The present disclosure relates to an electrocardiogram analyzing method. In addition, the present disclosure also relates to an electrocardiogram analyzing apparatus, an electrocardiogram analyzing program, and a computer-readable medium stored with the electrocardiogram analyzing program.
U.S. Pat. No. 6,496,722 discloses a method for inspecting an autonomic nerve function such as baroreflex of a patient using HRT (Heart Rate Turbulence) obtained from an electrocardiogram waveform to thereby predict a sudden death after myocardial infarction or due to cardiac failure. Here, HRT means a variation of a sinus rhythm immediately after appearance of a premature ventricular contraction (hereinafter referred to as PVC) causing a compensatory pause.
U.S. Pat. No. 6,496,722 further discloses that a graph representing the relationship between heart beat numbers immediately after the PVC and RR intervals corresponding to time intervals between adjacent ones of the heart beats is acquired from the electrocardiogram waveform and the graph is analyzed on a time area by an HRT analysis method using TO (Turbulence Onset), TS (Turbulence Slope) etc. Here, TO expresses a shortened amount of each RR interval after the PVC, and TS expresses the speed for elongation of the RR interval.
However, in the HRT analysis method disclosed in U.S. Pat. No. 6,496,722, TO and TS are used as two evaluation parameters. Accordingly, when, for example, one of the evaluation parameters indicates a normal value while the other evaluation parameter indicates an abnormal value, there is a possibility that doubt may occur in the diagnosis result. In addition, the baroreflex etc. is evaluated based on analysis on the variation in the RR intervals before and after the PVC. The HRT analysis method using TO does not directly evaluate the variation in the RR intervals but simply evaluates a shortened amount of each RR interval.
An aspect of the present disclosure provides an electrocardiogram analyzing method by which an autonomic nerve function such as baroreflex of a patient can be inspected relatively easily. In addition, other aspect of the present disclosure provides an electrocardiogram analyzing apparatus for carrying out the electrocardiogram analyzing method, an electrocardiogram analyzing program, and a computer-readable medium stored with the electrocardiogram analyzing program.
According to a first aspect of the present disclosure, the electrocardiogram analyzing method comprises:
(a) acquiring electrocardiogram data representing an electrocardiogram waveform having heart beat waveforms occurring continuously on a time axis;
(b) acquiring RR interval data from the electrocardiogram data, wherein the RR interval data includes RR intervals, and each of the RR interval represents a time interval between adjacent ones of the heart beat waveforms;
(c) detecting at least one premature ventricular contraction causing a compensatory pause;
(d) extracting, from the RR interval data, RR intervals during occurrence of the detected premature ventricular contraction and before and after the occurrence of the detected premature ventricular contraction;
(e) extracting a first RR interval group and a second interval group respectively from the RR intervals, wherein the first RR interval group includes the RR intervals before the occurrence of the premature ventricular contraction, and the second RR interval group includes the RR intervals after the occurrence of the premature ventricular contraction;
(f) performing a predetermined frequency analysis on the first RR interval group;
(g) performing the predetermined frequency analysis on the second RR interval group; and
(h) making a comparison between a first analysis result obtained by the step (f) and a second analysis result obtained by the step (g).
According to a second aspect of the present disclosure, the electrocardiogram analyzing apparatus.
The apparatus comprises:
an electrocardiogram data acquiring section configured to acquire electrocardiogram data representing an electrocardiogram waveform having heart beat waveforms occurring continuously on a time axis;
an RR interval data acquiring section configured to acquire RR interval data from the electrocardiogram data, wherein the RR interval data includes RR intervals, and each of the RR interval represents a time interval between adjacent ones of the heart beat waveforms;
a detector configured to detect at least one premature ventricular contraction causing a compensatory pause;
a first extractor configured to extract, from the RR interval data, RR intervals during occurrence of the detected premature ventricular contraction and before and after the occurrence of the detected premature ventricular contraction;
a second extractor configured to extract a first RR interval group and a second interval group respectively from the RR intervals, wherein the first RR interval group includes the RR intervals before the occurrence of the premature ventricular contraction, and the second RR interval group includes the RR intervals after the occurrence of the premature ventricular contraction;
a first analyzer configured to perform a predetermined frequency analysis on the first RR interval group;
a second analyzer configured to perform the predetermined frequency analysis on the second RR interval group; and
a comparing section configured to make a comparison between a first analysis result obtained by the first analyzer and a second analysis result obtained by the second analyzer.
According to a third aspect of the present disclosure, the electrocardiogram analyzing program causes a computer to perform operations comprising:
(a) acquiring electrocardiogram data representing an electrocardiogram waveform having heart beat waveforms occurring continuously on a time axis;
(b) acquiring RR interval data from the electrocardiogram data, wherein the RR interval data includes RR intervals, and each of the RR interval represents a time interval between adjacent ones of the heart beat waveforms;
(c) detecting at least one premature ventricular contraction causing a compensatory pause;
(d) extracting, from the RR interval data, RR intervals during occurrence of the detected premature ventricular contraction and before and after the occurrence of the detected premature ventricular contraction;
(e) extracting a first RR interval group and a second interval group respectively from the RR intervals, wherein the first RR interval group includes the RR intervals before the occurrence of the premature ventricular contraction, and the second RR interval group includes the RR intervals after the occurrence of the premature ventricular contraction;
(f) performing a predetermined frequency analysis on the first RR interval group;
(g) performing the predetermined frequency analysis on the second RR interval group; and
(h) making a comparison between a first analysis result obtained by the step (f) and a second analysis result obtained by the step (g).
An embodiment of the present disclosure will be described below with reference to the drawings. Incidentally, description about elements having the same reference signs as those which have been already described will be omitted in description of the embodiment for convenience of explanation.
Although the electrocardiogram analyzing apparatus 1 is a dedicated apparatus for analyzing an electrocardiogram waveform, it may be, for example, a personal computer, a smartphone, a tablet, or a wearable device such as an Apple Watch.
The controller 2 can include a memory and a processor. For example, the memory can include an ROM (Read Only Memory) in which various programs etc. have been stored, an RAM (Random Access Memory) having plural work areas where various programs etc. to be executed by the processor can be stored. For example, the processor is a CPU (Central Processing Unit) which is configured to load a designated program from the various programs incorporated in the ROM onto the RAM and execute various processes in cooperation with the RAM.
The controller 2 may control various operations of the electrocardiogram analyzing apparatus 1, particularly when the processor loads an electrocardiogram analyzing program which will be described later on the RAM and executes the electrocardiogram analyzing program in cooperation with the RAM. The controller 2 and the electrocardiogram analyzing program will be described below in detail.
For example, the storage 3 is a storage device such as an HDD (Hard Disk Drive), an SSD (Solid State Drive) or a flash memory, which is configured to store programs or various data. The electrocardiogram analyzing program may be incorporated in the storage 3. In addition, electrocardiogram data acquired by a not-shown electrocardiogram sensor may be stored in the storage 3. The electrocardiogram sensor is configured to acquire a weak electric signal generated from the heart of a patient in order to generate electrocardiogram data. Here, the electrocardiogram data represent an electrocardiogram waveform having heart beat waveforms (QRS waveforms etc.) occurring continuously on a time axis.
The sensor interface 4 can be configured to connect the electrocardiogram analyzing apparatus 1 to the electrocardiogram sensor communicably. For example, the electrocardiogram data acquired by the electrocardiogram sensor are transmitted to the controller 2 or the storage 3 through the sensor interface 4. The sensor interface 4 may have an A/D converting function.
The network interface 5 can be configured to connect the electrocardiogram analyzing apparatus 1 to a not-shown communication network. Here, the communication network can include an LAN (Local Area Network), a WAN (Wide Area Network) or the Internet etc. For example, an analysis result outputted from the controller 2 may be transmitted to another computer disposed on the communication network through the network interface 5.
The output section 6 can include a display device such as a liquid crystal display or an organic EL display, or a printer device such as an inkjet printer or a laser printer. For example, the analysis result outputted from the controller 2 may be displayed on a display screen of the display device or printed by the printer.
The input section 7 can be configured to accept an input operation from an operator operating the electrocardiogram analyzing apparatus 1 and output an operation signal correspondingly to the input operation. For example, the input section 7 is a touch panel superimposed and disposed on the display device of the output section 6, an operation button attached to a housing, a mouse, a keyboard, etc.
The respective functions of the controller 2 shown in
At the beginning, in a step S10 shown in
Next, in a step S12, the detector 23 detects plural premature ventricular contractions (hereinafter referred to as PVCs simply) each causing a compensatory pause based on the RR interval data acquired by the RR interval data acquiring section 22. For example, the detector 23 can detect the PVCs based on a variation in the RR intervals corresponding to the beat numbers. When each of the PVCs occurs, the RR intervals vary largely before and after appearance of a V beat (abnormal heart beat waveform) (see
Next, in a step S13, the first extractor 24 extracts, from the RR interval data, RR intervals during occurrence of each of the PVCs detected by the detector 23 and before and after the occurrence of the PVC. For example, as shown in
Next, in a step S14, the RR interval averaging section 25 obtains an average of the RR intervals extracted for the PVCs for each of the beat numbers N. For example, assume that the RR interval in the beat number N=1 in the PVC appearing in a first time is R11, the RR interval in the beat number N=1 in the PVC appearing in a second time is R21, and the RR interval in the beat number N=1 in the PVC appearing in an m-th (the last) time is Rm1. Thus, an average Rav-1 of the RR intervals in the beat number N=1 can be obtained as in the following expression (1). Incidentally, the number of the detected PVCs may be regarded as m here.
Rav-1=(R11+R21 . . . Rm1)/m (1)
Similarly, an average Rav-n of the RR intervals in the beat number N=n can be obtained as in the following expression (2).
Rav-n=(R1n+R2n . . . Rmn)/m (2)
In the aforementioned manner, the RR interval averaging section 25 obtains an average of the RR intervals for each of the beat numbers. Accordingly, the averages of the RR intervals associated with the beat numbers respectively can be obtained, as shown in
Next, in a step S15, the second extractor 26 extracts a first RR interval group constituted by the plural RR intervals before the occurrence of the PVCs and a second RR interval group constituted by the plural RR intervals after the occurrence of the PVCs respectively from the averages of the RR intervals shown in
Then, in a step S16, the second extractor 26 removes a DC component from each of the first RR interval group and the second RR interval group. Here, the first RR interval group and the second RR interval group in each of which the DC component has been removed are shown in
Then, in a step S17, the first analyzer 27 performs frequency analysis using fast Fourier transform (FFT) on the first RR interval group, and the second analyzer 28 performs the frequency analysis using the fast Fourier transform on the second RR interval group.
According to the embodiment, the first RR interval group and the second RR interval group are subjected to be the frequency analysis using the FFT. Thus, results of the frequency analysis can be obtained fast. In addition, although the frequency analysis using the FFT has been described in the embodiment, frequency analysis using another method such as a maximum entropy method (MEM) etc. may be performed.
Finally, in a step S18, the comparing section 29 makes comparison between a first analysis result obtained by the first analyzer 27 and a second analysis result obtained by the second analyzer 28. Specifically, the comparing section 29 calculates a ratio between a total value (integrated value) P1total of powers in respective frequency bands of the power spectrum of the first RR interval group obtained by the first analyzer 27 and a total value (integrated value) P2total of powers in the respective frequency bands of the power spectrum of the second RR interval group obtained by the second analyzer 28. For example, P2total/P1total is about 2.5 in the example shown in
In addition, the comparing section 29 may calculate a ratio (P2max/P1max) or a difference (P2max−P1max) between a peak value P1max of the powers in the respective frequency bands of the power spectrum of the first RR interval group obtained by the first analyzer 27 and a peak value P2max of the powers in the respective frequency bands of the power spectrum of the second RR interval group obtained by the second analyzer 28.
A comparison result obtained by the comparing section 29 is inputted to the output section 6. For example, the comparison result may be displayed on the display screen of the display device or printed by the printer. Further, each of the graphs shown in
In the example shown in
In the graph shown in
According to the embodiment, plural first RR interval groups constituted by the RR intervals before the occurrence of the PVCs can be subjected to the frequency analysis, and second RR interval groups constituted by the plural RR intervals after the occurrence of the PVCs can be subjected to the frequency analysis. Then, a first analysis result obtained by the first analyzer 27, and a second analysis result obtained by the second analyzer 28 are compared with each other. In this manner, it is possible to provide the electrocardiogram analyzing apparatus 1 or the electrocardiogram analyzing method which can apply frequency analysis to plural RR intervals before occurrence of each PVC and plural RR intervals after the occurrence of the PVC to thereby make it relatively easy to inspect an autonomic nerve function such as baroreflex of a patient.
According to the embodiment, the plural RR intervals extracted for the PVCs are averaged. Then, the first RR interval group and the second RR interval group are extracted respectively from the averaged plural RR intervals, and subjected to the frequency analysis. When the averaging step is provided thus, the frequency analysis does not have to be individually performed on the RR intervals extracted for the PVCs but may be performed only on the averaged RR intervals. Therefore, it is possible to reduce the number of times of calculation of the electrocardiogram analyzing apparatus 1 (or the electrocardiogram analyzing method).
According to the embodiment, the ratio between the total value P1total of the powers in the respective frequency bands of the power spectrum of the first RR interval group and the total value P2total of the powers in the respective frequency bands of the power spectrum of the second RR interval group is calculated. Thus, the first analysis result obtained by the first analyzer 27 and the second analysis result obtained by the second analyzer 28 can be compared with each other.
In addition, the ratio or difference between the peak value P1max of the powers in the respective frequency bands of the power spectrum of the first RR interval group and the peak value P2max of the powers in the respective frequency bands of the power spectrum of the second RR interval group may be calculated. Thus, a first analysis result obtained by the first analyzer 27 and a second analysis result obtained by the second analyzer 28 can be compared with each other.
In this manner, it is possible to provide the electrocardiogram analyzing apparatus 1 which can inspect an autonomic nerve function such as baroreflex of a patient relatively easily. Further, according to the electrocardiogram analyzing apparatus 1 according to the embodiment, HRT is evaluated directly. Thus, it is possible to evaluate the autonomic nerve function such as baroreflex with high accuracy.
In order to carry out the electrocardiogram analyzing apparatus 1 according to the embodiment by software, the electrocardiogram analyzing program may be incorporated in the storage 3 or the ROM in advance. In addition, the electrocardiogram analyzing program may be stored in a computer-readable medium such as a magnetic disk (an HDD or a floppy (trademark) disk), an optical disk (a CD-ROM, a DVD-ROM, a Blu-ray (trademark) disk, or the like), a magneto-optical disk (an MO, or the like), a flash memory (an SD card, a USB memory, an SSD, or the like), or the like. In this case, when the computer-readable medium is connected to the electrocardiogram analyzing apparatus 1, the electrocardiogram analyzing program stored in the storage medium can be incorporated into the storage 3. When the program incorporated in the storage 3 is uploaded onto the RAM and the processor executes the uploaded program, the controller 2 can execute the various processes shown in
The electrocardiogram analyzing program may be downloaded from a computer on a communication network through the network interface 5. Also in this case, the downloaded program can be similarly incorporated into the storage 3.
Although the embodiment of the present disclosure has been described above, the technical scope of the invention should not be limitedly interpreted based on the description of the embodiment. The embodiment is merely an example. It should be understood by those skilled in the art that change can be made on the embodiment variously within the scope of the claimed invention. The technical scope of the invention should be defined based on the scope of the claimed invention and the scope of any equivalent thereto.
This application is based on Japanese Patent Application No. 2015-178764 filed on Sep. 10, 2015, the entire contents of which are incorporated herein by reference.
Number | Date | Country | Kind |
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2015-178764 | Sep 2015 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2016/003928 | 8/29/2016 | WO | 00 |