Heart diseases are the main cause of death worldwide. The first step in the diagnose of these diseases is the analysis of the electrocardiographic (ECG) signal. In turn, the ECG analysis begins with the detection of the QRS complex, which is the one with the most energy in the cardiac cycle. Numerous methods have been proposed in the bibliography for QRS complex detection, but few authors have analyzed the possibility of taking advantage of the information redundancy present in multiple ECG leads (simultaneously acquired) to produce accurate QRS detection. In our previous work we presented such an approach, proposing various data fusion techniques to combine the detections made by an algorithm on multiple ECG leads. In this paper we present further studies that show the advantages of this multi-lead detection approach, analyzing how many leads are necessary in order to observe an improvement in the detection performance. A well known QRS detection algorithm was used to test the fusion techniques on the St. Petersburg Institute of Cardiological Technics database. Results show improvement in the detection performance with as little as three leads, but the reliability of these results becomes interesting only after using seven or more leads. Results were evaluated using the detection error rate (DER). The multi-lead detection approach allows an improvement from DER = 3.04% to DER = 1.88%. Further works are to be made in order to improve the detection performance by implementing further fusion steps.
This work presents a methodology for studying the Heart Rate Variability (HRV) and Insulin Sensitivity (IS) during the Oral Glucose Tolerance Test (OGTT) in subjects with Metabolic Syndrome (MS). For this, it was designed a clinical protocol that includes the acquisition of ECG signals during OGTT for 15 subjects with MS and 10 subjects for control group. HRV parameters were obtained from electrocardiographic recordings. Significant differences in RR values were found between groups in the 30 minutes stage of the OGTT. In control subjects the RR values were higher compared with subjects with MS. The values of normalized low frequencies between baseline stages and the stage at 30 minutes in subjects with MS showed a significant increase in sympathetic tone during the OGTT, that was not observed in group control. The following methods were implemented for quantification of IS: integral equation, insulin sensitivity index, insulin sensitivity, metabolic, HOMA and QUICKI. We found significantly lower values of IS in the group with MS. It was concluded that there are changes in the HRV and the IS in the subjects with MS, which is a pre-diabetic disease. These findings suggest that HRV and IS can be used for diagnosis of MS and prevention of Diabetes Mellitus.Keywords Diabetes mellitus, Metabolic syndrome, Heart rate variability, Insulin sensitivity, Oral glucose tolerance test.
Metodologia para o estudo da síndrome metabólica partindo da variabilidade da frequência cardíaca assim como da sensibilidade à insulina Resumo Este trabalho apresenta uma metodologia para o estudo da Variabilidade da Frequência Cardíaca (VFC) e Sensibilidade à Insulina (SI) durante o Teste de Oral de Tolerância à Glicose (TOTG) em indivíduos com Síndrome Metabólica (SM
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