Generalized discriminant analysis for congestive heart failure risk assessment based on long-term heart rate variability

The aims of this study are summarized in the following items: first, to investigate the class discrimination power of long-term heart rate variability (HRV) features for risk assessment in patients suffering from congestive heart failure (CHF); second, to introduce the most discriminative features of HRV to discriminate low risk patients (LRPs) and high risk patients (HRPs), and third, to examine the influence of feature dimension reduction in order to achieve desired accuracy of the classification. We analyzed two public Holter databases: 12 data of patients suffering from mild CHF (NYHA class I and II), labeled as LRPs and 32 data of patients suffering from severe CHF (NYHA class III and IV), labeled as HRPs. A K-nearest neighbor classifier was used to evaluate the performance of feature set in the classification. Moreover, to reduce the number of features as well as the overlap of the samples of two classes in feature space, we used generalized discriminant analysis (GDA) as a feature extraction method. By applying GDA to the discriminative nonlinear features, we achieved sensitivity and specificity of 100% having the least number of features. Finally, the results were compared with other similar conducted studies regarding the performance of feature selection procedure and classifier besides the number of features used in training.

[1]  J. Fleiss,et al.  RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction. , 1995, Circulation.

[2]  J. Peters,et al.  Congestive heart failure: Diagnosis, pathophysiology, therapy, and implications for respiratory care. , 2006, Respiratory care.

[3]  J. Floras,et al.  Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. , 2009, Journal of the American College of Cardiology.

[4]  David G. Stork,et al.  Pattern Classification , 1973 .

[5]  B. Sredniawa,et al.  Heart rate variability in heart failure. , 2003, Kardiologia polska.

[6]  Seyed Kamaledin Setarehdan,et al.  Support vector machine-based arrhythmia classification using reduced features of heart rate variability signal , 2008, Artif. Intell. Medicine.

[7]  Ron Kohavi,et al.  Guest Editors' Introduction: On Applied Research in Machine Learning , 1998, Machine Learning.

[8]  A L Goldberger,et al.  The pNNx files: re-examining a widely used heart rate variability measure , 2002, Heart.

[9]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[10]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[11]  Václav Hlaváč,et al.  Statistical Pattern Recognition Toolbox for Matlab User's guide , 2004 .

[12]  David G. Stork,et al.  Pattern classification, 2nd Edition , 2000 .

[13]  Paolo Melillo,et al.  Remote Health Monitoring of Heart Failure With Data Mining via CART Method on HRV Features , 2011, IEEE Transactions on Biomedical Engineering.

[14]  Anil K. Jain,et al.  Statistical Pattern Recognition: A Review , 2000, IEEE Trans. Pattern Anal. Mach. Intell..

[15]  Cozza,et al.  Usefulness of heart rate variability as a predictor of sudden cardiac death in muscular dystrophies. , 2008, Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology.

[16]  G. Casolo,et al.  Heart rate variability and functional severity of congestive heart failure secondary to coronary artery disease. , 1995, European heart journal.

[17]  Stefano Guzzetti,et al.  Heart rate variability in chronic heart failure , 2001, Autonomic Neuroscience.

[18]  Browne,et al.  Cross-Validation Methods. , 2000, Journal of mathematical psychology.

[19]  Takuya Kishi,et al.  Heart failure as an autonomic nervous system dysfunction. , 2012, Journal of cardiology.

[20]  Jeffrey M. Hausdorff,et al.  Physionet: Components of a New Research Resource for Complex Physiologic Signals". Circu-lation Vol , 2000 .

[21]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[22]  肌勢 光,et al.  Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure , 2005 .

[23]  Sung-Nien Yu,et al.  Bispectral analysis and genetic algorithm for congestive heart failure recognition based on heart rate variability , 2012, Comput. Biol. Medicine.

[24]  M. Gulati,et al.  Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing. , 2007, Circulation.

[25]  T. Smuc,et al.  The Chaos Theory and Non-linear Dynamics in Heart Rate Variability in Patients with Heart Failure , 2008, 2008 Computers in Cardiology.

[26]  Sung-Nien Yu,et al.  Conditional mutual information-based feature selection for congestive heart failure recognition using heart rate variability , 2012, Comput. Methods Programs Biomed..

[27]  T. Smilde,et al.  Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure , 2009, Clinical Research in Cardiology.

[28]  Paolo Melillo,et al.  Discrimination Power of Short-Term Heart Rate Variability Measures for CHF Assessment , 2011, IEEE Transactions on Information Technology in Biomedicine.

[29]  P. Caminal,et al.  Linear and nonlinear heart rate variability risk stratification in heart failure patients , 2008, 2008 Computers in Cardiology.

[30]  G. Baudat,et al.  Generalized Discriminant Analysis Using a Kernel Approach , 2000, Neural Computation.

[31]  R. Maestri,et al.  Short-Term Heart Rate Variability Strongly Predicts Sudden Cardiac Death in Chronic Heart Failure Patients , 2003, Circulation.

[32]  R. Califf,et al.  Lower Serum Sodium Is Associated With Increased Short-Term Mortality in Hospitalized Patients With Worsening Heart Failure: Results From the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Study , 2005, Circulation.

[33]  Paolo Melillo,et al.  Discrimination power of long-term heart rate variability measures for chronic heart failure detection , 2011, Medical & Biological Engineering & Computing.

[34]  I. K. Daskalov,et al.  Comparison of heart rate variability spectra using generic relationships of their input signals , 1998, Medical and Biological Engineering and Computing.

[35]  U. Rajendra Acharya,et al.  Heart rate variability: a review , 2006, Medical and Biological Engineering and Computing.

[36]  M C Limacher,et al.  Assessment of functional capacity in clinical and research applications: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association. , 2000, Circulation.

[37]  黄亚明 PhysioBank , 2009 .

[38]  Juerg Schwitter,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2010, European journal of heart failure.

[39]  G N Arbolishvili,et al.  [Heart rate variability in chronic heart failure and its role in prognosis of the disease.]. , 2006, Kardiologiia.

[40]  Ahmad R. Sharafat,et al.  AN ADAPTIVE BACKPROPAGATION NEURAL NETWORK FOR ARRHYTHMIA CLASSIFICATION USING R-R INTERVAL SIGNAL , 2012 .

[41]  L. A. Bonet,et al.  ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 , 2010, European journal of heart failure.

[42]  D. J. Veldhuisen,et al.  Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure , 2009, Clinical research in cardiology : official journal of the German Cardiac Society.

[43]  Paolo Melillo,et al.  Classification Tree for Risk Assessment in Patients Suffering From Congestive Heart Failure via Long-Term Heart Rate Variability , 2013, IEEE Journal of Biomedical and Health Informatics.

[44]  Espen Alexander Fürst Ihlen,et al.  A comparison of two Hilbert spectral analyses of heart rate variability , 2009, Medical & Biological Engineering & Computing.

[45]  M. Schweizer,et al.  Heart rate variability enhances the prognostic value of established parameters in patients with congestive heart failure , 2002, Zeitschrift für Kardiologie.

[46]  Ahmad Ayatollahi,et al.  Classification of Cardiac Abnormalities Using Reduced Features of Heart Rate Variability Signal , 2009 .

[47]  Yalcin Isler,et al.  Combining classical HRV indices with wavelet entropy measures improves to performance in diagnosing congestive heart failure , 2007, Comput. Biol. Medicine.

[48]  Doron Aronson,et al.  Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. , 2004, The American journal of cardiology.