Heart Rate Variability measured during rest and after orthostatic challenge to detect autonomic dysfunction in Type 2 Diabetes Mellitus using the Classification and Regression Tree model
| العنوان: | Heart Rate Variability measured during rest and after orthostatic challenge to detect autonomic dysfunction in Type 2 Diabetes Mellitus using the Classification and Regression Tree model |
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| المؤلفون: | Leena Phadke, C. Y. Patil, Shashikant Rathod, U. M. Chaskar |
| المصدر: | Technology and Health Care. 30:361-378 |
| بيانات النشر: | IOS Press, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Adult, Male, Cart, medicine.medical_specialty, Biomedical Engineering, Biophysics, India, 030209 endocrinology & metabolism, Health Informatics, Bioengineering, 030204 cardiovascular system & hematology, Biomaterials, 03 medical and health sciences, Orthostatic vital signs, 0302 clinical medicine, Diabetic Neuropathies, Heart Rate, Internal medicine, medicine, Humans, Heart rate variability, General hospital, Glycemic, Receiver operating characteristic, business.industry, Type 2 Diabetes Mellitus, Autonomic Nervous System Diseases, Diabetes Mellitus, Type 2, Cardiology, Female, business, Regression tree model, Information Systems |
| الوصف: | BACKGROUND: According to the World Health Organization, one in ten adults will have Type 2 Diabetes Mellitus (T2DM) in the next few years. Autonomic dysfunction is one of the significant complications of T2DM. Autonomic dysfunction is usually assessed by standard Ewing’s test and resting Heart Rate Variability (HRV) indices. OBJECTIVE: Resting HRV has limited use in screening due to its large intra and inter-individual variations. Therefore, a combined approach of resting and orthostatic challenge HRV measurement with a machine learning technique was used in the present study. METHODS: A total of 213 subjects of both genders between 20 to 70 years of age participated in this study from March 2018 to December 2019 at Smt. Kashibai Navale Medical College and General Hospital (SKNMCGH) in Pune, India. The volunteers were categorized according to their glycemic status as control (n= 51 Euglycemic) and T2DM (n= 162). The short-term ECG signal in the resting and after an orthostatic challenge was recorded. The HRV indices were extracted from the ECG signal as per HRV-Taskforce guidelines. RESULTS: We observed a significant difference in time, frequency, and non-linear resting HRV indices between the control and T2DM groups. A blunted autonomic response to an orthostatic challenge quantified by percentage difference was observed in T2DM compared to the control group. HRV patterns during rest and the orthostatic challenge were extracted by various machine learning algorithms. The Classification and Regression Tree (CART) model has shown better performance among all the machine learning algorithms. It has shown an accuracy of 84.04%, the sensitivity of 89.51%, a specificity of 66.67%, with an Area Under Receiver Operating Characteristic Curve (AUC) of 0.78 compared to resting HRV alone with 75.12% accuracy, 86.42% sensitivity, 39.22% specificity, with an AUC of 0.63 for differentiating autonomic dysfunction in non-diabetic control and T2DM. CONCLUSION: It was possible to develop a Classification and Regression Tree (CART) model to detect autonomic dysfunction. The technique of percentage difference between resting and orthostatic challenge HRV indicates the blunted autonomic response. The developed CART model can differentiate the autonomic dysfunction using both resting and orthostatic challenge HRV data compared to only resting HRV data in T2DM. Thus, monitoring HRV parameters using the CART model during rest and after orthostatic challenge may be a better alternative to detect autonomic dysfunction in T2DM as against only resting HRV. |
| تدمد: | 1878-7401 0928-7329 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d540ab6f931dafb3a5463275d420c172 https://doi.org/10.3233/thc-213048 |
| رقم الأكسشن: | edsair.doi.dedup.....d540ab6f931dafb3a5463275d420c172 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18787401 09287329 |
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