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La Neuropatía Autonómica Diabética (NAD) es una de las frecuentes y serias de la diabetes mellitus. Este trabajo pretende analizar la Variabilidad de la Frecuencia Cardiaca (VFC) con el fin de desarrollar métodos que permitan ayudar a... more
La Neuropatía Autonómica Diabética (NAD) es una de las frecuentes y serias de la diabetes mellitus. Este trabajo pretende analizar la Variabilidad de la Frecuencia Cardiaca (VFC) con el fin de desarrollar métodos que permitan ayudar a incrementar el valor diagnóstico de las pruebas clínicas en la NAD. Este estudio se lleva a cabo en señales electrocardiográficas (ECG) durante una
prueba de esfuerzo de pacientes diabéticos y de sujetos control. Si bien las series a analizar usando las técnicas clásicas de VFC deben ser estacionarias, las series de esta base de datos no lo son, lo cual representa el desafío de este estudio.
Heart rate variability (HRV) exhibits a different response to different external stimuli (emotional, auditory, etc). In this paper, HRV irregularity and correlations in short time scales were assessed after a sudden increase in plasma... more
Heart rate variability (HRV) exhibits a different response to different external stimuli (emotional, auditory, etc). In this paper, HRV irregularity and correlations in short time scales were assessed after a sudden increase in plasma glucose concentration (a stimulus of glucose), using approximate entropy (ApEn) and short-term fluctuation (α1) of detrended fluctuation analysis, respectively, in people with metabolic syndrome and healthy control subjects. 5-min RR interval time series were extracted from ECG recordings acquired at five timed intervals (0, 30,. .. , 120 min) of an oral glucose tolerance test. We have found that, in fasting and 30 min after the glucose stimulus, people with metabolic syndrome showed statistically significantly greater values of ApEn than control, an indicative of a more irregular HRV. In addition, 60 min after the glucose stimulus, when plasma glucose concentration reaches its maximum value, HRV irregularity and short-term HRV correlation showed a reduction in people with metabolic syndrome. Further studies, using other non-linear measures and a larger dataset, must be carried to characterize the response of HRV to the glucose stimulus.
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El estudio de la variabilidad de la frecuencia cardíaca es útil en la evaluación del desempeño del sistema nervioso autónomo y para explorar afecciones del sistema cardiovascular. El análisis de la variabilidad de la frecuencia cardíaca... more
El estudio de la variabilidad de la frecuencia cardíaca es útil en la evaluación del desempeño del sistema nervioso autónomo y para explorar afecciones del sistema cardiovascular. El análisis de la variabilidad de la frecuencia cardíaca se ha utilizado para evaluar la respuesta cardíaca de deportistas y para analizar patologías como la diabetes o el síndrome metabólico. La intensión del presente trabajo es analizar indicadores temporales, frecuenciales y no lineales de la variabilidad de la frecuencia cardíaca en sujetos diagnosticados con síndrome metabólico, sedentarios y deportistas. La particularidad de este estudio radica en que la variabilidad de la frecuencia de estos sujetos es analizada durante una prueba oral de tolerancia a la glucosa (POTG) de cinco etapas. En ese sentido, el ECG fue adquirido durante los primeros 15 minutos de cada una de las etapas de la POTG. El objetivo es comparar los indicadores de la variabilidad de la frecuencia cardíaca entre grupos y entre etapas de la POTG. Los resultados obtenidos muestran que los indicadores SDANN, RMSSD y SD2 son estadísticamente diferentes (p < 0,05) entre los pacientes con síndrome metabólico y los deportistas.
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Gathering experimental data to test computer methods developed during a research is a hard work. Nowadays, some databases have been stored online that can be freely downloaded, however there is not a wide range of databases yet and not... more
Gathering experimental data to test computer methods developed during a research is a hard work. Nowadays, some databases have been stored online that can be freely downloaded, however there is not a wide range of databases yet and not all pathologies are covered. Researchers with low resources are in need of more data they can consult for free. To cope with this we present an on-line portal containing a compilation of ECG databases recorded over the last two decades for research purposes. The first version of this portal contains four databases of ECG records: ischemic cardiopathy (72 patients, 3-lead ECG each), ischemic preconditioning (20 patients, 3-lead ECG each), diabetes (51 patients, 8-lead ECG each) and metabolic syndrome (25 subjects, 12-lead ECG each). In addition, one computer program and three routines are provided in order to correctly read the signals, and two digital filters along with two ECG waves detectors are provided for further processing. This portal will be constantly growing, other ECG databases and signal processing software will be uploaded. With this project, we give the scientific community a resource to avoid hours of data collection and to develop free software.
Low insulin sensitivity and development of type 2 diabetes might be the consequence of cardiovascular autonomic dysfunction. Cardiovascular autonomic function may be assessed noninvasively by the analysis of the heart rate variability... more
Low insulin sensitivity and development of type 2 diabetes might be the consequence of cardiovascular autonomic dysfunction. Cardiovascular autonomic function may be assessed noninvasively by the analysis of the heart rate variability (HRV) using time-domain, frequency-domain and non-linear methods. Time-domain and frequency-domain methods have been extensively used in subjects with metabolic syndrome but non-linear methods are not commonly employed. In this paper, we use non-linear and time-and frequency-domain methods to analyze the HRV of people that underwent a 2-hour 5-sample oral glucose tolerance test (OGTT). The main goal of this work is to find clinical indicators that could relate insulin sensitivity with HRV parameters in subjects with metabolic syndrome, marathoners and sedentaries people. Results show that, compared with marathoners, people with metabolic syndrome have lower rMSSD, SDNN, SD1 and SD2 during 5-sample OGTT. In LF and LF/HF ratio, marathoners presented increased values and people with metabolic syndrome reduced values respect to sedentaries, showing a parasympathetic activity decreased in people wih metabolic syndrome, but increased in marathoners. Differences found in HRV parameter along the OGTT in people wih metabolic syndrome and marathoners suggest that changes in their cardiac autonomic function are due to sudden increases of insulin levels. OGTT altered HRV parameters in people wih metabolic syndrome, marathoners and sedentaries subjects. HRV was reduced in metabolic syndrome subjects and increased in marathoners comparing with sedentary subjects.
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Resumen. Los deportistas suelen comenzar el ejercicio con un contenido de agua corporal normal y se deshidratan durante la práctica deportiva. El déficit de agua puede contribuir al aumento de la frecuencia cardiaca y por tanto,... more
Resumen. Los deportistas suelen comenzar el ejercicio con un contenido de agua corporal normal y se deshidratan durante la práctica deportiva. El déficit de agua puede contribuir al aumento de la frecuencia cardiaca y por tanto, alteraciones de la variabilidad de la frecuencia cardiaca (VFC) post-ejercicio. En este trabajo se realizó un protocolo para estudiar la deshidratación a partir de la señal electrocardiográfica en deportistas, que comprendió tres fases: i) Pre-ejercicio (basal): se adquirió la señal electrocardiográfica antes de cualquier actividad física, ii) post-ejercicio (PE): los sujetos realizaron una actividad física que consistió en 37
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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,... more
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.