%, p = 0.01), and longer QT intervals (0.429 vs. 0.358 ms, +16.6%, p = 0.01) compared to controls. Sinus bradycardia was present in 68.2% of triathletes, with varying severity. First-degree atrioventricular block was identified in 13.6% of athletes, and left ventricular hypertrophy was confirmed in 18 triathletes via echocardiography. A significant positive relationship was identified between VO2peak and left ventricular mass (r = 0.68, p = 0.003). Conclusions: National-level triathletes exhibited ECG and structural cardiac adaptations consistent with high-intensity endurance training. Echocardiography is recommended for the accurate identification of LVH. These findings highlight the need for comprehensive cardiac evaluation in athletes to distinguish between physiological and pathological adaptations. Full article
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<p>Relationship between resting heart rate (HR Rest) and VO<sub>2</sub> peak for cycle and treadmill tests.</p>
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<p>Relationship between resting heart rate (HR Rest) and left ventricular mass.</p>
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33 pages, 15628 KiB  
Article
Towards Transparent AI in Medicine: ECG-Based Arrhythmia Detection with Explainable Deep Learning
by Oleksii Kovalchuk, Oleksandr Barmak, Pavlo Radiuk, Liliana Klymenko and Iurii Krak
Technologies 2025, 13(1), 34; https://doi.org/10.3390/technologies13010034 - 14 Jan 2025
Viewed by 747
Abstract
Cardiovascular diseases are the leading cause of death globally, highlighting the need for accurate diagnostic tools. To address this issue, we introduce a novel approach for arrhythmia detection based on electrocardiogram (ECG) that incorporates explainable artificial intelligence through three key methods. First, we [...] Read more.
Cardiovascular diseases are the leading cause of death globally, highlighting the need for accurate diagnostic tools. To address this issue, we introduce a novel approach for arrhythmia detection based on electrocardiogram (ECG) that incorporates explainable artificial intelligence through three key methods. First, we developed an enhanced R peak detection method that integrates domain-specific knowledge into the ECG, improving peak identification accuracy by accounting for the characteristic features of R peaks. Second, we proposed an arrhythmia classification method utilizing a modified convolutional neural network (CNN) architecture with additional convolutional and batch normalization layers. This model processes a triad of cardio cycles—the preceding, current, and following cycles—to capture temporal dependencies and hidden features related to arrhythmias. Third, we implemented an interpretation method that explains CNN’s decisions using clinically relevant features, making the results understandable to clinicians. Using the MIT-BIH database, our approach achieved an accuracy of 99.43%, with F1-scores approaching 100% for major arrhythmia classes. The integration of these methods enhances both the performance and transparency of arrhythmia detection systems. Full article
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Figure 1
<p>A schematic of a typical ECG waveform, illustrating the sequential components of an ideal cardiac cycle known as the QRST complex [<a href="#B4-technologies-13-00034" class="html-bibr">4</a>]. The diagram highlights the primary waveforms: P, Q, R, S, T, and U. Each segment and interval, including the PR interval, QRS duration, ST segment, and T-wave duration, is labeled to show phases of electrical activity in the heart.</p>
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<p>This figure outlines a three-task ECG arrhythmia classification approach using XAI. It starts with ECG input and proceeds through R peak identification, arrhythmia classification, and result interpretation, resulting in classified ECG fragments. This approach integrates domain knowledge to improve diagnostic accuracy and interpretability for clinicians.</p>
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<p>This figure illustrates the R peak detection method in ECG analysis, consisting of three key steps: knowledge integration, CNN processing, and post-processing. This method leverages domain knowledge of the reference heart cycle to enhance R peak detection accuracy, producing precise R peak locations in the output.</p>
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<p>This figure details Step 1 of the R peak detection method, focusing on integrating reference ECG knowledge. The process begins by analyzing 260 data points of the ECG to find the maximum deviation, representing the wave peak. If confirmed, knowledge integration is applied. The process skips 100 items after each peak to avoid redundancy until the end of the signal, generating a knowledge-integrated array <span class="html-italic">K</span> for further processing.</p>
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<p>A schematic representation illustrating the integration of reference ECG knowledge into the current ECG signal. The grey curve represents the raw ECG waveform, highlighting the natural fluctuations in cardiac electrical activity. The green overlay marks the regions where knowledge integration is applied, focusing on the R-peaks.</p>
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<p>This figure illustrates the post-processing steps for CNN-predicted R peak identification. Starting with CNN predictions, the process filters data, identifies the maximum prediction in each range, and saves it in an output array <span class="html-italic">D</span>. It iterates through the signal to create a comprehensive index array of R peak positions.</p>
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<p>This figure presents an ECG classification method for arrhythmia detection, beginning with ECG and R peak indices. The process involves splitting the ECG into fragments and using a CNN model to classify each fragment, resulting in predicted pathology labels for individual ECG segments to support clinical diagnosis.</p>
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<p>This figure illustrates a step-by-step method for detecting specific features in a classified ECG fragment. Starting with a 700-length ECG segment, it empirically identifies the receptive region, analyzes the presence of features, and applies methods like formula-based verification, visualization, and ML or DL classification. Each step is designed to confirm or deny feature presence, with outcomes supporting clinical interpretation of ECG data.</p>
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<p>Training samples for two ECG classes, illustrating separation clarity within a designated zone of interest. Subfigures (<b>a</b>,<b>b</b>) show cases with unclear separation, while (<b>c</b>,<b>d</b>) display distinct separation patterns in the zone. The cardiac cycle, highlighted in green, is overlaid with a black rectangle to emphasize the zone of interest and represent the relevant signal fragment.</p>
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<p>The application of PCA on ECG fragments within the zone of interest. Red and blue clusters represent two distinct classes, highlighting areas of overlap and separation; the green dot represents the target ECG.</p>
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<p>Training and validation curves for accuracy (<b>a</b>) and loss (<b>b</b>) over 18 epochs. The rapid convergence of accuracy and reduction in loss indicate effective training with minimal overfitting, demonstrating the CNN model’s stability and generalizability for ECG classification tasks.</p>
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<p>ROC curves for a multi-class classification of ECG data, showing near-perfect AUC values (mostly 1.00), indicating high model performance. Minor deviations in classes 7 and 9 suggest slight inconsistencies in distinguishing these classes, reflecting model robustness overall.</p>
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<p>This figure presents One-vs-One ROC curves for ECG classification, demonstrating high accuracy in class differentiation: (<b>a</b>) shows normal vs. others (AUC 0.99), (<b>b</b>) class 9 vs. 1 (AUC 1.00), (<b>c</b>) LBBB vs. RBBB (AUC 1.00), and (<b>d</b>) classes 5 vs. 4 (AUC 1.00).</p>
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<p>A multi-channel ECG recording used in clinical trials, with annotations indicating normal cycles and those with PVC.</p>
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<p>This figure illustrates the process of splitting a multi-channel ECG image into separate channel-specific images. Each channel is isolated to enable focused analysis, facilitating the detection of specific patterns and anomalies within each individual ECG trace, such as PVC.</p>
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<p>This confusion matrix summarizes the performance of the pathology classification model in clinical trials. Two Class 1 (“Normal”) cycles were misclassified as Class 3 (PVC), and one Class 3 cycle was misclassified as Class 1, indicating high but not flawless consistency. No cases were predicted as Class 2 (RBBB) because the clinical dataset contained no instances meeting its diagnostic criteria, leaving the model without examples to learn from or identify for that category.</p>
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<p>Visual confirmation of key features and abnormalities in ECG cycles, including (<b>a</b>) a normal ECG cycle, (<b>b</b>) key peak markers represented by colored dots: purple for the P wave, brown for the R peak, and dark purple for the T wave, (<b>c</b>) PQ and ST segments decline highlighted in red to indicate deviations from the baseline, and (<b>d</b>) a deformed QRS complex with red markings to emphasize morphological distortions.</p>
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<p>Visual confirmation of ECG pathology features, illustrating (<b>a</b>) a normal ECG cycle with standard waveforms, (<b>b</b>) an extended QRS complex highlighted in red to emphasize its abnormal duration, and (<b>c</b>) discordant changes in the ST-T segment, where red markings indicate deviations from the baseline.</p>
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<p>Visual confirmation of ECG features, associated with LBBB, including (<b>a</b>) a baseline ECG, (<b>b</b>) a signal fragment marked with a yellow highlight that confirms the feature of an extended QRS complex, (<b>c</b>) ST-segment elevation emphasized in red to signify abnormal changes, and (<b>d</b>) a widened QRS complex highlighted in red to depict the prolonged intraventricular delay time.</p>
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<p>Visual confirmation of feature “Ventricular Extrasystole” in an ECG, including (<b>a</b>) a baseline ECG, (<b>b</b>) an extended and deformed QRS complex highlighted in light red to signify its abnormal morphology, (<b>c</b>) a segment marked in red indicating the absence of the P wave, and (<b>d</b>) a compensatory pause emphasized in pink to highlight the recovery period following the ectopic beat.</p>
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<p>This figure displays an ECG classified as “Fusion of Ventricular Extrasystole”. The waveform demonstrates characteristics of both normal and ectopic ventricular beats, indicative of fusion, where premature ventricular and normal impulses overlap, producing a unique hybrid beat.</p>
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<p>Visual confirmation of feature “Fusion of Ventricular Extrasystole” in an ECG, illustrating (<b>a</b>) an extended and deformed QRS complex highlighted in pink to indicate abnormal morphology, (<b>b</b>) the absence of the P peak marked in light brown to show missing atrial depolarization, (<b>c</b>) the lack of a compensatory pause emphasized with magenta to highlight the abnormal rhythm recovery, and (<b>d</b>) ventricular extrasystole highlighted in purple and pink that occurs between normal cardiac cycles.</p>
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22 pages, 1529 KiB  
Article
Exercise ECG Classification Based on Novel R-Peak Detection Using BILSTM-CNN and Multi-Feature Fusion Method
by Xinhua Su, Xuxuan Wang and Huanmin Ge
Electronics 2025, 14(2), 281; https://doi.org/10.3390/electronics14020281 - 12 Jan 2025
Viewed by 389
Abstract
Excessive exercise is a primary cause of sports injuries and sudden death. Therefore, it is vital to develop an effective monitoring technology for exercise intensity. Based on the noninvasiveness and real-time nature of an electrocardiogram (ECG), exercise ECG classification based on ECG features [...] Read more.
Excessive exercise is a primary cause of sports injuries and sudden death. Therefore, it is vital to develop an effective monitoring technology for exercise intensity. Based on the noninvasiveness and real-time nature of an electrocardiogram (ECG), exercise ECG classification based on ECG features could be used for detecting exercise intensity. However, current R-peak detection algorithms still have limitations, especially in high-intensity exercise scenarios and in the presence of noise interference. Additionally, the features utilized for exercise ECG classification are not comprehensive. To address these issues, the following tasks have been accomplished: (1) a hybrid time–frequency-domain model, BILSTM-CNN, is proposed for R-peak detection by utilizing BILSTM, multi-scale convolution, and an attention mechanism; (2) to enhance the robustness of the detector, a preprocessing data generator and a post-processing adaptive filter technique are proposed; (3) to improve the reliability of exercise intensity detection, the accurate heart rate variability (HRV) features derived from the proposed BILSTM-CNN and comprehensive features are constructed, which include various descriptive features (wavelets, local binary patterns (LBP), and higher-order statistics (HOS)) tested by the feasibility experiments and optimized deep learning features extracted from the continuous wavelet transform (CWT) of exercise ECG signals. The proposed system is evaluated by real ECG datasets, and it shows remarkable effectiveness in classifying five types of motion states, with an accuracy of 99.1%, a recall of 99.1%, and an F1 score of 99.1%. Full article
(This article belongs to the Special Issue Artificial Intelligence Methods for Biomedical Data Processing)
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<p>The segments corresponding to the levels of exercise fatigue [<a href="#B21-electronics-14-00281" class="html-bibr">21</a>] are seg1: [VT2 − 50, VT2 − 30], seg2: [VT2 + 60, VT2 + 80], seg3: [VO2max − 50, VO2max − 30], seg4: [VO2max − 10, VO2max + 10], and seg5: [VO2max + 60, VO2max + 80].</p>
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<p>Overview of exercise ECG classification based on multi-feature fusion method.</p>
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<p>The proposed robust and adaptive R-peak detection. BW = baseline wander; MA = muscle artifact. U indicates uniform distribution where a random multiplier is drawn. SWT represents wavelet transform and DFT represents Discrete Fourier Transform. The sliding window represents the set cardiac cycle. *: multiplication.</p>
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<p>(<b>a</b>) SWT enhances the local features at the positions of R-peaks; (<b>b</b>) DFT extracts the frequency-domain representation of the signal.</p>
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<p>Tree-structured decomposition process of SWT: “S” represents the signal itself, “CD” represents the detail coefficients, and “CA” represents the approximate coefficients.</p>
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<p>The comparison results of R-peak detection without the proposed adaptive filter and one with the proposed adaptive filter: (<b>a</b>) due to noise and high-intensity movement, false detections of R-peaks occur; (<b>b</b>) the falsely detected R-peak is filtered out by the proposed adaptive filter.</p>
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<p>Average beats from the EPFL database are grouped by the five exercise fatigue classes (Seg_1, Seg_2, Seg_3, Seg_4, and Seg_5): (<b>a</b>) represents the comparison of the extracted wavelet features under five different fatigue levels, and (<b>b</b>) represents the comparison of the HOS features under five different fatigue levels (best seen in color). The abscissa represents the number of features, and the ordinate represents the calculated values.</p>
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<p>Comparison of the F1 score conducted by all R-peak detection algorithms on the EPFL dataset with various Gaussian noise (different SNRs). The results indicate that our R-peak detection method achieves the best robustness.</p>
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<p>The confusion matrix of using HRV features to classify.</p>
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<p>The confusion matrix of using HRV and ECG features to classify.</p>
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<p>The confusion matrix of using all features to classify.</p>
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15 pages, 1711 KiB  
Article
Research on ECG Signal Classification Based on Hybrid Residual Network
by Tianyu Qi, He Zhang, Huijun Zhao, Chong Shen and Xiaochen Liu
Appl. Sci. 2024, 14(23), 11202; https://doi.org/10.3390/app142311202 - 1 Dec 2024
Viewed by 944
Abstract
Arrhythmia detection in electrocardiogram (ECG) signals is essential for monitoring cardiovascular health. Current automated arrhythmia classification methods frequently encounter difficulties in detecting multiple cardiac abnormalities, particularly when dealing with imbalanced datasets. This paper proposes a novel deep learning approach for the detection and [...] Read more.
Arrhythmia detection in electrocardiogram (ECG) signals is essential for monitoring cardiovascular health. Current automated arrhythmia classification methods frequently encounter difficulties in detecting multiple cardiac abnormalities, particularly when dealing with imbalanced datasets. This paper proposes a novel deep learning approach for the detection and classification of arrhythmias in ECG signals using a Hybrid Residual Network (Hybrid ResNet). Our method employs a Hybrid Residual Network architecture that integrates standard convolution, depthwise separable convolution, and residual connections to enhance the feature extraction efficiency and classification accuracy. To guarantee superior input signals, we preprocess the ECG signals by removing baseline drift with a high-pass Butterworth filter, denoising via discrete wavelet transform, and segmenting heartbeat cycles through R-peak detection. Additionally, we rectify the class imbalance in the MIT-BIH Arrhythmia Database by applying the Synthetic Minority Oversampling Technique (SMOTE), therefore enhancing the model’s ability to detect infrequent arrhythmia types. The suggested system achieves a classification accuracy of 99.09% on the MIT-BIH dataset, surpassing conventional convolutional neural networks and other state-of-the-art methodologies. Compared to existing approaches, our strategy exhibits superior effectiveness and robustness in managing diverse irregular heartbeats and arrhythmias. Full article
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<p>ECG waveform with key intervals and segments.</p>
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<p>Flowchart of our proposed method.</p>
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<p>Architecture of the Hybrid ResNet model.</p>
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<p>A plot illustrating the training and evaluation accuracies on the MIT-BIH dataset as a function of the number of epochs.</p>
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<p>Classifier performance using confusion matrix with normalization.</p>
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20 pages, 764 KiB  
Article
A Multi-Class ECG Signal Classifier Using a Binarized Depthwise Separable CNN with the Merged Convolution–Pooling Method
by Rui Zhang, Ranran Zhou, Zuting Zhong, Haifeng Qi and Yong Wang
Sensors 2024, 24(22), 7207; https://doi.org/10.3390/s24227207 - 11 Nov 2024
Viewed by 674
Abstract
Binarized convolutional neural networks (bCNNs) are favored for the design of low-storage, low-power cardiac arrhythmia classifiers owing to their high weight compression rate. However, multi-class classification of ECG signals based on bCNNs is challenging due to the accuracy loss introduced by the binarization [...] Read more.
Binarized convolutional neural networks (bCNNs) are favored for the design of low-storage, low-power cardiac arrhythmia classifiers owing to their high weight compression rate. However, multi-class classification of ECG signals based on bCNNs is challenging due to the accuracy loss introduced by the binarization operation. In this paper, an effective multi-classifier system is proposed for electrocardiogram (ECG) signals using a binarized depthwise separable convolutional neural network (bDSCNN) with the merged convolution–pooling (MCP) method. The binarized depthwise separable convolution layer is adopted to reduce the increased number of parameters in multi-classification systems. Instead of operating convolution and pooling sequentially as in a traditional convolutional neural network (CNN), the MCP method merges pooling together with convolution layers to reduce the number of computations. To further reduce hardware resources, this work employs blockwise incremental calculation to eliminate redundant storage with computations. In addition, the R peak interval data are integrated with P-QRS-T features to improve the classification accuracy. The proposed bDSCNN model is evaluated on an Intel DE1-SoC field-programmable gate array (FPGA), and the experimental results demonstrate that the proposed system achieves a five-class classification accuracy of 96.61% and a macro-F1 score of 89.08%, along with a dynamic power dissipation of 20 μW for five-category ECG signal classification. The hardware resource usage of BRAM and LUTs plus REGs is reduced by at least 2.94 and 1.74 times, respectively, compared with existing ECG classifiers using bCNN methods. Full article
(This article belongs to the Section Biomedical Sensors)
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<p>The SoC architecture with the bDSCNN model.</p>
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<p>Overall design of the bDSCNN model.</p>
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<p>(<b>a</b>) The numbers of the five original classes and balanced beat subtype for training. (<b>b</b>) The proportions of the original and balanced data for the five types of beat data in training.</p>
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<p>The original ECG N-image and the resized ECG N-image.</p>
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<p>The proposed MCP method with kernel size of 4 × 4 and transposed stride of 2: (<b>a</b>) the comparison of parallel computations between “baseline” and MCP methods; (<b>b</b>) the reconstruction process of the proposed merged convolution–pooling kernel; (<b>c</b>) the comparisons of operation numbers between the “baseline” and MCP methods.</p>
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<p>Illustration of the pruning process in the MCP method.</p>
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<p>Blockwise incremental calculation to eliminate repetitive storage and computations in the bDSCNN.</p>
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<p>(<b>a</b>) The latency of traditional layer-by-layer calculation. (<b>b</b>) The latency of blockwise incremental calculation. (<b>c</b>) Pipeline scheduling for blockwise incremental calculation.</p>
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<p>The overall hardware architecture of the proposed bDSCNN.</p>
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18 pages, 3939 KiB  
Review
Towards Reliable ECG Analysis: Addressing Validation Gaps in the Electrocardiographic R-Peak Detection
by Syed Talha Abid Ali, Sebin Kim and Young-Joon Kim
Appl. Sci. 2024, 14(21), 10078; https://doi.org/10.3390/app142110078 - 4 Nov 2024
Viewed by 1056
Abstract
Electrocardiographic (ECG) R-peak detection is essential for every sensor-based cardiovascular health monitoring system. To validate R-peak detectors, comparing the predicted results with reference annotations is crucial. This comparison is typically performed using tools provided by the waveform database (WFDB) or custom methods. However, [...] Read more.
Electrocardiographic (ECG) R-peak detection is essential for every sensor-based cardiovascular health monitoring system. To validate R-peak detectors, comparing the predicted results with reference annotations is crucial. This comparison is typically performed using tools provided by the waveform database (WFDB) or custom methods. However, many studies fail to provide detailed information on the validation process. The literature also highlights inconsistencies in reporting window size, a crucial parameter used to compare predictions with expert annotations to distinguish false peaks from the true R-peak. Additionally, there is also a need for uniformity in reporting the total number of beats for individual or collective records of the widely used MIT-BIH arrhythmia database. Thus, we aim to review validation methods of various R-peak detection methodologies before their implementation in real time. This review discusses the impact of non-beat annotations when using a custom validation method, allowable window tolerance, the effects of window size deviations, and implications of varying numbers of beats and skipping segments on ECG testing, providing a comprehensive guide for researchers. Addressing these validation gaps is critical as they can significantly affect validatory outcomes. Finally, the conclusion section proposes a structured concept as a future approach, a guide to integrate WFDB R-peak validation tools for testing any QRS annotated ECG database. Overall, this review underscores the importance of complete transparency in reporting testing procedures, which prevents misleading assessments of R-peak detection algorithms and enables fair methodological comparison. Full article
(This article belongs to the Special Issue Applied Electronics and Functional Materials)
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<p>Graphical representation of various discrepancies found in the literature.</p>
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<p>Process Flow of the bxb Annotation Comparator.</p>
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<p>Calculation of Window-based Statistical Metrics.</p>
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<p>Case-based analysis of window size and its effect on FPs/FNs. (<b>a</b>) presents case study 1 featuring record 108 from the MIT-BIH dataset. (<b>b</b>) displays case study 2 with record 203 from the MIT-BIH arrhythmia dataset. These cases are included to demonstrate how altering window size can affect FP and FN counts.</p>
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<p>Acceptable Window Sample Tolerance. (<b>a</b>) Window tolerance reported in literature and (<b>b</b>) window tolerance in samples.</p>
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<p>Validation of the actual tolerance for the AAMI benchmark window of 0.15 s.</p>
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<p>Some of the Non-beats in MIT-BIH Arrhythmia Dataset. VT: Ventricular tachycardia, T: Ventricular trigeminy, N: Normal sinus rhythm, |: Isolated QRS-like artifact, !: Ventricular flutter, B: Ventricular bigeminy, NOD: Nodal (A-V junctional) rhythm, IVR: Idioventricular rhythm, AFIB: Atrial fibrillation, and SVTA: Supraventricular tachyarrhythmia.</p>
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<p>WFDB comparator bxb excluding a non-beat.</p>
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<p>Proposed structured hierarchy that could be utilized for ECG R-peak Validation.</p>
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14 pages, 4061 KiB  
Article
Validity and Reliability of Movesense HR+ ECG Measurements for High-Intensity Running and Cycling
by Raúl Martín Gómez, Enzo Allevard, Haye Kamstra, James Cotter and Peter Lamb
Sensors 2024, 24(17), 5713; https://doi.org/10.3390/s24175713 - 2 Sep 2024
Cited by 1 | Viewed by 1888
Abstract
Low-cost, portable devices capable of accurate physiological measurements are attractive tools for coaches, athletes, and practitioners. The purpose of this study was primarily to establish the validity and reliability of Movesense HR+ ECG measurements compared to the criterion three-lead ECG, and secondarily, to [...] Read more.
Low-cost, portable devices capable of accurate physiological measurements are attractive tools for coaches, athletes, and practitioners. The purpose of this study was primarily to establish the validity and reliability of Movesense HR+ ECG measurements compared to the criterion three-lead ECG, and secondarily, to test the industry leader Garmin HRM. Twenty-one healthy adults participated in running and cycling incremental test protocols to exhaustion, both with rest before and after. Movesense HR+ demonstrated consistent and accurate R-peak detection, with an overall sensitivity of 99.7% and precision of 99.6% compared to the criterion; Garmin HRM sensitivity and precision were 84.7% and 87.7%, respectively. Bland–Altman analysis compared to the criterion indicated mean differences (SD) in RR’ intervals of 0.23 (22.3) ms for Movesense HR+ at rest and 0.38 (18.7) ms during the incremental test. The mean difference for Garmin HRM-Pro at rest was −8.5 (111.5) ms and 27.7 (128.7) ms for the incremental test. The incremental test correlation was very strong (r = 0.98) between Movesense HR+ and criterion, and moderate (r = 0.66) for Garmin HRM-Pro. This study developed a robust peak detection algorithm and data collection protocol for Movesense HR+ and established its validity and reliability for ECG measurement. Full article
(This article belongs to the Special Issue Sensor Techniques and Methods for Sports Science)
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<p>Configuration of 3-lead ECG, Movesense and Garmin devices. Participants were also equipped with a respiratory face mask; however, respiratory data were not included in the current study.</p>
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<p>Diagram illustrating the data collection and statistical analysis process.</p>
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<p>Bland-Altman plots of RR’ intervals derived from the detected peaks using Movesense HR+ and criterion for (<b>a</b>) Activity 1, initial 5 min rest; (<b>b</b>) Activity 2, incremental test; (<b>c</b>) Activity 3, final 5 min rest; and Bland-Altman plots of Garmin HRM-Pro RR’ vs. 3-lead RR’ intervals for (<b>d</b>) Activity 1, (<b>e</b>) Activity 2, and (<b>f</b>) Activity 3. An alpha value of 0.3 was applied to the plots (blue dots) to reduce the effect of over-plotting.</p>
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<p>Correlation of the heart rate derived from the RR’ values through the different intensities of the incremental test: (<b>a</b>) Movesense HR+ vs. criterion and (<b>b</b>) Garmin HRM-Pro vs. criterion. An alpha value of 0.3 was applied to the plots (blue dots) to reduce the effect of over-plotting.</p>
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<p>Comparative analysis of RR’ interval samples for one participant. (<b>a</b>) Activity 1 (resting), Movesense HR+ vs. 3-lead; (<b>b</b>) Activity 2 (incremental test), Movesense HR+ vs. criterion; (<b>c</b>) Activity 1 (resting), Garmin HRM-Pro vs. criterion; (<b>d</b>) Activity 2, Garmin HRM-Pro vs. criterion. Data for the same participant, activity and time are shown in (<b>a</b>) and (<b>c</b>) and in (<b>b</b>) and (<b>d</b>), respectively.</p>
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<p>(<b>a</b>) Correlation of standard deviation (SD) of the RR’ intervals for Movesense HR+ and 3-lead ECG; (<b>b</b>) Bland-Altman plot of the SD of the RR’ intervals for Movesense HR+ and 3-lead ECG; (<b>c</b>) Correlation of SD of the RR’ intervals for Garmin HRM-Pro and 3-lead ECG; (<b>d</b>) Bland-Altman plot of the SD of the RR’ intervals for Garmin HRM-Pro and 3-lead ECG.</p>
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15 pages, 3559 KiB  
Article
Advanced Denoising and Meta-Learning Techniques for Enhancing Smart Health Monitoring Using Wearable Sensors
by Minyechil Alehegn Tefera, Amare Mulatie Dehnaw, Yibeltal Chanie Manie, Cheng-Kai Yao, Shegaw Demessie Bogale and Peng-Chun Peng
Future Internet 2024, 16(8), 280; https://doi.org/10.3390/fi16080280 - 5 Aug 2024
Cited by 2 | Viewed by 1777
Abstract
This study introduces a novel meta-learning method to enhance diabetes detection using wearable sensor systems in smart health applications. Wearable sensor technology often needs to operate accurately across a wide range of users, each characterized by unique physiological and behavioral patterns. However, the [...] Read more.
This study introduces a novel meta-learning method to enhance diabetes detection using wearable sensor systems in smart health applications. Wearable sensor technology often needs to operate accurately across a wide range of users, each characterized by unique physiological and behavioral patterns. However, the specific data for a particular application or user group might be scarce. Moreover, collecting extensive training data from wearable sensor experiments is challenging, time-consuming, and expensive. In these cases, meta-learning can be particularly useful. This model can quickly adapt to the nuances of new users or specific applications with minimal data. Therefore, to solve the need for a huge amount of training data and to enable the application of artificial intelligence (AI) in data-scarce scenarios, a meta-learning method is proposed. This meta-learning model has been implemented to forecast diabetes, resolve cross-talk issues, and accurately detect R peaks from overlapping electrocardiogram (ECG) signals affected by movement artifacts, poor electrode contact, electrical interference, or muscle activity. Motion artifacts from body movements, external conditions such as temperature, humidity, and electromagnetic interference, and the inherent quality and calibration of the sensor can all contribute to noise. Contact quality between the sensor and the skin, signal processing errors, power supply variations, user-generated interference from activities like talking or exercising, and the materials used in the wearable device also play significant roles in the overall noise in wearable sensor data and can significantly distort the true signal, leading to erroneous interpretations and potential diagnostic errors. Furthermore, discrete wavelet transform (DWT) was also implemented to improve the quality of the data and enhance the performance of the proposed model. The demonstrated results confirmed that with only a limited amount of target data, the proposed meta-learning and DWT denoising method can adapt more quickly and improve the detection of diabetes compared to the traditional method. Therefore, the proposed system is cost-effective, flexible, faster, and adaptable, reduces the need for training data, and can enhance the accuracy of chronic disease detection such as diabetes for smart health systems. Full article
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<p>Proposed discrete wavelet transform (DWT) multi-level denoising (<b>a</b>) before applying the denoising technique, (<b>b</b>) after applying the denoising technique.</p>
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<p>The scheme and implementation framework of the proposed system.</p>
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<p>Proposed technique performance based on RMSE and MSE according to various iterations (k) steps.</p>
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<p>Comparison of performance of meta-learning, without pre-train, after fine-tune, and before fine-tune in terms of MAE and time.</p>
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<p>Predicted vs actual glucose level using the proposed method.</p>
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<p>ROC curve of the proposed model.</p>
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<p>Detected r-peaks using the proposed method.</p>
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<p>Performance of different models.</p>
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14 pages, 3120 KiB  
Article
A Novel Instruction Driven 1-D CNN Processor for ECG Classification
by Jiawen Deng, Jie Yang, Xin’an Wang and Xing Zhang
Sensors 2024, 24(13), 4376; https://doi.org/10.3390/s24134376 - 5 Jul 2024
Viewed by 1144
Abstract
Electrocardiography (ECG) has emerged as a ubiquitous diagnostic tool for the identification and characterization of diverse cardiovascular pathologies. Wearable health monitoring devices, equipped with on-device biomedical artificial intelligence (AI) processors, have revolutionized the acquisition, analysis, and interpretation of ECG data. However, these systems [...] Read more.
Electrocardiography (ECG) has emerged as a ubiquitous diagnostic tool for the identification and characterization of diverse cardiovascular pathologies. Wearable health monitoring devices, equipped with on-device biomedical artificial intelligence (AI) processors, have revolutionized the acquisition, analysis, and interpretation of ECG data. However, these systems necessitate AI processors that exhibit flexible configuration, facilitate portability, and demonstrate optimal performance in terms of power consumption and latency for the realization of various functionalities. To address these challenges, this study proposes an instruction-driven convolutional neural network (CNN) processor. This processor incorporates three key features: (1) An instruction-driven CNN processor to support versatile ECG-based application. (2) A Processing element (PE) array design that simultaneously considers parallelism and data reuse. (3) An activation unit based on the CORDIC algorithm, supporting both Tanh and Sigmoid computations. The design has been implemented using 110 nm CMOS process technology, occupying a die area of 1.35 mm2 with 12.94 µW power consumption. It has been demonstrated with two typical ECG AI applications, including two-class (i.e., normal/abnormal) classification and five-class classification. The proposed 1-D CNN algorithm performs with a 97.95% accuracy for the two-class classification and 97.9% for the five-class classification, respectively. Full article
(This article belongs to the Section Biomedical Sensors)
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<p>ECG waveform from MIT_BIH database.</p>
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<p>Algorithm for 1-D convolution layer and partition.</p>
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<p>Block diagram of the proposed system.</p>
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<p>Work flow of the proposed system.</p>
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<p>Hardware architecture of the R-peak detection engine.</p>
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<p>The overall architecture of the 1-D CNN engine.</p>
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<p>The IEEE 754 standard half-precision floating-point data format.</p>
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<p>The demonstration of the PE array and data buffer.</p>
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<p>The architecture of computing Sigmoid(x) and Tanh(x) and T(x) based on CORDIC.</p>
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<p>The architecture of the pooling unit.</p>
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<p>The processor layout and specifications.</p>
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17 pages, 4902 KiB  
Article
Automated Heart Rate Detection in Seismocardiograms Using Electrocardiogram-Based Algorithms—A Feasibility Study
by Evgenii Pustozerov, Ulf Kulau and Urs-Vito Albrecht
Bioengineering 2024, 11(6), 596; https://doi.org/10.3390/bioengineering11060596 - 11 Jun 2024
Cited by 1 | Viewed by 1818
Abstract
In recent decades, much work has been implemented in heart rate (HR) analysis using electrocardiographic (ECG) signals. We propose that algorithms developed to calculate HR based on detected R-peaks using ECG can be applied to seismocardiographic (SCG) signals, as they utilize common knowledge [...] Read more.
In recent decades, much work has been implemented in heart rate (HR) analysis using electrocardiographic (ECG) signals. We propose that algorithms developed to calculate HR based on detected R-peaks using ECG can be applied to seismocardiographic (SCG) signals, as they utilize common knowledge regarding heart rhythm and its underlying physiology. We implemented the experimental framework with methods developed for ECG signal processing and peak detection to be applied and evaluated on SCGs. Furthermore, we assessed and chose the best from all combinations of 15 peak detection and 6 preprocessing methods from the literature on the CEBS dataset available on Physionet. We then collected experimental data in the lab experiment to measure the applicability of the best-selected technique to the real-world data; the abovementioned method showed high precision for signals recorded during sitting rest (HR difference between SCG and ECG: 0.12 ± 0.35 bpm) and a moderate precision for signals recorded with interfering physical activity—reading out a book loud (HR difference between SCG and ECG: 6.45 ± 3.01 bpm) when compared to the results derived from the state-of-the-art photoplethysmographic (PPG) methods described in the literature. The study shows that computationally simple preprocessing and peak detection techniques initially developed for ECG could be utilized as the basis for HR detection on SCG, although they can be further improved. Full article
(This article belongs to the Special Issue Addressing Health Disparities with Accessible Sensors and Diagnostics)
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<p>The experimental scheme of the measurement. Patch 1 (yellow) is for sternal accelerometers; patch 2 (green) is for apex cordis accelerometers. The other patches belong to the reference ECGs.</p>
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<p>A block diagram of the measurement system, showing the primary hardware modules (such as sensor patches, ECG, and processing unit), along with the main firmware blocks within the preprocessing unit (PU).</p>
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<p>The detection example for the hamilton2002 preprocessing and nabian2018 peak detection combination of methods. Gray curve—raw signal, orange curve—signal after being processed with the hamilton2002 pipeline, black curve in the bottom plot—ECG signal, red vertical lines—timestamps of R-peaks detected on ECG, blue vertical lines—J-peaks detected on SCG, the numbers next to blue vertical lines show the distance from the previous and to the next peak in ms. For the selected interval: precision = 100%, recall = 100%, F1-score = 1.00, HR: 61.9 bpm, <span class="html-italic">n</span>(j_peaks) = <span class="html-italic">n</span>(R_peaks) = 9. The accuracy calculation does not include peaks close to the plot’s border. Signal magnitudes are normalized for demonstrational purposes.</p>
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<p>The detection results for the hamilton2002 preprocessing and nabian2018 peak detection combination on the experimental data. Gray curve—raw signal, orange curve—signal after being processed with hamilton2002 algorithm, black curve in the bottom plot—ECG signal, red vertical lines—timestamps of R-peaks detected on ECG, blue vertical lines—J-peaks detected on SCG, the numbers around blue vertical lines show the distance from the previous and to the next peak in ms. The patch with the best precision is shown with a blue frame. For the selected interval: precision = 100%, recall = 100%, F1-score = 1.00, HR: 81.2 bpm, <span class="html-italic">n</span>(j_peaks) = <span class="html-italic">n</span>(R_peaks) = 12. The accuracy calculation does not include peaks close to the plot’s border. Signal magnitudes are normalized for demonstration purposes.</p>
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<p>Five-second samples from the middle of the recording for different subjects while resting and during reading interference. All measurements were acquired from Patch 1, axis Z. Gray curve—raw signal, orange curve—signal after being processed with hamilton2002 pipeline, red vertical lines—timestamps of the R-peaks detected on the ECG, blue vertical lines—the J-peaks detected on the SCG, the numbers next to blue vertical lines show the distance from the previous and to the next peak in ms.</p>
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<p>Averaged plots were created based on detected anchor points (in this case, J-peaks detected on the signal from Patch 1, axis Z were taken as anchor points for all signals); subject 2, relaxed, t = 60 s. The prominent peaks are labeled with letters. The number next to the letter shows the distance between each peak and the anchor point. Gray lines show the individual trajectories of each heartbeat.</p>
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10 pages, 787 KiB  
Article
The Role of Galectin-3 Levels for Predicting Paroxysmal Atrial Fibrillation in Patients with Embolic Stroke of Undetermined Source
by Bekir Çalapkorur, Erkan Demirci, Oğuzhan Baran, Ersin Kasım Ulusoy, Derya Koçer, Selami Demirelli, Mustafa Gök and Ziya Şimşek
J. Clin. Med. 2024, 13(11), 3175; https://doi.org/10.3390/jcm13113175 - 29 May 2024
Viewed by 781
Abstract
Background/Objectives: Paroxysmal atrial fibrillation (PAF) is an important cause that is thought main potential factor in Embolic stroke of undetermined source (ESUS). Extended Holter ECG is an expensive and time-consuming examination. It needs another tools for predicting PAF in ESUS patients. In this [...] Read more.
Background/Objectives: Paroxysmal atrial fibrillation (PAF) is an important cause that is thought main potential factor in Embolic stroke of undetermined source (ESUS). Extended Holter ECG is an expensive and time-consuming examination. It needs another tools for predicting PAF in ESUS patients. In this study, serum galectin-3 levels, ECG parameters (PR interval, P wave time and P wave peak time) LA volume index, LA global peak strain and atrial electromechanical conduction time values were investigated for predicting PAF. Methods: 150 patients with ESUS and 30 volunteers for the control group were recruited to study. 48–72 h Holter ECG monitoring was used for detecting PAF. Patients were divided into two groups (ESUS + PAF and ESUS-PAF) according to the development of PAF in Holter ECG monitoring. Results: 30 patients with ESUS whose Holter ECG monitoring showed PAF, were recruited to the ESUS + PAF group. Other 120 patients with ESUS were recruited to the ESUS-PAF group. PA lateral, PA septum, and PA tricuspid were higher in the ESUS + PAF group (p < 0.001 for all). Serum galectin-3 levels were significantly higher in ESUS + PAF than in ESUS-PAF and control groups (479.0 pg/mL ± 435.8 pg/mL, 297.8 pg/mL ± 280.3 pg/mL, and 125.4 ± 87.0 pg/mL, p < 0.001, respectively). Serum galectin-3 levels were significantly correlated with LAVI, PA lateral, and global peak LA strain (r = 0.246, p = 0.001, p = 0.158, p = 0.035, r = −0.176, p = 0.018, respectively). Conclusion: Serum galectin-3 levels is found higher in ESUS patients which developed PAF and Serum galectin-3 levels are associated LA adverse remodeling in patients with ESUS. Full article
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<p>Demonstrates the correlation between serum Galectin-3 levels and PA lateral (<b>A</b>), global peak left atrium strain (<b>B</b>), left atrial volume index (<b>C</b>), LA: left atrium, LAVI: left atrium volume index.</p>
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<p>Demonstrating of receiver operating characteristics (ROC) curve of 235.1 pg/mL serum galectin-3 level for predicting paroxysmal atrial fibrillation, AUC: Area under curve.</p>
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15 pages, 911 KiB  
Article
A New and Lightweight R-Peak Detector Using the TEDA Evolving Algorithm
by Lucileide M. D. da Silva, Sérgio N. Silva, Luísa C. de Souza, Karolayne S. de Azevedo, Luiz Affonso Guedes and Marcelo A. C. Fernandes
Mach. Learn. Knowl. Extr. 2024, 6(2), 736-750; https://doi.org/10.3390/make6020034 - 29 Mar 2024
Viewed by 2051
Abstract
The literature on ECG delineation algorithms has seen significant growth in recent decades. However, several challenges still need to be addressed. This work aims to propose a lightweight R-peak-detection algorithm that does not require pre-setting and performs classification on a sample-by-sample basis. The [...] Read more.
The literature on ECG delineation algorithms has seen significant growth in recent decades. However, several challenges still need to be addressed. This work aims to propose a lightweight R-peak-detection algorithm that does not require pre-setting and performs classification on a sample-by-sample basis. The novelty of the proposed approach lies in the utilization of the typicality eccentricity detection anomaly (TEDA) algorithm for R-peak detection. The proposed method for R-peak detection consists of three phases. Firstly, the ECG signal is preprocessed by calculating the signal’s slope and applying filtering techniques. Next, the preprocessed signal is inputted into the TEDA algorithm for R-peak estimation. Finally, in the third and last step, the R-peak identification is carried out. To evaluate the effectiveness of the proposed technique, experiments were conducted on the MIT-BIH arrhythmia database (MIT-AD) for R-peak detection and validation. The results of the study demonstrated that the proposed evolutive algorithm achieved a sensitivity (Se in %), positive predictivity (+P in %), and accuracy (ACC in %) of 95.45%, 99.61%, and 95.09%, respectively, with a tolerance (TOL) of 100 milliseconds. One key advantage of the proposed technique is its low computational complexity, as it is based on a statistical framework calculated recursively. It employs the concepts of typicity and eccentricity to determine whether a given sample is normal or abnormal within the dataset. Unlike most traditional methods, it does not require signal buffering or windowing. Furthermore, the proposed technique employs simple decision rules rather than heuristic approaches, further contributing to its computational efficiency. Full article
(This article belongs to the Topic Bioinformatics and Intelligent Information Processing)
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<p>Block chart of the proposed method overview.</p>
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<p>Flow chart of the proposed method overview.</p>
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<p>Block chart overview of the preprocessing steps.</p>
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<p>An example of ECG preprocessing (record 113): (<b>a</b>) raw ECG signal, (<b>b</b>) ECG slope, and (<b>c</b>) ECG slope signal after normalization and filtering.</p>
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<p>R-wave sequence from TEDA algorithm calculated as the most eccentric points in the slope signal (record 113): (<b>a</b>) raw ECG signal and R wave; (<b>b</b>) ECG preprocessed signal; (<b>c</b>) eccentricity, threshold and R-wave interval.</p>
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<p>R-peak estimation (record 124): (<b>a</b>) R-wave sequence from TEDA algorithm calculated as the most eccentric points in the preprocessed signal; (<b>b</b>) R peak is the sample with highest absolute eccentricity.</p>
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16 pages, 3865 KiB  
Article
Fundamental and Practical Feasibility of Electrocardiogram Reconstruction from Photoplethysmogram
by Gašper Slapničar, Jie Su and Wenjin Wang
Sensors 2024, 24(7), 2100; https://doi.org/10.3390/s24072100 - 25 Mar 2024
Cited by 1 | Viewed by 1711
Abstract
Electrocardiogram (ECG) reconstruction from contact photoplethysmogram (PPG) would be transformative for cardiac monitoring. We investigated the fundamental and practical feasibility of such reconstruction by first replicating pioneering work in the field, with the aim of assessing the methods and evaluation metrics used. We [...] Read more.
Electrocardiogram (ECG) reconstruction from contact photoplethysmogram (PPG) would be transformative for cardiac monitoring. We investigated the fundamental and practical feasibility of such reconstruction by first replicating pioneering work in the field, with the aim of assessing the methods and evaluation metrics used. We then expanded existing research by investigating different cycle segmentation methods and different evaluation scenarios to robustly verify both fundamental feasibility, as well as practical potential. We found that reconstruction using the discrete cosine transform (DCT) and a linear ridge regression model shows good results when PPG and ECG cycles are semantically aligned—the ECG R peak and PPG systolic peak are aligned—before training the model. Such reconstruction can be useful from a morphological perspective, but loses important physiological information (precise R peak location) due to cycle alignment. We also found better performance when personalization was used in training, while a general model in a leave-one-subject-out evaluation performed poorly, showing that a general mapping between PPG and ECG is difficult to derive. While such reconstruction is valuable, as the ECG contains more fine-grained information about the cardiac activity as well as offers a different modality (electrical signal) compared to the PPG (optical signal), our findings show that the usefulness of such reconstruction depends on the application, with a trade-off between morphological quality of QRS complexes and precise temporal placement of the R peak. Finally, we highlight future directions that may resolve existing problems and allow for reliable and robust cross-modal physiological monitoring using just PPG. Full article
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<p>The relationship between the ECG and PPG based on the underlying cardiovascular system.</p>
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<p>Histograms of patients ages and weights in the CapnoBase dataset used in our study [<a href="#B14-sensors-24-02100" class="html-bibr">14</a>].</p>
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<p>Raw ECG examples containing noise as well as stable periods, showing the apparent need for additional data cleaning.</p>
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<p>Architecture of the used pipeline, showing the inputs, outputs, and intermediate steps. The yellow blocks denote inputs used in training, the blue blocks denote the inputs used for testing, and the green block shows the system output. Other blocks are universal and always used.</p>
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<p>Original (pre-processed) signals in red, inverse DCT reconstruction with zero padding in yellow, inverse DCT reconstruction without zero padding in green.</p>
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<p>Per-subject boxplots of Pearson’s correlation coefficient using direct and semantic ECG cycle segmentation in the personalized evaluation experiment. Subject 147 was an outlier when doing semantic cycle segmentation, which can happen as a consequence of peak detector failing to correctly segment cycles in case of consistent severe distortions. This does not affect the direct PPG-based segmentation using different signal.</p>
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<p>Per-subject boxplots of Pearson’s correlation coefficient using direct and semantic ECG cycle segmentation in the generalized evaluation experiment.</p>
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<p>The plots compare different segmentation methods at different HRs. Left plot shows two ECG cycles of a subject at different HRs when using direct segmentation based on systolic peaks. The right plot shows the same cycles when using semantic (aligned) segmentation based on ECG R peaks. We can see the temporal shift between the two when using the first method, while the second preserves the shape to be almost the same.</p>
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<p>Boxplots showing decreasing Pearson’s correlation coefficients when we concatenate several subsequent cycle reconstructions. Due to accumulation of temporal misalignment, the value decreases the more cycles we add.</p>
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<p>Example poor reconstruction (red) and reference ECG cycle (blue) in a LOSO experiment when using direct cycle segmentation.</p>
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<p>Example reference ECG cycles (<b>left</b>) and their corresponding reconstructions (<b>right</b>) in a LOSO experiment when using semantic cycle segmentation.</p>
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