QRS波の周波数解析による非視覚的情報の解釈と臨床応用について

QRS内に発生する高周波成分に関しては，いまだその発生原因や臨床的意義が確立されたとは言い難く，現在においても心電図情報のmysterious subjectsの一つである．QRS区間内に発生する高周波信号は，さまざまな病態におけるミリメーターレベルの脱分極異常についての情報を含んでいる可能性があり，高周波解析により新たな非視覚的心電情報がもたらされることが期待される．筆者は2000年頃より心電図学者としての立場から，QRS波の周波数解析の問題に取り組んできた．そこで，今後この方面に興味がある心電図研究者のために，周波数解析に関する総説を書くことを企図した．本稿では，近年，フーリエ変換法に代わ...

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Published in心電図 Vol. 39; no. 4; pp. 247 - 260
Main Author 堤, 健
Format Journal Article
LanguageJapanese
Published 一般社団法人　日本不整脈心電学会 23.12.2019
日本不整脈心電学会
Subjects
QRS波
ウェーブレット変換
脱分極異常
高周波成分
Online AccessGet full text
ISSN0285-1660
1884-2437
DOI10.5105/jse.39.247

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Abstract QRS内に発生する高周波成分に関しては，いまだその発生原因や臨床的意義が確立されたとは言い難く，現在においても心電図情報のmysterious subjectsの一つである．QRS区間内に発生する高周波信号は，さまざまな病態におけるミリメーターレベルの脱分極異常についての情報を含んでいる可能性があり，高周波解析により新たな非視覚的心電情報がもたらされることが期待される．筆者は2000年頃より心電図学者としての立場から，QRS波の周波数解析の問題に取り組んできた．そこで，今後この方面に興味がある心電図研究者のために，周波数解析に関する総説を書くことを企図した．本稿では，近年，フーリエ変換法に代わる周波数解析法として期待されているウェーブレット変換法の応用を中心として，①周波数解析の歴史，②ウェーブレット変換の臨床応用，③高周波発生機序解明の一手段としてcomputer simulationの応用，という三つのテーマを概説する．
AbstractList QRS内に発生する高周波成分に関しては, いまだその発生原因や臨床的意義が確立されたとは言い難く, 現在においても心電図情報のmysterious subjectsの一つである. QRS区間内に発生する高周波信号は, さまざまな病態におけるミリメーターレベルの脱分極異常についての情報を含んでいる可能性があり, 高周波解析により新たな非視覚的心電情報がもたらされることが期待される. 筆者は2000年頃より心電図学者としての立場から, QRS波の周波数解析の問題に取り組んできた. そこで, 今後この方面に興味がある心電図研究者のために, 周波数解析に関する総説を書くことを企図した. 本稿では, 近年, フーリエ変換法に代わる周波数解析法として期待されているウェーブレット変換法の応用を中心として, (1) 周波数解析の歴史, (2) ウェーブレット変換の臨床応用, (3) 高周波発生機序解明の一手段としてcomputer simulationの応用, という三つのテーマを概説する.
QRS内に発生する高周波成分に関しては，いまだその発生原因や臨床的意義が確立されたとは言い難く，現在においても心電図情報のmysterious subjectsの一つである．QRS区間内に発生する高周波信号は，さまざまな病態におけるミリメーターレベルの脱分極異常についての情報を含んでいる可能性があり，高周波解析により新たな非視覚的心電情報がもたらされることが期待される．筆者は2000年頃より心電図学者としての立場から，QRS波の周波数解析の問題に取り組んできた．そこで，今後この方面に興味がある心電図研究者のために，周波数解析に関する総説を書くことを企図した．本稿では，近年，フーリエ変換法に代わる周波数解析法として期待されているウェーブレット変換法の応用を中心として，①周波数解析の歴史，②ウェーブレット変換の臨床応用，③高周波発生機序解明の一手段としてcomputer simulationの応用，という三つのテーマを概説する．
Author 堤, 健
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References 34) . Murata H, Ohara T, Kobayashi Y, Miyauchi Y, Katoh T, Mizuno K : Detection of arrhythmogenic substrates in prior myocardial infarction patients with complete right bundle branch block QRS using wavelet-transformed ECG. J Nippon Med Sch, 2009 ; 76 : 291～299
16) . Benchimol-Barbosa PR, Nasario-Junior O, Nadal J : The effect of configuration parameters of time-frequency maps in the detection of intra-QRS electrical transients of the signal-averaged electrocardiogram : impact in clinical diagnostic performance. Int J Cardiol, 2010 ; 145 : 59～61
1) . Langner PH Jr : The value of high fidelity electrocardiography using the cathode ray oscillograph and an expanded time scale. Circulation, 1952 ; 5 : 249～256
30) . 堤, 健，岡本良夫：心電図波形に対するウェーブレット法の応用について．日本応用数理学会2006年度年会講演予稿集，2006 ; 56～59
37) . Watanabe T, Yamaki M, Tachibana H, Kubota I, Tomoike H : Decrease in the high frequency QRS components depending on the local conduction delay. Jpn Circ J, 1998 ; 62 : 844～848
31) . Tsutsumi T, Takano N, Matsuyama N, Higashi Y, Iwasawa K, Nakajima T : High-frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients. Heart Rhythm, 2011 ; 8 : 1509～1515
9) . Cain ME, Ambos HD, Witkowski FX, Sobel BE : Fast-Fourier transform analysis of signal-averaged electrocardiograms for identification of patients prone to sustained ventricular tachycardia. Circulation, 1984 ; 69 : 711～720
21) . Gramatikov B, Brinker J, Yi-chun S, Thakor NV : Wavelet analysis and time-frequency distributions of the body surface ECG before and after angioplasty. Comput Methods Programs Biomed, 2000 ; 62 : 87～98
22) . Morlet D, Peyrin F, Desseigne P, Touboul P, Rubel P : Wavelet analysis of high-resolution signal-averaged ECGs in postinfarction patients. J Electrocardiol, 1993 ; 26 : 311～320
24) . Couderc JP, Chevalier P, Fayn J, Rubel P, Touboul P : Identification of post-myocardial infarction patients prone to ventricular tachycardia using time-frequency analysis of QRS and ST segments. Europace, 2000 ; 2 : 141～153
20) . Addison PS : Wavelet transforms and the ECG : a review. Physiol Meas, 2005 ; 26 : R155～R199
15) . Kelen GJ, Henkin R, Starr AM, Caref EB, Bloomfield D, El-Sherif N : Spectral turbulence analysis of the signal-averaged electrocardiogram and its predictive accuracy for inducible sustained monomorphic ventricular tachycardia. Am J Cardiol, 1991 ; 67 : 965～975
18) . 榊原進編：ウェーブレットビギナーズガイド．東京電機大学出版局，東京，1998 ; 3～7
33) . Tsutsumi T, Okamoto Y, Takano N, Wakatsuki D, Tomaru T, Nakajima T : High-frequency power within the QRS complex in ischemic cardiomyopathy patients with ventricular arrhythmia : Insights from a clinical study and computer simulation of cardiac fibrous tissue. Comp Biol Med, 2017 ; 87 : 132～140
8) . Amit G, Granot Y, Abboud S : Quantifying QRS changes during myocardial ischemia : Insights from high frequency electrocardiography. J Electrocardiol, 2014 ; 47 : 505～511
26) . Takayama H, Yodogawa K, Katoh T, Takano T : Evaluation of arrhythmogenic substrate in patients with hypertrophic cardiomyopathy using wavelet transform analysis. Circ J, 2006 ; 70 : 69～74
35) . Vassilikos VP, Mantziari L, Dukes G, Kamperidis V, Couvade I, Chatzizisis YS, et al : QRS analysis using wavelet transformation for the prediction of response to Cardiac resynchronization therapy : A prospective pilot study. J of Electrocardiol, 2014 ; 47 : 59～65
32) . Tsutsumi T, Okamoto Y, Kubota-Takano N, Wakatsuki D, Suzuki H, Sezaki K, et al : Time-frequency analysis of the QRS complex in patients with ischemic cardiomyopathy and myocardial infarction. Int J Cardiol Heart " Vessels, 2014 ; 4 : 177～187
3) . Reynolds EW Jr, Muller BF, Anderson GJ, Muller BT : High-frequency components in the electrocardiogram. A comparative study of normals and patients with myocardial disease. Circulation, 1967 ; 35 : 195～206
38) . Ota K, Tsutsumi T, Kawachi K, Wakatsuki D, Shimizu N, Asano F, Takeyama Y, Okamoto Y : Time-frequency analysis of QRS complex with wavelet transform in patients with triple-vessel disease. Anadolu Kardiyol Derg, 2007 ; 7（Suppl. 1）：133～134
10) . Lindsay BD, Ambos HD, Schechtman KB, Cain ME : Improved selection of patients for programmed ventricular stimulation by frequency analysis of signal-averaged electrocardiograms. Circulation, 1986 ; 73 : 675～683
6) . Goldberger AL, Bhargava V, Froelicher V, Covell J : Effect of myocardial infarction on high-frequency QRS potentials. Circulation, 1981 ; 64 : 34～42
14) . Haberl R, Schels HF, Steinbigler P, Jilge G, Steinbeck G : Top-resolution frequency analysis of electrocardiogram with adaptive frequency determination. Identification of late potentials in patients with coronary artery disease. Circulation, 1990 ; 82 : 1183～1192
12) . Haberl R, Jilge G, Pulter R, Steinbeck G : Comparison of frequency and time domain analysis of the signal-averaged electrocardiogram in patients with ventricular tachycardia and coronary artery disease : methodologic validation and clinical relevance. J Am Coll Cardiol, 1988 ; 12 : 150～158
28) . Shimojima H, Tsutsumi T, Yanagisawa F, Komukai M, Zenda N, Higashi Y, Takeyama Y and Okamoto Y. Application of wavelet transform for analysis of QRS complex in intraventricular conduction abnormalities. Inter J of Bioelectromag, 2003 ; 5 : 279～281
36) . Mor-Avi V, Akselrod S : Spectral analysis of canine epicardial electrogram. Short-term variations in the frequency content induced by myocardial ischemia. Circ Res, 1990 ; 66 : 1681～1691
27) . Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Katoh T, Takano T : High-frequency potentials developed in wavelet-transformed electrocardiogram as a novel indicator for detecting Brugada syndrome. Heart Rhythm, 2006 ; 3 : 1436～1444
39) . Kubota N, Tsutsumi T, Nakajima T, Okamoto Y, Takeyama Y : Modification of olmesartan on time-frequency distribution in QRS and expression of TIMP-1 mRNA in spontaneously hypertensive rat’s heart. Inter J of Bioelectromag, 2007 ; 9（Suppl.1）：15～16
4) . Flowers NC, Horan LG, Thomas JR, Tolleson WJ : The anatomic basis for high-frequency components in the electrocardiogram. Circulation, 1969 ; 39 : 531～539
19) . 石川康弘編：臨床医学のためのウェーブレット解析．医学出版，東京，2000 ; 61～62
2) . Langner PH Jr, Geselowitz DB, Mansure FT : High-frequency components in the electrocardiograms of normal subjects and of patients with coronary heart disease. Am Heart J, 1961 ; 62 : 746～755
7) . Abboud S, Cohen RJ, Selwyn A, Ganz P, Sadeh D, Friedman PL : Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing percutaneous transluminal coronary angioplasty. Circulation, 1987 ; 76 : 585～596
13) . Nogami A, Iesaka Y, Akiyama J, Takahashi A, Nitta J, Chun Y, Aonuma K, Hiroe M, Marumo F, Hiraoka M : Combined use of time and frequency domain variables in signal-averaged ECG as a predictor of inducible sustained monomorphic ventricular tachycardia in myocardial infarction. Circulation, 1992 ; 86 : 780～789
23) . Lewandowski P, Meste O, Maniewski R, Mroczka T, Steinbach K, Rix H : Risk evaluation of ventricular tachycardia using wavelet transform irregularity of the high-resolution electrocardiogram. Med " Biol Eng " Comput, 2000 ; 38 : 666～673
40) . Takano NK, Tsutsumi T, Suzuki H, Okamoto Y, Nakajima T : Time frequency power profile of QRS complex obtained with wavelet transform in spontaneously hypertensive rats. Comput Biol Med, 2012 ; 42 : 205～212
5) . Scher AM, Young AC : Frequency analysis of the electrocardiogram. Circ Res, 1960 ; 8 : 344～346
17) . Morlet J, Arens G, Fourgeau E, Glard D : Wave propagation and sampling theory. Part I : Complex signal and scattering in multilayered media. Geophysics, 1982 ; 47 : 203～236
25) . Maehara K, Kokubun T, Awano N, Taira K, Ono M, Furukawa T, Shimizu Y, Maruyama Y : Detection of abnormal high-frequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy. Jpn Circ J, 1999 ; 63 : 25～32
11) . Pierce DL, Easley AR Jr, Windle JR, Engel TR : Fast Fourier transformation of the entire low amplitude late QRS potential to predict ventricular tachycardia. J Am Coll Cardiol, 1989 ; 14 : 1731～1740
29) . Tsutsumi T, Wakatsuki D, Shimojima H, Higashi Y, Takeyama Y : Analyzing time-frequency power spectrum limited in QRS complex based on the wavelet transform. Inter J of Bioelectromag, 2004 ; 6 : http.www.ijbem.org/volume 6/number 1/007.html
References_xml – reference: 4) . Flowers NC, Horan LG, Thomas JR, Tolleson WJ : The anatomic basis for high-frequency components in the electrocardiogram. Circulation, 1969 ; 39 : 531～539
– reference: 14) . Haberl R, Schels HF, Steinbigler P, Jilge G, Steinbeck G : Top-resolution frequency analysis of electrocardiogram with adaptive frequency determination. Identification of late potentials in patients with coronary artery disease. Circulation, 1990 ; 82 : 1183～1192
– reference: 15) . Kelen GJ, Henkin R, Starr AM, Caref EB, Bloomfield D, El-Sherif N : Spectral turbulence analysis of the signal-averaged electrocardiogram and its predictive accuracy for inducible sustained monomorphic ventricular tachycardia. Am J Cardiol, 1991 ; 67 : 965～975
– reference: 16) . Benchimol-Barbosa PR, Nasario-Junior O, Nadal J : The effect of configuration parameters of time-frequency maps in the detection of intra-QRS electrical transients of the signal-averaged electrocardiogram : impact in clinical diagnostic performance. Int J Cardiol, 2010 ; 145 : 59～61
– reference: 29) . Tsutsumi T, Wakatsuki D, Shimojima H, Higashi Y, Takeyama Y : Analyzing time-frequency power spectrum limited in QRS complex based on the wavelet transform. Inter J of Bioelectromag, 2004 ; 6 : http.www.ijbem.org/volume 6/number 1/007.html
– reference: 6) . Goldberger AL, Bhargava V, Froelicher V, Covell J : Effect of myocardial infarction on high-frequency QRS potentials. Circulation, 1981 ; 64 : 34～42
– reference: 25) . Maehara K, Kokubun T, Awano N, Taira K, Ono M, Furukawa T, Shimizu Y, Maruyama Y : Detection of abnormal high-frequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy. Jpn Circ J, 1999 ; 63 : 25～32
– reference: 23) . Lewandowski P, Meste O, Maniewski R, Mroczka T, Steinbach K, Rix H : Risk evaluation of ventricular tachycardia using wavelet transform irregularity of the high-resolution electrocardiogram. Med " Biol Eng " Comput, 2000 ; 38 : 666～673
– reference: 26) . Takayama H, Yodogawa K, Katoh T, Takano T : Evaluation of arrhythmogenic substrate in patients with hypertrophic cardiomyopathy using wavelet transform analysis. Circ J, 2006 ; 70 : 69～74
– reference: 12) . Haberl R, Jilge G, Pulter R, Steinbeck G : Comparison of frequency and time domain analysis of the signal-averaged electrocardiogram in patients with ventricular tachycardia and coronary artery disease : methodologic validation and clinical relevance. J Am Coll Cardiol, 1988 ; 12 : 150～158
– reference: 39) . Kubota N, Tsutsumi T, Nakajima T, Okamoto Y, Takeyama Y : Modification of olmesartan on time-frequency distribution in QRS and expression of TIMP-1 mRNA in spontaneously hypertensive rat’s heart. Inter J of Bioelectromag, 2007 ; 9（Suppl.1）：15～16
– reference: 36) . Mor-Avi V, Akselrod S : Spectral analysis of canine epicardial electrogram. Short-term variations in the frequency content induced by myocardial ischemia. Circ Res, 1990 ; 66 : 1681～1691
– reference: 27) . Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Katoh T, Takano T : High-frequency potentials developed in wavelet-transformed electrocardiogram as a novel indicator for detecting Brugada syndrome. Heart Rhythm, 2006 ; 3 : 1436～1444
– reference: 9) . Cain ME, Ambos HD, Witkowski FX, Sobel BE : Fast-Fourier transform analysis of signal-averaged electrocardiograms for identification of patients prone to sustained ventricular tachycardia. Circulation, 1984 ; 69 : 711～720
– reference: 20) . Addison PS : Wavelet transforms and the ECG : a review. Physiol Meas, 2005 ; 26 : R155～R199
– reference: 34) . Murata H, Ohara T, Kobayashi Y, Miyauchi Y, Katoh T, Mizuno K : Detection of arrhythmogenic substrates in prior myocardial infarction patients with complete right bundle branch block QRS using wavelet-transformed ECG. J Nippon Med Sch, 2009 ; 76 : 291～299
– reference: 21) . Gramatikov B, Brinker J, Yi-chun S, Thakor NV : Wavelet analysis and time-frequency distributions of the body surface ECG before and after angioplasty. Comput Methods Programs Biomed, 2000 ; 62 : 87～98
– reference: 22) . Morlet D, Peyrin F, Desseigne P, Touboul P, Rubel P : Wavelet analysis of high-resolution signal-averaged ECGs in postinfarction patients. J Electrocardiol, 1993 ; 26 : 311～320
– reference: 32) . Tsutsumi T, Okamoto Y, Kubota-Takano N, Wakatsuki D, Suzuki H, Sezaki K, et al : Time-frequency analysis of the QRS complex in patients with ischemic cardiomyopathy and myocardial infarction. Int J Cardiol Heart " Vessels, 2014 ; 4 : 177～187
– reference: 1) . Langner PH Jr : The value of high fidelity electrocardiography using the cathode ray oscillograph and an expanded time scale. Circulation, 1952 ; 5 : 249～256
– reference: 2) . Langner PH Jr, Geselowitz DB, Mansure FT : High-frequency components in the electrocardiograms of normal subjects and of patients with coronary heart disease. Am Heart J, 1961 ; 62 : 746～755
– reference: 10) . Lindsay BD, Ambos HD, Schechtman KB, Cain ME : Improved selection of patients for programmed ventricular stimulation by frequency analysis of signal-averaged electrocardiograms. Circulation, 1986 ; 73 : 675～683
– reference: 24) . Couderc JP, Chevalier P, Fayn J, Rubel P, Touboul P : Identification of post-myocardial infarction patients prone to ventricular tachycardia using time-frequency analysis of QRS and ST segments. Europace, 2000 ; 2 : 141～153
– reference: 37) . Watanabe T, Yamaki M, Tachibana H, Kubota I, Tomoike H : Decrease in the high frequency QRS components depending on the local conduction delay. Jpn Circ J, 1998 ; 62 : 844～848
– reference: 33) . Tsutsumi T, Okamoto Y, Takano N, Wakatsuki D, Tomaru T, Nakajima T : High-frequency power within the QRS complex in ischemic cardiomyopathy patients with ventricular arrhythmia : Insights from a clinical study and computer simulation of cardiac fibrous tissue. Comp Biol Med, 2017 ; 87 : 132～140
– reference: 11) . Pierce DL, Easley AR Jr, Windle JR, Engel TR : Fast Fourier transformation of the entire low amplitude late QRS potential to predict ventricular tachycardia. J Am Coll Cardiol, 1989 ; 14 : 1731～1740
– reference: 7) . Abboud S, Cohen RJ, Selwyn A, Ganz P, Sadeh D, Friedman PL : Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing percutaneous transluminal coronary angioplasty. Circulation, 1987 ; 76 : 585～596
– reference: 17) . Morlet J, Arens G, Fourgeau E, Glard D : Wave propagation and sampling theory. Part I : Complex signal and scattering in multilayered media. Geophysics, 1982 ; 47 : 203～236
– reference: 13) . Nogami A, Iesaka Y, Akiyama J, Takahashi A, Nitta J, Chun Y, Aonuma K, Hiroe M, Marumo F, Hiraoka M : Combined use of time and frequency domain variables in signal-averaged ECG as a predictor of inducible sustained monomorphic ventricular tachycardia in myocardial infarction. Circulation, 1992 ; 86 : 780～789
– reference: 35) . Vassilikos VP, Mantziari L, Dukes G, Kamperidis V, Couvade I, Chatzizisis YS, et al : QRS analysis using wavelet transformation for the prediction of response to Cardiac resynchronization therapy : A prospective pilot study. J of Electrocardiol, 2014 ; 47 : 59～65
– reference: 30) . 堤, 健，岡本良夫：心電図波形に対するウェーブレット法の応用について．日本応用数理学会2006年度年会講演予稿集，2006 ; 56～59
– reference: 28) . Shimojima H, Tsutsumi T, Yanagisawa F, Komukai M, Zenda N, Higashi Y, Takeyama Y and Okamoto Y. Application of wavelet transform for analysis of QRS complex in intraventricular conduction abnormalities. Inter J of Bioelectromag, 2003 ; 5 : 279～281
– reference: 40) . Takano NK, Tsutsumi T, Suzuki H, Okamoto Y, Nakajima T : Time frequency power profile of QRS complex obtained with wavelet transform in spontaneously hypertensive rats. Comput Biol Med, 2012 ; 42 : 205～212
– reference: 8) . Amit G, Granot Y, Abboud S : Quantifying QRS changes during myocardial ischemia : Insights from high frequency electrocardiography. J Electrocardiol, 2014 ; 47 : 505～511
– reference: 3) . Reynolds EW Jr, Muller BF, Anderson GJ, Muller BT : High-frequency components in the electrocardiogram. A comparative study of normals and patients with myocardial disease. Circulation, 1967 ; 35 : 195～206
– reference: 18) . 榊原進編：ウェーブレットビギナーズガイド．東京電機大学出版局，東京，1998 ; 3～7
– reference: 19) . 石川康弘編：臨床医学のためのウェーブレット解析．医学出版，東京，2000 ; 61～62
– reference: 31) . Tsutsumi T, Takano N, Matsuyama N, Higashi Y, Iwasawa K, Nakajima T : High-frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients. Heart Rhythm, 2011 ; 8 : 1509～1515
– reference: 38) . Ota K, Tsutsumi T, Kawachi K, Wakatsuki D, Shimizu N, Asano F, Takeyama Y, Okamoto Y : Time-frequency analysis of QRS complex with wavelet transform in patients with triple-vessel disease. Anadolu Kardiyol Derg, 2007 ; 7（Suppl. 1）：133～134
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Snippet QRS内に発生する高周波成分に関しては，いまだその発生原因や臨床的意義が確立されたとは言い難く，現在においても心電図情報のmysterious...
QRS内に発生する高周波成分に関しては, いまだその発生原因や臨床的意義が確立されたとは言い難く, 現在においても心電図情報のmysterious subjectsの一つである. QRS区間内に発生する高周波信号は, さまざまな病態におけるミリメーターレベルの脱分極異常についての情報を含んでいる可能性があり,...
SourceID medicalonline
jstage
SourceType Publisher
StartPage 247
SubjectTerms QRS波
ウェーブレット変換
脱分極異常
高周波成分
Title QRS波の周波数解析による非視覚的情報の解釈と臨床応用について
URI https://www.jstage.jst.go.jp/article/jse/39/4/39_247/_article/-char/ja
http://mol.medicalonline.jp/en/journal/download?GoodsID=dn4eleca/2019/003904/002&name=0247-0260j
Volume 39
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ispartofPNX 心電図, 2019/12/23, Vol.39(4), pp.247-260
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