Novel imaging revealing inner dynamics for cardiovascular waveform analysis via unsupervised manifold learning

TL;DR

This paper introduces a novel 3D imaging approach using unsupervised manifold learning to analyze cardiovascular waveforms, revealing dynamic changes and physiological insights in ECG and ABP data for clinical diagnosis.

Contribution

It applies diffusion map-based manifold learning to visualize and quantify waveform dynamics, providing new insights into cardiovascular conditions and intraoperative changes.

Findings

High classification accuracy for ECG and ABP waveform analysis.

Visualization of waveform evolution during clinical events.

Identification of inter-individual differences and physiological trajectories.

Abstract

Cardiovascular waveforms contain information for clinical diagnosis. By "learning" and organizing the subtle change of waveform morphology from large amounts of raw waveform data, unsupervised manifold learning helps delineate a high-dimensional structure and display it as a novel three-dimensional (3D) image. We investigate the electrocardiography (ECG) waveform for ischemic heart disease and arterial blood pressure (ABP) waveform in dynamic vasoactive episodes. We model each beat or pulse to be a point lying on a manifold, like a surface, and use the diffusion map (DMap) to establish the relationship among those pulses. For ECG datasets, first we analyzed the non-ST-elevation ECG waveform distribution from unstable angina to healthy control, and we investigated intraoperative ST-elevation ECG waveforms to show the dynamic ECG waveform changes. For ABP datasets, we analyzed waveforms collected under endotracheal intubation and administration of vasodilator. To quantify the dynamic separation, we applied the support vector machine (SVM) analysis and the trajectory analysis. For the non-ST-elevation ECG, a hierarchical tree structure comprising consecutive ECG waveforms spanning from unstable angina to healthy control is presented in the 3D image (accuracy=97.6%, macro-F1=96.1%). The DMap helps quantify and visualize the evolving direction of intraoperative ST-elevation myocardial episode in a 1-hour period (accuracy=97.58%, macro-F1=96.06%). The ABP waveform analysis of Nicardipine administration shows inter-individual difference (accuracy=95.01%, macro-F1=96.9%) and their common directions from intra-individual moving trajectories. The dynamic change of the ABP waveform during endotracheal intubation shows a loop-like trajectory structure, which can be further divided using the knowledge obtained from Nicardipine. The 3D images provide clues of underneath physiological mechanisms.