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Analysis of institutional authors

Muniz, Alvaro MontesAuthorAlfonso, FernandoAuthorJimenez-Borreguero, Luis JesusAuthor

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May 5, 2025
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Article

Computer-Assisted Electrocardiogram Analysis Improves Risk Assessment of Underlying Atrial Fibrillation in Cryptogenic Stroke

Publicated to: Cardiology Research. 16 (2): 120-129 - 2025-04-01 16(2), DOI: 10.14740/cr2016

Authors:

Viliani, D; Cecconi, A; Tena, MAS; Vera, A; Ximenez-Carrillo, A; Ramos, C; Martinez-Vives, P; Lopez-Melgar, B; Muniz, AM; Aguirre, C; Vivancos, J; Ortega, G; Alfonso, F; Jimenez-Borreguero, LJ
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Affiliations

Consejo Nacl Invest Cient & Tecn, Consejo Nacl Invest Cient & Tecn, Buenos Aires, Argentina - Author
Hosp Univ Princesa, Inst Invest Sanit, Data Anal Unit, Madrid, Spain - Author
Hosp Univ Ramon & Cajal, Cardiol Dept, Madrid, Spain - Author
IIS IP, CIBER CV, Madrid, Spain - Author
Natl Univ Quilmes, Sci & Technol Dept, Quilmes, Argentina - Author
Osped Santa Chiara, Cardiol Dept, Trento, Italy - Author
Univ Autonoma Madrid, Hosp Univ Princesa, Cardiol Dept, Madrid, Spain - Author
Univ Autonoma Madrid, Hosp Univ Princesa, Stroke Ctr, Neurol Dept,IISIP, Madrid, Spain - Author
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Abstract

Background: The detection of underlying paroxysmal atrial fibrillation (AF) in patients with cryptogenic stroke (CS) can be challenging, and there is great interest in finding predictors of its hidden presence. The recent development of sophisticated software has enhanced the agnostic and prognostic performance of the 12-lead electrocardiogram (ECG). Our aim was to assess the additional role of a computer-assisted ECG analysis in identifying predictors ofAF in patients with CS. Methods: Sixty-seven patients with ischemic stroke or high-risk transient ischemic attack of unknown etiology were prospectively studied. Their 12-lead digitized ECG was analyzed with dedicated software, quantifying 468 morphological variables. The main clinical, biochemical, and echocardiographic variables were also collected. At discharge, patients were monitored with a wearable Holter for days, and the primary outcome was the detection of AF. Results: The median age was 80 (interquartile range (IQR): 73-84) and AF was detected in 21 patients (31.3%). After preselecting significant ECG variables from the univariate analysis, a multivariate regression including other significant clinical, biochemical and echo-cardiographic predictors of AF was performed. Among the automatically analyzed ECG parameters, the amplitude of the R wave in V1 (V1_ramp) was significantly associated with the outcome. The best model to predict AF was composed of age, N-terminal B-type natriuretic peptide (NT-proBNP), left atrial reservoir strain (LASr) and V1_ ramp. This model showed good discrimination capacity (corrected Somer's Dxy 0.941) and performed better than the same model without the ECG variable (Somer's Dxy: 0.827, Brier's B: 0.119,AUC: 0.896). : 0.907, Brier's B: 0.079, area under the curve (AUC): Conclusions: The addition of computer-assisted ECG analysis can help stratify the risk ofAF in the challenging clinical setting of CS.
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Keywords

Bundle-branch blockClassificationComputer-assisted ecg analysisCryptogenic strokCryptogenic strokeParoxysmal atrial fi brillationParoxysmal atrial fibrillationPredic

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Cardiology Research, and although the journal is classified in the quartile Q3 (Agencia WoS (JCR)), its regional focus and specialization in Cardiac & Cardiovascular Systems, give it significant recognition in a specific niche of scientific knowledge at an international level.

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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 8 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Argentina; Italy.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (JIMENEZ BORREGUERO, LUIS JESUS).

the author responsible for correspondence tasks has been Cecconi, Alberto.

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Awards linked to the item

The authors received a research grant from the Carlos III Insti-tute of Health under the health strategy action 2020-2022 with reference PI20/00792.
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