title: Mathematical detection of aortic valve opening (B point) in impedance cardiography: A comparison of three popular algorithms.
abstract: The preejection period (PEP) is an index of left ventricle contractility widely used in psychophysiological research. Its computation requires detecting the moment when the aortic valve opens, which coincides with the B point in the first derivative of impedance cardiogram (ICG). Although this operation has been traditionally made via visual inspection, several algorithms based on derivative calculations have been developed to enable an automatic performance of the task. However, despite their popularity, data about their empirical validation are not always available. The present study analyzes the performance in the estimation of the aortic valve opening of three popular algorithms, by comparing their performance with the visual detection of the B point made by two independent scorers. Algorithm 1 is based on the first derivative of the ICG, Algorithm 2 on the second derivative, and Algorithm 3 on the third derivative. Algorithm 3 showed the highest accuracy rate (78.77%), followed by Algorithm 1 (24.57%) and Algorithm 2 (13.82%). In the automatic computation of PEP, Algorithm 2 resulted in significantly more missed cycles (48.57%) than Algorithm 1 (6.3%) and Algorithm 3 (3.5%). Algorithm 2 also estimated a significantly lower average PEP (70 ms), compared with the values obtained by Algorithm 1 (119 ms) and Algorithm 3 (113 ms). Our findings indicate that the algorithm based on the third derivative of the ICG performs significantly better. Nevertheless, a visual inspection of the signal proves indispensable, and this article provides a novel visual guide to facilitate the manual detection of the B point.
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: Javier Rodríguez
authors.initials: JR
authors.lastname: Árbol
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: Pandelis
authors.initials: P
authors.lastname: Perakakis
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Garrido
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Mata
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Fernández-Santaella
authors.affiliation: Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Vila
mesh_terms: D000328:Adult; D000465:Algorithms; D001021:Aortic Valve / Q000502:physiology*; D002307:Cardiography, Impedance / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted; D016276:Ventricular Function; D055815:Young Adult
keywords: Isoelectric crossings; Preejection period; Second derivative classification; Third derivative classification