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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81339完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林彥宏(Yen-Hung Lin) | |
| dc.contributor.author | Tsung-Yan Chen | en |
| dc.contributor.author | 陳宗彥 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:44:08Z | - |
| dc.date.available | 2021-08-18 | |
| dc.date.available | 2022-11-24T03:44:08Z | - |
| dc.date.copyright | 2021-08-18 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-07-18 | |
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Jung J, Heisel A, Tscholl D, et al. Factors influencing heart rate variability in patients with severe aortic valve disease. Clin Cardiol 1997;20:341-4. 73. Werner B, Piorecka-Makula A, Bobkowski W. Heart rate variability in children with aortic valve stenosis - a pilot study. Arch Med Sci 2013;9:535-9. 74. Küçükosmanoğlu O, Ozbarlas N, Birand A, Kudaiberdieva GZ. Power spectral analysis of heart rate variability in children with aortic stenosis. Turk J Pediatr 2002;44:109-15. 75. Kang DH, Park SJ, Lee SA, et al. Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis. N Engl J Med 2020;382:111-9. 76. Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med 2000;343:611-7. 77. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021;143:e35-e71. 78. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal 2017;38:2739-91. 79. Costa M, Goldberger AL, Peng CK. Multiscale entropy analysis of biological signals. Phys Rev E Stat Nonlin Soft Matter Phys 2005;71:021906. 80. Robin X, Turck N, Hainard A, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 2011;12:77. 81. Vukasovic JL, Florenzano F, Adriazola P, Escobar E. Heart rate variability in severe aortic stenosis. J Heart Valve Dis 1999;8:143-8. 82. Carvalho TD, Pastre CM, de Godoy MF, et al. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81339 | - |
| dc.description.abstract | "[背景]主動脈瓣狹窄是一種進行性的疾病，一旦嚴重度加劇而開始產生症狀，病患預後迅速變差，對於嚴重主動脈瓣狹窄的病患，心因性猝死更是令人忌憚的問題，而自律神經系統功能異常與心律不整和猝死的發生可能有相關性。在過去的研究中，心率變異度藉由自律神經系統調節，可應用於評估心血管疾病病患之死亡及心律不整風險，然而心率變化呈現高度不規則卻非隨機的特性，傳統線性分析方法著重在測量心跳的變異度，這樣的方法用以描述心律複雜度是不夠的，非線性方法被運用來進一步了解生理訊號長時間的關聯性，其中去趨勢波動分析及多尺度熵是目前最常用的非線性分析方法，過去文獻中對於嚴重主動脈瓣狹窄病患的心律複雜度研究不甚完整，此類病患可能在心律複雜度上產生異常，影響其預後，在本研究中，針對嚴重主動脈瓣狹窄的病患，除了線性分析外，我們也將利用上述兩種非線性分析方式以了解其心律複雜度的變化。 [方法]我們收錄經由胸前心臟超音波確診為嚴重主動脈瓣狹窄的病患，對照組為年齡性別配對且無主動脈瓣狹窄之健康族群，所有試驗參與者接受24小時連續性心電圖記錄，針對每一個參與者選擇四小時穩定的日間心跳間期用以分析，我們利用傳統線性分析、去趨勢波動分析及多尺度熵來分析心律複雜度。 [結果]共有35位嚴重主動脈瓣狹窄病患及70位對照組被收錄到本研究做最終的分析，在線性分析的指數中，主動脈瓣狹窄病患的低頻/高頻比值顯著較低，然而其餘線性指數皆無顯著差異，去趨勢波動分析中，主動脈瓣狹窄病患的DFAα1顯著較低，而在多尺度熵分析中，短時間尺度及長時間尺度的指數(slope 1-5, area 1-5,及 area 6-20)皆顯著地在主動脈瓣狹窄病患中較低，非線性指數用於嚴重主動脈瓣狹窄的鑑別度是可接受的(ROC曲線下面積DFAα1: 0.639, slope 1-5: 0.622, area 1-5: 0.627, 及area 6-20: 0.696)。 [結論]本研究藉由非線性方法中的去趨勢波動分析及多尺度熵發現嚴重主動脈瓣狹窄病患有較差的心律複雜度，而頻域分析的低頻/高頻比值亦有顯著差異。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:44:08Z (GMT). No. of bitstreams: 1 U0001-1707202103013800.pdf: 1460423 bytes, checksum: 5eebb55a1ec28eef5bc7435332938176 (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | 致謝 ....................................................... i 中文摘要 .................................................. ii 英文摘要 .................................................. iv 一、緒論 Introduction ...................................... 1 Introduction to Aortic Stenosis ............................ 1 Introduction to Heart Rhythm Complexity Analysis ........... 3 Clinical Application of Heart Rhythm Complexity Analysis in Cardiovascular Disease ..................................... 5 Rationale of the Present Study ............................. 6 二、研究方法Method ........................................ 7 Patients ................................................... 7 Echocardiography ........................................... 7 ECG Data Pre-processing .................................... 8 Linear Analysis ............................................ 8 Detrended Fluctuation Analysis ............................. 9 Multiscale Entropy ......................................... 9 Statistical Analysis ....................................... 9 三、結果 Results .......................................... 10 Patient Characteristics ................................... 10 Heart Rhythm Complexity Analysis .......................... 11 Discrimination Power ...................................... 11 Logistic Regression Analysis .............................. 12 四、討論 Discussion ....................................... 12 參考文獻 References ....................................... 17 | |
| dc.language.iso | en | |
| dc.subject | 去趨勢波動分析 | zh_TW |
| dc.subject | 心律複雜度 | zh_TW |
| dc.subject | 非線性分析 | zh_TW |
| dc.subject | 多尺度熵 | zh_TW |
| dc.subject | 主動脈瓣狹窄 | zh_TW |
| dc.subject | detrended fluctuation analysis | en |
| dc.subject | multiscale entropy | en |
| dc.subject | aortic stenosis | en |
| dc.subject | heart rhythm complexity | en |
| dc.subject | nonlinear analysis | en |
| dc.title | 嚴重主動脈瓣狹窄病患之心律複雜度分析 | zh_TW |
| dc.title | Heart Rhythm Complexity Analysis in Patients with Severe Aortic Stenosis | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.author-orcid | 0000-0002-2590-8598 | |
| dc.contributor.oralexamcommittee | 吳振吉(Hsin-Tsai Liu),馬席彬(Chih-Yang Tseng),林澂 | |
| dc.subject.keyword | 主動脈瓣狹窄,心律複雜度,非線性分析,多尺度熵,去趨勢波動分析, | zh_TW |
| dc.subject.keyword | aortic stenosis,heart rhythm complexity,nonlinear analysis,multiscale entropy,detrended fluctuation analysis, | en |
| dc.relation.page | 36 | |
| dc.identifier.doi | 10.6342/NTU202101528 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-07-19 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
| 顯示於系所單位： | 臨床醫學研究所 | |
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