PhD Opportunity

Advanced Body Surface Potential Mapping Techniques for Detecting Cardiac Risk Factors in Diabetic Patients and for Preventive Early Evidence of Hyperglycemia

Coronary artery disease is the leading cause of death in diabetic patients. Diabetes is characterised by chronic hyperglycemia. Although much is known about mechanical and electrical cardiac dysfunction in diabetes, few studies have investigated propagation of the electrical signal in the diabetic heart, and the associated changes in intercellular gap junctions, in order to assess cardiac risk factors at an early stage. Prolonged and/or fractionated depolarisation due to tissue degeneration of the ventricular myocardium is a feature of cardiomyopathy. High-resolution electrocardiography (HRECG) is a non-invasive technique to quantify fractionated high-frequency components within the ventricular depolarisation event. Conventional HRECG uses only 3 bipolar leads. In order to enhance the level of bioinformation and definition, a high definition ECG mapping (HDECGM) technique is proposed for this investigation of cardiac risk factors in diabetic patients and early evidence of hyperglycemia.

 

A conventional (low-resolution) body surface potential mapping (BSPM) database of 2500 patients is available at the University of Ulster. In a retrospective review of this, 52 were found being pre-diabetic, 519 being from diabetic patients and 67 were healthy subjects. This BSPM database could provide valuable initial findings for the proposed study; by means of adequate techniques of knowledge mining for cardiac risk factors in pre-diabetic and in diabetic patients. Then, an advanced portable HDECGM system, together with a developed version of the Intelesens 29-lead disposable harness, will be used for clinical HDECGM data gathering for the study of diabetic patients and asymptomatic individuals using novel HDECGM methods. The developed HDECGM database will be analysed using novel processing techniques to investigate reliable cardiac markers of risk in diabetes, and early evidence of hyperglycemia. The latter one can provide an alternative tool for preventive screening programmes.

 

 

       References 

 

[1]   Buse JB, et al. (2007). “Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association”. Circulation; 115:114 –126.

[2]  Ghaly HA, et al. (2010). “Simulations of reduced conduction reserve in the diabetic rat heart: response to uncoupling and reduced excitability”. Annals of Biomedical Engineering: 38 (4): 1415-1425.  

[3]  Lee SP, et al. (2005). “Effect of atenolol on QTc interval lengthening during hypoglycaemia in type 1 diabetes”. Diabetologia; 48: 1269–1272.

[4] Ireland RH, et al. (2000). “Measurement of high resolution ECG QT interval during controlled euglycaemia and hypoglycaemia”. Physiol. Meas.; 21: 295–303.

[5]  Zdarska D, Peliskova P, Charvat J, Slavicek J, Mlcek M, Medova E, Kittnar O. ECG Body Surface Mapping (BSM) in Type 1 Diabetic Patients. Physiol. Res. 2007;56:403-410.

[6]  Kubara I, et al. (1999). “Dispersion of Filtered P Wave Duration by P Wave Signal-Averaged ECG Mapping System: Its Usefulness for Determining Efficacy of Disopyramide on Paroxysmal Atrial Fibrillation. J Cardiovasc Electrophysiol; 10: 670-679.

[7]   Escalona OJ, et al. (1996).” A robust procedure for P-wave detection and segmentation in high resolution 12-lead ECG”. Proceedings of the IEEE/EMBS-1996; 4: 1365-1366.

[8]  Owens C, et al. (2006). “Improved Detection of Acute Myocardial Infarction Using a Diagnostic Algorithm Based on Calculated Epicardial Potentials. Int. J. Cardiol.; 111: 292-301.

[9]  Scott PJ, et al. (2010). “Utilising a Genetic Algorithm to Minimise the Number of Leads in Body Surface Mapping for the Electrocardiographic Diagnosis of MI”. Computing in Cardiology; 37:297−300.

Personnel Involved

First Supervisor: Escalona, OJ Prof
Second Supervisor: Meenan, BJ Prof
Collaborator: Prof Jennifer Adgey, Dr Peter Scott

Collaboration: Belfast Health and Social Care Trust

Synopsis:

The project will investigate and develop a high definition ECG mapping (HDECGM) technique for detecting cardiac risk factors in diabetic patients and early evidence of hyperglycemia. An available BSPM database will be mined to provide cardiac risk factors in pre-diabetic and in diabetic patients. A HDECGM database version will be created to validate postulated novel processing techniques for reliable cardiac markers of risk in diabetes.

Return to list of PhD Opportunities