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Mortality Prediction in Severe Congestive Heart Failure Patients With Multifractal Point-Process Modeling of Heartbeat Dynamics

Valenza, Gaetano and Wendt, Herwig and Kiyono, Ken and Hayano, Junihiro and Watanabe, Eiichi and Yamamoto, Yoshiharu and Abry, Patrice and Barbieri, Riccardo Mortality Prediction in Severe Congestive Heart Failure Patients With Multifractal Point-Process Modeling of Heartbeat Dynamics. (2018) IEEE Transactions on Biomedical Engineering, 65 (10). 2345-2354. ISSN 0018-9294

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Official URL: https://doi.org/10.1109/TBME.2018.2797158

Abstract

Background: Multifractal analysis of human heartbeat dynamics has been demonstrated to provide promising markers of congestive heart failure (CHF). Yet, it crucially builds on the interpolation of RR interval series which has been generically performed with limited links to CHF pathophysiology. Objective: We devise a novel methodology estimating multifractal autonomic dynamics from heartbeat-derived series defined in the continuous time. We hypothesize that markers estimated from our novel framework are also effective for mortality prediction in severe CHF. Methods: We merge multifractal analysis within a methodological framework based on inhomogeneous point process models of heartbeat dynamics. Specifically, wavelet coefficients and wavelet leaders are computed over measures extracted from instantaneous statistics of probability density functions characterizing and predicting the time until the next heartbeat event occurs. The proposed approach is tested on data from 94 CHF patients aiming at predicting survivor and nonsurvivor individuals as determined after a four years follow up. Results and Discussion: Instantaneous markers of vagal and sympathovagal dynamics display power-law scaling for a large range of scales, from ≃ 0.5 to ≃ 100 s. Using standard support vector machine algorithms, the proposed inhomogeneous point-process representation-based multifractal analysis achieved the best CHF mortality prediction accuracy of 79.11% (sensitivity 90.48%, specificity 67.74%). Conclusion: Our results suggest that heartbeat scaling and multifractal properties in CHF patients are not generated at the sinus-node level, but rather by the intrinsic action of vagal short-term control and of sympatho-vagal fluctuations associated with circadian cardiovascular control especially within the very low frequency band. These markers might provide critical information in devising a clinical tool for individualized prediction of survivor and nonsurvivor CHF patients.

Item Type:Article
HAL Id:hal-02089319
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:French research institutions > Centre National de la Recherche Scientifique - CNRS (FRANCE)
Other partners > Ecole Normale Supérieure de Lyon - ENS de Lyon (FRANCE)
Université de Toulouse > Institut National Polytechnique de Toulouse - INPT (FRANCE)
Other partners > Osaka University (JAPAN)
Université de Toulouse > Université Toulouse III - Paul Sabatier - UPS (FRANCE)
Université de Toulouse > Université Toulouse - Jean Jaurès - UT2J (FRANCE)
Université de Toulouse > Université Toulouse 1 Capitole - UT1 (FRANCE)
Other partners > Université Claude Bernard-Lyon I - UCBL (FRANCE)
Other partners > Fujita Health University (JAPAN)
Other partners > Municipal University Corporation Nagoya City University - NCU (JAPAN)
Other partners > Politecnico di Milano (ITALY)
Other partners > Université de Lyon - UDL (FRANCE)
Other partners > Università di Pisa (ITALY)
Other partners > University of Tokyo (JAPAN)
Laboratory name:
Funders:
French ANR MultiFracs under Grant ANR-16-CE33-0020 - CNRS PICS7260 MATCHA
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Deposited By: IRIT IRIT
Deposited On:13 Mar 2019 15:35

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