Continuous ECG Monitoring in Patients With Acute Coronary Syndrome or Heart Failure: EASI Versus Gold Standard.

PubMed

Lancia, Loreto; Toccaceli, Andrea; Petrucci, Cristina; Romano, Silvio; Penco, Maria

2018-05-01

The purpose of the study was to compare the EASI system with the standard 12-lead surface electrocardiogram (ECG) for the accuracy in detecting the main electrocardiographic parameters (J point, PR, QT, and QRS) commonly monitored in patients with acute coronary syndromes or heart failure. In this observational comparative study, 253 patients who were consecutively admitted to the coronary care unit with acute coronary syndrome or heart failure were evaluated. In all patients, two complete 12-lead ECGs were acquired simultaneously. A total of 6,072 electrocardiographic leads were compared (3,036 standard and 3,036 EASI). No significant differences were found between the investigate parameters of the two measurement methods, either in patients with acute coronary syndrome or in those with heart failure. This study confirmed the accuracy of the EASI system in monitoring the main ECG parameters in patients admitted to the coronary care unit with acute coronary syndrome or heart failure.

Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease.

PubMed

Mebius, Mirthe J; du Marchie Sarvaas, Gideon J; Wolthuis, Diana W; Bartelds, Beatrijs; Kneyber, Martin C J; Bos, Arend F; Kooi, Elisabeth M W

2017-03-16

Some infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation. We report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent. These two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease.

Military Performance and Health Monitoring in Extreme Environments

DTIC Science & Technology

2009-10-01

radiation and wind to give a true temperature reading . At high ambient temperatures, in particular in combination with solar radiation, objects may...Equivital multi-sensor unit enabling the real-time, parallel and continuous assessment of EKG (and heart rate), respiration (and respiration rate), skin

Utility of Time and Frequency Domain Parameters of Heart Rate Variability in the Context of Autonomic Disorders Characterized by Orthostatic Dysfunction.

PubMed

Baker, Jacquie; Racosta, Juan M; Balint, Brittany; Kimpinski, Kurt

2018-03-01

The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included. Time and frequency parameters during baseline, head-up tilt (HUT), and heart rate response to deep breathing (HRDB) were compared. Cardiovagal time parameters were significantly reduced during HUT in healthy young and postural tachycardia syndrome (P < 0.001). Healthy young had significantly higher time parameters during baseline, HUT, and HRDB (P < 0.01). This was reflected by a significantly lower resting heart rate (HR) (61.4 ± 9.0 bpm vs. 76.8 ± 13.6 bpm; P < 0.001) and a smaller [INCREMENT]HR during HUT (32.8 ± 10.5 bpm vs. 44.4 ± 13.3 bpm; P < 0.001). Time parameters increased in young and postural tachycardia syndrome during HRDB, which was characterized by a nonsignificant difference in [INCREMENT]HR between both groups. Time parameters were significantly higher in healthy old versus neurogenic orthostatic hypotension at rest and during HRDB (P < 0.05). During HUT, only the SD of all normal RR intervals remained significantly higher. Heart rate changes corroborated these findings. Resting HR was significantly lower in healthy older (62.6 ± 11.0 bpm vs. 70.7 ± 12.4 bpm), and [INCREMENT]HR during HRDB was significantly higher (15.9 ± 9.2 bpm vs. 3.9 ± 4.2 bpm; P < 0.001). During HUT, [INCREMENT]HR showed no significant differences. Time domain parameters of heart rate variability have a greater utility than frequency parameters in clinical autonomic disorders.

Characterization of Sensory-Motor Behavior Under Cognitive Load Using a New Statistical Platform for Studies of Embodied Cognition

PubMed Central

Ryu, Jihye; Torres, Elizabeth B.

2018-01-01

The field of enacted/embodied cognition has emerged as a contemporary attempt to connect the mind and body in the study of cognition. However, there has been a paucity of methods that enable a multi-layered approach tapping into different levels of functionality within the nervous systems (e.g., continuously capturing in tandem multi-modal biophysical signals in naturalistic settings). The present study introduces a new theoretical and statistical framework to characterize the influences of cognitive demands on biophysical rhythmic signals harnessed from deliberate, spontaneous and autonomic activities. In this study, nine participants performed a basic pointing task to communicate a decision while they were exposed to different levels of cognitive load. Within these decision-making contexts, we examined the moment-by-moment fluctuations in the peak amplitude and timing of the biophysical time series data (e.g., continuous waveforms extracted from hand kinematics and heart signals). These spike-trains data offered high statistical power for personalized empirical statistical estimation and were well-characterized by a Gamma process. Our approach enabled the identification of different empirically estimated families of probability distributions to facilitate inference regarding the continuous physiological phenomena underlying cognitively driven decision-making. We found that the same pointing task revealed shifts in the probability distribution functions (PDFs) of the hand kinematic signals under study and were accompanied by shifts in the signatures of the heart inter-beat-interval timings. Within the time scale of an experimental session, marked changes in skewness and dispersion of the distributions were tracked on the Gamma parameter plane with 95% confidence. The results suggest that traditional theoretical assumptions of stationarity and normality in biophysical data from the nervous systems are incongruent with the true statistical nature of empirical data. This work offers a unifying platform for personalized statistical inference that goes far beyond those used in conventional studies, often assuming a “one size fits all model” on data drawn from discrete events such as mouse clicks, and observations that leave out continuously co-occurring spontaneous activity taking place largely beneath awareness. PMID:29681805

Injection of Contaminants into a Simulated Water Distribution System Equipped with Continuous Multi-Parameter Water Monitors

EPA Science Inventory

The U.S. EPA’s Technology Testing and Evaluation Program has been charged by EPA to evaluate the performance of commercially available water security-related technologies. Multi-parameter water monitors for distributions systems have been evaluated as such a water security techn...

OLAM: A wearable, non-contact sensor for continuous heart-rate and activity monitoring.

PubMed

Albright, Ryan K; Goska, Benjamin J; Hagen, Tory M; Chi, Mike Y; Cauwenberghs, G; Chiang, Patrick Y

2011-01-01

A wearable, multi-modal sensor is presented that can non-invasively monitor a patient's activity level and heart function concurrently for more than a week. The 4 in(2) sensor incorporates both a non-contact heartrate sensor and a 5-axis inertial measurement unit (IMU), allowing simultaneous heart, respiration, and movement monitoring without requiring physical contact with the skin [1]. Hence, this Oregon State University Life and Activity Monitor (OLAM) provides the unique opportunity to combine motion data with heart-rate information, enabling assessment of actual physical activity beyond conventional movement sensors. OLAM also provides a unique platform for non-contact sensing, enabling the filtering of movement artifacts generated by the non-contact capacitive interface, using the IMU data as a movement noise channel. Intended to be used in clinical trials for weeks at a time with no physician intervention, the OLAM allows continuous non-invasive monitoring of patients, providing the opportunity for long-term observation into a patient's physical activity and subtle longitudinal changes.

The application of information theory for the research of aging and aging-related diseases.

PubMed

Blokh, David; Stambler, Ilia

2017-10-01

This article reviews the application of information-theoretical analysis, employing measures of entropy and mutual information, for the study of aging and aging-related diseases. The research of aging and aging-related diseases is particularly suitable for the application of information theory methods, as aging processes and related diseases are multi-parametric, with continuous parameters coexisting alongside discrete parameters, and with the relations between the parameters being as a rule non-linear. Information theory provides unique analytical capabilities for the solution of such problems, with unique advantages over common linear biostatistics. Among the age-related diseases, information theory has been used in the study of neurodegenerative diseases (particularly using EEG time series for diagnosis and prediction), cancer (particularly for establishing individual and combined cancer biomarkers), diabetes (mainly utilizing mutual information to characterize the diseased and aging states), and heart disease (mainly for the analysis of heart rate variability). Few works have employed information theory for the analysis of general aging processes and frailty, as underlying determinants and possible early preclinical diagnostic measures for aging-related diseases. Generally, the use of information-theoretical analysis permits not only establishing the (non-linear) correlations between diagnostic or therapeutic parameters of interest, but may also provide a theoretical insight into the nature of aging and related diseases by establishing the measures of variability, adaptation, regulation or homeostasis, within a system of interest. It may be hoped that the increased use of such measures in research may considerably increase diagnostic and therapeutic capabilities and the fundamental theoretical mathematical understanding of aging and disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

A usability study of a mobile monitoring system for congestive heart failure patients.

PubMed

Svagård, I; Austad, H O; Seeberg, T; Vedum, J; Liverud, A; Mathiesen, B M; Keller, B; Bendixen, O C; Osborne, P; Strisland, F

2014-01-01

Sensor-based monitoring of congestive heart-failure (CHF) patients living at home can improve quality of care, detect exacerbations of disease at an earlier stage and motivate the patient for better self care. This paper reports on a usability study of the ESUMS system that provides continuous measurements of heart rate, activity, upper body posture and skin temperature via a sensor belt and a smartphone as patient terminal. Five CHF patients were included in the trial, all recently discharged from hospital. The nurses experienced continuous heart rate, activity and posture monitoring as useful and objective tools that helped them in their daily assessment of patient health. They also saw the system as an important educational tool to help patients gain insight into their own condition. Three patients liked that they could have a view of their own physiological and activity data, however the smartphones used in the study turned out to be too complicated for the patients to operate. A smartphone is built to be a multi-purpose device, and this may (conceptually and practically) be incompatible with the patients' demands for ease of use.

Aerobic Interval vs. Continuous Training in Patients with Coronary Artery Disease or Heart Failure: An Updated Systematic Review and Meta-Analysis with a Focus on Secondary Outcomes.

PubMed

Pattyn, Nele; Beulque, Randy; Cornelissen, Véronique

2018-05-01

In a previous meta-analysis including nine trials comparing aerobic interval training with aerobic continuous training in patients with coronary artery disease, we found a significant difference in peak oxygen uptake favoring aerobic interval training. The objective of this study was to (1) update the original meta-analysis focussing on peak oxygen uptake and (2) evaluate the effect on secondary outcomes. We conducted a systematic review with a meta-analysis by searching PubMed and SPORTDiscus databases up to March 2017. We included randomized trials comparing aerobic interval training and aerobic continuous training in patients with coronary artery disease or chronic heart failure. The primary outcome was change in peak oxygen uptake. Secondary outcomes included cardiorespiratory parameters, cardiovascular risk factors, cardiac and vascular function, and quality of life. Twenty-four papers were identified (n = 1080; mean age 60.7 ± 10.7 years). Aerobic interval training resulted in a higher increase in peak oxygen uptake compared with aerobic continuous training in all patients (1.40 mL/kg/min; p < 0.001), and in the subgroups of patients with coronary artery disease (1.25 mL/kg/min; p = 0.001) and patients with chronic heart failure with reduced ejection fraction (1.46 mL/kg/min; p = 0.03). Moreover, a larger increase of the first ventilatory threshold and peak heart rate was observed after aerobic interval training in all patients. Other cardiorespiratory parameters, cardiovascular risk factors, and quality of life were equally affected. This meta-analysis adds further evidence to the clinically significant larger increase in peak oxygen uptake following aerobic interval training vs. aerobic continuous training in patients with coronary artery disease and chronic heart failure. More well-designed randomized controlled trials are needed to establish the safety of aerobic interval training and the sustainability of the training response over longer periods.

Continuous and Noninvasive Recording of Cardiovascular Parameters with the Finapres Finger Cuff Enhances Undergraduate Student Understanding of Physiology

ERIC Educational Resources Information Center

Hodgson, Yvonne; Choate, Julia

2012-01-01

The Finapres finger cuff recording system provides continuous calculations of beat-to-beat variations in cardiac output (CO), total peripheral resistance, heart rate (HR), and blood pressure (BP). This system is unique in that it allows experimental subjects to immediately, continuously, and noninvasively visualize changes in CO at rest and during…

[Evaluation of heart impact in the 100 m extreme intensity sport using near-infrared non-invasive muscle oxygen detecting device and sports heart rate detection technology].

PubMed

Wang, Pei-Yong; Long, Fei-Xiao; Fu, Lan-Ying; Li, Yue; Ding, Hai-Shu; Qu, An-Lian; Zhou, Xiao-Ping

2010-02-01

Using continuous two wavelength near-infrared technology to detect the variation in the consistency of oxygen hemoglobin in the muscle and the sports heart rate wireless real time collection technology, we devised the real time muscle tissue oxygenation and instantaneous heart rate experiment scheme and implemented it for the process of the 100 m run with two parameters given simultaneously. The experiment shows that the concentration of the oxygen hemoglobin in the muscle tissue continues decreasing after the end of the 100 m run, and the time interval between the moment when the concentration of the oxygen hemoglobin attains the minimum value and the moment when the athletes finish the 100 m run is (6.65 +/- 1.10) sec; while the heart rate continues increasing after the end of the 100 m run, and the time interval between the moment when the heart rate attains the maximum value and the moment when the athletes finish the 100 m run is (8.00 +/- 1.57) sec. The results show that the two wavelength near-infrared tissue oxygenation detection technology and the sports heart rate real time collection equipment can accurately measure the sports tissue oxygenation and the heart rate in the extreme intensity sport, and reveal the process of muscle oxygen transportation and consumption and its dynamic character with the heart rate in the extreme intensity sport.

Wearable vital parameters monitoring system

NASA Astrophysics Data System (ADS)

Caramaliu, Radu Vadim; Vasile, Alexandru; Bacis, Irina

2015-02-01

The system we propose monitors body temperature, heart rate and beside this, it tracks if the person who wears it suffers a faint. It uses a digital temperature sensor, a pulse sensor and a gravitational acceleration sensor to monitor the eventual faint or small heights free falls. The system continuously tracks the GPS position when available and stores the last valid data. So, when measuring abnormal vital parameters the module will send an SMS, using the GSM cellular network , with the person's social security number, the last valid GPS position for that person, the heart rate, the body temperature and, where applicable, a valid fall alert or non-valid fall alert. Even though such systems exist, they contain only faint detection or heart rate detection. Usually there is a strong correlation between low/high heart rate and an eventual faint. Combining both features into one system results in a more reliable detection device.

A mobile phone based alarm system for supervising vital parameters in free moving rats.

PubMed

Kellermann, Kristine; Kreuzer, Matthias; Omerovich, Adem; Hoetzinger, Franziska; Kochs, Eberhard F; Jungwirth, Bettina

2012-02-23

Study protocols involving experimental animals often require the monitoring of different parameters not only in anesthetized, but also in free moving animals. Most animal research involves small rodents, in which continuously monitoring parameters such as temperature and heart rate is very stressful for the awake animals or simply not possible. Aim of the underlying study was to monitor heart rate, temperature and activity and to assess inflammation in the heart, lungs, liver and kidney in the early postoperative phase after experimental cardiopulmonary bypass involving 45 min of deep hypothermic circulatory arrest in rats. Besides continuous monitoring of heart rate, temperature and behavioural activity, the main focus was on avoiding uncontrolled death of an animal in the early postoperative phase in order to harvest relevant organs before autolysis would render them unsuitable for the assessment of inflammation. We therefore set up a telemetry-based system (Data Science International, DSI™) that continuously monitored the rat's temperature, heart rate and activity in their cages. The data collection using telemetry was combined with an analysis software (Microsoft excel™), a webmail application (GMX) and a text message-service. Whenever an animal's heart rate dropped below the pre-defined threshold of 150 beats per minute (bpm), a notification in the form of a text message was automatically sent to the experimenter's mobile phone. With a positive predictive value of 93.1% and a negative predictive value of 90.5%, the designed surveillance and alarm system proved a reliable and inexpensive tool to avoid uncontrolled death in order to minimize suffering and harvest relevant organs before autolysis would set in. This combination of a telemetry-based system and software tools provided us with a reliable notification system of imminent death. The system's high positive predictive value helped to avoid uncontrolled death and facilitated timely organ harvesting. Additionally we were able to markedly reduce the drop out rate of experimental animals, and therefore the total number of animals used in our study. This system can be easily adapted to different study designs and prove a helpful tool to relieve stress and more importantly help to reduce animal numbers.

Study of continuous blood pressure estimation based on pulse transit time, heart rate and photoplethysmography-derived hemodynamic covariates.

PubMed

Feng, Jingjie; Huang, Zhongyi; Zhou, Congcong; Ye, Xuesong

2018-06-01

It is widely recognized that pulse transit time (PTT) can track blood pressure (BP) over short periods of time, and hemodynamic covariates such as heart rate, stiffness index may also contribute to BP monitoring. In this paper, we derived a proportional relationship between BP and PPT -2 and proposed an improved method adopting hemodynamic covariates in addition to PTT for continuous BP estimation. We divided 28 subjects from the Multi-parameter Intelligent Monitoring for Intensive Care database into two groups (with/without cardiovascular diseases) and utilized a machine learning strategy based on regularized linear regression (RLR) to construct BP models with different covariates for corresponding groups. RLR was performed for individuals as the initial calibration, while recursive least square algorithm was employed for the re-calibration. The results showed that errors of BP estimation by our method stayed within the Association of Advancement of Medical Instrumentation limits (- 0.98 ± 6.00 mmHg @ SBP, 0.02 ± 4.98 mmHg @ DBP) when the calibration interval extended to 1200-beat cardiac cycles. In comparison with other two representative studies, Chen's method kept accurate (0.32 ± 6.74 mmHg @ SBP, 0.94 ± 5.37 mmHg @ DBP) using a 400-beat calibration interval, while Poon's failed (- 1.97 ± 10.59 mmHg @ SBP, 0.70 ± 4.10 mmHg @ DBP) when using a 200-beat calibration interval. With additional hemodynamic covariates utilized, our method improved the accuracy of PTT-based BP estimation, decreased the calibration frequency and had the potential for better continuous BP estimation.

Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

PubMed

Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

2008-08-01

To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits. However, in our clinical practice it is vital that clinical audits are undertaken for evaluation purposes. The findings of this study raise awareness of inconsistent ethical processes and highlight the need for expedient ethical review for clinical audits.

Chronic Heart Failure Follow-up Management Based on Agent Technology.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2015-10-01

Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making.

A Sparse Bayesian Learning Algorithm for White Matter Parameter Estimation from Compressed Multi-shell Diffusion MRI.

PubMed

Pisharady, Pramod Kumar; Sotiropoulos, Stamatios N; Sapiro, Guillermo; Lenglet, Christophe

2017-09-01

We propose a sparse Bayesian learning algorithm for improved estimation of white matter fiber parameters from compressed (under-sampled q-space) multi-shell diffusion MRI data. The multi-shell data is represented in a dictionary form using a non-monoexponential decay model of diffusion, based on continuous gamma distribution of diffusivities. The fiber volume fractions with predefined orientations, which are the unknown parameters, form the dictionary weights. These unknown parameters are estimated with a linear un-mixing framework, using a sparse Bayesian learning algorithm. A localized learning of hyperparameters at each voxel and for each possible fiber orientations improves the parameter estimation. Our experiments using synthetic data from the ISBI 2012 HARDI reconstruction challenge and in-vivo data from the Human Connectome Project demonstrate the improvements.

Pilot Workload Measurement and Experience on Supersonic Cruise Aircraft

NASA Technical Reports Server (NTRS)

Rezek, T. W.

1978-01-01

Aircraft parameters and physiological parameters most indicative of crew workload were investigated. Recommendations were used to form the basis for a continuing study in which variations of the interval between heart beats are used as a measure of nonphysical workload. Preliminary results are presented and current efforts in further defining this physiological measure are outlined.

Adding the 'heart' to hanging drop networks for microphysiological multi-tissue experiments.

PubMed

Rismani Yazdi, Saeed; Shadmani, Amir; Bürgel, Sebastian C; Misun, Patrick M; Hierlemann, Andreas; Frey, Olivier

2015-11-07

Microfluidic hanging-drop networks enable culturing and analysis of 3D microtissue spheroids derived from different cell types under controlled perfusion and investigating inter-tissue communication in multi-tissue formats. In this paper we introduce a compact on-chip pumping approach for flow control in hanging-drop networks. The pump includes one pneumatic chamber located directly above one of the hanging drops and uses the surface tension at the liquid-air-interface for flow actuation. Control of the pneumatic protocol provides a wide range of unidirectional pulsatile and continuous flow profiles. With the proposed concept several independent hanging-drop networks can be operated in parallel with only one single pneumatic actuation line at high fidelity. Closed-loop medium circulation between different organ models for multi-tissue formats and multiple simultaneous assays in parallel are possible. Finally, we implemented a real-time feedback control-loop of the pump actuation based on the beating of a human iPS-derived cardiac microtissue cultured in the same system. This configuration allows for simulating physiological effects on the heart and their impact on flow circulation between the organ models on chip.

Respiratory sleep disorders in patients with congestive heart failure

PubMed Central

2015-01-01

Respiratory sleep disorders (RSD) occur in about 40-50% of patients with symptomatic congestive heart failure (CHF). Obstructive sleep apnea (OSA) is considered a cause of CHF, whereas central sleep apnea (CSA) is considered a response to heart failure, perhaps even compensatory. In the setting of heart failure, continuous positive airway pressure (CPAP) has a definite role in treating OSA with improvements in cardiac parameters expected. However in CSA, CPAP is an adjunctive therapy to other standard therapies directed towards the heart failure (pharmacological, device and surgical options). Whether adaptive servo controlled ventilatory support, a variant of CPAP, is beneficial is yet to be proven. Supplemental oxygen therapy should be used with caution in heart failure, in particular, by avoiding hyperoxia as indicated by SpO2 values >95%. PMID:26380758

Heart rate variability in normal-weight patients with polycystic ovary syndrome.

PubMed

Kilit, Celal; Paşalı Kilit, Türkan

2017-05-01

Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors of cardiovascular disease. Obese women with PCOS show altered autonomic modulation. The results of studies investigating cardiac autonomic functions of normal-weight women with PCOS are conflicting. The aim of the study was to assess the reactivity of cardiac sympathovagal balance in normal-weight women with PCOS by heart rate variability analysis. We examined the heart rate variability in 60 normal-weight women with PCOS and compared them with that in 60 age-matched healthy women having a similar metabolic profile. Time and frequency domain parameters of heart rate variability were analyzed based on 5-min-long continuous electrocardiography recordings for the following 3 periods: (1) during rest in supine position, (2) during controlled breathing, and (3) during isometric handgrip exercise. Time and frequency domain parameters of heart rate variability for the 3 periods assessed were similar in the two groups. Although modified Ferriman-Gallwey score and serum testosterone and luteinizing hormone levels were significantly higher in women with PCOS, homeostatic model assessment-insulin resistance (HOMA-IR) was not different the between the PCOS and control groups. There were no significant correlations between serum testosterone levels and heart rate variability parameters among the study population. The findings of this study suggest that the reactivity of cardiac sympathovagal balance is not altered in normal-weight women with PCOS having a normal HOMA-IR.

Implantable cardiac resynchronization therapy devices to monitor heart failure clinical status.

PubMed

Fung, Jeffrey Wing-Hong; Yu, Cheuk-Man

2007-03-01

Cardiac resynchronization therapy is a standard therapy for selected patients with heart failure. With advances in technology and storage capacity, the device acts as a convenient platform to provide valuable information about heart failure status in these high-risk patients. Unlike other modalities of investigation which may only allow one-off evaluation, heart failure status can be monitored by device diagnostics including heart rate variability, activity status, and intrathoracic impedance in a continuous basis. These parameters do not just provide long-term prognostic information but also may be useful to predict upcoming heart failure exacerbation. Prompt and early intervention may abort decompensation, prevent hospitalization, improve quality of life, and reduce health care cost. Moreover, this information may be applied to titrate the dosage of medication and monitor response to heart failure treatment. This review will focus on the prognostic and predictive values of heart failure status monitoring provided by these devices.

[Evaluation of Slavic continuity for electrocardiograph (ECG)-gated non-helical scan using multi detector-row computed tomography with 64 data acquisition system].

PubMed

Shiotani, Masataka; Ogawa, Masato; Watanabe, Ryo; Shinohara, Tamotsu

2012-01-01

Multi detector-row computed tomography with 64 data acquisition systems are widely used for coronary CT angiography with an electrocardiograph (ECG) gated helical scan (HS). Step and shoot with ECG gated non-helical scan (snap shot pulse: SSP) could reduce exposure dose but banding artifact-like discontinuity was observed between adjacent slabs on volume rendering (VR) and curved planner reconstruction (CPR). Therefore, we investigated the factors that influence continuity of VR and CPR images by calculating image properties of Z-axis direction of slab. The observer performance studies were performed for evaluating continuity of simulated blood vessels of VR and CPR images at simulated heart rates: 50, 55, 57 and 60 beat per minute (bpm). As a result, the value of SD at both slab edges in SSP were 20.5% lower than middle part of slab and differences of value of SD were up to 4.4 between adjacent slab edges. Slice thickness of both slab edges were 20.3% thinner than that of the peripheral part of slab. At the border of the adjacent slab, the position of the simulated blood vessel was shifted. VR images of SSP at 57 bpm was indicated as the highest score and HS was significantly superior to SSP at 55 and 60 bpm (p<0.05). In CPR images, there were no significant differences at all simulated heart rates. In conclusion, we considered that VR images of SSP were influenced heart rates except 57 bpm (resonance case) and there was little difference of visibility for discontinuity of both CPR images obtained by SSP and HS.

Single-sensor system for spatially resolved, continuous, and multiparametric optical mapping of cardiac tissue

PubMed Central

Lee, Peter; Bollensdorff, Christian; Quinn, T. Alexander; Wuskell, Joseph P.; Loew, Leslie M.; Kohl, Peter

2011-01-01

Background Simultaneous optical mapping of multiple electrophysiologically relevant parameters in living myocardium is desirable for integrative exploration of mechanisms underlying heart rhythm generation under normal and pathophysiologic conditions. Current multiparametric methods are technically challenging, usually involving multiple sensors and moving parts, which contributes to high logistic and economic thresholds that prevent easy application of the technique. Objective The purpose of this study was to develop a simple, affordable, and effective method for spatially resolved, continuous, simultaneous, and multiparametric optical mapping of the heart, using a single camera. Methods We present a new method to simultaneously monitor multiple parameters using inexpensive off-the-shelf electronic components and no moving parts. The system comprises a single camera, commercially available optical filters, and light-emitting diodes (LEDs), integrated via microcontroller-based electronics for frame-accurate illumination of the tissue. For proof of principle, we illustrate measurement of four parameters, suitable for ratiometric mapping of membrane potential (di-4-ANBDQPQ) and intracellular free calcium (fura-2), in an isolated Langendorff-perfused rat heart during sinus rhythm and ectopy, induced by local electrical or mechanical stimulation. Results The pilot application demonstrates suitability of this imaging approach for heart rhythm research in the isolated heart. In addition, locally induced excitation, whether stimulated electrically or mechanically, gives rise to similar ventricular propagation patterns. Conclusion Combining an affordable camera with suitable optical filters and microprocessor-controlled LEDs, single-sensor multiparametric optical mapping can be practically implemented in a simple yet powerful configuration and applied to heart rhythm research. The moderate system complexity and component cost is destined to lower the threshold to broader application of functional imaging and to ease implementation of more complex optical mapping approaches, such as multiparametric panoramic imaging. A proof-of-principle application confirmed that although electrically and mechanically induced excitation occur by different mechanisms, their electrophysiologic consequences downstream from the point of activation are not dissimilar. PMID:21459161

Exhaled CO2 Parameters as a Tool to Assess Ventilation-Perfusion Mismatching during Neonatal Resuscitation in a Swine Model of Neonatal Asphyxia

PubMed Central

Li, Elliott Shang-shun; Cheung, Po-Yin; O'Reilly, Megan; LaBossiere, Joseph; Lee, Tze-Fun; Cowan, Shaun; Bigam, David L.; Schmölzer, Georg Marcus

2016-01-01

Background End-tidal CO2 (ETCO2), partial pressure of exhaled CO2 (PECO2), and volume of expired CO2 (VCO2) can be continuously monitored non-invasively to reflect pulmonary ventilation and perfusion status. Although ETCO2 ≥14mmHg has been shown to be associated with return of an adequate heart rate in neonatal resuscitation and quantifying the PECO2 has the potential to serve as an indicator of resuscitation quality, there is little information regarding capnometric measurement of PECO2 and ETCO2 in detecting return of spontaneous circulation (ROSC) and survivability in asphyxiated neonates receiving cardiopulmonary resuscitation (CPR). Methods Seventeen newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by apnea to induce asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Respiratory and hemodynamic parameters including ETCO2, PECO2, VCO2, heart rate, cardiac output, and carotid artery flow were continuously measured and analyzed. Results There were no differences in respiratory and hemodynamic parameters between surviving and non-surviving piglets prior to CPR. Surviving piglets had significantly higher ETCO2, PECO2, VCO2, cardiac index, and carotid artery flow values during CPR compared to non-surviving piglets. Conclusion Surviving piglets had significantly better respiratory and hemodynamic parameters during resuscitation compared to non-surviving piglets. In addition to optimizing resuscitation efforts, capnometry can assist by predicting outcomes of newborns requiring chest compressions. PMID:26766424

Integrating multi-scale data to create a virtual physiological mouse heart.

PubMed

Land, Sander; Niederer, Steven A; Louch, William E; Sejersted, Ole M; Smith, Nicolas P

2013-04-06

While the virtual physiological human (VPH) project has made great advances in human modelling, many of the tools and insights developed as part of this initiative are also applicable for facilitating mechanistic understanding of the physiology of a range of other species. This process, in turn, has the potential to provide human relevant insights via a different scientific path. Specifically, the increasing use of mice in experimental research, not yet fully complemented by a similar increase in computational modelling, is currently missing an important opportunity for using and interpreting this growing body of experimental data to improve our understanding of cardiac function. This overview describes our work to address this issue by creating a virtual physiological mouse model of the heart. We describe the similarities between human- and mouse-focused modelling, including the reuse of VPH tools, and the development of methods for investigating parameter sensitivity that are applicable across species. We show how previous results using this approach have already provided important biological insights, and how these can also be used to advance VPH heart models. Finally, we show an example application of this approach to test competing multi-scale hypotheses by investigating variations in length-dependent properties of cardiac muscle.

Integrating multi-scale data to create a virtual physiological mouse heart

PubMed Central

Land, Sander; Niederer, Steven A.; Louch, William E.; Sejersted, Ole M.; Smith, Nicolas P.

2013-01-01

While the virtual physiological human (VPH) project has made great advances in human modelling, many of the tools and insights developed as part of this initiative are also applicable for facilitating mechanistic understanding of the physiology of a range of other species. This process, in turn, has the potential to provide human relevant insights via a different scientific path. Specifically, the increasing use of mice in experimental research, not yet fully complemented by a similar increase in computational modelling, is currently missing an important opportunity for using and interpreting this growing body of experimental data to improve our understanding of cardiac function. This overview describes our work to address this issue by creating a virtual physiological mouse model of the heart. We describe the similarities between human- and mouse-focused modelling, including the reuse of VPH tools, and the development of methods for investigating parameter sensitivity that are applicable across species. We show how previous results using this approach have already provided important biological insights, and how these can also be used to advance VPH heart models. Finally, we show an example application of this approach to test competing multi-scale hypotheses by investigating variations in length-dependent properties of cardiac muscle. PMID:24427525

Reflexology has no immediate haemodynamic effect in patients with chronic heart failure: a double blind randomised controlled trial.

PubMed

Jones, Jenny; Thomson, Patricia; Lauder, William; Howie, Kate; Leslie, Stephen J

2013-08-01

This study measured the effects of reflexology in 12 reflexology-naive patients with chronic heart failure in a placebo-controlled, double blind randomised controlled study design. Outcomes included 'beat-to-beat' non-invasive continuous measurement of cardiovascular parameters and measurement of state of anxiety and pain/discomfort. There were no changes in any of the haemodynamic parameters measured (all p > 0.05). Perceived state of anxiety was significantly reduced post treatment in the control group only (p = 0.03). Reflexology applied to the feet of patients with chronic heart failure appears to have no immediate haemodynamic effects. While any long term treatment effect is uncertain, it would appear that reflexology is safe for use in this patient group. Copyright © 2013 Elsevier Ltd. All rights reserved.

Continuous infusion or bolus injection of loop diuretics for patients admitted for severe acute heart failure: is one strategy better than the other?

PubMed

Caetano, Francisca; Mota, Paula; Almeida, Inês; Fernandes, Andreia; Botelho, Ana; Leitão Marques, António

2015-02-01

Intravenous loop diuretics are an essential part of acute heart failure management; however, data to guide their use is sparse. Our aim was to compare continuous intravenous infusion of loop diuretics with intravenous bolus administration in terms of efficacy and adverse events in patients admitted with severe acute heart failure. Over a period of three years, 110 patients were admitted to our cardiac intensive care unit with acute heart failure. Clinical, laboratory and prognostic parameters were compared according to the diuretic strategy used and mortality and readmission for acute heart failure during follow-up were analyzed. Previous medical history was similar in the two groups. At admission, the continuous infusion group met criteria for worse prognosis: lower systolic blood pressure (p=0.011), more severe renal injury (p=0.008), lower left ventricular ejection fraction (p=0.016) and higher incidence of restrictive pattern of diastolic dysfunction (p=0.032). They were more often treated with vasopressors (p=0.003), inotropes (p=0.010), renal support therapy (p=0.003) and non-invasive ventilation (p<0.001). They had longer hospitalizations (p=0.014) and a higher incidence of cardiorenal syndrome (p=0.009); however, at discharge, there were no differences in renal function between the groups. In-hospital mortality was similar, and during follow-up there were no differences in mortality or readmission for acute heart failure. Continuous infusion was preferred in patients presenting with worse clinical status, in whom renal dysfunction was transiently worse. However, in-hospital mortality and creatinine at discharge were similar. Continuous infusion thus appears to counteract the initial dire prognosis of more unstable patients. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Keys to Successful Interactive Storytelling: A Study of the Booming "Choose-Your-Own-Adventure" Video Game Industry

ERIC Educational Resources Information Center

Tyndale, Eric; Ramsoomair, Franklin

2016-01-01

Video gaming has become a multi-billion dollar industry that continues to capture the hearts, minds and pocketbooks of millions of gamers who span all ages. Narrative and interactive games form part of this market. The popularity of tablet computers and the technological advances of video games have led to a renaissance in the genre for both youth…

Short-term association between personal exposure to noise and heart rate variability: The RECORD MultiSensor Study.

PubMed

El Aarbaoui, Tarik; Méline, Julie; Brondeel, Ruben; Chaix, Basile

2017-12-01

Studies revealed long-term associations between noise exposure and cardiovascular health, but the underlying short-term mechanisms remain uncertain. To explore the concomitant and lagged short-term associations between personal exposure to noise and heart rate variability (HRV) in a real life setting in the Île-de-France region. The RECORD MultiSensor Study collected between July 2014 and June 2015 noise and heart rate data for 75 participants, aged 34-74 years, in their living environments for 7 days using a personal dosimeter and electrocardiography (ECG) sensor on the chest. HRV parameters and noise levels were calculated for 5-min windows. Short-term relationships between noise level and log-transformed HRV parameters were assessed using mixed effects models with a random intercept for participants and a temporal autocorrelation structure, adjusted for heart rate, physical activity (accelerometry), and short-term trends. An increase by one dB(A) of A-weighted equivalent sound pressure level (Leq) was associated with a 0.97% concomitant increase of the Standard deviation of normal to normal intervals (SDNN) (95% CI: 0.92, 1.02), of 2.08% of the Low frequency band power (LF) (95% CI: 1.97, 2.18), of 1.30% of the High frequency band power (HF) (95% CI: 1.17, 1.43), and of 1.16% of the LF/HF ratio (95% CI: 1.10, 1.23). The analysis of lagged exposures to noise adjusted for the concomitant exposure illustrates the dynamic of recovery of the autonomic nervous system. Non-linear associations were documented with all HRV parameters with the exception of HF. Piecewise regression revealed that the association was almost 6 times stronger below than above 65 Leq dB(A) for the SDNN and LF/HF ratio. Personal noise exposure was found to be related to a concomitant increase of the overall HRV, with evidence of imbalance of the autonomic nervous system towards sympathetic activity, a pathway to increased cardiovascular morbidity and mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Chronic Heart Failure Follow-up Management Based on Agent Technology

PubMed Central

Safdari, Reza

2015-01-01

Objectives Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. Methods This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. Results Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. Conclusions The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making. PMID:26618038

LONG-TERM MECHANICAL CIRCULATORY SUPPORT (DESTINATION THERAPY): ON TRACK TO COMPETE WITH HEART TRANSPLANTATIO?

PubMed Central

Kirklin, James K.; Naftel, David C.; Pagani, Francis D.; Kormos, Robert L.; Stevenson, Lynne; Miller, Marissa; Young, James B.

2012-01-01

Objective(s) Average two-year survival following cardiac transplantation is approximately 80%. The evolution and subsequent approval of larger pulsatile and, more recently, continuous flow mechanical circulatory support (MCS) technology for destination therapy (DT) offers the potential for triage of some patients awaiting cardiac transplantation to DT. Methods The National Heart, Lung and Blood Institute Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) is a national multi-institutional study of chronic mechanical circulatory support. Between June 2006 and December 2011, 127 pulsatile and 1160 continuous flow pumps (24% of total primary LVADs) carried an initial strategy of DT therapy. Results By multivariable analysis, risk factors (p<0.05) for mortality following DT included older age, larger body mass index, history of cancer, history of cardiac surgery, INTERMACS level I (cardiogenic shock), dialysis, increased BUN, use of a pulsatile flow device and use of a RVAD. Among continuous flow LVAD patients who were not in cardiogenic shock, a particularly favorable survival was associated with no cancer, patients not in cardiogenic shock, and BUN < 50, resulting in one and two year survival of 88 and 80%. Conclusions 1) Evolution from pulsatile to continuous flow technology has dramatically improved one and two year survival; 2) Destination Therapy is not appropriate for patients with rapid hemodynamic deterioration; or severe right ventricular failure 4) Important subsets of continuous flow DT patients now enjoy survival which is competitive with heart transplantation out to about two years. PMID:22795459

Mechanical signaling coordinates the embryonic heart

NASA Astrophysics Data System (ADS)

Chiou, Kevin; Rocks, Jason; Prosser, Benjamin; Discher, Dennis; Liu, Andrea

The heart is an active material which relies on robust signaling mechanisms between cells in order to produce well-timed, coordinated beats. Heart tissue is composed primarily of active heart muscle cells (cardiomyocytes) embedded in a passive extracellular matrix. During a heartbeat, cardiomyocyte contractions are coordinated across the heart to form a wavefront that propagates through the tissue to pump blood. In the adult heart, this contractile wave is coordinated via intercellular electrical signaling.Here we present theoretical and experimental evidence for mechanical coordination of embryonic heartbeats. We model cardiomyocytes as mechanically excitable Eshelby inclusions embedded in an overdamped elastic-fluid biphasic medium. For physiological parameters, this model replicates recent experimental measurements of the contractile wavefront which are not captured by electrical signaling models. We additionally challenge our model by pharmacologically blocking gap junctions, inhibiting electrical signaling between myocytes. We find that while adult hearts stop beating almost immediately after gap junctions are blocked, embryonic hearts continue beating even at significantly higher concentrations, providing strong support for a mechanical signaling mechanism.

The role of patient-held alert cards in promoting continuity of care for Heart Failure Patients.

PubMed

McBride, Anne; Burey, Lorraine; Megahed, Margo; Feldman, Carolyne; Deaton, Christi

2014-02-01

Patients with heart failure managed by community heart failure specialist nurses (CHFSNs) may have episodes of (often unrelated) ill-health managed separately in hospital. Inadequate communication and multi-disciplinary working between these different providers can impact on the effectiveness of care. This service improvement project explored the potential of patient-held alert cards to improve communication and continuity of care for heart failure patients moving between CHFSNs and hospital settings. Alert cards were distributed to 119 patients on a community case load for presentation at hospital or emergency department. Follow-up data were obtained from practitioners and patients at 12 months. At 12 months, 38 patients from the CHFSN caseload experienced 61 hospital admissions. CHFSNs were informed of 80% of admissions by practitioners (61%) and family members (38%). They were also informed of 59% of discharges. Notification of admission by hospital staff increased from zero in the previous 12 months, to 19 notifications. CHFSNs were more involved with hospital care, and patients reported increased confidence with the alert cards. The study has shown that alert cards can increase the involvement of CHFSNs in the ongoing care and discharge planning process. They can also empower patients and carers to take an active role in their own care.

Implantation of radiotelemetry transmitters yielding data on ECG, heart rate, core body temperature and activity in free-moving laboratory mice.

PubMed

Cesarovic, Nikola; Jirkof, Paulin; Rettich, Andreas; Arras, Margarete

2011-11-21

The laboratory mouse is the animal species of choice for most biomedical research, in both the academic sphere and the pharmaceutical industry. Mice are a manageable size and relatively easy to house. These factors, together with the availability of a wealth of spontaneous and experimentally induced mutants, make laboratory mice ideally suited to a wide variety of research areas. In cardiovascular, pharmacological and toxicological research, accurate measurement of parameters relating to the circulatory system of laboratory animals is often required. Determination of heart rate, heart rate variability, and duration of PQ and QT intervals are based on electrocardiogram (ECG) recordings. However, obtaining reliable ECG curves as well as physiological data such as core body temperature in mice can be difficult using conventional measurement techniques, which require connecting sensors and lead wires to a restrained, tethered, or even anaesthetized animal. Data obtained in this fashion must be interpreted with caution, as it is well known that restraining and anesthesia can have a major artifactual influence on physiological parameters. Radiotelemetry enables data to be collected from conscious and untethered animals. Measurements can be conducted even in freely moving animals, and without requiring the investigator to be in the proximity of the animal. Thus, known sources of artifacts are avoided, and accurate and reliable measurements are assured. This methodology also reduces interanimal variability, thus reducing the number of animals used, rendering this technology the most humane method of monitoring physiological parameters in laboratory animals. Constant advancements in data acquisition technology and implant miniaturization mean that it is now possible to record physiological parameters and locomotor activity continuously and in realtime over longer periods such as hours, days or even weeks. Here, we describe a surgical technique for implantation of a commercially available telemetry transmitter used for continuous measurements of core body temperature, locomotor activity and biopotential (i.e. onelead ECG), from which heart rate, heart rate variability, and PQ and QT intervals can be established in freeroaming, untethered mice. We also present pre-operative procedures and protocols for post-operative intensive care and pain treatment that improve recovery, well-being and survival rates in implanted mice.

Multivariable Parametric Cost Model for Ground Optical: Telescope Assembly

NASA Technical Reports Server (NTRS)

Stahl, H. Philip; Rowell, Ginger Holmes; Reese, Gayle; Byberg, Alicia

2004-01-01

A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis of both engineering and performance parameters. While diameter continues to be the dominant cost driver, diffraction limited wavelength is found to be a secondary driver. Other parameters such as radius of curvature were examined. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter were derived.

HRV Analysis to Identify Stages of Home-based Telerehabilitation Exercise.

PubMed

Jeong, In Cheol; Finkelstein, Joseph

2014-01-01

Spectral analysis of heart rate variability (HRV) has been widely used to investigate activity of autonomous nervous system. Previous studies demonstrated potential of analysis of short-term sequences of heart rate data in a time domain for continuous monitoring of levels of physiological stress however the value of HRV parameters in frequency domain for monitoring cycling exercise has not been established. The goal of this study was to assess whether HRV parameters in frequency domain differ depending on a stage of cycling exercise. We compared major HRV parameters in high, low and very low frequency ranges during rest, height of exercise, and recovery during cycling exercise. Our results indicated responsiveness of frequency-domain indices to different phases of cycling exercise program and their potential in monitoring autonomic balance and stress levels as a part of a tailored home-based telerehabilitation program.

Representativeness comparisons of nurse and computer charting of heart rate across nursing-intensity protocols.

PubMed

Luna, Jorge M; Yip, Natalie; Pivovarov, Rimma; Vawdrey, David K

2016-08-01

Clinical teams in acute inpatient settings can greatly benefit from automated charting technologies that continuously monitor patient vital status. NewYork-Presbyterian has designed and developed a real-time patient monitoring system that integrates vital signs sensors, networking, and electronic health records, to allow for automatic charting of patient status. We evaluate the representativeness (a combination of agreement, safety and timing) of a core vital sign across nursing intensity care protocols for preliminary feasibility assessment. Our findings suggest an automated way of summarizing heart rate provides representation of true heart rate status and can facilitate alternatives approaches to burdensome manual nurse charting of physiological parameters.

Exercise training in adults with repaired tetralogy of Fallot: A randomized controlled pilot study of continuous versus interval training.

PubMed

Novaković, Marko; Prokšelj, Katja; Rajkovič, Uroš; Vižintin Cuderman, Tjaša; Janša Trontelj, Katja; Fras, Zlatko; Jug, Borut

2018-03-15

Adults with repaired tetralogy of Fallot (ToF) have impaired exercise capacity, vascular and cardiac autonomic function, and quality of life (QoL). Specific effects of high-intensity interval or moderate continuous exercise training on these parameters in adults with repaired ToF remain unknown. Thirty adults with repaired ToF were randomized to either high-intensity interval, moderate intensity continuous training (36 sessions, 2-3 times a week) or usual care (no supervised exercise). Exercise capacity, flow-mediated vasodilation, pulse wave velocity, NT-proBNP and fibrinogen levels, heart rate variability and recovery, and QoL (SF-36 questionnaire) were determined at baseline and after the intervention period. Twenty-seven patients (mean age 39±9years, 63% females, 9 from each group) completed this pilot study. Both training groups improved in at least some parameters of cardiovascular health compared to no exercise. Interval-but not continuous-training improved VO2peak (21.2 to 22.9ml/kg/min, p=0.004), flow-mediated vasodilation (8.4 to 12.9%, p=0.019), pulse wave velocity (5.4 to 4.8m/s, p=0.028), NT-proBNP (202 to 190ng/L, p=0.032) and fibrinogen levels (2.67 to 2.46g/L, p=0.018). Conversely, continuous-but not interval-training improved heart rate variability (low-frequency domain, 0.32 to 0.22, p=0.039), heart rate recovery after 2min post-exercise (40 to 47 beats, p=0.023) and mental domain of SF-36 (87 to 95, p=0.028). Both interval and continuous exercise training modalities were safe. Interval training seems more efficacious in improving exercise capacity, vascular function, NT-proBNP and fibrinogen levels, while continuous training seems more efficacious in improving cardiac autonomic function and QoL. (Clinicaltrials.gov, NCT02643810). Copyright © 2018 Elsevier Ireland Ltd. All rights reserved.

'Multi-associations': predisposed to misinterpretation of peripheral tissue oxygenation and circulation in neonates.

PubMed

Pichler, Gerhard; Pocivalnik, Mirjam; Riedl, Regina; Pichler-Stachl, Elisabeth; Morris, Nicholas; Zotter, Heinz; Müller, Wilhelm; Urlesberger, Berndt

2011-08-01

Interpretation of peripheral circulation in ill neonates is crucial but difficult. The aim was to analyse parameters potentially influencing peripheral oxygenation and circulation. In a prospective observational cohort study in 116 cardio-circulatory stable neonates, peripheral muscle near-infrared spectroscopy (NIRS) with venous occlusion was performed. Tissue oxygenation index (TOI), mixed venous oxygenation (SvO(2)), fractional oxygen extraction (FOE), fractional tissue oxygen extraction (FTOE), haemoglobin flow (Hbflow), oxygen delivery (DO(2)), oxygen consumption (VO(2)), and vascular resistance (VR) were assessed. Correlation coefficients between NIRS parameters and demographic parameters (gestational age, birth weight, age, actual weight, diameter of calf, subcutaneous adipose tissue), monitoring parameters (heart rate, arterial oxygen saturation (SaO(2)), mean blood pressure (MAP), core/peripheral temperature, central/peripheral capillary refill time) and laboratory parameters (haemoglobin concentration (Hb-blood), pCO(2)) were calculated. All demographic parameters except for Hbflow and DO(2) correlated with NIRS parameters. Heart rate correlated with TOI, SvO(2), VO(2) and VR. SaO(2) correlated with FOE/FTOE. MAP correlated with Hbflow, DO(2), VO(2) and VR. Core temperature correlated with FTOE. Peripheral temperature correlated with all NIRS parameters except VO(2). Hb-blood correlated with FOE and VR. pCO(2) levels correlated with TOI and SvO(2). The presence of multiple interdependent factors associated with peripheral oxygenation and circulation highlights the difficulty in interpreting NIRS data. Nevertheless, these findings have to be taken into account when analysing peripheral oxygenation and circulation data.

Optimization Strategies for Single-Stage, Multi-Stage and Continuous ADRs

NASA Technical Reports Server (NTRS)

Shirron, Peter J.

2014-01-01

Adiabatic Demagnetization Refrigerators (ADR) have many advantages that are prompting a resurgence in their use in spaceflight and laboratory applications. They are solid-state coolers capable of very high efficiency and very wide operating range. However, their low energy storage density translates to larger mass for a given cooling capacity than is possible with other refrigeration techniques. The interplay between refrigerant mass and other parameters such as magnetic field and heat transfer points in multi-stage ADRs gives rise to a wide parameter space for optimization. This paper first presents optimization strategies for single ADR stages, focusing primarily on obtaining the largest cooling capacity per stage mass, then discusses the optimization of multi-stage and continuous ADRs in the context of the coordinated heat transfer that must occur between stages. The goal for the latter is usually to obtain the largest cooling power per mass or volume, but there can also be many secondary objectives, such as limiting instantaneous heat rejection rates and producing intermediate temperatures for cooling of other instrument components.

Evaluation of Left Ventricular Diastolic Dysfunction with Early Systolic Dysfunction Using Two-Dimensional Speckle Tracking Echocardiography in Canine Heart Failure Model.

PubMed

Wu, Wei-Chun; Ma, Hong; Xie, Rong-Ai; Gao, Li-Jian; Tang, Yue; Wang, Hao

2016-04-01

This study evaluated the role of two-dimensional speckle tracking echocardiography (2DSTE) for predicting left ventricular (LV) diastolic dysfunction in pacing-induced canine heart failure. Pacing systems were implanted in 8 adult mongrel dogs, and continuous rapid right ventricular pacing (RVP, 240 beats/min) was maintained for 2 weeks. The obtained measurements from 2DSTE included global strain rate during early diastole (SRe) and during late diastole (SRa) in the longitudinal (L-SRe, L-SRa), circumferential (C-SRe, C-SRa), and radial directions (R-SRe, R-SRa). Changes in heart morphology were observed by light microscopy and transmission electron microscopy at 2 weeks. The onset of LV diastolic dysfunction with early systolic dysfunction occurred 3 days after RVP initiation. Most of the strain rate imaging indices were altered at 1 or 3 days after RVP onset and continued to worsen until heart failure developed. Light and transmission electron microscopy showed myocardial vacuolar degeneration and mitochondrial swelling in the left ventricular at 2 weeks after RVP onset. Pearson's correlation analysis revealed that parameters of conventional echocardiography and 2DSTE showed moderate correlation with LV pressure parameters, including E/Esep' (r = 0.58, P < 0.01), L-SRe (r = -0.58, P < 0.01), E/L-SRe (r = 0.65, P < 0.01), and R-SRe (r = 0.53, P < 0.01). ROC curves analysis showed that these indices of conventional echocardiography and strain rate imaging could effectively predict LV diastolic dysfunction (area under the curve: E/Esep' 0.78; L-SRe 0.84; E/L-SRe 0.80; R-SRe 0.80). 2DSTE was a sensitive and accurate technique that could be used for predicting LV diastolic dysfunction in canine heart failure model. © 2015, Wiley Periodicals, Inc.

Observing continuous change in heart rate variability and photoplethysmography-derived parameters during the process of pain production/relief with thermal stimuli.

PubMed

Ye, Jing-Jhao; Lee, Kuan-Ting; Lin, Jing-Siang; Chuang, Chiung-Cheng

2017-01-01

Continuously monitoring and efficiently managing pain has become an important issue. However, no study has investigated a change in physiological parameters during the process of pain production/relief. This study modeled the process of pain production/relief using ramped thermal stimulation (no pain: 37°C water, process of pain production: a heating rate of 1°C/min, and subject feels pain: water kept at the painful temperature for each subject, with each segment lasting 10 min). In this duration, the variation of the heat rate variability and photoplethysmography-derived parameters was observed. A total of 40 healthy individuals participated: 30 in the trial group (14 males and 16 females with a mean age of 22.5±1.9 years) and 10 in the control group (7 males and 3 females with a mean age of 22.5±1.3 years). The results showed that the numeric rating scale value was 5.03±1.99 when the subjects felt pain, with a temperature of 43.54±1.70°C. Heart rate, R-R interval, low frequency, high frequency, photoplethysmography amplitude, baseline, and autonomic nervous system state showed significant changes during the pain production process, but these changes differed during the period Segment D (painful temperature 10: min). In summary, the study observed that physiological parameters changed qualitatively during the process of pain production and relief and found that the high frequency, low frequency, and photoplethysmography parameters seemed to have different responses in four situations (no pain, pain production, pain experienced, and pain relief). The trends of these variations may be used as references in the clinical setting for continuously observing pain intensity.

Continuous non-contact vital sign monitoring in neonatal intensive care unit

PubMed Central

Guazzi, Alessandro; Jorge, João; Davis, Sara; Watkinson, Peter; Green, Gabrielle; Shenvi, Asha; McCormick, Kenny; Tarassenko, Lionel

2014-01-01

Current technologies to allow continuous monitoring of vital signs in pre-term infants in the hospital require adhesive electrodes or sensors to be in direct contact with the patient. These can cause stress, pain, and also damage the fragile skin of the infants. It has been established previously that the colour and volume changes in superficial blood vessels during the cardiac cycle can be measured using a digital video camera and ambient light, making it possible to obtain estimates of heart rate or breathing rate. Most of the papers in the literature on non-contact vital sign monitoring report results on adult healthy human volunteers in controlled environments for short periods of time. The authors' current clinical study involves the continuous monitoring of pre-term infants, for at least four consecutive days each, in the high-dependency care area of the Neonatal Intensive Care Unit (NICU) at the John Radcliffe Hospital in Oxford. The authors have further developed their video-based, non-contact monitoring methods to obtain continuous estimates of heart rate, respiratory rate and oxygen saturation for infants nursed in incubators. In this Letter, it is shown that continuous estimates of these three parameters can be computed with an accuracy which is clinically useful. During stable sections with minimal infant motion, the mean absolute error between the camera-derived estimates of heart rate and the reference value derived from the ECG is similar to the mean absolute error between the ECG-derived value and the heart rate value from a pulse oximeter. Continuous non-contact vital sign monitoring in the NICU using ambient light is feasible, and the authors have shown that clinically important events such as a bradycardia accompanied by a major desaturation can be identified with their algorithms for processing the video signal. PMID:26609384

Continuous non-contact vital sign monitoring in neonatal intensive care unit.

PubMed

Villarroel, Mauricio; Guazzi, Alessandro; Jorge, João; Davis, Sara; Watkinson, Peter; Green, Gabrielle; Shenvi, Asha; McCormick, Kenny; Tarassenko, Lionel

2014-09-01

Current technologies to allow continuous monitoring of vital signs in pre-term infants in the hospital require adhesive electrodes or sensors to be in direct contact with the patient. These can cause stress, pain, and also damage the fragile skin of the infants. It has been established previously that the colour and volume changes in superficial blood vessels during the cardiac cycle can be measured using a digital video camera and ambient light, making it possible to obtain estimates of heart rate or breathing rate. Most of the papers in the literature on non-contact vital sign monitoring report results on adult healthy human volunteers in controlled environments for short periods of time. The authors' current clinical study involves the continuous monitoring of pre-term infants, for at least four consecutive days each, in the high-dependency care area of the Neonatal Intensive Care Unit (NICU) at the John Radcliffe Hospital in Oxford. The authors have further developed their video-based, non-contact monitoring methods to obtain continuous estimates of heart rate, respiratory rate and oxygen saturation for infants nursed in incubators. In this Letter, it is shown that continuous estimates of these three parameters can be computed with an accuracy which is clinically useful. During stable sections with minimal infant motion, the mean absolute error between the camera-derived estimates of heart rate and the reference value derived from the ECG is similar to the mean absolute error between the ECG-derived value and the heart rate value from a pulse oximeter. Continuous non-contact vital sign monitoring in the NICU using ambient light is feasible, and the authors have shown that clinically important events such as a bradycardia accompanied by a major desaturation can be identified with their algorithms for processing the video signal.

Effect of randomness on multi-frequency aeroelastic responses resolved by Unsteady Adaptive Stochastic Finite Elements

NASA Astrophysics Data System (ADS)

Witteveen, Jeroen A. S.; Bijl, Hester

2009-10-01

The Unsteady Adaptive Stochastic Finite Elements (UASFE) method resolves the effect of randomness in numerical simulations of single-mode aeroelastic responses with a constant accuracy in time for a constant number of samples. In this paper, the UASFE framework is extended to multi-frequency responses and continuous structures by employing a wavelet decomposition pre-processing step to decompose the sampled multi-frequency signals into single-frequency components. The effect of the randomness on the multi-frequency response is then obtained by summing the results of the UASFE interpolation at constant phase for the different frequency components. Results for multi-frequency responses and continuous structures show a three orders of magnitude reduction of computational costs compared to crude Monte Carlo simulations in a harmonically forced oscillator, a flutter panel problem, and the three-dimensional transonic AGARD 445.6 wing aeroelastic benchmark subject to random fields and random parameters with various probability distributions.

A Pulse Rate Detection Method for Mouse Application Based on Multi-PPG Sensors

PubMed Central

Chen, Wei-Hao

2017-01-01

Heart rate is an important physiological parameter for healthcare. Among measurement methods, photoplethysmography (PPG) is an easy and convenient method for pulse rate detection. However, as the PPG signal faces the challenge of motion artifacts and is constrained by the position chosen, the purpose of this paper is to implement a comfortable and easy-to-use multi-PPG sensor module combined with a stable and accurate real-time pulse rate detection method on a computer mouse. A weighted average method for multi-PPG sensors is used to adjust the weight of each signal channel in order to raise the accuracy and stability of the detected signal, therefore reducing the disturbance of noise under the environment of moving effectively and efficiently. According to the experiment results, the proposed method can increase the usability and probability of PPG signal detection on palms. PMID:28708112

Heart CT scan

MedlinePlus

... Computed tomography scan - heart; Calcium scoring; Multi-detector CT scan - heart; Electron beam computed tomography - heart; Agatston ... table that slides into the center of the CT scanner. You will lie on your back with ...

Novel application of multi dynamic trend analysis as a sensitive tool for detecting the effects of aging and congestive heart failure on heart rate variability

NASA Astrophysics Data System (ADS)

Lin, Yu-Cheng; Lin, Yu-Hsuan; Lo, Men-Tzung; Peng, Chung-Kang; Huang, Norden E.; Yang, Cheryl C. H.; Kuo, Terry B. J.

2016-02-01

The complex fluctuations in heart rate variability (HRV) reflect cardiac autonomic modulation and are an indicator of congestive heart failure (CHF). This paper proposes a novel nonlinear approach to HRV investigation, the multi dynamic trend analysis (MDTA) method, based on the empirical mode decomposition algorithm of the Hilbert-Huang transform combined with a variable-sized sliding-window method. Electrocardiographic signal data obtained from the PhysioNet database were used. These data were from subjects with CHF (mean age = 59.4 ± 8.4), an age-matched elderly healthy control group (59.3 ± 10.6), and a healthy young group (30.3 ± 4.8); the HRVs of these subjects were processed using the MDTA method, time domain analysis, and frequency domain analysis. Among all HRV parameters, the MDTA absolute value slope (MDTS) and MDTA deviation (MDTD) exhibited the greatest area under the curve (AUC) of the receiver operating characteristics in distinguishing between the CHF group and the healthy controls (AUC = 1.000) and between the healthy elderly subject group and the young subject group (AUC = 0.834 ± 0.067 for MDTS; 0.837 ± 0.066 for MDTD). The CHF subjects presented with lower MDTA indices than those of the healthy elderly subject group. Furthermore, the healthy elderly subjects exhibited lower MDTA indices than those of the young controls. The MDTA method can adaptively and automatically identify the intrinsic fluctuation on variable temporal and spatial scales when investigating complex fluctuations in the cardiac autonomic regulation effects of aging and CHF.

A multi-channel opto-electronic sensor to accurately monitor heart rate against motion artefact during exercise.

PubMed

Alzahrani, Abdullah; Hu, Sijung; Azorin-Peris, Vicente; Barrett, Laura; Esliger, Dale; Hayes, Matthew; Akbare, Shafique; Achart, Jérôme; Kuoch, Sylvain

2015-10-12

This study presents the use of a multi-channel opto-electronic sensor (OEPS) to effectively monitor critical physiological parameters whilst preventing motion artefact as increasingly demanded by personal healthcare. The aim of this work was to study how to capture the heart rate (HR) efficiently through a well-constructed OEPS and a 3-axis accelerometer with wireless communication. A protocol was designed to incorporate sitting, standing, walking, running and cycling. The datasets collected from these activities were processed to elaborate sport physiological effects. t-test, Bland-Altman Agreement (BAA), and correlation to evaluate the performance of the OEPS were used against Polar and Mio-Alpha HR monitors. No differences in the HR were found between OEPS, and either Polar or Mio-Alpha (both p > 0.05); a strong correlation was found between Polar and OEPS (r: 0.96, p < 0.001); the bias of BAA 0.85 bpm, the standard deviation (SD) 9.20 bpm, and the limits of agreement (LOA) from -17.18 bpm to +18.88 bpm. For the Mio-Alpha and OEPS, a strong correlation was found (r: 0.96, p < 0.001); the bias of BAA 1.63 bpm, SD 8.62 bpm, LOA from -15.27 bpm to +18.58 bpm. These results demonstrate the OEPS to be capable of carrying out real time and remote monitoring of heart rate.

The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.)

PubMed Central

Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

2017-01-01

Abstract Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient’s prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30–35% reduction in mortality and 15–20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional ‘chronic care model’. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation PMID:28751839

The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.).

PubMed

Di Lenarda, Andrea; Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

2017-05-01

Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30-35% reduction in mortality and 15-20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional 'chronic care model'. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation.

The Impact of Preterm Infants' Continuous Exposure to Breast Milk Odor on Stress Parameters: A Pilot Study.

PubMed

Maayan-Metzger, Ayala; Kedem-Friedrich, Peri; Bransburg Zabary, Sharron; Morag, Iris; Hemi, Rina; Kanety, Hannah; Strauss, Tzipora

2018-04-01

This pilot study aimed to assess the effect of continuous exposure to the odor of own mothers' breast milk (BM) on the stress parameters of preterm infants. Fifteen healthy preterm infants were included. Mean heart rate and salivary cortisol were measured over three consecutive time periods, each lasting 2 days: (1) preintervention (odor free); (2) intervention, during which a cotton pad soaked with 1.5 mL of BM was placed near the infant's head with the aim of providing continuous exposure to its odor; (3) postintervention period (odor free). Saliva cortisol levels differed significantly between the three exposure periods (pre-, during, and post-BM odor exposure): 11.38 ± 5.03, 9.51 ± 4.38, and 4.99 ± 3.42 nmol/L, respectively. A repeated univariate analysis of the cortisol measure showed a significant difference (F = 9.34; df = 2.28, p < 0.001). There was no difference in mean heart rate over the three study periods. Preterm infants exposed to BM odor from their own mothers demonstrate a persistent decrease in saliva cortisol levels, which continues after termination of the intervention. This finding may suggest that exposure to own mothers' BM odor has a soothing effect on preterm infants. Further randomized controlled studies are needed to evaluate this simple, safe, and inexpensive intervention.

Continuous ambulatory right heart pressure measurements with an implantable hemodynamic monitor: a multicenter, 12-month follow-up study of patients with chronic heart failure.

PubMed

Magalski, Anthony; Adamson, Philip; Gadler, Frederick; Böehm, Michael; Steinhaus, David; Reynolds, Dwight; Vlach, Kathryn; Linde, Cecilia; Cremers, Bodo; Sparks, Brandon; Bennett, Tom

2002-04-01

We describe the performance of an implantable hemodynamic monitor (IHM) that allows continuous recording of heart rate, patient activity levels, and right ventricular systolic, right ventricular diastolic, and estimated pulmonary artery diastolic pressures. Pressure parameters derived from the implantable monitor were correlated to measurements made with a balloon-tipped catheter to establish accuracy and reproducibility over time in patients with chronic heart failure (CHF). IHM devices were implanted in 32 patients with CHF (left ventricular ejection fraction, 29% +/- 11%; range, 14%-62%) and were tested with right heart catheterization at implantation and 3, 6, and 12 months later. Hemodynamic variables were digitally recorded simultaneously from the IHM and catheter. Values were recorded during supine rest, peak response of Valsalva maneuver, sitting, peak of a 2-stage (25-50 W) bicycle exercise test, and final rest period. The median of 21 paired beat-to-beat cardiac cycles was analyzed for each intervention. A total of 217 paired data values from all maneuvers were analyzed for 32 patients at implantation and 129 paired data values for 20 patients at 1 year. The IHM and catheter values were not different at baseline or at 1 year (P >.05). Combining all interventions, correlation coefficients were 0.96 and 0.94 for right ventricular systolic pressure, 0.96 and 0.83 for right ventricular diastolic pressure, and 0.87 and 0.87 for estimated pulmonary artery diastolic pressure at implantation and 1 year, respectively. The IHM and a standard reference pressure system recorded comparable right heart pressure values in patients with CHF. This implantable pressure transducer is accurate over time and provides a means to precisely monitor the hemodynamic condition of patients with CHF in a continuous fashion.

Heart rate variability changes in business process outsourcing employees working in shifts.

PubMed

Kunikullaya, Kirthana U; Kirthi, Suresh K; Venkatesh, D; Goturu, Jaisri

2010-10-31

Irregular and poor quality sleep is common in business process outsourcing (BPO) employees due to continuous shift working. The influence of this on the cardiac autonomic activity was investigated by the spectral analysis of heart rate variability (HRV). 36 night shift BPO employees (working from 22:00 to 06:00h) and 36 age and sex matched day shift BPO employees (working from 08:00 to 16:00h) were recruited for the study. Five minute electrocardiogram (ECG) was recorded in all the subjects. Heart rate variability was analyzed by fast Fourier transformation using RMS Vagus HRV software. The results were analyzed using Mann Whitney U test, Student t-test, Wilcoxon signed rank test and were expressed as mean ± SD. Sleepiness was significantly higher among night shift workers as measured by Epworth Sleepiness Scale (p<0.001). Night shift BPO employees were found to have a trend towards lower values of vagal parameters - HF power (ms(2)), and higher values of sympathovagal parameters like LF Power (ms(2)) and the LF/HF power (%) suggesting decreased vagal activity and sympathetic over activity, when compared to day shift employees. However, HRV parameters did not vary significantly between the day shift employees and night shift workers baseline values, and also within the night shift group. Night shift working increased the heart rate and shifted the sympathovagal balance towards sympathetic dominance and decreased vagal parameters of HRV. This is an indicator of unfavorable change in the myocardial system, and thus shows increased risk of cardiovascular disease among the night shift employees.

Device Management and Flow Optimization on Left Ventricular Assist Device Support.

PubMed

Tchoukina, Inna; Smallfield, Melissa C; Shah, Keyur B

2018-07-01

The authors discuss principles of continuous flow left ventricular assist device (LVAD) operation, basic differences between the axial and centrifugal flow designs and hemodynamic performance, normal LVAD physiology, and device interaction with the heart. Systematic interpretation of LVAD parameters and recognition of abnormal patterns of flow and pulsatility on the device interrogation are necessary for clinical assessment of the patient. Optimization of pump flow using LVAD parameters and echocardiographic and hemodynamics guidance are reviewed. Copyright © 2018 Elsevier Inc. All rights reserved.

Arterial stiffness and cardiac functions in patients with chronic venous disease.

PubMed

Ozpelit, E; Ozpelit, M E; Albayrak, G; Karabay, O; Nesli Sahin, B; Gonencer, J Z; Badak, O

2015-12-01

Although the venous system is in direct continuity with the heart and the arterial system, it is not known whether chronic venous disease (CVD) has any impact on either of these. The aims of this study were to investigate the global functions of the left and right heart, and also arterial stiffness parameters in patients with CVD. Forty-eight patients with primary stage C4-C6 CVD were enrolled into the study. The control group consisted of 39 age/sex and Body Mass Index matched healthy volunteers. All of the patients underwent detailed echocardiographic examination with further focus on Doppler and tissue Doppler (TD) parameters of the left and right ventricle. Arterial stiffness was evaluated via applanation tonometry in each patient. The left atrial area (LAA) and interventricular septum thickness were slightly increased in patients with CVD. Regarding Doppler and tissue Doppler measurements of the LV, all of the parameters were similar among the groups, while RV tissue Doppler systolic velocity and TAPSE were higher in patients with CVD. Among the arterial stiffness parameters, central aortic pressure, augmentation index, and pulse wave velocity were slightly higher in patients with CVD. The results of this study indicated that CVD may be associated with a subclinical disease state in the arterial system and also in the heart. Further studies are needed to confirm this association and to describe the possible mechanisms.

TACtic- A Multi Behavioral Agent for Trading Agent Competition

NASA Astrophysics Data System (ADS)

Khosravi, Hassan; Shiri, Mohammad E.; Khosravi, Hamid; Iranmanesh, Ehsan; Davoodi, Alireza

Software agents are increasingly being used to represent humans in online auctions. Such agents have the advantages of being able to systematically monitor a wide variety of auctions and then make rapid decisions about what bids to place in what auctions. They can do this continuously and repetitively without losing concentration. To provide a means of evaluating and comparing (benchmarking) research methods in this area the trading agent competition (TAC) was established. This paper describes the design, of TACtic. Our agent uses multi behavioral techniques at the heart of its decision making to make bidding decisions in the face of uncertainty, to make predictions about the likely outcomes of auctions, and to alter the agent's bidding strategy in response to the prevailing market conditions.

Proteomic analysis of cardiac metabolic enzymes in asphyxiated newborn piglets.

PubMed

Fert-Bober, Justyna; Sawicki, Grzegorz; Lopaschuk, Gary D; Cheung, Po-Yin

2008-11-01

Hypoxia/reoxygenation (H/R) creates an energetic deficiency in the heart, which may contribute to myocardial dysfunction. We hypothesized that H/R-induced impairment of cardioenergetic enzymes occurs in asphyxiated newborn animals. After hypoxia for 2 h (10-15% oxygen), newborn piglets were resuscitated with 100% oxygen for 1 h, followed by 21% oxygen for 3 h. Sham-operated control piglets had no H/R. Hemodynamic parameters in the piglets were continuously measured. At the end of experiment, hearts were isolated for proteomic analysis. In asphyxiated hearts, the level of isocitrate dehydrogenase and malate dehydrogenase was reduced compared to controls. Inverse correlations between the level of myocardial malate dehydrogenase and cardiac function were observed in the control, but not the H/R hearts. We conclude that reoxygenation of asphyxiated newborn piglets reduces the level of myocardial isocitrate dehydrogenase and malate dehydrogenase. While the cause is not clear, it may be related to the impaired tricarboxylic acid cycle pathway and energy production in the heart.

Confocal Microscopy-Based Estimation of Parameters for Computational Modeling of Electrical Conduction in the Normal and Infarcted Heart.

PubMed

Greiner, Joachim; Sankarankutty, Aparna C; Seemann, Gunnar; Seidel, Thomas; Sachse, Frank B

2018-01-01

Computational modeling is an important tool to advance our knowledge on cardiac diseases and their underlying mechanisms. Computational models of conduction in cardiac tissues require identification of parameters. Our knowledge on these parameters is limited, especially for diseased tissues. Here, we assessed and quantified parameters for computational modeling of conduction in cardiac tissues. We used a rabbit model of myocardial infarction (MI) and an imaging-based approach to derive the parameters. Left ventricular tissue samples were obtained from fixed control hearts (animals: 5) and infarcted hearts (animals: 6) within 200 μm (region 1), 250-750 μm (region 2) and 1,000-1,250 μm (region 3) of the MI border. We assessed extracellular space, fibroblasts, smooth muscle cells, nuclei and gap junctions by a multi-label staining protocol. With confocal microscopy we acquired three-dimensional (3D) image stacks with a voxel size of 200 × 200 × 200 nm. Image segmentation yielded 3D reconstructions of tissue microstructure, which were used to numerically derive extracellular conductivity tensors. Volume fractions of myocyte, extracellular, interlaminar cleft, vessel and fibroblast domains in control were (in %) 65.03 ± 3.60, 24.68 ± 3.05, 3.95 ± 4.84, 7.71 ± 2.15, and 2.48 ± 1.11, respectively. Volume fractions in regions 1 and 2 were different for myocyte, myofibroblast, vessel, and extracellular domains. Fibrosis, defined as increase in fibrotic tissue constituents, was (in %) 21.21 ± 1.73, 16.90 ± 9.86, and 3.58 ± 8.64 in MI regions 1, 2, and 3, respectively. For control tissues, image-based computation of longitudinal, transverse and normal extracellular conductivity yielded (in S/m) 0.36 ± 0.11, 0.17 ± 0.07, and 0.1 ± 0.06, respectively. Conductivities were markedly increased in regions 1 ( + 75 , + 171, and + 100%), 2 ( + 53 , + 165, and + 80%), and 3 ( + 42 , + 141, and + 60%) . Volume fractions of the extracellular space including interlaminar clefts strongly correlated with conductivities in control and MI hearts. Our study provides novel quantitative data for computational modeling of conduction in normal and MI hearts. Notably, our study introduces comprehensive statistical information on tissue composition and extracellular conductivities on a microscopic scale in the MI border zone. We suggest that the presented data fill a significant gap in modeling parameters and extend our foundation for computational modeling of cardiac conduction.

Prognostic capacity of a clinically indicated exercise test for cardiovascular mortality is enhanced by combined analysis of exercise capacity, heart rate recovery and T-wave alternans.

PubMed

Minkkinen, Mikko; Nieminen, Tuomo; Verrier, Richard L; Leino, Johanna; Lehtimäki, Terho; Viik, Jari; Lehtinen, Rami; Nikus, Kjell; Kööbi, Tiit; Turjanmaa, Väinö; Kähönen, Mika

2015-09-01

Exercise capacity, heart rate recovery and T-wave alternans are independent predictors of cardiovascular mortality. We tested whether these parameters contain supplementary prognostic information. A total of 3609 consecutive patients (2157 men) referred for a routine, clinically indicated bicycle exercise test were enrolled in the Finnish Cardiovascular Study (FINCAVAS). Exercise capacity was measured in metabolic equivalents, heart rate recovery as the decrease in heart rate from maximum to one minute post-exercise, and T-wave alternans by time-domain Modified Moving Average method. During 57-month median follow-up (interquartile range 35-78 months), 96 patients died of cardiovascular causes (primary endpoint) and 233 from any cause. All three parameters were independent predictors of cardiovascular mortality when analysed as continuous variables. Adding metabolic equivalents (p < 0.001), heart rate recovery (p = 0.002) or T-wave alternans (p = 0.01) to the linear model improved its predictive power for cardiovascular mortality. The combination of low exercise capacity (<6 metabolic equivalents), reduced heart rate recovery (≤12 beats/min) and elevated T-wave alternans (≥60 μV) yielded the highest hazard ratio for cardiovascular mortality of 16.5 (95% confidence interval 4.0-67.7, p < 0.001). Harrell's C index was 0.719 (confidence interval 0.665-0.772) for cardiovascular mortality with previously defined cutpoints (<8 units for metabolic equivalents, ≤18 beats/min for heart rate recovery and ≥60 μV for T-wave alternans). The prognostic capacity of the clinical exercise test is enhanced by combined analysis of exercise capacity, heart rate recovery and T-wave alternans. © The European Society of Cardiology 2014.

A randomised study of perioperative esmolol infusion for haemodynamic stability during major vascular surgery; rationale and design of DECREASE-XIII.

PubMed

Bakker, E J; Ravensbergen, N J; Voute, M T; Hoeks, S E; Chonchol, M; Klimek, M; Poldermans, D

2011-09-01

This article describes the rationale and design of the DECREASE-XIII trial, which aims to evaluate the potential of esmolol infusion, an ultra-short-acting beta-blocker, during surgery as an add-on to chronic low-dose beta-blocker therapy to maintain perioperative haemodynamic stability during major vascular surgery. A double-blind, placebo-controlled, randomised trial. A total of 260 vascular surgery patients will be randomised to esmolol or placebo as an add-on to standard medical care, including chronic low-dose beta-blockers. Esmolol is titrated to maintain a heart rate within a target window of 60-80 beats per minute for 24 h from the induction of anaesthesia. Heart rate and ischaemia are assessed by continuous 12-lead electrocardiographic monitoring for 72 h, starting 1 day prior to surgery. The primary outcome measure is duration of heart rate outside the target window during infusion of the study drug. Secondary outcome measures will be the efficacy parameters of occurrence of cardiac ischaemia, troponin T release, myocardial infarction and cardiac death within 30 days after surgery and safety parameters such as the occurrence of stroke and hypotension. This study will provide data on the efficacy of esmolol titration in chronic beta-blocker users for tight heart-rate control and reduction of ischaemia in patients undergoing vascular surgery as well as data on safety parameters. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Using Renyi entropy to detect early cardiac autonomic neuropathy.

PubMed

Cornforth, David J; Tarvainen, Mika P; Jelinek, Herbert F

2013-01-01

Cardiac Autonomic Neuropathy (CAN) is a disease that involves nerve damage leading to abnormal control of heart rate. CAN affects the correct operation of the heart and in turn leads to associated arrhythmias and heart attack. An open question is to what extent this condition is detectable by the measurement of Heart Rate Variability (HRV). An even more desirable option is to detect CAN in its early, preclinical stage, to improve treatment and outcomes. In previous work we have shown a difference in the Renyi spectrum between participants identified with well-defined CAN and controls. In this work we applied the multi-scale Renyi entropy for identification of early CAN in diabetes patients. Results suggest that Renyi entropy derived from a 20 minute, Lead-II ECG recording, forms a useful contribution to the detection of CAN even in the early stages of the disease. The positive α parameters (1 ≤ α ≤ 5) associated with the Renyi distribution indicated a significant difference (p < 0.00004) between controls and early CAN as well as definite CAN. This is a significant achievement given the simple nature of the information collected, and raises prospects of a simple screening test and improved outcomes of patients.

Telecommunications model for continuing education of health professionals: the Royal Brompton case.

PubMed

Kotis, Takis

2003-01-01

Telemedicine is said to be helpful to both patients and providers, but we need real-world examples to demonstrate its effectiveness. This paper presents such an example. Royal Brompton, under the Tele-remedy Program of EC Telecom, conducted a project with the Children's Hospital of Athens, Greece, to provide remote diagnosis management and continuing education for heart disease, using European ISDN technology. Preliminary results showed that, when carried out in a large scale multi-site environment, Teleremedy program significantly reduced geographic and socio-economic isolation for the patient and the professional isolation for the physician. Comparison of original vs. transmitted data revealed no significant differences, with diagnosis accuracy of 100%.

A clinical decision-making mechanism for context-aware and patient-specific remote monitoring systems using the correlations of multiple vital signs.

PubMed

Forkan, Abdur Rahim Mohammad; Khalil, Ibrahim

2017-02-01

In home-based context-aware monitoring patient's real-time data of multiple vital signs (e.g. heart rate, blood pressure) are continuously generated from wearable sensors. The changes in such vital parameters are highly correlated. They are also patient-centric and can be either recurrent or can fluctuate. The objective of this study is to develop an intelligent method for personalized monitoring and clinical decision support through early estimation of patient-specific vital sign values, and prediction of anomalies using the interrelation among multiple vital signs. In this paper, multi-label classification algorithms are applied in classifier design to forecast these values and related abnormalities. We proposed a completely new approach of patient-specific vital sign prediction system using their correlations. The developed technique can guide healthcare professionals to make accurate clinical decisions. Moreover, our model can support many patients with various clinical conditions concurrently by utilizing the power of cloud computing technology. The developed method also reduces the rate of false predictions in remote monitoring centres. In the experimental settings, the statistical features and correlations of six vital signs are formulated as multi-label classification problem. Eight multi-label classification algorithms along with three fundamental machine learning algorithms are used and tested on a public dataset of 85 patients. Different multi-label classification evaluation measures such as Hamming score, F1-micro average, and accuracy are used for interpreting the prediction performance of patient-specific situation classifications. We achieved 90-95% Hamming score values across 24 classifier combinations for 85 different patients used in our experiment. The results are compared with single-label classifiers and without considering the correlations among the vitals. The comparisons show that multi-label method is the best technique for this problem domain. The evaluation results reveal that multi-label classification techniques using the correlations among multiple vitals are effective ways for early estimation of future values of those vitals. In context-aware remote monitoring this process can greatly help the doctors in quick diagnostic decision making. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A computer model of the pediatric circulatory system for testing pediatric assist devices.

PubMed

Giridharan, Guruprasad A; Koenig, Steven C; Mitchell, Michael; Gartner, Mark; Pantalos, George M

2007-01-01

Lumped parameter computer models of the pediatric circulatory systems for 1- and 4-year-olds were developed to predict hemodynamic responses to mechanical circulatory support devices. Model parameters, including resistance, compliance and volume, were adjusted to match hemodynamic pressure and flow waveforms, pressure-volume loops, percent systole, and heart rate of pediatric patients (n = 6) with normal ventricles. Left ventricular failure was modeled by adjusting the time-varying compliance curve of the left heart to produce aortic pressures and cardiac outputs consistent with those observed clinically. Models of pediatric continuous flow (CF) and pulsatile flow (PF) ventricular assist devices (VAD) and intraaortic balloon pump (IABP) were developed and integrated into the heart failure pediatric circulatory system models. Computer simulations were conducted to predict acute hemodynamic responses to PF and CF VAD operating at 50%, 75% and 100% support and 2.5 and 5 ml IABP operating at 1:1 and 1:2 support modes. The computer model of the pediatric circulation matched the human pediatric hemodynamic waveform morphology to within 90% and cardiac function parameters with 95% accuracy. The computer model predicted PF VAD and IABP restore aortic pressure pulsatility and variation in end-systolic and end-diastolic volume, but diminish with increasing CF VAD support.

Selection and collection of multi parameter physiological data for cardiac rhythm diagnostic algorithm development

NASA Astrophysics Data System (ADS)

Bostock, J.; Weller, P.; Cooklin, M.

2010-07-01

Automated diagnostic algorithms are used in implantable cardioverter-defibrillators (ICD's) to detect abnormal heart rhythms. Algorithms misdiagnose and improved specificity is needed to prevent inappropriate therapy. Knowledge engineering (KE) and artificial intelligence (AI) could improve this. A pilot study of KE was performed with artificial neural network (ANN) as AI system. A case note review analysed arrhythmic events stored in patients ICD memory. 13.2% patients received inappropriate therapy. The best ICD algorithm had sensitivity 1.00, specificity 0.69 (p<0.001 different to gold standard). A subset of data was used to train and test an ANN. A feed-forward, back-propagation network with 7 inputs, a 4 node hidden layer and 1 output had sensitivity 1.00, specificity 0.71 (p<0.001). A prospective study was performed using KE to list arrhythmias, factors and indicators for which measurable parameters were evaluated and results reviewed by a domain expert. Waveforms from electrodes in the heart and thoracic bio-impedance; temperature and motion data were collected from 65 patients during cardiac electrophysiological studies. 5 incomplete datasets were due to technical failures. We concluded that KE successfully guided selection of parameters and ANN produced a usable system and that complex data collection carries greater risk of technical failure, leading to data loss.

Resting Heart Rate as Predictor for Left Ventricular Dysfunction and Heart Failure: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

Opdahl, Anders; Venkatesh, Bharath Ambale; Fernandes, Veronica R. S.; Wu, Colin O.; Nasir, Khurram; Choi, Eui-Young; Almeida, Andre L. C.; Rosen, Boaz; Carvalho, Benilton; Edvardsen, Thor; Bluemke, David A.; Lima, Joao A. C.

2014-01-01

OBJECTIVE To investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction. BACKGROUND The association of resting heart rate to HF and LV function is not well described in an asymptomatic multi-ethnic population. METHODS Participants in the Multi-Ethnic Study of Atherosclerosis had resting heart rate measured at inclusion. Incident HF was registered (n=176) during follow-up (median 7 years) in those who underwent cardiac MRI (n=5000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume and mass in addition to resting heart rate. RESULTS Cox analysis demonstrated that for 1 bpm increase in resting heart rate there was a 4% greater adjusted relative risk for incident HF (Hazard Ratio: 1.04 (1.02, 1.06 (95% CI); P<0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even in analyses when all coronary heart disease events were excluded from the model. CONCLUSION Elevated resting heart rate is associated with increased risk for incident HF in asymptomatic participants in MESA. Higher heart rate is related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. PMID:24412444

Ultrasound Current Source Density Imaging in live rabbit hearts using clinical intracardiac catheter

NASA Astrophysics Data System (ADS)

Li, Qian

Ultrasound Current Source Density Imaging (UCSDI) is a noninvasive modality for mapping electrical activities in the body (brain and heart) in 4-dimensions (space + time). Conventional cardiac mapping technologies for guiding the radiofrequency ablation procedure for treatment of cardiac arrhythmias have certain limitations. UCSDI can potentially overcome these limitations and enhance the electrophysiology mapping of the heart. UCSDI exploits the acoustoelectric (AE) effect, an interaction between ultrasound pressure and electrical resistivity. When an ultrasound beam intersects a current path in a material, the local resistivity of the material is modulated by the ultrasonic pressure, and a change in voltage signal can be detected based on Ohm's Law. The degree of modulation is determined by the AE interaction constant K. K is a fundamental property of any type of material, and directly affects the amplitude of the AE signal detected in UCSDI. UCSDI requires detecting a small AE signal associated with electrocardiogram. So sensitivity becomes a major challenge for transferring UCSDI to the clinic. This dissertation will determine the limits of sensitivity and resolution for UCSDI, balancing the tradeoff between them by finding the optimal parameters for electrical cardiac mapping, and finally test the optimized system in a realistic setting. This work begins by describing a technique for measuring K, the AE interaction constant, in ionic solution and biological tissue, and reporting the value of K in excised rabbit cardiac tissue for the first time. K was found to be strongly dependent on concentration for the divalent salt CuSO4, but not for the monovalent salt NaCl, consistent with their different chemical properties. In the rabbit heart tissue, K was determined to be 0.041 +/- 0.012 %/MPa, similar to the measurement of K in physiologic saline: 0.034 +/- 0.003 %/MPa. Next, this dissertation investigates the sensitivity limit of UCSDI by quantifying the relation between the recording electrode distance and the measured AE signal amplitude in gel phantoms and excised porcine heart tissue using a clinical intracardiac catheter. Sensitivity of UCSDI with catheter was 4.7 microV/mA (R2 = 0.999) in cylindrical gel (0.9% NaCl), and 3.2 microV/mA (R2 = 0.92) in porcine heart tissue. The AE signal was detectable more than 25 mm away from the source in cylindrical gel (0.9% NaCl). Effect of transducer properties on UCSDI sensitivity is also investigated using simulation. The optimal ultrasound transducer parameters chosen for cardiac imaging are center frequency = 0.5 MHz and f/number = 1.4. Last but not least, this dissertation shows the result of implementing the optimized ultrasound parameters in live rabbit heart preparation, the comparison of different recording electrode configuration and multichannel UCSDI recording and reconstruction. The AE signal detected using the 0.5 MHz transducer was much stronger (2.99 microV/MPa) than the 1.0 MHz transducer (0.42 microV/MPa). The clinical lasso catheter placed on the epicardium exhibited excellent sensitivity without being too invasive. 3-dimensional cardiac activation maps of the live rabbit heart using only one pair of recording electrodes were also demonstrated for the first time. Cardiac conduction velocity for atrial (1.31 m/s) and apical (0.67 m/s) pacing were calculated based on the activation maps. The future outlook of this dissertation includes integrating UCSDI with 2-dimensional ultrasound transducer array for fast imaging, and developing a multi-modality catheter with 4-dimensional UCSDI, multi-electrode recording and echocardiography capacity.

BioMEMS for multiparameter clinical monitoring

NASA Astrophysics Data System (ADS)

Moser, Isabella

2003-01-01

For diabetes patients glucose monitoring means an important improvement of their life quality and additionally it is a $3-billion-a-year business. Continuous glucose monitoring provides gapless glucose level control, an early warning of hypoglycemia, and is intended to control insulin pumps. An upgrading to multi-parameter monitoring would not only benefit patients with severe metabolism defects but also the metabolism of diabetes patient could be better controlled by monitoring an additional parameter like lactate. Multi-parameter monitoring devices are not commercially available, one of the complications in the integration of different biosensors using the same detecting molecule for all analytes is chemical cross talk between adjacent amperometric biosensors. Recently some integrated biosensors were published but either they were not mass producible or they were realized in an expensive silicon based technology. In addition to it most of them were not tested under monitoring conditions but their integration principles will be discussed. As an example a low cost multi- parameter microsystem and some applications of it in clinical diagnosis will be presented. Also an overlook of non-invasive methods and (minimal) invasive methods will be given with a focus on microdialysis.

A novel LabVIEW-based multi-channel non-invasive abdominal maternal-fetal electrocardiogram signal generator.

PubMed

Martinek, Radek; Kelnar, Michal; Koudelka, Petr; Vanus, Jan; Bilik, Petr; Janku, Petr; Nazeran, Homer; Zidek, Jan

2016-02-01

This paper describes the design, construction, and testing of a multi-channel fetal electrocardiogram (fECG) signal generator based on LabVIEW. Special attention is paid to the fetal heart development in relation to the fetus' anatomy, physiology, and pathology. The non-invasive signal generator enables many parameters to be set, including fetal heart rate (FHR), maternal heart rate (MHR), gestational age (GA), fECG interferences (biological and technical artifacts), as well as other fECG signal characteristics. Furthermore, based on the change in the FHR and in the T wave-to-QRS complex ratio (T/QRS), the generator enables manifestations of hypoxic states (hypoxemia, hypoxia, and asphyxia) to be monitored while complying with clinical recommendations for classifications in cardiotocography (CTG) and fECG ST segment analysis (STAN). The generator can also produce synthetic signals with defined properties for 6 input leads (4 abdominal and 2 thoracic). Such signals are well suited to the testing of new and existing methods of fECG processing and are effective in suppressing maternal ECG while non-invasively monitoring abdominal fECG. They may also contribute to the development of a new diagnostic method, which may be referred to as non-invasive trans-abdominal CTG +  STAN. The functional prototype is based on virtual instrumentation using the LabVIEW developmental environment and its associated data acquisition measurement cards (DAQmx). The generator also makes it possible to create synthetic signals and measure actual fetal and maternal ECGs by means of bioelectrodes.

A dose-response study of dexmedetomidine administered as the primary sedative in infants following open heart surgery.

PubMed

Su, Felice; Nicolson, Susan C; Zuppa, Athena F

2013-06-01

To evaluate the dose-response relationship of dexmedetomidine in infants with congenital heart disease postoperative from open heart surgery. Prospective open-label dose-escalation pharmacokinetic-pharmacodynamic study. Tertiary pediatric cardiac ICU. Thirty-six evaluable infants, 1-24 months old, postoperative from open heart surgery requiring mechanical ventilation. Cohorts of 12 infants were enrolled sequentially to one of the three IV loading doses of dexmedetomidine (0.35, 0.7, and 1 mcg/kg) over 10 minutes followed by respective continuous infusions (0.25, 0.5, and 0.75 mcg/kg/hr) for up to 24 hours. Dexmedetomidine plasma concentrations were obtained at timed intervals during and following discontinuation of infusion. Pharmacodynamic variables evaluated included sedation scores, supplemental sedation and analgesia medication administration, time to tracheal extubation, respiratory function, and hemodynamic parameters. Infants achieved a deeper sedation measured by the University of Michigan Sedation Scale score (2.6 vs 1) despite requiring minimal supplemental sedation (0 unit doses/hr) and fewer analgesic medications (0.07 vs 0.15 unit doses/hr) while receiving dexmedetomidine compared with the 12-hour follow-up period. Thirty-one patients were successfully extubated while receiving the dexmedetomidine infusion. Only one patient remained intubated due to oversedation during the infusion. While receiving dexmedetomidine, there was a decrease in heart rate compared with baseline, 132 versus 161 bpm, but there was an increase in heart rate compared with postinfusion values, 132 versus 128 bpm. There was no statistically or clinically significant change in mean arterial blood pressure. Dexmedetomidine administration in infants following open heart surgery can provide improved sedation with reduction in supplemental medication requirements, leading to successful extubation while receiving a continuous infusion. The postoperative hemodynamic changes that occur in infants postoperative from open heart surgery are multifactorial. Although dexmedetomidine may play a role in decreasing heart rate immediately postoperative, the changes were not clinically significant and did not fall below postinfusion heart rates.

Strain and Torsion Quantification in Mouse Hearts under Dobutamine Stimulation using 2D Multi-Phase MR DENSE

PubMed Central

Zhong, Jia; Yu, Xin

2010-01-01

In the current study, a 2D multi-phase MR displacement encoding with stimulated echoes (DENSE) imaging and analysis method was developed for direct quantification of Lagrangian strain in the mouse heart. Using the proposed method, less than 10 ms temporal resolution and 0.56 mm in-plane resolution were achieved. A validation study that compared strain calculation by DENSE and by MR tagging showed high correlation between the two methods (R2 > 0.80). Regional ventricular wall strain and twist were characterized in mouse hearts at baseline and under dobutamine stimulation. Dobutamine stimulation induced significant increase in radial and circumferential strains and torsion at peak-systole. A rapid untwisting was also observed during early diastole. This work demonstrates the capability of characterizing cardiac functional response to dobutamine stimulation in the mouse heart using 2D multi-phase MR DENSE. PMID:20740659

Continuous cardiac troponin I release in Fabry disease.

PubMed

Feustel, Andreas; Hahn, Andreas; Schneider, Christian; Sieweke, Nicole; Franzen, Wolfgang; Gündüz, Dursun; Rolfs, Arndt; Tanislav, Christian

2014-01-01

Fabry disease (FD) is a rare lysosomal storage disorder also affecting the heart. The aims of this study were to determine the frequency of cardiac troponin I (cTNI) elevation, a sensitive parameter reflecting myocardial damage, in a smaller cohort of FD-patients, and to analyze whether persistent cTNI can be a suitable biomarker to assess cardiac dysfunction in FD. cTNI values were determined at least twice per year in 14 FD-patients (6 males and 8 females) regularly followed-up in our centre. The data were related to other parameters of heart function including cardiac magnetic resonance imaging (cMRI). Three patients (21%) without specific vascular risk factors other than FD had persistent cTNI-elevations (range 0.05-0.71 ng/ml, normal: <0.01). cMRI disclosed late gadolinium enhancement (LGE) in all three individuals with cTNI values ≥0.01, while none of the 11 patients with cTNI <0.01 showed a pathological enhancement (p<0.01). Two subjects with increased cTNI-values underwent coronary angiography, excluding relevant stenoses. A myocardial biopsy performed in one during this procedure demonstrated substantial accumulation of globotriaosylceramide (Gb3) in cardiomyocytes. Continuous cTNI elevation seems to occur in a substantial proportion of patients with FD. The high accordance with LGE, reflecting cardiac dysfunction, suggests that cTNI-elevation can be a useful laboratory parameter for assessing myocardial damage in FD.

Removing flicker based on sparse color correspondences in old film restoration

NASA Astrophysics Data System (ADS)

Huang, Xi; Ding, Youdong; Yu, Bing; Xia, Tianran

2018-04-01

In the long history of human civilization, archived film is an indispensable part of it, and using digital method to repair damaged film is also a mainstream trend nowadays. In this paper, we propose a sparse color correspondences based technique to remove fading flicker for old films. Our model, combined with multi frame images to establish a simple correction model, includes three key steps. Firstly, we recover sparse color correspondences in the input frames to build a matrix with many missing entries. Secondly, we present a low-rank matrix factorization approach to estimate the unknown parameters of this model. Finally, we adopt a two-step strategy that divide the estimated parameters into reference frame parameters for color recovery correction and other frame parameters for color consistency correction to remove flicker. Our method combined multi-frames takes continuity of the input sequence into account, and the experimental results show the method can remove fading flicker efficiently.

[Multi-month dynamics of the functional condition of organism of normal male northeners of Russia].

PubMed

Solonin, Iu G; Markov, A L; Boĭko, E R

2012-01-01

In conjunction with the Mars-500 project, 17 male residents (25-46 y.o.) of the North of Russia (62 degrees 40'N) were examined monthly using hard- and software EKOSAN-2007. In the period of June, 2010 through to November, 2011 they visited a standard laboratory to go through comprehensive anthropophysiometric, psychophysiological and physiological investigations at rest and combined with exercise, standing and cold tests aimed at tracking the seasonal responses of the body functional parameters. The larger part of group-average psychomotor, breathing and circulation measurements as well as heart rate variability did not exhibit statistically significant differences between months or seasons. Reliable seasonal variations were documented in the life index, body and cutaneous temperature, myocardium index and regulatory systems activity. A correlation between environmental and some body functional parameters was established. In the course of the multi-month monitoring there were periods when essentially healthy people were diagnosed as prenosologic and even premorbid. Some findings in the functioning of male northerner's organism are clearly attributable to living in the high-altitude area.

Bridge to transplantation with a left ventricular assist device.

PubMed

Jung, Jae Jun; Sung, Kiick; Jeong, Dong Seop; Kim, Wook Sung; Lee, Young Tak; Park, Pyo Won

2012-04-01

A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.

Measurement and Data Transmission Validity of a Multi-Biosensor System for Real-Time Remote Exercise Monitoring Among Cardiac Patients.

PubMed

Rawstorn, Jonathan C; Gant, Nicholas; Warren, Ian; Doughty, Robert Neil; Lever, Nigel; Poppe, Katrina K; Maddison, Ralph

2015-03-20

Remote telemonitoring holds great potential to augment management of patients with coronary heart disease (CHD) and atrial fibrillation (AF) by enabling regular physiological monitoring during physical activity. Remote physiological monitoring may improve home and community exercise-based cardiac rehabilitation (exCR) programs and could improve assessment of the impact and management of pharmacological interventions for heart rate control in individuals with AF. Our aim was to evaluate the measurement validity and data transmission reliability of a remote telemonitoring system comprising a wireless multi-parameter physiological sensor, custom mobile app, and middleware platform, among individuals in sinus rhythm and AF. Participants in sinus rhythm and with AF undertook simulated daily activities, low, moderate, and/or high intensity exercise. Remote monitoring system heart rate and respiratory rate were compared to reference measures (12-lead ECG and indirect calorimeter). Wireless data transmission loss was calculated between the sensor, mobile app, and remote Internet server. Median heart rate (-0.30 to 1.10 b∙min -1 ) and respiratory rate (-1.25 to 0.39 br∙min -1 ) measurement biases were small, yet statistically significant (all P≤.003) due to the large number of observations. Measurement reliability was generally excellent (rho=.87-.97, all P<.001; intraclass correlation coefficient [ICC]=.94-.98, all P<.001; coefficient of variation [CV]=2.24-7.94%), although respiratory rate measurement reliability was poor among AF participants (rho=.43, P<.001; ICC=.55, P<.001; CV=16.61%). Data loss was minimal (<5%) when all system components were active; however, instability of the network hosting the remote data capture server resulted in data loss at the remote Internet server during some trials. System validity was sufficient for remote monitoring of heart and respiratory rates across a range of exercise intensities. Remote exercise monitoring has potential to augment current exCR and heart rate control management approaches by enabling the provision of individually tailored care to individuals outside traditional clinical environments. ©Jonathan C Rawstorn, Nicholas Gant, Ian Warren, Robert Neil Doughty, Nigel Lever, Katrina K Poppe, Ralph Maddison. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 20.03.2015.

Management of heart failure in the new era: the role of scores.

PubMed

Mantegazza, Valentina; Badagliacca, Roberto; Nodari, Savina; Parati, Gianfranco; Lombardi, Carolina; Di Somma, Salvatore; Carluccio, Erberto; Dini, Frank Lloyd; Correale, Michele; Magrì, Damiano; Agostoni, Piergiuseppe

2016-08-01

Heart failure is a widespread syndrome involving several organs, still characterized by high mortality and morbidity, and whose clinical course is heterogeneous and hardly predictable.In this scenario, the assessment of heart failure prognosis represents a fundamental step in clinical practice. A single parameter is always unable to provide a very precise prognosis. Therefore, risk scores based on multiple parameters have been introduced, but their clinical utility is still modest. In this review, we evaluated several prognostic models for acute, right, chronic, and end-stage heart failure based on multiple parameters. In particular, for chronic heart failure we considered risk scores essentially based on clinical evaluation, comorbidities analysis, baroreflex sensitivity, heart rate variability, sleep disorders, laboratory tests, echocardiographic imaging, and cardiopulmonary exercise test parameters. What is at present established is that a single parameter is not sufficient for an accurate prediction of prognosis in heart failure because of the complex nature of the disease. However, none of the scoring systems available is widely used, being in some cases complex, not user-friendly, or based on expensive or not easily available parameters. We believe that multiparametric scores for risk assessment in heart failure are promising but their widespread use needs to be experienced.

Multiphysics and multiscale modelling, data-model fusion and integration of organ physiology in the clinic: ventricular cardiac mechanics.

PubMed

Chabiniok, Radomir; Wang, Vicky Y; Hadjicharalambous, Myrianthi; Asner, Liya; Lee, Jack; Sermesant, Maxime; Kuhl, Ellen; Young, Alistair A; Moireau, Philippe; Nash, Martyn P; Chapelle, Dominique; Nordsletten, David A

2016-04-06

With heart and cardiovascular diseases continually challenging healthcare systems worldwide, translating basic research on cardiac (patho)physiology into clinical care is essential. Exacerbating this already extensive challenge is the complexity of the heart, relying on its hierarchical structure and function to maintain cardiovascular flow. Computational modelling has been proposed and actively pursued as a tool for accelerating research and translation. Allowing exploration of the relationships between physics, multiscale mechanisms and function, computational modelling provides a platform for improving our understanding of the heart. Further integration of experimental and clinical data through data assimilation and parameter estimation techniques is bringing computational models closer to use in routine clinical practice. This article reviews developments in computational cardiac modelling and how their integration with medical imaging data is providing new pathways for translational cardiac modelling.

A low cost implementation of multi-parameter patient monitor using intersection kernel support vector machine classifier

NASA Astrophysics Data System (ADS)

Mohan, Dhanya; Kumar, C. Santhosh

2016-03-01

Predicting the physiological condition (normal/abnormal) of a patient is highly desirable to enhance the quality of health care. Multi-parameter patient monitors (MPMs) using heart rate, arterial blood pressure, respiration rate and oxygen saturation (S pO2) as input parameters were developed to monitor the condition of patients, with minimum human resource utilization. The Support vector machine (SVM), an advanced machine learning approach popularly used for classification and regression is used for the realization of MPMs. For making MPMs cost effective, we experiment on the hardware implementation of the MPM using support vector machine classifier. The training of the system is done using the matlab environment and the detection of the alarm/noalarm condition is implemented in hardware. We used different kernels for SVM classification and note that the best performance was obtained using intersection kernel SVM (IKSVM). The intersection kernel support vector machine classifier MPM has outperformed the best known MPM using radial basis function kernel by an absoute improvement of 2.74% in accuracy, 1.86% in sensitivity and 3.01% in specificity. The hardware model was developed based on the improved performance system using Verilog Hardware Description Language and was implemented on Altera cyclone-II development board.

Multi-Ethnic Study of Atherosclerosis (MESA)

ClinicalTrials.gov

2016-07-28

Atherosclerosis; Cardiovascular Diseases; Heart Diseases; Coronary Artery Disease; Coronary Disease; Stroke; Myocardial Infarction; Heart Failure; Diabetes Mellitus, Type 2; Hypertension; Diabetes Mellitus

Cell-accurate optical mapping across the entire developing heart.

PubMed

Weber, Michael; Scherf, Nico; Meyer, Alexander M; Panáková, Daniela; Kohl, Peter; Huisken, Jan

2017-12-29

Organogenesis depends on orchestrated interactions between individual cells and morphogenetically relevant cues at the tissue level. This is true for the heart, whose function critically relies on well-ordered communication between neighboring cells, which is established and fine-tuned during embryonic development. For an integrated understanding of the development of structure and function, we need to move from isolated snap-shot observations of either microscopic or macroscopic parameters to simultaneous and, ideally continuous, cell-to-organ scale imaging. We introduce cell-accurate three-dimensional Ca 2+ -mapping of all cells in the entire electro-mechanically uncoupled heart during the looping stage of live embryonic zebrafish, using high-speed light sheet microscopy and tailored image processing and analysis. We show how myocardial region-specific heterogeneity in cell function emerges during early development and how structural patterning goes hand-in-hand with functional maturation of the entire heart. Our method opens the way to systematic, scale-bridging, in vivo studies of vertebrate organogenesis by cell-accurate structure-function mapping across entire organs.

Cell-accurate optical mapping across the entire developing heart

PubMed Central

Meyer, Alexander M; Panáková, Daniela; Kohl, Peter

2017-01-01

Organogenesis depends on orchestrated interactions between individual cells and morphogenetically relevant cues at the tissue level. This is true for the heart, whose function critically relies on well-ordered communication between neighboring cells, which is established and fine-tuned during embryonic development. For an integrated understanding of the development of structure and function, we need to move from isolated snap-shot observations of either microscopic or macroscopic parameters to simultaneous and, ideally continuous, cell-to-organ scale imaging. We introduce cell-accurate three-dimensional Ca2+-mapping of all cells in the entire electro-mechanically uncoupled heart during the looping stage of live embryonic zebrafish, using high-speed light sheet microscopy and tailored image processing and analysis. We show how myocardial region-specific heterogeneity in cell function emerges during early development and how structural patterning goes hand-in-hand with functional maturation of the entire heart. Our method opens the way to systematic, scale-bridging, in vivo studies of vertebrate organogenesis by cell-accurate structure-function mapping across entire organs. PMID:29286002

Cuff-less PPG based continuous blood pressure monitoring: a smartphone based approach.

PubMed

Gaurav, Aman; Maheedhar, Maram; Tiwari, Vijay N; Narayanan, Rangavittal

2016-08-01

Cuff-less estimation of systolic (SBP) and diastolic (DBP) blood pressure is an efficient approach for non-invasive and continuous monitoring of an individual's vitals. Although pulse transit time (PTT) based approaches have been successful in estimating the systolic and diastolic blood pressures to a reasonable degree of accuracy, there is still scope for improvement in terms of accuracies. Moreover, PTT approach requires data from sensors placed at two different locations along with individual calibration of physiological parameters for deriving correct estimation of systolic and diastolic blood pressure (BP) and hence is not suitable for smartphone deployment. Heart Rate Variability is one of the extensively used non-invasive parameters to assess cardiovascular autonomic nervous system and is known to be associated with SBP and DBP indirectly. In this work, we propose a novel method to extract a comprehensive set of features by combining PPG signal based and Heart Rate Variability (HRV) related features using a single PPG sensor. Further, these features are fed into a DBP feedback based combinatorial neural network model to arrive at a common weighted average output of DBP and subsequently SBP. Our results show that using this current approach, an accuracy of ±6.8 mmHg for SBP and ±4.7 mmHg for DBP is achievable on 1,750,000 pulses extracted from a public database (comprising 3000 people). Since most of the smartphones are now equipped with PPG sensor, a mobile based cuff-less BP estimation will enable the user to monitor their BP as a vital parameter on demand. This will open new avenues towards development of pervasive and continuous BP monitoring systems leading to an early detection and prevention of cardiovascular diseases.

Sodium Tanshinone IIA Sulfonate Improves Hemodynamic Parameters, Cytokine Release, and Multi-Organ Damage in Endotoxemia Rabbits.

PubMed

Ma, Shaolei; Wang, Xian; Wang, Yujie; Zuo, Xiangrong

2018-05-08

BACKGROUND The aim of this study was to evaluate the protective effects of sodium tanshinone IIA sulfonate (STS) on hemodynamic parameters, cytokine release, and multiple organ damage in an animal model of lipopolysaccharide (LPS)-induced endotoxemia. MATERIAL AND METHODS Twenty-four rabbits were randomly divided into 3 groups: control (n=8), LPS (n=8), and STS pretreatment + LPS (n=8) groups. With arterial invasive monitoring, hemodynamic variables were observed at 30 min before and at 0, 10, 20, 30, 60, 120, 180, 240, and 300 min after LPS injection. Circulatory inflammatory cytokines, including tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10), and relevant biochemical markers, including arterial partial pressure of oxygen (PaO2), plasma cardiac troponin I (cTnI), alanine aminotransferase (ALT), and creatinine (Cr), were measured at each time point. At the end of the experiment, all rabbits were sacrificed; histopathological examination of the heart, lung, liver, and kidney tissue was performed and organ injury was semi-quantitatively scored for each organ. RESULTS Mean arterial pressure (MAP) and heart rate (HR) significantly decreased within 30 min and again after 120 min following LPS injection. However, STS pretreatment gradually normalized MAP and HR after 120 min following LPS injection. In addition, STS ameliorated LPS-induced decrease of PaO2, LPS-induced increase of TNF-α, cTnI, and ALT, and enhanced LPS-induced increase of IL-10. Moreover, STS reduced heart, lung, and liver histopathologic injury. CONCLUSIONS STS can significantly stabilize LPS-induced hemodynamic deterioration, regulate inflammatory cytokine secretion, and protect heart, lung, and liver in rabbits.

A comparison of three apolipoprotein B methods and their associations with incident coronary heart disease risk over a 12-year follow-up period: The Multi-Ethnic Study of Atherosclerosis.

PubMed

Cao, Jing; Steffen, Brian T; Guan, Weihua; Remaley, Alan T; McConnell, Joseph P; Palamalai, Vikram; Tsai, Michael Y

Apolipoprotein B-100 (ApoB) is a well-researched lipoprotein marker used in assessing the risk of coronary heart disease (CHD) development. Despite its continued use at the bedside, ApoB methodologies have not been thoroughly compared and may differentially discriminate CHD risk, resulting in patient misclassification. This study compared 3 ApoB immunoassays and their associations with incident CHD risk over a 12-year follow-up period in the Multi-Ethnic Study of Atherosclerosis. Plasma ApoB concentrations were measured in 4679 participants of Multi-Ethnic Study of Atherosclerosis at baseline, using 3 immunoturbidimetric methods. Roche and Kamiya reagent-based methods were analyzed on a Roche modular P analyzer, and the Diazyme reagent-based method was analyzed on a Siemens Dimension analyzer. Cox proportional analysis estimated ApoB-related risk of incident CHD over a median follow-up period of 12.5 years with adjustments for nonlipid CHD risk factors. ApoB concentrations were examined as continuous variables but were also dichotomized based on clinical designations of borderline (100 mg/dL), high (120 mg/dL), and very high ApoB levels (140 mg/dL). Moderate to strong correlations among ApoB methods were observed (r = 0.79-0.98). ApoB concentrations (per standard deviation) were similarly associated with CHD risk and hazard ratio (95% confidence interval): Roche: 1.16 (1.03-1.30); Kamiya: 1.14 (1.02-1.28); and Diazyme: 1.14 (1.02-1.28). Although all 3 ApoB were similarly associated with risk of incident CHD over the study period regardless of the reagent type, the bias between methods suggests that these reagents are not fungible, and assay harmonization may be warranted. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

(-) Epicatechin attenuates mitochondrial damage by enhancing mitochondrial multi-marker enzymes, adenosine triphosphate and lowering calcium in isoproterenol induced myocardial infarcted rats.

PubMed

Stanely Mainzen Prince, P

2013-03-01

Cardiac mitochondrial damage plays an important role in the pathology of myocardial infarction. The protective effects of (-) epicatechin on cardiac mitochondrial damage in isoproterenol induced myocardial infarction were evaluated in rats. Rats were pretreated with (-) epicatechin (20 mg/kg body weight) daily for a period of 21 days. After the pretreatment period, isoproterenol (100 mg/kg body weight) was injected subcutaneously into rats twice at an interval of 24 h to induce myocardial infarction. Isoproterenol induced myocardial infarcted rats showed a significant increase in the levels of cardiac diagnostic markers, heart mitochondrial lipid peroxidation, calcium, and a significant decrease in the activities/levels of heart mitochondrial glutathione peroxidase, glutathione reductase, reduced glutathione, isocitrate, succinate, malate, α-ketoglutarate and NADH-dehydrogenases, cytochrome-C-oxidase and adenosine triphosphate. (-) Epicatechin pretreatment showed significant protective effects on all the biochemical parameters evaluated. The in vitro study revealed the superoxide and hydroxyl radical scavenging activity of (-) epicatechin. The possible mechanisms for the beneficial effects of (-) epicatechin on cardiac mitochondria could be attributed to scavenging of free radicals, decreasing calcium, increasing multi-enzymes (antioxidant, tricarboxylic acid cycle and respiratory chain enzymes), reduced glutathione and adenosine triphosphate. Thus, (-) epicatechin attenuated mitochondrial damage in isoproterenol induced myocardial infarcted rats. Copyright © 2012 Elsevier Ltd. All rights reserved.

Short-term heart rate variability (HRV) in healthy dogs.

PubMed

Bogucki, Sz; Noszczyk-Nowak, A

2015-01-01

Heart rate variability (HRV) is a well established mortality risk factor in both healthy dogs and those with heart failure. While the standards for short-term HRV analysis have been developed in humans, only reference values for HRV parameters determined from 24-hour ECG have been proposed in dogs. The aim of this study was to develop the reference values for short-term HRV parameters in a group of 50 healthy dogs of various breeds (age 4.86 ± 2.74 years, body weight 12.2 ± 3.88 kg). The ECG was recorded continuously for at least 180 min in a dark and quiet room. All electrocardiograms were inspected automatically and manually to eliminate atrial or ventricular premature complexes. Signals were transformed into a spectrum using the fast Fourier transform. The HRV parameters were measured at fixed times from 60-min ECG segments. The following time-domain parameters (ms) were analyzed: mean NN, SDNN, SDANN, SDNN index, rMSSD and pNN50. Moreover, frequency-domain parameters (Hz) were determined, including very low frequency (VLF), low frequency (LF) and high frequency (HF) components, total power (TP) and the LF/HF ratio. The results (means ± SD) were as follows: mean NN = 677.68 ± 126.89; SDNN = 208.86 ± 77.1; SDANN = 70.75 ± 30.9; SDNN index = 190.75 ± 76.12; rMSSD = 259 ± 120.17, pNN50 = 71.84 ± 13.96; VLF = 984.96 ± 327.7; LF = 1501.24 ± 736.32; HF = 5845.45 ± 2914.20; TP = 11065.31 ± 3866.87; LF/HF = 0.28 ± 0.11.

Prognostic value of heart rate variability footprint and standard deviation of average 5-minute intrinsic R-R intervals for mortality in cardiac resynchronization therapy patients.

PubMed

Gilliam, F Roosevelt; Singh, Jagmeet P; Mullin, Christopher M; McGuire, Maureen; Chase, Kellie J

2007-10-01

Cardiac resynchronization therapy devices provide effective therapy for heart failure. Heart rate variability (HRV) parameters in the device such as HRV footprint and SD of average 5-minute intrinsic R-R intervals (SDANN) are related to autonomic function and may be used to identify patients with a higher risk of mortality. We examined the relationship between HRV and mortality in a prospective cohort study. The 842 patients (mean age, 67.7 +/- 11.2; 23.5 % female; New York Heart Association class III, 88.6%; class IV, 11.4%) included in the analysis were implanted with a cardiac resynchronization therapy with defibrillation device and had baseline HRV measurements available. During a median of 11.6 months of follow-up, 7.8% (66/842) of patients died. Heart rate variability footprint and SDANN were significant predictors of mortality (all P < .05); patients with lower HRV values were at greater risk for death, compared with patients with higher HRV values. Heart rate variability changes over time tended to predict the risk of mortality in follow-up (P = nonsignificant); patients with low baseline HRV and small changes in HRV during the follow-up period were at the highest risk for death (7% mortality for SDANN and 8.9% for HRV footprint), and patients with high baseline HRV and large changes in HRV were at the lowest risk (1.5% mortality for SDANN and 2.4% for HRV footprint). Results were consistent when adjusted for age, sex, body mass index, and diastolic blood pressure. Continuously measured device HRV parameters provide prognostic information about patient mortality that may be helpful for risk stratification.

Optimized scheme in coal-fired boiler combustion based on information entropy and modified K-prototypes algorithm

NASA Astrophysics Data System (ADS)

Gu, Hui; Zhu, Hongxia; Cui, Yanfeng; Si, Fengqi; Xue, Rui; Xi, Han; Zhang, Jiayu

2018-06-01

An integrated combustion optimization scheme is proposed for the combined considering the restriction in coal-fired boiler combustion efficiency and outlet NOx emissions. Continuous attribute discretization and reduction techniques are handled as optimization preparation by E-Cluster and C_RED methods, in which the segmentation numbers don't need to be provided in advance and can be continuously adapted with data characters. In order to obtain results of multi-objections with clustering method for mixed data, a modified K-prototypes algorithm is then proposed. This algorithm can be divided into two stages as K-prototypes algorithm for clustering number self-adaptation and clustering for multi-objective optimization, respectively. Field tests were carried out at a 660 MW coal-fired boiler to provide real data as a case study for controllable attribute discretization and reduction in boiler system and obtaining optimization parameters considering [ maxηb, minyNOx ] multi-objective rule.

Body position and activity, but not heart rate, affect pump flows in patients with continuous-flow left ventricular assist devices.

PubMed

Muthiah, Kavitha; Gupta, Sunil; Otton, James; Robson, Desiree; Walker, Robyn; Tay, Andre; Macdonald, Peter; Keogh, Anne; Kotlyar, Eugene; Granger, Emily; Dhital, Kumud; Spratt, Phillip; Jansz, Paul; Hayward, Christopher S

2014-08-01

The aim of this study was to determine the contribution of pre-load and heart rate to pump flow in patients implanted with continuous-flow left ventricular assist devices (cfLVADs). Although it is known that cfLVAD pump flow increases with exercise, it is unclear if this increment is driven by increased heart rate, augmented intrinsic ventricular contraction, or enhanced venous return. Two studies were performed in patients implanted with the HeartWare HVAD. In 11 patients, paced heart rate was increased to approximately 40 beats/min above baseline and then down to approximately 30 beats/min below baseline pacing rate (in pacemaker-dependent patients). Ten patients underwent tilt-table testing at 30°, 60°, and 80° passive head-up tilt for 3 min and then for a further 3 min after ankle flexion exercise. This regimen was repeated at 20° passive head-down tilt. Pump parameters, noninvasive hemodynamics, and 2-dimensional echocardiographic measures were recorded. Heart rate alteration by pacing did not affect LVAD flows or LV dimensions. LVAD pump flow decreased from baseline 4.9 ± 0.6 l/min to approximately 4.5 ± 0.5 l/min at each level of head-up tilt (p < 0.0001 analysis of variance). With active ankle flexion, LVAD flow returned to baseline. There was no significant change in flow with a 20° head-down tilt with or without ankle flexion exercise. There were no suction events. Centrifugal cfLVAD flows are not significantly affected by changes in heart rate, but they change significantly with body position and passive filling. Previously demonstrated exercise-induced changes in pump flows may be related to altered loading conditions, rather than changes in heart rate. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE)

PubMed Central

Tian, Xin; Li, Zengyuan; Chen, Erxue; Liu, Qinhuo; Yan, Guangjian; Wang, Jindi; Niu, Zheng; Zhao, Shaojie; Li, Xin; Pang, Yong; Su, Zhongbo; van der Tol, Christiaan; Liu, Qingwang; Wu, Chaoyang; Xiao, Qing; Yang, Le; Mu, Xihan; Bo, Yanchen; Qu, Yonghua; Zhou, Hongmin; Gao, Shuai; Chai, Linna; Huang, Huaguo; Fan, Wenjie; Li, Shihua; Bai, Junhua; Jiang, Lingmei; Zhou, Ji

2015-01-01

The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE) comprises a network of remote sensing experiments designed to enhance the dynamic analysis and modeling of remotely sensed information for complex land surfaces. Two types of experimental campaigns were established under the framework of COMPLICATE. The first was designed for continuous and elaborate experiments. The experimental strategy helps enhance our understanding of the radiative and scattering mechanisms of soil and vegetation and modeling of remotely sensed information for complex land surfaces. To validate the methodologies and models for dynamic analyses of remote sensing for complex land surfaces, the second campaign consisted of simultaneous satellite-borne, airborne, and ground-based experiments. During field campaigns, several continuous and intensive observations were obtained. Measurements were undertaken to answer key scientific issues, as follows: 1) Determine the characteristics of spatial heterogeneity and the radiative and scattering mechanisms of remote sensing on complex land surfaces. 2) Determine the mechanisms of spatial and temporal scale extensions for remote sensing on complex land surfaces. 3) Determine synergist inversion mechanisms for soil and vegetation parameters using multi-mode remote sensing on complex land surfaces. Here, we introduce the background, the objectives, the experimental designs, the observations and measurements, and the overall advances of COMPLICATE. As a result of the implementation of COMLICATE and for the next several years, we expect to contribute to quantitative remote sensing science and Earth observation techniques. PMID:26332035

Continuous Cardiac Troponin I Release in Fabry Disease

PubMed Central

Schneider, Christian; Sieweke, Nicole; Franzen, Wolfgang; Gündüz, Dursun; Rolfs, Arndt

2014-01-01

Background Fabry disease (FD) is a rare lysosomal storage disorder also affecting the heart. The aims of this study were to determine the frequency of cardiac troponin I (cTNI) elevation, a sensitive parameter reflecting myocardial damage, in a smaller cohort of FD-patients, and to analyze whether persistent cTNI can be a suitable biomarker to assess cardiac dysfunction in FD. Methods cTNI values were determined at least twice per year in 14 FD-patients (6 males and 8 females) regularly followed-up in our centre. The data were related to other parameters of heart function including cardiac magnetic resonance imaging (cMRI). Results Three patients (21%) without specific vascular risk factors other than FD had persistent cTNI-elevations (range 0.05–0.71 ng/ml, normal: <0.01). cMRI disclosed late gadolinium enhancement (LGE) in all three individuals with cTNI values ≥0.01, while none of the 11 patients with cTNI <0.01 showed a pathological enhancement (p<0.01). Two subjects with increased cTNI-values underwent coronary angiography, excluding relevant stenoses. A myocardial biopsy performed in one during this procedure demonstrated substantial accumulation of globotriaosylceramide (Gb3) in cardiomyocytes. Conclusion Continuous cTNI elevation seems to occur in a substantial proportion of patients with FD. The high accordance with LGE, reflecting cardiac dysfunction, suggests that cTNI-elevation can be a useful laboratory parameter for assessing myocardial damage in FD. PMID:24626231

Obstructive sleep apnea alters sleep stage transition dynamics.

PubMed

Bianchi, Matt T; Cash, Sydney S; Mietus, Joseph; Peng, Chung-Kang; Thomas, Robert

2010-06-28

Enhanced characterization of sleep architecture, compared with routine polysomnographic metrics such as stage percentages and sleep efficiency, may improve the predictive phenotyping of fragmented sleep. One approach involves using stage transition analysis to characterize sleep continuity. We analyzed hypnograms from Sleep Heart Health Study (SHHS) participants using the following stage designations: wake after sleep onset (WASO), non-rapid eye movement (NREM) sleep, and REM sleep. We show that individual patient hypnograms contain insufficient number of bouts to adequately describe the transition kinetics, necessitating pooling of data. We compared a control group of individuals free of medications, obstructive sleep apnea (OSA), medical co-morbidities, or sleepiness (n = 374) with mild (n = 496) or severe OSA (n = 338). WASO, REM sleep, and NREM sleep bout durations exhibited multi-exponential temporal dynamics. The presence of OSA accelerated the "decay" rate of NREM and REM sleep bouts, resulting in instability manifesting as shorter bouts and increased number of stage transitions. For WASO bouts, previously attributed to a power law process, a multi-exponential decay described the data well. Simulations demonstrated that a multi-exponential process can mimic a power law distribution. OSA alters sleep architecture dynamics by decreasing the temporal stability of NREM and REM sleep bouts. Multi-exponential fitting is superior to routine mono-exponential fitting, and may thus provide improved predictive metrics of sleep continuity. However, because a single night of sleep contains insufficient transitions to characterize these dynamics, extended monitoring of sleep, probably at home, would be necessary for individualized clinical application.

Cardiac Light-Sheet Fluorescent Microscopy for Multi-Scale and Rapid Imaging of Architecture and Function

NASA Astrophysics Data System (ADS)

Fei, Peng; Lee, Juhyun; Packard, René R. Sevag; Sereti, Konstantina-Ioanna; Xu, Hao; Ma, Jianguo; Ding, Yichen; Kang, Hanul; Chen, Harrison; Sung, Kevin; Kulkarni, Rajan; Ardehali, Reza; Kuo, C.-C. Jay; Xu, Xiaolei; Ho, Chih-Ming; Hsiai, Tzung K.

2016-03-01

Light Sheet Fluorescence Microscopy (LSFM) enables multi-dimensional and multi-scale imaging via illuminating specimens with a separate thin sheet of laser. It allows rapid plane illumination for reduced photo-damage and superior axial resolution and contrast. We hereby demonstrate cardiac LSFM (c-LSFM) imaging to assess the functional architecture of zebrafish embryos with a retrospective cardiac synchronization algorithm for four-dimensional reconstruction (3-D space + time). By combining our approach with tissue clearing techniques, we reveal the entire cardiac structures and hypertrabeculation of adult zebrafish hearts in response to doxorubicin treatment. By integrating the resolution enhancement technique with c-LSFM to increase the resolving power under a large field-of-view, we demonstrate the use of low power objective to resolve the entire architecture of large-scale neonatal mouse hearts, revealing the helical orientation of individual myocardial fibers. Therefore, our c-LSFM imaging approach provides multi-scale visualization of architecture and function to drive cardiovascular research with translational implication in congenital heart diseases.

Right Ventricular Failure Post LVAD Implantation Corrected with Biventricular Support: An In Vitro Model.

PubMed

Shehab, Sajad; Allida, Sabine M; Davidson, Patricia M; Newton, Phillip J; Robson, Desiree; Jansz, Paul C; Hayward, Christopher S

Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system. Our hypothesis was that delayed continuous flow RVAD (RVAD) would produce similar hemodynamic and flow parameters to those of initial BiVAD support. Using the MCL, baseline biventricular heart failure with elevated right and left filling pressures with low cardiac output was simulated. The addition of LVAD within a biventricular configuration improved cardiac output somewhat, but was associated with persistent right heart failure with elevated right-sided filling pressures. The addition of an RVAD significantly improved LVAD outputs and returned filling pressures to normal throughout the circulation. In conclusion, RVAD support successfully restored hemodynamics and flow parameters of biventricular failure supported with isolated LVAD with persistent elevated right atrial pressure.

Simultaneous multi-depth assessment of tissue oxygen saturation in thenar and forearm using near-infrared spectroscopy during a simple cardiovascular challenge

PubMed Central

2009-01-01

Introduction Hypovolemia and hypovolemic shock are life-threatening conditions that occur in numerous clinical scenarios. Near-infrared spectroscopy (NIRS) has been widely explored, successfully and unsuccessfully, in an attempt to use it as an early detector of hypovolemia by measuring tissue oxygen saturation (StO2). In order to investigate the measurement site dependence and probe dependence of NIRS in response to hemodynamic changes, such as hypovolemia, we applied a simple cardiovascular challenge: a posture change from supine to upright, causing a decrease in stroke volume (as in hypovolemia) and a heart rate increase in combination with peripheral vasoconstriction to maintain adequate blood pressure. Methods Multi-depth NIRS was used in nine healthy volunteers to assess changes in StO2 in the thenar and forearm in response to the hemodynamic changes associated with a posture change from supine to upright. Results A posture change from supine to upright resulted in a significant increase (P < 0.001) in heart rate. Thenar StO2 did not respond to the hemodynamic changes following the posture change, whereas forearm StO2 did. Forearm StO2 was significantly lower (P < 0.001) in the upright position compared to supine for all probing depths. Conclusions The primary findings in this study were that forearm StO2 is a more sensitive parameter to hemodynamic changes than thenar StO2 and that the depth at which StO2 is measured is of minor influence. Our data support the use of forearm StO2 as a sensitive parameter for the detection of central hypovolemia and hypovolemic shock in (trauma) patients. PMID:19951389

Contribution of the Arterial System and the Heart to Blood Pressure during Normal Aging - A Simulation Study.

PubMed

Maksuti, Elira; Westerhof, Nico; Westerhof, Berend E; Broomé, Michael; Stergiopulos, Nikos

2016-01-01

During aging, systolic blood pressure continuously increases over time, whereas diastolic pressure first increases and then slightly decreases after middle age. These pressure changes are usually explained by changes of the arterial system alone (increase in arterial stiffness and vascular resistance). However, we hypothesise that the heart contributes to the age-related blood pressure progression as well. In the present study we quantified the blood pressure changes in normal aging by using a Windkessel model for the arterial system and the time-varying elastance model for the heart, and compared the simulation results with data from the Framingham Heart Study. Parameters representing arterial changes (resistance and stiffness) during aging were based on literature values, whereas parameters representing cardiac changes were computed through physiological rules (compensated hypertrophy and preservation of end-diastolic volume). When taking into account arterial changes only, the systolic and diastolic pressure did not agree well with the population data. Between 20 and 80 years, systolic pressure increased from 100 to 122 mmHg, and diastolic pressure decreased from 76 to 55 mmHg. When taking cardiac adaptations into account as well, systolic and diastolic pressure increased from 100 to 151 mmHg and decreased from 76 to 69 mmHg, respectively. Our results show that not only the arterial system, but also the heart, contributes to the changes in blood pressure during aging. The changes in arterial properties initiate a systolic pressure increase, which in turn initiates a cardiac remodelling process that further augments systolic pressure and mitigates the decrease in diastolic pressure.

Cardiac volumetry in patients with heart failure and reduced ejection fraction: a comparative study correlating multi-slice computed tomography and magnetic resonance tomography. Reasons for intermodal disagreement.

PubMed

Schroeder, Janina; Peterschroeder, Andreas; Vaske, Bernhard; Butz, Thomas; Barth, Peter; Oldenburg, Olaf; Bitter, Thomas; Burchert, Wolfgang; Horstkotte, Dieter; Langer, Christoph

2009-11-01

In humans with normal hearts multi-slice computed tomography (MSCT) based volumetry was shown to correlate well with the gold standard, cardiac magnetic resonance imaging (CMR). We correlated both techniques in patients with various degrees of heart failure and reduced ejection fraction (HFREF) resulting from cardiac dilatation. Twenty-four patients with a left ventricular enddiastolic volume (LV-EDV) of C 150 ml measured by angiography underwent MSCT and CMR scanning for left and right ventricular (LV, RV) volumetry. MSCT based short cardiac axis views were obtained beginning at the cardiac base advancing to the apex. These were reconstructed in 20 different time windows of the RR-interval (0-95%) serving for identification of enddiastole (ED) and end-systole (ES) and for planimetry. ED and ES volumes and the ejection fraction (EF) were calculated for LV and RV. MSCT based volumetry was compared with CMR. MSCT based LV volumetry significantly correlates with CMR as follows: LV-EDV r = 0.94, LV-ESV r = 0.98 and LV-EF r = 0.93, but significantly overestimates LV-EDV and LV-ESV and underestimates EF (P \\ 0.0001). MSCT based RV volumetry significantly correlates with CMR as follows: RV-EDV r = 0.79, RVESV r = 0.78 and RV-EF r = 0.73, but again significantly overestimates RV-EDV and RV-ESV and underestimates RV-EF (P \\ 0.0001). When compared with CMR a continuous overestimation of volumes and underestimation of EF needs to be considered when applying MSCT in HFREF patients.

Consensus for second-order multi-agent systems with position sampled data

NASA Astrophysics Data System (ADS)

Wang, Rusheng; Gao, Lixin; Chen, Wenhai; Dai, Dameng

2016-10-01

In this paper, the consensus problem with position sampled data for second-order multi-agent systems is investigated. The interaction topology among the agents is depicted by a directed graph. The full-order and reduced-order observers with position sampled data are proposed, by which two kinds of sampled data-based consensus protocols are constructed. With the provided sampled protocols, the consensus convergence analysis of a continuous-time multi-agent system is equivalently transformed into that of a discrete-time system. Then, by using matrix theory and a sampled control analysis method, some sufficient and necessary consensus conditions based on the coupling parameters, spectrum of the Laplacian matrix and sampling period are obtained. While the sampling period tends to zero, our established necessary and sufficient conditions are degenerated to the continuous-time protocol case, which are consistent with the existing result for the continuous-time case. Finally, the effectiveness of our established results is illustrated by a simple simulation example. Project supported by the Natural Science Foundation of Zhejiang Province, China (Grant No. LY13F030005) and the National Natural Science Foundation of China (Grant No. 61501331).

Generalized model of electromigration with 1:1 (analyte:selector) complexation stoichiometry: part I. Theory.

PubMed

Dubský, Pavel; Müllerová, Ludmila; Dvořák, Martin; Gaš, Bohuslav

2015-03-06

The model of electromigration of a multivalent weak acidic/basic/amphoteric analyte that undergoes complexation with a mixture of selectors is introduced. The model provides an extension of the series of models starting with the single-selector model without dissociation by Wren and Rowe in 1992, continuing with the monovalent weak analyte/single-selector model by Rawjee, Williams and Vigh in 1993 and that by Lelièvre in 1994, and ending with the multi-selector overall model without dissociation developed by our group in 2008. The new multivalent analyte multi-selector model shows that the effective mobility of the analyte obeys the original Wren and Row's formula. The overall complexation constant, mobility of the free analyte and mobility of complex can be measured and used in a standard way. The mathematical expressions for the overall parameters are provided. We further demonstrate mathematically that the pH dependent parameters for weak analytes can be simply used as an input into the multi-selector overall model and, in reverse, the multi-selector overall parameters can serve as an input into the pH-dependent models for the weak analytes. These findings can greatly simplify the rationale method development in analytical electrophoresis, specifically enantioseparations. Copyright © 2015 Elsevier B.V. All rights reserved.

Using Generalizability Analysis to Estimate Parameters for Anatomy Assessments: A Multi-institutional Study

ERIC Educational Resources Information Center

Byram, Jessica N.; Seifert, Mark F.; Brooks, William S.; Fraser-Cotlin, Laura; Thorp, Laura E.; Williams, James M.; Wilson, Adam B.

2017-01-01

With integrated curricula and multidisciplinary assessments becoming more prevalent in medical education, there is a continued need for educational research to explore the advantages, consequences, and challenges of integration practices. This retrospective analysis investigated the number of items needed to reliably assess anatomical knowledge in…

Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis.

PubMed

Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

2012-10-01

Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if self-reported early menopause (menopause at an age <46 y) identifies women as at risk for future coronary heart disease or stroke. The study population came from the Multi-Ethnic Study of Atherosclerosis, a longitudinal, ethnically diverse cohort study of US men and women aged 45 to 84 years enrolled in 2000-2002 and followed up until 2008. The association between a personal history of early menopause (either natural menopause or surgical removal of ovaries at an age <46 y) and future coronary heart disease and stroke was assessed in 2,509 women (ages 45-84 y; 987 white, 331 Chinese, 641 black, and 550 Hispanic) from the Multi-ethnic Study Atherosclerosis who were free of cardiovascular disease at baseline. Of 2,509 women, 693 (28%) reported either surgical or natural early menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank P = 0.008 and P = 0.0158). In models adjusted for age, race/ethnicity, Multi-ethnic Study Atherosclerosis site, and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (hazard ratio, 2.08; 95% CI, 1.17-3.70; and hazard ratio, 2.19; 95% CI, 1.11-4.32, respectively). Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors.

Early Menopause Predicts Future Coronary Heart Disease and Stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

2012-01-01

Objective Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if a self-reported early menopause (menopause at an age <46) identifies women as at risk for future coronary heart disease or stroke. Methods The study population came from the Multi-Ethnic Study of Atherosclerosis, a longitudinal, ethnically diverse cohort study of US men and women aged 45 to 84 years enrolled in 2000–2002 and followed up until 2008. The association between a personal history of early menopause (either natural menopause or surgical removal of ovaries at an age <46) and future coronary heart disease and stroke was assessed in 2509 women (ages 45–84, 987 White, 331 Chinese, 641 Black, 550 Hispanic) from the Multi-Ethnic Study Atherosclerosis, who were free of cardiovascular disease at baseline. Results 693/2509 (28%) of women reported either surgical or natural early menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank p=<0.008 and 0.0158). In models adjusted for age, race/ethnicity, Multi-Ethnic Study Atherosclerosis site and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (HR 2.08, 95% CI 1.17, 3.70 and 2.19, 95% CI 1.11, 4.32, respectively). Conclusions Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors. PMID:22692332

SVM-Based Spectral Analysis for Heart Rate from Multi-Channel WPPG Sensor Signals.

PubMed

Xiong, Jiping; Cai, Lisang; Wang, Fei; He, Xiaowei

2017-03-03

Although wrist-type photoplethysmographic (hereafter referred to as WPPG) sensor signals can measure heart rate quite conveniently, the subjects' hand movements can cause strong motion artifacts, and then the motion artifacts will heavily contaminate WPPG signals. Hence, it is challenging for us to accurately estimate heart rate from WPPG signals during intense physical activities. The WWPG method has attracted more attention thanks to the popularity of wrist-worn wearable devices. In this paper, a mixed approach called Mix-SVM is proposed, it can use multi-channel WPPG sensor signals and simultaneous acceleration signals to measurement heart rate. Firstly, we combine the principle component analysis and adaptive filter to remove a part of the motion artifacts. Due to the strong relativity between motion artifacts and acceleration signals, the further denoising problem is regarded as a sparse signals reconstruction problem. Then, we use a spectrum subtraction method to eliminate motion artifacts effectively. Finally, the spectral peak corresponding to heart rate is sought by an SVM-based spectral analysis method. Through the public PPG database in the 2015 IEEE Signal Processing Cup, we acquire the experimental results, i.e., the average absolute error was 1.01 beat per minute, and the Pearson correlation was 0.9972. These results also confirm that the proposed Mix-SVM approach has potential for multi-channel WPPG-based heart rate estimation in the presence of intense physical exercise.

Perceptions of seniors with heart failure regarding autonomous zero-effort monitoring of physiological parameters in the smart-home environment.

PubMed

Grace, Sherry L; Taherzadeh, Golnoush; Jae Chang, Isaac Sung; Boger, Jennifer; Arcelus, Amaya; Mak, Susanna; Chessex, Caroline; Mihailidis, Alex

Technological advances are leading to the ability to autonomously monitor patient's health status in their own homes, to enable aging-in-place. To understand the perceptions of seniors with heart failure (HF) regarding smart-home systems to monitor their physiological parameters. In this qualitative study, HF outpatients were invited to a smart-home lab, where they completed a sequence of activities, during which the capacity of 5 autonomous sensing modalities was compared to gold standard measures. Afterwards, a semi-structured interview was undertaken. These were transcribed and analyzed using an interpretive-descriptive approach. Five themes emerged from the 26 interviews: (1) perceptions of technology, (2) perceived benefits of autonomous health monitoring, (3) disadvantages of autonomous monitoring, (4) lack of perceived need for continuous health monitoring, and (5) preferences for autonomous monitoring. Patient perception towards autonomous monitoring devices was positive, lending credence to zero-effort technology as a viable and promising approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Research on fatigue driving pre-warning system based on multi-information fusion

NASA Astrophysics Data System (ADS)

Zhao, Xuyang; Ye, Wenwu

2018-05-01

With the development of science and technology, transportation network has grown faster. But at the same time, the quantity of traffic accidents due to fatigue driving grows faster as well. In the meantime, fatigue driving has been one of the main causes of traffic accidents. Therefore, it is indispensable for us to study the detection of fatigue driving to help to driving safety. There are numerous approaches in discrimination method. Each type of method has its reasonable theoretical basis, but the disadvantages of traditional fatigue driving detection methods have been more and more obvious since we study the traditional physiology and psychological features of fatigue drivers. So we set up a new system based on multi-information fusion and pattern recognition theory. In the paper, the fatigue driving pre-warning system discriminates fatigue by analyzing the characteristic parameters, the parameters derived from the steering wheel angle, the driver's power of gripping and the heart rate. And the data analysis system is established based on fuzzy C-means clustering theory. Finally, KNN classifier is used to establish the relation between feature indexes and fatigue degree. It is verified that the system has the better accuracy, agility and robustness according to our confirmatory experiment.

Multivariable Parametric Cost Model for Ground Optical Telescope Assembly

NASA Technical Reports Server (NTRS)

Stahl, H. Philip; Rowell, Ginger Holmes; Reese, Gayle; Byberg, Alicia

2005-01-01

A parametric cost model for ground-based telescopes is developed using multivariable statistical analysis of both engineering and performance parameters. While diameter continues to be the dominant cost driver, diffraction-limited wavelength is found to be a secondary driver. Other parameters such as radius of curvature are examined. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e., multi-telescope phased-array systems). Additionally, single variable models Based on aperture diameter are derived.

Progression of Coronary Artery Calcium and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis.

PubMed

Bakhshi, Hooman; Ambale-Venkatesh, Bharath; Yang, Xiaoying; Ostovaneh, Mohammad R; Wu, Colin O; Budoff, Matthew; Bahrami, Hossein; Wong, Nathan D; Bluemke, David A; Lima, João A C

2017-04-20

Although the association between coronary artery calcium (CAC) and future heart failure (HF) has been shown previously, the value of CAC progression in the prediction of HF has not been investigated. In this study, we investigated the association of CAC progression with subclinical left ventricular (LV) dysfunction and incident HF in the Multi-Ethnic Study of Atherosclerosis. The Multi-Ethnic Study of Atherosclerosis is a population-based study consisting of 6814 men and women aged 45 to 84, free of overt cardiovascular disease at enrollment, who were recruited from 4 ethnicities. We included 5644 Multi-Ethnic Study of Atherosclerosis participants who had baseline and follow-up cardiac computed tomography and were free of HF and coronary heart disease before the second cardiac computed tomography. Mean (±SD) age was 61.7±10.2 years and 47.2% were male. The Cox proportional hazard models and multivariable linear regression models were deployed to determine the association of CAC progression with incident HF and subclinical LV dysfunction, respectively. Over a median follow-up of 9.6 (interquartile range: 8.8-10.6) years, 182 participants developed incident HF. CAC progression of 10 units per year was associated with 3% of increased risk of HF independent of overt coronary heart disease ( P =0.008). In 2818 participants with available cardiac magnetic resonance images, CAC progression was associated with increased LV end diastolic volume (β=0.16; P =0.03) and LV end systolic volume (β=0.12; P =0.006) after excluding participants with any coronary heart disease. CAC progression was associated with incident HF and modestly increased LV end diastolic volume and LV end systolic volume at follow-up exam independent of overt coronary heart disease. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Evaluation of a transient, simultaneous, arbitrary Lagrange-Euler based multi-physics method for simulating the mitral heart valve.

PubMed

Espino, Daniel M; Shepherd, Duncan E T; Hukins, David W L

2014-01-01

A transient multi-physics model of the mitral heart valve has been developed, which allows simultaneous calculation of fluid flow and structural deformation. A recently developed contact method has been applied to enable simulation of systole (the stage when blood pressure is elevated within the heart to pump blood to the body). The geometry was simplified to represent the mitral valve within the heart walls in two dimensions. Only the mitral valve undergoes deformation. A moving arbitrary Lagrange-Euler mesh is used to allow true fluid-structure interaction (FSI). The FSI model requires blood flow to induce valve closure by inducing strains in the region of 10-20%. Model predictions were found to be consistent with existing literature and will undergo further development.

Multi-Ethnic Study of Atherosclerosis (MESA) - Ancillary Eye Study

ClinicalTrials.gov

2016-02-05

Atherosclerosis; Cardiovascular Diseases; Coronary Arteriosclerosis; Coronary Disease; Cerebrovascular Disorders; Heart Failure, Congestive; Myocardial Infarction; Heart Diseases; Diabetes Mellitus, Non-insulin Dependent; Hypertension; Diabetic Retinopathy; Macular Degeneration; Diabetes Mellitus

Is 50 Hz high enough ECG sampling frequency for accurate HRV analysis?

PubMed

Mahdiani, Shadi; Jeyhani, Vala; Peltokangas, Mikko; Vehkaoja, Antti

2015-01-01

With the worldwide growth of mobile wireless technologies, healthcare services can be provided at anytime and anywhere. Usage of wearable wireless physiological monitoring system has been extensively increasing during the last decade. These mobile devices can continuously measure e.g. the heart activity and wirelessly transfer the data to the mobile phone of the patient. One of the significant restrictions for these devices is usage of energy, which leads to requiring low sampling rate. This article is presented in order to investigate the lowest adequate sampling frequency of ECG signal, for achieving accurate enough time domain heart rate variability (HRV) parameters. For this purpose the ECG signals originally measured with high 5 kHz sampling rate were down-sampled to simulate the measurement with lower sampling rate. Down-sampling loses information, decreases temporal accuracy, which was then restored by interpolating the signals to their original sampling rates. The HRV parameters obtained from the ECG signals with lower sampling rates were compared. The results represent that even when the sampling rate of ECG signal is equal to 50 Hz, the HRV parameters are almost accurate with a reasonable error.

Results of the post-market Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE).

PubMed

Strueber, Martin; Larbalestier, Robert; Jansz, Paul; Zimpfer, Daniel; Fiane, Arnt E; Tsui, Steven; Simon, André; Schmitto, Jan D; Khaghani, Asghar; Wieselthaler, George M; Najarian, Kevin; Schueler, Stephan

2014-05-01

The post-market Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE) is an investigator-initiated registry established to collect post-CE Mark Trial clinical data on patients receiving a HeartWare ventricular assist device (HVAD) in the European Union and Australia. The ReVOLVE is a multi-center, prospective, single-arm registry performed at seven centers in Europe and two in Australia. Herein we describe a total of 254 commercial HVAD implants according to labeled indications between February 2009 and November 2012. Summary statistics included patients' demographics, adverse events, length of support and outcomes. Compared with the clinical trial supporting the CE Mark of the HeartWare system, patient selection differed in that patients were older, and there were higher proportions of females and patients with idiopathic cardiomyopathies in the ReVOLVE cohort. Duration of support ranged from 1 to 1,057 days, with a mean of 363 ± 280 days (median 299.5 days). Transplantation was done in 56 patients (22%), explant for recovery was performed in 3 patients (1%), 43 died while on support (17%), and 152 (60%) remain on the device. Success in patients with the HeartWare system was 87% at 6 months, 85% at 1 year, 79% at 2 years and 73% at 3 years. Adverse event rates were low, comparable or improved when compared to the CE Mark Trial. Real-world use of the HeartWare system continues to demonstrate excellent clinical outcomes in patients supported with the device. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Diurnal changes in the power spectral characteristics of eye movements and heart rate variability in the human fetus at term.

PubMed

Morokuma, S; Horimoto, N; Nakano, H

2001-08-01

It is well known that 1/f characteristics in power spectral patterns exist in various biological factors including heart rate variability. In the present study, we tried to elucidate the diurnal variation in spectral properties of eye movement and heart rate variability in the human fetus at term, via continuous 24-h observation of both these parameters. Studied were five uncomplicated fetuses at term. We observed eye movement and fetal heart rate (FHR) with real-time ultrasound and Doppler cardiotocograph, respectively, and analyzed the diurnal change in spectral properties, using the maximum entropy method. In four of five cases, the slope values of power spectra for both eye movement frequency and FHR, ranging approximately between 0.5 and 1.8, indicated diurnal variation, where the slopes tended to have high values during the day and low values at night. These findings suggest that, in the human fetus at term, eye movement and FHR are under the control of a common central mechanism, and this center changes its complexity as seen through diurnal rhythm.

Effects of renin-angiotensin-aldosterone system inhibitors on mortality, hospitalization, and diastolic function in patients with HFpEF. A meta-analysis of 13 randomized controlled trials.

PubMed

Zhang, Q; Chen, Y; Liu, Q; Shan, Q

2016-02-01

The purpose of this meta-analysis was to evaluate the effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on mortality, hospitalization, diastolic function, and exercise capacity in heart failure with preserved ejection fraction (HFpEF). Thirteen randomized controlled trials (RCTs), totaling 12,532 patients with HFpEF, were selected. All-cause and cardiovascular mortality, all-cause and heart failure-related hospitalization, diastolic function, and the 6-min walk distance were assessed. The risk ratios (RR) of the dichotomous data, weighted mean difference (WMD) of continuous data, and 95 % confidence intervals (CI) were calculated to assess the effects of RAAS inhibitors. RAAS inhibitors significantly decreased heart failure-related hospitalization (RR 0.89; 95 % CI 0.82-0.97; p = 0.01) and improved the diastolic function, as reflected in a reduced E/e' index (MD -1.38; 95 % CI -2.01 to -0.74; p < 0.0001). However, there were no beneficial effects on all-cause cardiovascular mortality and all-cause hospitalization. Other diastolic parameters had few changes compared with the controls. The 6-min walk distance was not improved by the use of RAAS inhibitors. In patients with HFpEF, RAAS inhibitors decreased heart-failure hospitalization and the E/e' index without affecting mortality, all-cause hospitalization, other diastolic function parameters, and the 6-min walk distance.

[Assessment of exercise capacity in congenital heart disease].

PubMed

Bouzo-López, Raquel; González-Represas, Alicia

2016-01-01

For many years, the treatment of congenital heart diseases has been a field in which, based on the seriousness of these conditions, treatment options were viewed with the greatest deference. This has conditioned, in many cases, the interventions to be undertaken in each. In this sense, exercise was thought to have a negative impact and thus the practise of almost any physical activity was limited. Although there has recently been a change in the paradigm with respect to exercise, this idea continues to hold sway. For many cardiopathies, the information obtained through a stress test is essential in order to implement and supervise an exercise program. The aim of this study is to analyze the parameters within the stress test which allow for an adequate stratification of the risk to subjects with congenital heart diseases who undertake exercise, as well as their values in accordance with the type of pathology, the gravity of such, and the age of the patients. Furthermore, these parameters will be analyzed for both their survival markers and the protocols that can best be adjusted for patients with these characteristic. Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Computational models of aortic coarctation in hypoplastic left heart syndrome: considerations on validation of a detailed 3D model.

PubMed

Biglino, Giovanni; Corsini, Chiara; Schievano, Silvia; Dubini, Gabriele; Giardini, Alessandro; Hsia, Tain-Yen; Pennati, Giancarlo; Taylor, Andrew M

2014-05-01

Reliability of computational models for cardiovascular investigations strongly depends on their validation against physical data. This study aims to experimentally validate a computational model of complex congenital heart disease (i.e., surgically palliated hypoplastic left heart syndrome with aortic coarctation) thus demonstrating that hemodynamic information can be reliably extrapolated from the model for clinically meaningful investigations. A patient-specific aortic arch model was tested in a mock circulatory system and the same flow conditions were re-created in silico, by setting an appropriate lumped parameter network (LPN) attached to the same three-dimensional (3D) aortic model (i.e., multi-scale approach). The model included a modified Blalock-Taussig shunt and coarctation of the aorta. Different flow regimes were tested as well as the impact of uncertainty in viscosity. Computational flow and pressure results were in good agreement with the experimental signals, both qualitatively, in terms of the shape of the waveforms, and quantitatively (mean aortic pressure 62.3 vs. 65.1 mmHg, 4.8% difference; mean aortic flow 28.0 vs. 28.4% inlet flow, 1.4% difference; coarctation pressure drop 30.0 vs. 33.5 mmHg, 10.4% difference), proving the reliability of the numerical approach. It was observed that substantial changes in fluid viscosity or using a turbulent model in the numerical simulations did not significantly affect flows and pressures of the investigated physiology. Results highlighted how the non-linear fluid dynamic phenomena occurring in vitro must be properly described to ensure satisfactory agreement. This study presents methodological considerations for using experimental data to preliminarily set up a computational model, and then simulate a complex congenital physiology using a multi-scale approach.

QUest for the Arrhythmogenic Substrate of Atrial fibRillation in Patients Undergoing Cardiac Surgery (QUASAR Study): Rationale and Design.

PubMed

van der Does, Lisette J M E; Yaksh, Ameeta; Kik, Charles; Knops, Paul; Lanters, Eva A H; Teuwen, Christophe P; Oei, Frans B S; van de Woestijne, Pieter C; Bekkers, Jos A; Bogers, Ad J J C; Allessie, Maurits A; de Groot, Natasja M S

2016-06-01

The heterogeneous presentation and progression of atrial fibrillation (AF) implicate the existence of different pathophysiological processes. Individualized diagnosis and therapy of the arrhythmogenic substrate underlying AF may be required to improve treatment outcomes. Therefore, this single-center study aims to identify the arrhythmogenic areas underlying AF by intra-operative, high-resolution, multi-site epicardial mapping in 600 patients with different heart diseases. Participants are divided into 12 groups according to the underlying heart diseases and presence of prior AF episodes. Mapping is performed with a 192-electrode array for 5-10 s during sinus rhythm and (induced) AF of the entire atrial surface. Local activation times are converted into activation and wave maps from which various electrophysiological parameters are derived. Postoperative cardiac rhythm registrations and a 5-year follow-up will show the incidence of postoperative and persistent AF. This project provides the first step in the development of a tool for individual AF diagnosis and treatment.

In Situ Optical Mapping of Voltage and Calcium in the Heart

PubMed Central

Ewart, Paul; Ashley, Euan A.; Loew, Leslie M.; Kohl, Peter; Bollensdorff, Christian; Woods, Christopher E.

2012-01-01

Electroanatomic mapping the interrelation of intracardiac electrical activation with anatomic locations has become an important tool for clinical assessment of complex arrhythmias. Optical mapping of cardiac electrophysiology combines high spatiotemporal resolution of anatomy and physiological function with fast and simultaneous data acquisition. If applied to the clinical setting, this could improve both diagnostic potential and therapeutic efficacy of clinical arrhythmia interventions. The aim of this study was to explore this utility in vivo using a rat model. To this aim, we present a single-camera imaging and multiple light-emitting-diode illumination system that reduces economic and technical implementation hurdles to cardiac optical mapping. Combined with a red-shifted calcium dye and a new near-infrared voltage-sensitive dye, both suitable for use in blood-perfused tissue, we demonstrate the feasibility of in vivo multi-parametric imaging of the mammalian heart. Our approach combines recording of electrophysiologically-relevant parameters with observation of structural substrates and is adaptable, in principle, to trans-catheter percutaneous approaches. PMID:22876327

Ground-Based Telescope Parametric Cost Model

NASA Technical Reports Server (NTRS)

Stahl, H. Philip; Rowell, Ginger Holmes

2004-01-01

A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis, The model includes both engineering and performance parameters. While diameter continues to be the dominant cost driver, other significant factors include primary mirror radius of curvature and diffraction limited wavelength. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e.. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter are derived. This analysis indicates that recent mirror technology advances have indeed reduced the historical telescope cost curve.

Initial in vitro testing of a paediatric continuous-flow total artificial heart.

PubMed

Fukamachi, Kiyotaka; Karimov, Jamshid H; Horvath, David J; Sunagawa, Gengo; Byram, Nicole A; Kuban, Barry D; Moazami, Nader

2018-06-01

Mechanical circulatory support has become standard therapy for adult patients with end-stage heart failure; however, in paediatric patients with congenital heart disease, the options for chronic mechanical circulatory support are limited to paracorporeal devices or off-label use of devices intended for implantation in adults. Congenital heart disease and cardiomyopathy often involve both the left and right ventricles; in such cases, heart transplantation, a biventricular assist device or a total artificial heart is needed to adequately sustain both pulmonary and systemic circulations. We aimed to evaluate the in vitro performance of the initial prototype of our paediatric continuous-flow total artificial heart. The paediatric continuous-flow total artificial heart pump was downsized from the adult continuous-flow total artificial heart configuration by a scale factor of 0.70 (1/3 of total volume) to enable implantation in infants. System performance of this prototype was evaluated using the continuous-flow total artificial heart mock loop set to mimic paediatric circulation. We generated maps of pump performance and atrial pressure differences over a wide range of systemic vascular resistance/pulmonary vascular resistance and pump speeds. Performance data indicated left pump flow range of 0.4-4.7 l/min at 100 mmHg delta pressure. The left/right atrial pressure difference was maintained within ±5 mmHg with systemic vascular resistance/pulmonary vascular resistance ratios between 1.4 and 35, with/without pump speed modulation, verifying expected passive self-regulation of atrial pressure balance. The paediatric continuous-flow total artificial heart prototype met design requirements for self-regulation and performance; in vivo pump performance studies are ongoing.

An integrated approach to patient-specific predictive modeling for single ventricle heart palliation.

PubMed

Corsini, Chiara; Baker, Catriona; Kung, Ethan; Schievano, Silvia; Arbia, Gregory; Baretta, Alessia; Biglino, Giovanni; Migliavacca, Francesco; Dubini, Gabriele; Pennati, Giancarlo; Marsden, Alison; Vignon-Clementel, Irene; Taylor, Andrew; Hsia, Tain-Yen; Dorfman, Adam

2014-01-01

In patients with congenital heart disease and a single ventricle (SV), ventricular support of the circulation is inadequate, and staged palliative surgery (usually 3 stages) is needed for treatment. In the various palliative surgical stages individual differences in the circulation are important and patient-specific surgical planning is ideal. In this study, an integrated approach between clinicians and engineers has been developed, based on patient-specific multi-scale models, and is here applied to predict stage 2 surgical outcomes. This approach involves four distinct steps: (1) collection of pre-operative clinical data from a patient presenting for SV palliation, (2) construction of the pre-operative model, (3) creation of feasible virtual surgical options which couple a three-dimensional model of the surgical anatomy with a lumped parameter model (LPM) of the remainder of the circulation and (4) performance of post-operative simulations to aid clinical decision making. The pre-operative model is described, agreeing well with clinical flow tracings and mean pressures. Two surgical options (bi-directional Glenn and hemi-Fontan operations) are virtually performed and coupled to the pre-operative LPM, with the hemodynamics of both options reported. Results are validated against postoperative clinical data. Ultimately, this work represents the first patient-specific predictive modeling of stage 2 palliation using virtual surgery and closed-loop multi-scale modeling.

Effects of multi-directional vibrotactile feedback on vestibular-deficient postural performance during continuous multi-directional support surface perturbations.

PubMed

Sienko, K H; Balkwill, M D; Oddsson, L I E; Wall, C

2008-01-01

Single-axis vibrotactile feedback of trunk tilt provided in real-time has previously been shown to significantly reduce the root-mean-square (RMS) trunk sway in subjects with vestibular loss during single-axis perturbation. This research examines the effect of multi-directional vibrotactile feedback on postural sway during continuous multi-directional surface perturbations when the subjects' eyes are closed. Eight subjects with vestibular loss donned a multi-axis feedback device that mapped body tilt estimates onto their torsos with a 3-row by 16-column array of tactile actuators (tactors). Tactor row indicated tilt magnitude and tactor column indicated tilt direction. Root-mean-square trunk tilt, elliptical fits to trunk sway trajectory areas, percentage of time spent outside a no vibrotactile feedback zone, RMS center of pressure, and anchoring index parameters indicating intersegmental coordination were used to assess the efficacy of the multi-directional vibrotactile balance aid. Four tactor display configurations in addition to the tactors off configuration were evaluated. Subjects had significantly reduced RMS trunk sway, significantly smaller elliptical fits of the trajectory area, and spent significantly less time outside of the no feedback zone in the tactors on versus the tactors off configuration. Among the displays evaluated in this study, there was not an optimal tactor column configuration for standing tasks involving continuous surface perturbations. Furthermore, subjects performed worse when erroneous information was displayed. Therefore, a spatial resolution of 90 degrees (4 columns) seems to be as effective as a spatial resolution of 22.5 degrees (16 columns) for control of standing.

Relationships between QT interval and heart rate variability at rest and the covariates in healthy young adults.

PubMed

Arai, Kaori; Nakagawa, Yui; Iwata, Toyoto; Horiguchi, Hyogo; Murata, Katsuyuki

2013-01-01

To clarify the links between ECG QT-related parameters and heart rate variability (HRV) and the covariates possibly distorting them, the averaged RR and QT intervals in a single lead ECG were measured for 64 male and 86 female subjects aged 18-26. The QT index, defined by Rautaharju et al., in the young adults was not significantly related to any HRV parameters nor heart rate, but the Bazett's corrected QT (QTc) interval was associated negatively with the parasympathetic activity and positively with heart rate. No significant differences in the QTc interval, QT index or heart rate were seen between the men and women, but they significantly differed between both sexes after adjustment for possible covariates such as age and body mass index (BMI). Significant sex differences in parasympathetic parameters of the HRV were unchanged before and after the adjustment, but significant differences observed in the unadjusted sympathetic parameters disappeared after adjusting for covariates. Age, BMI and body fat percentage also were significant covariates affecting these ECG parameters. Consequently, QT index, unaffected by heart rate and HRV parameters, appears to be a more useful indicator than the QTc interval. Instead, the QT index and HRV parameters are recommended to be simultaneously measured in epidemiological research because they are probably complementary in assessing autonomic nervous function. Also, these parameters should be analyzed in men and women separately. Copyright © 2012 Elsevier B.V. All rights reserved.

Correlators in simultaneous measurement of non-commuting qubit observables

NASA Astrophysics Data System (ADS)

Atalaya, Juan; Hacohen-Gourgy, Shay; Martin, Leigh S.; Siddiqi, Irfan; Korotkov, Alexander N.

We consider simultaneous continuous measurement of non-commuting qubit observables and analyze multi-time correlators 〈i κ1 (t1) ^i κN (tN) 〉 for output signals i κ (t) from the detectors. Both informational (''spooky'') and phase backactions from cQED-type measurements with phase-sensitive amplifiers are taken into account. We find an excellent agreement between analytical results and experimental data for two-time correlators of the output signals from simultaneous measurement of qubit observables σx and σφ =σx cosφ +σy sinφ . The correlators can be used to extract small deviations of experimental parameters, e.g., phase backaction and residual Rabi frequency. The multi-time correlators are important in analysis of Bacon-Shor error correction/detection codes, operated with continuous measurements.

Heart involvement in cystic fibrosis: A specific cystic fibrosis-related myocardial changes?

PubMed

Labombarda, Fabien; Saloux, Eric; Brouard, Jacques; Bergot, Emmanuel; Milliez, Paul

2016-09-01

Cystic fibrosis is a complex multi-systemic chronic disease characterized by progressive organ dysfunction with development of fibrosis, possibly affecting the heart. Over the last four decades pathological, experimental, and clinical evidence points towards the existence of a specific myocardial involvement in cystic fibrosis. Multi-modality cardiac imaging, especially recent echocardiographic techniques, evidenced diastolic and/or systolic ventricular dysfunction in cystic fibrosis leading to the concept of a cystic fibrosis-related cardiomyopathy. Hypoxemia and inflammation are among the most important factors for heart involvement in cystic fibrosis. Cystic Fibrosis Transmembrane Regulator was found to be involved in the regulation of cardiomyocyte contraction and may also account for cystic fibrosis-related myocardial dysfunction. This review, mainly focused on echocardiographic studies, seeks to synthesize the existing literature for and against the existence of heart involvement in cystic fibrosis, its mechanisms and prognostic implications. Careful investigation of the heart function may be helpful for risk stratification and therapeutic decisions in patients with cystic fibrosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multi-Material Tissue Engineering Scaffold with Hierarchical Pore Architecture.

PubMed

Morgan, Kathy Ye; Sklaviadis, Demetra; Tochka, Zachary L; Fischer, Kristin M; Hearon, Keith; Morgan, Thomas D; Langer, Robert; Freed, Lisa E

2016-08-23

Multi-material polymer scaffolds with multiscale pore architectures were characterized and tested with vascular and heart cells as part of a platform for replacing damaged heart muscle. Vascular and muscle scaffolds were constructed from a new material, poly(limonene thioether) (PLT32i), which met the design criteria of slow biodegradability, elastomeric mechanical properties, and facile processing. The vascular-parenchymal interface was a poly(glycerol sebacate) (PGS) porous membrane that met different criteria of rapid biodegradability, high oxygen permeance, and high porosity. A hierarchical architecture of primary (macroscale) and secondary (microscale) pores was created by casting the PLT32i prepolymer onto sintered spheres of poly(methyl methacrylate) (PMMA) within precisely patterned molds followed by photocuring, de-molding, and leaching out the PMMA. Pre-fabricated polymer templates were cellularized, assembled, and perfused in order to engineer spatially organized, contractile heart tissue. Structural and functional analyses showed that the primary pores guided heart cell alignment and enabled robust perfusion while the secondary pores increased heart cell retention and reduced polymer volume fraction.

Relationships between heart rate and age, bodyweight and breed in 10,849 dogs.

PubMed

Hezzell, M J; Dennis, S G; Humm, K; Agee, L; Boswood, A

2013-06-01

To evaluate relationships between heart rate and clinical variables in healthy dogs and dogs examined at a referral hospital. Clinical data were extracted from the electronic patient records of a first opinion group (5000 healthy dogs) and a referral hospital (5849 dogs). Univariable and multi-variable general linear models were used to assess associations between heart rate and clinical characteristics. Separate multi-variable models were constructed for first opinion and referral populations. In healthy dogs, heart rate was negatively associated with bodyweight (P<0.001) but was higher in Chihuahuas. The mean difference in heart rate between a 5 and 55 kg dog was 10.5 beats per minute. In dogs presenting to a referral hospital, heart rate was negatively associated with bodyweight (P<0.001) and the following breeds; border collie, golden retriever, Labrador retriever, springer spaniel and West Highland white terrier and positively associated with age, admitting service (emergency and critical care, emergency first opinion and cardiology) and the following breeds; Cavalier King Charles spaniel, Staffordshire bull terrier and Yorkshire terrier. Bodyweight, age, breed and disease status all influence heart rate in dogs, although these factors account for a relatively small proportion of the overall variability in heart rate. © 2013 British Small Animal Veterinary Association.

Early in vivo experience with the pediatric continuous-flow total artificial heart.

PubMed

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Kuban, Barry D; Gao, Shengqiang; Dessoffy, Raymond; Fukamachi, Kiyotaka

2018-03-30

Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing. In acute studies, the P-CFTAH was implanted in 4 lambs (average weight: 28.7 ± 2.3 kg) via a median sternotomy under cardiopulmonary bypass. Pulmonary and systemic pump performance parameters were recorded. The experiments showed good anatomical fit and easy implantation, with an average aortic cross-clamp time of 98 ± 18 minutes. Baseline hemodynamics were stable in all 4 animals (pump speed: 3.4 ± 0.2 krpm; pump flow: 2.1 ± 0.9 liters/min; power: 3.0 ± 0.8 W; arterial pressure: 68 ± 10 mm Hg; left and right atrial pressures: 6 ± 1 mm Hg, for both). Any differences between left and right atrial pressures were maintained within the intended limit of ±5 mm Hg over a wide range of ratios of systemic-to-pulmonary vascular resistance (0.7 to 12), with and without pump-speed modulation. Pump-speed modulation was successfully performed to create arterial pulsation. This initial P-CFTAH prototype met the proposed requirements for self-regulation, performance, and pulse modulation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Immobilised enzyme microreactor for screening of multi-step bioconversions: characterisation of a de novo transketolase-ω-transaminase pathway to synthesise chiral amino alcohols.

PubMed

Matosevic, S; Lye, G J; Baganz, F

2011-09-20

Complex molecules are synthesised via a number of multi-step reactions in living cells. In this work, we describe the development of a continuous flow immobilized enzyme microreactor platform for use in evaluation of multi-step bioconversion pathways demonstrating a de novo transketolase/ω-transaminase-linked asymmetric amino alcohol synthesis. The prototype dual microreactor is based on the reversible attachment of His₆-tagged enzymes via Ni-NTA linkage to two surface derivatised capillaries connected in series. Kinetic parameters established for the model transketolase (TK)-catalysed conversion of lithium-hydroxypyruvate (Li-HPA) and glycolaldehyde (GA) to L-erythrulose using a continuous flow system with online monitoring of reaction output was in good agreement with kinetic parameters determined for TK in stop-flow mode. By coupling the transketolase catalysed chiral ketone forming reaction with the biocatalytic addition of an amine to the TK product using a transaminase (ω-TAm) it is possible to generate chiral amino alcohols from achiral starting compounds. We demonstrated this in a two-step configuration, where the TK reaction was followed by the ω-TAm-catalysed amination of L-erythrulose to synthesise 2-amino-1,3,4-butanetriol (ABT). Synthesis of the ABT product via the dual reaction and the on-line monitoring of each component provided a full profile of the de novo two-step bioconversion and demonstrated the utility of this microreactor system to provide in vitro multi-step pathway evaluation. Copyright © 2011 Elsevier B.V. All rights reserved.

Reverse design and characteristic study of multi-range HMCVT

NASA Astrophysics Data System (ADS)

Zhu, Zhen; Chen, Long; Zeng, Falin

2017-09-01

The reduction of fuel consumption and increase of transmission efficiency is one of the key problems of the agricultural machinery. Many promising technologies such as hydromechanical continuously variable transmissions (HMCVT) are the focus of research and investments, but there is little technical documentation that describes the design principle and presents the design parameters. This paper presents the design idea and characteristic study of HMCVT, in order to find out the suitable scheme for the big horsepower tractors. Analyzed the kinematics and dynamics of a large horsepower tractor, according to the characteristic parameters, a hydro-mechanical continuously variable transmission has been designed. Compared with the experimental curves and theoretical curves of the stepless speed regulation of transmission, the experimental result illustrates the rationality of the design scheme.

Heart failure: not a single organ disease but a multisystem syndrome.

PubMed

Warriner, David; Sheridan, Paul; Lawford, Patricia

2015-06-01

Heart failure is not simply a single organ disease; rather it is a complex multi-system clinical syndrome, with impairment of endocrine, haematological, musculoskeletal, renal, respiratory and vascular systems, which influence morbidity and mortality.

[The effectiveness of romifidine on myocardial function in horses with and without heart disease, evaluated with M-mode echocardiography and PW-tissue Doppler imaging].

PubMed

Nagel, Deborah; Gehlen, Heidrun

2013-01-01

The aim of this study was to evaluate to what extent the myocardial function in horses (measured by PW-tissue Doppler = PW-TDI) is affected during a sedation with romifidine (0.04 mg/kg, i. v.), particularly in case of an accompanying heart disease. Based on an echo- and electrocardiographic examination, a total of 45 horses was subdivided into group 1 (no heart disease), group 2 (heart disease without increased heart dimensions) and group 3 (heart disease with increased heart dimensions). Heart rate (HF), M-mode- (FS%) and TDI-measurements were performed before and after the application of romifidine. The velocities of the radial myocardial movement in the left and right ventricular wall were evaluated using PW-TDI. The TDI parameters included the isovolumic contraction (IVC), the systolic (S) as well as the early (E) and late diastolic maximal velocity (A). After the application of romifidine HF and FS were significantly decreased in all groups. IVC, S and E, determined by PW-TDI were also significantly decreased in both ventricular walls. A significant difference between groups was shown for the isovolumic contraction in the left ventricular wall. This was observed distinctly more in horses with heart disease and increased heart dimensions compared to horses with heart disease but no increased heart dimensions. The results of the study indicate that PW-TDI is a suitable imaging technique to analyse the effects of romifidine on equine myocardial function. The major percentage change after application of romifidine for TDI measurements compared to the M-mode parameters indicate that the parameter myocardial velocity measured with TDI appeared to be the most sensitive parameter to document romifidine--induced changes on the myocardium.

Relationship between RANKL and neuroendocrine activation in elderly males with heart failure.

PubMed

Loncar, Goran; Bozic, Biljana; Cvorovic, Vojkan; Radojicic, Zoran; Dimkovic, Sinisa; Markovic, Natasa; Prodanovic, Nenad; Lepic, Toplica; Putnikovic, Biljana; Popovic-Brkic, Vera

2010-02-01

The main cytokines regulating bone remodeling are the receptor activator of nuclear factor-κB ligand (RANKL) and its decoy receptor, osteoprotegerin (OPG). Recent data have linked RANKL and OPG to cardiovascular disease as well. NT-pro-BNP and adiponectin are well-established biomarkers of heart failure reflecting neuroendocrine activation in this multi-complex disorder. The objective of this article was to investigate whether RANKL is associated with neuroendocrine activation in 75 elderly males with mild to moderate congestive heart failure (CHF) and left ventricular ejection fraction <40%. The control group consisted of 20 healthy male volunteers with matching age and body mass index (BMI). Serum RANKL (sRANKL), OPG, NT-pro-BNP, adiponectin, leptin, clinical, and echocardiography parameters were evaluated. In comparison to the control group, the CHF patients showed significantly increased sRANKL levels [126.8 (122.6) vs. 47.8 (44.4) pg/ml, P < 0.0001]. There was a significant relative risk of systolic CHF in elderly males associated with increased sRANKL above the calculated cut-off of 83 pg/ml [OR = 10.286 (95%CI 3.079-34.356), P < 0.0001; RR = 3.600 (95%CI = 1.482-8.747)]. In the CHF patients, the log-transformed values of sRANKL levels correlated positively with the log-transformed values of the serum NT-pro-BNP and adiponectin levels (P = 0.004, r = 0.326 and P = 0.037, r = 0. 241, respectively), while inversely correlated with the BMI and creatinine clearance (P = 0.015, r = -0.281 and P = 0.042, r = -0.236, respectively). In multivariate regression model, sRANKL was a significant determinant of NT-pro-BNP independent of age, BMI and creatinine clearance (P = 0.002, R (2) = 0.546). In conclusion, our study suggests that in elderly males with systolic heart failure sRANKL was significantly associated with parameters of neuroendocrine activation such as NT-pro-BNP and adiponectin. Further studies are needed to elucidate the potential role of sRANKL in the complex pathogenesis of heart failure.

Accelerated Bayesian model-selection and parameter-estimation in continuous gravitational-wave searches with pulsar-timing arrays

NASA Astrophysics Data System (ADS)

Taylor, Stephen; Ellis, Justin; Gair, Jonathan

2014-11-01

We describe several new techniques which accelerate Bayesian searches for continuous gravitational-wave emission from supermassive black-hole binaries using pulsar-timing arrays. These techniques mitigate the problematic increase of search dimensionality with the size of the pulsar array which arises from having to include an extra parameter per pulsar as the array is expanded. This extra parameter corresponds to searching over the phase of the gravitational wave as it propagates past each pulsar so that we can coherently include the pulsar term in our search strategies. Our techniques make the analysis tractable with powerful evidence-evaluation packages like MultiNest. We find good agreement of our techniques with the parameter-estimation and Bayes factor evaluation performed with full signal templates and conclude that these techniques make excellent first-cut tools for detection and characterization of continuous gravitational-wave signals with pulsar-timing arrays. Crucially, at low to moderate signal-to-noise ratios the factor by which the analysis is sped up can be ≳100 , permitting rigorous programs of systematic injection and recovery of signals to establish robust detection criteria within a Bayesian formalism.

Diurnal variation of eye movement and heart rate variability in the human fetus at term.

PubMed

Morokuma, S; Horimoto, N; Satoh, S; Nakano, H

2001-07-01

To elucidate diurnal variations in eye movement and fetal heart rate (FHR) variability in the term fetus, we observed these two parameters continuously for 24 h, using real-time ultrasound and Doppler cardiotocograph, respectively. Studied were five uncomplicated fetuses at term. The time series data of the presence and absence of eye movement and mean FHR value for each 1 min were analyzed using the maximum entropy method (MEM) and subsequent nonlinear least squares fitting. According to the power value of eye movement, all five cases were classified into two groups: three cases in the large power group and two cases in the small power group. The acrophases of eye movement and FHR variability in the large power group were close, thereby implying the existence of a diurnal rhythm in both these parameters and also that they are synchronized. In the small power group, the acrophases were separated. The synchronization of eye movement and FHR variability in the large power group suggests that these phenomena are governed by a common central mechanism related to diurnal rhythm generation.

Cardiac risk index as a simple geometric indicator to select patients for the heart-sparing radiotherapy of left-sided breast cancer.

PubMed

Sung, KiHoon; Choi, Young Eun; Lee, Kyu Chan

2017-06-01

This is a dosimetric study to identify a simple geometric indicator to discriminate patients who meet the selection criterion for heart-sparing radiotherapy (RT). The authors proposed a cardiac risk index (CRI), directly measurable from the CT images at the time of scanning. Treatment plans were regenerated using the CT data of 312 consecutive patients with left-sided breast cancer. Dosimetric analysis was performed to estimate the risk of cardiac mortality using cardiac dosimetric parameters, such as the relative heart volumes receiving ≥25 Gy (heart V 25 ). For each CT data set, in-field heart depth (HD) and in-field heart width (HW) were measured to generate the geometric parameters, including maximum HW (HW max ) and maximum HD (HD max ). Seven geometric parameters were evaluated as candidates for CRI. Receiver operating characteristic (ROC) curve analyses were used to examine the overall discriminatory power of the geometric parameters to select high-risk patients (heart V 25  ≥ 10%). Seventy-one high-risk (22.8%) and 241 low-risk patients (77.2%) were identified by dosimetric analysis. The geometric and dosimetric parameters were significantly higher in the high-risk group. Heart V 25 showed the strong positive correlations with all geometric parameters examined (r > 0.8, p < 0.001). The product of HD max and HW max (CRI) revealed the largest area under the curve (AUC) value (0.969) and maintained 100% sensitivity and 88% specificity at the optimal cut-off value of 14.58 cm 2 . Cardiac risk index proposed as a simple geometric indicator to select high-risk patients provides useful guidance for clinicians considering optimal implementation of heart-sparing RT. © 2016 The Royal Australian and New Zealand College of Radiologists.

Predicting non-melanoma skin cancer via a multi-parameterized artificial neural network.

PubMed

Roffman, David; Hart, Gregory; Girardi, Michael; Ko, Christine J; Deng, Jun

2018-01-26

Ultraviolet radiation (UVR) exposure and family history are major associated risk factors for the development of non-melanoma skin cancer (NMSC). The objective of this study was to develop and validate a multi-parameterized artificial neural network based on available personal health information for early detection of NMSC with high sensitivity and specificity, even in the absence of known UVR exposure and family history. The 1997-2015 NHIS adult survey data used to train and validate our neural network (NN) comprised of 2,056 NMSC and 460,574 non-cancer cases. We extracted 13 parameters for our NN: gender, age, BMI, diabetic status, smoking status, emphysema, asthma, race, Hispanic ethnicity, hypertension, heart diseases, vigorous exercise habits, and history of stroke. This study yielded an area under the ROC curve of 0.81 and 0.81 for training and validation, respectively. Our results (training sensitivity 88.5% and specificity 62.2%, validation sensitivity 86.2% and specificity 62.7%) were comparable to a previous study of basal and squamous cell carcinoma prediction that also included UVR exposure and family history information. These results indicate that our NN is robust enough to make predictions, suggesting that we have identified novel associations and potential predictive parameters of NMSC.

Pacsin 2 is required for the maintenance of a normal cardiac function in the developing mouse heart.

PubMed

Semmler, Judith; Kormann, Jan; Srinivasan, Sureshkumar Perumal; Köster, Annette; Sälzer, Daniel; Reppel, Michael; Hescheler, Jürgen; Plomann, Markus; Nguemo, Filomain

2018-02-01

The Pacsin proteins (Pacsin 1, 2 and 3) play an important role in intracellular trafficking and thereby signal transduction in many cells types. This study was designed to examine the role of Pacsin 2 in cardiac development and function. We investigated the development and electrophysiological properties of Pacsin 2 knockout (P2KO) hearts and single cardiomyocytes isolated from 11.5 and 15.5days old fetal mice. Immunofluorescence experiments confirmed the lack of Pacsin 2 protein expression in P2KO cardiac myocytes in comparison to wildtype (WT). Western blotting demonstrates low expression levels of connexin 43 and T-box 3 proteins in P2KO compared to wildtype (WT). Electrophysiology measurements including online Multi-Electrode Array (MEA) based field potential (FP) recordings on isolated whole heart of P2KO mice showed a prolonged AV-conduction time. Patch clamp measurements of P2KO cardiomyocytes revealed differences in action potential (AP) parameters and decreased pacemaker funny channel (I f ), as well as L-type Ca 2+ channel (I CaL ), and sodium channel (I Na ). These findings demonstrate that Pacsin 2 is necessary for cardiac development and function in mouse embryos, which will enhance our knowledge to better understand the genesis of cardiovascular diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Analytic Approximations to the Free Boundary and Multi-dimensional Problems in Financial Derivatives Pricing

NASA Astrophysics Data System (ADS)

Lau, Chun Sing

This thesis studies two types of problems in financial derivatives pricing. The first type is the free boundary problem, which can be formulated as a partial differential equation (PDE) subject to a set of free boundary condition. Although the functional form of the free boundary condition is given explicitly, the location of the free boundary is unknown and can only be determined implicitly by imposing continuity conditions on the solution. Two specific problems are studied in details, namely the valuation of fixed-rate mortgages and CEV American options. The second type is the multi-dimensional problem, which involves multiple correlated stochastic variables and their governing PDE. One typical problem we focus on is the valuation of basket-spread options, whose underlying asset prices are driven by correlated geometric Brownian motions (GBMs). Analytic approximate solutions are derived for each of these three problems. For each of the two free boundary problems, we propose a parametric moving boundary to approximate the unknown free boundary, so that the original problem transforms into a moving boundary problem which can be solved analytically. The governing parameter of the moving boundary is determined by imposing the first derivative continuity condition on the solution. The analytic form of the solution allows the price and the hedging parameters to be computed very efficiently. When compared against the benchmark finite-difference method, the computational time is significantly reduced without compromising the accuracy. The multi-stage scheme further allows the approximate results to systematically converge to the benchmark results as one recasts the moving boundary into a piecewise smooth continuous function. For the multi-dimensional problem, we generalize the Kirk (1995) approximate two-asset spread option formula to the case of multi-asset basket-spread option. Since the final formula is in closed form, all the hedging parameters can also be derived in closed form. Numerical examples demonstrate that the pricing and hedging errors are in general less than 1% relative to the benchmark prices obtained by numerical integration or Monte Carlo simulation. By exploiting an explicit relationship between the option price and the underlying probability distribution, we further derive an approximate distribution function for the general basket-spread variable. It can be used to approximate the transition probability distribution of any linear combination of correlated GBMs. Finally, an implicit perturbation is applied to reduce the pricing errors by factors of up to 100. When compared against the existing methods, the basket-spread option formula coupled with the implicit perturbation turns out to be one of the most robust and accurate approximation methods.

Wearable sensors for health monitoring

NASA Astrophysics Data System (ADS)

Suciu, George; Butca, Cristina; Ochian, Adelina; Halunga, Simona

2015-02-01

In this paper we describe several wearable sensors, designed for monitoring the health condition of the patients, based on an experimental model. Wearable sensors enable long-term continuous physiological monitoring, which is important for the treatment and management of many chronic illnesses, neurological disorders, and mental health issues. The system is based on a wearable sensors network, which is connected to a computer or smartphone. The wearable sensor network integrates several wearable sensors that can measure different parameters such as body temperature, heart rate and carbon monoxide quantity from the air. After the portable sensors measuring parameter values, they are transmitted by microprocessor through the Bluetooth to the application developed on computer or smartphone, to be interpreted.

A multi-channel setup to study fractures in scintillators

NASA Astrophysics Data System (ADS)

Tantot, A.; Bouard, C.; Briche, R.; Lefèvre, G.; Manier, B.; Zaïm, N.; Deschanel, S.; Vanel, L.; Di Stefano, P. C. F.

2016-12-01

To investigate fractoluminescence in scintillating crystals used for particle detection, we have developed a multi-channel setup built around samples of double-cleavage drilled compression (DCDC) geometry in a controllable atmosphere. The setup allows the continuous digitization over hours of various parameters, including the applied load, and the compressive strain of the sample, as well as the acoustic emission. Emitted visible light is recorded with nanosecond resolution, and crack propagation is monitored using infrared lighting and camera. An example of application to \\text{B}{{\\text{i}}4}\\text{G}{{\\text{e}}3}{{\\text{O}}12} (BGO) is provided.

Dynamic modeling and parameter estimation of a radial and loop type distribution system network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jun Qui; Heng Chen; Girgis, A.A.

1993-05-01

This paper presents a new identification approach to three-phase power system modeling and model reduction taking power system network as multi-input, multi-output (MIMO) processes. The model estimate can be obtained in discrete-time input-output form, discrete- or continuous-time state-space variable form, or frequency-domain impedance transfer function matrix form. An algorithm for determining the model structure of this MIMO process is described. The effect of measurement noise on the approach is also discussed. This approach has been applied on a sample system and simulation results are also presented in this paper.

The year 2013 in the European Heart Journal--Cardiovascular Imaging: Part II.

PubMed

Plein, Sven; Edvardsen, Thor; Pierard, Luc A; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

2014-08-01

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in two articles. Part I of the review has summarized studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging. Part II is focussed on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Utilization of Expert Knowledge in a Multi-Objective Hydrologic Model Automatic Calibration Process

NASA Astrophysics Data System (ADS)

Quebbeman, J.; Park, G. H.; Carney, S.; Day, G. N.; Micheletty, P. D.

2016-12-01

Spatially distributed continuous simulation hydrologic models have a large number of parameters for potential adjustment during the calibration process. Traditional manual calibration approaches of such a modeling system is extremely laborious, which has historically motivated the use of automatic calibration procedures. With a large selection of model parameters, achieving high degrees of objective space fitness - measured with typical metrics such as Nash-Sutcliffe, Kling-Gupta, RMSE, etc. - can easily be achieved using a range of evolutionary algorithms. A concern with this approach is the high degree of compensatory calibration, with many similarly performing solutions, and yet grossly varying parameter set solutions. To help alleviate this concern, and mimic manual calibration processes, expert knowledge is proposed for inclusion within the multi-objective functions, which evaluates the parameter decision space. As a result, Pareto solutions are identified with high degrees of fitness, but also create parameter sets that maintain and utilize available expert knowledge resulting in more realistic and consistent solutions. This process was tested using the joint SNOW-17 and Sacramento Soil Moisture Accounting method (SAC-SMA) within the Animas River basin in Colorado. Three different elevation zones, each with a range of parameters, resulted in over 35 model parameters simultaneously calibrated. As a result, high degrees of fitness were achieved, in addition to the development of more realistic and consistent parameter sets such as those typically achieved during manual calibration procedures.

A novel device based on smart textile to control heart's activity during exercise.

PubMed

Romagnoli, Marco; Alis, Rafael; Guillen, Javier; Basterra, Javier; Villacastin, J P; Guillen, Sergio

2014-06-01

In recent years, several systems have been developed to control cardiac function during exercise, and some are also capable of recording RR data to provide heart rate variability (HRV) analyses. In this study we compare time between heart beats and HRV parameters obtained with a smart textile system (GOW; Weartech sl., Spain) and an electrocardiogram machine commonly used in hospitals during continuous cycling tests. Twelve cardiology patients performed a 30-min cycling test at stable submaximal intensity. RR interval data were recorded during the test by both systems. 3-min RR segments were taken to compare the time intervals between beats and HRV variables using Bland-Altman analyses and intraclass correlation coefficients. Limits of agreement (LoAs) on RR intervals were stable at around 3 ms (widest LoAs -5.754 to 6.094 ms, tightest LoAs -2.557 to 3.105 ms, medium LoAs -3.638 ± 0.812 to 3.145 ± 0.539 ms). HRV parameters related to short-term change presented wide LoAs (RMSSD -0.17 to 18.41 %, HF -17.64 to 33.21 %, SD1 -0.50 to 17.54 %) as an effect of the error measurement of the GOW system. The GOW system is a valid tool for controlling HR during physical activity, although its use as a clinical tool for HRV cannot be supported.

Right ventricular functional analysis utilizing first pass radionuclide angiography for pre-operative ventricular assist device planning: a multi-modality comparison.

PubMed

Avery, Ryan; Day, Kevin; Jokerst, Clinton; Kazui, Toshinobu; Krupinski, Elizabeth; Khalpey, Zain

2017-10-10

Advanced heart failure treated with a left ventricular assist device is associated with a higher risk of right heart failure. Many advanced heart failures patients are treated with an ICD, a relative contraindication to MRI, prior to assist device placement. Given this limitation, left and right ventricular function for patients with an ICD is calculated using radionuclide angiography utilizing planar multigated acquisition (MUGA) and first pass radionuclide angiography (FPRNA), respectively. Given the availability of MRI protocols that can accommodate patients with ICDs, we have correlated the findings of ventricular functional analysis using radionuclide angiography to cardiac MRI, the reference standard for ventricle function calculation, to directly correlate calculated ejection fractions between these modalities, and to also assess agreement between available echocardiographic and hemodynamic parameters of right ventricular function. A retrospective review from January 2012 through May 2014 was performed to identify advanced heart failure patients who underwent both cardiac MRI and radionuclide angiography for ventricular functional analysis. Nine heart failure patients (8 men, 1 woman; mean age of 57.0 years) were identified. The average time between the cardiac MRI and radionuclide angiography exams was 38.9 days (range: 1 - 119 days). All patients undergoing cardiac MRI were scanned using an institutionally approved protocol for ICD with no device-related complications identified. A retrospective chart review of each patient for cardiomyopathy diagnosis, clinical follow-up, and echocardiogram and right heart catheterization performed during evaluation was also performed. The 9 patients demonstrated a mean left ventricular ejection fraction (LVEF) using cardiac MRI of 20.7% (12 - 40%). Mean LVEF using MUGA was 22.6% (12 - 49%). The mean right ventricular ejection fraction (RVEF) utilizing cardiac MRI was 28.3% (16 - 43%), and the mean RVEF calculated by FPRNA was 32.6% (9 - 56%). The mean discrepancy for LVEF between cardiac MRI and MUGA was 4.1% (0 - 9%), and correlation of calculated LVEF using cardiac MRI and MUGA demonstrated an R of 0.9. The mean discrepancy for RVEF between cardiac MRI and FPRNA was 12.0% (range: 2 - 24%) with a moderate correlation (R = 0.5). The increased discrepancies for RV analysis were statistically significant using an unpaired t-test (t = 3.19, p = 0.0061). Echocardiogram parameters of RV function, including TAPSE and FAC, were for available for all 9 patients and agreement with cardiac MRI demonstrated a kappa statistic for TAPSE of 0.39 (95% CI of 0.06 - 0.72) and for FAC of 0.64 (95% of 0.21 - 1.00). Heart failure patients are increasingly requiring left ventricular assist device placement; however, definitive evaluation of biventricular function is required due to the increased mortality rate associated with right heart failure after assist device placement. Our results suggest that FPRNA only has a moderate correlation with reference standard RVEFs calculated using cardiac MRI, which was similar to calculated agreements between cardiac MRI and echocardiographic parameters of right ventricular function. Given the need for identification of patients at risk for right heart failure, further studies are warranted to determine a more accurate estimate of RVEF for heart failure patients during pre-operative ventricular assist device planning.

A measure of the auditory-perceptual quality of strain from electroglottographic analysis of continuous dysphonic speech: Application to adductor spasmodic dysphonia

PubMed Central

Somanath, Keerthan; Mau, Ted

2016-01-01

Objectives (1) To develop an automated algorithm to analyze electroglottographic (EGG) signal in continuous, dysphonic speech, and (2) to identify EGG waveform parameters that correlate with the auditory-perceptual quality of strain in the speech of patients with adductor spasmodic dysphonia (ADSD). Study Design Software development with application in a prospective controlled study. Methods EGG was recorded from 12 normal speakers and 12 subjects with ADSD reading excerpts from the Rainbow Passage. Data were processed by a new algorithm developed with the specific goal of analyzing continuous dysphonic speech. The contact quotient (CQ), pulse width (EGGW), a new parameter peak skew, and various contact closing slope quotient (SC) and contact opening slope quotient (SO) measures were extracted. EGG parameters were compared between normal and ADSD speech. Within the ADSD group, intra-subject comparison was also made between perceptually strained syllables and unstrained syllables. Results The opening slope quotient SO7525 distinguished strained syllables from unstrained syllables in continuous speech within individual ADSD subjects. The standard deviations, but not the means, of CQ, EGGW50, peak skew, and SO7525 were different between normal and ADSD speakers. The strain-stress pattern in continuous speech can be visualized as color gradients based on the variation of EGG parameter values. Conclusions EGG parameters may provide a within-subject measure of vocal strain and serve as a marker for treatment response. The addition of EGG to multi-dimensional assessment may lead to improved characterization of the voice disturbance in ADSD. PMID:26739857

Influence of geomagnetic activity and earth weather changes on heart rate and blood pressure in young and healthy population

NASA Astrophysics Data System (ADS)

Ozheredov, V. A.; Chibisov, S. M.; Blagonravov, M. L.; Khodorovich, N. A.; Demurov, E. A.; Goryachev, V. A.; Kharlitskaya, E. V.; Eremina, I. S.; Meladze, Z. A.

2017-05-01

There are many references in the literature related to connection between the space weather and the state of human organism. The search of external factors influence on humans is a multi-factor problem and it is well known that humans have a meteo-sensitivity. A direct problem of finding the earth weather conditions, under which the space weather manifests itself most strongly, is discussed in the present work for the first time in the helio-biology. From a formal point of view, this problem requires identification of subset (magnetobiotropic region) in three-dimensional earth's weather parameters such as pressure, temperature, and humidity, corresponding to the days when the human body is the most sensitive to changes in the geomagnetic field variations and when it reacts by statistically significant increase (or decrease) of a particular physiological parameter. This formulation defines the optimization of the problem, and the solution of the latter is not possible without the involvement of powerful metaheuristic methods of searching. Using the algorithm of differential evolution, we prove the existence of magnetobiotropic regions in the earth's weather parameters, which exhibit magneto-sensitivity of systolic, diastolic blood pressure, and heart rate of healthy young subjects for three weather areas (combinations of atmospheric temperature, pressure, and humidity). The maximum value of the correlation confidence for the measurements attributable to the days of the weather conditions that fall into each of three magnetobiotropic areas is an order of 0.006, that is almost 10 times less than the confidence, equal to 0.05, accepted in many helio-biological researches.

Influence of geomagnetic activity and earth weather changes on heart rate and blood pressure in young and healthy population.

PubMed

Ozheredov, V A; Chibisov, S M; Blagonravov, M L; Khodorovich, N A; Demurov, E A; Goryachev, V A; Kharlitskaya, E V; Eremina, I S; Meladze, Z A

2017-05-01

There are many references in the literature related to connection between the space weather and the state of human organism. The search of external factors influence on humans is a multi-factor problem and it is well known that humans have a meteo-sensitivity. A direct problem of finding the earth weather conditions, under which the space weather manifests itself most strongly, is discussed in the present work for the first time in the helio-biology. From a formal point of view, this problem requires identification of subset (magnetobiotropic region) in three-dimensional earth's weather parameters such as pressure, temperature, and humidity, corresponding to the days when the human body is the most sensitive to changes in the geomagnetic field variations and when it reacts by statistically significant increase (or decrease) of a particular physiological parameter. This formulation defines the optimization of the problem, and the solution of the latter is not possible without the involvement of powerful metaheuristic methods of searching. Using the algorithm of differential evolution, we prove the existence of magnetobiotropic regions in the earth's weather parameters, which exhibit magneto-sensitivity of systolic, diastolic blood pressure, and heart rate of healthy young subjects for three weather areas (combinations of atmospheric temperature, pressure, and humidity). The maximum value of the correlation confidence for the measurements attributable to the days of the weather conditions that fall into each of three magnetobiotropic areas is an order of 0.006, that is almost 10 times less than the confidence, equal to 0.05, accepted in many helio-biological researches.

A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial.

PubMed

Black, Jeanne T; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D; Ganiats, Theodore G; Greenfield, Sheldon; Kaplan, Sherrie H; Ong, Michael K

2014-04-13

Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure. ClinicalTrials.gov # NCT01360203.

Spectral and multi-wavelength continuous-wave laser properties of Yb3+:BaLaGa3O7

NASA Astrophysics Data System (ADS)

Gao, Shufang; Xu, Shan

2018-05-01

Yb3+ doped BaLaGa3O7 crystal has been successfully grown by Czochralski method. The polarized absorption spectra, the fluorescence spectra and the fluorescence decay lifetime of Yb3+:BaLaGa3O7 crystal were measured at room temperature. The spectroscopic parameters of Yb3+:BaLaGa3O7 crystal are calculated. A continuous wave output power of 1.32W was obtained with four-wavelength emission corresponding to an optical-optical slope efficiency of 55%.

High Spatial Resolution Multi-Organ Finite Element Modeling of Ventricular-Arterial Coupling

PubMed Central

Shavik, Sheikh Mohammad; Jiang, Zhenxiang; Baek, Seungik; Lee, Lik Chuan

2018-01-01

While it has long been recognized that bi-directional interaction between the heart and the vasculature plays a critical role in the proper functioning of the cardiovascular system, a comprehensive study of this interaction has largely been hampered by a lack of modeling framework capable of simultaneously accommodating high-resolution models of the heart and vasculature. Here, we address this issue and present a computational modeling framework that couples finite element (FE) models of the left ventricle (LV) and aorta to elucidate ventricular—arterial coupling in the systemic circulation. We show in a baseline simulation that the framework predictions of (1) LV pressure—volume loop, (2) aorta pressure—diameter relationship, (3) pressure—waveforms of the aorta, LV, and left atrium (LA) over the cardiac cycle are consistent with the physiological measurements found in healthy human. To develop insights of ventricular-arterial interactions, the framework was then used to simulate how alterations in the geometrical or, material parameter(s) of the aorta affect the LV and vice versa. We show that changing the geometry and microstructure of the aorta model in the framework led to changes in the functional behaviors of both LV and aorta that are consistent with experimental observations. On the other hand, changing contractility and passive stiffness of the LV model in the framework also produced changes in both the LV and aorta functional behaviors that are consistent with physiology principles. PMID:29551977

A Multi-Route Model of Nicotine-Cotinine Pharmacokinetics, Pharmacodynamics and Brain Nicotinic Acetylcholine Receptor Binding in Humans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teeguarden, Justin G.; Housand, Conrad; Smith, Jordan N.

The pharmacokinetics of nicotine, the pharmacologically active alkaloid in tobacco responsible for addiction, are well characterized in humans. We developed a physiologically based pharmacokinetic/pharmacodynamic model of nicotine pharmacokinetics, brain dosimetry and brain nicotinic acetylcholine receptor (nAChRs) occupancy. A Bayesian framework was applied to optimize model parameters against multiple human data sets. The resulting model was consistent with both calibration and test data sets, but in general underestimated variability. A pharmacodynamic model relating nicotine levels to increases in heart rate as a proxy for the pharmacological effects of nicotine accurately described the nicotine related changes in heart rate and the developmentmore » and decay of tolerance to nicotine. The PBPK model was utilized to quantitatively capture the combined impact of variation in physiological and metabolic parameters, nicotine availability and smoking compensation on the change in number of cigarettes smoked and toxicant exposure in a population of 10,000 people presented with a reduced toxicant (50%), reduced nicotine (50%) cigarette Across the population, toxicant exposure is reduced in some but not all smokers. Reductions are not in proportion to reductions in toxicant yields, largely due to partial compensation in response to reduced nicotine yields. This framework can be used as a key element of a dosimetry-driven risk assessment strategy for cigarette smoke constituents.« less

Epigenome-Wide Association Study Identifies Cardiac Gene Patterning and a Novel Class of Biomarkers for Heart Failure.

PubMed

Meder, Benjamin; Haas, Jan; Sedaghat-Hamedani, Farbod; Kayvanpour, Elham; Frese, Karen; Lai, Alan; Nietsch, Rouven; Scheiner, Christina; Mester, Stefan; Bordalo, Diana Martins; Amr, Ali; Dietrich, Carsten; Pils, Dietmar; Siede, Dominik; Hund, Hauke; Bauer, Andrea; Holzer, Daniel Benjamin; Ruhparwar, Arjang; Mueller-Hennessen, Matthias; Weichenhan, Dieter; Plass, Christoph; Weis, Tanja; Backs, Johannes; Wuerstle, Maximilian; Keller, Andreas; Katus, Hugo A; Posch, Andreas E

2017-10-17

Biochemical DNA modification resembles a crucial regulatory layer among genetic information, environmental factors, and the transcriptome. To identify epigenetic susceptibility regions and novel biomarkers linked to myocardial dysfunction and heart failure, we performed the first multi-omics study in myocardial tissue and blood of patients with dilated cardiomyopathy and controls. Infinium human methylation 450 was used for high-density epigenome-wide mapping of DNA methylation in left-ventricular biopsies and whole peripheral blood of living probands. RNA deep sequencing was performed on the same samples in parallel. Whole-genome sequencing of all patients allowed exclusion of promiscuous genotype-induced methylation calls. In the screening stage, we detected 59 epigenetic loci that are significantly associated with dilated cardiomyopathy (false discovery corrected P ≤0.05), with 3 of them reaching epigenome-wide significance at P ≤5×10 -8 . Twenty-seven (46%) of these loci could be replicated in independent cohorts, underlining the role of epigenetic regulation of key cardiac transcription regulators. Using a staged multi-omics study design, we link a subset of 517 epigenetic loci with dilated cardiomyopathy and cardiac gene expression. Furthermore, we identified distinct epigenetic methylation patterns that are conserved across tissues, rendering these CpGs novel epigenetic biomarkers for heart failure. The present study provides to our knowledge the first epigenome-wide association study in living patients with heart failure using a multi-omics approach. © 2017 American Heart Association, Inc.

Experimental Assessment of the Hydraulics of a Miniature Axial-Flow Left Ventricular Assist Device

NASA Astrophysics Data System (ADS)

Smith, P. Alex; Cohn, William; Metcalfe, Ralph

2017-11-01

A minimally invasive partial-support left ventricular assist device (LVAD) has been proposed with a flow path from the left atrium to the arterial system to reduce left ventricular stroke work. In LVAD design, peak and average efficiency must be balanced over the operating range to reduce blood trauma. Axial flow pumps have many geometric parameters. Until recently, testing all these parameters was impractical, but modern 3D printing technology enables multi-parameter studies. Following theoretical design, experimental hydraulic evaluation in steady state conditions examines pressure, flow, pressure-flow gradient, efficiency, torque, and axial force as output parameters. Preliminary results suggest that impeller blades and stator vanes with higher inlet angles than recommended by mean line theory (MLT) produce flatter gradients and broader efficiency curves, increasing compatibility with heart physiology. These blades also produce less axial force, which reduces bearing load. However, they require slightly higher torque, which is more demanding of the motor. MLT is a low order, empirical model developed on large pumps. It does not account for the significant viscous losses in small pumps like LVADs. This emphasizes the importance of experimental testing for hydraulic design. Roderick D MacDonald Research Fund.

Different surgical strategies for implantation of continuous-flow VADs—Experience from Deutsches Herzzentrum Berlin

PubMed Central

Drews, Thorsten; Potapov, Evgenij; Weng, Yugo; Pasic, Miralem; Hetzer, Roland

2014-01-01

Objective This manuscript summarizes our surgical experience with the implantation of recent continuous-flow left ventricular assist devices (LVADs), with special emphasis on the HeartWare HVAD pump. Methods The HeartWare HVAD is, in our experience currently implanted in four different techniques: (I) “Classical” LVAD implantation with heart-lung machine and median sternotomy; (II) “Minimally-invasive” implantation without sternotomy and without heart-lung machine; (III) “Lateral implantation” to the descending aorta; (IV) Using two continuous-flow LVADs for implantable biventricular support. Results Five-hundred and four HeartWare HVADs have been implanted using the described techniques in our institution up to now. Conclusions The HeartWare HVAD is a versatile device. It has been found to be eminently suited to these four different modes of implantation. PMID:25452906

Wavelet extractor: A Bayesian well-tie and wavelet extraction program

NASA Astrophysics Data System (ADS)

Gunning, James; Glinsky, Michael E.

2006-06-01

We introduce a new open-source toolkit for the well-tie or wavelet extraction problem of estimating seismic wavelets from seismic data, time-to-depth information, and well-log suites. The wavelet extraction model is formulated as a Bayesian inverse problem, and the software will simultaneously estimate wavelet coefficients, other parameters associated with uncertainty in the time-to-depth mapping, positioning errors in the seismic imaging, and useful amplitude-variation-with-offset (AVO) related parameters in multi-stack extractions. It is capable of multi-well, multi-stack extractions, and uses continuous seismic data-cube interpolation to cope with the problem of arbitrary well paths. Velocity constraints in the form of checkshot data, interpreted markers, and sonic logs are integrated in a natural way. The Bayesian formulation allows computation of full posterior uncertainties of the model parameters, and the important problem of the uncertain wavelet span is addressed uses a multi-model posterior developed from Bayesian model selection theory. The wavelet extraction tool is distributed as part of the Delivery seismic inversion toolkit. A simple log and seismic viewing tool is included in the distribution. The code is written in Java, and thus platform independent, but the Seismic Unix (SU) data model makes the inversion particularly suited to Unix/Linux environments. It is a natural companion piece of software to Delivery, having the capacity to produce maximum likelihood wavelet and noise estimates, but will also be of significant utility to practitioners wanting to produce wavelet estimates for other inversion codes or purposes. The generation of full parameter uncertainties is a crucial function for workers wishing to investigate questions of wavelet stability before proceeding to more advanced inversion studies.

On the role of density and attenuation in 3D multi-parameter visco-acoustic VTI frequency-domain FWI: an OBC case study from the North Sea

NASA Astrophysics Data System (ADS)

Operto, S.; Miniussi, A.

2018-03-01

Three-dimensional frequency-domain full waveform inversion (FWI) is applied on North Sea wide-azimuth ocean-bottom cable data at low frequencies (≤ 10 Hz) to jointly update vertical wavespeed, density and quality factor Q in the visco-acoustic VTI approximation. We assess whether density and Q should be viewed as proxy to absorb artefacts resulting from approximate wave physics or are valuable for interpretation in presence of saturated sediments and gas. FWI is performed in the frequency domain to account for attenuation easily. Multi-parameter frequency-domain FWI is efficiently performed with a few discrete frequencies following a multi-scale frequency continuation. However, grouping a few frequencies during each multi-scale step is necessary to mitigate acquisition footprint and match dispersive shallow guided waves. Q and density absorb a significant part of the acquisition footprint hence cleaning the velocity model from this pollution. Low Q perturbations correlate with low velocity zones associated with soft sediments and gas cloud. However, the amplitudes of the Q perturbations show significant variations when the inversion tuning is modified. This dispersion in the Q reconstructions is however not passed on the velocity parameter suggesting that cross-talks between first-order kinematic and second-order dynamic parameters are limited. The density model shows a good match with a well log at shallow depths. Moreover, the impedance built a posteriori from the FWI velocity and density models shows a well-focused image with however local differences with the velocity model near the sea bed where density might have absorbed elastic effects. The FWI models are finally assessed against time-domain synthetic seismogram modelling performed with the same frequency-domain modelling engine used for FWI.

Maximum sustained fin-kick thrust in underwater swimming.

PubMed

Yamaguchi, H; Shidara, F; Naraki, N; Mohri, M

1995-09-01

We examined the upper limit of a diver's fin-kick thrust force using a stationary-swimming ergometer. Heart rate, respiratory minute volume, oxygen uptake, and performance rate were measured in four male subjects who swam constantly for 8 min to maintain a horizontal position against an applied force at a depth of 0.7 m. The water temperature was controlled at 26 degrees +/- 1 degree C. The performance rate, which was the parameter of how well the subjects compensated for the applied load, showed an upper limit around 64 N of sustainable thrust force. This meant that the diver could generate the swimming thrust force within 64 N continuously for 8 min in a steady state. Heart rate, respiratory minute volume, and O2 uptake showed almost proportional increases to the applied load within 64 N and tended to plateau about 69 N.

Adding the ‘heart’ to hanging drop networks for microphysiological multi-tissue experiments†

PubMed Central

Yazdi, Saeed Rismani; Shadmani, Amir; Bürgel, Sebastian C.; Misun, Patrick M.; Hierlemann, Andreas; Frey, Olivier

2017-01-01

Microfluidic hanging-drop networks enable culturing and analysis of 3D microtissue spheroids derived from different cell types under controlled perfusion and investigating inter-tissue communication in multi-tissue formats. In this paper we introduce a compact on-chip pumping approach for flow control in hanging-drop networks. The pump includes one pneumatic chamber located directly above one of the hanging drops and uses the surface tension at the liquid–air-interface for flow actuation. Control of the pneumatic protocol provides a wide range of unidirectional pulsatile and continuous flow profiles. With the proposed concept several independent hanging-drop networks can be operated in parallel with only one single pneumatic actuation line at high fidelity. Closed-loop medium circulation between different organ models for multi-tissue formats and multiple simultaneous assays in parallel are possible. Finally, we implemented a real-time feedback control-loop of the pump actuation based on the beating of a human iPS-derived cardiac microtissue cultured in the same system. This configuration allows for simulating physiological effects on the heart and their impact on flow circulation between the organ models on chip. PMID:26401602

Integrating bio-prosthetic valves in the Fontan operation - Novel treatment to control retrograde flow in caval veins

NASA Astrophysics Data System (ADS)

Vukicevic, Marija; Conover, Timothy; Zhou, Jian; Hsia, Tain-Yen; Figliola, Richard

2012-11-01

For a child born with only one functional heart ventricle, the sequence of palliative surgeries typically culminates in the Fontan operation. This procedure is usually successful initially, but leads to later complications, for reasons not fully understood. Examples are respiratory-dependent retrograde flows in the caval and hepatic veins, and increased pulmonary vascular resistance (PVR), hypothesized to be responsible for elevated pressure in the liver and disease of the liver and intestines. Here we study the parameters responsible for retrograde flows in the inferior vena cava (IVC) and hepatic vein (HV), and investigate two novel interventions to control retrograde flow: implanting either a Medtronic Contegra valved conduit or an Edwards lifescience pericardial aortic valve in the IVC or HV. We performed the experiments in a multi-scale, patient specific mock circuit, with normal and elevated PVR, towards the optimization of the Fontan circulation. The results show that both valves can significantly reduce retrograde flows in the veins, suggesting potential advantages in the treatment of the patients with congenital heart diseases. Fondation Leducq

Improving the performance of AlGaN-based deep-ultraviolet light-emitting diodes using electron blocking layer with a heart-shaped graded Al composition

NASA Astrophysics Data System (ADS)

Kwon, M. R.; Park, T. H.; Lee, T. H.; Lee, B. R.; Kim, T. G.

2018-04-01

We propose a design for highly efficient AlGaN-based deep-ultraviolet light-emitting diodes (DUV LEDs) using a heart-shaped graded Al composition electron-blocking layer (EBL). This novel structure reduced downward band bending at the interface between the last quantum barrier and the EBL and flattened the electrostatic field in the interlayer between the barriers of the multi-quantum barrier EBL. Consequently, electron leakage was significantly suppressed and hole injection efficiency was found to have improved. The parameter values of simulation were extracted from the experimental data of the reference DUV LEDs. Using the SimuLED, we compared the electrical and optical properties of three structures with different Al compositions in the active region and the EBL. The internal quantum efficiency of the proposed structure was shown to exceed those of the reference DUV LEDs by a factor of 1.9. Additionally, the output power at 20 mA was found to increase by a factor of 2.1.

[The clinical economic analysis of the methods of ischemic heart disease diagnostics].

PubMed

Kalashnikov, V Iu; Mitriagina, S N; Syrkin, A L; Poltavskaia, M G; Sorokina, E G

2007-01-01

The clinical economical analysis was applied to assess the application of different techniques of ischemic heart disease diagnostics - the electro-cardiographic monitoring, the treadmill-testing, the stress-echo cardiographic with dobutamine, the single-photon computerized axial tomography with load, the multi-spiral computerized axial tomography with coronary arteries staining in patients with different initial probability of disease occurrence. In all groups, the best value of "cost-effectiveness" had the treadmill-test. The patients with low risk needed 17.4 rubles to precise the probability of ischemic heart disease occurrence at 1%. In the group with medium and high risk this indicator was 9.4 and 24.7 rubles correspondingly. It is concluded that to precise the probability of ischemic heart disease occurrence after tredmil-test in the patients with high probability it is appropriate to use the single-photon computerized axial tomography with load and in the case of patients with low probability the multi-spiral computerized axial tomography with coronary arteries staining.

A novel auto-tuning PID control mechanism for nonlinear systems.

PubMed

Cetin, Meric; Iplikci, Serdar

2015-09-01

In this paper, a novel Runge-Kutta (RK) discretization-based model-predictive auto-tuning proportional-integral-derivative controller (RK-PID) is introduced for the control of continuous-time nonlinear systems. The parameters of the PID controller are tuned using RK model of the system through prediction error-square minimization where the predicted information of tracking error provides an enhanced tuning of the parameters. Based on the model-predictive control (MPC) approach, the proposed mechanism provides necessary PID parameter adaptations while generating additive correction terms to assist the initially inadequate PID controller. Efficiency of the proposed mechanism has been tested on two experimental real-time systems: an unstable single-input single-output (SISO) nonlinear magnetic-levitation system and a nonlinear multi-input multi-output (MIMO) liquid-level system. RK-PID has been compared to standard PID, standard nonlinear MPC (NMPC), RK-MPC and conventional sliding-mode control (SMC) methods in terms of control performance, robustness, computational complexity and design issue. The proposed mechanism exhibits acceptable tuning and control performance with very small steady-state tracking errors, and provides very short settling time for parameter convergence. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Inhalation of ultrafine carbon particles alters heart rate and heart rate variability in people with type 2 diabetes.

PubMed

Vora, Rathin; Zareba, Wojciech; Utell, Mark J; Pietropaoli, Anthony P; Chalupa, David; Little, Erika L; Oakes, David; Bausch, Jan; Wiltshire, Jelani; Frampton, Mark W

2014-07-16

Diabetes may confer an increased risk for the cardiovascular health effects of particulate air pollution, but few human clinical studies of air pollution have included people with diabetes. Ultrafine particles (UFP, ≤100 nm in diameter) have been hypothesized to be an important component of particulate air pollution with regard to cardiovascular health effects. 17 never-smoker subjects 30-60 years of age, with stable type 2 diabetes but otherwise healthy, inhaled either filtered air (0-10 particles/cm3) or elemental carbon UFP (~107 particles/cm3, ~50 ug/m3, count median diameter 32 nm) by mouthpiece, for 2 hours at rest, in a double-blind, randomized, crossover study design. A digital 12-lead electrocardiogram (ECG) was recorded continuously for 48 hours, beginning 1 hour prior to exposure. Analysis of 5-minute segments of the ECG during quiet rest showed reduced high-frequency heart rate variability with UFP relative to air exposure (p = 0.014), paralleled by non-significant reductions in time-domain heart rate variability parameters. In the analysis of longer durations of the ECG, we found that UFP exposure increased the heart rate relative to air exposure. During the 21- to 45-hour interval after exposure, the average heart rate increased approximately 8 beats per minute with UFP, compared to 5 beats per minute with air (p = 0.045). There were no UFP effects on cardiac rhythm or repolarization. Inhalation of elemental carbon ultrafine particles alters heart rate and heart rate variability in people with type 2 diabetes. Our findings suggest that effects may occur and persist hours after a single 2-hour exposure.

Continuous micron-scaled rope engineering using a rotating multi-nozzle electrospinning emitter

NASA Astrophysics Data System (ADS)

Zhang, Chunchen; Gao, Chengcheng; Chang, Ming-Wei; Ahmad, Zeeshan; Li, Jing-Song

2016-10-01

Electrospinning (ES) enables simple production of fibers for broad applications (e.g., biomedical engineering, energy storage, and electronics). However, resulting structures are predominantly random; displaying significant disordered fiber entanglement, which inevitably gives rise to structural variations and reproducibility on the micron scale. Surface and structural features on this scale are critical for biomaterials, tissue engineering, and pharmaceutical sciences. In this letter, a modified ES technique using a rotating multi-nozzle emitter is developed and utilized to fabricate continuous micron-scaled polycaprolactone (PCL) ropes, providing control on fiber intercalation (twist) and structural order. Micron-scaled ropes comprising 312 twists per millimeter are generated, and rope diameter and pitch length are regulated using polymer concentration and process parameters. Electric field simulations confirm vector and distribution mechanisms, which influence fiber orientation and deposition during the process. The modified fabrication system provides much needed control on reproducibility and fiber entanglement which is crucial for electrospun biomedical materials.

Reliability of the Parabola Approximation Method in Heart Rate Variability Analysis Using Low-Sampling-Rate Photoplethysmography.

PubMed

Baek, Hyun Jae; Shin, JaeWook; Jin, Gunwoo; Cho, Jaegeol

2017-10-24

Photoplethysmographic signals are useful for heart rate variability analysis in practical ambulatory applications. While reducing the sampling rate of signals is an important consideration for modern wearable devices that enable 24/7 continuous monitoring, there have not been many studies that have investigated how to compensate the low timing resolution of low-sampling-rate signals for accurate heart rate variability analysis. In this study, we utilized the parabola approximation method and measured it against the conventional cubic spline interpolation method for the time, frequency, and nonlinear domain variables of heart rate variability. For each parameter, the intra-class correlation, standard error of measurement, Bland-Altman 95% limits of agreement and root mean squared relative error were presented. Also, elapsed time taken to compute each interpolation algorithm was investigated. The results indicated that parabola approximation is a simple, fast, and accurate algorithm-based method for compensating the low timing resolution of pulse beat intervals. In addition, the method showed comparable performance with the conventional cubic spline interpolation method. Even though the absolute value of the heart rate variability variables calculated using a signal sampled at 20 Hz were not exactly matched with those calculated using a reference signal sampled at 250 Hz, the parabola approximation method remains a good interpolation method for assessing trends in HRV measurements for low-power wearable applications.

World scientific collaboration in coronary heart disease research.

PubMed

Yu, Qi; Shao, Hongfang; He, Peifeng; Duan, Zhiguang

2013-08-10

Coronary heart disease (CHD) will continue to exert a heavy burden for countries all over the world. Scientific collaboration has become the only choice for progress in biomedicine. Unfortunately, there is a scarcity of scientific publications about scientific collaboration in CHD research. This study examines collaboration behaviors across multiple collaboration types in the CHD research. 294,756 records about CHD were retrieved from Web of Science. Methods such as co-authorship, social network analysis, connected component, cliques, and betweenness centrality were used in this study. Collaborations have increased at the author, institution and country/region levels in CHD research over the past three decades. 3000 most collaborative authors, 572 most collaborative institutions and 52 countries/regions are extracted from their corresponding collaboration network. 766 cliques are found in the most collaborative authors. 308 cliques are found in the most collaborative institutions. Western countries/regions represent the core of the world's collaboration. The United States ranks first in terms of number of multi-national publications, while Hungary leads in the ranking measured by their proportion of collaborative output. The rate of economic development in the countries/regions also affects the multi-national collaboration behavior. Collaborations among countries/regions need to be encouraged in the CHD research. The visualization of overlapping cliques in the most collaborative authors and institutions are considered "skeleton" of the collaboration network. Eastern countries/regions should strengthen cooperation with western countries/regions in the CHD research. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Cardiac imaging with multi-sector data acquisition in volumetric CT: variation of effective temporal resolution and its potential clinical consequences

NASA Astrophysics Data System (ADS)

Tang, Xiangyang; Hsieh, Jiang; Taha, Basel H.; Vass, Melissa L.; Seamans, John L.; Okerlund, Darin R.

2009-02-01

With increasing longitudinal detector dimension available in diagnostic volumetric CT, step-and-shoot scan is becoming popular for cardiac imaging. In comparison to helical scan, step-and-shoot scan decouples patient table movement from cardiac gating/triggering, which facilitates the cardiac imaging via multi-sector data acquisition, as well as the administration of inter-cycle heart beat variation (arrhythmia) and radiation dose efficiency. Ideally, a multi-sector data acquisition can improve temporal resolution at a factor the same as the number of sectors (best scenario). In reality, however, the effective temporal resolution is jointly determined by gantry rotation speed and patient heart beat rate, which may significantly lower than the ideal or no improvement (worst scenario). Hence, it is clinically relevant to investigate the behavior of effective temporal resolution in cardiac imaging with multi-sector data acquisition. In this study, a 5-second cine scan of a porcine heart, which cascades 6 porcine cardiac cycles, is acquired. In addition to theoretical analysis and motion phantom study, the clinical consequences due to the effective temporal resolution variation are evaluated qualitative or quantitatively. By employing a 2-sector image reconstruction strategy, a total of 15 (the permutation of P(6, 2)) cases between the best and worst scenarios are studied, providing informative guidance for the design and optimization of CT cardiac imaging in volumetric CT with multi-sector data acquisition.

WastePD, an innovative center on materials degradation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frankel, Gerald S.; Vienna, John; Lian, Jie

The US Department of Energy recently awarded funds to create the Center for Performance and Design of Nuclear Waste Forms and Containers (WastePD) as part of the Energy Frontier Research Center (EFRC) program. EFRCs are multi-investigator collaborations of universities, national labs and companies that “conduct fundamental research focusing on one or more “grand challenges” and use-inspired “basic research needs” identified in major strategic planning efforts by the scientific community.” The major performance parameter of nuclear waste forms is their ability to isolate the radionuclides by withstanding degradation in a repository environment over very long periods of time. So WastePD ismore » at heart a center focused on materials degradation.« less

Periodontitis in coronary heart disease patients: strong association between bleeding on probing and systemic biomarkers.

PubMed

Bokhari, Syed Akhtar H; Khan, Ayyaz A; Butt, Arshad K; Hanif, Mohammad; Izhar, Mateen; Tatakis, Dimitris N; Ashfaq, Mohammad

2014-11-01

Few studies have examined the relationship of individual periodontal parameters with individual systemic biomarkers. This study assessed the possible association between specific clinical parameters of periodontitis and systemic biomarkers of coronary heart disease risk in coronary heart disease patients with periodontitis. Angiographically proven coronary heart disease patients with periodontitis (n = 317), aged >30 years and without other systemic illness were examined. Periodontal clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) and systemic levels of high-sensitivity C-reactive protein (CRP), fibrinogen (FIB) and white blood cells (WBC) were noted and analyzed to identify associations through linear and stepwise multiple regression analyses. Unadjusted linear regression showed significant associations between periodontal and systemic parameters; the strongest association (r = 0.629; p < 0.001) was found between BOP and CRP levels, the periodontal and systemic inflammation marker, respectively. Stepwise regression analysis models revealed that BOP was a predictor of systemic CRP levels (p < 0.0001). BOP was the only periodontal parameter significantly associated with each systemic parameter (CRP, FIB, and WBC). In coronary heart disease patients with periodontitis, BOP is strongly associated with systemic CRP levels; this association possibly reflects the potential significance of the local periodontal inflammatory burden for systemic inflammation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Delayed heart rate recovery after exercise as a risk factor of incident type 2 diabetes mellitus after adjusting for glycometabolic parameters in men.

PubMed

Yu, Tae Yang; Jee, Jae Hwan; Bae, Ji Cheol; Hong, Won-Jung; Jin, Sang-Man; Kim, Jae Hyeon; Lee, Moon-Kyu

2016-10-15

Some studies have reported that delayed heart rate recovery (HRR) after exercise is associated with incident type 2 diabetes mellitus (T2DM). This study aimed to investigate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with the development of T2DM including glucose-associated parameters as an adjusting factor in healthy Korean men. Analyses including fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c as confounding factors and known confounders were performed. HRR was calculated as peak heart rate minus heart rate after a 1-min rest (HRR 1). Cox proportional hazards model was used to quantify the independent association between HRR and incident T2DM. During 9082 person-years of follow-up between 2006 and 2012, there were 180 (10.1%) incident cases of T2DM. After adjustment for age, BMI, systolic BP, diastolic BP, smoking status, peak heart rate, peak oxygen uptake, TG, LDL-C, HDL-C, fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c, the hazard ratios (HRs) [95% confidence interval (CI)] of incident T2DM comparing the second and third tertiles to the first tertile of HRR 1 were 0.867 (0.609-1.235) and 0.624 (0.426-0.915), respectively (p for trend=0.017). As a continuous variable, in the fully-adjusted model, the HR (95% CI) of incident T2DM associated with each 1 beat increase in HRR 1 was 0.980 (0.960-1.000) (p=0.048). This study demonstrated that delayed HRR after exercise predicts incident T2DM in men, even after adjusting for fasting glucose, HOMA-IR, HOMA-β, and HbA1c. However, only HRR 1 had clinical significance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Joint coverage probability in a simulation study on Continuous-Time Markov Chain parameter estimation.

PubMed

Benoit, Julia S; Chan, Wenyaw; Doody, Rachelle S

2015-01-01

Parameter dependency within data sets in simulation studies is common, especially in models such as Continuous-Time Markov Chains (CTMC). Additionally, the literature lacks a comprehensive examination of estimation performance for the likelihood-based general multi-state CTMC. Among studies attempting to assess the estimation, none have accounted for dependency among parameter estimates. The purpose of this research is twofold: 1) to develop a multivariate approach for assessing accuracy and precision for simulation studies 2) to add to the literature a comprehensive examination of the estimation of a general 3-state CTMC model. Simulation studies are conducted to analyze longitudinal data with a trinomial outcome using a CTMC with and without covariates. Measures of performance including bias, component-wise coverage probabilities, and joint coverage probabilities are calculated. An application is presented using Alzheimer's disease caregiver stress levels. Comparisons of joint and component-wise parameter estimates yield conflicting inferential results in simulations from models with and without covariates. In conclusion, caution should be taken when conducting simulation studies aiming to assess performance and choice of inference should properly reflect the purpose of the simulation.

Pulmonary arterial compliance: How and why should we measure it?

PubMed Central

Ghio, Stefano; Schirinzi, Sandra; Pica, Silvia

2015-01-01

The pulmonary circulation is a high-flow/low-pressure system, coupled with a flow generator chamber–the right ventricle–, which is relatively unable to tolerate increases in afterload. A right heart catheterization, using a fluid-filled, balloon-tipped Swan-Ganz catheter allows the measurement of all hemodynamic parameters characterizing the pulmonary circulation: the inflow pressure, an acceptable estimate the outflow pressure, and the pulmonary blood flow. However, the study of the pulmonary circulation as a continuous flow system is an oversimplification and a thorough evaluation of the pulmonary circulation requires a correct understanding of the load that the pulmonary vascular bed imposes on the right ventricle, which includes static and dynamic components. This is critical to assess the prognosis of patients with pulmonary hypertension or with heart failure. Pulmonary compliance is a measure of arterial distensibility and, either alone or in combination with pulmonary vascular resistance, gives clinicians the possibility of a good prognostic stratification of patients with heart failure or with pulmonary hypertension. The measurement of pulmonary arterial compliance should be included in the routine clinical evaluation of such patients. PMID:26779530

Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice.

PubMed

Venkatachalam, Sridhar; Wu, Geru; Ahmad, Masood

2017-12-01

The right ventricle has unique structural and functional characteristics. It is now well recognized that the so-called forgotten ventricle is a key player in cardiovascular physiology. Furthermore, there is accumulating evidence that demonstrates right ventricular dysfunction as an important marker of morbidity and mortality in several commonly encountered clinical situations such as heart failure, pulmonary hypertension, pulmonary embolism, right ventricular myocardial infarction, and adult congenital heart disease. In contrast to the left ventricle, echocardiographic assessment of right ventricular function is more challenging as volume estimations are not possible without the use of three-dimensional (3D) echocardiography. Guidelines on chamber quantification provide a standardized approach to assessment of the right ventricle. The technique and limitations of each of the parameters for RV size and function need to be fully understood. In this era of multimodality imaging, echocardiography continues to remain a useful tool for the initial assessment and follow-up of patients with right heart pathology. Several novel approaches such as 3D and strain imaging of the right ventricle have expanded the usefulness of this indispensable modality. © 2017, Wiley Periodicals, Inc.

[Design of hand-held heart rate variability acquisition and analysis system].

PubMed

Li, Kaiyuan; Wang, Buqing; Wang, Weidong

2012-07-01

A design of handheld heart rate variability acquisition and analysis system is proposed. The system collects and stores the patient's ECG every five minutes through both hands touching on the electrodes, and then -uploads data to a PC through USB port. The system uses software written in LabVIEW to analyze heart rate variability parameters, The parameters calculated function is programmed and generated to components in Matlab.

Estimation of body temperature rhythm based on heart activity parameters in daily life.

PubMed

Sooyoung Sim; Heenam Yoon; Hosuk Ryou; Kwangsuk Park

2014-01-01

Body temperature contains valuable health related information such as circadian rhythm and menstruation cycle. Also, it was discovered from previous studies that body temperature rhythm in daily life is related with sleep disorders and cognitive performances. However, monitoring body temperature with existing devices during daily life is not easy because they are invasive, intrusive, or expensive. Therefore, the technology which can accurately and nonintrusively monitor body temperature is required. In this study, we developed body temperature estimation model based on heart rate and heart rate variability parameters. Although this work was inspired by previous research, we originally identified that the model can be applied to body temperature monitoring in daily life. Also, we could find out that normalized Mean heart rate (nMHR) and frequency domain parameters of heart rate variability showed better performance than other parameters. Although we should validate the model with more number of subjects and consider additional algorithms to decrease the accumulated estimation error, we could verify the usefulness of this approach. Through this study, we expect that we would be able to monitor core body temperature and circadian rhythm from simple heart rate monitor. Then, we can obtain various health related information derived from daily body temperature rhythm.

The use of heart rate turbulence and heart rate variability in the assessment of autonomic regulation and circadian rhythm in patients with systemic lupus erythematosus without apparent heart disease.

PubMed

Poliwczak, A R; Waszczykowska, E; Dziankowska-Bartkowiak, B; Koziróg, M; Dworniak, K

2018-03-01

Background Systemic lupus erythematosus is a progressive autoimmune disease. There are reports suggesting that patients even without overt signs of cardiovascular complications have impaired autonomic function. The aim of this study was to assess autonomic function using heart rate turbulence and heart rate variability parameters indicated in 24-hour ECG Holter monitoring. Methods Twenty-six women with systemic lupus erythematosus and 30 healthy women were included. Twenty-four hour ambulatory ECG-Holter was performed in home conditions. The basic parameters of heart rate turbulence and heart rate variability were calculated. The analyses were performed for the entire day and separately for daytime activity and night time rest. Results There were no statistically significant differences in the basic anthropometric parameters. The mean duration of disease was 11.52 ± 7.42. There was a statistically significant higher turbulence onset (To) value in patients with systemic lupus erythematosus, median To = -0.17% (minimum -1.47, maximum 3.0) versus To = -1.36% (minimum -4.53, maximum -0.41), P < 0.001. There were no such differences for turbulence slope (Ts). In the 24-hour analysis almost all heart rate variability parameters were significantly lower in the systemic lupus erythematosus group than in the healthy controls, including SDANN and r-MSSD and p50NN. Concerning the morning activity and night resting periods, the results were similar as for the whole day. In the control group, higher values in morning activity were noted for parameters that characterise sympathetic activity, especially SDANN, and were significantly lower for parasympathetic parameters, including r-MSSD and p50NN, which prevailed at night. There were no statistically significant changes for systemic lupus erythematosus patients for p50NN and low and very low frequency. There was a positive correlation between disease duration and SDNN, R = 0.417; P < 0.05 and SDANN, R = 0.464; P < 0.05, a negative correlation between low/high frequency ratio and r-MSSD, R = -0.454; P < 0.05; p50NN, R = -0.435; P < 0.05 and high frequency, R = -0.478; P < 0.05. In contrast, there was no statistically significant correlation between heart rate turbulence and other variables evaluated, including disease duration and the type of autoantibodies. Our study confirms the presence of autonomic disorders with respect to both heart rate variability and heart rate turbulence parameters and the presence of diurnal disturbances of sympathetic-parasympathetic balance. Further studies are required.

Post-explant visualization of thrombi in outflow grafts and their junction to a continuous-flow total artificial heart using a high-definition miniaturized camera.

PubMed

Karimov, Jamshid H; Horvath, David; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-12-01

Post-explant evaluation of the continuous-flow total artificial heart in preclinical studies can be extremely challenging because of the device's unique architecture. Determining the exact location of tissue regeneration, neointima formation, and thrombus is particularly important. In this report, we describe our first successful experience with visualizing the Cleveland Clinic continuous-flow total artificial heart using a custom-made high-definition miniature camera.

Continuation of periodic orbits in the Sun-Mercury elliptic restricted three-body problem

NASA Astrophysics Data System (ADS)

Peng, Hao; Bai, Xiaoli; Xu, Shijie

2017-06-01

Starting from resonant Halo orbits in the Circular Restricted Three-Body Problem (CRTBP), Multi-revolution Elliptic Halo (ME-Halo) orbits around L1 and L2 points in the Sun-Mercury Elliptic Restricted Three-Body Problem (ERTBP) are generated systematically. Three pairs of resonant parameters M5N2, M7N3 and M9N4 are tested. The first pair shows special features and is investigated in detail. Three separated characteristic curves of periodic orbit around each libration point are obtained, showing the eccentricity varies non-monotonically along these curves. The eccentricity of the Sun-Mercury system can be achieved by continuation method in just a few cases. The stability analysis shows that these orbits are all unstable and the complex instability occurs with certain parameters. This paper shows new periodic orbits in both the CRTBP and the ERTBP. Totally four periodic orbits with parameters M5N2 around each libration points are extracted in the Sun-Mercury ERTBP.

Heart rate variability as determinism with jump stochastic parameters.

PubMed

Zheng, Jiongxuan; Skufca, Joseph D; Bollt, Erik M

2013-08-01

We use measured heart rate information (RR intervals) to develop a one-dimensional nonlinear map that describes short term deterministic behavior in the data. Our study suggests that there is a stochastic parameter with persistence which causes the heart rate and rhythm system to wander about a bifurcation point. We propose a modified circle map with a jump process noise term as a model which can qualitatively capture such this behavior of low dimensional transient determinism with occasional (stochastically defined) jumps from one deterministic system to another within a one parameter family of deterministic systems.

Variation of safety indices during in the learning curve for color Doppler assessment of the fetal heart at 11+0 to 13+6 weeks' gestation.

PubMed

Nemescu, Dragos; Berescu, Anca; Rotariu, Cristian

2015-12-01

The aim of our study was to analyze the variation of acoustic output, as expressed by the thermal (TI) and mechanical index (MI), during the learning curve for a fetal heart scan at 11-13 gestational weeks, with the introduction of a new ultrasound system. This was a prospective, observational study on 303 normal fetuses. The fetal heart was examined transabdominally using B-Mode and high definition (HD) color Doppler to obtain standard parameters: four-chamber, outflow tracts and three-vessel-trachea views. Data were analyzed in groups of 20 consecutive examinations and the percentage of successful examinations was calculated. TI and MI were retrieved from HD color Doppler examinations of the fetal heart and from pulsed-wave Doppler assessment of the tricuspid flow and ductus venosus. MI values from the color Doppler examination of the fetal heart showed a continuous decrease (0.81 to 0.75, p<0.001), along the learning phase. TI and MI indices from pulsed-wave Doppler evaluation of the tricuspid flow increased at the beginning of the learning phase and stabilized afterwards (0.34 to 0.36, p<0.05 and 0.37 to 0.4, p<0.001, respectively). TI from color Doppler exam of the heart and indices from ductus venosus assessment were very constant and did not change along the studied periods. The length of Doppler examination of the heart increased after about 80 cases by 25%, to a mean of 4 minutes (p<0.05). Safety indices from Doppler evaluation of the fetal heart and tricuspid flow vary during the learning curve for fetal heart assessment. Also, the occurrence of constant values suggests the potential for their supplementary active reduction. For a better adaptation to a new ultrasound technology, the sonographer should scan the fetal heart longer in the first trimester and follow displayed safety indices along the first 80 cases.

Heart Failure with Recovered EF and Heart Failure with Mid-Range EF: Current Recommendations and Controversies.

PubMed

Unkovic, Peter; Basuray, Anupam

2018-04-03

This review explores key features and potential management controversies in two emerging populations in heart failure: heart failure with recovered ejection fraction (HF-recovered EF) and heart failure with mid-range ejection fraction (HFmrEF). While HF-recovered EF patients have better outcomes than heart failure with reduced ejection fraction (HFrEF), they continue to have symptoms, persistent biomarker elevations, and abnormal outcomes suggesting a continued disease process. HFmrEF patients appear to have features of HFrEF and heart failure with preserved ejection fraction (HFpEF), but have a high prevalence of ischemic heart disease and may represent a transitory phase between the HFrEF and HFpEF. Management strategies have insufficient data to warrant standardization at this time. HF-recovered EF and HFmrEF represent new populations with unmet needs and expose the pitfalls of an EF basis for heart failure classification.

The role of angiography in the congruence of cardiovascular measurements between autopsy and postmortem imaging.

PubMed

Troxler, Renaud; Minoiu, Costin; Vaucher, Paul; Michaud, Katarzyna; Doenz, Francesco; Ducrot, Kewin; Grabherr, Silke

2018-01-01

Postmortem CT angiography is the method of choice for the postmortem imaging investigations of the cardiovascular (CV) system. However, autopsy still remains the gold standard for CV measurement. Nevertheless, there are not any studies on CV measurements on the multi-phase postmortem angiography (MPMCTA) which includes comparisons with autopsy. Therefore, the aim of this study is to compare CV measurements between the native CT scan and the three phases of the MPMCTA to find out which of these modalities correlate the best with autopsy measurements. For this study, we selected retrospectively 50 postmortem cases that underwent both MPMCTA and autopsy. A comparison was carried out between the CV measurements obtained with imaging (aorta; heart cavities and cardiac wall thicknesses; maximum cardiac diameter and cardiothoracic ratio) and at the autopsy (aorta; cardiac valves, ventricular thicknesses, and weight). Our results show that the dynamic phase displays an advantage for the measurement of the aortas. However, the MPMCTA is not accurate to measure the cardiac wall thicknesses. The measurements of the heart cavities show no correlation with the heart valves. The cardiothoracic ratio measured by the MPMCTA shows no correlation with the heart weight. Nevertheless, the maximum cardiac diameter exhibits a correlation with the latter on the venous and dynamic phase. These results show that only few CV parameters measured with imaging correlate with measurement obtained at the autopsy. These results indicate that in order to better estimate values obtained at the autopsy, we need to define new reference values for the CV measurement on MPMCTA.

Determination of right ventricular ejection fraction in children with cystic fibrosis, using krypton-81m

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piepsz, A.; Ham, H.R.; Millet, E.

1984-01-01

The diagnosis of cor pulmonale and incipient heart failure remains difficult to assess in cystic fibrosis (CF) on the basis of the clinical as well as the biological parameters. The measurement of the right ventricular ejection fraction has been facilitated these last years by the introduction of the radionuclide methods. Methodological difficulties are however encountered when Tc-99m RBC are used, and are mainly related to heart chambers superposition (equilibrium method) or the low count density (first pass method). Few papers have been published on RVEF in cystic fibrosis and the results are somewhat contradictory. The authors have recently introduced amore » new method for the determination of RVEF, using equilibrium study during continuous injection of Kr-81m in glucose solution. This method offers several advantages related to an increased accuracy and a favorable dosimetry. In 25 patients aged 2 to 23 years with CF, one or more RVEF studies were performed. The severity of the disease was evaluated on the basis of the clinical Schwachman score, the lung function tests, the ventilation scan and the pa02. RVEF tended to decrease with the progression of the lung disease, although, owing to the spread of the results, no RVEF could be predicted on the basis of the other parameters. The decrease of RVEF in patients with advanced lung disease was moderate and terminal lung disease was sometimes associated with normal right heart contractility.« less

[The effects of work in an air-conditioned cabin and stay in a resting chamber on blood pressure and heart rate of operators employed in deep copper mines].

PubMed

Borodulin-Nadzieja, L; Janocha, A; Pietraszkiewicz, T; Salomon, E; Stańda, M

2001-01-01

This paper is part of a wider comparative study of the heart rate, blood pressure, external and core temperature in operators of self-propelled mining machines with and without air-conditioning cabins. Two groups, each of ten operators, characterised by the similar age and duration of employment, stayed for 20 min a specially prepared resting chamber with much more advantageous microclimatic conditions. The results of our examinations (Holter heart rate and continuous blood pressure recordings, external and core temperature measurements) revealed that during the work (particularly during the increased work-load) all parameters recorded were significantly lower in air-conditioning cabins as compared with the group working without air-condition. In both groups, a complete restitution of the heart rate and blood pressure was observed after a 20-min stay in the resting chamber. During the work, a statistically significant increase in the external temperature was found in both groups of operators, whereas the increase in the core temperature was observed only in operators working without air-condition. After a 20-min stay in the resting chamber, a complete return to the normal temperature was noted only in operators working in air-conditioned cabins.

Localised photoplethysmography imaging for heart rate estimation of pre-term infants in the clinic

NASA Astrophysics Data System (ADS)

Chaichulee, Sitthichok; Villarroel, Mauricio; Jorge, João.; Arteta, Carlos; Green, Gabrielle; McCormick, Kenny; Zisserman, Andrew; Tarassenko, Lionel

2018-02-01

Non-contact vital-sign estimation allows the monitoring of physiological parameters (such as heart rate, respiratory rate, and peripheral oxygen saturation) without contact electrodes or sensors. Our recent work has demonstrated that a convolutional neural network (CNN) can be used to detect the presence of a patient and segment the patient's skin area for vital-sign estimation, thus enabling the automatic continuous monitoring of vital signs in a hospital environment. In a study approved by the local Research Ethical Committee, we made video recordings of pre-term infants nursed in a Neonatal Intensive Care Unit (NICU) at the John Radcliffe Hospital in Oxford, UK. We extended the CNN model to detect the head, torso and diaper of the infants. We extracted multiple photoplethysmographic imaging (PPGi) signals from each body part, analysed their signal quality, and compared them with the PPGi signal derived from the entire skin area. Our results demonstrated the benefits of estimating heart rate combined from multiple regions of interest using data fusion. In the test dataset, we achieved a mean absolute error of 2.4 beats per minute for 80% (31.1 hours) from a total recording time of 38.5 hours for which both reference heart rate and video data were valid.

Multi-variant study of obesity risk genes in African Americans: The Jackson Heart Study.

PubMed

Liu, Shijian; Wilson, James G; Jiang, Fan; Griswold, Michael; Correa, Adolfo; Mei, Hao

2016-11-30

Genome-wide association study (GWAS) has been successful in identifying obesity risk genes by single-variant association analysis. For this study, we designed steps of analysis strategy and aimed to identify multi-variant effects on obesity risk among candidate genes. Our analyses were focused on 2137 African American participants with body mass index measured in the Jackson Heart Study and 657 common single nucleotide polymorphisms (SNPs) genotyped at 8 GWAS-identified obesity risk genes. Single-variant association test showed that no SNPs reached significance after multiple testing adjustment. The following gene-gene interaction analysis, which was focused on SNPs with unadjusted p-value<0.10, identified 6 significant multi-variant associations. Logistic regression showed that SNPs in these associations did not have significant linear interactions; examination of genetic risk score evidenced that 4 multi-variant associations had significant additive effects of risk SNPs; and haplotype association test presented that all multi-variant associations contained one or several combinations of particular alleles or haplotypes, associated with increased obesity risk. Our study evidenced that obesity risk genes generated multi-variant effects, which can be additive or non-linear interactions, and multi-variant study is an important supplement to existing GWAS for understanding genetic effects of obesity risk genes. Copyright © 2016 Elsevier B.V. All rights reserved.

Simulation of multi-stage nonlinear bone remodeling induced by fixed partial dentures of different configurations: a comparative clinical and numerical study.

PubMed

Liao, Zhipeng; Yoda, Nobuhiro; Chen, Junning; Zheng, Keke; Sasaki, Keiichi; Swain, Michael V; Li, Qing

2017-04-01

This paper aimed to develop a clinically validated bone remodeling algorithm by integrating bone's dynamic properties in a multi-stage fashion based on a four-year clinical follow-up of implant treatment. The configurational effects of fixed partial dentures (FPDs) were explored using a multi-stage remodeling rule. Three-dimensional real-time occlusal loads during maximum voluntary clenching were measured with a piezoelectric force transducer and were incorporated into a computerized tomography-based finite element mandibular model. Virtual X-ray images were generated based on simulation and statistically correlated with clinical data using linear regressions. The strain energy density-driven remodeling parameters were regulated over the time frame considered. A linear single-stage bone remodeling algorithm, with a single set of constant remodeling parameters, was found to poorly fit with clinical data through linear regression (low [Formula: see text] and R), whereas a time-dependent multi-stage algorithm better simulated the remodeling process (high [Formula: see text] and R) against the clinical results. The three-implant-supported and distally cantilevered FPDs presented noticeable and continuous bone apposition, mainly adjacent to the cervical and apical regions. The bridged and mesially cantilevered FPDs showed bone resorption or no visible bone formation in some areas. Time-dependent variation of bone remodeling parameters is recommended to better correlate remodeling simulation with clinical follow-up. The position of FPD pontics plays a critical role in mechanobiological functionality and bone remodeling. Caution should be exercised when selecting the cantilever FPD due to the risk of overloading bone resorption.

[The functional state classification and evaluation of the stability level in mental loads based on the factor structure of heart rate variability parameters].

PubMed

Mashin, V A; Mashina, M N

2004-12-01

In the paper, outcomes of the researches devoted to factor analysis of heart rate variability parameters and definition of the most informative parameters for diagnostics of functional states and an evaluation of level of stability to mental loads, are presented. The factor structure of parameters, which unclude integral level of heart rate variability (1), balance between activity of vagus and brain cortical-limbic systems (2), integrated level of cardiovascular system functioning (3), is substantiated. Factor analysis outcomes have been used for construction of functional state classification, for their differential diagnostics, and for development and check of algorithm for evaluation of the stability level in mental loads.

Real time reconstruction of quasiperiodic multi parameter physiological signals

NASA Astrophysics Data System (ADS)

Ganeshapillai, Gartheeban; Guttag, John

2012-12-01

A modern intensive care unit (ICU) has automated analysis systems that depend on continuous uninterrupted real time monitoring of physiological signals such as electrocardiogram (ECG), arterial blood pressure (ABP), and photo-plethysmogram (PPG). These signals are often corrupted by noise, artifacts, and missing data. We present an automated learning framework for real time reconstruction of corrupted multi-parameter nonstationary quasiperiodic physiological signals. The key idea is to learn a patient-specific model of the relationships between signals, and then reconstruct corrupted segments using the information available in correlated signals. We evaluated our method on MIT-BIH arrhythmia data, a two-channel ECG dataset with many clinically significant arrhythmias, and on the CinC challenge 2010 data, a multi-parameter dataset containing ECG, ABP, and PPG. For each, we evaluated both the residual distance between the original signals and the reconstructed signals, and the performance of a heartbeat classifier on a reconstructed ECG signal. At an SNR of 0 dB, the average residual distance on the CinC data was roughly 3% of the energy in the signal, and on the arrhythmia database it was roughly 16%. The difference is attributable to the large amount of diversity in the arrhythmia database. Remarkably, despite the relatively high residual difference, the classification accuracy on the arrhythmia database was still 98%, indicating that our method restored the physiologically important aspects of the signal.

Power law versus exponential state transition dynamics: application to sleep-wake architecture.

PubMed

Chu-Shore, Jesse; Westover, M Brandon; Bianchi, Matt T

2010-12-02

Despite the common experience that interrupted sleep has a negative impact on waking function, the features of human sleep-wake architecture that best distinguish sleep continuity versus fragmentation remain elusive. In this regard, there is growing interest in characterizing sleep architecture using models of the temporal dynamics of sleep-wake stage transitions. In humans and other mammals, the state transitions defining sleep and wake bout durations have been described with exponential and power law models, respectively. However, sleep-wake stage distributions are often complex, and distinguishing between exponential and power law processes is not always straightforward. Although mono-exponential distributions are distinct from power law distributions, multi-exponential distributions may in fact resemble power laws by appearing linear on a log-log plot. To characterize the parameters that may allow these distributions to mimic one another, we systematically fitted multi-exponential-generated distributions with a power law model, and power law-generated distributions with multi-exponential models. We used the Kolmogorov-Smirnov method to investigate goodness of fit for the "incorrect" model over a range of parameters. The "zone of mimicry" of parameters that increased the risk of mistakenly accepting power law fitting resembled empiric time constants obtained in human sleep and wake bout distributions. Recognizing this uncertainty in model distinction impacts interpretation of transition dynamics (self-organizing versus probabilistic), and the generation of predictive models for clinical classification of normal and pathological sleep architecture.

The pharmacotherapy of the HeartMate II, a continuous flow left ventricular assist device, in patients with advanced heart failure: integration of disease, device, and drug.

PubMed

Jennings, Douglas L; Chambers, Rachel M; Schillig, Jessica M

2010-10-01

Advanced heart failure continues to be a significant cause of morbidity and mortality in the US. Patients with advanced heart failure have a poor prognosis without cardiac transplantation. The use of left ventricular assist devices (LVADs) as destination therapy for these patients is therefore expected to increase in the coming years as technology advances. The HeartMate II, a continuous flow implantable device, is currently the only LVAD that has been approved by the Food and Drug Administration for destination therapy in patients with advanced heart failure. The pharmacotherapy associated with this device is very complex and, therefore, the need for expertly trained clinical pharmacists to care for this expanding patient population will also likely increase. Unfortunately, most pharmacists are unfamiliar with the effect of LVADs on the physiology and pharmacotherapy of a patient's heart failure. The purpose of this article is to give clinical pharmacists an introduction to the most common pharmacotherapeutic issues for patients with LVADs and present practical solutions for managing common drug therapy problems.

Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) Trial: Design and Rationale

PubMed Central

Reeves, Gordon R.; Whellan, David J.; Duncan, Pamela; O’Connor, Christopher M.; Pastva, Amy M.; Eggebeen, Joel D; Hewston, Leigh Ann; Morgan, Timothy M.; Reed, Shelby D.; Rejeski, W. Jack; Mentz, Robert J.; Rosenberg, Paul B.; Kitzman, Dalane W.

2017-01-01

Background Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. Hypothesis Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. Study Design Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) is a multi-center clinical trial in which 360 patients ≥ 60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. Conclusions REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities. PMID:28267466

Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation.

PubMed

Yaksh, Ameeta; Kik, Charles; Knops, Paul; Zwiers, Korinne; van Ettinger, Maarten J B; Manintveld, Olivier C; de Wijs, Marcel C J; van der Kemp, Peter; Bogers, Ad J J C; de Groot, Natasja M S

2016-07-08

Early postoperative ventricular tachyarrhythmia (PoVT) after left ventricular assist device (LVAD) implantation are common and associated with higher mortality-rates. At present, there is no data on initiation of these PoVT and the role of alterations in cardiac hemodynamics. A LVAD was implanted in a patient with end-stage heart failure due to a ischemic cardiomyopathy. Alterations in cardiac rhythm and hemodynamics preceding PoVT-episodes during the first five postoperative days were examined by using continuous recordings of cardiac rhythm and various hemodynamic parameters. All PoVT (N=120) were monomorphic, most often preceded by short-long-short-sequences or regular SR and initiated by ventricular runs. Prior to PoVT, mean arterial pressure decreased; heart rate and ST-segments deviations increased. PoVT are caused by different underlying electrophysiological mechanisms. Yet, they are all monomorphic and preceded by hemodynamic deterioration due to myocardial ischemia.

Piezoelectric extraction of ECG signal

NASA Astrophysics Data System (ADS)

Ahmad, Mahmoud Al

2016-11-01

The monitoring and early detection of abnormalities or variations in the cardiac cycle functionality are very critical practices and have significant impact on the prevention of heart diseases and their associated complications. Currently, in the field of biomedical engineering, there is a growing need for devices capable of measuring and monitoring a wide range of cardiac cycle parameters continuously, effectively and on a real-time basis using easily accessible and reusable probes. In this paper, the revolutionary generation and extraction of the corresponding ECG signal using a piezoelectric transducer as alternative for the ECG will be discussed. The piezoelectric transducer pick up the vibrations from the heart beats and convert them into electrical output signals. To this end, piezoelectric and signal processing techniques were employed to extract the ECG corresponding signal from the piezoelectric output voltage signal. The measured electrode based and the extracted piezoelectric based ECG traces are well corroborated. Their peaks amplitudes and locations are well aligned with each other.

Understanding heart rate alarm adjustment in the intensive care units through an analytical approach.

PubMed

Fidler, Richard L; Pelter, Michele M; Drew, Barbara J; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J Matt; Hu, Xiao

2017-01-01

Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision.

Motion-compensated noncontact imaging photoplethysmography to monitor cardiorespiratory status during exercise

NASA Astrophysics Data System (ADS)

Sun, Yu; Hu, Sijung; Azorin-Peris, Vicente; Greenwald, Stephen; Chambers, Jonathon; Zhu, Yisheng

2011-07-01

With the advance of computer and photonics technology, imaging photoplethysmography [(PPG), iPPG] can provide comfortable and comprehensive assessment over a wide range of anatomical locations. However, motion artifact is a major drawback in current iPPG systems, particularly in the context of clinical assessment. To overcome this issue, a new artifact-reduction method consisting of planar motion compensation and blind source separation is introduced in this study. The performance of the iPPG system was evaluated through the measurement of cardiac pulse in the hand from 12 subjects before and after 5 min of cycling exercise. Also, a 12-min continuous recording protocol consisting of repeated exercises was taken from a single volunteer. The physiological parameters (i.e., heart rate, respiration rate), derived from the images captured by the iPPG system, exhibit functional characteristics comparable to conventional contact PPG sensors. Continuous recordings from the iPPG system reveal that heart and respiration rates can be successfully tracked with the artifact reduction method even in high-intensity physical exercise situations. The outcome from this study thereby leads to a new avenue for noncontact sensing of vital signs and remote physiological assessment, with clear applications in triage and sports training.

A novel yet effective motion artefact reduction method for continuous physiological monitoring

NASA Astrophysics Data System (ADS)

Alzahrani, A.; Hu, S.; Azorin-Peris, V.; Kalawsky, R.; Zhang, X.; Liu, C.

2014-03-01

This study presents a non-invasive and wearable optical technique to continuously monitor vital human signs as required for personal healthcare in today's increasing ageing population. The study has researched an effective way to capture human critical physiological parameters, i.e., oxygen saturation (SaO2%), heart rate, respiration rate, body temperature, heart rate variability by a closely coupled wearable opto-electronic patch sensor (OEPS) together with real-time and secure wireless communication functionalities. The work presents the first step of this research; an automatic noise cancellation method using a 3-axes MEMS accelerometer to recover signals corrupted by body movement which is one of the biggest sources of motion artefacts. The effects of these motion artefacts have been reduced by an enhanced electronic design and development of self-cancellation of noise and stability of the sensor. The signals from the acceleration and the opto-electronic sensor are highly correlated thus leading to the desired pulse waveform with rich bioinformatics signals to be retrieved with reduced motion artefacts. The preliminary results from the bench tests and the laboratory setup demonstrate that the goal of the high performance wearable opto-electronics is viable and feasible.

Echocardiographic findings in stable outpatients with properly functioning HeartMate II left ventricular assist devices.

PubMed

Topilsky, Yan; Oh, Jae K; Atchison, Fawn W; Shah, Dipesh K; Bichara, Valentina M; Schirger, John A; Kushwaha, Sudhir S; Pereira, Naveen L; Park, Soon J

2011-02-01

Continuous-flow left ventricular assist devices (LVADs) have become part of the standard of care for the treatment of advanced heart failure. However, knowledge of normal values for transthoracic echocardiographic examination and measurements in these patients are lacking. All transthoracic echocardiographic examinations in 63 consecutive patients, performed 90 and 180 days after surgery with the implantation of a HeartMate II continuous-flow LVAD between February 2007 and January 2010, were retrospectively analyzed. All patients had to be outpatients at 3 and 6 months after surgery and considered stable on LVAD therapy (New York Heart Association class I or II and no need for inotropes, intravenous furosemide, or hospitalization). End-diastolic and end-systolic diameters and left ventricular mass decreased considerably compared with baseline measurements before LVAD implantation. Mitral inflow deceleration time increased (188 ± 70 vs 132.5 ± 27 msec, P = .009) and left atrial volume (84.1 ± 33 vs 141.7 ± 62 mL, P = .003) and E/e' ratio decreased (20.3 ± 9 vs 26 ± 11, P = .01), all consistent with decreased left ventricular filling pressure. Estimated right ventricular (RV) and right atrial pressure decreased significantly (34.1 ± 10 vs 51.7 ± 14 mm Hg and 9.5 ± 5 vs 14.4 ± 5 mm Hg, respectively, P < .0001 for both). Quantitatively estimated RV function (P = .02), RV fractional area change (27.9 ± 10% vs 37.4 ± 10.9%, P < .0001), and the RV index of myocardial performance (0.32 ± 0.1 vs 0.65 ± 0.2 vs 0.32 ± .01, P < .0001) improved, suggesting improved RV efficiency. LVAD therapy resulted in significant decreases in the severity of mitral regurgitation. Tricuspid regurgitation improved in patients who had concurrent tricuspid surgical correction and was unchanged otherwise. Aortic regurgitation severity increased 3 months after LVAD implantation. There were no significant differences in any of the echocardiographic parameters in the 6-month evaluation compared with the 3-month evaluation. This is the first report of selected typical echocardiographic values in a group of stable patients with normally functioning HeartMate II continuous-flow LVADs. A stable functioning continuous LVAD is associated with evidence of efficient unloading of the left ventricle, improved RV function, significant improvement in mitral regurgitation, improvement in tricuspid regurgitation only in patients undergoing repair, and increased aortic regurgitation. These normal data provide a basis for future echocardiographic studies after LVAD implantation. Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

[On the extinction of populations with several types in a random environment].

PubMed

Bacaër, Nicolas

2018-03-01

This study focuses on the extinction rate of a population that follows a continuous-time multi-type branching process in a random environment. Numerical computations in a particular example inspired by an epidemic model suggest an explicit formula for this extinction rate, but only for certain parameter values. Copyright © 2018 Académie des sciences. Published by Elsevier Masson SAS. All rights reserved.

HEART: an automated beat-to-beat cardiovascular analysis package using Matlab.

PubMed

Schroeder, M J Mark J; Perreault, Bill; Ewert, D L Daniel L; Koenig, S C Steven C

2004-07-01

A computer program is described for beat-to-beat analysis of cardiovascular parameters from high-fidelity pressure and flow waveforms. The Hemodynamic Estimation and Analysis Research Tool (HEART) is a post-processing analysis software package developed in Matlab that enables scientists and clinicians to document, load, view, calibrate, and analyze experimental data that have been digitally saved in ascii or binary format. Analysis routines include traditional hemodynamic parameter estimates as well as more sophisticated analyses such as lumped arterial model parameter estimation and vascular impedance frequency spectra. Cardiovascular parameter values of all analyzed beats can be viewed and statistically analyzed. An attractive feature of the HEART program is the ability to analyze data with visual quality assurance throughout the process, thus establishing a framework toward which Good Laboratory Practice (GLP) compliance can be obtained. Additionally, the development of HEART on the Matlab platform provides users with the flexibility to adapt or create study specific analysis files according to their specific needs. Copyright 2003 Elsevier Ltd.

Multi-agent system as a new approach to effective chronic heart failure management: key considerations.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-09-01

Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology.

Multi-Agent System as a New Approach to Effective Chronic Heart Failure Management: Key Considerations

PubMed Central

Mohammadzadeh, Niloofar; Rahimi, Azin

2013-01-01

Objectives Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. Methods In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. Results Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. Conclusions Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology. PMID:24195010

Pharmacists' role in the post-discharge management of patients with heart failure: a literature review.

PubMed

Ponniah, A; Anderson, B; Shakib, S; Doecke, C J; Angley, M

2007-08-01

The incidence of heart failure is increasing in developed countries. In the aged population, heart failure is a common cause of hospitalization and hospital readmission, which in conjunction with post-discharge care, impose a significant cost burden. Inappropriate medication management and drug-related problems have been identified as major contributors to hospital readmissions. In order to enhance the care and clinical outcomes, and reduce treatment costs, heart failure disease management programmes (DMPs) have been developed. It is recommended that these programmes adopt a multi-disciplinary approach, and pharmacists, with their understanding and knowledge of medication management, can play a vital role in the post-discharge care of heart failure patients. The aim of this literature review was to assess the role of pharmacists in the provision of post-charge services for heart failure patients. An extensive literature search was undertaken to identify published studies and review articles evaluating the benefits of an enhanced medication management service for patients with heart failure post-discharge. Seven studies were identified evaluating 'outpatient' or 'post-discharge' pharmacy services for patients with heart failure. In three studies, services were delivered prior to discharge with either subsequent telephone or home visit follow-up. Three studies involved the role of a pharmacist in a specialist heart failure outpatient clinic. One study focused on a home-based intervention. In six of these studies, positive outcomes, such as decreases in unplanned hospital readmissions, death rates and greater compliance and medication knowledge were demonstrated. One study did not show any difference in the number of hospitalizations between intervention and control groups. The quality of evidence of the randomized controlled trials was assessed using the Jadad scoring method. None of the studies achieved a score of more than 2, out of a maximum of 5, indicating the potential for bias. The DMPs carried out by pharmacists have contributed to positive patient outcomes, which has highlighted the value of extending the traditional roles of pharmacists from the provision of professional guidance to the delivery of continuity of care through a more holistic and direct approach. This review has demonstrated the effectiveness of pharmacists' interventions to reduce the morbidity and mortality associated with heart failure. However, there is an on-going need for the development and evaluation of pharmacy services for these patients.

The development of selected cardiovascular parameters in patients with type 2 diabetes mellitus during a spa treatment.

PubMed

Fialová, E; Kittnar, O

2015-01-01

Diabetes mellitus is not just a simple metabolic disorder, however, it is considered to be a cardiovascular disease of a metabolic origin. This is apparent especially when speaking about type 2 diabetes (DM II). The objective of our study was to determine whether a comprehensive spa treatment (procedures and drinking cure) may affect the level of the sympathetic tone of patients suffering from DM II. As an indicator of the sympathetic tone, selected electrocardiographic parameters derived from the heart rate variability and microwave alternans were chosen. There were 96 patients enrolled in our study: 38 patients with poorly controlled DM II and two control groups: 9 patients with compensated DM II and 49 patients, average age without diabetes or other disorders of the glucose metabolism. All received an identical spa treatment and continued their medical therapy. The electrophysiological examination of patients was performed before and after a three-week spa treatment using the KARDiVAR system. Parameters derived from the analysis of heart rate variability (HRV), microvolt T-wave alternans, and microvolt R-wave alternans were analyzed in order to evaluate the tones of the autonomic nervous system (ANS). The control group showed a slight increase of parameter the index of activity of regulatory systems (IRSA) (4.4+/-1.3 vs. 3.8+/-1.4; p=0.006) after the spa treatment, while increased heart rate (80.9+/-11.0 vs. 74.6+/-9.6; p=0.028), reduced index of centralization (IC) (1.3+/-0.6 vs. 2.9+/-1.4; p=0.027) and reduced index of myocardium (IM) (9.9+/-7.4 vs. 18.0+/-6.3; p=0.041) were found in patients with a compensated DM II. Patients with a poorly compensated DM II showed a decreased IM (10.9+/-8.6 vs. 16.9+/-5.2; p=0.001) and also a reduced IRSA (4.1+/-3.5 vs. 6.3+/-1.9; p=0.001). The results proved favorable changes in ANS cardiovascular control of patients with DM II after a spa treatment, especially in terms of reducing the sympathoadrenal system activity (decreased IRSA), improving electrical stability of the myocardium and increasing centrally controlled heart rate variability without overloading the cardiovascular system (drop of IM).

Multi-criteria optimization achieves superior normal tissue sparing in a planning study of intensity-modulated radiation therapy for RTOG 1308-eligible non-small cell lung cancer patients.

PubMed

Kamran, Sophia C; Mueller, Birgit S; Paetzold, Peter; Dunlap, Joseph; Niemierko, Andrzej; Bortfeld, Thomas; Willers, Henning; Craft, David

2016-03-01

In this planning study, we studied the benefit of intensity-modulated radiation therapy (IMRT) with multi-criteria optimization (MCO) in locally advanced non-small cell lung carcinoma (NSCLC). We selected 10 consecutive patients with gross tumor within 1cm of the esophagus eligible for RTOG 1308, randomized phase II trial of 70 Gy protons vs photons. Planning was performed per protocol. In addition, a novel approach for esophagus sparing was applied by making the contralateral esophagus (CE) an avoidance structure. MCO and non-MCO plans underwent double-blinded review. Plan differences in dose-volume histogram parameters were analyzed. Median plan differences were mean lung dose=0.8 Gy (p=0.01), lung V20=1.1% (p=0.06), heart V30=1.0% (p=0.03), heart V45=0.6% (p=0.03), esophagus V60=1.2% (p=0.04), and CE V45=3.2% (p=0.01), all favoring MCO over non-MCO. PTV coverage with 95% dose was ⩾98.0% for both plans. There were 5 minor protocol deviations with non-MCO plans and 2 with MCO. Median improvement of active planning time with MCO was 88 min (p<0.01). Physicians preferred 8 MCO and 2 non-MCO plans (p=0.04). MCO plans yielded significant improvements in organ-at-risk sparing without compromising target coverage, consumed less dosimetrist time, and were preferred by physicians. We suggest incorporating MCO into prospective clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Continuous infusion or bolus injection of loop diuretics for congestive heart failure?

PubMed

Zepeda, Patricio; Rain, Carmen; Sepúlveda, Paola

2016-04-22

Loop diuretics are widely used in acute heart failure. However, there is controversy about the superiority of continuous infusion over bolus administration. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded continuous administration of loop diuretics probably reduces mortality and length of stay compared to intermittent administration in patients with acute heart failure.

Assessment of the value of a genetic risk score in improving the estimation of coronary risk

USDA-ARS?s Scientific Manuscript database

The American Heart Association has established criteria for the evaluation of novel markers of cardiovascular risk. In accordance with these criteria, we assessed the association between a multi-locus genetic risk score (GRS) and incident coronary heart disease (CHD), and evaluated whether this GRS ...

Assessment of Diastolic Function in Congenital Heart Disease

PubMed Central

Panesar, Dilveer Kaur; Burch, Michael

2017-01-01

Diastolic function is an important component of left ventricular (LV) function which is often overlooked. It can cause symptoms of heart failure in patients even in the presence of normal systolic function. The parameters used to assess diastolic function often measure flow and are affected by the loading conditions of the heart. The interpretation of diastolic function in the context of congenital heart disease requires some understanding of the effects of the lesions themselves on these parameters. Individual congenital lesions will be discussed in this paper. Recently, load-independent techniques have led to more accurate measurements of ventricular compliance and remodeling in heart disease. The combination of inflow velocities and tissue Doppler measurements can be used to estimate diastolic function and LV filling pressures. This review focuses on diastolic function and assessment in congenital heart disease. PMID:28261582

Development of an Ex Vivo, Beating Heart Model for CT Myocardial Perfusion

PubMed Central

Das, Marco; Haberland, Ulrike; Slump, Cees; Handayani, Astri; van Tuijl, Sjoerd; Stijnen, Marco; Oudkerk, Matthijs; Wildberger, Joachim E.; Vliegenthart, Rozemarijn

2015-01-01

Objective. To test the feasibility of a CT-compatible, ex vivo, perfused porcine heart model for myocardial perfusion CT imaging. Methods. One porcine heart was perfused according to Langendorff. Dynamic perfusion scanning was performed with a second-generation dual source CT scanner. Circulatory parameters like blood flow, aortic pressure, and heart rate were monitored throughout the experiment. Stenosis was induced in the circumflex artery, controlled by a fractional flow reserve (FFR) pressure wire. CT-derived myocardial perfusion parameters were analysed at FFR of 1 to 0.10/0.0. Results. CT images did not show major artefacts due to interference of the model setup. The pacemaker-induced heart rhythm was generally stable at 70 beats per minute. During most of the experiment, blood flow was 0.9–1.0 L/min, and arterial pressure varied between 80 and 95 mm/Hg. Blood flow decreased and arterial pressure increased by approximately 10% after inducing a stenosis with FFR ≤ 0.50. Dynamic perfusion scanning was possible across the range of stenosis grades. Perfusion parameters of circumflex-perfused myocardial segments were affected at increasing stenosis grades. Conclusion. An adapted Langendorff porcine heart model is feasible in a CT environment. This model provides control over physiological parameters and may allow in-depth validation of quantitative CT perfusion techniques. PMID:26185756

Heart rate differentiates urgency and emergency in hypertensive crisis.

PubMed

Al Bannay, Rashed; Böhm, Michael; Husain, Aysha

2013-08-01

To study the clinical significance of presenting blood pressure parameters and heart rate in patients with hypertensive crisis. In patients admitted with hypertensive crisis between January 2011 and May 2011, demography, mode of presentation, co-morbidities, blood pressure readings, and heart rate at presentation were documented. Further clustering of hypertensive crisis into emergency or urgency was based on the presence or absence of target organ involvement. The relationship between blood pressure parameters, heart rate, and other variables was analyzed. 189 patients in sinus rhythm were enrolled in this pilot study. The rate of hypertensive urgency was 56 %, whereas the rate of hypertensive emergency was 44 %, respectively. Subjects with hypertensive emergency had a higher mean heart rate (93 ± 22.7 bpm) than those with urgency (81 ± 11.5 bpm) (P = 0.015). Women had higher heart rates (92 ± 18.5 bpm) than men (86 ± 17.6 bpm) (P = 0.014). Heart rates below 100 bpm had a specificity of 94 %, classifying patients as hypertensive urgency. Tachycardia had a powerful statistical association with hypertensive left ventricular failure (P < 0.0001). Other hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, pulse pressure, and mean blood pressure relates neither to urgency nor to emergency. Diabetic patients with HBA1c levels of more than 53 mmol/mol had a heart rate of more than 100 bpm (P = 0.015) during hypertensive crisis. Normal heart rate is characteristic of hypertensive urgency. Tachycardia in this setting is an ominous sign and denotes hypertensive complications in particular left ventricular failure. Among diabetics, elevated heart rate is associated with poor glycemic control.

Association between cardiac autonomic function, oxidative stress and inflammatory response in impaired fasting glucose subjects: cross-sectional study.

PubMed

Thiyagarajan, Ramkumar; Subramanian, Senthil Kumar; Sampath, Nishanth; Madanmohan Trakroo; Pal, Pravati; Bobby, Zachariah; Paneerselvam, Sankar; Das, Ashok Kumar

2012-01-01

The worldwide burden of diabetes in 2030 is projected around 552 million. Diabetes leads to higher risk for cardiovascular diseases (CVD). Altered cardiac autonomic function (CAF) measured by heart rate variability (HRV) is observed in early stages of diabetes but the relationship between impaired fasting glucose (IFG) and HRV is still debatable. The aim of the study was to evaluate the association between CAF, oxidative stress, insulin resistance (IR), and inflammatory response in IFG subjects. Cross-sectional blinded study. Volunteers recruited from health awareness camps underwent CAF and biochemical tests. Based on fasting plasma glucose (FPG) participants (n = 123) were divided into two groups, normal fasting glucose (n = 76) and IFG (n = 47). The comparison of parameters between the groups was carried out using student t test and Mann-Whitney U test for parametric and non-parametric data respectively. The correlation between the parameters was analyzed by Spearman's rank correlation using SPSS 13.0. The resting cardiovagal modulation parameters, heart rate response to forced timed breathing, and orthostatic stress were reduced in IFG subjects. Fasting plasma lipid profile, coronary atherogenic lipid risk factors, IR, thiobarbituric acid reactive substance (TBARS), high sensitive C-reactive protein, and tumor necrosis factor alpha were increased and total antioxidant capacity (TAC) was decreased significantly in IFG group but no significant alteration was observed in high-density lipoprotein (HDL-c). Cardiovagal modulation parameters were negatively correlated with triglycerides, FPG, insulin, IR, TBARS, and inflammatory markers and positively with TAC. There is a continuous interplay between the altered CAF, hyperinsulinemia, IR, oxidative stress parameters, inflammatory response, and IFG in which one factor perpetuates another leading to the progression of disease.

Echocardiographic predictors of adverse outcomes after continuous left ventricular assist device implantation.

PubMed

Topilsky, Yan; Oh, Jae K; Shah, Dipesh K; Boilson, Barry A; Schirger, John A; Kushwaha, Sudhir S; Pereira, Naveen L; Park, Soon J

2011-03-01

The purpose of the study was to identify echocardiographic predictors of adverse outcome in patients implanted with continuous-flow left ventricular assist devices (LVAD). Continuous flow LVAD have become part of the standard of care for the treatment of advanced heart failure. However, knowledge of echocardiographic predictors of outcome after LVAD are lacking. Overall, 83 patients received continuous-flow LVAD (HeartMate II, Thoratec Corporation, Pleasanton, California) from February 2007 to June 2010. The LVAD database, containing various echocardiographic parameters, was examined to analyze their influence on in-hospital mortality, a compound cardiac event (in-hospital mortality or acute right ventricular [RV] dysfunction), and long-term mortality. Eight patients died before discharge (operative mortality 9.6%), and another 15 patients were considered to have acute RV dysfunction immediately after surgery. Patients with relatively small left ventricular end-diastolic diameters (<63 mm) had significantly higher risk for in-hospital mortality (odds ratio [OR]: 0.9; 95% confidence interval [CI]: 0.83 to 0.99; p = 0.04) or occurrence of the compound cardiac event (OR: 0.89; 95% CI: 0.84 to 0.95; p < 0.001). The most significant predictor of outcome was the decreased timing interval between the onset and the cessation of tricuspid regurgitation flow corrected for heart rate (TRDc), a surrogate for early systolic equalization of RV and right atrial pressure. Short TRDc predicted in-hospital mortality (OR: 0.85; 95% CI: 0.74 to 0.97; p = 0.01) and the compound cardiac event (OR: 0.83; 95% CI: 0.74 to 0.91; p < 0.0001). Multivariate analysis based on a logistic regression model demonstrated that the accuracy of predicting the 30-day compound adverse outcome was improved with the addition of echocardiographic variables when added to the commonly used hemodynamic or clinical scores. TRDc predicted long-term survival, with adjusted risk ratios of 0.89 for death from any cause (95% CI: 0.83 to 0.96; p = 0.003) and 0.88 for cardiac-related death (95% CI: 0.77 to 0.98; p = 0.03). The presence of either a relatively small left ventricle (<63 mm) or early systolic equalization of RV and right atrial pressure (short TRDc) demonstrated by echocardiography is associated with increased 30-day morbidity and mortality. Prediction of early adverse outcomes by echocardiographic parameters is additive to laboratory or hemodynamic variables. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

An Appropriate Population for Acute Inpatient Rehabilitation? A Case Series of Three Patients With Advanced Heart Failure on Continuous Inotropic Support.

PubMed

McCormick, Zachary L; Chu, Samuel K; Goodman, Daniel; Oswald, Matthew; Reger, Christopher; Sliwa, James

2015-06-01

The number of individuals with heart failure and the treatment modalities available to manage heart failure are increasing. Continuous inotropic support is a treatment modality used in cases of severe heart failure. Although most patients initiated on continuous inotropic support are discharged home, those with greater functional compromise, comorbid conditions that cause disability, or other significant medical complexity may be referred to acute inpatient rehabilitation. The feasibility and benefits of acute inpatient rehabilitation in this population, however, has yet to be investigated. We report the functional progress and medical complications of 3 patients on continuous inotropic support who participated in acute inpatient rehabilitation. The patients demonstrated varying levels of success, highlighting a need for evidence-based, preadmission screening criteria for this population. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

An Enhanced Method to Estimate Heart Rate from Seismocardiography via Ensemble Averaging of Body Movements at Six Degrees of Freedom.

PubMed

Lee, Hyunwoo; Lee, Hana; Whang, Mincheol

2018-01-15

Continuous cardiac monitoring has been developed to evaluate cardiac activity outside of clinical environments due to the advancement of novel instruments. Seismocardiography (SCG) is one of the vital components that could develop such a monitoring system. Although SCG has been presented with a lower accuracy, this novel cardiac indicator has been steadily proposed over traditional methods such as electrocardiography (ECG). Thus, it is necessary to develop an enhanced method by combining the significant cardiac indicators. In this study, the six-axis signals of accelerometer and gyroscope were measured and integrated by the L2 normalization and multi-dimensional kineticardiography (MKCG) approaches, respectively. The waveforms of accelerometer and gyroscope were standardized and combined via ensemble averaging, and the heart rate was calculated from the dominant frequency. Thirty participants (15 females) were asked to stand or sit in relaxed and aroused conditions. Their SCG was measured during the task. As a result, proposed method showed higher accuracy than traditional SCG methods in all measurement conditions. The three main contributions are as follows: (1) the ensemble averaging enhanced heart rate estimation with the benefits of the six-axis signals; (2) the proposed method was compared with the previous SCG method that employs fewer-axis; and (3) the method was tested in various measurement conditions for a more practical application.

Effect of an orientation group for patients with chronic heart failure: randomized controlled trial 1

PubMed Central

Arruda, Cristina Silva; Pereira, Juliana de Melo Vellozo; Figueiredo, Lyvia da Silva; Scofano, Bruna dos Santos; Flores, Paula Vanessa Peclat; Cavalcanti, Ana Carla Dantas

2018-01-01

ABSTRACT Objective: To evaluate the effect of the orientation group on therapeutic adherence and self-care among patients with chronic heart failure. Method: Randomized controlled trial with 27 patients with chronic heart failure. The intervention group received nursing consultations and participated in group meetings with the multi-professional team. The control group only received nursing consultations in a period of four months. Questionnaires validated for use in Brazil were applied in the beginning and in the end of the study to assess self-care outcomes and adherence to treatment. Categorical variables were expressed through frequency and percentage distributions and the continuous variables through mean and standard deviation. The comparison between the initial and final scores of the intervention and control groups was done through the Student’s t-test. Results: The mean adherence in the intervention group was 13.9 ± 3.6 before the study and 4.8 ± 2.3 after the study. In the control group it was 14.2 ± 3.4 before the study and 14.7 ± 3.5 after the study. The self-care confidence score was lower after the intervention (p=0.01). Conclusion: The orientation group does not improve adherence to treatment and self-care management and maintenance and it may reduce confidence in self-care. Registry REBEC RBR-7r9f2m. PMID:29319747

Effect of an orientation group for patients with chronic heart failure: randomized controlled trial.

PubMed

Arruda, Cristina Silva; Pereira, Juliana de Melo Vellozo; Figueiredo, Lyvia da Silva; Scofano, Bruna Dos Santos; Flores, Paula Vanessa Peclat; Cavalcanti, Ana Carla Dantas

2018-01-08

To evaluate the effect of the orientation group on therapeutic adherence and self-care among patients with chronic heart failure. Randomized controlled trial with 27 patients with chronic heart failure. The intervention group received nursing consultations and participated in group meetings with the multi-professional team. The control group only received nursing consultations in a period of four months. Questionnaires validated for use in Brazil were applied in the beginning and in the end of the study to assess self-care outcomes and adherence to treatment. Categorical variables were expressed through frequency and percentage distributions and the continuous variables through mean and standard deviation. The comparison between the initial and final scores of the intervention and control groups was done through the Student's t-test. The mean adherence in the intervention group was 13.9 ± 3.6 before the study and 4.8 ± 2.3 after the study. In the control group it was 14.2 ± 3.4 before the study and 14.7 ± 3.5 after the study. The self-care confidence score was lower after the intervention (p=0.01). The orientation group does not improve adherence to treatment and self-care management and maintenance and it may reduce confidence in self-care. Registry REBEC RBR-7r9f2m.

Dependence of the Contact Resistance on the Design of Stranded Conductors

PubMed Central

Zeroukhi, Youcef; Napieralska-Juszczak, Ewa; Vega, Guillaume; Komeza, Krzysztof; Morganti, Fabrice; Wiak, Slawomir

2014-01-01

During the manufacturing process multi-strand conductors are subject to compressive force and rotation moments. The current distribution in the multi-strand conductors is not uniform and is controlled by the transverse resistivity. This is mainly determined by the contact resistance at the strand crossovers and inter-strand contact resistance. The surface layer properties, and in particular the crystalline structure and degree of oxidation, are key parameters in determining the transverse resistivity. The experimental set-ups made it possible to find the dependence of contact resistivity as a function of continuous working stresses and cable design. A study based on measurements and numerical simulation is made to identify the contact resistivity functions. PMID:25196112

Uptake and distribution of the abused inhalant 1,1-difluoroethane in the rat.

PubMed

Avella, Joseph; Kunaparaju, Naveen; Kumar, Sunil; Lehrer, Michael; Zito, S William; Barletta, Michael

2010-09-01

1,1-Difluoroethane (DFE) is a halogenated hydrocarbon used as a propellant in products designed for dusting electronic equipment and air brush painting. When abused, inhaled DFE produces intoxication and loss of muscular coordination. To investigate DFE toxicokinetics, groups (n = 3) of Sprague-Dawley rats were exposed to 30 s of 20 L/min DFE. The experimental model was designed to mimic exposure during abuse, a protocol which has not been conducted. Tissue collection (blood, brain, heart, liver, and kidney) occurred at 0, 10, 20, 30, 45, 60, 120, 240, 480, and 900 s. Average peak DFE levels were blood 352, brain 519, heart 338, liver 187, and kidney 364 mg/L or mg/kg. The total percent uptake of the administered dose was 4.0%. Uptake into individual compartments was 2.72, 0.38, 0.15, 0.41, and 0.32% for blood, brain, heart, liver, and kidney, respectively. All animals showed signs of intoxication within 20 s manifested as lethargy, prostration and loss of righting reflex. Marked intoxication continued for about 4 min when DFE averaged 21 mg/L in blood and 17 mg/kg in brain. Between 4 and 8 min, animals continued to show signs of sedation as evidenced by reduced aggression and excitement during handling. No discernable intoxication was evident after 8 min and blood and brain levels had fallen to 10 and 6 mg/L or kg, respectively. Plots of concentration (log) versus time were consistent with a two compartment model. Initial distribution was rapid with average half life (t((1/2))) during the alpha phase of 9 s for blood, 18 s for brain and 27 s in cardiac tissue. During beta slope elimination average t((1/2)) was 86 s in blood, 110 s in brain and 168 s in heart. Late elimination half lives were longer with blood gamma = 240 s, brain gamma = 340 s, and heart gamma = 231 s. Following acute exposure the Vd = 0.06 L, beta = 0.48 min(-1), AUC = 409.8 mg.min L(-1), and CL from blood was 0.03 L min(-1). The calculated toxicokinetic data may underestimate these parameters if DFE is abused chronically due to continued uptake into lowly perfused tissues with repeated dosing.

Heart transplantation on the first day of life from an anencephalic donor.

PubMed

Parisi, F; Squitieri, C; Carotti, A; Di Carlo, D; Gagliardi, M G

1999-05-01

Heart transplantation on the first day of life, and graft harvesting from anencephalic donors, have been very rare events in the history of transplantation. At Bambino Gesù Hospital (Rome), heart transplantation was performed on a newborn 9 h after birth, using a graft harvested from an anencephalic donor. This graft achieved a good cardiocirculatory function, but the recipient died of necrotizing enterocolitis (NEC) on post-operative day (POD) 10. Despite failure, this case and other reports support the concept that hearts from anencephalic donors can work normally, and indicate that heart transplantation on the first day of life may have a favorable outcome if postoperative maintenance of multi-organ balance and function is successful.

Critically Underdeveloped Left Heart Morphology Associated with Prematurity and Low Birth Weight: Conditional Staged Rehabilitation Towards Biventricular Repair and Time-Related Growth of Left Heart Structures.

PubMed

Ahmad, Fareed; Mangano, Robert; Shore, Shirah; Polimenakos, Anastasios

2017-10-01

This is a case report of premature low birth weight infant with hypoplasia of left heart structures and a large malaligned VSD who underwent successful staged approach of biventricular repair. We obtained qualitative and quantitative echocardiographic, MRI, and conventional catheterization data to support stepwise strategy towards LV rehabilitation to sustain adequate cardiac output. A thorough and intense follow-up has shown significant growth of left heart structures and favorable clinical status following staged biventricular repair. Our data indicate usefulness of qualitative and quantitative advanced complimentary multi-imaging modalities in predicting the postnatal growth potential of critically underdeveloped left heart structures.

Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database.

PubMed

Nakajima, Kenichi; Matsumoto, Naoya; Kasai, Tokuo; Matsuo, Shinro; Kiso, Keisuke; Okuda, Koichi

2016-04-01

As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created. The CT-based correction provided similar perfusion patterns between genders. In phase analysis of gated myocardial perfusion SPECT, a new approach for analyzing dyssynchrony, normal ranges of parameters for phase bandwidth, standard deviation and entropy were determined in four software programs. Although the results were not interchangeable, dependency on gender, ejection fraction and volumes were common characteristics of these parameters. Standardization of (123)I-MIBG sympathetic imaging was performed regarding heart-to-mediastinum ratio (HMR) using a calibration phantom method. The HMRs from any collimator types could be converted to the value with medium-energy comparable collimators. Appropriate quantification based on common normal databases and standard technology could play a pivotal role for clinical practice and researches.

Multi-wavelength lenses for terahertz surface wave.

PubMed

Wei, Minggui; Yang, Quanlong; Xu, Quan; Zhang, Xueqian; Li, Yanfeng; Gu, Jianqiang; Han, Jiaguang; Zhang, Weili

2017-10-16

Metasurface-based surface wave (SW) devices working at multi-wavelength has been continuously arousing enormous curiosity recently, especially in the terahertz community. In this work, we propose a multi-layer metasurface structure composed of metallic slit pairs to build terahertz SW devices. The slit pair has a narrow bandwidth and its response frequency can be altered by its geometric parameter, thereby suppressing the frequency crosstalk and reducing the difficulty of design. By elaborately tailoring the distribution of the slit pairs, a series of achromatic SW lenses (SWLs) working at 0.6, 0.75 and 1 THz are experimentally demonstrated by the near field scanning terahertz microscope (NSTM) system. In addition, a wavelength-division-multiplexer (WDM) is further designed and implemented, which is promising in building multiplexed devices for plasmonic circuits. The structure proposed here cannot only couple the terahertz wave from free space to SWs, but also control its propagation. Moreover, our findings demonstrate the great potential to design multi-wavelength plasmonic metasurface devices, which can be extended to microwave and visible frequencies as well.

Reversible heart rhythm complexity impairment in patients with primary aldosteronism

NASA Astrophysics Data System (ADS)

Lin, Yen-Hung; Wu, Vin-Cent; Lo, Men-Tzung; Wu, Xue-Ming; Hung, Chi-Sheng; Wu, Kwan-Dun; Lin, Chen; Ho, Yi-Lwun; Stowasser, Michael; Peng, Chung-Kang

2015-08-01

Excess aldosterone secretion in patients with primary aldosteronism (PA) impairs their cardiovascular system. Heart rhythm complexity analysis, derived from heart rate variability (HRV), is a powerful tool to quantify the complex regulatory dynamics of human physiology. We prospectively analyzed 20 patients with aldosterone producing adenoma (APA) that underwent adrenalectomy and 25 patients with essential hypertension (EH). The heart rate data were analyzed by conventional HRV and heart rhythm complexity analysis including detrended fluctuation analysis (DFA) and multiscale entropy (MSE). We found APA patients had significantly decreased DFAα2 on DFA analysis and decreased area 1-5, area 6-15, and area 6-20 on MSE analysis (all p < 0.05). Area 1-5, area 6-15, area 6-20 in the MSE study correlated significantly with log-transformed renin activity and log-transformed aldosterone-renin ratio (all p < = 0.01). The conventional HRV parameters were comparable between PA and EH patients. After adrenalectomy, all the altered DFA and MSE parameters improved significantly (all p < 0.05). The conventional HRV parameters did not change. Our result suggested that heart rhythm complexity is impaired in APA patients and this is at least partially reversed by adrenalectomy.

A multi-functional, portable device with wireless transmission for home monitoring of children with a learning disability.

PubMed

Tura, A; Badanai, M; Longo, D; Quareni, L

2004-01-01

A portable monitoring device was developed to assist in the management of children with a learning disability. The device was designed for continuous home monitoring of blood oxygen saturation, heart and respiration rates, and patient activity. It could be worn on a belt, while the patient continued normal activities. Data were stored on a multimedia card and automatically transmitted to a PC at prescribed intervals via a Bluetooth wireless link. From the PC the data were transmitted to a Web server, where the information was made available to the staff involved in the patient's care. Preliminary clinical studies were performed with nine patients (four with Down's syndrome, three with cerebral palsy and two with mental retardation). Patients and families considered the device easy to use and to wear. The monitoring device identified events of possible clinical interest. Although it was designed for monitoring children with a learning disability, it may also be useful with other groups, such as elderly people.

Recent advances in heart failure.

PubMed

Kassi, Mahwash; Hannawi, Bashar; Trachtenberg, Barry

2018-03-01

Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Two new drugs have been added to the armamentarium for HFrEF; ivabradine and angiotensin receptor-neprilysin inhibitors (ARNIs). Initial data from a new left ventricular assist device (LVAD) pump, the HeartMate 3 (HM III), have demonstrated no reports of pump thrombosis at 6 months, but stroke and right ventricle failure continue to be a challenge with comparable rates compared with the HeartMate II. Several large studies in HFpEF failed to show improvement in outcomes and management continues to be geared towards lifestyle modification and symptom relief. Newer therapies and devices have met with great success, yet there are several therapies that provide no benefit and even harm. A careful review of the recent literature remains instrumental to the effective management of patients with heart failure.

Understanding heart rate alarm adjustment in the intensive care units through an analytical approach

PubMed Central

Pelter, Michele M.; Drew, Barbara J.; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J. Matt; Hu, Xiao

2017-01-01

Background Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. Objectives To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Methods Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). Results There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). Conclusions HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision. PMID:29176776

Relation of Heart Rate and its Variability during Sleep with Age, Physical Activity, and Body Composition in Young Children

PubMed Central

Herzig, David; Eser, Prisca; Radtke, Thomas; Wenger, Alina; Rusterholz, Thomas; Wilhelm, Matthias; Achermann, Peter; Arhab, Amar; Jenni, Oskar G.; Kakebeeke, Tanja H.; Leeger-Aschmann, Claudia S.; Messerli-Bürgy, Nadine; Meyer, Andrea H.; Munsch, Simone; Puder, Jardena J.; Schmutz, Einat A.; Stülb, Kerstin; Zysset, Annina E.; Kriemler, Susi

2017-01-01

Background: Recent studies have claimed a positive effect of physical activity and body composition on vagal tone. In pediatric populations, there is a pronounced decrease in heart rate with age. While this decrease is often interpreted as an age-related increase in vagal tone, there is some evidence that it may be related to a decrease in intrinsic heart rate. This factor has not been taken into account in most previous studies. The aim of the present study was to assess the association between physical activity and/or body composition and heart rate variability (HRV) independently of the decline in heart rate in young children. Methods: Anthropometric measurements were taken in 309 children aged 2–6 years. Ambulatory electrocardiograms were collected over 14–18 h comprising a full night and accelerometry over 7 days. HRV was determined of three different night segments: (1) over 5 min during deep sleep identified automatically based on HRV characteristics; (2) during a 20 min segment starting 15 min after sleep onset; (3) over a 4-h segment between midnight and 4 a.m. Linear models were computed for HRV parameters with anthropometric and physical activity variables adjusted for heart rate and other confounding variables (e.g., age for physical activity models). Results: We found a decline in heart rate with increasing physical activity and decreasing skinfold thickness. HRV parameters decreased with increasing age, height, and weight in HR-adjusted regression models. These relationships were only found in segments of deep sleep detected automatically based on HRV or manually 15 min after sleep onset, but not in the 4-h segment with random sleep phases. Conclusions: Contrary to most previous studies, we found no increase of standard HRV parameters with age, however, when adjusted for heart rate, there was a significant decrease of HRV parameters with increasing age. Without knowing intrinsic heart rate correct interpretation of HRV in growing children is impossible. PMID:28286485

Relation of Heart Rate and its Variability during Sleep with Age, Physical Activity, and Body Composition in Young Children.

PubMed

Herzig, David; Eser, Prisca; Radtke, Thomas; Wenger, Alina; Rusterholz, Thomas; Wilhelm, Matthias; Achermann, Peter; Arhab, Amar; Jenni, Oskar G; Kakebeeke, Tanja H; Leeger-Aschmann, Claudia S; Messerli-Bürgy, Nadine; Meyer, Andrea H; Munsch, Simone; Puder, Jardena J; Schmutz, Einat A; Stülb, Kerstin; Zysset, Annina E; Kriemler, Susi

2017-01-01

Background: Recent studies have claimed a positive effect of physical activity and body composition on vagal tone. In pediatric populations, there is a pronounced decrease in heart rate with age. While this decrease is often interpreted as an age-related increase in vagal tone, there is some evidence that it may be related to a decrease in intrinsic heart rate. This factor has not been taken into account in most previous studies. The aim of the present study was to assess the association between physical activity and/or body composition and heart rate variability (HRV) independently of the decline in heart rate in young children. Methods: Anthropometric measurements were taken in 309 children aged 2-6 years. Ambulatory electrocardiograms were collected over 14-18 h comprising a full night and accelerometry over 7 days. HRV was determined of three different night segments: (1) over 5 min during deep sleep identified automatically based on HRV characteristics; (2) during a 20 min segment starting 15 min after sleep onset; (3) over a 4-h segment between midnight and 4 a.m. Linear models were computed for HRV parameters with anthropometric and physical activity variables adjusted for heart rate and other confounding variables (e.g., age for physical activity models). Results: We found a decline in heart rate with increasing physical activity and decreasing skinfold thickness. HRV parameters decreased with increasing age, height, and weight in HR-adjusted regression models. These relationships were only found in segments of deep sleep detected automatically based on HRV or manually 15 min after sleep onset, but not in the 4-h segment with random sleep phases. Conclusions: Contrary to most previous studies, we found no increase of standard HRV parameters with age, however, when adjusted for heart rate, there was a significant decrease of HRV parameters with increasing age. Without knowing intrinsic heart rate correct interpretation of HRV in growing children is impossible.

Modeling challenges and approaches in simulating the Jovian synchrotron radiation belts from an in-situ perspective

NASA Astrophysics Data System (ADS)

Adumitroaie, V.; Oyafuso, F. A.; Levin, S.; Gulkis, S.; Janssen, M. A.; Santos-Costa, D.; Bolton, S. J.

2017-12-01

In order to obtain credible atmospheric composition retrieval values from Jupiter's observed radiative signature via Juno's MWR instrument, it is necessary to separate as robustly as possible the contributions from three emission sources: CMB, planet and synchrotron radiation belts. The numerical separation requires a refinement, based on the in-situ data, of a higher fidelity model for the synchrotron emission, namely the multi-parameter, multi-zonal model of Levin at al. (2001). This model employs an empirical electron energy distribution, which prior to the Juno mission, has been adjusted exclusively from VLA observations. At minimum 8 sets of perijove observations (i.e. by PJ9) have to be delivered to an inverse model for retrieval of the electron distribution parameters with the goal of matching the synchrotron emission observed along MWR's lines of sight. The challenges and approaches taken to perform this task are discussed here. The model will be continuously improved with the availability of additional information, both from the MWR and magnetometer instruments.

The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Ding, Jingzhong; Hsu, Fang-Chi; Harris, Tamara B; Liu, Yongmei; Kritchevsky, Stephen B; Szklo, Moyses; Ouyang, Pamela; Espeland, Mark A; Lohman, Kurt K; Criqui, Michael H; Allison, Matthew; Bluemke, David A; Carr, J Jeffrey

2009-09-01

Pericardial fat (ie, fat around the heart) may have a direct role in the atherosclerotic process in coronary arteries through local release of inflammation-related cytokines. Cross-sectional studies suggest that pericardial fat is positively associated with coronary artery disease independent of total body fat. We investigated whether pericardial fat predicts future coronary heart disease events. We conducted a case-cohort study in 998 individuals, who were randomly selected from 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants and 147 MESA participants (26 from those 998 individuals) who developed incident coronary heart disease from 2000 to 2005. The volume of pericardial fat was determined from cardiac computed tomography at baseline. The age range of the subjects was 45-84 y (42% men, 45% white, 10% Asian American, 22% African American, and 23% Hispanic). Pericardial fat was positively correlated with both body mass index (correlation coefficient = 0.45, P < 0.0001) and waist circumference (correlation coefficient = 0.57, P < 0.0001). In unadjusted analyses, pericardial fat (relative hazard per 1-SD increment: 1.33; 95% CI: 1.15, 1.54), but not body mass index (1.00; 0.84, 1.18), was associated with the risk of coronary heart disease. Waist circumference (1.14; 0.97, 1.34; P = 0.1) was marginally associated with the risk of coronary heart disease. The relation between pericardial fat and coronary heart disease remained significant after further adjustment for body mass index and other cardiovascular disease risk factors (1.26; 1.01, 1.59). The relation did not differ by sex. Pericardial fat predicts incident coronary heart disease independent of conventional risk factors, including body mass index.

Modelling and regulating of cardio-respiratory response for the enhancement of interval training

PubMed Central

2014-01-01

Background The interval training method has been a well known exercise protocol which helps strengthen and improve one’s cardiovascular fitness. Purpose To develop an effective training protocol to improve cardiovascular fitness based on modelling and analysis of Heart Rate (HR) and Oxygen Uptake (VO2) dynamics. Methods In order to model the cardiorespiratory response to the onset and offset exercises, the (K4b2, Cosmed) gas analyzer was used to monitor and record the heart rate and oxygen uptake for ten healthy male subjects. An interval training protocol was developed for young health users and was simulated using a proposed RC switching model which was presented to accommodate the variations of the cardiorespiratory dynamics to running exercises. A hybrid system model was presented to describe the adaptation process and a multi-loop PI control scheme was designed for the tuning of interval training regime. Results By observing the original data for each subject, we can clearly identify that all subjects have similar HR and VO2 profiles. The proposed model is capable to simulate the exercise responses during onset and offset exercises; it ensures the continuity of the outputs within the interval training protocol. Under some mild assumptions, a hybrid system model can describe the adaption process and accordingly a multi-loop PI controller can be designed for the tuning of interval training protocol. The self-adaption feature of the proposed controller gives the exerciser the opportunity to reach his desired setpoints after a certain number of training sessions. Conclusions The established interval training protocol targets a range of 70-80% of HRmax which is mainly a training zone for the purpose of cardiovascular system development and improvement. Furthermore, the proposed multi-loop feedback controller has the potential to tune the interval training protocol according to the feedback from an individual exerciser. PMID:24499131

Cosmological surveys with multi-object spectrographs

NASA Astrophysics Data System (ADS)

Colless, Matthew

2016-08-01

Multi-object spectroscopy has been a key technique contributing to the current era of `precision cosmology.' From the first exploratory surveys of the large-scale structure and evolution of the universe to the current generation of superbly detailed maps spanning a wide range of redshifts, multi-object spectroscopy has been a fundamentally important tool for mapping the rich structure of the cosmic web and extracting cosmological information of increasing variety and precision. This will continue to be true for the foreseeable future, as we seek to map the evolving geometry and structure of the universe over the full extent of cosmic history in order to obtain the most precise and comprehensive measurements of cosmological parameters. Here I briefly summarize the contributions that multi-object spectroscopy has made to cosmology so far, then review the major surveys and instruments currently in play and their prospects for pushing back the cosmological frontier. Finally, I examine some of the next generation of instruments and surveys to explore how the field will develop in coming years, with a particular focus on specialised multi-object spectrographs for cosmology and the capabilities of multi-object spectrographs on the new generation of extremely large telescopes.

Visibility graph analysis of heart rate time series and bio-marker of congestive heart failure

NASA Astrophysics Data System (ADS)

Bhaduri, Anirban; Bhaduri, Susmita; Ghosh, Dipak

2017-09-01

Study of RR interval time series for Congestive Heart Failure had been an area of study with different methods including non-linear methods. In this article the cardiac dynamics of heart beat are explored in the light of complex network analysis, viz. visibility graph method. Heart beat (RR Interval) time series data taken from Physionet database [46, 47] belonging to two groups of subjects, diseased (congestive heart failure) (29 in number) and normal (54 in number) are analyzed with the technique. The overall results show that a quantitative parameter can significantly differentiate between the diseased subjects and the normal subjects as well as different stages of the disease. Further, the data when split into periods of around 1 hour each and analyzed separately, also shows the same consistent differences. This quantitative parameter obtained using the visibility graph analysis thereby can be used as a potential bio-marker as well as a subsequent alarm generation mechanism for predicting the onset of Congestive Heart Failure.

Impact of a Health Promotion Nurse Intervention on Disability and Health Care Costs among Elderly Adults with Heart Conditions

ERIC Educational Resources Information Center

Meng, Hongdao; Wamsley, Brenda R.; Eggert, Gerald M.; Van Nostrand, Joan F.

2007-01-01

Context: Patients with heart conditions in rural areas may have different responses to health promotion-disease Self-management interventions compared to their urban counterparts. Purpose: To estimate the impact of a multi-component health promotion nurse intervention on physical function and total health care expenditures among elderly adults…

[Analysis of the heart sound with arrhythmia based on nonlinear chaos theory].

PubMed

Ding, Xiaorong; Guo, Xingming; Zhong, Lisha; Xiao, Shouzhong

2012-10-01

In this paper, a new method based on the nonlinear chaos theory was proposed to study the arrhythmia with the combination of the correlation dimension and largest Lyapunov exponent, through computing and analyzing these two parameters of 30 cases normal heart sound and 30 cases with arrhythmia. The results showed that the two parameters of the heart sounds with arrhythmia were higher than those with the normal, and there was significant difference between these two kinds of heart sounds. That is probably due to the irregularity of the arrhythmia which causes the decrease of predictability, and it's more complex than the normal heart sound. Therefore, the correlation dimension and the largest Lyapunov exponent can be used to analyze the arrhythmia and for its feature extraction.

Parasympathetic reinnervation accompanied by improved post-exercise heart rate recovery and quality of life in heart transplant recipients.

PubMed

Imamura, Teruhiko; Kinugawa, Koichiro; Okada, Ikuko; Kato, Naoko; Fujino, Takeo; Inaba, Toshiro; Maki, Hisataka; Hatano, Masaru; Kinoshita, Osamu; Nawata, Kan; Kyo, Shunei; Ono, Minoru

2015-01-01

Although sympathetic reinnervation is accompanied by the improvement of exercise tolerability during the first years after heart transplantation (HTx), little is known about parasympathetic reinnervation and its clinical impact. We enrolled 21 recipients (40 ± 16 years, 71% male) who had received successive cardiopulmonary exercise testing at 6 months, and 1 and 2 years after HTx. Exercise parameters such as peak oxygen consumption or achieved maximum load remained unchanged, whereas recovery parameters including heart rate (HR) recovery during 2 minutes and the delay of peak HR, which are influenced by parasympathetic activity, improved significantly during post-HTx 2 years (P < 0.05 for both). HR variability was analysed at post-HTx 6 months in 18 recipients, and high frequency power, representing parasympathetic activity, was significantly associated with the 2 recovery parameters (P < 0.05 for all). We also assessed quality of life using the Minnesota Living with Heart Failure (HF) Questionnaire at post-HTx 6 months and 2 years in the same 18 recipients, and those with improved recovery parameters enjoyed a better HF-specific quality of life (P < 0.05 for both). In conclusion, parasympathetic reinnervation emerges along with improved post-exercise recovery ability of HR and quality of life during post-HTx 2 years.

Smart phone monitoring of second heart sound split.

PubMed

Thiyagaraja, Shanti R; Vempati, Jagannadh; Dantu, Ram; Sarma, Tom; Dantu, Siva

2014-01-01

Heart Auscultation (listening to heart sounds) is the basic element of cardiac diagnosis. The interpretation of these sounds is a difficult skill to acquire. In this work we have developed an application to detect, monitor, and analyze the split in second heart sound (S2) using a smart phone. The application records the heartbeat using a stethoscope connected to the smart phone. The audio signal is converted into the frequency domain using Fast Fourier Transform to detect the first and second heart sounds (S1 and S2). S2 is extracted and fed into the Discrete Wavelet Transform (DWT) and then to Continuous Wavelet Transform (CWT) to detect the Aortic (A2) and the Pulmonic (P2) components, which are used to calculate the split in S2. With our application, users can continuously monitor their second heart sound irrespective of ages and check for a split in their hearts with a low-cost, easily available equipment.

Application of dragonfly algorithm for optimal performance analysis of process parameters in turn-mill operations- A case study

NASA Astrophysics Data System (ADS)

Vikram, K. Arun; Ratnam, Ch; Lakshmi, VVK; Kumar, A. Sunny; Ramakanth, RT

2018-02-01

Meta-heuristic multi-response optimization methods are widely in use to solve multi-objective problems to obtain Pareto optimal solutions during optimization. This work focuses on optimal multi-response evaluation of process parameters in generating responses like surface roughness (Ra), surface hardness (H) and tool vibration displacement amplitude (Vib) while performing operations like tangential and orthogonal turn-mill processes on A-axis Computer Numerical Control vertical milling center. Process parameters like tool speed, feed rate and depth of cut are considered as process parameters machined over brass material under dry condition with high speed steel end milling cutters using Taguchi design of experiments (DOE). Meta-heuristic like Dragonfly algorithm is used to optimize the multi-objectives like ‘Ra’, ‘H’ and ‘Vib’ to identify the optimal multi-response process parameters combination. Later, the results thus obtained from multi-objective dragonfly algorithm (MODA) are compared with another multi-response optimization technique Viz. Grey relational analysis (GRA).

Circadian rhythms of visual accommodation responses and physiological correlations.

NASA Technical Reports Server (NTRS)

Murphy, M. R.; Randle, R. J.; Williams, B. A.

1972-01-01

Use of a recently developed servocontrolled infrared optometer to continuously record the state of monocular focus while subjects viewed a visual target for which the stimulus to focus was systematically varied. Calculated parameters form recorded data - e.g., speeds of accommodation to approaching and receding targets, magnitude of accommodation to step changes in target distance, and amplitude and phase lag of response to sinusoidally varying stimuli were submitted to periodicity analyses. Ear canal temperature (ECT) and heart rate (HR) rhythms were also recorded for physiological correlation with accommodation rhythms. HR demonstrated a 24-hr rhythm, but ECT data did not.

Multi-parameter actuation of a neutrally stable shell: a flexible gear-less motor.

PubMed

Hamouche, W; Maurini, C; Vidoli, S; Vincenti, A

2017-08-01

We have designed and tested experimentally a morphing structure consisting of a neutrally stable thin cylindrical shell driven by a multi-parameter piezoelectric actuation. The shell is obtained by plastically deforming an initially flat copper disc, so as to induce large isotropic and almost uniform inelastic curvatures. Following the plastic deformation, in a perfectly isotropic system, the shell is theoretically neutrally stable, having a continuous set of stable cylindrical shapes corresponding to the rotation of the axis of maximal curvature. Small imperfections render the actual structure bistable, giving preferred orientations. A three-parameter piezoelectric actuation, exerted through micro-fibre-composite actuators, allows us to add a small perturbation to the plastic inelastic curvature and to control the direction of maximal curvature. This actuation law is designed through a geometrical analogy based on a fully nonlinear inextensible uniform-curvature shell model. We report on the fabrication, identification and experimental testing of a prototype and demonstrate the effectiveness of the piezoelectric actuators in controlling its shape. The resulting motion is an apparent rotation of the shell, controlled by the voltages as in a 'gear-less motor', which is, in reality, a precession of the axis of principal curvature.

Multi-parameter actuation of a neutrally stable shell: a flexible gear-less motor

NASA Astrophysics Data System (ADS)

Hamouche, W.; Maurini, C.; Vidoli, S.; Vincenti, A.

2017-08-01

We have designed and tested experimentally a morphing structure consisting of a neutrally stable thin cylindrical shell driven by a multi-parameter piezoelectric actuation. The shell is obtained by plastically deforming an initially flat copper disc, so as to induce large isotropic and almost uniform inelastic curvatures. Following the plastic deformation, in a perfectly isotropic system, the shell is theoretically neutrally stable, having a continuous set of stable cylindrical shapes corresponding to the rotation of the axis of maximal curvature. Small imperfections render the actual structure bistable, giving preferred orientations. A three-parameter piezoelectric actuation, exerted through micro-fibre-composite actuators, allows us to add a small perturbation to the plastic inelastic curvature and to control the direction of maximal curvature. This actuation law is designed through a geometrical analogy based on a fully nonlinear inextensible uniform-curvature shell model. We report on the fabrication, identification and experimental testing of a prototype and demonstrate the effectiveness of the piezoelectric actuators in controlling its shape. The resulting motion is an apparent rotation of the shell, controlled by the voltages as in a `gear-less motor', which is, in reality, a precession of the axis of principal curvature.

HARV ANSER Flight Test Data Retrieval and Processing Procedures

NASA Technical Reports Server (NTRS)

Yeager, Jessie C.

1997-01-01

Under the NASA High-Alpha Technology Program the High Alpha Research Vehicle (HARV) was used to conduct flight tests of advanced control effectors, advanced control laws, and high-alpha design guidelines for future super-maneuverable fighters. The High-Alpha Research Vehicle is a pre-production F/A-18 airplane modified with a multi-axis thrust-vectoring system for augmented pitch and yaw control power and Actuated Nose Strakes for Enhanced Rolling (ANSER) to augment body-axis yaw control power. Flight testing at the Dryden Flight Research Center (DFRC) began in July 1995 and continued until May 1996. Flight data will be utilized to evaluate control law performance and aircraft dynamics, determine aircraft control and stability derivatives using parameter identification techniques, and validate design guidelines. To accomplish these purposes, essential flight data parameters were retrieved from the DFRC data system and stored on the Dynamics and Control Branch (DCB) computer complex at Langley. This report describes the multi-step task used to retrieve and process this data and documents the results of these tasks. Documentation includes software listings, flight information, maneuver information, time intervals for which data were retrieved, lists of data parameters and definitions, and example data plots.

Operational validation of a multi-period and multi-criteria model conditioning approach for the prediction of rainfall-runoff processes in small forest catchments

NASA Astrophysics Data System (ADS)

Choi, H.; Kim, S.

2012-12-01

Most of hydrologic models have generally been used to describe and represent the spatio-temporal variability of hydrological processes in the watershed scale. Though it is an obvious fact that hydrological responses have the time varying nature, optimal values of model parameters were normally considered as time invariants or constants in most cases. The recent paper of Choi and Beven (2007) presents a multi-period and multi-criteria model conditioning approach. The approach is based on the equifinality thesis within the Generalised Likelihood Uncertainty Estimation (GLUE) framework. In their application, the behavioural TOPMODEL parameter sets are determined by several performance measures for global (annual) and short (30-days) periods, clustered using a Fuzzy C-means algorithm, into 15 types representing different hydrological conditions. Their study shows a good performance on the calibration of a rainfall-runoff model in a forest catchment, and also gives strong indications that it is uncommon to find model realizations that were behavioural over all multi-periods and all performance measures, and multi-period model conditioning approach may become new effective tool for predictions of hydrological processes in ungauged catchments. This study is a follow-up study on the Choi and Beven's (2007) model conditioning approach to test how the approach is effective for the prediction of rainfall-runoff responses in ungauged catchments. To achieve this purpose, 6 small forest catchments are selected among the several hydrological experimental catchments operated by Korea Forest Research Institute. In each catchment, long-term hydrological time series data varying from 10 to 30 years were available. The areas of the selected catchments range from 13.6 to 37.8 ha, and all areas are covered by coniferous or broad-leaves forests. The selected catchments locate in the southern coastal area to the northern part of South Korea. The bed rocks are Granite gneiss, Granite or Limestone. The study is progressed based on the followings. Firstly, hydrological time series of each catchment are sampled and clustered into multi-period having distinctly different temporal characteristics, and secondly, behavioural parameter distributions are determined in each multi-period based on the specification of multi-criteria model performance measures. Finally, behavioural parameter sets of each multi-period of single catchment are applied on the corresponding period of other catchments, and the cross-validations are conducted in this manner for all catchments The multi-period model conditioning approach is clearly effective to reduce the width of prediction limits, giving better model performance against the temporal variability of hydrological characteristics, and has enough potential to be the effective prediction tool for ungauged catchments. However, more advanced and continuous studies are needed to expand the application of this approach in prediction of hydrological responses in ungauged catchments,

Cardiovascular effects of Zumba® performed in a virtual environment using XBOX Kinect

PubMed Central

Neves, Luceli Eunice Da Silva; Cerávolo, Mariza Paver Da Silva; Silva, Elisangela; De Freitas, Wagner Zeferino; Da Silva, Fabiano Fernandes; Higino, Wonder Passoni; Carvalho, Wellington Roberto Gomes; De Souza, Renato Aparecido

2015-01-01

[Purpose] This study evaluated the acute cardiovascular responses during a session of Zumba® Fitness in a virtual reality environment. [Subjects] Eighteen healthy volunteers were recruited. [Methods] The following cardiovascular variables: heart rate, systolic blood pressure, diastolic blood pressure, and double product were assessed before and after the practice of virtual Zumba®, which was performed as a continuous sequence of five choreographed movements lasting for 22 min. The game Zumba Fitness Core®, with the Kinect-based virtual reality system for the XBOX 360, was used to create the virtual environment. Comparisons were made among mean delta values (delta=post-Zumba® minus pre-Zumba® values) for systolic and diastolic blood pressure, heart rate, and double product using Student’s t-test for paired samples. [Results] After a single session, a significant increase was noted in all the analyzed parameters (Systolic blood pressure=18%; Diastolic blood pressure=13%; Heart rate=67%; and Double product=97%). [Conclusion] The results support the feasibility of the use of Zumba Fitness Core® with the Kinect-based virtual reality system for the XBOX 360 in physical activity programs and further favor its indication for this purpose. PMID:26504312

Modelling breast cancer tumour growth for a stable disease population.

PubMed

Isheden, Gabriel; Humphreys, Keith

2017-01-01

Statistical models of breast cancer tumour progression have been used to further our knowledge of the natural history of breast cancer, to evaluate mammography screening in terms of mortality, to estimate overdiagnosis, and to estimate the impact of lead-time bias when comparing survival times between screen detected cancers and cancers found outside of screening programs. Multi-state Markov models have been widely used, but several research groups have proposed other modelling frameworks based on specifying an underlying biological continuous tumour growth process. These continuous models offer some advantages over multi-state models and have been used, for example, to quantify screening sensitivity in terms of mammographic density, and to quantify the effect of body size covariates on tumour growth and time to symptomatic detection. As of yet, however, the continuous tumour growth models are not sufficiently developed and require extensive computing to obtain parameter estimates. In this article, we provide a detailed description of the underlying assumptions of the continuous tumour growth model, derive new theoretical results for the model, and show how these results may help the development of this modelling framework. In illustrating the approach, we develop a model for mammography screening sensitivity, using a sample of 1901 post-menopausal women diagnosed with invasive breast cancer.

A 4-Week Intervention Involving Mobile-Based Daily 6-Minute Micro-Sessions of Functional High-Intensity Circuit Training Improves Strength and Quality of Life, but Not Cardio-Respiratory Fitness of Young Untrained Adults.

PubMed

Sperlich, Billy; Hahn, Lea-Sofie; Edel, Antonia; Behr, Tino; Helmprobst, Julian; Leppich, Robert; Wallmann-Sperlich, Birgit; Holmberg, Hans-Christer

2018-01-01

The present study was designed to assess the psycho-physiological responses of physically untrained individuals to mobile-based multi-stimulating, circuit-like, multiple-joint conditioning (Circuit HIIT ) performed either once (1xCircuit HIIT ) or twice (2xCircuit HIIT ) daily for 4 weeks. In this single-center, two-arm randomized, controlled study, 24 men and women (age: 25 ± 5 years) first received no training instructions for 4 weeks and then performed 4 weeks of either 1xCircuit HIIT or 2xCircuit HIIT (5 men and 7 women in each group) daily. The 1xCircuit HIIT and 2xCircuit HIIT participants carried out 90.7 and 85.7% of all planned training sessions, respectively, with average heart rates during the 6-min sessions of 74.3 and 70.8% of maximal heart rate. Body, fat and fat-free mass, and metabolic rate at rest did not differ between the groups or between time-points of measurement. Heart rate while running at 6 km⋅h -1 declined after the intervention in both groups. Submaximal and peak oxygen uptake, the respiratory exchange ratio and heart rate recovery were not altered by either intervention. The maximal numbers of push-ups, leg-levers, burpees, 45°-one-legged squats and 30-s skipping, as well as perception of general health improved in both groups. Our 1xCircuit HIIT or 2xCircuit HIIT interventions improved certain parameters of functional strength and certain dimensions of quality of life in young untrained individuals. However, they were not sufficient to enhance cardio-respiratory fitness, in particular peak oxygen uptake.

Continuing Education Programs within the American Heart Association

ERIC Educational Resources Information Center

Lembright, Katherine A.

1970-01-01

Because it believes the nurse can and must be a participant in the co-professional health team (doctor, nurse), the American Heart Association has become increasingly concerned with planning and carrying out activities that contribute to the continuing education of nurses. (PT)

Myocardial motion estimation of tagged cardiac magnetic resonance images using tag motion constraints and multi-level b-splines interpolation.

PubMed

Liu, Hong; Yan, Meng; Song, Enmin; Wang, Jie; Wang, Qian; Jin, Renchao; Jin, Lianghai; Hung, Chih-Cheng

2016-05-01

Myocardial motion estimation of tagged cardiac magnetic resonance (TCMR) images is of great significance in clinical diagnosis and the treatment of heart disease. Currently, the harmonic phase analysis method (HARP) and the local sine-wave modeling method (SinMod) have been proven as two state-of-the-art motion estimation methods for TCMR images, since they can directly obtain the inter-frame motion displacement vector field (MDVF) with high accuracy and fast speed. By comparison, SinMod has better performance over HARP in terms of displacement detection, noise and artifacts reduction. However, the SinMod method has some drawbacks: 1) it is unable to estimate local displacements larger than half of the tag spacing; 2) it has observable errors in tracking of tag motion; and 3) the estimated MDVF usually has large local errors. To overcome these problems, we present a novel motion estimation method in this study. The proposed method tracks the motion of tags and then estimates the dense MDVF by using the interpolation. In this new method, a parameter estimation procedure for global motion is applied to match tag intersections between different frames, ensuring specific kinds of large displacements being correctly estimated. In addition, a strategy of tag motion constraints is applied to eliminate most of errors produced by inter-frame tracking of tags and the multi-level b-splines approximation algorithm is utilized, so as to enhance the local continuity and accuracy of the final MDVF. In the estimation of the motion displacement, our proposed method can obtain a more accurate MDVF compared with the SinMod method and our method can overcome the drawbacks of the SinMod method. However, the motion estimation accuracy of our method depends on the accuracy of tag lines detection and our method has a higher time complexity. Copyright © 2015 Elsevier Inc. All rights reserved.

Optimal Control Method of Robot End Position and Orientation Based on Dynamic Tracking Measurement

NASA Astrophysics Data System (ADS)

Liu, Dalong; Xu, Lijuan

2018-01-01

In order to improve the accuracy of robot pose positioning and control, this paper proposed a dynamic tracking measurement robot pose optimization control method based on the actual measurement of D-H parameters of the robot, the parameters is taken with feedback compensation of the robot, according to the geometrical parameters obtained by robot pose tracking measurement, improved multi sensor information fusion the extended Kalan filter method, with continuous self-optimal regression, using the geometric relationship between joint axes for kinematic parameters in the model, link model parameters obtained can timely feedback to the robot, the implementation of parameter correction and compensation, finally we can get the optimal attitude angle, realize the robot pose optimization control experiments were performed. 6R dynamic tracking control of robot joint robot with independent research and development is taken as experimental subject, the simulation results show that the control method improves robot positioning accuracy, and it has the advantages of versatility, simplicity, ease of operation and so on.

Tactile stimulation during neonatal transition and its effect on vital parameters in neonates during neonatal transition.

PubMed

Baik-Schneditz, Nariae; Urlesberger, Berndt; Schwaberger, Bernhard; Mileder, Lukas; Schmölzer, Georg; Avian, Alexander; Pichler, Gerhard

2018-06-01

This study analysed tactile stimulation during neonatal transition and resuscitation in preterm and term neonates born by Caesarean delivery. It examined the frequency, location and body region, duration and possible effects of stimulation on heart rate and arterial oxygen saturation (SpO 2 ). Two independent investigators analysed video recordings of tactile stimulation on term and preterm neonates during neonatal transition from January 2012 to December 2014. They were recorded during a prospective observational study and randomised controlled trial at a tertiary centre, the Medical University of Graz, Austria. SpO 2 and heart rate were continuously recorded. Data on the frequency, body region and duration of stimulation were collected. To investigate the possible effects of stimulation, SpO 2 and heart rate were compared before and after stimulation. Term infants received tactile stimulation more than once, and it tended to start later, last longer and be applied in more locations than in preterm infants. Only preterm infants showed a significant increase in SpO 2 after stimulation and heart rates did not show any significant changes in either group. Tactile stimulation was applied in different ways to preterm and term infants during neonatal transition and SpO 2 showed a significant increase in preterm infants. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Multi-level basis selection of wavelet packet decomposition tree for heart sound classification.

PubMed

Safara, Fatemeh; Doraisamy, Shyamala; Azman, Azreen; Jantan, Azrul; Abdullah Ramaiah, Asri Ranga

2013-10-01

Wavelet packet transform decomposes a signal into a set of orthonormal bases (nodes) and provides opportunities to select an appropriate set of these bases for feature extraction. In this paper, multi-level basis selection (MLBS) is proposed to preserve the most informative bases of a wavelet packet decomposition tree through removing less informative bases by applying three exclusion criteria: frequency range, noise frequency, and energy threshold. MLBS achieved an accuracy of 97.56% for classifying normal heart sound, aortic stenosis, mitral regurgitation, and aortic regurgitation. MLBS is a promising basis selection to be suggested for signals with a small range of frequencies. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Carmat Bioprosthetic Total Artificial Heart Is Associated With Early Hemostatic Recovery and no Acquired von Willebrand Syndrome in Calves.

PubMed

Smadja, David M; Susen, Sophie; Rauch, Antoine; Cholley, Bernard; Latrémouille, Christian; Duveau, Daniel; Zilberstein, Luca; Méléard, Denis; Boughenou, Marie-Fazia; Belle, Eric Van; Gaussem, Pascale; Capel, Antoine; Jansen, Piet; Carpentier, Alain

2017-10-01

To determine hemostasis perturbations, including von Willebrand factor (VWF) multimers, after implantation of a new bioprosthetic and pulsatile total artificial heart (TAH). Preclinical study SETTING: Single-center biosurgical research laboratory. Female Charolais calves, 2-to-6 months old, weighing 102-to-122 kg. Surgical implantation of TAH through a mid-sternotomy approach. Four of 12 calves had a support duration of several days (4, 4, 8, and 10 days), allowing for the exploration of early steps of hemostasis parameters, including prothrombin time; coagulation factor levels (II, V, VII+X, and fibrinogen); and platelet count. Multimeric analysis of VWF was performed to detect a potential loss of high-molecular weight (HMW) multimers, as previously described for continuous flow rotary blood pumps. Despite the absence of anticoagulant treatment administered in the postoperative phase, no signs of coagulation activation were detected. Indeed, after an immediate postsurgery decrease of prothrombin time, platelet count, and coagulation factor levels, most parameters returned to baseline values. HMW multimers of VWF remained stable either after initiation or during days of support. Coagulation parameters and platelet count recovery in the postoperative phase of the Carmat TAH (Camat SA, Velizy Villacoublay Cedex, France) implantation in calves, in the absence of anticoagulant treatment and associated with the absence of decrease in HMW multimers of VWF, is in line with early hemocompatibility that is currently being validated in human clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

The KUT meteor radar: An educational low cost meteor observation system by radio forward scattering

NASA Astrophysics Data System (ADS)

Madkour, W.; Yamamoto, M.

2016-01-01

The Kochi University of Technology (KUT) meteor radar is an educational low cost observation system built at Kochi, Japan by successive graduate students since 2004. The system takes advantage of the continuous VHF- band beacon signal emitted from Fukui National College of Technology (FNCT) for scientific usage all over Japan by receiving the forward scattered signals. The system uses the classical forward scattering setup similar to the setup described by the international meteor organization (IMO), gradually developed from the most basic single antenna setup to the multi-site meteor path determination setup. The primary objective is to automate the observation of the meteor parameters continuously to provide amounts of data sufficient for statistical analysis. The developed software system automates the observation of the astronomical meteor parameters such as meteor direction, velocity and trajectory. Also, automated counting of meteor echoes and their durations are used to observe mesospheric ozone concentration by analyzing the duration distribution of different meteor showers. The meteor parameters observed and the methodology used for each are briefly summarized.

Electrocardiographic Impact of Myocardial Diffuse Fibrosis and Scar: MESA (Multi-Ethnic Study of Atherosclerosis)

PubMed Central

Inoue, Yuko Y.; Ambale-Venkatesh, Bharath; Mewton, Nathan; Volpe, Gustavo J.; Ohyama, Yoshiaki; Sharma, Ravi K.; Wu, Colin O.; Liu, Chia-Ying; Bluemke, David A.; Soliman, Elsayed Z.; Lima, João A. C.

2017-01-01

Purpose To examine the associations of myocardial diffuse fibrosis and scar with surface electrocardiographic (ECG) parameters in individuals free of prior coronary heart disease in four different ethnicities. Materials and Methods This prospective cross-sectional study was approved by the institutional review boards, and all participants gave informed consent. A total of 1669 participants in the Multi-Ethnic Study of Atherosclerosis, or MESA, who were free of prior myocardial infarction underwent both ECG and cardiac magnetic resonance imaging. In individuals without a late gadolinium enhancement–defined myocardial scar (n = 1131), T1 mapping was used to assess left ventricular (LV) interstitial diffuse fibrosis. The associations of LV diffuse fibrosis or myocardial scar with ECG parameters (QRS voltage, QRS duration, and corrected QT interval [QTc]) were evaluated by using multivariable regression analyses adjusted for demographic data, risk factors for scar, LV end-diastolic volume, and LV mass. Results The mean age of the 1669 participants was 67.4 years ± 8.7 (standard deviation); 49.8% were women. Lower postcontrast T1 time at 12 minutes was significantly associated with lower QRS Sokolow-Lyon voltage (β = 15.1 µV/10 msec, P = .004), lower QRS Cornell voltage (β = 9.2 µV/10 msec, P = .031), and shorter QRS duration (β = 0.16 msec/10 msec, P = .049). Greater extracellular volume (ECV) fraction was also significantly associated with lower QRS Sokolow-Lyon voltage (β = −35.2 µV/1% ECV increase, P < .001) and Cornell voltage (β = −23.7 µV/1% ECV increase, P < .001), independent of LV structural indexes. In contrast, the presence of LV scar (n = 106) was associated with longer QTc (β = 4.3 msec, P = .031). Conclusion In older adults without prior coronary heart disease, underlying greater LV diffuse fibrosis is associated with lower QRS voltage and shorter QRS duration at surface ECG, whereas clinically unrecognized myocardial scar is associated with a longer QT interval. © RSNA, 2016 Online supplemental material is available for this article. PMID:27740904

The role of noninvasive cardiovascular testing, applied clinical nutrition and nutritional supplements in the prevention and treatment of coronary heart disease.

PubMed

Houston, Mark

2018-03-01

Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. About 80% of heart disease (heart attacks, angina, coronary heart disease and congestive heart failure) can be prevented by optimal nutrition, optimal exercise, optimal weight and body composition, mild alcohol intake and avoiding smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite presently defined 'normal' levels of the five risk factors listed above. This is often referred to as the 'CHD gap'. Novel and more accurate definitions and evaluations of these top five risk factors are required, such as 24 h ambulatory blood pressure (ABM) results, advanced lipid profiles, redefined fasting and 2 h dysglycemia parameters, a focus on visceral obesity and body composition and the effects of adipokines on cardiovascular risk. There are numerous traumatic insults from the environment that damage the cardiovascular system but there are only three finite vascular endothelial responses, which are inflammation, oxidative stress and immune vascular dysfunction. In addition, the concept of translational cardiovascular medicine is mandatory in order to correlate the myriad of CHD risk factors to the presence or absence of functional or structural damage to the vascular system, preclinical and clinical CHD. This can be accomplished by utilizing advanced and updated CV risk scoring systems, new and redefined CV risk factors and biomarkers, micronutrient testing, cardiovascular genetics, nutrigenomics, metabolomics, genetic expression testing and noninvasive cardiovascular testing.

The role of noninvasive cardiovascular testing, applied clinical nutrition and nutritional supplements in the prevention and treatment of coronary heart disease

PubMed Central

Houston, Mark

2018-01-01

Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. About 80% of heart disease (heart attacks, angina, coronary heart disease and congestive heart failure) can be prevented by optimal nutrition, optimal exercise, optimal weight and body composition, mild alcohol intake and avoiding smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite presently defined ‘normal’ levels of the five risk factors listed above. This is often referred to as the ‘CHD gap’. Novel and more accurate definitions and evaluations of these top five risk factors are required, such as 24 h ambulatory blood pressure (ABM) results, advanced lipid profiles, redefined fasting and 2 h dysglycemia parameters, a focus on visceral obesity and body composition and the effects of adipokines on cardiovascular risk. There are numerous traumatic insults from the environment that damage the cardiovascular system but there are only three finite vascular endothelial responses, which are inflammation, oxidative stress and immune vascular dysfunction. In addition, the concept of translational cardiovascular medicine is mandatory in order to correlate the myriad of CHD risk factors to the presence or absence of functional or structural damage to the vascular system, preclinical and clinical CHD. This can be accomplished by utilizing advanced and updated CV risk scoring systems, new and redefined CV risk factors and biomarkers, micronutrient testing, cardiovascular genetics, nutrigenomics, metabolomics, genetic expression testing and noninvasive cardiovascular testing. PMID:29316855

The integration of depressive behaviors and cardiac dysfunction during an operational measure of depression: investigating the role of negative social experiences in an animal model.

PubMed

Grippo, Angela J; Moffitt, Julia A; Sgoifo, Andrea; Jepson, Amanda J; Bates, Suzanne L; Chandler, Danielle L; McNeal, Neal; Preihs, Kristin

2012-01-01

There is a bidirectional association between depression and cardiovascular disease. The neurobiological mechanisms underlying this association may involve an inability to cope with disrupted social bonds. This study investigated in an animal model the integration of depressive behaviors and cardiac dysfunction after a disrupted social bond and during an operational measure of depression, relative to the protective effects of intact social bonds. Depressive behaviors in the forced swim test and continuous electrocardiographic parameters were measured in 14 adult, female socially monogamous prairie voles (rodents), after 4 weeks of social pairing or isolation. After social isolation, animals exhibited (all values are mean ± standard error of the mean; isolated versus paired, respectively) increased heart rate (416 ± 14 versus 370 ± 14 bpm, p < .05) and reduced heart rate variability (3.3 ± 0.2 versus 3.9 ± 0.2 ln(ms(2))). During the forced swim test, isolated animals exhibited greater helpless behavior (immobility = 106 ± 11 versus 63 ± 11 seconds, p < .05), increased heart rate (530 ± 22 versus 447 ± 15 bpm, p < .05), reduced heart rate variability (1.8 ± 0.4 versus 2.7 ± 0.2 ln(ms(2)), p < .05), and increased arrhythmias (arrhythmic burden score = 181 ± 46 versus 28 ± 12, p < .05). The display of depressive behaviors during an operational measure of depression is coupled with increased heart rate, reduced heart rate variability, and increased arrhythmias, indicative of dysfunctional behavioral and physiological stress coping abilities as a function of social isolation. In contrast, social pairing with a sibling is behaviorally protective and cardioprotective. The present results can provide insight into a possible social mechanism underlying the association between depression and cardiovascular disease in humans.

Symptomatic radiation-induced cardiac disease in long-term survivors of esophageal cancer.

PubMed

Ogino, Ichiro; Watanabe, Shigenobu; Iwahashi, Noriaki; Kosuge, Masami; Sakamaki, Kentaro; Kunisaki, Chikara; Kimura, Kazuo

2016-06-01

To evaluate clinical and dosimetric factors retrospectively affecting the risk of symptomatic cardiac disease (SCD) in esophageal cancer patients treated with radiotherapy. A total of 343 patients with newly diagnosed esophageal cancer were managed with concurrent chemoradiotherapy or radiotherapy alone. Of these, 58 patients were followed at our hospital for at least 4 years. Median clinical follow-up was 79 months. Cardiac toxicity was determined by Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0. The maximum and mean doses to the heart and percentage of the volume were calculated from the dose-volume histograms. SCD manifested in 11 patients. The heart diseases included three pericardial effusions, one pericardial effusion with valvular disease and paroxysmal atrial tachycardia, three atrial fibrillations, one sinus tachycardia, one coronary artery disease, one chest pain with strongly suspected coronary artery disease, and one congestive heart failure. The actual incidence of SCD was 13.8 % at 5 years. Univariate and multivariate analyses of continuous variables revealed that the risk of developing an SCD depended on the volume of the heart receiving a dose greater than 45 Gy (V45), 50 Gy (V50), and 55 Gy (V55). No other clinical factors were found to influence the risk of SCD. For V45, V50, and V55, the lowest significant cutoff values were 15, 10, and 5 %, respectively. High-dose and large-volume irradiation of the heart increased the risk of SCD in long-term survivors. Using modern radiotherapy techniques, it is important to minimize the heart dose-volume parameters without reducing the tumor dose.

Fetal heart and uterine contraction monitor (image)

MedlinePlus

The fetal heart monitor and uterine contraction monitor provide a continuous record of the baby's heart rate and the mother's contraction rate as labor progresses. This device can provide early warning of fetal distress.

Higher psychological and psychovegetative strain in adolescents with atypical pigment naevi.

PubMed

Trapp, Michael; Egger, Josef Wilhelm; Kapfhammer, Hans-Peter; Trapp, Eva-Maria; Rohrer, Peter Michael; Hörlesberger, Nina; Schwantzer, Gerold; Komericki, Peter; Linder, Michael Dennis; Lvov, Andrey; Baulmann, Johannes; Richtig, Erika

2015-01-01

An observational, exploratory, cross-sectional study was performed to assess whether the presence of atypical naevi (AN) in adolescents is associated with psychological and psychovegetative stress parameters. Fifty-one students of a secondary school in Graz, Austria, completed a defined test procedure consisting of an initial period of rest, a standardised mental stress task, another period rest and a questionnaire, the change-sensitive symptom list (ASS-SYM). Electrocardiogram and blood pressure were recorded continuously. The study population was divided in two groups: probands without AN (NAN, n = 33), and probands with at least one AN (n = 18). We found higher values for the AN group in all scales of ASS-SYM, reaching statistical significance in the dimensions "nervousness and mental tension" (p = 0.025), "psychophysiological dysregulation" (p = 0.020), burden of pain" (p = 0.023) and "general symptoms and problems" (p = 0.031). Regarding physiological parameters, the AN group showed higher vegetative strain reflected in heart rate and heart rate varibility during the periods of rest as well as a reduced baroreceptor sensitivity. On the basis of our results, the presence of AN in adolescents seems to be associated with a higher vegetative arousal. Additionally, participants with AN complained significantly more often about stress-associated general psychological symptoms and problems.

Stress levels during emergency care: A comparison between reality and simulated scenarios.

PubMed

Daglius Dias, Roger; Scalabrini Neto, Augusto

2016-06-01

Medical simulation is fast becoming a standard of health care training throughout undergraduate, postgraduate and continuing medical education. Our aim was to evaluate if simulated scenarios have a high psychological fidelity and induce stress levels similarly to real emergency medical situations. Medical residents had their stress levels measured during emergency care (real-life and simulation) in baseline (T1) and immediately post-emergencies (T2). Parameters measuring acute stress were: heart rate, systolic and diastolic blood pressure, salivary α-amylase, salivary interleukin-1β, and State-Trait Anxiety Inventory score. Twenty-eight internal medicine residents participated in 32 emergency situations (16 real-life and 16 simulated emergencies). In the real-life group, all parameters increased significantly (P < .05) between T1 and T2. In the simulation group, only heart rate and interleukin-1β increased significantly after emergencies. The comparison between groups demonstrates that acute stress response (T2 - T1) and State-Trait Anxiety Inventory score (in T2) did not differ between groups. Acute stress response did not differ between both groups. Our results indicate that emergency medicine simulation may create a high psychological fidelity environment similarly to what is observed in a real emergency room. Copyright © 2016 Elsevier Inc. All rights reserved.

Quantitative analysis of vascular parameters for micro-CT imaging of vascular networks with multi-resolution.

PubMed

Zhao, Fengjun; Liang, Jimin; Chen, Xueli; Liu, Junting; Chen, Dongmei; Yang, Xiang; Tian, Jie

2016-03-01

Previous studies showed that all the vascular parameters from both the morphological and topological parameters were affected with the altering of imaging resolutions. However, neither the sensitivity analysis of the vascular parameters at multiple resolutions nor the distinguishability estimation of vascular parameters from different data groups has been discussed. In this paper, we proposed a quantitative analysis method of vascular parameters for vascular networks of multi-resolution, by analyzing the sensitivity of vascular parameters at multiple resolutions and estimating the distinguishability of vascular parameters from different data groups. Combining the sensitivity and distinguishability, we designed a hybrid formulation to estimate the integrated performance of vascular parameters in a multi-resolution framework. Among the vascular parameters, degree of anisotropy and junction degree were two insensitive parameters that were nearly irrelevant with resolution degradation; vascular area, connectivity density, vascular length, vascular junction and segment number were five parameters that could better distinguish the vascular networks from different groups and abide by the ground truth. Vascular area, connectivity density, vascular length and segment number not only were insensitive to multi-resolution but could also better distinguish vascular networks from different groups, which provided guidance for the quantification of the vascular networks in multi-resolution frameworks.

Development of a wearable wireless body area network for health monitoring of the elderly and disabled

NASA Astrophysics Data System (ADS)

Rushambwa, Munyaradzi C.; Gezimati, Mavis; Jeeva, J. B.

2017-11-01

Novel advancements in systems miniaturization, electronics in health care and communication technologies are enabling the integration of both patients and doctors involvement in health care system. A Wearable Wireless Body Area Network (WWBAN) provides continuous, unobtrusive ambulatory, ubiquitous health monitoring, and provide real time patient’s status to the physician without any constraint on their normal daily life activities. In this project we developed a wearable wireless body area network system that continuously monitor the health of the elderly and the disabled and provide them with independent, safe and secure living. The WWBAN system monitors the following parameters; blood oxygen saturation using a pulse oximeter sensor (SpO2), heart rate (HR) pulse sensor, Temperature, hydration, glucose level and fall detection. When the wearable system is put on, the sensor values are processed and analysed. If any of the monitored parameter values falls below or exceeds the normal range, there is trigger of remote alert by which an SMS is send to a doctor or physician via GSM module and network. The developed system offers flexibility and mobility to the user; it is a real time system and has significance in revolutionizing health care system by enabling non-invasive, inexpensive, continuous health monitoring.

Construction and Use of Resting 12-Lead High Fidelity ECG "SuperScores" in Screening for Heart Disease

NASA Technical Reports Server (NTRS)

Schlegel, T. T.; Arenare, B.; Greco, E. C.; DePalma, J. L.; Starc, V.; Nunez, T.; Medina, R.; Jugo, D.; Rahman, M.A.; Delgado, R.

2007-01-01

We investigated the accuracy of several conventional and advanced resting ECG parameters for identifying obstructive coronary artery disease (CAD) and cardiomyopathy (CM). Advanced high-fidelity 12-lead ECG tests (approx. 5-min supine) were first performed on a "training set" of 99 individuals: 33 with ischemic or dilated CM and low ejection fraction (EF less than 40%); 33 with catheterization-proven obstructive CAD but normal EF; and 33 age-/gender-matched healthy controls. Multiple conventional and advanced ECG parameters were studied for their individual and combined retrospective accuracies in detecting underlying disease, the advanced parameters falling within the following categories: 1) Signal averaged ECG, including 12-lead high frequency QRS (150-250 Hz) plus multiple filtered and unfiltered parameters from the derived Frank leads; 2) 12-lead P, QRS and T-wave morphology via singular value decomposition (SVD) plus signal averaging; 3) Multichannel (12-lead, derived Frank lead, SVD lead) beat-to-beat QT interval variability; 4) Spatial ventricular gradient (and gradient component) variability; and 5) Heart rate variability. Several multiparameter ECG SuperScores were derivable, using stepwise and then generalized additive logistic modeling, that each had 100% retrospective accuracy in detecting underlying CM or CAD. The performance of these same SuperScores was then prospectively evaluated using a test set of another 120 individuals (40 new individuals in each of the CM, CAD and control groups, respectively). All 12-lead ECG SuperScores retrospectively generated for CM continued to perform well in prospectively identifying CM (i.e., areas under the ROC curve greater than 0.95), with one such score (containing just 4 components) maintaining 100% prospective accuracy. SuperScores retrospectively generated for CAD performed somewhat less accurately, with prospective areas under the ROC curve typically in the 0.90-0.95 range. We conclude that resting 12-lead high-fidelity ECG employing and combining the results of several advanced ECG software techniques shows great promise as a rapid and inexpensive tool for screening of heart disease.

Fundamental Cardiovascular Research: Returns on Societal Investment: A Scientific Statement From the American Heart Association.

PubMed

Hill, Joseph A; Ardehali, Reza; Clarke, Kimberli Taylor; Del Zoppo, Gregory J; Eckhardt, Lee L; Griendling, Kathy K; Libby, Peter; Roden, Dan M; Sadek, Hesham A; Seidman, Christine E; Vaughan, Douglas E

2017-07-21

Recent decades have witnessed robust successes in conquering the acutely lethal manifestations of heart and vascular diseases. Many patients who previously would have died now survive. Lifesaving successes like these provide a tremendous and easily recognized benefit to individuals and society. Although cardiovascular mortality has declined, the devastating impact of chronic heart disease and comorbidities on quality of life and healthcare resources continues unabated. Future strides, extending those made in recent decades, will require continued research into mechanisms underlying disease prevention, pathogenesis, progression, and therapeutic intervention. However, severe financial constraints currently jeopardize these efforts. To chart a path for the future, this report analyzes the challenges and opportunities we face in continuing the battle against cardiovascular disease and highlights the return on societal investment afforded by fundamental cardiovascular research. © 2017 American Heart Association, Inc.

Performance parameters and post exercise heart rate recovery in Warmblood sports horses of different performance levels.

PubMed

Bitschnau, C; Wiestner, T; Trachsel, D S; Auer, J A; Weishaupt, M A

2010-11-01

Standardised exercise tests are used for fitness evaluation of sports horses. Standards are described for Thoroughbreds and Standardbreds; however, limited information is available for Warmbloods. To establish normative standards of performance parameters and heart rate recovery (HRR) in Warmblood riding horses of different levels of fitness using a submaximal incremental exercise test (SIET) performed on a treadmill. A SIET was carried out with 29 healthy and treadmill-accustomed Warmbloods: eleven 3-day event horses (TDE) and 18 horses from the National Equestrian Centre (NEC) competing in amateur jumping and/or dressage events. After a warm-up phase, horses performed 2 stages at trot and 3-5 stages at gallop at 6% incline. The first stage lasted 120 s, all others 90 s. Velocity (V) and heart rate (HR) were measured continuously and blood lactate concentration (LAC) at the end of each exercise stage. V at HR 150 and 200 beats/min (V(150), V(200)), V and HR at 2 and 4 mmol/l LAC (V(2), V(4) and HR(2), HR(4), respectively) were calculated and compared between discipline groups. For reference values, horses were divided on the basis of the V(4) -results in good (GP) and average performers (AP) (performance groups). Five minute passive HRR was compared between performance groups. Fifteen NEC horses were retested within 1-3 months. Groups were compared with t tests and P < 0.05 considered significant. Three-day event horses had higher V(150), V(2) and V(4) values than NEC. GP had higher values in all performance parameters compared to AP. No differences were found between test and retest. GP mean recovery HR was different from that of AP from 120 s of recovery onwards. Treadmill SIETs are suitable to objectify aerobic capacity in Warmblood riding horses. Normative standards were assessed for well and averagely-trained horses. The results can be referred to when diagnosing patients with exercise intolerance. © 2010 EVJ Ltd.

Effects of foot reflexology on anxiety and physiological parameters in patients undergoing coronary artery bypass graft surgery: A clinical trial.

PubMed

Abbaszadeh, Yaser; Allahbakhshian, Atefeh; Seyyedrasooli, Alehe; Sarbakhsh, Parvin; Goljarian, Sakineh; Safaei, Naser

2018-05-01

This study aimed to investigate the effect of foot reflexology on anxiety and physiological parameters in patients after CABG surgery. This was a single-blind, three-arm, parallel-group, randomized controlled trial with three groups of 40 male patients undergoing CABG. Participants were placed in three groups, named intervention, placebo, and control. Physiological parameters were measured including systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate, percutaneous oxygen saturation, and anxiety of participants. Results showed a statistically significant difference between intervention and control groups in terms of the level of anxiety (p < 0.05). Also, results showed a statistically significant effect on all physiological parameters except heart rate (p < 0.05). This study indicated that foot reflexology may be used by nurses as an adjunct to standard ICU care to reduce anxiety and stabilize physiological parameters such as systolic, diastolic, mean arterial pressure, and heart rate. Copyright © 2018 Elsevier Ltd. All rights reserved.

Research on human physiological parameters intelligent clothing based on distributed Fiber Bragg Grating

NASA Astrophysics Data System (ADS)

Miao, Changyun; Shi, Boya; Li, Hongqiang

2008-12-01

A human physiological parameters intelligent clothing is researched with FBG sensor technology. In this paper, the principles and methods of measuring human physiological parameters including body temperature and heart rate in intelligent clothing with distributed FBG are studied, the mathematical models of human physiological parameters measurement are built; the processing method of body temperature and heart rate detection signals is presented; human physiological parameters detection module is designed, the interference signals are filtered out, and the measurement accuracy is improved; the integration of the intelligent clothing is given. The intelligent clothing can implement real-time measurement, processing, storage and output of body temperature and heart rate. It has accurate measurement, portability, low cost, real-time monitoring, and other advantages. The intelligent clothing can realize the non-contact monitoring between doctors and patients, timely find the diseases such as cancer and infectious diseases, and make patients get timely treatment. It has great significance and value for ensuring the health of the elders and the children with language dysfunction.

Heart valve scaffold fabrication: Bioinspired control of macro-scale morphology, mechanics and micro-structure.

PubMed

D'Amore, Antonio; Luketich, Samuel K; Raffa, Giuseppe M; Olia, Salim; Menallo, Giorgio; Mazzola, Antonino; D'Accardi, Flavio; Grunberg, Tamir; Gu, Xinzhu; Pilato, Michele; Kameneva, Marina V; Badhwar, Vinay; Wagner, William R

2018-01-01

Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial. This study aimed to overcome these limitations by introducing double component deposition (DCD), an electrodeposition technique that employs multi-phase electrodes to dictate valve macro and microstructure and resultant function. Results in this report demonstrate the capacity of the DCD method to simultaneously control scaffold macro-scale morphology, mechanics and microstructure while producing fully assembled stent-less multi-leaflet valves composed of microscopic fibers. DCD engineered valve characterization included: leaflet thickness, biaxial properties, bending properties, and quantitative structural analysis of multi-photon and scanning electron micrographs. Quasi-static ex-vivo valve coaptation testing and dynamic organ level functional assessment in a pressure pulse duplicating device demonstrated appropriate acute valve functionality. Copyright © 2017. Published by Elsevier Ltd.

[Multi-central controlled study on three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen].

PubMed

Zhou, Yun-feng; Wei, Yu-long; Zhang, Pu-lin; Gao, Shan; Ning, Guo-li; Zhang, Zhen-qiang; Hu, Bin; Wang, Dan-yi; Yan, Mei-rong; Liu, Wen-jun

2006-06-01

To make multi-central clinical evaluation for three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen. One hundred and sixty-six cases were randomly divided into a test group (n = 84) and a control group (n = 82). Multi-central, randomized and controlled methods were adopted. The test group were treated by the three-part massage therapy, i. e. acupoints at the head, abdomen and back were massaged, once each day; and the control group by oral administration of Guipi Pills [symbol: see text], 8 pills each time, thrice daily. The treatment was given for 15 consecutive days and then the therapeutic effects were observed. Sixty-seven cases were cured, 11 markedly effective, 3 effective, and 3 ineffective in the test group, and the corresponding figures were 10, 21, 29 and 22 in the control group with a very significant difference between the two groups (P< 0.001). The test group was superior to the control group in improvement for Pittsburgh Sleep Quality Index (PSQI), Sleepless Anxiety Scale (SAS) and Sleepless Depression Scale (SDS) (P < 0.001). The three-part massage therapy has definite therapeutic effect on insomnia of deficiency of both the heart and spleen with safety.

History of the Congenital Heart Surgeons' Society.

PubMed

Mavroudis, Constantine; Williams, William G

2015-10-01

The Congenital Heart Surgeons' Society is a group of over 100 pediatric heart surgeons representing 72 institutions that specialize in the treatment of patients with congenital heart defects. The Society began in 1972 and incorporated as a not-for-profit charitable organization in 2004. It has become the face and voice of congenital heart surgery in North America. In 1985, the Society established a data center for multicenter clinical research studies to encourage congenital heart professionals to participate in improving outcomes for our patients. The goals of the Congenital Heart Surgeons' Society are to stimulate the study of congenital cardiac physiology, pathology, and management options which are instantiated in data collection, multi-institutional studies, and scientific meetings. Honest and open discussion of problems with possible solutions to the challenges facing congenital heart professionals have been the strength of the Congenital Heart Surgeons' Society. It is imperative for the growth of an organization to know from where it came in order to know to where it is going. The purpose of this article is to review the history of the Congenital Heart Surgeons' Society. © The Author(s) 2015.

Echocardiographic Parameters and Survival in Chagas Heart Disease with Severe Systolic Dysfunction

PubMed Central

Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Arruda, Ana Lúcia Martins; Hotta, Viviane Tiemi; Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador

2014-01-01

Background Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis. Objective To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%. Methods Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation. Results In the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m2 were associated with a significant increase in mortality (log rank p < 0.0001). Conclusion The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction. PMID:24553982

Echocardiographic parameters and survival in Chagas heart disease with severe systolic dysfunction.

PubMed

Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Arruda, Ana Lúcia Martins; Hotta, Viviane Tiemi; Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador

2014-03-01

Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis. To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%. Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation. In the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m2 were associated with a significant increase in mortality (log rank p < 0.0001). The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction.

Heart rate variability enhances the prognostic value of established parameters in patients with congestive heart failure.

PubMed

Krüger, C; Lahm, T; Zugck, C; Kell, R; Schellberg, D; Schweizer, M W F; Kübler, W; Haass, M

2002-12-01

This prospective study evaluated whether heart rate variability (HRV) assessed from Holter ECG has prognostic value in addition to established parameters in patients with congestive heart failure (CHF). The study included 222 patients with CHF due to dilated or ischemic cardiomyopathy (left ventricular ejection fraction LVEF 21+/-1%; mean+/-SEM). During a mean follow-up of 15+/-1 months, 38 (17%) patients died and 45 (20%) were hospitalized due to worsening of CHF. The HRV parameter SDNN (standard deviation of all intervals between normal beats) was significantly lower in non-surviving or hospitalized than in event-free patients (118+/-6 vs 142+/-5 ms), as were LVEF (18+/-1 vs 23+/-1%), and peak oxygen uptake during exercise (peak VO(2)) (12.8+/-0.5 vs 15.6+/-0.5 ml/min/kg). While each of these parameters was a risk predictor in univariate analysis, multivariate analysis revealed that HRV provides both independent and additional prognostic information with respect to the risk 'cardiac mortality or deterioration of CHF'. It is concluded that the determination of HRV enhances the prognostic power given by the most widely used parameters LVEF and peak VO(2) in the prediction of mortality or deterioration of CHF and thus enables to improve risk stratification.

Effects of temporal and spatial resolution of calibration data on integrated hydrologic water quality model identification

NASA Astrophysics Data System (ADS)

Jiang, Sanyuan; Jomaa, Seifeddine; Büttner, Olaf; Rode, Michael

2014-05-01

Hydrological water quality modeling is increasingly used for investigating runoff and nutrient transport processes as well as watershed management but it is mostly unclear how data availablity determins model identification. In this study, the HYPE (HYdrological Predictions for the Environment) model, which is a process-based, semi-distributed hydrological water quality model, was applied in two different mesoscale catchments (Selke (463 km2) and Weida (99 km2)) located in central Germany to simulate discharge and inorganic nitrogen (IN) transport. PEST and DREAM(ZS) were combined with the HYPE model to conduct parameter calibration and uncertainty analysis. Split-sample test was used for model calibration (1994-1999) and validation (1999-2004). IN concentration and daily IN load were found to be highly correlated with discharge, indicating that IN leaching is mainly controlled by runoff. Both dynamics and balances of water and IN load were well captured with NSE greater than 0.83 during validation period. Multi-objective calibration (calibrating hydrological and water quality parameters simultaneously) was found to outperform step-wise calibration in terms of model robustness. Multi-site calibration was able to improve model performance at internal sites, decrease parameter posterior uncertainty and prediction uncertainty. Nitrogen-process parameters calibrated using continuous daily averages of nitrate-N concentration observations produced better and more robust simulations of IN concentration and load, lower posterior parameter uncertainty and IN concentration prediction uncertainty compared to the calibration against uncontinuous biweekly nitrate-N concentration measurements. Both PEST and DREAM(ZS) are efficient in parameter calibration. However, DREAM(ZS) is more sound in terms of parameter identification and uncertainty analysis than PEST because of its capability to evolve parameter posterior distributions and estimate prediction uncertainty based on global search and Bayesian inference schemes.

Acoustic monitoring of first responder's physiology for health and performance surveillance

NASA Astrophysics Data System (ADS)

Scanlon, Michael V.

2002-08-01

Acoustic sensors have been used to monitor firefighter and soldier physiology to assess health and performance. The Army Research Laboratory has developed a unique body-contacting acoustic sensor that can monitor the health and performance of firefighters and soldiers while they are doing their mission. A gel-coupled sensor has acoustic impedance properties similar to the skin that facilitate the transmission of body sounds into the sensor pad, yet significantly repel ambient airborne noises due to an impedance mismatch. This technology can monitor heartbeats, breaths, blood pressure, motion, voice, and other indicators that can provide vital feedback to the medics and unit commanders. Diverse physiological parameters can be continuously monitored with acoustic sensors and transmitted for remote surveillance of personnel status. Body-worn acoustic sensors located at the neck, breathing mask, and wrist do an excellent job at detecting heartbeats and activity. However, they have difficulty extracting physiology during rigorous exercise or movements due to the motion artifacts sensed. Rigorous activity often indicates that the person is healthy by virtue of being active, and injury often causes the subject to become less active or incapacitated making the detection of physiology easier. One important measure of performance, heart rate variability, is the measure of beat-to-beat timing fluctuations derived from the interval between two adjacent beats. The Lomb periodogram is optimized for non-uniformly sampled data, and can be applied to non-stationary acoustic heart rate features (such as 1st and 2nd heart sounds) to derive heart rate variability and help eliminate errors created by motion artifacts. Simple peak-detection above or below a certain threshold or waveform derivative parameters can produce the timing and amplitude features necessary for the Lomb periodogram and cross-correlation techniques. High-amplitude motion artifacts may contribute to a different frequency or baseline noise due to the timing differences between the noise artifacts and heartbeat features. Data from a firefighter experiment is presented.

Dynamic molecular imaging of cardiac innervation using a dual headpinhole SPECT system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Jicun; Boutchko, Rostyslav; Sitek, Arkadiusz

2008-03-29

Typically 123I-MIBG is used for the study of innervation andfunction of the sympathetic nervous system in heart failure. The protocolinvolves two studies: first a planar or SPECT scan is performed tomeasure initial uptake of the tracer, followed some 3-4 hours later byanother study measuring the wash-out of the tracer from the heart. A fastwash-out is indicative of a compromised heart. In this work, a dual headpinhole SPECT system was used for imaging the distribution and kineticsof 123I-MIBG in the myocardium of spontaneous hypertensive rats (SHR) andnormotensive Wistar Kyoto (WKY) rats. The system geometry was calibratedbased on a nonlinear point projectionmore » fitting method using a three-pointsource phantom. The angle variation effect of the parameters was modeledwith a sinusoidal function. A dynamic acquisition was performed byinjecting 123I-MIBG into rats immediately after starting the dataacquisition. The detectors rotated continuously performing a 360o dataacquisition every 90 seconds. We applied the factor analysis (FA)methodand region of interest (ROI) sampling method to obtain time activitycurves (TACs)in the blood pool and myocardium and then appliedtwo-compartment modeling to estimate the kinetic parameters. Since theinitial injection bolus is too fast for obtaining a consistenttomographic data set in the first few minutes of the study, we appliedthe FA method directly to projections during the first rotation. Then thetime active curves for blood and myocardial tissue were obtained from ROIsampling. The method was applied to determine if there were differencesin the kinetics between SHR and WKY rats and requires less time byreplacing the delayed scan at 3-4 hours after injection with a dynamicacquisition over 90 to 120 minutes. The results of a faster washout and asmaller distribution volume of 123IMIBG near the end of life in the SHRmodel of hypertrophic cardiomyopthy may be indicative of a failing heartin late stages of heart failure.« less

Ionospheric and receiver DCB-constrained multi-GNSS single-frequency PPP integrated with MEMS inertial measurements

NASA Astrophysics Data System (ADS)

Gao, Zhouzheng; Ge, Maorong; Shen, Wenbin; Zhang, Hongping; Niu, Xiaoji

2017-11-01

Single-frequency precise point positioning (SF-PPP) is a potential precise positioning technique due to the advantages of the high accuracy in positioning after convergence and the low cost in operation. However, there are still challenges limiting its applications at present, such as the long convergence time, the low reliability, and the poor satellite availability and continuity in kinematic applications. In recent years, the achievements in the dual-frequency PPP have confirmed that its performance can be significantly enhanced by employing the slant ionospheric delay and receiver differential code bias (DCB) constraint model, and the multi-constellation Global Navigation Satellite Systems (GNSS) data. Accordingly, we introduce the slant ionospheric delay and receiver DCB constraint model, and the multi-GNSS data in SF-PPP modular together. In order to further overcome the drawbacks of SF-PPP in terms of reliability, continuity, and accuracy in the signal easily blocking environments, the inertial measurements are also adopted in this paper. Finally, we form a new approach to tightly integrate the multi-GNSS single-frequency observations and inertial measurements together to ameliorate the performance of the ionospheric delay and receiver DCB-constrained SF-PPP. In such model, the inter-system bias between each two GNSS systems, the inter-frequency bias between each two GLONASS frequencies, the hardware errors of the inertial sensors, the slant ionospheric delays of each user-satellite pair, and the receiver DCB are estimated together with other parameters in a unique Kalman filter. To demonstrate its performance, the multi-GNSS and low-cost inertial data from a land-borne experiment are analyzed. The results indicate that visible positioning improvements in terms of accuracy, continuity, and reliability can be achieved in both open-sky and complex conditions while using the proposed model in this study compared to the conventional GPS SF-PPP.

Toxic effects of lead exposure in Wistar rats: involvement of oxidative stress and the beneficial role of edible jute (Corchorus olitorius) leaves.

PubMed

Dewanjee, Saikat; Sahu, Ranabir; Karmakar, Sarmila; Gangopadhyay, Moumita

2013-05-01

Lead (Pb) is considered to be a multi-target toxicant. The present study was undertaken to evaluate the protective effect of aqueous extract of Corchorus olitorius leaves against Pb-acetate induced toxic manifestation in blood, liver, kidney, brain and heart of Wistar rats. The Pb-acetate (5mg/kg body weight) treated rats exhibited a significant inhibition of co-enzymes Q, antioxidant enzymes and reduced glutathione levels in the tissues. In addition, the extent of lipid peroxidation, DNA fragmentation and haematological parameters were significantly altered in the Pb-acetate treated rats as compared to control. Simultaneous administration of test extract (25, 50 and 100mg/kg body weight), could significantly restore the biochemical and haematological parameters near to the normal status through antioxidant activity and/or by preventing bioaccumulation of Pb within the tissues of experimental rats. Presence of substantial quantity of phenolics and flavonoids in the extract may be responsible for the observed protective role against Pb-intoxication. Copyright © 2012 Elsevier Ltd. All rights reserved.

Metabolic and cardiovascular adaptation, monkey. NASA SMD 3, project 76, experiment 44 conducted at NASA/JSC, 14-25 May 1977

NASA Technical Reports Server (NTRS)

Pace, N.; Rahlmann, D. F.; Mains, R. C.; Kodama, A. M.; Mccutcheon, E. P.

1977-01-01

The biomedical results from an experiment on a monkey subjected to space flight conditions are reported. A background history of the development and testing of an experiment system designed to permit measurement of physiological parameters in subhuman primates during continuous, comfortable, couch restraint for periods of up to 30 days is reviewed. Of major importance in the experimental design of the system was the use of a fiberglass pod, which could be sealed and subdivided into upper and lower parts, to monitor and control the physiological responses for various parts of the animal's body. The experiment was conducted within the Spacelab Simulator for a period of 11 days. Data recorded includes: Spacelab Simulator cabin temperature; ventilation rate; pod internal temperature; fraction percent oxygen; fraction percent carbon dioxide; oxygen consumption rate; carbon dioxide production rate; respiratory quotient; intrathoracic temperature; heart rate; mean aortic pressure; mean ventricular pressure; diurnal variation of parameters measured; comparison of mean preflight, flight, and postflight values of the parameters measured; and correlation matrix for the parameters measured.

Right Ventricular Structure and Function Are Associated With Incident Atrial Fibrillation: MESA-RV Study (Multi-Ethnic Study of Atherosclerosis-Right Ventricle).

PubMed

Chatterjee, Neal A; Shah, Ravi V; Murthy, Venkatesh L; Praestgaard, Amy; Shah, Sanjiv J; Ventetuolo, Corey E; Barr, R Graham; Kronmal, Richard; Lima, Joao A C; Bluemke, David A; Jerosch-Herold, Michael; Alonso, Alvaro; Kawut, Steven M

2017-01-01

Right ventricular (RV) morphology has been associated with drivers of atrial fibrillation (AF) risk, including left ventricular and pulmonary pathology, systemic inflammation, and neurohormonal activation. The aim of this study was to investigate the association between RV morphology and risk of incident AF. We interpreted cardiac magnetic resonance imaging in 4204 participants free of clinical cardiovascular disease in the MESA (Multi-Ethnic Study of Atherosclerosis). Incident AF was determined using hospital discharge records, study electrocardiograms, and Medicare claims data. The study sample (n=3819) was 61±10 years old and 47% male with 47.2% current/former smokers. After adjustment for demographics and clinical factors, including incident heart failure, higher RV ejection fraction (hazard ratio, 1.16 per SD; 95% confidence interval, 1.03-1.32; P=0.02) and greater RV mass (hazard ratio, 1.25 per SD; 95% confidence interval, 1.08-1.44; P=0.002) were significantly associated with incident AF. After additional adjustment for the respective left ventricular parameter, higher RV ejection fraction remained significantly associated with incident AF (hazard ratio, 1.15 per SD; 95% confidence interval, 1.01-1.32; P=0.04), whereas the association was attenuated for RV mass (hazard ratio, 1.16 per SD; 95% confidence interval, 0.99-1.35; P=0.07). In a subset of patients with available spirometry (n=2540), higher RV ejection fraction and mass remained significantly associated with incident AF after additional adjustment for lung function (P=0.02 for both). Higher RV ejection fraction and greater RV mass were associated with an increased risk of AF in a multiethnic population free of clinical cardiovascular disease at baseline. © 2017 American Heart Association, Inc.

Large scale cardiac modeling on the Blue Gene supercomputer.

PubMed

Reumann, Matthias; Fitch, Blake G; Rayshubskiy, Aleksandr; Keller, David U; Weiss, Daniel L; Seemann, Gunnar; Dössel, Olaf; Pitman, Michael C; Rice, John J

2008-01-01

Multi-scale, multi-physical heart models have not yet been able to include a high degree of accuracy and resolution with respect to model detail and spatial resolution due to computational limitations of current systems. We propose a framework to compute large scale cardiac models. Decomposition of anatomical data in segments to be distributed on a parallel computer is carried out by optimal recursive bisection (ORB). The algorithm takes into account a computational load parameter which has to be adjusted according to the cell models used. The diffusion term is realized by the monodomain equations. The anatomical data-set was given by both ventricles of the Visible Female data-set in a 0.2 mm resolution. Heterogeneous anisotropy was included in the computation. Model weights as input for the decomposition and load balancing were set to (a) 1 for tissue and 0 for non-tissue elements; (b) 10 for tissue and 1 for non-tissue elements. Scaling results for 512, 1024, 2048, 4096 and 8192 computational nodes were obtained for 10 ms simulation time. The simulations were carried out on an IBM Blue Gene/L parallel computer. A 1 s simulation was then carried out on 2048 nodes for the optimal model load. Load balances did not differ significantly across computational nodes even if the number of data elements distributed to each node differed greatly. Since the ORB algorithm did not take into account computational load due to communication cycles, the speedup is close to optimal for the computation time but not optimal overall due to the communication overhead. However, the simulation times were reduced form 87 minutes on 512 to 11 minutes on 8192 nodes. This work demonstrates that it is possible to run simulations of the presented detailed cardiac model within hours for the simulation of a heart beat.

The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

PubMed

Park, Jun I K; Heikhmakhtiar, Aulia Khamas; Kim, Chang Hyun; Kim, Yoo Seok; Choi, Seong Wook; Song, Kwang Soup; Lim, Ki Moo

2018-05-22

Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

Determination of Anaerobic Threshold by Heart Rate or Heart Rate Variability using Discontinuous Cycle Ergometry.

PubMed

Park, Sung Wook; Brenneman, Michael; Cooke, William H; Cordova, Alberto; Fogt, Donovan

The purpose was to determine if heart rate (HR) and heart rate variability (HRV) responses would reflect anaerobic threshold (AT) using a discontinuous, incremental, cycle test. AT was determined by ventilatory threshold (VT). Cyclists (30.6±5.9y; 7 males, 8 females) completed a discontinuous cycle test consisting of 7 stages (6 min each with 3 min of rest between). Three stages were performed at power outputs (W) below those corresponding to a previously established AT, one at W corresponding to AT, and 3 at W above those corresponding to AT. The W at the intersection of the trend lines was considered each metric's "threshold". The averaged stage data for Ve, HR, and time- and frequency-domain HRV metrics were plotted versus W. The W at the "threshold" for the metrics of interest were compared using correlation analysis and paired-sample t -test. In all, several heart rate-related parameters accurately reflected AT with significant correlations (p≤0.05) were observed between AT W and HR, mean RR interval (MRR), low and high frequency spectral energy (LF and HR, respectively), high frequency peak (fHF), and HFxfHF metrics' threshold W (i.e., MRRTW, etc.). Differences in HR or HRV metric threshold W and AT for all subjects were less than 14 W. The steady state data from discontinuous protocols may allow for a true indication of steady-state physiologic stress responses and corresponding W at AT, compared to continuous protocols using 1-2 min exercise stages.

The effects of N-acetylcysteine on cisplatin-induced changes of cardiodynamic parameters within coronary autoregulation range in isolated rat hearts.

PubMed

Rosic, Gvozden; Selakovic, Dragica; Joksimovic, Jovana; Srejovic, Ivan; Zivkovic, Vladimir; Tatalović, Nikola; Orescanin-Dusic, Zorana; Mitrovic, Slobodanka; Ilic, Milena; Jakovljevic, Vladimir

2016-02-03

The aim of this study was to evaluate the effects of chronic NAC administration along with cisplatin on cisplatin-induced cardiotoxicity by means of coronary flow (CF), cardiodynamic parameters, oxidative stress markers and morphological changes in isolated rat heart. Isolated hearts of Wistar albino rats (divided into four groups: control, cisplatin, NAC and cisplatin+NAC group) were perfused according to Langendorff technique at constant coronary perfusion pressure starting at 50 and gradually increased to 65, 80, 95 and 110 cm H2O to evaluate cardiodynamic parameters within autoregulation range. Samples of coronary venous effluent (CVE) were collected for determination of CF and biochemical assays, and heart tissue samples for biochemical assays and histopathological examination. Cisplatin treatment decreased CF and heart rate, and increased left ventricular systolic pressure and maximum left ventricular pressure development rate. Cisplatin increased H2O2 and TBARS, but decreased NO2(-) levels in CVE. In tissue samples, cisplatin reduced pathological alterations in myocardium and coronary vessels, with no changes in the amount of total glutathione, as well as in activity of glutathione peroxidase and glutathione reductase. NAC coadministration, by reducing oxidative damage, attenuated cisplatin-induced changes of cardiodynamic and oxidative stress parameters, as well as morphological changes in myocardium and coronary vasculature. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sleep Apnea and Cardiovascular Disease: Lessons From Recent Trials and Need for Team Science.

PubMed

Drager, Luciano F; McEvoy, R Doug; Barbe, Ferran; Lorenzi-Filho, Geraldo; Redline, Susan

2017-11-07

Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation. Central sleep apnea associated with Cheyne-Stokes respiration predicts incident heart failure and atrial fibrillation; among patients with heart failure, it strongly predicts mortality. Thus, a strong literature provides the mechanistic and empirical bases for considering obstructive sleep apnea and central sleep apnea associated with Cheyne-Stokes respiration as potentially modifiable risk factors for cardiovascular disease. Data from small trials provide evidence that treatment of obstructive sleep apnea with continuous positive airway pressure improves not only patient-reported outcomes such as sleepiness, quality of life, and mood but also intermediate cardiovascular end points such as blood pressure, cardiac ejection fraction, vascular parameters, and arrhythmias. However, data from large-scale randomized controlled trials do not currently support a role for positive pressure therapies for reducing cardiovascular mortality. The results of 2 recent large randomized controlled trials, published in 2015 and 2016, raise questions about the effectiveness of pressure therapies in reducing clinical end points, although 1 trial supported the beneficial effect of continuous positive airway pressure on quality of life, mood, and work absenteeism. This review provides a contextual framework for interpreting the results of recent studies, key clinical messages, and suggestions for future sleep and cardiovascular research, which include further consideration of individual risk factors, use of existing and new multimodality therapies that also address adherence, and implementation of trials that are sufficiently powered to target end points and to support subgroup analyses. These goals may best be addressed through strengthening collaboration among the cardiology, sleep medicine, and clinical trial communities. © 2017 American Heart Association, Inc.

The development of a tele-monitoring system for physiological parameters based on the B/S model.

PubMed

Shuicai, Wu; Peijie, Jiang; Chunlan, Yang; Haomin, Li; Yanping, Bai

2010-01-01

The development of a new physiological multi-parameter remote monitoring system is based on the B/S model. The system consists of a server monitoring center, Internet network and PC-based multi-parameter monitors. Using the B/S model, the clients can browse web pages via the server monitoring center and download and install ActiveX controls. The physiological multi-parameters are collected, displayed and remotely transmitted. The experimental results show that the system is stable, reliable and operates in real time. The system is suitable for use in physiological multi-parameter remote monitoring for family and community healthcare. Copyright © 2010 Elsevier Ltd. All rights reserved.

Long-Term Coarse Particulate Matter Exposure and Heart Rate Variability in the Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Adhikari, Richa; D’Souza, Jennifer; Solimon, Elsayed Z.; Burke, Gregory L.; Daviglus, Martha; Jacobs, David R.; Park, Sung Kyun; Sheppard, Lianne; Thorne, Peter S.; Kaufman, Joel D.; Larson, Timothy V.; Adar, Sara D.

2017-01-01

Background Reduced heart rate variability, a marker of impaired cardiac autonomic function, has been linked to short-term exposure to airborne particles. This research adds to the literature by examining associations with long-term exposures to coarse particles (PM10-2.5). Methods Using electrocardiogram recordings from 2,780 participants (45-84 years) from three Multi-Ethnic Study of Atherosclerosis sites, we assessed the standard deviation of normal-to-normal intervals (SDNN) and root-mean square differences of successive normal-to-normal intervals (rMSSD) at a baseline (2000-2002) and follow-up (2010-2012) examination (mean visits/person=1.5). Annual average concentrations of PM10-2.5 mass, copper, zinc, phosphorus, silicon, and endotoxin were estimated using site-specific spatial prediction models. We assessed associations for baseline heart rate variability and rate of change in heart rate variability over time using multivariable mixed models adjusted for time, sociodemographic, lifestyle, health, and neighborhood confounders, including co-pollutants. Results In our primary models adjusted for demographic and lifestyle factors and site, PM10-2.5 mass was associated with 1.0% (95% CI: -4.1, 2.1%) lower SDNN levels per interquartile range of 2 μg/m3. Stronger associations, however, were observed prior to site adjustment and with increasing residential stablity. Similar patterns were found for rMSSD. We found little evidence for associations with other chemical species and with with the rate of change in heart rate variability, though endotoxin was associated with increasing heart rate variability over time. Conclusion We found only weak evidence that long-term PM10-2.5 exposures are associated with lowered heart rate variability. Stronger associations among residentially stable individuals suggest that confirmatory studies are needed. PMID:27035690

Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients.

PubMed

Drigny, J; Gremeaux, V; Guiraud, T; Gayda, M; Juneau, M; Nigam, A

2013-07-01

QT dispersion (QTd) is a marker of myocardial electrical instability, and is increased in metabolic syndrome (MetS). Moderate intensity continuous exercise (MICE) training was shown to improve QTd in MetS patients. To describe long-term effects of MICE and high-intensity interval exercise training (HIIT) on QTd parameters in MetS. Sixty-five MetS patients (53 ± 9 years) were assigned to either a MICE (60% of peak power output [PPO]), or a HIIT program (alternating phases of 15-30 s at 80% of PPO interspersed by passive recovery phases of equal duration), twice weekly during 9 months. Ventricular repolarization indices (QT dispersion=QTd, standard deviation of QT = sdQT, relative dispersion of QT = rdQT, QT corrected dispersion = QTcd), metabolic, anthropometric and exercise parameters were measured before and after the intervention. No adverse events were noted during exercise. QTd decreased significantly in both groups (51 vs 56 ms in MICE, P < 0.05; 34 vs 38 ms in HIIT, P < 0.05). Changes in QTd were correlated with changes in maximal heart rate (r = -0.69, P < 0.0001) and in heart rate recovery (r = -0.49, P < 0.01) in the HIIT group only. When compared to MICE, HIIT training induced a greater decrease in weight, BMI and waist circumference. Exercise capacity significantly improved by 0.82 and 1.25 METs in MICE and HIIT groups respectively (P < 0.0001). Lipid parameters also improved to the same degree in both groups. In MetS, long-term HIIT and MICE training led to comparable effects on ventricular repolarization indices, and HIIT might be associated with greater improvements in certain cardiometabolic risk factors. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Pulsatile support using a rotary left ventricular assist device with an electrocardiography-synchronized rotational speed control mode for tracking heart rate variability.

PubMed

Arakawa, Mamoru; Nishimura, Takashi; Takewa, Yoshiaki; Umeki, Akihide; Ando, Masahiko; Kishimoto, Yuichiro; Kishimoto, Satoru; Fujii, Yutaka; Date, Kazuma; Kyo, Shunei; Adachi, Hideo; Tatsumi, Eisuke

2016-06-01

We previously developed a novel control system for a continuous-flow left ventricular assist device (LVAD), the EVAHEART, and demonstrated that sufficient pulsatility can be created by increasing its rotational speed in the systolic phase (pulsatile mode) in a normal heart animal model. In the present study, we assessed this system in its reliability and ability to follow heart rate variability. We implanted an EVAHEART via left thoracotomy into five goats for the Study for Fixed Heart Rate with ventricular pacing at 80, 100, 120 and 140 beats/min and six goats for the Study for native heart rhythm. We tested three modes: the circuit clamp, the continuous mode and the pulsatile mode. In the pulsatile mode, rotational speed was increased during the initial 35 % of the RR interval by automatic control based on the electrocardiogram. Pulsatility was evaluated by pulse pressure and dP/dt max of aortic pressure. As a result, comparing the pulsatile mode with the continuous mode, the pulse pressure was 28.5 ± 5.7 vs. 20.3 ± 7.9 mmHg, mean dP/dt max was 775.0 ± 230.5 vs 442.4 ± 184.7 mmHg/s at 80 bpm in the study for fixed heart rate, respectively (P < 0.05). The system successfully determined the heart rate to be 94.6 % in native heart rhythm. Furthermore, pulse pressure was 41.5 ± 7.9 vs. 27.8 ± 5.6 mmHg, mean dP/dt max was 716.2 ± 133.9 vs 405.2 ± 86.0 mmHg/s, respectively (P < 0.01). In conclusion, our newly developed the pulsatile mode for continuous-flow LVADs reliably provided physiological pulsatility with following heart rate variability.

NASA Exhibits

NASA Technical Reports Server (NTRS)

Deardorff, Glenn; Djomehri, M. Jahed; Freeman, Ken; Gambrel, Dave; Green, Bryan; Henze, Chris; Hinke, Thomas; Hood, Robert; Kiris, Cetin; Moran, Patrick;

Flow dynamics and energy efficiency of flow in the left ventricle during myocardial infarction.

PubMed

Vasudevan, Vivek; Low, Adriel Jia Jun; Annamalai, Sarayu Parimal; Sampath, Smita; Poh, Kian Keong; Totman, Teresa; Mazlan, Muhammad; Croft, Grace; Richards, A Mark; de Kleijn, Dominique P V; Chin, Chih-Liang; Yap, Choon Hwai

2017-10-01

Cardiovascular disease is a leading cause of death worldwide, where myocardial infarction (MI) is a major category. After infarction, the heart has difficulty providing sufficient energy for circulation, and thus, understanding the heart's energy efficiency is important. We induced MI in a porcine animal model via circumflex ligation and acquired multiple-slice cine magnetic resonance (MR) images in a longitudinal manner-before infarction, and 1 week (acute) and 4 weeks (chronic) after infarction. Computational fluid dynamic simulations were performed based on MR images to obtain detailed fluid dynamics and energy dynamics of the left ventricles. Results showed that energy efficiency flow through the heart decreased at the acute time point. Since the heart was observed to experience changes in heart rate, stroke volume and chamber size over the two post-infarction time points, simulations were performed to test the effect of each of the three parameters. Increasing heart rate and stroke volume were found to significantly decrease flow energy efficiency, but the effect of chamber size was inconsistent. Strong complex interplay was observed between the three parameters, necessitating the use of non-dimensional parameterization to characterize flow energy efficiency. The ratio of Reynolds to Strouhal number, which is a form of Womersley number, was found to be the most effective non-dimensional parameter to represent energy efficiency of flow in the heart. We believe that this non-dimensional number can be computed for clinical cases via ultrasound and hypothesize that it can serve as a biomarker for clinical evaluations.

An empirical study on the utility of BRDF model parameters and topographic parameters for mapping vegetation in a semi-arid region with MISR imagery

USDA-ARS?s Scientific Manuscript database

Multi-angle remote sensing has been proved useful for mapping vegetation community types in desert regions. Based on Multi-angle Imaging Spectro-Radiometer (MISR) multi-angular images, this study compares roles played by Bidirectional Reflectance Distribution Function (BRDF) model parameters with th...

Mortality, Length of Stay, and Inpatient Charges for Heart Failure Patients at Public versus Private Hospitals in South Korea

PubMed Central

Kim, Sun Jung; Park, Eun-Cheol; Kim, Tae Hyun; Yoo, Ji Won

2015-01-01

Purpose This study compared in-hospital mortality within 30 days of admission, lengths of stay, and inpatient charges among patients with heart failure admitted to public and private hospitals in South Korea. Materials and Methods We obtained health insurance claims data for all heart failure inpatients nationwide between November 1, 2011 and May 31, 2012. These data were then matched with hospital-level data, and multi-level regression models were examined. A total of 8406 patients from 253 hospitals, including 31 public hospitals, were analyzed. Results The in-hospital mortality rate within 30 days of admission was 0.92% greater and the mean length of stay was 1.94 days longer at public hospitals than at private hospitals (mortality: 5.18% and 4.26%, respectively; LOS: 12.08 and 10.14 days, respectively). The inpatient charges were 11.4% lower per case and 24.5% lower per day at public hospitals than at private hospitals. After adjusting for patient- and hospital-level confounders, public hospitals had a 1.62-fold higher in-hospital mortality rate, a 16.5% longer length of stay, and an 11.7% higher inpatient charge per case than private hospitals, although the charges of private hospitals were greater in univariate analysis. Conclusion We recommend that government agencies and policy makers continue to monitor quality of care, lengths of stay in the hospital, and expenditures according to type of hospital ownership to improve healthcare outcomes and reduce spending. PMID:25837196

A blended continuous–discontinuous finite element method for solving the multi-fluid plasma model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sousa, E.M., E-mail: sousae@uw.edu; Shumlak, U., E-mail: shumlak@uw.edu

The multi-fluid plasma model represents electrons, multiple ion species, and multiple neutral species as separate fluids that interact through short-range collisions and long-range electromagnetic fields. The model spans a large range of temporal and spatial scales, which renders the model stiff and presents numerical challenges. To address the large range of timescales, a blended continuous and discontinuous Galerkin method is proposed, where the massive ion and neutral species are modeled using an explicit discontinuous Galerkin method while the electrons and electromagnetic fields are modeled using an implicit continuous Galerkin method. This approach is able to capture large-gradient ion and neutralmore » physics like shock formation, while resolving high-frequency electron dynamics in a computationally efficient manner. The details of the Blended Finite Element Method (BFEM) are presented. The numerical method is benchmarked for accuracy and tested using two-fluid one-dimensional soliton problem and electromagnetic shock problem. The results are compared to conventional finite volume and finite element methods, and demonstrate that the BFEM is particularly effective in resolving physics in stiff problems involving realistic physical parameters, including realistic electron mass and speed of light. The benefit is illustrated by computing a three-fluid plasma application that demonstrates species separation in multi-component plasmas.« less

Dynamic Task Allocation in Multi-Hop Multimedia Wireless Sensor Networks with Low Mobility

PubMed Central

Jin, Yichao; Vural, Serdar; Gluhak, Alexander; Moessner, Klaus

2013-01-01

This paper presents a task allocation-oriented framework to enable efficient in-network processing and cost-effective multi-hop resource sharing for dynamic multi-hop multimedia wireless sensor networks with low node mobility, e.g., pedestrian speeds. The proposed system incorporates a fast task reallocation algorithm to quickly recover from possible network service disruptions, such as node or link failures. An evolutional self-learning mechanism based on a genetic algorithm continuously adapts the system parameters in order to meet the desired application delay requirements, while also achieving a sufficiently long network lifetime. Since the algorithm runtime incurs considerable time delay while updating task assignments, we introduce an adaptive window size to limit the delay periods and ensure an up-to-date solution based on node mobility patterns and device processing capabilities. To the best of our knowledge, this is the first study that yields multi-objective task allocation in a mobile multi-hop wireless environment under dynamic conditions. Simulations are performed in various settings, and the results show considerable performance improvement in extending network lifetime compared to heuristic mechanisms. Furthermore, the proposed framework provides noticeable reduction in the frequency of missing application deadlines. PMID:24135992

Heart Rate and Reinforcement Sensitivity in ADHD

ERIC Educational Resources Information Center

Luman, Marjolein; Oosterlaan, Jaap; Hyde, Christopher; van Meel, Catharina S.; Sergeant, Joseph A.

2007-01-01

Background: Both theoretical and clinical accounts of attention-deficit/hyperactivity disorder (ADHD) implicate a dysfunctional reinforcement system. This study investigated heart rate parameters in response to feedback associated with reward and response cost in ADHD children and controls aged 8 to 12. Methods: Heart rate responses (HRRs)…

Multi-modality imaging: Bird's-eye view from the 2014 American Heart Association Scientific Sessions.

PubMed

AlJaroudi, Wael A; Einstein, Andrew J; Chaudhry, Farooq A; Lloyd, Steven G; Hage, Fadi G

2015-04-01

A large number of studies were presented at the 2014 American Heart Association Scientific Sessions. In this review, we will summarize key studies in nuclear cardiology, computed tomography, echocardiography, and cardiac magnetic resonance imaging. This brief review will be helpful for readers of the Journal who are interested in being updated on the latest research covering these imaging modalities.

Application of Multi-Parameter Data Visualization by Means of Multidimensional Scaling to Evaluate Possibility of Coal Gasification

NASA Astrophysics Data System (ADS)

Jamróz, Dariusz; Niedoba, Tomasz; Surowiak, Agnieszka; Tumidajski, Tadeusz; Szostek, Roman; Gajer, Mirosław

2017-09-01

The application of methods drawing upon multi-parameter visualization of data by transformation of multidimensional space into two-dimensional one allow to show multi-parameter data on computer screen. Thanks to that, it is possible to conduct a qualitative analysis of this data in the most natural way for human being, i.e. by the sense of sight. An example of such method of multi-parameter visualization is multidimensional scaling. This method was used in this paper to present and analyze a set of seven-dimensional data obtained from Janina Mining Plant and Wieczorek Coal Mine. It was decided to examine whether the method of multi-parameter data visualization allows to divide the samples space into areas of various applicability to fluidal gasification process. The "Technological applicability card for coals" was used for this purpose [Sobolewski et al., 2012; 2017], in which the key parameters, important and additional ones affecting the gasification process were described.

Human heart conjugate cooling simulation: Unsteady thermo-fluid-stress analysis

PubMed Central

Abdoli, Abas; Dulikravich, George S.; Bajaj, Chandrajit; Stowe, David F.; Jahania, M. Salik

2015-01-01

The main objective of this work was to demonstrate computationally that realistic human hearts can be cooled much faster by performing conjugate heat transfer consisting of pumping a cold liquid through the cardiac chambers and major veins while keeping the heart submerged in cold gelatin filling a cooling container. The human heart geometry used for simulations was obtained from three-dimensional, high resolution MRI scans. Two fluid flow domains for the right (pulmonic) and left (systemic) heart circulations, and two solid domains for the heart tissue and gelatin solution were defined for multi-domain numerical simulation. Detailed unsteady temperature fields within the heart tissue were calculated during the conjugate cooling process. A linear thermoelasticity analysis was performed to assess the stresses applied on the heart due to the coolant fluid shear and normal forces and to examine the thermal stress caused by temperature variation inside the heart. It was demonstrated that a conjugate cooling effort with coolant temperature at +4°C is capable of reducing the average heart temperature from +37°C to +8°C in 25 minutes for cases in which the coolant was steadily pumped only through major heart inlet veins and cavities. PMID:25045006

Understanding the C-pulse device and its potential to treat heart failure.

PubMed

Sales, Virna L; McCarthy, Patrick M

2010-03-01

The Sunshine Heart C-Pulse (C-Pulse; Sunshine Heart Inc., Tustin, CA) device is an extra-aortic implantable counterpulsation pump designed as a non-blood contacting ambulatory heart assist device, which may provide relief from symptoms for class II-III congestive heart failure patients. It has a comparable hemodynamic augmentation to intra-aortic balloon counterpulsation devices. The C-Pulse cuff is implanted through a median sternotomy, secured around the ascending aorta, and pneumatically driven by an external system controller. Pre-clinical studies in the acute pig model, and initial temporary clinical studies in patients undergoing off-pump coronary bypass surgery have shown substantial increase in diastolic perfusion of the coronary vessels, which translated to a favorable improvement in ventricular function. A U.S. prospective multi-center trial to evaluate the safety and efficacy of the C-Pulse in class III patients with moderate heart failure is now in progress.

Multi-Sensor Based State Prediction for Personal Mobility Vehicles

PubMed Central

Gupta, Pankaj; Umata, Ichiro; Watanabe, Atsushi; Even, Jani; Suyama, Takayuki; Ishii, Shin

2016-01-01

This paper presents a study on multi-modal human emotional state detection while riding a powered wheelchair (PMV; Personal Mobility Vehicle) in an indoor labyrinth-like environment. The study reports findings on the habituation of human stress response during self-driving. In addition, the effects of “loss of controllability”, change in the role of the driver to a passenger, are investigated via an autonomous driving modality. The multi-modal emotional state detector sensing framework consists of four sensing devices: electroencephalograph (EEG), heart inter-beat interval (IBI), galvanic skin response (GSR) and stressor level lever (in the case of autonomous riding). Physiological emotional state measurement characteristics are organized by time-scale, in terms of capturing slower changes (long-term) and quicker changes from moment-to-moment. Experimental results with fifteen participants regarding subjective emotional state reports and commercial software measurements validated the proposed emotional state detector. Short-term GSR and heart signal characterizations captured moment-to-moment emotional state during autonomous riding (Spearman correlation; ρ = 0.6, p < 0.001). Short-term GSR and EEG characterizations reliably captured moment-to-moment emotional state during self-driving (Classification accuracy; 69.7). Finally, long-term GSR and heart characterizations were confirmed to reliably capture slow changes during autonomous riding and also of emotional state during participant resting state. The purpose of this study and the exploration of various algorithms and sensors in a structured framework is to provide a comprehensive background for multi-modal emotional state prediction experiments and/or applications. Additional discussion regarding the feasibility and utility of the possibilities of these concepts are given. PMID:27732589

Multi-Sensor Based State Prediction for Personal Mobility Vehicles.

PubMed

Abdur-Rahim, Jamilah; Morales, Yoichi; Gupta, Pankaj; Umata, Ichiro; Watanabe, Atsushi; Even, Jani; Suyama, Takayuki; Ishii, Shin

2016-01-01

This paper presents a study on multi-modal human emotional state detection while riding a powered wheelchair (PMV; Personal Mobility Vehicle) in an indoor labyrinth-like environment. The study reports findings on the habituation of human stress response during self-driving. In addition, the effects of "loss of controllability", change in the role of the driver to a passenger, are investigated via an autonomous driving modality. The multi-modal emotional state detector sensing framework consists of four sensing devices: electroencephalograph (EEG), heart inter-beat interval (IBI), galvanic skin response (GSR) and stressor level lever (in the case of autonomous riding). Physiological emotional state measurement characteristics are organized by time-scale, in terms of capturing slower changes (long-term) and quicker changes from moment-to-moment. Experimental results with fifteen participants regarding subjective emotional state reports and commercial software measurements validated the proposed emotional state detector. Short-term GSR and heart signal characterizations captured moment-to-moment emotional state during autonomous riding (Spearman correlation; ρ = 0.6, p < 0.001). Short-term GSR and EEG characterizations reliably captured moment-to-moment emotional state during self-driving (Classification accuracy; 69.7). Finally, long-term GSR and heart characterizations were confirmed to reliably capture slow changes during autonomous riding and also of emotional state during participant resting state. The purpose of this study and the exploration of various algorithms and sensors in a structured framework is to provide a comprehensive background for multi-modal emotional state prediction experiments and/or applications. Additional discussion regarding the feasibility and utility of the possibilities of these concepts are given.

Exo-organoplasty interventions: A brief review of past, present and future directions for advance heart failure management.

PubMed

Nawaz, Waqas; Khan, Farhan Ullah; Khan, Muhammad Zahid; Gang, Wang; Yang, Mengqi; Liao, Xiaoqian; Zhang, Li; Ihsan, Awais Ullah; Khan, Amjad; Han, Lei; Zhou, Xiaohui

2017-04-01

Heart failure (HF) is a debilitating disease in which abnormal function of the heart leads to imbalance of blood demand to tissues and organs. The pathogenesis of HF is very complex and various factors can contribute including myocardial infarction, ischemia, hypertension and genetic cardiomyopathies. HF is the leading cause of death and its prevalence is expected to increase in parallel with the population age. Different kind of therapeutic approaches including lifestyle modification, medication and pacemakers are used for HF patients in NYHA I-III functional class. However, for advance stage HF patient's (NYHA IV), ventricle assist devices are clinically use and stem cells are under active investigation. Most of these therapies leads to modest symptoms relief and have no significant role in long-term survival rate. Currently there is no effective treatment for advance HF except heart transplantation, which is still remain clinically insignificant because of donor pool limitation. As HF is a result of multiple etiologies therefore multi-functional therapeutic platform is needed. Exo-organoplasty interventions are studied from almost one century. The major goals of these interventions are to treat various kind of heart disease from outside the heart muscle without having direct contact with blood. Various kind of interventions (devices and techniques) are developed in this arena with the passage of time. The purpose of this review is to describe the theory behind intervention devices, the devices themselves, their clinical results, advantages and limitations. Furthermore, to present a future multi-functional therapeutic platform (ASD) for advance stage HF management. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[Ginseng prescription rules and molecular mechanism in treating coronary heart disease based on data mining and integrative pharmacology].

PubMed

Li, Sen; Tang, Shi-Huan; Liu, Jin-Ling; Su, Jin; He, Fu-Yuan

2018-04-01

The ancient dragon Materia Medica, Compendium of Materia Medica and other works recorded that the main effect of ginseng is tonifying qi. It is reported that the main active ingredient of ginseng is ginsenoside. Modern studies have found that ginseng mono saponins are effective for cardiovascular related diseases. This paper preliminary clarified the efficacy of traditional ginseng-nourishing qi and cardiovascular disease through the traditional Chinese medicine (TCM) inheritance auxiliary platform and integration platform of association of pharmacology. With the help of TCM inheritance auxiliary platform-analysis of "Chinese medicine database", Chinese medicine treatment of modern diseases that ginseng rules, so the traditional effect associated with modern medicine and pharmacology; application integration platform enrichment analysis on the target of drug and gene function, metabolic pathway, to further explore the molecular mechanism of ginseng in the treatment of coronary heart disease, aimed at mining the molecular mechanism of ginseng in the treatment of coronary heart disease. Chinese medicine containing ginseng 307 prescriptions, 87 kinds of disease indications, western medicine disease Chinese medicine therapy for ginseng main coronary heart disease; analysis of molecular mechanism of ginseng pharmacology integration platform for the treatment of coronary heart disease. Ginsenosides（Ra₁, Ra₂, Rb₁, Rb₂, Rg₁, Ro) bind these targets, PRKAA1, PRKAA2, NDUFA4, COX5B, UQCRC1, affect chemokines, non-alcoholic fatty liver, gonadotropin, carbon metabolism, glucose metabolism and other pathways to treat coronary heart disease indirectly. The molecular mechanism of Panax ginseng's multi-component, multi-target and synergistic action is preliminarily elucidated in this paper. Copyright© by the Chinese Pharmaceutical Association.

Iris features-based heart disease diagnosis by computer vision

NASA Astrophysics Data System (ADS)

Nguchu, Benedictor A.; Li, Li

2017-07-01

The study takes advantage of several new breakthroughs in computer vision technology to develop a new mid-irisbiomedical platform that processes iris image for early detection of heart-disease. Guaranteeing early detection of heart disease provides a possibility of having non-surgical treatment as suggested by biomedical researchers and associated institutions. However, our observation discovered that, a clinical practicable solution which could be both sensible and specific for early detection is still lacking. Due to this, the rate of majority vulnerable to death is highly increasing. The delayed diagnostic procedures, inefficiency, and complications of available methods are the other reasons for this catastrophe. Therefore, this research proposes the novel IFB (Iris Features Based) method for diagnosis of premature, and early stage heart disease. The method incorporates computer vision and iridology to obtain a robust, non-contact, nonradioactive, and cost-effective diagnostic tool. The method analyzes abnormal inherent weakness in tissues, change in color and patterns, of a specific region of iris that responds to impulses of heart organ as per Bernard Jensen-iris Chart. The changes in iris infer the presence of degenerative abnormalities in heart organ. These changes are precisely detected and analyzed by IFB method that includes, tensor-based-gradient(TBG), multi orientations gabor filters(GF), textural oriented features(TOF), and speed-up robust features(SURF). Kernel and Multi class oriented support vector machines classifiers are used for classifying normal and pathological iris features. Experimental results demonstrated that the proposed method, not only has better diagnostic performance, but also provides an insight for early detection of other diseases.

Predictive Modeling of Cardiac Ischemia

NASA Technical Reports Server (NTRS)

Anderson, Gary T.

1996-01-01

The goal of the Contextual Alarms Management System (CALMS) project is to develop sophisticated models to predict the onset of clinical cardiac ischemia before it occurs. The system will continuously monitor cardiac patients and set off an alarm when they appear about to suffer an ischemic episode. The models take as inputs information from patient history and combine it with continuously updated information extracted from blood pressure, oxygen saturation and ECG lines. Expert system, statistical, neural network and rough set methodologies are then used to forecast the onset of clinical ischemia before it transpires, thus allowing early intervention aimed at preventing morbid complications from occurring. The models will differ from previous attempts by including combinations of continuous and discrete inputs. A commercial medical instrumentation and software company has invested funds in the project with a goal of commercialization of the technology. The end product will be a system that analyzes physiologic parameters and produces an alarm when myocardial ischemia is present. If proven feasible, a CALMS-based system will be added to existing heart monitoring hardware.

Respiratory gating and multifield technique radiotherapy for esophageal cancer.

PubMed

Ohta, Atsushi; Kaidu, Motoki; Tanabe, Satoshi; Utsunomiya, Satoru; Sasamoto, Ryuta; Maruyama, Katsuya; Tanaka, Kensuke; Saito, Hirotake; Nakano, Toshimichi; Shioi, Miki; Takahashi, Haruna; Kushima, Naotaka; Abe, Eisuke; Aoyama, Hidefumi

2017-03-01

To investigate the effects of a respiratory gating and multifield technique on the dose-volume histogram (DVH) in radiotherapy for esophageal cancer. Twenty patients who underwent four-dimensional computed tomography for esophageal cancer were included. We retrospectively created the four treatment plans for each patient, with or without the respiratory gating and multifield technique: No gating-2-field, No gating-4-field, Gating-2-field, and Gating-4-field plans. We compared the DVH parameters of the lung and heart in the No gating-2-field plan with the other three plans. In the comparison of the parameters in the No gating-2-field plan, there are significant differences in the Lung V 5Gy , V 20Gy , mean dose with all three plans and the Heart V 25Gy -V 40Gy with Gating-2-field plan, V 35Gy , V 40Gy , mean dose with No Gating-4-field plan and V 30Gy -V 40Gy , and mean dose with Gating-4-field plan. The lung parameters were smaller in the Gating-2-field plan and larger in the No gating-4-field and Gating-4-field plans. The heart parameters were all larger in the No gating-2-field plan. The lung parameters were reduced by the respiratory gating technique and increased by the multifield technique. The heart parameters were reduced by both techniques. It is important to select the optimal technique according to the risk of complications.

[Review of wireless energy transmission system for total artificial heart].

PubMed

Zhang, Chi; Yang, Ming

2009-11-01

This paper sums up the fundamental structure of wireless energy transmission system for total artificial heart, and compares the key parameters and performance of some representative systems. After that, it is discussed that the future development trend of wireless energy transmission system for total artificial heart.

The effect of multi-directional nanocomposite materials on the vibrational response of thick shell panels with finite length and rested on two-parameter elastic foundations

NASA Astrophysics Data System (ADS)

Tahouneh, Vahid; Naei, Mohammad Hasan

2016-03-01

The main purpose of this paper is to investigate the effect of bidirectional continuously graded nanocomposite materials on free vibration of thick shell panels rested on elastic foundations. The elastic foundation is considered as a Pasternak model after adding a shear layer to the Winkler model. The panels reinforced by randomly oriented straight single-walled carbon nanotubes are considered. The volume fractions of SWCNTs are assumed to be graded not only in the radial direction, but also in axial direction of the curved panel. This study presents a 2-D six-parameter power-law distribution for CNTs volume fraction of 2-D continuously graded nanocomposite that gives designers a powerful tool for flexible designing of structures under multi-functional requirements. The benefit of using generalized power-law distribution is to illustrate and present useful results arising from symmetric, asymmetric and classic profiles. The material properties are determined in terms of local volume fractions and material properties by Mori-Tanaka scheme. The 2-D differential quadrature method as an efficient numerical tool is used to discretize governing equations and to implement boundary conditions. The fast rate of convergence of the method is shown and results are compared against existing results in literature. Some new results for natural frequencies of the shell are prepared, which include the effects of elastic coefficients of foundation, boundary conditions, material and geometrical parameters. The interesting results indicate that a graded nanocomposite volume fraction in two directions has a higher capability to reduce the natural frequency than conventional 1-D functionally graded nanocomposite materials.

MR fingerprinting reconstruction with Kalman filter.

PubMed

Zhang, Xiaodi; Zhou, Zechen; Chen, Shiyang; Chen, Shuo; Li, Rui; Hu, Xiaoping

2017-09-01

Magnetic resonance fingerprinting (MR fingerprinting or MRF) is a newly introduced quantitative magnetic resonance imaging technique, which enables simultaneous multi-parameter mapping in a single acquisition with improved time efficiency. The current MRF reconstruction method is based on dictionary matching, which may be limited by the discrete and finite nature of the dictionary and the computational cost associated with dictionary construction, storage and matching. In this paper, we describe a reconstruction method based on Kalman filter for MRF, which avoids the use of dictionary to obtain continuous MR parameter measurements. With this Kalman filter framework, the Bloch equation of inversion-recovery balanced steady state free-precession (IR-bSSFP) MRF sequence was derived to predict signal evolution, and acquired signal was entered to update the prediction. The algorithm can gradually estimate the accurate MR parameters during the recursive calculation. Single pixel and numeric brain phantom simulation were implemented with Kalman filter and the results were compared with those from dictionary matching reconstruction algorithm to demonstrate the feasibility and assess the performance of Kalman filter algorithm. The results demonstrated that Kalman filter algorithm is applicable for MRF reconstruction, eliminating the need for a pre-define dictionary and obtaining continuous MR parameter in contrast to the dictionary matching algorithm. Copyright © 2017 Elsevier Inc. All rights reserved.

Multi-Resolution Climate Ensemble Parameter Analysis with Nested Parallel Coordinates Plots.

PubMed

Wang, Junpeng; Liu, Xiaotong; Shen, Han-Wei; Lin, Guang

2017-01-01

Due to the uncertain nature of weather prediction, climate simulations are usually performed multiple times with different spatial resolutions. The outputs of simulations are multi-resolution spatial temporal ensembles. Each simulation run uses a unique set of values for multiple convective parameters. Distinct parameter settings from different simulation runs in different resolutions constitute a multi-resolution high-dimensional parameter space. Understanding the correlation between the different convective parameters, and establishing a connection between the parameter settings and the ensemble outputs are crucial to domain scientists. The multi-resolution high-dimensional parameter space, however, presents a unique challenge to the existing correlation visualization techniques. We present Nested Parallel Coordinates Plot (NPCP), a new type of parallel coordinates plots that enables visualization of intra-resolution and inter-resolution parameter correlations. With flexible user control, NPCP integrates superimposition, juxtaposition and explicit encodings in a single view for comparative data visualization and analysis. We develop an integrated visual analytics system to help domain scientists understand the connection between multi-resolution convective parameters and the large spatial temporal ensembles. Our system presents intricate climate ensembles with a comprehensive overview and on-demand geographic details. We demonstrate NPCP, along with the climate ensemble visualization system, based on real-world use-cases from our collaborators in computational and predictive science.

The investigation of the possible protective influence of selenium on antioxidant barrier in heart of rats exposed to lithium.

PubMed

Musik, Irena; Kocot, Joanna; Lewandowska, Anna; Żelazowska, Renata; Kiełczykowska, Małgorzata

2015-07-01

Selenium is an essential element possessing antioxidant properties and the treatment with it has displayed protective effects against toxicity of different substances occurring in the environment and food as well as against the side effects of some drugs. Lithium is used in medicine although numerous side effects can occur during therapy, including disturbances of the heart. For these reasons studies to find protective adjuvants have been performed. In the current study the possibility of selenium (as sodium selenite) application as a protective adjuvant in lithium treatment was studied. Male Wistar rats were treated: control - with saline; Li-group - with Li2CO3 (2.7 mg Li/kg b.w.); Se-group - with Na2SeO3 (0.5 mg Se/kg b.w.); Li+Se-group simultaneously with Li2CO3 and Na2SeO3 (2.7 mg Li/kg b.w. and 0.5 mg Se/kg b.w., respectively) by a stomach tube for a period of three weeks, once a day. In heart homogenate activities of antioxidant enzymes - catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), concentrations of low-molecular-weight antioxidants - ascorbic acid (AA) and reduced glutathione (GSH) as well as total antioxidant status (TAS) values were determined. GPx/SOD and CAT/SOD ratios were evaluated. In comparison with control selenium caused no significant changes of the studied parameters except for GPx, whereas lithium slightly disturbed TAS and markedly GPx, CAT and CAT/SOD ratio. In Li-treated rats co-administration of selenium displayed tendency towards restoring the impaired parameters. The results suggest that research on selenium application as an adjuvant in lithium therapy is worthy to be continued. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving Heart rate variability in sleep apnea patients: differences in treatment with auto-titrating positive airway pressure (APAP) versus conventional CPAP.

PubMed

Karasulu, Levent; Epöztürk, Pinar Ozkan; Sökücü, Sinem Nedime; Dalar, Levent; Altin, Sedat

2010-08-01

The effect of positive airway pressure treatments in different modalities on the cardiovascular consequences of the disease in sleep apnea patients is still unclear. We aimed to compare auto-titrating positive airway pressure (APAP) and conventional continuous positive airway pressure (CPAP) in terms of improving heart rate variability (HRV) in obstructive sleep apnea patients. This was a prospective study done in a tertiary research hospital. All patients underwent a manual CPAP titration procedure to determine the optimal pressure that abolishes abnormal respiratory events. Then patients underwent two treatment nights, one under APAP mode and one under conventional CPAP mode with a 1-week interval. Forty newly diagnosed obstructive sleep apnea patients were enrolled in the study. We compared heart rate variability analysis parameters between the APAP night and the CPAP night. This final analysis included the data of 28 patients (M/F: 22/6; mean age = 46 +/- 10 years). Sleep characteristics were comparable between the two treatment nights, whereas all-night time domains of HRV analysis such as HF, nuLF, and LF/HF were different between APAP and CPAP nights (2.93 +/- 0.31 vs. 3.01 +/- 0.31; P = 0.041; 0.75 +/- 0.13 vs. 0.71 +/- 0.14; P = 0.027; and 4.37 +/- 3.24 vs. 3.56 +/- 2.07; P = 0.023, respectively). HRV analysis for individual sleep stages showed that Stage 2 LF, nuLF, nuHF, LF/HF parameters entirely improved under CPAP treatment whereas APAP treatment resulted in nonsignificant changes. These results suggest that despite comparable improvement in abnormal respiratory events with APAP or CPAP treatments, CPAP may be superior to APAP in terms of correcting cardiovascular alterations in sleep apnea patients.

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations.

PubMed

Nieminen, Markku S; Dickstein, Kenneth; Fonseca, Cândida; Serrano, Jose Magaña; Parissis, John; Fedele, Francesco; Wikström, Gerhard; Agostoni, Piergiuseppe; Atar, Shaul; Baholli, Loant; Brito, Dulce; Colet, Josep Comín; Édes, István; Gómez Mesa, Juan E; Gorjup, Vojka; Garza, Eduardo Herrera; González Juanatey, José R; Karanovic, Nenad; Karavidas, Apostolos; Katsytadze, Igor; Kivikko, Matti; Matskeplishvili, Simon; Merkely, Béla; Morandi, Fabrizio; Novoa, Angel; Oliva, Fabrizio; Ostadal, Petr; Pereira-Barretto, Antonio; Pollesello, Piero; Rudiger, Alain; Schwinger, Robert H G; Wieser, Manfred; Yavelov, Igor; Zymliński, Robert

2015-07-15

End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed. Copyright © 2015. Published by Elsevier Ireland Ltd.

The Role of Autonomic Function in Exercise-induced Endogenous Analgesia: A Case-control Study in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Healthy People.

PubMed

Oosterwijck, Jessica Van; Marusic, Uros; De Wandele, Inge; Paul, Lorna; Meeus, Mira; Moorkens, Greta; Lambrecht, Luc; Danneels, Lieven; Nijs, Jo

2017-03-01

Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are unable to activate brain-orchestrated endogenous analgesia (or descending inhibition) in response to exercise. This physiological impairment is currently regarded as one factor explaining post-exertional malaise in these patients. Autonomic dysfunction is also a feature of ME/CFS. This study aims to examine the role of the autonomic nervous system in exercise-induced analgesia in healthy people and those with ME/CFS, by studying the recovery of autonomic parameters following aerobic exercise and the relation to changes in self-reported pain intensity. A controlled experimental study. The study was conducted at the Human Physiology lab of a University. Twenty women with ME/CFS- and 20 healthy, sedentary controls performed a submaximal bicycle exercise test known as the Aerobic Power Index with continuous cardiorespiratory monitoring. Before and after the exercise, measures of autonomic function (i.e., heart rate variability, blood pressure, and respiration rate) were performed continuously for 10 minutes and self-reported pain levels were registered. The relation between autonomous parameters and self-reported pain parameters was examined using correlation analysis. Some relationships of moderate strength between autonomic and pain measures were found. The change (post-exercise minus pre-exercise score) in pain severity was correlated (r = .580, P = .007) with the change in diastolic blood pressure in the healthy group. In the ME/CFS group, positive correlations between the changes in pain severity and low frequency (r = .552, P = .014), and between the changes in bodily pain and diastolic blood pressure (r = .472, P = .036), were seen. In addition, in ME/CHFS the change in headache severity was inversely correlated (r = -.480, P = .038) with the change in high frequency heart rate variability. Based on the cross-sectional design of the study, no firm conclusions can be drawn on the causality of the relations. Reduced parasympathetic reactivation during recovery from exercise is associated with the dysfunctional exercise-induced analgesia in ME/CFS. Poor recovery of diastolic blood pressure in response to exercise, with blood pressure remaining elevated, is associated with reductions of pain following exercise in ME/CFS, suggesting a role for the arterial baroreceptors in explaining dysfunctional exercise-induced analgesia in ME/CFS patients.Key words: Aerobic exercise, aerobic power index, autonomic nervous system, exercise-induced analgesia, exercise-induced hypoalgesia, fibromyalgia, heart rate variability, stress-induced analgesia, pain.

Effects of high-intensity interval versus continuous exercise training on post-exercise heart rate recovery in coronary heart-disease patients.

PubMed

Villelabeitia-Jaureguizar, Koldobika; Vicente-Campos, Davinia; Senen, Alejandro Berenguel; Jiménez, Verónica Hernández; Garrido-Lestache, María Elvira Barrios; Chicharro, Jose López

2017-10-01

Heart rate recovery (HRR) has been considered a prognostic and mortality indicator in both healthy and coronary patients. Physical exercise prescription has shown improvements in VO 2 peak and HRR, but most of the studies have been carried out applying continuous training at a moderate intensity, being very limited the use of protocols of high intensity interval training in coronary patients. We aimed to compare the effects of a moderate continuous training (MCT) versus a high intensity interval training (HIIT) programme on VO 2 peak and HRR. Seventy three coronary patients were assigned to either HIIT or MCT groups for 8weeks. Incremental exercise tests in a cycloergometer were performed to obtain VO 2 peak data and heart rate was monitored during and after the exercise test to obtain heart rate recovery data. Both exercise programmes significantly increase VO 2 peak with a higher increase in the HIIT group (HIIT: 4.5±4.46ml/kg/min vs MCT: 2.46±3.57ml/kg/min; p=0.039). High intensity interval training resulted in a significantly increase in HRR at the first and second minute of the recovery phase (15,44±7,04 vs 21,22±6,62, p<0,0001 and 23,73±9,64 vs 31,52±8,02, p<0,0001, respectively). The results of our research show that the application of HIIT to patients with chronic ischemic heart disease of low risk resulted in an improvement in VO 2 peak, and also improvements in post-exercise heart-rate recovery, compared with continuous training. Copyright © 2017 Elsevier B.V. All rights reserved.

Seismo-Geochemical Variations in SW Taiwan: Multi-Parameter Automatic Gas Monitoring Results

NASA Astrophysics Data System (ADS)

Yang, T. F.; Fu, C.-C.; Walia, V.; Chen, C.-H.; Chyi, L. L.; Liu, T.-K.; Song, S.-R.; Lee, M.; Lin, C.-W.; Lin, C.-C.

2006-04-01

Gas variations of many mud volcanoes and hot springs distributed along the tectonic sutures in southwestern Taiwan are considered to be sensitive to the earthquake activity. Therefore, a multi-parameter automatic gas station was built on the bank of one of the largest mud-pools at an active fault zone of southwestern Taiwan, for continuous monitoring of CO2, CH4, N2 and H2O, the major constituents of its bubbling gases. During the year round monitoring from October 2001 to October 2002, the gas composition, especially, CH4 and CO2, of the mud pool showed significant variations. Taking the CO2/CH4 ratio as the main indicator, anomalous variations can be recognized from a few days to a few weeks before earthquakes and correlated well with those with a local magnitude >4.0 and local intensities >2. It is concluded that the gas composition in the area is sensitive to the local crustal stress/strain and is worthy to conduct real-time monitoring for the seismo-geochemical precursors.

Reduction of coenzyme q10 content: a possible effect of isoproterenol on heart failure and myocardial infarction in rat.

PubMed

Khorrami, A; Garjani, A; Ghanbarzadeh, S; Andalib, S

2014-04-01

Myocardial infarction (MI) was induced by subcutaneous injection of isoproterenol (ISO) to investigate the effect of ISO on Coenzyme Q10 (CoQ10) content of myocardium and subsequent effects on lipid peroxidation, electrocardiogram pattern and hemodynamic parameters of the rat's heart.36 male Wistar rats were divided randomly into 6 groups. To induce heart failure (HF) and MI, 10 and 100 mg/kg of ISO was administered subcutaneously for 10 and 2 consecutive days, respectively. The effects of ISO on myocardium CoQ10 content, concentration of malondialdehyde, ECG pattern and hemodynamic parameters of heart were analyzed.ISO-treated rats showed significant alteration in heart hemodynamic parameters such as reduction of left-ventricular systolic pressure, maximum and minimum rate of developed left ventricular pressure, besides increase of left ventricular end-diastolic pressure. Significant depletion of heart CoQ10 content (from 4.57 and 4.55 µg/100 mg tissue in control groups to 2.85 and 2.89 µg/100 mg tissue in ISO-induced HF and MI groups respectively) and increase in tissue levels of malondialdehyde (47.1 and 53.8 nmol/100 mg tissue in ISO-induced HF and MI groups, respectively) were also observed in ISO-treated animals compared with the normal animals (17.4 and 18.8 nmol/100 mg tissue in control groups, respectively). Additionally CoQ10 improved ISO effects on hemodynamic parameters and ECG pattern in ISO-induced HF and myocardial injury.The present findings have demonstrated that the cardiotoxic effects of ISO such as oxidative damage and hemodynamic declination might be related to depletion of CoQ10 concentration. © Georg Thieme Verlag KG Stuttgart · New York.

Applying a particle filtering technique for canola crop growth stage estimation in Canada

NASA Astrophysics Data System (ADS)

Sinha, Abhijit; Tan, Weikai; Li, Yifeng; McNairn, Heather; Jiao, Xianfeng; Hosseini, Mehdi

2017-10-01

Accurate crop growth stage estimation is important in precision agriculture as it facilitates improved crop management, pest and disease mitigation and resource planning. Earth observation imagery, specifically Synthetic Aperture Radar (SAR) data, can provide field level growth estimates while covering regional scales. In this paper, RADARSAT-2 quad polarization and TerraSAR-X dual polarization SAR data and ground truth growth stage data are used to model the influence of canola growth stages on SAR imagery extracted parameters. The details of the growth stage modeling work are provided, including a) the development of a new crop growth stage indicator that is continuous and suitable as the state variable in the dynamic estimation procedure; b) a selection procedure for SAR polarimetric parameters that is sensitive to both linear and nonlinear dependency between variables; and c) procedures for compensation of SAR polarimetric parameters for different beam modes. The data was collected over three crop growth seasons in Manitoba, Canada, and the growth model provides the foundation of a novel dynamic filtering framework for real-time estimation of canola growth stages using the multi-sensor and multi-mode SAR data. A description of the dynamic filtering framework that uses particle filter as the estimator is also provided in this paper.

A-Kinase Anchoring Proteins That Regulate Cardiac Remodeling

PubMed Central

Carnegie, Graeme K.; Burmeister, Brian T.

2012-01-01

In response to injury or stress, the adult heart undergoes maladaptive changes, collectively defined as pathological cardiac remodeling. Here, we focus on the role of A-kinase anchoring proteins (AKAPs) in 3 main areas associated with cardiac remodeling and the progression of heart failure: excitation–contraction coupling, sarcomeric regulation, and induction of pathological hypertrophy. AKAPs are a diverse family of scaffold proteins that form multi-protein complexes, integrating cAMP signaling with protein kinases, phosphatases, and other effector proteins. Many AKAPs have been characterized in the heart, where they play a critical role in modulating cardiac function. PMID:22075671

Slowed atrial and atrioventricular conduction and depressed HRV in a murine model of hypertrophic cardiomyopathy.

PubMed

Lim, Wei-Wen; Baumert, Mathias; Neo, Melissa; Kuklik, Pawel; Ganesan, Anand N; Lau, Dennis H; Tsoutsman, Tatiana; Semsarian, Christopher; Sanders, Prashanthan; Saint, David A

2016-01-01

Hypertrophic cardiomyopathy (HCM) is a common heritable cardiac disorder with diverse clinical outcomes including sudden death, heart failure, and stroke. Depressed heart rate variability (HRV), a measure of cardiac autonomic regulation, has been shown to predict mortality in patients with cardiovascular disease. Cardiac autonomic remodelling in animal models of HCM are not well characterised. This study analysed Gly203Ser cardiac troponin-I transgenic (TG) male mice previously demonstrated to develop hallmarks of HCM by age 21 weeks. 33 mice aged 30 and 50 weeks underwent continuous electrocardiogram (ECG) recording for 30 min under anaesthesia. TG mice demonstrated prolonged P-wave duration (P < 0.001) and PR intervals (P < 0.001) compared to controls. Additionally, TG mice demonstrated depressed standard deviation of RR intervals (SDRR; P < 0.01), coefficient of variation of RR intervals (CVRR; P < 0.001) and standard deviation of heart rate (SDHR; P < 0.001) compared to controls. Additionally, total power was significantly reduced in TG mice (P < 0.05). No significant age-related difference in either strain was observed in ECG or HRV parameters. Mice with HCM developed slowed atrial and atrioventricular conduction and depressed HRV. These changes were conserved with increasing age. This finding may be indicative of atrial and ventricular hypertrophy or dysfunction, and perhaps an indication of worse clinical outcome in heart failure progression in HCM patients. © 2015 Wiley Publishing Asia Pty Ltd.

[Cardiovascular repercussion of lodenafil carbonate, a new PDE5 inhibitor, with and without alcohol consumption].

PubMed

Silva, Adauto Carvalho; Toffoletto, Odaly; Lucio, Luiz Antonio Galvão; Santos, Paula Ferreira Dos; Afiune, Jorge Barros; Massud Filho, João; Tufik, Sergio

2010-02-01

Millions of men around the world suffer from erectile dysfunction, for which phosphodiesterase 5 inhibitors (PDE-5 inhibitors) are currently the first treatment option. Sexual activity and alcohol consumption are closely related, and the simultaneous use of alcohol and PDE-5 inhibitors can happen. Lodenafil carbonate is a new PDE-5 inhibitor, developed by a Brazilian pharmaceutical company. This work aimed at evaluating the cardiovascular safety of lodenafil carbonate, with and without simultaneous alcohol consumption. Fifteen male volunteers received 160 mg lodenafil carbonate (LC), in three different moments. Participants were assigned to three groups, treated with LC in fasting condition, with alcohol or receiving only placebo. The volunteers were continuously monitored during 24 hours for physical impairment, blood pressure, heart rate, QT interval and lodenafil's pharmacokinetic parameters. Lodenafil carbonate alone or with alcohol did not induce clinically relevant modifications in arterial blood pressure or heart rate. A statistically significant decrease in blood pressure was seen four hours after LC and alcohol intake, and an increase in heart rate six hours after intake of lodenafil carbonate alone. The QTc interval was not significantly modified. Lodenafil carbonate bioavailability was increased in 74% when drug intake was associated with alcohol. These results show that the use of lodenafil carbonate did not have clinically relevant effects on blood pressure or heart rate, and was not associated with QT interval prolongation. The association of lodenafil carbonate and alcohol affected its pharmacokinetic properties, increasing the bioavailability of the drug.

The effect of meditation on regulation of internal body states

PubMed Central

Khalsa, Sahib S.; Rudrauf, David; Davidson, Richard J.; Tranel, Daniel

2015-01-01

Meditation is commonly thought to induce physiologically quiescent states, as evidenced by decreased autonomic parameters during the meditation practice including reduced heart rate, respiratory rate, blood pressure, skin conductance, and increased alpha activity in the electroencephalogram. Preliminary empirical support for this idea was provided in a case report by Dimsdale and Mills (2002), where it was found that meditation seemed to regulate increased levels of cardiovascular arousal induced by bolus isoproterenol infusions. In that study, while meditating, a self-taught meditator exhibited unexpected decreases in heart rate while receiving moderate intravenous doses of the beta adrenergic agonist isoproterenol. This effect was no longer observed when the individual received isoproterenol infusions while not meditating. The current study was designed to explore this phenomenon empirically in a group of formally trained meditators. A total of 15 meditators and 15 non-meditators individually matched on age, sex, and body mass index were recruited. Participants received four series of infusions in a pseudorandomized order: isoproterenol while meditating (or during a relaxation condition for the non-meditators), isoproterenol while resting, saline while meditating (or during a relaxation condition for the non-meditators), and saline while resting. Heart rate was continuously measured throughout all infusions, and several measures of heart rate were derived from the instantaneous cardiac waveform. There was no evidence at the group or individual level suggesting that meditation reduced the cardiovascular response to isoproterenol, across all measures. These results suggest that meditation is not associated with increased regulation of elevated cardiac adrenergic tone. PMID:26217263

Functional role of diverse changes in sympathetic nerve activity in regulating arterial pressure during REM sleep.

PubMed

Yoshimoto, Misa; Yoshida, Ikue; Miki, Kenju

2011-08-01

This study aimed to investigate whether REM sleep evoked diverse changes in sympathetic outflows and, if so, to elucidate why REM sleep evokes diverse changes in sympathetic outflows. Male Wistar rats were chronically implanted with electrodes to measure renal (RSNA) and lumbar sympathetic nerve activity (LSNA), electroencephalogram, electromyogram, and electrocardiogram, and catheters to measure systemic arterial and central venous pressure; these parameters were measured simultaneously and continuously during the sleep-awake cycle in the same rat. REM sleep resulted in a step reduction in RNSA by 36.1% ± 2.7% (P < 0.05), while LSNA increased in a step manner by 15.3% ± 2% (P < 0.05) relative to the NREM level. Systemic arterial pressure increased gradually (P < 0.05), while heart rate decreased in a step manner (P < 0.05) during REM sleep. In contrast to REM sleep, RSNA, LSNA, systemic arterial pressure, and heart rate increased in a unidirectional manner associated with increases in physical activity levels in the order from NREM sleep, quiet awake, moving, and grooming state. Thus, the relationship between RSNA vs. LSNA and systemic arterial pressure vs. heart rate observed during REM sleep was dissociated compared with that obtained during the other behavioral states. It is suggested that the diverse changes in sympathetic outflows during REM sleep may be needed to increase systemic arterial pressure by balancing vascular resistance between muscles and vegetative organs without depending on the heart.

Heart Rate and Heart Rate Variability in Dairy Cows with Different Temperament and Behavioural Reactivity to Humans

PubMed Central

Tőzsér, János; Szenci, Ottó; Póti, Péter; Pajor, Ferenc

2015-01-01

From the 1990s, extensive research was started on the physiological aspects of individual traits in animals. Previous research has established two extreme (proactive and reactive) coping styles in several animal species, but the means of reactivity with the autonomic nervous system (ANS) activity has not yet been investigated in cattle. The aim of this study was the characterization of cardiac autonomic activity under different conditions in cows with different individual characteristics. For this purpose, we investigated heart rate and ANS-related heart rate variability (HRV) parameters of dairy cows (N = 282) on smaller- and larger-scale farms grouped by (1) temperament and (2) behavioural reactivity to humans (BRH). Animals with high BRH scores were defined as impulsive, while animals with low BRH scores were defined as reserved. Cardiac parameters were calculated for undisturbed lying (baseline) and for milking bouts, the latter with the presence of an unfamiliar person (stressful situation). Sympathetic tone was higher, while vagal activity was lower in temperamental cows than in calm animals during rest both on smaller- and larger-scale farms. During milking, HRV parameters were indicative of a higher sympathetic and a lower vagal activity of temperamental cows as compared to calm ones in farms of both sizes. Basal heart rate did not differ between BRH groups either on smaller- or larger-scale farms. Differences between basal ANS activity of impulsive and reserved cows reflected a higher resting vagal and lower sympathetic activity of reserved animals compared to impulsive ones both on smaller- and larger-scale farms. There was no difference either in heart rate or in HRV parameters between groups during milking neither in smaller- nor in larger-scale farms. These two groupings allowed to draw possible parallels between personality and cardiac autonomic activity during both rest and milking in dairy cows. Heart rate and HRV seem to be useful for characterisation of physiological differences related to temperament and BRH. PMID:26291979

Method and system to perform energy-extraction based active noise control

NASA Technical Reports Server (NTRS)

Kelkar, Atul (Inventor); Joshi, Suresh M. (Inventor)

2009-01-01

A method to provide active noise control to reduce noise and vibration in reverberant acoustic enclosures such as aircraft, vehicles, appliances, instruments, industrial equipment and the like is presented. A continuous-time multi-input multi-output (MIMO) state space mathematical model of the plant is obtained via analytical modeling and system identification. Compensation is designed to render the mathematical model passive in the sense of mathematical system theory. The compensated system is checked to ensure robustness of the passive property of the plant. The check ensures that the passivity is preserved if the mathematical model parameters are perturbed from nominal values. A passivity-based controller is designed and verified using numerical simulations and then tested. The controller is designed so that the resulting closed-loop response shows the desired noise reduction.

Swarming behaviors in multi-agent systems with nonlinear dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Wenwu, E-mail: wenwuyu@gmail.com; School of Electrical and Computer Engineering, RMIT University, Melbourne VIC 3001; Chen, Guanrong

2013-12-15

The dynamic analysis of a continuous-time multi-agent swarm model with nonlinear profiles is investigated in this paper. It is shown that, under mild conditions, all agents in a swarm can reach cohesion within a finite time, where the upper bounds of the cohesion are derived in terms of the parameters of the swarm model. The results are then generalized by considering stochastic noise and switching between nonlinear profiles. Furthermore, swarm models with limited sensing range inducing changing communication topologies and unbounded repulsive interactions between agents are studied by switching system and nonsmooth analysis. Here, the sensing range of each agentmore » is limited and the possibility of collision among nearby agents is high. Finally, simulation results are presented to demonstrate the validity of the theoretical analysis.« less

Cardioproteomics: advancing the discovery of signaling mechanisms involved in cardiovascular diseases

PubMed Central

Cui, Ziyou; Dewey, Shannamar; Gomes, Aldrin V

2011-01-01

Cardioproteomics (Cardiovascular proteomics) is fast becoming an indispensible technique in deciphering changes in signaling pathways that occur in cardiovascular diseases (CVDs). The quality and availability of the instruments and bioinformatics software used for cardioproteomics continues to improve, and these techniques are now available to most cardiovascular researchers either directly or indirectly via university core centers. The heart and aorta are specialized tissues which present unique challenges to investigate. Currently, the diverse range of proteomic techniques available for cardiovascular research makes the choice of the best method or best combination of methods for the disease parameter(s) being investigated as important as the equipment used. This review focuses on proteomic techniques and their applications which have advanced our understanding of the signaling mechanisms involved in CVDs at the levels of protein complex/protein-protein interaction, post-translational modifications and signaling induced protein changes. PMID:22254205

Modeling Single Ventricle Physiology: Review of Engineering Tools to Study First Stage Palliation of Hypoplastic Left Heart Syndrome

PubMed Central

Biglino, Giovanni; Giardini, Alessandro; Hsia, Tain-Yen; Figliola, Richard; Taylor, Andrew M.; Schievano, Silvia

2013-01-01

First stage palliation of hypoplastic left heart syndrome, i.e., the Norwood operation, results in a complex physiological arrangement, involving different shunting options (modified Blalock-Taussig, RV-PA conduit, central shunt from the ascending aorta) and enlargement of the hypoplastic ascending aorta. Engineering techniques, both computational and experimental, can aid in the understanding of the Norwood physiology and their correct implementation can potentially lead to refinement of the decision-making process, by means of patient-specific simulations. This paper presents some of the available tools that can corroborate clinical evidence by providing detailed insight into the fluid dynamics of the Norwood circulation as well as alternative surgical scenarios (i.e., virtual surgery). Patient-specific anatomies can be manufactured by means of rapid prototyping and such models can be inserted in experimental set-ups (mock circulatory loops) that can provide a valuable source of validation data as well as hydrodynamic information. Such models can be tuned to respond to differing the patient physiologies. Experimental set-ups can also be compatible with visualization techniques, like particle image velocimetry and cardiovascular magnetic resonance, further adding to the knowledge of the local fluid dynamics. Multi-scale computational models include detailed three-dimensional (3D) anatomical information coupled to a lumped parameter network representing the remainder of the circulation. These models output both overall hemodynamic parameters while also enabling to investigate the local fluid dynamics of the aortic arch or the shunt. As an alternative, pure lumped parameter models can also be employed to model Stage 1 palliation, taking advantage of a much lower computational cost, albeit missing the 3D anatomical component. Finally, analytical techniques, such as wave intensity analysis, can be employed to study the Norwood physiology, providing a mechanistic perspective on the ventriculo-arterial coupling for this specific surgical scenario. PMID:24400277

Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial.

PubMed

Amanullah, Muhammad M; Hamid, Mohammad; Hanif, Hashim M; Muzaffar, Marium; Siddiqui, Maria T; Adhi, Fatima; Ahmad, Khabir; Khan, Shahjahan; Hasan, Zahra

2016-03-01

Cardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters. To assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery. A randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010-2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines - Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha - were measured. Clinical parameters were also assessed. Blood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (p<0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p<0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups. Dexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term.

Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial.

PubMed

Amini, E; Rafiei, P; Zarei, K; Gohari, M; Hamidi, M

2013-01-01

Music is considered a subset of developmental supportive care. It may act as a suitable auditory stimulant in preterm infants. Also, it may reduce stress responses in autonomic, motor and state systems. To assess and compare the influence of lullaby and classical music on physiologic parameters. This is a randomized clinical trial with cross-over design. A total of 25 stable preterm infants with birth weight of 1000-2500 grams were studied for six consecutive days. Each infant was exposed to three phases: lullaby music, classical music, and no music (control) for two days each. The sequence of these phases was assigned randomly to each subject. Babies were continuously monitored for heart rate, respiratory rate, and oxygen saturation and changes between phases were analyzed. Lullaby reduced heart rate (p < 0.001) and respiratory rate (p = 0.004). These effects extended in the period after the exposure (p < .001 and p = 0.001, respectively). Classical music reduced heart rate (p = 0.018). The effects of classical music disappeared once the music stopped. Oxygen saturation did not change during intervention. Music can affect vital signs of preterm infants; this effect can possibly be related to the reduction of stress during hospitalization. The implications of these findings on clinical and developmental outcomes need further study.

A critical pathway for the frail elderly cardiac patient.

PubMed

Wit, Mirjam; Schaap, Annet; Umans, Victor

2011-12-01

The medical community needs to better respond to the predictable complexities associated with admission of frail and elderly cardiac patients who may need specific attention and care programs. The nurse practitioner can play an important role to continue and coordinate nursing and medical care. We propose a new critical pathway designed to improve cardiac and nursing care for frail elderly cardiac patients admitted with heart failure or atrial fibrillation. The critical pathway is developed by the nurse practitioner who will act as a pathway coordinator and take care of the medical care of these patients in a teaching hospital setting. This critical pathway is applied to all patients aged >75 years who are admitted for heart failure or atrial fibrillation. The pathway implementation identified 5 important socio-medical parameters that may account for a delayed length of stay, even in patients without a complicated medical situation: delirium and fall prevention, nutritional awareness, fluid restriction efforts, and information optimization of patients and spouses. We developed a critical care pathway for the frail elderly patients who are admitted for heart failure or atrial fibrillation. In doing so, we have been able to change the medical and social management of these patients at a general cardiology ward in a teaching hospital.

Effects of amitriptyline and clomipramine in the isolated, perfused rabbit heart.

PubMed

Nielsen-Kudsk, F; Quist, S

1980-04-01

The cardiac effects of supratherapeutic concentrations of two tricyclic antidepressants were studied in isolated rabbit hearts, which were perfused with a modified Krebs-Henseleit solution containing 0.25 or 0.50 micrograms ml-1 of amitriptyline or 0.28 micrograms mg-1 of clomipramine. The following parameters were continuously recorded:heart rate, amplitude and rate of contraction, coronary flow rate, myocardial oxygen consumption and ECG. The lowest concentration of amitriptyline caused a time correlated decrease (20%) in the frequency of spontaneous beating and a pronounced decrease in the amplitude (62%) and rate of cardiac contraction (58%). Maximum increases of the PQ-interval of about 46% and of the QRS-complex of about 100% were observed. At the higher amitriptyline concentration these effect further increased. Clomipramine 0.28 micrograms ml-1 also had a very pronounced and time correlated negative inotropic effect, but the effects upon the conduction velocities were substantially lesser than those produced by the equimilar concentration of amitriptyline. The compounds caused only insignificant changes in coronary flow. The oxygen consumption did not decrease in proportion to the decrease in contractility, as an expression of decreased myocardial efficiency. The effects of the drugs are discussed in relation to theri myocardial accumulation pharmacokinetics and influence upon the membraneous sodium and calcium flux and intracellular metabolism.

Improving hemodynamics of cardiovascular system under a novel intraventricular assist device support via modeling and simulations.

PubMed

Zhu, Shidong; Luo, Lin; Yang, Bibo; Li, Xinghui; Wang, Xiaohao

2017-12-01

Ventricular assist devices (LVADs) are increasingly recognized for supporting blood circulation in heart failure patients who are non-transplant eligible. Because of its volume, the traditional pulsatile device is not easy to implant intracorporeally. Continuous flow LVADs (CF-LVADs) reduce arterial pulsatility and only offer continuous flow, which is different from physiological flow, and may cause long-term complications in the cardiovascular system. The aim of this study was to design a new pulsatile assist device that overcomes this disadvantage, and to test this device in the cardiovascular system. Firstly, the input and output characteristics of the new device were tested in a simple cardiovascular mock system. A detailed mathematical model was established by fitting the experimental data. Secondly, the model was tested in four pathological cases, and was simulated and coupled with a fifth-order cardiovascular system and a new device model using Matlab software. Using assistance of the new device, we demonstrated that the left ventricle pressure, aortic pressure, and aortic flow of heart failure patients improved to the levels of a healthy individual. Especially, in state IV level heart failure patients, the systolic blood pressure increased from 81.34 mmHg to 132.1 mmHg, whereas the diastolic blood pressure increased from 54.28 mmHg to 78.7 mmHg. Cardiac output increased from 3.21 L/min to 5.16 L/min. The newly-developed assist device not only provided a physiological flow that was similar to healthy individuals, but also effectively improved the ability of the pathological ventricular volume. Finally, the effects of the new device on other hemodynamic parameters are discussed.

Linear and nonlinear dynamics of heart rate variability in the process of exposure to 3600 m in 10 min.

PubMed

Zhang, Da; She, Jin; Yang, Jun; Yu, Mengsun

2015-06-01

Acute hypoxia activates several autonomic mechanisms, mainly in cardiovascular system and respiratory system. The influence of acute hypoxia on linear and nonlinear heart rate variability (HRV) has been studied, but the parameters in the process of hypoxia are still unclear. Although the changes of HRV in frequency domain are related to autonomic responses, how nonlinear dynamics change with the decrease of ambient atmospheric pressure is unknown either. Eight healthy male subjects were exposed to simulated altitude from sea level to 3600 m in 10 min. HRV parameters in frequency domain were analyzed by wavelet packet transform (Daubechies 4, 4 level) followed by Hilbert transform to assess the spectral power of modified low frequency (0.0625-0.1875 Hz, LFmod), modified high frequency (0.1875-0.4375 Hz, HFmod), and the LFmod/HFmod ratio in every 1 min. Nonlinear parameters were also quantified by sample entropy (SampEn) and short term fractal correlation exponent (α1) in the process. Hypoxia was associated with the depression of both LFmod and HFmod component. They were significantly lower than that at sea level at 3600 m and 2880 m respectively (both p < 0.05). The LFmod/HFmod ratio was acutely increased at 3600 m (p < 0.05). SampEn was significantly declined at 2880 m (p < 0.05). Although the value of α1 was close to 1, it changed not significantly in the whole process. These results indicated hypoxia gradually attenuated both spectral HRV parameters and SampEn. The balance of sympathovagal shifted towards sympathetic dominance at a certain altitude. Monitoring linear and nonlinear HRV parameters continuously in the process of hypoxia would be an effective way to evaluate the different regulatory mechanisms of autonomic nervous system.

Systemic Scedosporium prolificans infection in an 11-month-old Border collie with cobalamin deficiency secondary to selective cobalamin malabsorption (canine Imerslund-Gräsbeck syndrome).

PubMed

Erles, K; Mugford, A; Barfield, D; Leeb, T; Kook, P H

2018-04-01

An 11-month-old Border collie presented collapsed and continued to deteriorate rapidly despite supportive treatment. The dog had a history of failure to thrive and recurring respiratory infection. Laboratory abnormalities included neutrophilic leucocytosis, Heinz body anaemia, hyperammonaemia, hyperbilirubinaemia, proteinuria and hypocobalaminaemia. Post-mortem examination revealed multi-focal necrosis within the heart, kidneys, pancreas, liver, meninges and cerebral cortex. Fungal hyphae in lesions were identified as Scedosporium prolificans following culture. Subsequent genotyping confirmed that the dog carried the CUBN:c.8392delC mutation in a homozygous state, verifying hereditary cobalamin deficiency (a.k.a. Imerslund-Gräsbeck syndrome). Cobalamin deficiency may have been a predisposing factor for the development of systemic fungal infection in this dog. © 2017 British Small Animal Veterinary Association.

Development of an infection screening system for entry inspection at airport quarantine stations using ear temperature, heart and respiration rates.

PubMed

Sun, Guanghao; Abe, Nobujiro; Sugiyama, Youhei; Nguyen, Quang Vinh; Nozaki, Kohei; Nakayama, Yosuke; Takei, Osamu; Hakozaki, Yukiya; Abe, Shigeto; Matsui, Takemi

2013-01-01

After the outbreak of severe acute respiratory syndrome (SARS) in 2003, many international airport quarantine stations conducted fever-based screening to identify infected passengers using infrared thermography for preventing global pandemics. Due to environmental factors affecting measurement of facial skin temperature with thermography, some previous studies revealed the limits of authenticity in detecting infectious symptoms. In order to implement more strict entry screening in the epidemic seasons of emerging infectious diseases, we developed an infection screening system for airport quarantines using multi-parameter vital signs. This system can automatically detect infected individuals within several tens of seconds by a neural-network-based discriminant function using measured vital signs, i.e., heart rate obtained by a reflective photo sensor, respiration rate determined by a 10-GHz non-contact respiration radar, and the ear temperature monitored by a thermography. In this paper, to reduce the environmental effects on thermography measurement, we adopted the ear temperature as a new screening indicator instead of facial skin. We tested the system on 13 influenza patients and 33 normal subjects. The sensitivity of the infection screening system in detecting influenza were 92.3%, which was higher than the sensitivity reported in our previous paper (88.0%) with average facial skin temperature.

The Onset of Type 2 Diabetes: Proposal for a Multi-Scale Model

PubMed Central

Tieri, Paolo; De Graaf, Albert; Franceschi, Claudio; Liò, Pietro; Van Ommen, Ben; Mazzà, Claudia; Tuchel, Alexander; Bernaschi, Massimo; Samson, Clare; Colombo, Teresa; Castellani, Gastone C; Capri, Miriam; Garagnani, Paolo; Salvioli, Stefano; Nguyen, Viet Anh; Bobeldijk-Pastorova, Ivana; Krishnan, Shaji; Cappozzo, Aurelio; Sacchetti, Massimo; Morettini, Micaela; Ernst, Marc

2013-01-01

Background Type 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-funded project that aims to develop and validate an integrated, multilevel, and patient-specific model, incorporating genetic, metabolic, and nutritional data for the simulation and prediction of metabolic and inflammatory processes in the onset and progression of T2D. The project will ultimately provide a tool for diagnosis and clinical decision making that can estimate the risk of developing T2D and predict its progression in response to possible therapies. Recent data showed that T2D and its complications, specifically in the heart, kidney, retina, and feet, should be considered a systemic disease that is sustained by a pervasive, metabolically-driven state of inflammation. Accordingly, there is an urgent need (1) to understand the complex mechanisms underpinning the onset of this disease, and (2) to identify early patient-specific diagnostic parameters and related inflammatory indicators. Objective We aim to accomplish this mission by setting up a multi-scale model to study the systemic interactions of the biological mechanisms involved in response to a variety of nutritional and metabolic stimuli and stressors. Methods Specifically, we will be studying the biological mechanisms of immunological/inflammatory processes, energy intake/expenditure ratio, and cell cycle rate. The overall architecture of the model will exploit an already established immune system simulator as well as several discrete and continuous mathematical methods for modeling of the processes critically involved in the onset and progression of T2D. We aim to validate the predictions of our models using actual biological and clinical data. Results This study was initiated in March 2013 and is expected to be completed by February 2016. Conclusions MISSION-T2D aims to pave the way for translating validated multilevel immune-metabolic models into the clinical setting of T2D. This approach will eventually generate predictive biomarkers for this disease from the integration of clinical data with metabolic, nutritional, immune/inflammatory, genetic, and gut microbiota profiles. Eventually, it should prove possible to translate these into cost-effective and mobile-based diagnostic tools. PMID:24176906

Hypothyroidism and the Heart.

PubMed

Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

2017-01-01

Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters.

A protocol to study ex vivo mouse working heart at human-like heart rate.

PubMed

Feng, Han-Zhong; Jin, Jian-Ping

2018-01-01

Genetically modified mice are widely used as experimental models to study human heart function and diseases. However, the fast rate of normal mouse heart at 400-600bpm limits its capacity of assessing kinetic parameters that are important for the physiology and pathophysiology of human heart that beats at a much slower rate (75-180bpm). To extend the value of mouse models, we established a protocol to study ex vivo mouse working hearts at a human-like heart rate. In the presence of 300μM lidocaine to lower pacemaker and conductive activities and prevent arrhythmia, a stable rate of 120-130bpm at 37°C is achieved for ex vivo mouse working hearts. The negative effects of decreased heart rate on force-frequency dependence and lidocaine as a myocardial depressant on intracellular calcium can be compensated by using a higher but still physiological level of calcium (2.75mM) in the perfusion media. Multiple parameters were studied to compare the function at the human-like heart rate with that of ex vivo mouse working hearts at the standard rate of 480bpm. The results showed that the conditions for slower heart rate in the presence of 300μM lidocaine did not have depressing effect on left ventricular pressure development, systolic and diastolic velocities and stroke volume with maintained positive inotropic and lusitropic responses to β-adrenergic stimulation. Compared with that at 480bpm, the human-like heart rate increased ventricular filling and end diastolic volume with enhanced Frank-Starling responses. Coronary perfusion was increased from longer relaxation time and interval between beats whereas cardiac efficiency was significantly improved. Although the intrinsic differences between mouse and human heart remain, this methodology for ex vivo mouse hearts to work at human-like heart rate extends the value of using genetically modified mouse models to study cardiac function and human heart diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Elucidation of the Strongest Predictors of Cardiovascular Events in Patients with Heart Failure.

PubMed

Fukuda, Hiroki; Shindo, Kazuhiro; Sakamoto, Mari; Ide, Tomomi; Kinugawa, Shintaro; Fukushima, Arata; Tsutsui, Hiroyuki; Ito, Shin; Ishii, Akira; Washio, Takashi; Kitakaze, Masafumi

2018-06-20

In previous retrospective studies, we identified the 50 most influential clinical predictors of cardiovascular outcomes in patients with heart failure (HF). The present study aimed to use the novel limitless-arity multiple-testing procedure to filter these 50 clinical factors and thus yield combinations of no more than four factors that could potentially predict the onset of cardiovascular events. A Kaplan-Meier analysis was used to investigate the importance of the combinations. In a multi-centre observational trial, we prospectively enrolled 213 patients with HF who were hospitalized because of exacerbation, discharged according to HF treatment guidelines and observed to monitor cardiovascular events. After the observation period, we stratified patients according to whether they experienced cardiovascular events (rehospitalisation or cardiovascular death). Among 77,562 combinations of fewer than five clinical parameters, we identified 151 combinations that could potentially explain the occurrence of cardiovascular events. Of these, 145 combinations included the use of inotropic agents, whereas the remaining 6 included the use of diuretics without bradycardia or tachycardia, suggesting that the high probability of cardiovascular events is exclusively determined by these two clinical factors. Importantly, Kaplan-Meier curves demonstrated that the use of inotropes or of diuretics without bradycardia or tachycardia were independent predictors of a markedly worse cardiovascular prognosis. Patients treated with either inotropic agents or diuretics without bradycardia or tachycardia were at a higher risk of cardiovascular events. The uses of these drugs, regardless of heart rate, are the strongest clinical predictors of cardiovascular events in patients with HF. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Real-time Continuous Assessment Method for Mental and Physiological Condition using Heart Rate Variability

NASA Astrophysics Data System (ADS)

Yoshida, Yutaka; Yokoyama, Kiyoko; Ishii, Naohiro

It is necessary to monitor the daily health condition for preventing stress syndrome. In this study, it was proposed the method assessing the mental and physiological condition, such as the work stress or the relaxation, using heart rate variability at real time and continuously. The instantanuous heart rate (HR), and the ratio of the number of extreme points (NEP) and the number of heart beats were calculated for assessing mental and physiological condition. In this method, 20 beats heart rate were used to calculate these indexes. These were calculated in one beat interval. Three conditions, which are sitting rest, performing mental arithmetic and watching relaxation movie, were assessed using our proposed algorithm. The assessment accuracies were 71.9% and 55.8%, when performing mental arithmetic and watching relaxation movie respectively. In this method, the mental and physiological condition was assessed using only 20 regressive heart beats, so this method is considered as the real time assessment method.

Minimal changes in heart rate of incubating American Oystercatchers (Haematopus palliatus) in response to human activity

USGS Publications Warehouse

Borneman, Tracy E.; Rose, Eli T.; Simons, Theodore R.

2014-01-01

An organism's heart rate is commonly used as an indicator of physiological stress due to environmental stimuli. We used heart rate to monitor the physiological response of American Oystercatchers (Haematopus palliatus) to human activity in their nesting environment. We placed artificial eggs with embedded microphones in 42 oystercatcher nests to record the heart rate of incubating oystercatchers continuously for up to 27 days. We used continuous video and audio recordings collected simultaneously at the nests to relate physiological response of birds (heart rate) to various types of human activity. We observed military and civilian aircraft, off-road vehicles, and pedestrians around nests. With the exception of high-speed, low-altitude military overflights, we found little evidence that oystercatcher heart rates were influenced by most types of human activity. The low-altitude flights were the only human activity to significantly increase average heart rates of incubating oystercatchers (12% above baseline). Although statistically significant, we do not consider the increase in heart rate during high-speed, low-altitude military overflights to be of biological significance. This noninvasive technique may be appropriate for other studies of stress in nesting birds.

Prognosis parameters and polarimetric properties of erythrocytes of the patients suffering from arterial hypertension and coronary heart disease at various patterns of left ventricular remodeling

NASA Astrophysics Data System (ADS)

Ivaschuk, Oleg I.; Kolomoiets, M. Y.; Mikhaliev, K. O.; Chursina, T. Ya.

2011-09-01

The results of examination of 35 arterial hypertension and coronary heart disease patients are presented. The clinical, paraclinical and echocardiographic examinations were performed, and the parameters of prognosis (survival) according to Seattle Heart Failure Model, as well as the optical (polarimetric) properties of erythrocytic suspension were determined. The group of patients under examination was stratified by patterns of remodeling of left ventricle (LV). It was determined that increasing of anisotropy of erythrocytic suspension along LV remodeling patterns continuum correlates with aggravation of structural and functional state of LV and is associated with unfavorable prognosis.

Heart Electrical Actions as Biometric Indicia

NASA Technical Reports Server (NTRS)

Schipper, John F. (Inventor); Dusan, Sorin V. (Inventor); Jorgensen, Charles C. (Inventor); Belousof, Eugene (Inventor)

2013-01-01

A method and associated system for use of statistical parameters based on peak amplitudes and/or time interval lengths and/or depolarization-repolarization vector angles and/or depolarization-repolarization vector lengths for PQRST electrical signals associated with heart waves, to identify a person. The statistical parameters, estimated to be at least 192, serve as biometric indicia, to authenticate, or to decline to authenticate, an asserted identity of a candidate person.

Short-term heart rate variability in dogs with sick sinus syndrome or chronic mitral valve disease as compared to healthy controls.

PubMed

Bogucki, Sz; Noszczyk-Nowak, A

2017-03-28

Heart rate variability is an established risk factor for mortality in both healthy dogs and animals with heart failure. The aim of this study was to compare short-term heart rate variability (ST-HRV) parameters from 60-min electrocardiograms in dogs with sick sinus syndrome (SSS, n=20) or chronic mitral valve disease (CMVD, n=20) and healthy controls (n=50), and to verify the clinical application of ST-HRV analysis. The study groups differed significantly in terms of both time - and frequency- domain ST-HRV parameters. In the case of dogs with SSS and healthy controls, particularly evident differences pertained to HRV parameters linked directly to the variability of R-R intervals. Lower values of standard deviation of all R-R intervals (SDNN), standard deviation of the averaged R-R intervals for all 5-min segments (SDANN), mean of the standard deviations of all R-R intervals for all 5-min segments (SDNNI) and percentage of successive R-R intervals >50 ms (pNN50) corresponded to a decrease in parasympathetic regulation of heart rate in dogs with CMVD. These findings imply that ST-HRV may be useful for the identification of dogs with SSS and for detection of dysautonomia in animals with CMVD.

Reliability and concurrent validity of a peripheral pulse oximeter and health-app system for the quantification of heart rate in healthy adults.

PubMed

Losa-Iglesias, Marta Elena; Becerro-de-Bengoa-Vallejo, Ricardo; Becerro-de-Bengoa-Losa, Klark Ricardo

2016-06-01

There are downloadable applications (Apps) for cell phones that can measure heart rate in a simple and painless manner. The aim of this study was to assess the reliability of this type of App for a Smartphone using an Android system, compared to the radial pulse and a portable pulse oximeter. We performed a pilot observational study of diagnostic accuracy, randomized in 46 healthy volunteers. The patients' demographic data and cardiac pulse were collected. Radial pulse was measured by palpation of the radial artery with three fingers at the wrist over the radius; a low-cost portable, liquid crystal display finger pulse oximeter; and a Heart Rate Plus for Samsung Galaxy Note®. This study demonstrated high reliability and consistency between systems with respect to the heart rate parameter of healthy adults using three systems. For all parameters, ICC was > 0.93, indicating excellent reliability. Moreover, CVME values for all parameters were between 1.66-4.06 %. We found significant correlation coefficients and no systematic differences between radial pulse palpation and pulse oximeter and a high precision. Low-cost pulse oximeter and App systems can serve as valid instruments for the assessment of heart rate in healthy adults. © The Author(s) 2014.

A multiparameter wearable physiologic monitoring system for space and terrestrial applications

NASA Technical Reports Server (NTRS)

Mundt, Carsten W.; Montgomery, Kevin N.; Udoh, Usen E.; Barker, Valerie N.; Thonier, Guillaume C.; Tellier, Arnaud M.; Ricks, Robert D.; Darling, Robert B.; Cagle, Yvonne D.; Cabrol, Nathalie A.;

Echocardiography and risk prediction in advanced heart failure: incremental value over clinical markers.

PubMed

Agha, Syed A; Kalogeropoulos, Andreas P; Shih, Jeffrey; Georgiopoulou, Vasiliki V; Giamouzis, Grigorios; Anarado, Perry; Mangalat, Deepa; Hussain, Imad; Book, Wendy; Laskar, Sonjoy; Smith, Andrew L; Martin, Randolph; Butler, Javed

2009-09-01

Incremental value of echocardiography over clinical parameters for outcome prediction in advanced heart failure (HF) is not well established. We evaluated 223 patients with advanced HF receiving optimal therapy (91.9% angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, 92.8% beta-blockers, 71.8% biventricular pacemaker, and/or defibrillator use). The Seattle Heart Failure Model (SHFM) was used as the reference clinical risk prediction scheme. The incremental value of echocardiographic parameters for event prediction (death or urgent heart transplantation) was measured by the improvement in fit and discrimination achieved by addition of standard echocardiographic parameters to the SHFM. After a median follow-up of 2.4 years, there were 38 (17.0%) events (35 deaths; 3 urgent transplants). The SHFM had likelihood ratio (LR) chi(2) 32.0 and C statistic 0.756 for event prediction. Left ventricular end-systolic volume, stroke volume, and severe tricuspid regurgitation were independent echocardiographic predictors of events. The addition of these parameters to SHFM improved LR chi(2) to 72.0 and C statistic to 0.866 (P < .001 and P=.019, respectively). Reclassifying the SHFM-predicted risk with use of the echocardiography-added model resulted in improved prognostic separation. Addition of standard echocardiographic variables to the SHFM results in significant improvement in risk prediction for patients with advanced HF.

Disease management: remote monitoring in heart failure patients with implantable defibrillators, resynchronization devices, and haemodynamic monitors.

PubMed

Abraham, William T

2013-06-01

Heart failure represents a major public health concern, associated with high rates of morbidity and mortality. A particular focus of contemporary heart failure management is reduction of hospital admission and readmission rates. While optimal medical therapy favourably impacts the natural history of the disease, devices such as cardiac resynchronization therapy devices and implantable cardioverter defibrillators have added incremental value in improving heart failure outcomes. These devices also enable remote patient monitoring via device-based diagnostics. Device-based measurement of physiological parameters, such as intrathoracic impedance and heart rate variability, provide a means to assess risk of worsening heart failure and the possibility of future hospitalization. Beyond this capability, implantable haemodynamic monitors have the potential to direct day-to-day management of heart failure patients to significantly reduce hospitalization rates. The use of a pulmonary artery pressure measurement system has been shown to significantly reduce the risk of heart failure hospitalization in a large randomized controlled study, the CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients (CHAMPION) trial. Observations from a pilot study also support the potential use of a left atrial pressure monitoring system and physician-directed patient self-management paradigm; these observations are under further investigation in the ongoing LAPTOP-HF trial. All these devices depend upon high-intensity remote monitoring for successful detection of parameter deviations and for directing and following therapy.

Demonstration of SLUMIS: a clinical database and management information system for a multi organ transplant program.

PubMed Central

Kurtz, M.; Bennett, T.; Garvin, P.; Manuel, F.; Williams, M.; Langreder, S.

1991-01-01

Because of the rapid evolution of the heart, heart/lung, liver, kidney and kidney/pancreas transplant programs at our institution, and because of a lack of an existing comprehensive database, we were required to develop a computerized management information system capable of supporting both clinical and research requirements of a multifaceted transplant program. SLUMIS (ST. LOUIS UNIVERSITY MULTI-ORGAN INFORMATION SYSTEM) was developed for the following reasons: 1) to comply with the reporting requirements of various transplant registries, 2) for reporting to an increasing number of government agencies and insurance carriers, 3) to obtain updates of our operative experience at regular intervals, 4) to integrate the Histocompatibility and Immunogenetics Laboratory (HLA) for online test result reporting, and 5) to facilitate clinical investigation. PMID:1807741

Comparison of heart rate variability and pulse rate variability detected with photoplethysmography

NASA Astrophysics Data System (ADS)

Rauh, Robert; Limley, Robert; Bauer, Rainer-Dieter; Radespiel-Troger, Martin; Mueck-Weymann, Michael

2004-08-01

This study compares ear photoplethysmography (PPG) and electrocardiogram (ECG) in providing accurate heart beat intervals for use in calculations of heart rate variability (HRV, from ECG) or of pulse rate variability (PRV, from PPG) respectively. Simultaneous measurements were taken from 44 healthy subjects at rest during spontaneous breathing and during forced metronomic breathing (6/min). Under both conditions, highly significant (p > 0.001) correlations (1.0 > r > 0.97) were found between all evaluated common HRV and PRV parameters. However, under both conditions the PRV parameters were higher than HRV. In addition, we calculated the limits of agreement according to Bland and Altman between both techniques and found good agreement (< 10% difference) for heart rate and standard deviation of normal-to-normal intervals (SDNN), but only moderate (10-20%) or even insufficient (> 20%) agreement for other standard HRV and PRV parameters. Thus, PRV data seem to be acceptable for screening purposes but, at least at this state of knowledge, not for medical decision making. However, further studies are needed before more certain determination can be made.

Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology.

PubMed

Jenkins, Kathy J; Koch Kupiec, Jennifer; Owens, Pamela L; Romano, Patrick S; Geppert, Jeffrey J; Gauvreau, Kimberlee

2016-05-20

The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. Parameters that were identical between the 2 methods were retained. AHRQ's Healthcare Cost and Utilization Project State Inpatient Databases (SID) 2008 were used to select optimal parameters where differences existed, with a goal to maximize model performance and face validity. Inclusion criteria were not changed and included all discharges for patients <18 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes for congenital heart surgery or nonspecific heart surgery combined with congenital heart disease diagnosis codes. The final model includes procedure risk group, age (0-28 days, 29-90 days, 91-364 days, 1-17 years), low birth weight (500-2499 g), other congenital anomalies (Clinical Classifications Software 217, except for 758.xx), multiple procedures, and transfer-in status. Among 17 945 eligible cases in the SID 2008, the c statistic for model performance was 0.82. In the SID 2013 validation data set, the c statistic was 0.82. Risk-adjusted mortality rates by center ranged from 0.9% to 4.1% (5th-95th percentile). Congenital heart surgery programs can now obtain national benchmarking reports by applying AHRQ Quality Indicator software to hospital administrative data, based on the harmonized RACHS-1 method, with high discrimination and face validity. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Estimation of heart rate and heart rate variability from pulse oximeter recordings using localized model fitting.

PubMed

Wadehn, Federico; Carnal, David; Loeliger, Hans-Andrea

2015-08-01

Heart rate variability is one of the key parameters for assessing the health status of a subject's cardiovascular system. This paper presents a local model fitting algorithm used for finding single heart beats in photoplethysmogram recordings. The local fit of exponentially decaying cosines of frequencies within the physiological range is used to detect the presence of a heart beat. Using 42 subjects from the CapnoBase database, the average heart rate error was 0.16 BPM and the standard deviation of the absolute estimation error was 0.24 BPM.

Multi-tissue analysis of co-expression networks by higher-order generalized singular value decomposition identifies functionally coherent transcriptional modules.

PubMed

Xiao, Xiaolin; Moreno-Moral, Aida; Rotival, Maxime; Bottolo, Leonardo; Petretto, Enrico

2014-01-01

Recent high-throughput efforts such as ENCODE have generated a large body of genome-scale transcriptional data in multiple conditions (e.g., cell-types and disease states). Leveraging these data is especially important for network-based approaches to human disease, for instance to identify coherent transcriptional modules (subnetworks) that can inform functional disease mechanisms and pathological pathways. Yet, genome-scale network analysis across conditions is significantly hampered by the paucity of robust and computationally-efficient methods. Building on the Higher-Order Generalized Singular Value Decomposition, we introduce a new algorithmic approach for efficient, parameter-free and reproducible identification of network-modules simultaneously across multiple conditions. Our method can accommodate weighted (and unweighted) networks of any size and can similarly use co-expression or raw gene expression input data, without hinging upon the definition and stability of the correlation used to assess gene co-expression. In simulation studies, we demonstrated distinctive advantages of our method over existing methods, which was able to recover accurately both common and condition-specific network-modules without entailing ad-hoc input parameters as required by other approaches. We applied our method to genome-scale and multi-tissue transcriptomic datasets from rats (microarray-based) and humans (mRNA-sequencing-based) and identified several common and tissue-specific subnetworks with functional significance, which were not detected by other methods. In humans we recapitulated the crosstalk between cell-cycle progression and cell-extracellular matrix interactions processes in ventricular zones during neocortex expansion and further, we uncovered pathways related to development of later cognitive functions in the cortical plate of the developing brain which were previously unappreciated. Analyses of seven rat tissues identified a multi-tissue subnetwork of co-expressed heat shock protein (Hsp) and cardiomyopathy genes (Bag3, Cryab, Kras, Emd, Plec), which was significantly replicated using separate failing heart and liver gene expression datasets in humans, thus revealing a conserved functional role for Hsp genes in cardiovascular disease.

Measurement of the efficacy of 2% lipid in reversing bupivacaine- induced asystole in isolated rat hearts

PubMed Central

2014-01-01

Background The reversal efficacy of 2% lipid emulsion in cardiac asystole induced by different concentrations of bupivacaine is poorly defined and needs to be determined. Methods Forty-two male Sprague–Dawley rats were randomly divided into seven groups: B40, B60, B80, B100, B120, B140 and B160, n = 6. The Langendorff isolated heart perfusion model was used, which consisted of a balanced perfusion with Krebs-Henseleit solution for 25 minutes and a continuous infusion of 100 μmol/L bupivacaine until asystole had been induced for 3 minutes. The hearts in the seven groups were perfused with Krebs-Henseleit solution containing a 2% lipid emulsion, and 40, 60, 80, 100, 120, 140 or 160 μmol/L bupivacaine, respectively. Cardiac recovery was defined as a spontaneous and regular rhythm with a rate-pressure product > 10% of the baseline value for more than 1 minute. Our primary outcome was the rate-pressure product 25 minutes after cardiac recovery. Other cardiac function parameters were also recorded. Results All groups demonstrated cardiac recovery. During the recovery phase, heart rate, rate-pressure product, the maximum left ventricular pressure rise and decline in heart rate in the B120-B160 groups was significantly lower than those in the B40-B80 groups (P < 0.05). The concentration of bupivacaine and the reversal effects of a 2% lipid emulsion showed a typical transoid S-shaped curve, R2 = 0.9983, IC50 value was 102.5 μmol/L (95% CI: 92.44 - 113.6). Conclusions There is a concentration-response relationship between the concentrations of bupivacaine and the reversal effects of 2% lipid emulsion. PMID:25089118

Effects of diffusion on total biomass in heterogeneous continuous and discrete-patch systems

USGS Publications Warehouse

DeAngelis, Donald L.; Ming Ni, Wei; Zhang, Bo

2016-01-01

Theoretical models of populations on a system of two connected patches previously have shown that when the two patches differ in maximum growth rate and carrying capacity, and in the limit of high diffusion, conditions exist for which the total population size at equilibrium exceeds that of the ideal free distribution, which predicts that the total population would equal the total carrying capacity of the two patches. However, this result has only been shown for the Pearl-Verhulst growth function on two patches and for a single-parameter growth function in continuous space. Here, we provide a general criterion for total population size to exceed total carrying capacity for three commonly used population growth rates for both heterogeneous continuous and multi-patch heterogeneous landscapes with high population diffusion. We show that a sufficient condition for this situation is that there is a convex positive relationship between the maximum growth rate and the parameter that, by itself or together with the maximum growth rate, determines the carrying capacity, as both vary across a spatial region. This relationship occurs in some biological populations, though not in others, so the result has ecological implications.

Identifying increased risk of post-infarct people with diabetes using multi-lag Tone-Entropy analysis.

PubMed

Karmakar, Chandan; Jelinek, Herbert; Khandoker, Ahsan; Tulppo, Mikko; Makikallio, Timo; Kiviniemi, Antti; Huikuri, Heikki; Palaniswami, Marimuthu

2012-01-01

Diabetes mellitus is associated with multi-organ system dysfunction. One of the key causative factors is the increased blood sugar level that leads to an increase in free radical activity and organ damage including the cardiovascular and nervous system. Heart rhythm is extrinsically modulated by the autonomic nervous system and cardiac autonomic neuropathy or dysautonomia has been shown to lead to sudden cardiac death in people with diabetes due to the decrease in heart rate variability (HRV). Current algorithms for determining HRV describe only beat-to-beat variation and therefore do not consider the ability of a heart beat to influence a train of succeeding beats. Therefore mortality risk analysis based on HRV has often not been able to discern the presence of an increased risk. This study used a novel innovation of the tone-entropy algorithm by incorporating increased lag intervals and found that both the sympatho-vagal balance and total activity changed at larger lag intervals. Tone-Entropy was found to be better risk identifier of cardiac mortality in people with diabetes at lags higher than one and best at lag seven.

Serum Bicarbonate Is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis.

PubMed

Kendrick, Jessica B; Zelnick, Leila; Chonchol, Michel B; Siscovick, David; Hoofnagle, Andrew N; Ix, Joachim H; Sarnak, Mark; Shlipak, Michael G; Kestenbaum, Bryan; de Boer, Ian H

2017-01-01

Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. We performed a cohort study of 6,229 adult participants from the Multi-Ethnic Study of Atherosclerosis, a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: (1) subclinical CVD (left ventricular mass [LVM] and aortic pulse pressure [PP] measured at baseline), (2) incident atherosclerotic cardiovascular events (CVE; composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), and (3) incident heart failure. During a median (interquartile range) follow-up of 8.5 (7.7-8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 g greater LVM (95% CI 0.5-5.0) and 1.0 mm Hg higher aortic PP (95% CI 0.4-2.0) compared to bicarbonate 23-24 mEq/L. Each 1 mEq/L of bicarbonate increase was associated with a 13% higher risk of incident heart failure (hazards ratio 1.13, 95% CI 1.01-2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure. © 2016 S. Karger AG, Basel.

Serum Bicarbonate is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Kendrick, Jessica; Zelnick, Leila; Chonchol, Michel; Siscovick, David; Hoofnagle, Andrew N.; Ix, Joachim H.; Sarnak, Mark; Shlipak, Michael; Kestenbaum, Bryan; de Boer, Ian H.

2016-01-01

Background Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. Methods We performed a cohort study of 6229 adult participants from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: 1) subclinical CVD (left ventricular mass (LVM) and aortic pulse pressure (PP) measured at baseline), 2) incident atherosclerotic cardiovascular events (CVE) (composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death and stroke death), and 3) incident heart failure. Results During a median (IQR) follow-up of 8.5 (7.7–8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 gram greater LVM (95% CI 0.5 to 5.0) and 1.0 mmHg higher aortic PP (95% CI 0.4 to 2.0) compared to bicarbonate 23–24 mEq/L. Each 1mEq/L higher bicarbonate was associated with a 13% higher risk of incident heart failure (HR 1.13, 95% CI 1.01 to 2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Conclusion Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure. PMID:27941322

Developing Mesoscale Model of Fibrin-Platelet Network Representing Blood Clotting =

NASA Astrophysics Data System (ADS)

Sun, Yueyi; Nikolov, Svetoslav; Bowie, Sam; Alexeev, Alexander; Lam, Wilbur; Myers, David

Blood clotting disorders which prevent the body's natural ability to achieve hemostasis can lead to a variety of life threatening conditions such as, excessive bleeding, stroke, or heart attack. Treatment of these disorders is highly dependent on understanding the underlying physics behind the clotting process. Since clotting is a highly complex multi scale mechanism developing a fully atomistic model is currently not possible. We develop a mesoscale model based on dissipative particle dynamics (DPD) to gain fundamental understanding of the underlying principles controlling the clotting process. In our study, we examine experimental data on clot contraction using stacks of confocal microscopy images to estimate the crosslink density in the fibrin networks and platelet location. Using this data we reconstruct the platelet rich fibrin network and study how platelet-fibrin interactions affect clotting. Furthermore, we probe how different system parameters affect clot contraction. ANSF CAREER Award DMR-1255288.

Influence of a Multi-parametric Optimization Strategy for General Anesthesia on Postoperative Morbidity and Mortality

ClinicalTrials.gov

2017-11-20

Coronary; Ischemic; Arrhythmias, Cardiac; Heart Failure; Peripheral Vascular Diseases; Dementia; Stroke; Pulmonary Disease, Chronic Obstructive; Respiratory Insufficiency; Alcoholism; Cancer; Diabetes; Renal Insufficiency

Automated processing of first-pass radioisotope ventriculography data to determine essential central circulation parameters

NASA Astrophysics Data System (ADS)

Krotov, Aleksei; Pankin, Victor

2017-09-01

The assessment of central circulation (including heart function) parameters is vital in the preventive diagnostics of inherent and acquired heart failures and during polychemotherapy. The protocols currently applied in Russia do not fully utilize the first-pass assessment (FPRNA) and that results in poor data formalization, while the FPRNA is the one of the fastest, affordable and compact methods among other radioisotope diagnostics protocols. A non-imaging algorithm basing on existing protocols has been designed to use the readings of an additional detector above vena subclavia to determine the total blood volume (TBV), not requiring blood sampling in contrast to current protocols. An automated processing of precordial detector readings is presented, in order to determine the heart strike volume (SV). Two techniques to estimate the ejection fraction (EF) of the heart are discussed.

[Spectral analysis of Heart Rate Variability in psychiatric patients: autonomic nervous system evaluation in psychotic, anxiety and depressive disorders].

PubMed

Lo Turco, Giovanni; Grimaldi Di Terresena, Liria

2012-01-01

The aim of this study was to test the primary hypothesis of altered Heart Rate Variability (HRV) and heart rate in a sample of patients with mental disorders and the secondary hypothesis of normalization of HRV values as a result of clinical improvement. The study was conducted on a sample of 90 patients with psychotic, anxiety and mood disorders. Each patient was subjected to detection of HRV and heart rate via a photoplethysmographic sensor and evaluated with rating scales based on the specific disorder. The parameters detected in the sample were compared with a control group of healthy subjects. There were no significant differences of cardiac autonomic modulation between the group of patients in whom is possible exclude the drug influence and the control group; significantly lower values of HRV parameters in the group of patients with drug influence, and especially in subgroup of psychotic patients, compared to controls, are, instead, detected. The study also shows a significant increase in heart rate as a common feature in mental disorders, regardless of treatment. Clinical improvement appears to promote the normalization of the variability in patients with high DS of tachogram. The study suggests a potential increased risk of cardiovascular mortality in patients, as evidenced by the increased values of heart rate, regardless of drug treatment. This risk is even more pronounced in psychotic patients in drug treatment because of the simultaneous significant reduction of HRV parameters.

Association of heart rate profile during exercise with the severity of coronary artery disease.

PubMed

Cay, Serkan; Ozturk, Sezgin; Biyikoglu, Funda; Yildiz, Abdulkadir; Cimen, Tolga; Uygur, Belma; Tuna, Funda

2009-05-01

Coronary artery disease is the leading cause of morbidity and mortality around the world. Autonomic nervous system abnormalities are associated with coronary artery disease and its complications. Exercise stress tests are routinely used for the detection of the presence of coronary artery disease. In this study, we observed the association between heart rate profile during exercise and the severity of coronary artery disease. One hundred and sixty patients with abnormal exercise treadmill test (> or =1 mm horizontal or downsloping ST-segment depression; 119 men, 41 women; mean age = 57 +/- 9 years) were included in the study. Use of any drug affecting heart rate was not permitted. Resting heart rate before exercise, maximum heart rate during exercise, and resting heart rate after exercise (5 min later) were measured and two parameters were calculated: heart rate increment (maximum heart rate - resting heart rate before exercise) and heart rate decrement (maximum heart rate - resting heart rate after exercise). All patients underwent selective coronary angiography and subclassified into two groups according to stenotic lesion severity. Group 1 had at least 50% of stenotic lesion and group 2 had less than 50%. Patients in the first group had increased resting heart rate, decreased maximum heart rate, decreased heart rate increment, and decreased heart rate decrement compared with second group. All patients were classified into tertiles of resting heart rate, heart rate increment, and heart rate decrement level to evaluate whether these parameters were associated with severity of coronary artery stenosis in the study. The multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 21.888 (95% confidence interval 6.983-68.606) for the highest tertile of resting heart rate level compared with the lowest tertile. In addition, the multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 20.987 (95% confidence interval 6.635-66.387) for the lowest tertile of heart rate increment level compared with the highest tertile and 2.360 (95% confidence interval 1.004-5.544) for the lowest tertile of heart rate decrement level compared with the highest tertile. Altered autonomic nervous system regulation affects heart rate profile, increased resting heart rate, decreased heart rate increment, and decreased heart rate decrement, during exercise and this effect is strongly and independently associated with the severity of coronary artery disease.

Influences of meteorological parameters on indoor radon concentrations (222Rn) excluding the effects of forced ventilation and radon exhalation from soil and building materials.

PubMed

Schubert, Michael; Musolff, Andreas; Weiss, Holger

2018-06-13

Elevated indoor radon concentrations ( 222 Rn) in dwellings pose generally a potential health risk to the inhabitants. During the last decades a considerable number of studies discussed both the different sources of indoor radon and the drivers for diurnal and multi day variations of its concentration. While the potential sources are undisputed, controversial opinions exist regarding their individual relevance and regarding the driving influences that control varying radon indoor concentrations. These drivers include (i) cyclic forced ventilation of dwellings, (ii) the temporal variance of the radon exhalation from soil and building materials due to e.g. a varying moisture content and (iii) diurnal and multi day temperature and pressure patterns. The presented study discusses the influences of last-mentioned temporal meteorological parameters by effectively excluding the influences of forced ventilation and undefined radon exhalation. The results reveal the continuous variation of the indoor/outdoor pressure gradient as key driver for a constant "breathing" of any interior space, which affects the indoor radon concentration with both diurnal and multi day patterns. The diurnally recurring variation of the pressure gradient is predominantly triggered by the day/night cycle of the indoor temperature that is associated with an expansion/contraction of the indoor air volume. Multi day patterns, on the other hand, are mainly due to periods of negative air pressure indoors that is triggered by periods of elevated wind speeds as a result of Bernoulli's principle. Copyright © 2018 Elsevier Ltd. All rights reserved.

Coarctation of the aorta

MedlinePlus

... brain Early development of coronary artery disease (CAD) Endocarditis (infection in the heart) Heart failure Hoarseness Kidney ... include: Continued or repeated narrowing of the aorta Endocarditis High blood pressure

An Algebraic Construction of Duality Functions for the Stochastic {U_q( A_n^{(1)})} Vertex Model and Its Degenerations

NASA Astrophysics Data System (ADS)

Kuan, Jeffrey

2018-03-01

A recent paper (Kuniba in Nucl Phys B 913:248-277, 2016) introduced the stochastic U}_q(A_n^{(1)})} vertex model. The stochastic S-matrix is related to the R-matrix of the quantum group {U_q(A_n^{(1)})} by a gauge transformation. We will show that a certain function {D^+_{m intertwines with the transfer matrix and its space reversal. When interpreting the transfer matrix as the transition matrix of a discrete-time totally asymmetric particle system on the one-dimensional lattice Z , the function {D^+m} becomes a Markov duality function {Dm} which only depends on q and the vertical spin parameters μ_x. By considering degenerations in the spectral parameter, the duality results also hold on a finite lattice with closed boundary conditions, and for a continuous-time degeneration. This duality function had previously appeared in a multi-species ASEP(q, j) process (Kuan in A multi-species ASEP(q, j) and q-TAZRP with stochastic duality, 2017). The proof here uses that the R-matrix intertwines with the co-product, but does not explicitly use the Yang-Baxter equation. It will also be shown that the stochastic U}_q(A_n^{(1)})} is a multi-species version of a stochastic vertex model studied in Borodin and Petrov (Higher spin six vertex model and symmetric rational functions, 2016) and Corwin and Petrov (Commun Math Phys 343:651-700, 2016). This will be done by generalizing the fusion process of Corwin and Petrov (2016) and showing that it matches the fusion of Kulish and yu (Lett Math Phys 5:393-403, 1981) up to the gauge transformation. We also show, by direct computation, that the multi-species q-Hahn Boson process (which arises at a special value of the spectral parameter) also satisfies duality with respect to D_∞, generalizing the single-species result of Corwin (Int Math Res Not 2015:5577-5603, 2015).

Sleep-disordered breathing and daytime cardiac conduction abnormalities on 12-lead electrocardiogram in community-dwelling older men

PubMed Central

Kwon, Younghoon; Picel, Katherine; Adabag, Selcuk; Vo, Tien; Taylor, Brent C.; Redline, Susan; Stone, Katie; Mehra, Reena; Ancoli-Israel, Sonia

2016-01-01

Purpose Nocturnal cardiac conduction abnormalities are commonly observed in patients with sleep-disordered breathing (SDB). However, few population-based studies have examined the association between SDB and daytime cardiac conduction abnormalities. Methods We examined a random sample of 471 community-dwelling men, aged ≥67 years, enrolled in the multi-center Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study. SDB severity was categorized using percent of total sleep time with oxygen saturation <90 % (%TST < 90) and apnea hypopnea index (AHI). Cardiac conduction parameters were assessed by resting 12-lead electrocardiography (ECG). All analyses were adjusted for age, site, β-blocker use, coronary heart disease, calcium channel blocker use, and use of antiarrhythmic medications. Results Mean age was 77 ± 6 years, median %TST < 90 was 0.7 (IQR 0.00–3.40), and median AHI was 7.06 (IQR 2.55–15.32). Men with greater nocturnal hypoxemia (%TST < 90 ≥ 3.5 %) compared with those without hypoxemia (%TST < 90 < 1.0 %) had a lower odds of bradycardia (OR 0.55 [0.32–0.94]) and right bundle branch block (RBBB) (OR 0.24 [0.08–0.75]) but a higher odds of ventricular paced rhythm (OR 4.42 [1.29–15.19]). Heart rate (HR) increased in a graded manner with increasing %TST < 90 (p-trend 0.01) and increasing AHI (p-trend 0.006), but these gradients were small in absolute magnitude. There were no associations of SDB measures with other ECG conduction parameters. Conclusions Greater nocturnal hypoxemia in older men was associated with a lower prevalence of daytime sinus bradycardia and RBBB, a higher prevalence of ventricular paced rhythm, and higher resting HR. PMID:26971326

Effects of age and mild cognitive impairment on the pain response system.

PubMed

Kunz, Miriam; Mylius, Veit; Schepelmann, Karsten; Lautenbacher, Stefan

2009-01-01

Both age and dementia have been shown to have an effect on nociception and pain processing. The question arises whether mild cognitive impairment (MCI), which is thought to be a transitional stage between normal ageing and dementia, is also associated with alterations in pain processing. The aim of the present study was to answer this question by investigating the impact of age and MCI on the pain response system. Forty young subjects, 45 cognitively unimpaired elderly subjects and 42 subjects with MCI were investigated by use of an experimental multi-method approach. The subjects were tested for their subjective (pain ratings), motor (RIII reflex), facial (Facial Action Coding System) and their autonomic (sympathetic skin response and evoked heart rate response) responses to noxious electrical stimulation of the nervus suralis. We found significant group differences in the autonomic responses to noxious stimulation. The sympathetic skin response amplitude was significantly reduced in the cognitively unimpaired elderly subjects compared to younger subjects and to an even greater degree in subjects with MCI. The evoked heart rate response was reduced to a similar degree in both groups of aged subjects. Regression analyses within the two groups of the elderly subjects revealed that age and, in the MCI group, cognitive status were significant predictors of the decrease in autonomic responsiveness to noxious stimulation. Except for the autonomic parameters, no other pain parameter differed between the three groups. The pain response system appeared to be quite unaltered in MCI patients compared to cognitively unimpaired individuals of the same age. Only the sympathetic responsiveness qualified as an indicator of early aging effects as well as of pathophysiology associated with MCI, which both seemed to affect the pain system independently from each other.

Paroxysmal atrial fibrillation prediction based on HRV analysis and non-dominated sorting genetic algorithm III.

PubMed

Boon, K H; Khalil-Hani, M; Malarvili, M B

2018-01-01

This paper presents a method that able to predict the paroxysmal atrial fibrillation (PAF). The method uses shorter heart rate variability (HRV) signals when compared to existing methods, and achieves good prediction accuracy. PAF is a common cardiac arrhythmia that increases the health risk of a patient, and the development of an accurate predictor of the onset of PAF is clinical important because it increases the possibility to electrically stabilize and prevent the onset of atrial arrhythmias with different pacing techniques. We propose a multi-objective optimization algorithm based on the non-dominated sorting genetic algorithm III for optimizing the baseline PAF prediction system, that consists of the stages of pre-processing, HRV feature extraction, and support vector machine (SVM) model. The pre-processing stage comprises of heart rate correction, interpolation, and signal detrending. After that, time-domain, frequency-domain, non-linear HRV features are extracted from the pre-processed data in feature extraction stage. Then, these features are used as input to the SVM for predicting the PAF event. The proposed optimization algorithm is used to optimize the parameters and settings of various HRV feature extraction algorithms, select the best feature subsets, and tune the SVM parameters simultaneously for maximum prediction performance. The proposed method achieves an accuracy rate of 87.7%, which significantly outperforms most of the previous works. This accuracy rate is achieved even with the HRV signal length being reduced from the typical 30 min to just 5 min (a reduction of 83%). Furthermore, another significant result is the sensitivity rate, which is considered more important that other performance metrics in this paper, can be improved with the trade-off of lower specificity. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep-disordered breathing and daytime cardiac conduction abnormalities on 12-lead electrocardiogram in community-dwelling older men.

PubMed

Kwon, Younghoon; Picel, Katherine; Adabag, Selcuk; Vo, Tien; Taylor, Brent C; Redline, Susan; Stone, Katie; Mehra, Reena; Ancoli-Israel, Sonia; Ensrud, Kristine E

2016-12-01

Nocturnal cardiac conduction abnormalities are commonly observed in patients with sleep-disordered breathing (SDB). However, few population-based studies have examined the association between SDB and daytime cardiac conduction abnormalities. We examined a random sample of 471 community-dwelling men, aged ≥67 years, enrolled in the multi-center Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study. SDB severity was categorized using percent of total sleep time with oxygen saturation <90 % (%TST < 90) and apnea hypopnea index (AHI). Cardiac conduction parameters were assessed by resting 12-lead electrocardiography (ECG). All analyses were adjusted for age, site, β-blocker use, coronary heart disease, calcium channel blocker use, and use of antiarrhythmic medications. Mean age was 77 ± 6 years, median %TST < 90 was 0.7 (IQR 0.00-3.40), and median AHI was 7.06 (IQR 2.55-15.32). Men with greater nocturnal hypoxemia (%TST < 90 ≥ 3.5 %) compared with those without hypoxemia (%TST < 90 < 1.0 %) had a lower odds of bradycardia (OR 0.55 [0.32-0.94]) and right bundle branch block (RBBB) (OR 0.24 [0.08-0.75]) but a higher odds of ventricular paced rhythm (OR 4.42 [1.29-15.19]). Heart rate (HR) increased in a graded manner with increasing %TST < 90 (p-trend 0.01) and increasing AHI (p-trend 0.006), but these gradients were small in absolute magnitude. There were no associations of SDB measures with other ECG conduction parameters. Greater nocturnal hypoxemia in older men was associated with a lower prevalence of daytime sinus bradycardia and RBBB, a higher prevalence of ventricular paced rhythm, and higher resting HR.

Hypothyroidism and the Heart

PubMed Central

Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

2017-01-01

Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters. PMID:28740582

Continuous-flow left ventricular assist device therapy in patients with preoperative hepatic failure: are we pushing the limits too far?

PubMed

Weymann, Alexander; Patil, Nikhil P; Sabashnikov, Anton; Mohite, Phrashant N; Garcia Saez, Diana; Bireta, Christian; Wahlers, Thorsten; Karck, Matthias; Kallenbach, Klaus; Ruhparwar, Arjang; Fatullayev, Javid; Amrani, Mohamed; De Robertis, Fabio; Bahrami, Toufan; Popov, Aron-Frederik; Simon, Andre R

2015-04-01

The purpose of this study was to evaluate the effects and outcome of continuous-flow left ventricular assist device (cf-LVAD) therapy in patients with preoperative acute hepatic failure. The study design was a retrospective review of prospectively collected data. Included were 42 patients who underwent cf-LVAD implantation (64.3% HeartMate II, 35.7% HeartWare) between July 2007 and May 2013 with preoperative hepatic failure defined as elevation of greater than or equal to two liver function parameters above twice the upper normal range. Mean patient age was 35 ± 12.5 years, comprising 23.8% females. Dilated cardiomyopathy was present in 92.9% of patients (left ventricular ejection fraction 17.3 ± 5.9%). Mean support duration was 511 ± 512 days (range: 2-1996 days). Mean preoperative laboratory parameters for blood urea nitrogen, serum creatinine, total bilirubin, and alanine aminotransferase were 9.5 ± 5.4 mg/dL, 110.3 ± 42.8 μmol/L, 51.7 ± 38.3 mmol/L, and 242.1 ± 268.6 U/L, respectively. All parameters decreased significantly 1 month postoperatively. The mean preoperative modified Model for Endstage Liver Disease excluding international normalized ratio score was 16.03 ± 5.57, which improved significantly after cf-LVAD implantation to 10.62 ± 5.66 (P < 0.001) at 7 days and 5.83 ± 4.98 (P < 0.001) at 30 days postoperatively. One-year and 5-year survival was 75.9 and 48.1%, respectively. 21.4% of the patients underwent LVAD explantation for myocardial recovery, 16.7% were successfully transplanted, and 7.1% underwent LVAD exchange for device failure over the follow-up period. Patients with preexisting acute hepatic failure are reasonable candidates for cf-LVAD implantation, with excellent rates of recovery and survival, suggesting that cf-LVAD therapy should not be denied to patients merely on grounds of "preoperative elevated liver enzymes/hepatopathy." Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Left-right asymmetry and cardiac looping: implications for cardiac development and congenital heart disease.

PubMed

Kathiriya, I S; Srivastava, D

2000-01-01

Proper morphogenesis and positioning of internal organs requires delivery and interpretation of precise signals along the anterior-posterior, dorsal-ventral, and left-right axes. An elegant signaling cascade determines left- versus right-sided identity in visceral organs in a concordant fashion, resulting in a predictable left-right (LR) organ asymmetry in all vertebrates. The complex morphogenesis of the heart and its connections to the vasculature are particularly dependent upon coordinated LR signaling pathways. Disorganization of LR signals can result in myriad congenital heart defects that are a consequence of abnormal looping and remodeling of the primitive heart tube into a multi-chambered organ. A framework for understanding how LR asymmetric signals contribute to normal organogenesis has emerged and begins to explain the basis of many human diseases of LR asymmetry. Here we review the impact of LR signaling pathways on cardiac development and congenital heart disease.

Clairvoyant fusion: a new methodology for designing robust detection algorithms

NASA Astrophysics Data System (ADS)

Schaum, Alan

2016-10-01

Many realistic detection problems cannot be solved with simple statistical tests for known alternative probability models. Uncontrollable environmental conditions, imperfect sensors, and other uncertainties transform simple detection problems with likelihood ratio solutions into composite hypothesis (CH) testing problems. Recently many multi- and hyperspectral sensing CH problems have been addressed with a new approach. Clairvoyant fusion (CF) integrates the optimal detectors ("clairvoyants") associated with every unspecified value of the parameters appearing in a detection model. For problems with discrete parameter values, logical rules emerge for combining the decisions of the associated clairvoyants. For many problems with continuous parameters, analytic methods of CF have been found that produce closed-form solutions-or approximations for intractable problems. Here the principals of CF are reviewed and mathematical insights are described that have proven useful in the derivation of solutions. It is also shown how a second-stage fusion procedure can be used to create theoretically superior detection algorithms for ALL discrete parameter problems.

Systems Biology and Biomechanical Model of Heart Failure

PubMed Central

Louridas, George E; Lourida, Katerina G

2012-01-01

Heart failure is seen as a complex disease caused by a combination of a mechanical disorder, cardiac remodeling and neurohormonal activation. To define heart failure the systems biology approach integrates genes and molecules, interprets the relationship of the molecular networks with modular functional units, and explains the interaction between mechanical dysfunction and cardiac remodeling. The biomechanical model of heart failure explains satisfactorily the progression of myocardial dysfunction and the development of clinical phenotypes. The earliest mechanical changes and stresses applied in myocardial cells and/or myocardial loss or dysfunction activate left ventricular cavity remodeling and other neurohormonal regulatory mechanisms such as early release of natriuretic peptides followed by SAS and RAAS mobilization. Eventually the neurohormonal activation and the left ventricular remodeling process are leading to clinical deterioration of heart failure towards a multi-organic damage. It is hypothesized that approaching heart failure with the methodology of systems biology we promote the elucidation of its complex pathophysiology and most probably we can invent new therapeutic strategies. PMID:22935019

Characterizing steady states of genome-scale metabolic networks in continuous cell cultures.

PubMed

Fernandez-de-Cossio-Diaz, Jorge; Leon, Kalet; Mulet, Roberto

2017-11-01

In the continuous mode of cell culture, a constant flow carrying fresh media replaces culture fluid, cells, nutrients and secreted metabolites. Here we present a model for continuous cell culture coupling intra-cellular metabolism to extracellular variables describing the state of the bioreactor, taking into account the growth capacity of the cell and the impact of toxic byproduct accumulation. We provide a method to determine the steady states of this system that is tractable for metabolic networks of arbitrary complexity. We demonstrate our approach in a toy model first, and then in a genome-scale metabolic network of the Chinese hamster ovary cell line, obtaining results that are in qualitative agreement with experimental observations. We derive a number of consequences from the model that are independent of parameter values. The ratio between cell density and dilution rate is an ideal control parameter to fix a steady state with desired metabolic properties. This conclusion is robust even in the presence of multi-stability, which is explained in our model by a negative feedback loop due to toxic byproduct accumulation. A complex landscape of steady states emerges from our simulations, including multiple metabolic switches, which also explain why cell-line and media benchmarks carried out in batch culture cannot be extrapolated to perfusion. On the other hand, we predict invariance laws between continuous cell cultures with different parameters. A practical consequence is that the chemostat is an ideal experimental model for large-scale high-density perfusion cultures, where the complex landscape of metabolic transitions is faithfully reproduced.

Characterizing steady states of genome-scale metabolic networks in continuous cell cultures

PubMed Central

Leon, Kalet; Mulet, Roberto

2017-01-01

In the continuous mode of cell culture, a constant flow carrying fresh media replaces culture fluid, cells, nutrients and secreted metabolites. Here we present a model for continuous cell culture coupling intra-cellular metabolism to extracellular variables describing the state of the bioreactor, taking into account the growth capacity of the cell and the impact of toxic byproduct accumulation. We provide a method to determine the steady states of this system that is tractable for metabolic networks of arbitrary complexity. We demonstrate our approach in a toy model first, and then in a genome-scale metabolic network of the Chinese hamster ovary cell line, obtaining results that are in qualitative agreement with experimental observations. We derive a number of consequences from the model that are independent of parameter values. The ratio between cell density and dilution rate is an ideal control parameter to fix a steady state with desired metabolic properties. This conclusion is robust even in the presence of multi-stability, which is explained in our model by a negative feedback loop due to toxic byproduct accumulation. A complex landscape of steady states emerges from our simulations, including multiple metabolic switches, which also explain why cell-line and media benchmarks carried out in batch culture cannot be extrapolated to perfusion. On the other hand, we predict invariance laws between continuous cell cultures with different parameters. A practical consequence is that the chemostat is an ideal experimental model for large-scale high-density perfusion cultures, where the complex landscape of metabolic transitions is faithfully reproduced. PMID:29131817

DDD pacemaker for severe heart failure-alternate to CRT.

PubMed

Krishnamani, N C

Patients with severe systolic Heart Failure continue to have poor quality of life and increased mortality in spite of optimal medical management. Cardiac Resynchronization Therapy [CRT] is promising modality in patients with systolic heart failure and electrocardiographic [ECG] evidence of left bundle branch block [LBBB]. Cost issues continue to elude many deserving cases of this therapy in our society. Relatively cost effective Dual chamber pacing [DDD] with right atrial and isolated left ventricular pacing [RA-LV] can be a good alternative. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

VERY LOW FREQUENCY 16 HZ AMPLITUDE MODULATED ELECTROMAGNETIC RADIATION INCREASES CALCIUM EFFLUX FROM THE FROG HEART

EPA Science Inventory

The effects of continuous and amplitude-modulated radiofrequency electromagnetic waves on calcium efflux from 45Ca preloaded frog hearts were examined. rog hearts, electrically stimulated at their natural beating frequency, were exposed for 30 min to 240 MHz radiowaves in a Crawf...

Sensing Disaster: The Use of Wearable Sensor Technology to Decrease Firefighter Line-of-Duty Deaths

DTIC Science & Technology

2015-12-01

peripheral oxygen or SpO2), and temperature , to name but a few.164 The current GTWM allows these sensors to be plugged in anywhere on the shirt, although...desired monitoring parameters included the “heart rate, respiratory rate, body temperature , blood oxygen saturation levels, environmental...physiological tests and parameters of firefighters that should be monitored are the EKG, heart rate (HR), body temperature , blood oxygen saturation

[Crataegus Special Extract WS 1442 in NYHA II heart failure. A placebo controlled randomized double-blind study].

PubMed

Leuchtgens, H

1993-07-20

In 30 patients with stage NYHA II cardiac insufficiency, a placebo-controlled randomized double-blind study was carried out to determine the efficacy of the Crataegus special extract WS 1442. Treatment duration was 8 weeks, and the substance was administered at a dose of 1 capsule taken twice a day. The main target parameters were alteration in the pressure-x-rate product (PRP) under standardised loading on a bicycle ergometer, and a score of subjective improvement of complaints elicited by a questionnaire. Secondary parameters were exercise tolerance and the change in heart rate and arterial blood pressure. The active substance group showed a statistically significant advantage over placebo in terms of changes in PRP (at a load of 50 W) and the score, but also in the secondary parameter heart rate. In both groups, systolic and diastolic blood pressure was mildly reduced. No adverse reactions occurred.

A monolithic 3D-0D coupled closed-loop model of the heart and the vascular system: Experiment-based parameter estimation for patient-specific cardiac mechanics.

PubMed

Hirschvogel, Marc; Bassilious, Marina; Jagschies, Lasse; Wildhirt, Stephen M; Gee, Michael W

2016-10-15

A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart, which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve, and atrial chamber model. The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parameterized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized. The imaging-based patient-specific ventricular model is prestressed to low end-diastolic pressure to account for the imaged, stressed configuration. Visco-elastic Robin boundary conditions are applied to the heart base and the epicardium to account for the embedding surrounding. We treat the 3D solid-0D fluid interaction as a strongly coupled monolithic problem, which is consistently linearized with respect to 3D solid and 0D fluid model variables to allow for a Newton-type solution procedure. The resulting coupled linear system of equations is solved iteratively in every Newton step using 2  ×  2 physics-based block preconditioning. Furthermore, we present novel efficient strategies for calibrating active contractile and vascular resistance parameters to experimental left ventricular pressure and stroke volume data gained in porcine experiments. Two exemplary states of cardiovascular condition are considered, namely, after application of vasodilatory beta blockers (BETA) and after injection of vasoconstrictive phenylephrine (PHEN). The parameter calibration to the specific individual and cardiovascular state at hand is performed using a 2-stage nonlinear multilevel method that uses a low-fidelity heart model to compute a parameter correction for the high-fidelity model optimization problem. We discuss 2 different low-fidelity model choices with respect to their ability to augment the parameter optimization. Because the periodic state conditions on the model (active stress, vascular pressures, and fluxes) are a priori unknown and also dependent on the parameters to be calibrated (and vice versa), we perform parameter calibration and periodic state condition estimation simultaneously. After a couple of heart beats, the calibration algorithm converges to a settled, periodic state because of conservation of blood volume within the closed-loop circulatory system. The proposed model and multilevel calibration method are cost-efficient and allow for an efficient determination of a patient-specific in silico heart model that reproduces physiological observations very well. Such an individual and state accurate model is an important predictive tool in intervention planning, assist device engineering and other medical applications. Copyright © 2016 John Wiley & Sons, Ltd.

[Heart Rate Variability as an Indicator of Mental Stress in Surgeons - A Review of the Literature].

PubMed

Thielmann, B; Boeckelmann, I

2016-10-01

The risk assessment of mental stress and early detection of mental illness among surgeons are much debated issues, because the perceived working conditions are important for their own health and that of the patients. Studies of predominantly mental stress are increasing and stay up-to-date. The psychological strain of surgeons is generally regarded as high. In order to objectively determine stress, the heart rate and its variability have been established as parameters. Based on the physiological stress parameter, it is possible to determine the previous level of strain. This work presents a summary of recent scientific studies to explore the stress in operative surgeons on the basis of the physiological stress parameters heart rate (HR) and heart rate variability (HRV). A PubMed search until spring of 2014 was performed. A total of 10 studies were included which deal with the mental stress and strain analysis by surgeons. In this case, 4 studies used only the HR and the further 6 studies used the HRV as a stress parameter. First stress and strain analyses of surgeons have been around since the early 1980s. The studies were usually carried out solely within the sample examined. Control groups have rarely or not been studied. In summary, stressed surgeons offered a higher intraoperative heart rate and a low expression of the HRV. The same was experienced in operating surgeons compared to the assistant surgeons or with inexperienced operating surgeons compared to experienced surgeons. Georg Thieme Verlag KG Stuttgart · New York.

Assessing effects of BL67 points stimulation on fetal heart rate parameters and fetal movements during nonstress test.

PubMed

Pirhadi, Masume; Valiani, Mahboube

2017-01-01

One of the main goals of antenatal testing is to identify fetuses at the risk of neurologic injury or death so that these adverse outcomes can be prevented. We want to assess the effects of BL67 points' stimulation on fetal heart rate parameters and fetal movements during nonstress test (NST). We did a quasi-experimental design in Shahid Beheshti Hospital in Isfahan in 2011. This study aims to assessment of the effects of BL67 points' stimulation on fetal heart rate parameters and fetal movements. We did a randomized controlled clinical trial in Shahid Beheshti Hospital in Isfahan in 2011. This study is a quasi-experimental design that was conducted in one group and the two steps (before-after study). Participants were pregnant women (primigravida) who were 35-18 years that refer to Shahid Beheshti Hospital in Isfahan in 2011 to receive routine prenatal care. The 32 pregnant women were selected for acupressure during the second NST. The statistical processing was performed by descriptive, paired t -test through SPSS version 20. There was no significant difference in mean number of accelerations in fetal heart rate and mean number of fetal movement before and after intervention; however, there was a significant difference in mean time to the second acceleration before and after the intervention ( P = 0.04). No difference between parameters of the fetal heart rate before and after stimulation and lack of uterine response by this method is a significant advantage and is probably why stimulating this point could not create a risk to the fetuses.

Heart Rate and Respiratory Rate Influence on Heart Rate Variability Repeatability: Effects of the Correction for the Prevailing Heart Rate

PubMed Central

Gąsior, Jakub S.; Sacha, Jerzy; Jeleń, Piotr J.; Zieliński, Jakub; Przybylski, Jacek

2016-01-01

Background: Since heart rate variability (HRV) is associated with average heart rate (HR) and respiratory rate (RespRate), alterations in these parameters may impose changes in HRV. Hence the repeatability of HRV measurements may be affected by differences in HR and RespRate. The study aimed to evaluate HRV repeatability and its association with changes in HR and RespRate. Methods: Forty healthy volunteers underwent two ECG examinations 7 days apart. Standard HRV indices were calculated from 5-min ECG recordings. The ECG-derived respiration signal was estimated to assess RespRate. To investigate HR impact on HRV, HRV parameters were corrected for prevailing HR. Results: Differences in HRV parameters between the measurements were associated with the changes in HR and RespRate. However, in multiple regression analysis only HR alteration proved to be independent determinant of the HRV differences—every change in HR by 1 bpm changed HRV values by 16.5% on average. After overall removal of HR impact on HRV, coefficients of variation of the HRV parameters significantly dropped on average by 26.8% (p < 0.001), i.e., by the same extent HRV reproducibility improved. Additionally, the HRV correction for HR decreased association between RespRate and HRV. Conclusions: In stable conditions, HR but not RespRate is the most powerful factor determining HRV reproducibility and even a minimal change of HR may considerably alter HRV. However, the removal of HR impact may significantly improve HRV repeatability. The association between HRV and RespRate seems to be, at least in part, HR dependent. PMID:27588006

Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery.

PubMed

Özer, Nadiye; Karaman Özlü, Zeynep; Arslan, Sevban; Günes, Nezihat

2013-03-01

The aim of this study was to investigate the effect of listening to personal choice of music on self-report of pain intensity and the physiologic parameters in patients who have undergone open heart surgery. The study design was quasiexperimental. Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a university hospital. The study was conducted with a total of 87 patients who underwent open heart surgery: 44 in the music group, 43 in the control group, ages between 18 and 78 years. Through pretest-posttest design, postoperative first-day data were collected. First, physiologic parameters (blood pressure, heart rate, oxygen saturation, and respiratory rate) were recorded and a unidimensional verbal pain intensity scale applied to all participants. Later, the control group had a rest in their beds while the music group listened to their choice of music for 30 minutes. Physiologic data were then collected and the pain intensity scale applied once more. In the music group, there was a statistically significant increase in oxygen saturation (p = .001) and a lower pain score (p = .001) than in the control group. There was no difference between the groups in the other physiologic parameters. Results of this research provide evidence to support the use of music. Music might be a simple, safe, and effective method of reducing potentially harmful physiologic responses arising from pain in patients after open heart surgery. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Methodology for quantitative rapid multi-tracer PET tumor characterizations.

PubMed

Kadrmas, Dan J; Hoffman, John M

2013-10-04

Positron emission tomography (PET) can image a wide variety of functional and physiological parameters in vivo using different radiotracers. As more is learned about the molecular basis for disease and treatment, the potential value of molecular imaging for characterizing and monitoring disease status has increased. Characterizing multiple aspects of tumor physiology by imaging multiple PET tracers in a single patient provides additional complementary information, and there is a significant body of literature supporting the potential value of multi-tracer PET imaging in oncology. However, imaging multiple PET tracers in a single patient presents a number of challenges. A number of techniques are under development for rapidly imaging multiple PET tracers in a single scan, where signal-recovery processing algorithms are employed to recover various imaging endpoints for each tracer. Dynamic imaging is generally used with tracer injections staggered in time, and kinetic constraints are utilized to estimate each tracers' contribution to the multi-tracer imaging signal. This article summarizes past and ongoing work in multi-tracer PET tumor imaging, and then organizes and describes the main algorithmic approaches for achieving multi-tracer PET signal-recovery. While significant advances have been made, the complexity of the approach necessitates protocol design, optimization, and testing for each particular tracer combination and application. Rapid multi-tracer PET techniques have great potential for both research and clinical cancer imaging applications, and continued research in this area is warranted.

Methodology for Quantitative Rapid Multi-Tracer PET Tumor Characterizations

PubMed Central

Kadrmas, Dan J.; Hoffman, John M.

2013-01-01

Positron emission tomography (PET) can image a wide variety of functional and physiological parameters in vivo using different radiotracers. As more is learned about the molecular basis for disease and treatment, the potential value of molecular imaging for characterizing and monitoring disease status has increased. Characterizing multiple aspects of tumor physiology by imaging multiple PET tracers in a single patient provides additional complementary information, and there is a significant body of literature supporting the potential value of multi-tracer PET imaging in oncology. However, imaging multiple PET tracers in a single patient presents a number of challenges. A number of techniques are under development for rapidly imaging multiple PET tracers in a single scan, where signal-recovery processing algorithms are employed to recover various imaging endpoints for each tracer. Dynamic imaging is generally used with tracer injections staggered in time, and kinetic constraints are utilized to estimate each tracers' contribution to the multi-tracer imaging signal. This article summarizes past and ongoing work in multi-tracer PET tumor imaging, and then organizes and describes the main algorithmic approaches for achieving multi-tracer PET signal-recovery. While significant advances have been made, the complexity of the approach necessitates protocol design, optimization, and testing for each particular tracer combination and application. Rapid multi-tracer PET techniques have great potential for both research and clinical cancer imaging applications, and continued research in this area is warranted. PMID:24312149

Multi-parameter optimization of piezoelectric actuators for multi-mode active vibration control of cylindrical shells

NASA Astrophysics Data System (ADS)

Hu, K. M.; Li, Hua

2018-07-01

A novel technique for the multi-parameter optimization of distributed piezoelectric actuators is presented in this paper. The proposed method is designed to improve the performance of multi-mode vibration control in cylindrical shells. The optimization parameters of actuator patch configuration include position, size, and tilt angle. The modal control force of tilted orthotropic piezoelectric actuators is derived and the multi-parameter cylindrical shell optimization model is established. The linear quadratic energy index is employed as the optimization criterion. A geometric constraint is proposed to prevent overlap between tilted actuators, which is plugged into a genetic algorithm to search the optimal configuration parameters. A simply-supported closed cylindrical shell with two actuators serves as a case study. The vibration control efficiencies of various parameter sets are evaluated via frequency response and transient response simulations. The results show that the linear quadratic energy indexes of position and size optimization decreased by 14.0% compared to position optimization; those of position and tilt angle optimization decreased by 16.8%; and those of position, size, and tilt angle optimization decreased by 25.9%. It indicates that, adding configuration optimization parameters is an efficient approach to improving the vibration control performance of piezoelectric actuators on shells.

Robust synthesis and continuous manufacturing of carbon nanotube forests and graphene films

NASA Astrophysics Data System (ADS)

Polsen, Erik S.

Successful translation of the outstanding properties of carbon nanotubes (CNTs) and graphene to commercial applications requires highly consistent methods of synthesis, using scalable and cost-effective machines. This thesis presents robust process conditions and a series of process operations that will enable integrated roll-to-roll (R2R) CNT and graphene growth on flexible substrates. First, a comprehensive study was undertaken to establish the sources of variation in laboratory CVD growth of CNT forests. Statistical analysis identified factors that contribute to variation in forest height and density including ambient humidity, sample position in the reactor, and barometric pressure. Implementation of system modifications and user procedures reduced the variation in height and density by 50% and 54% respectively. With improved growth, two new methods for continuous deposition and patterning of catalyst nanoparticles for CNT forest growth were developed, enabling the diameter, density and pattern geometry to be tailored through the control of process parameters. Convective assembly of catalyst nanoparticles in solution enables growth of CNT forests with density 3-fold higher than using sputtered catalyst films with the same growth parameters. Additionally, laser printing of magnetic ink character recognition toner provides a large scale patterning method, with digital control of the pattern density and tunable CNT density via laser intensity. A concentric tube CVD reactor was conceptualized, designed and built for R2R growth of CNT forests and graphene on flexible substrates helically fed through the annular gap. The design enables downstream injection of the hydrocarbon source, and gas consumption is reduced 90% compared to a standard tube furnace. Multi-wall CNT forests are grown continuously on metallic and ceramic fiber substrates at 33 mm/min. High quality, uniform bi- and multi-layer graphene is grown on Cu and Ni foils at 25 - 495 mm/min. A second machine for continuous forest growth and delamination was developed; and forest-substrate adhesion strength was controlled through CVD parameters. Taken together, these methods enable uniform R2R processing of CNT forests and graphene with engineered properties. Last, it is projected that foreseeable improvements in CNT forest quality and density using these methods will result in electrical and thermal properties that exceed state-of-the-art bulk materials.

Identifying and managing chest pain in women.

PubMed

Wyant, Andrew R; Collett, DeShana

2015-01-01

Heart disease continues to be the leading cause of death in women in the United States. Sex disparities remain despite research highlighting the unique aspects of managing women with ischemic heart disease. Increased mortality in women may be related to the critical differences in the clinical presentation of ischemic heart disease between the sexes. Sex-related differences in the pathophysiology of ischemic heart disease also influence diagnostic testing and management. This article reviews the differences in diagnosis and management between men and women with ischemic heart disease.

Initial fractal exponent of heart-rate variability is associated with success of early resuscitation in patients with severe sepsis or septic shock: a prospective cohort study

PubMed Central

Brown, Samuel M.; Tate, Quinn; Jones, Jason P.; Knox, Daniel; Kuttler, Kathryn G.; Lanspa, Michael; Rondina, Matthew T.; Grissom, Colin K.; Behera, Subhasis; Mathews, V.J.; Morris, Alan

2013-01-01

Introduction Heart-rate variability reflects autonomic nervous system tone as well as the overall health of the baroreflex system. We hypothesized that loss of complexity in heart-rate variability upon ICU admission would be associated with unsuccessful early resuscitation of sepsis. Methods We prospectively enrolled patients admitted to ICUs with severe sepsis or septic shock from 2009 to 2011. We studied 30 minutes of EKG, sampled at 500 Hz, at ICU admission and calculated heart-rate complexity via detrended fluctuation analysis. Primary outcome was vasopressor independence at 24 hours after ICU admission. Secondary outcome was 28-day mortality. Results We studied 48 patients, of whom 60% were vasopressor independent at 24 hours. Five (10%) died within 28 days. The ratio of fractal alpha parameters was associated with both vasopressor independence and 28-day mortality (p=0.04) after controlling for mean heart rate. In the optimal model, SOFA score and the long-term fractal alpha parameter were associated with vasopressor independence. Conclusions Loss of complexity in heart rate variability is associated with worse outcome early in severe sepsis and septic shock. Further work should evaluate whether complexity of heart rate variability (HRV) could guide treatment in sepsis. PMID:23958243

Physiological Characterization of the SynCardia Total Artificial Heart in a Mock Circulation System

PubMed Central

Crosby, Jessica R.; DeCook, Katrina J.; Tran, Phat L.; Smith, Richard G.; Larson, Douglas F.; Khalpey, Zain I.; Burkhoff, Daniel; Slepian, Marvin J.

2014-01-01

The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving bi-ventricular replacement system for a wide variety of patients with end-stage heart failure. While the clinical performance of the TAH is established, modern physiologic characterization, in terms of elastance behavior and pressure-volume characterization has not been defined. Herein we examine the TAH in terms of elastance using a non-ejecting left-ventricle, and then characterize the pressure-volume relationship of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Further, we show that the TAH has a pressure-volume relationship behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload, however this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared to the human heart. PMID:25551416

Physiological characterization of the SynCardia total artificial heart in a mock circulation system.

PubMed

Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

2015-01-01

The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving biventricular replacement system for a wide variety of patients with end-stage heart failure. Although the clinical performance of the TAH is established, modern physiological characterization, in terms of elastance behavior and pressure-volume (PV) characterization has not been defined. Herein, we examine the TAH in terms of elastance using a nonejecting left ventricle, and then characterize the PV relation of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Furthermore, we show that the TAH has a PV relation behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload-dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload; however, this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared with the human heart.

Echocardiographic examinations of 60 African grey parrots and 30 other psittacine birds.

PubMed

Pees, M; Straub, J; Krautwald-Junghanns, M-E

2004-07-17

The aim of this study was to establish reference values for the assessment of cardiac function in birds by measuring structures in the heart of healthy psittacine birds; 60 grey parrots, 10 Amazon parrots, 10 cockatoos and 10 Senegal parrots were anaesthetised with isoflurane and examined echocardiographically. The heart was visualised in two planes (vertical and horizontal views). Depending on the quality of the images, several dimensions of the heart could be measured and various parameters calculated. On the basis of these values, it was possible to establish reference values for each parrot genus. Some relative parameters showed no significant difference between the genera, independent of the bird's size.

Asphyxia-activated corticocardiac signaling accelerates onset of cardiac arrest.

PubMed

Li, Duan; Mabrouk, Omar S; Liu, Tiecheng; Tian, Fangyun; Xu, Gang; Rengifo, Santiago; Choi, Sarah J; Mathur, Abhay; Crooks, Charles P; Kennedy, Robert T; Wang, Michael M; Ghanbari, Hamid; Borjigin, Jimo

2015-04-21

The mechanism by which the healthy heart and brain die rapidly in the absence of oxygen is not well understood. We performed continuous electrocardiography and electroencephalography in rats undergoing experimental asphyxia and analyzed cortical release of core neurotransmitters, changes in brain and heart electrical activity, and brain-heart connectivity. Asphyxia stimulates a robust and sustained increase of functional and effective cortical connectivity, an immediate increase in cortical release of a large set of neurotransmitters, and a delayed activation of corticocardiac functional and effective connectivity that persists until the onset of ventricular fibrillation. Blocking the brain's autonomic outflow significantly delayed terminal ventricular fibrillation and lengthened the duration of detectable cortical activities despite the continued absence of oxygen. These results demonstrate that asphyxia activates a brainstorm, which accelerates premature death of the heart and the brain.

Successful continuous-flow left ventricular assist device implantation with adjuvant tricuspid valve repair for advanced heart failure.

PubMed

Lee, Chih-Hsien; Wei, Jeng

The prevalence of end-stage heart failure (HF) is on the increase, however, the availability of donor hearts remains limited. Left ventricular assist devices (LVADs) are increasingly being used for treating patients with end-stage HF. LVADs are not only used as a bridge to transplantation but also as a destination therapy. HeartMate II, a new-generation, continuous-flow LVAD (cf-LVAD), is currently an established treatment option for patients with HF. Technological progress and increasing implantation of cf-LVADs have significantly improved survival in patients with end-stage HF. Here we report a case of a patient with end-stage HF who was successfully supported using cf-LVAD implantation with adjuvant tricuspid valve repair in a general district hospital.

Review of basic medical results of the Salyut-7-Soyuz-T 8-month manned flight

NASA Astrophysics Data System (ADS)

Gazenko, O. G.; Schulzhenko, E. B.; Grigoriev, A. I.; Atkov, O. Yu.; Egorov, A. D.

This paper presents the results of medical investigations performed in the Salyut-7 8-month mission in which a professional physician took part. The paper contains anthropometric measurements, results of investigating the vestibular function, cardiovascular function at rest and in response to multi-step tests (with emphasis on echocardiographic measurements), metabolic parameters and hormonal status. It also discusses medical aspects of the extravehicular activity. The medical investigations, although some new methods were applied, provided the continuity of methodical approaches and data accumulated in previous missions.

[An artificial heart: bridge to transplantation or permanent?].

PubMed

de Mol, Bas A J M; Lahpor, Jaap

2013-01-01

An artificial heart is a continuous-flow pump device with a constant output, which usually supports the left ventricle. Over the past five years, survival rates with an artificial heart have increased dramatically, but with an annual mortality of 10% per year compared with 6% for heart transplantation the artificial heart is mainly a 'bridge to transplantation' or an alternative for those patients who are not suitable for heart transplant, 'destination therapy'. It is anticipated that the number and severity of complications will decrease as a result of technological progress. The artificial heart could then become a long-term treatment option providing a good quality of life and thus become equivalent to a heart transplant.

Health Insurance Trajectories and Long-Term Survival After Heart Transplantation.

PubMed

Tumin, Dmitry; Foraker, Randi E; Smith, Sakima; Tobias, Joseph D; Hayes, Don

2016-09-01

Health insurance status at heart transplantation influences recipient survival, but implications of change in insurance for long-term outcomes are unclear. Adults aged 18 to 64 receiving first-time orthotopic heart transplants between July 2006 and December 2013 were identified in the United Network for Organ Sharing registry. Patients surviving >1 year were categorized according to trajectory of insurance status (private compared with public) at wait listing, transplantation, and 1-year follow-up. The most common insurance trajectories were continuous private coverage (44%), continuous public coverage (27%), and transition from private to public coverage (11%). Among patients who survived to 1 year (n=9088), continuous public insurance (hazard ratio =1.36; 95% confidence interval 1.19, 1.56; P<0.001) and transition from private to public insurance (hazard ratio =1.25; 95% confidence interval 1.04, 1.50; P=0.017) were associated with increased mortality hazard relative to continuous private insurance. Supplementary analyses of 11 247 patients included all durations of post-transplant survival and examined post-transplant private-to-public and public-to-private transitions as time-varying covariates. In these analyses, transition from private to public insurance was associated with increased mortality hazard (hazard ratio =1.25; 95% confidence interval 1.07, 1.47; P=0.005), whereas transition from public to private insurance was associated with lower mortality hazard (hazard ratio =0.78; 95% confidence interval 0.62, 0.97; P=0.024). Transition from private to public insurance after heart transplantation is associated with worse long-term outcomes, compounding disparities in post-transplant survival attributed to insurance status at transplantation. By contrast, post-transplant gain of private insurance among patients receiving publicly funded heart transplants was associated with improved outcomes. © 2016 American Heart Association, Inc.

A study of reconstruction accuracy for a cardiac SPECT system with multi-segmental collimation

NASA Astrophysics Data System (ADS)

Yu, D.-C.; Chang, W.; Pan, T.-S.

1997-06-01

To improve the geometric efficiency of cardiac SPECT imaging, the authors previously proposed to use a multi-segmental collimation with a cylindrical geometry. The proposed collimator consists of multiple parallel-hole collimators with most of the segments directed toward a small central region, where the patient's heart should be positioned. This technique provides a significantly increased detection efficiency for the central region, but at the expense of reduced efficiency for the surrounding region. The authors have used computer simulations to evaluate the implication of this technique on the accuracy of the reconstructed cardiac images. Two imaging situations were simulated: 1) the heart well placed inside the central region, and 2) the heart shifted and partially outside the central region. A neighboring high-uptake liver was simulated for both imaging situations. The images were reconstructed and corrected for attenuation with ML-EM and OS-FM methods using a complete attenuation map. The results indicate that errors caused by projection truncation are not significant and are not strongly dependent on the activity of the liver when the heart is well positioned within the central region. When the heart is partially outside the central region, hybrid emission data (a combination of high-count projections from the central region and low-count projections from the background region) can be used to restore the activity of the truncated section of the myocardium. However, the variance of the image in the section of the myocardium outside the central region is increased by 2-3 times when 10% of the collimator segments are used to image the background region.

Geotechnical parameter spatial distribution stochastic analysis based on multi-precision information assimilation

NASA Astrophysics Data System (ADS)

Wang, C.; Rubin, Y.

2014-12-01

Spatial distribution of important geotechnical parameter named compression modulus Es contributes considerably to the understanding of the underlying geological processes and the adequate assessment of the Es mechanics effects for differential settlement of large continuous structure foundation. These analyses should be derived using an assimilating approach that combines in-situ static cone penetration test (CPT) with borehole experiments. To achieve such a task, the Es distribution of stratum of silty clay in region A of China Expo Center (Shanghai) is studied using the Bayesian-maximum entropy method. This method integrates rigorously and efficiently multi-precision of different geotechnical investigations and sources of uncertainty. Single CPT samplings were modeled as a rational probability density curve by maximum entropy theory. Spatial prior multivariate probability density function (PDF) and likelihood PDF of the CPT positions were built by borehole experiments and the potential value of the prediction point, then, preceding numerical integration on the CPT probability density curves, the posterior probability density curve of the prediction point would be calculated by the Bayesian reverse interpolation framework. The results were compared between Gaussian Sequential Stochastic Simulation and Bayesian methods. The differences were also discussed between single CPT samplings of normal distribution and simulated probability density curve based on maximum entropy theory. It is shown that the study of Es spatial distributions can be improved by properly incorporating CPT sampling variation into interpolation process, whereas more informative estimations are generated by considering CPT Uncertainty for the estimation points. Calculation illustrates the significance of stochastic Es characterization in a stratum, and identifies limitations associated with inadequate geostatistical interpolation techniques. This characterization results will provide a multi-precision information assimilation method of other geotechnical parameters.

Multi-parameter Observations and Validation of Pre-earthquake Atmospheric Signals

NASA Astrophysics Data System (ADS)

Ouzounov, D.; Pulinets, S. A.; Hattori, K.; Mogi, T.; Kafatos, M.

2014-12-01

We are presenting the latest development in multi-sensors observations of short-term pre-earthquake phenomena preceding major earthquakes. We are exploring the potential of pre-seismic atmospheric and ionospheric signals to alert for large earthquakes. To achieve this, we start validating anomalous ionospheric /atmospheric signals in retrospective and prospective modes. The integrated satellite and terrestrial framework (ISTF) is our method for validation and is based on a joint analysis of several physical and environmental parameters (Satellite thermal infrared radiation (OLR), electron concentration in the ionosphere (GPS/TEC), VHF-bands radio waves, radon/ion activities, air temperature and seismicity patterns) that were found to be associated with earthquakes. The science rationale for multidisciplinary analysis is based on concept Lithosphere-Atmosphere-Ionosphere Coupling (LAIC) [Pulinets and Ouzounov, 2011], which explains the synergy of different geospace processes and anomalous variations, usually named short-term pre-earthquake anomalies. Our validation processes consist in two steps: (1) A continuous retrospective analysis preformed over two different regions with high seismicity- Taiwan and Japan for 2003-2009 The retrospective tests (100+ major earthquakes, M>5.9, Taiwan and Japan) show OLR anomalous behavior before all of these events with no false negatives. False alarm ratio for false positives is less then 25%. (2) Prospective testing using multiple parameters with potential for M5.5+ events. The initial testing shows systematic appearance of atmospheric anomalies in advance (days) to the M5.5+ events for Taiwan and Japan (Honshu and Hokkaido areas). Our initial prospective results suggest that our approach show a systematic appearance of atmospheric anomalies, one to several days prior to the largest earthquakes That feature could be further studied and tested for advancing the multi-sensors detection of pre-earthquake atmospheric signals.

Physiological Responses to Two Hypoxic Conditioning Strategies in Healthy Subjects

PubMed Central

Chacaroun, Samarmar; Borowik, Anna; Morrison, Shawnda A.; Baillieul, Sébastien; Flore, Patrice; Doutreleau, Stéphane; Verges, Samuel

2017-01-01

Objective: Hypoxic exposure can be used as a therapeutic tool by inducing various cardiovascular, neuromuscular, and metabolic adaptations. Hypoxic conditioning strategies have been evaluated in patients with chronic diseases using either sustained (SH) or intermittent (IH) hypoxic sessions. Whether hypoxic conditioning via SH or IH may induce different physiological responses remains to be elucidated. Methods: Fourteen healthy active subjects (7 females, age 25 ± 8 years, body mass index 21.5 ± 2.5 kg·m−2) performed two interventions in a single blind, randomized cross-over design, starting with either 3 x SH (48 h apart), or 3 x IH (48 h apart), separated by a 2 week washout period. SH sessions consisted of breathing a gas mixture with reduced inspiratory oxygen fraction (FiO2), continuously adjusted to reach arterial oxygen saturations (SpO2) of 70–80% for 1 h. IH sessions consisted of 5 min with reduced FiO2 (SpO2 = 70–80%), followed by 3-min normoxia, repeated seven times. During the first (S1) and third (S3) sessions of each hypoxic intervention, cardiorespiratory parameters, and muscle and pre-frontal cortex oxygenation (near infrared spectroscopy) were assessed continuously. Results: Minute ventilation increased significantly during IH sessions (+2 ± 2 L·min−1) while heart rate increased during both SH (+11 ± 4 bpm) and IH (+13 ± 5 bpm) sessions. Arterial blood pressure increased during all hypoxic sessions, although baseline normoxic systolic blood pressure was reduced from S1 to S3 in IH only (−8 ± 11 mmHg). Muscle oxygenation decreased significantly during S3 but not S1, for both hypoxic interventions (S3: SH −6 ± 5%, IH −3 ± 4%); pre-frontal oxygenation decreased in S1 and S3, and to a greater extent in SH vs. IH (−13 ± 3% vs. −6 ± 6%). Heart rate variability indices indicated a significantly larger increase in sympathetic activity in SH vs. IH (lower SDNN, PNN50, and RMSSD values in SH). From S1 to S3, further reduction in heart rate variability was observed in SH (SDNN, PNN50, and RMSSD reduction) while heart rate variability increased in IH (SDNN and RMSSD increase). Conclusions: These results showed significant differences in heart rate variability, blood pressure, and tissue oxygenation changes during short-term SH vs. IH conditioning interventions. Heart rate variability may provide useful information about the early adaptations induced by such intervention. PMID:28119623

Physiological Responses to Two Hypoxic Conditioning Strategies in Healthy Subjects.

PubMed

Chacaroun, Samarmar; Borowik, Anna; Morrison, Shawnda A; Baillieul, Sébastien; Flore, Patrice; Doutreleau, Stéphane; Verges, Samuel

2016-01-01

Objective: Hypoxic exposure can be used as a therapeutic tool by inducing various cardiovascular, neuromuscular, and metabolic adaptations. Hypoxic conditioning strategies have been evaluated in patients with chronic diseases using either sustained (SH) or intermittent (IH) hypoxic sessions. Whether hypoxic conditioning via SH or IH may induce different physiological responses remains to be elucidated. Methods: Fourteen healthy active subjects (7 females, age 25 ± 8 years, body mass index 21.5 ± 2.5 kg·m -2 ) performed two interventions in a single blind, randomized cross-over design, starting with either 3 x SH (48 h apart), or 3 x IH (48 h apart), separated by a 2 week washout period. SH sessions consisted of breathing a gas mixture with reduced inspiratory oxygen fraction (FiO 2 ), continuously adjusted to reach arterial oxygen saturations (SpO 2 ) of 70-80% for 1 h. IH sessions consisted of 5 min with reduced FiO 2 (SpO 2 = 70-80%), followed by 3-min normoxia, repeated seven times. During the first (S1) and third (S3) sessions of each hypoxic intervention, cardiorespiratory parameters, and muscle and pre-frontal cortex oxygenation (near infrared spectroscopy) were assessed continuously. Results : Minute ventilation increased significantly during IH sessions (+2 ± 2 L·min -1 ) while heart rate increased during both SH (+11 ± 4 bpm) and IH (+13 ± 5 bpm) sessions. Arterial blood pressure increased during all hypoxic sessions, although baseline normoxic systolic blood pressure was reduced from S1 to S3 in IH only (-8 ± 11 mmHg). Muscle oxygenation decreased significantly during S3 but not S1, for both hypoxic interventions (S3: SH -6 ± 5%, IH -3 ± 4%); pre-frontal oxygenation decreased in S1 and S3, and to a greater extent in SH vs. IH (-13 ± 3% vs. -6 ± 6%). Heart rate variability indices indicated a significantly larger increase in sympathetic activity in SH vs. IH (lower SDNN, PNN50, and RMSSD values in SH). From S1 to S3, further reduction in heart rate variability was observed in SH (SDNN, PNN50, and RMSSD reduction) while heart rate variability increased in IH (SDNN and RMSSD increase). Conclusions: These results showed significant differences in heart rate variability, blood pressure, and tissue oxygenation changes during short-term SH vs. IH conditioning interventions. Heart rate variability may provide useful information about the early adaptations induced by such intervention.

Heart Rate Variability Dynamics for the Prognosis of Cardiovascular Risk

PubMed Central

Ramirez-Villegas, Juan F.; Lam-Espinosa, Eric; Ramirez-Moreno, David F.; Calvo-Echeverry, Paulo C.; Agredo-Rodriguez, Wilfredo

2011-01-01

Statistical, spectral, multi-resolution and non-linear methods were applied to heart rate variability (HRV) series linked with classification schemes for the prognosis of cardiovascular risk. A total of 90 HRV records were analyzed: 45 from healthy subjects and 45 from cardiovascular risk patients. A total of 52 features from all the analysis methods were evaluated using standard two-sample Kolmogorov-Smirnov test (KS-test). The results of the statistical procedure provided input to multi-layer perceptron (MLP) neural networks, radial basis function (RBF) neural networks and support vector machines (SVM) for data classification. These schemes showed high performances with both training and test sets and many combinations of features (with a maximum accuracy of 96.67%). Additionally, there was a strong consideration for breathing frequency as a relevant feature in the HRV analysis. PMID:21386966

Two-dimensional multi-heart cutting centrifugal partition chromatography-liquid chromatography for the preparative isolation of antioxidants from Edelweiss plant.

PubMed

Marlot, Léa; Batteau, Magali; Escofet, Marie-Claire; Nuccio, Sylvie; Coquoin, Véronique; De Vaumas, René; Faure, Karine

2017-06-30

The Edelweiss plant has been recognized as a very valuable source of anti-aging principles due to its composition of antioxidants compounds: leontopodic acid A and 3,5-dicaffeoylquinic acid. In this work, off-line multi-heart cutting CPC-LC separation was set up at industrial scale in order to isolate and produce new high quality reference material of these two antioxidants from Edelweiss. For this purpose, CPC and HPLC methods were developed and optimized at laboratory scale and a comprehensive CPCxHPLC analysis of the crude extract was established. Thereby, the CPC method led to a first separation of the target compounds according to their partition coefficient in the solvent system and the HPLC method was performed on the recovered fractions to lead to a second separation. A 2D CPCxHPLC plot was established in order to know the fractions to select at the industrial scale. Then, the CPC and HPLC methods were transferred at industrial scale and the multi-heart cutting CPC-LC was performed in off-line mode. Using CPC with methyl ter-butyl ether-water 1:1 (v/v) solvent system and LC with Denali C18 column, 2g of crude extract sample were injected and leontopodic acid A and 3,5-dicaffeoylquinic acid were recovered with purity over 97%. The compounds were identified by MS and NMR. Copyright © 2017 Elsevier B.V. All rights reserved.

The year 2012 in the European Heart Journal-Cardiovascular Imaging: Part I.

PubMed

Edvardsen, Thor; Plein, Sven; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

2013-06-01

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was started in 2012. During its first year, the new Journal has published an impressive collection of cardiovascular studies utilizing all cardiovascular imaging modalities. We will summarize the most important studies from its first year in two articles. The present 'Part I' of the review will focus on studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging.

Hyperthyroidism is characterized by both increased sympathetic and decreased vagal modulation of heart rate: evidence from spectral analysis of heart rate variability.

PubMed

Chen, Jin-Long; Chiu, Hung-Wen; Tseng, Yin-Jiun; Chu, Woei-Chyn

2006-06-01

The clinical manifestations of hyperthyroidism resemble those of the hyperadrenergic state. This study was designed to evaluate the impact of hyperthyroidism on the autonomic nervous system (ANS) and to investigate the relationship between serum thyroid hormone concentrations and parameters of spectral heart rate variability (HRV) analysis in hyperthyroidism. Thirty-two hyperthyroid Graves' disease patients (mean age 31 years) and 32 sex-, age-, and body mass index (BMI)-matched normal control subjects were recruited to receive one-channel electrocardiogram (ECG) recording. The cardiac autonomic nervous function was evaluated by the spectral analysis of HRV, which indicates the autonomic modulation of the sinus node. The correlation coefficients between serum thyroid hormone concentrations and parameters of the spectral HRV analysis were also computed. The hyperthyroid patients revealed significant differences (P < 0.001) compared with the controls in the following HRV parameters: a decrease in total power (TP), very low frequency power (VLF), low frequency power (LF), high frequency power (HF), and HF in normalized units (HF%); and an increase in LF in normalized units (LF%) and in the ratio of LF to HF (LF/HF). After correction of hyperthyroidism in 28 patients, all of the above parameters were restored to levels comparable to those of the controls. In addition, serum thyroid hormone concentrations showed significant correlations with spectral HRV parameters. Hyperthyroidism is in a sympathovagal imbalanced state, characterized by both increased sympathetic and decreased vagal modulation of the heart rate. These autonomic dysfunctions can be detected simultaneously by spectral analysis of HRV, and the spectral HRV parameters could reflect the disease severity in hyperthyroid patients.

Real-Time Monitoring and Analysis of Zebrafish Electrocardiogram with Anomaly Detection.

PubMed

Lenning, Michael; Fortunato, Joseph; Le, Tai; Clark, Isaac; Sherpa, Ang; Yi, Soyeon; Hofsteen, Peter; Thamilarasu, Geethapriya; Yang, Jingchun; Xu, Xiaolei; Han, Huy-Dung; Hsiai, Tzung K; Cao, Hung

2017-12-28

Heart disease is the leading cause of mortality in the U.S. with approximately 610,000 people dying every year. Effective therapies for many cardiac diseases are lacking, largely due to an incomplete understanding of their genetic basis and underlying molecular mechanisms. Zebrafish ( Danio rerio ) are an excellent model system for studying heart disease as they enable a forward genetic approach to tackle this unmet medical need. In recent years, our team has been employing electrocardiogram (ECG) as an efficient tool to study the zebrafish heart along with conventional approaches, such as immunohistochemistry, DNA and protein analyses. We have overcome various challenges in the small size and aquatic environment of zebrafish in order to obtain ECG signals with favorable signal-to-noise ratio (SNR), and high spatial and temporal resolution. In this paper, we highlight our recent efforts in zebrafish ECG acquisition with a cost-effective simplified microelectrode array (MEA) membrane providing multi-channel recording, a novel multi-chamber apparatus for simultaneous screening, and a LabVIEW program to facilitate recording and processing. We also demonstrate the use of machine learning-based programs to recognize specific ECG patterns, yielding promising results with our current limited amount of zebrafish data. Our solutions hold promise to carry out numerous studies of heart diseases, drug screening, stem cell-based therapy validation, and regenerative medicine.

Real-Time Monitoring and Analysis of Zebrafish Electrocardiogram with Anomaly Detection

PubMed Central

Lenning, Michael; Fortunato, Joseph; Le, Tai; Clark, Isaac; Sherpa, Ang; Yi, Soyeon; Hofsteen, Peter; Thamilarasu, Geethapriya; Yang, Jingchun; Xu, Xiaolei; Hsiai, Tzung K.; Cao, Hung

2017-01-01

Heart disease is the leading cause of mortality in the U.S. with approximately 610,000 people dying every year. Effective therapies for many cardiac diseases are lacking, largely due to an incomplete understanding of their genetic basis and underlying molecular mechanisms. Zebrafish (Danio rerio) are an excellent model system for studying heart disease as they enable a forward genetic approach to tackle this unmet medical need. In recent years, our team has been employing electrocardiogram (ECG) as an efficient tool to study the zebrafish heart along with conventional approaches, such as immunohistochemistry, DNA and protein analyses. We have overcome various challenges in the small size and aquatic environment of zebrafish in order to obtain ECG signals with favorable signal-to-noise ratio (SNR), and high spatial and temporal resolution. In this paper, we highlight our recent efforts in zebrafish ECG acquisition with a cost-effective simplified microelectrode array (MEA) membrane providing multi-channel recording, a novel multi-chamber apparatus for simultaneous screening, and a LabVIEW program to facilitate recording and processing. We also demonstrate the use of machine learning-based programs to recognize specific ECG patterns, yielding promising results with our current limited amount of zebrafish data. Our solutions hold promise to carry out numerous studies of heart diseases, drug screening, stem cell-based therapy validation, and regenerative medicine. PMID:29283402

Heart failure.

PubMed

Metra, Marco; Teerlink, John R

2017-10-28

Heart failure is common in adults, accounting for substantial morbidity and mortality worldwide. Its prevalence is increasing because of ageing of the population and improved treatment of acute cardiovascular events, despite the efficacy of many therapies for patients with heart failure with reduced ejection fraction, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists, and advanced device therapies. Combined angiotensin receptor blocker neprilysin inhibitors (ARNIs) have been associated with improvements in hospital admissions and mortality from heart failure compared with enalapril, and guidelines now recommend substitution of ACE inhibitors or ARBs with ARNIs in appropriate patients. Improved safety of left ventricular assist devices means that these are becoming more commonly used in patients with severe symptoms. Antidiabetic therapies might further improve outcomes in patients with heart failure. New drugs with novel mechanisms of action, such as cardiac myosin activators, are under investigation for patients with heart failure with reduced left ventricular ejection fraction. Heart failure with preserved ejection fraction is a heterogeneous disorder that remains incompletely understood and will continue to increase in prevalence with the ageing population. Although some data suggest that spironolactone might improve outcomes in these patients, no therapy has conclusively shown a significant effect. Hopefully, future studies will address these unmet needs for patients with heart failure. Admissions for acute heart failure continue to increase but, to date, no new therapies have improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictors of incident heart failure in patients after an acute coronary syndrome: The LIPID heart failure risk-prediction model.

PubMed

Driscoll, Andrea; Barnes, Elizabeth H; Blankenberg, Stefan; Colquhoun, David M; Hunt, David; Nestel, Paul J; Stewart, Ralph A; West, Malcolm J; White, Harvey D; Simes, John; Tonkin, Andrew

2017-12-01

Coronary heart disease is a major cause of heart failure. Availability of risk-prediction models that include both clinical parameters and biomarkers is limited. We aimed to develop such a model for prediction of incident heart failure. A multivariable risk-factor model was developed for prediction of first occurrence of heart failure death or hospitalization. A simplified risk score was derived that enabled subjects to be grouped into categories of 5-year risk varying from <5% to >20%. Among 7101 patients from the LIPID study (84% male), with median age 61years (interquartile range 55-67years), 558 (8%) died or were hospitalized because of heart failure. Older age, history of claudication or diabetes mellitus, body mass index>30kg/m 2 , LDL-cholesterol >2.5mmol/L, heart rate>70 beats/min, white blood cell count, and the nature of the qualifying acute coronary syndrome (myocardial infarction or unstable angina) were associated with an increase in heart failure events. Coronary revascularization was associated with a lower event rate. Incident heart failure increased with higher concentrations of B-type natriuretic peptide >50ng/L, cystatin C>0.93nmol/L, D-dimer >273nmol/L, high-sensitivity C-reactive protein >4.8nmol/L, and sensitive troponin I>0.018μg/L. Addition of biomarkers to the clinical risk model improved the model's C statistic from 0.73 to 0.77. The net reclassification improvement incorporating biomarkers into the clinical model using categories of 5-year risk was 23%. Adding a multibiomarker panel to conventional parameters markedly improved discrimination and risk classification for future heart failure events. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Statistical Analysis of Organ Morphometric Parameters and Weights in South Iranian Adult Autopsies.

PubMed

Gholamzadeh, Saeid; Zarenezhad, Mohammad; Montazeri, Mahmoud; Zareikordshooli, Marzieh; Sadeghi, Ghazaleh; Malekpour, Abdorrasoul; Hoseni, Sanaz; Bahrani, Mohammadreza; Hajatmand, Razieh

2017-05-01

Organ weight is one important indicator to discern normal from abnormal condition in forensic pathology as well as in clinical medicine. The present study aimed to investigate morphometric parameters and organ weights of southern Iranian adults, which can be fundamental sources to be compared to abnormal cases.Morphometric parameters and weights of 6 organs (heart, liver, kidney, spleen, appendix, and brain), which were harvested from 501 southern Iranian adults (385 males and 116 females) during ordinary postmortem examination, were measured.All the organs were heavier in males than in females. Heart, brain, spleen, and right kidney were significantly heavier in males compared to females, but no significant difference was observed between the 2 sexes regarding the weights of the rest of the organs. Moreover, brain and heart became heavier as one got older and most organs were heavier in middle-aged individuals compared to other age groups. Furthermore, various types of correlations were observed between different organs' weights and body parameters.These results can be useful anatomical data for autopsy investigations, clinical practices, and research in southern Iran.

Evaluation of prenatal risk factors for prediction of outcome in right heart lesions: CVP score in fetal right heart defects.

PubMed

Neves, Ana Luisa; Mathias, Leigh; Wilhm, Marilyn; Leshko, Jennifer; Linask, Kersti K; Henriques-Coelho, Tiago; Areias, José C; Huhta, James C

2014-09-01

To determine the prenatal variables predicting the risk of perinatal death in congenital right heart defects. Retrospective analysis of 28 fetuses with right heart defects was performed. Logistic regression analyses were performed to obtain odds ratios (OR) for the relationship between the risk of death and echocardiographic parameters. The parameters that correlated with the outcome were incorporated in an attempt to devise a disease-specific cardiovascular profile score. Fetal echocardiograms (143) from 28 patients were analyzed. The cardiovascular profile score predicted the risk of death. A lower right ventricle (RV) pressure was associated with mortality (OR 0.959; 95% confidence intervals (CI) 0.940-0.978). Higher peak aortic velocity through the aortic valve (OR 0.104; 95% CI 0.020-0.529) was associated with a better outcome. These cardiac function parameters were incorporated in a modified disease-specific CVP Score. Patients with a mean modified cardiovascular profile score of ≤ 6 were over 3.7 times more likely to die than those with scores of 7-10. The original Cardiovascular Profile Score predicted the risk of death in right heart defects. The modified score was not validated as a good prediction tool by this study. Fetal RV pressure estimate and peak aortic velocity can be used as independent prognostic predictors.

Myocardial Infarction Injury in Patients with Chronic Lung Disease Entering Pulmonary Rehabilitation: Frequency and Association with Heart Rate Parameters.

PubMed

Sima, Carmen A; Lau, Benny C; Taylor, Carolyn M; van Eeden, Stephan F; Reid, W Darlene; Sheel, Andrew W; Kirkham, Ashley R; Camp, Pat G

2018-03-14

Myocardial infarction (MI) remains under-recognized in chronic lung disease (CLD) patients. Rehabilitation health professionals need accessible clinical measurements to identify the presence of prior MI in order to determine appropriate training prescription. To estimate prior MI in CLD patients entering a pulmonary rehabilitation program, as well as its association with heart rate parameters such as resting heart rate and chronotropic response index. Retrospective cohort design. Pulmonary rehabilitation outpatient clinic in a tertiary care university-affiliated hospital. Eighty-five CLD patients were studied. Electrocardiograms at rest and peak cardiopulmonary exercise testing, performed before pulmonary rehabilitation, were analyzed. Electrocardiographic evidence of prior MI, quantified by the Cardiac Infarction Injury Score (CIIS), was contrasted with reported myocardial events and then correlated with resting heart rate and chronotropic response index parameters. CIIS, resting heart rate, and chronotropic response index. Sixteen CLD patients (19%) demonstrated electrocardiographic evidence of prior MI, but less than half (8%) had a reported MI history (P < .05). The Cohen's kappa test revealed poor level of agreement between CIIS and medical records (kappa = 0.165), indicating that prior MI diagnosis was under-reported in the medical records. Simple and multiple regression analyses showed that resting heart rate but not chronotropic response index was positively associated with CIIS in our population (R 2 = 0.29, P < .001). CLD patients with a resting heart rate higher than 80 beats/min had approximately 5 times higher odds of having prior MI, as evidenced by a CIIS ≥20. CLD patients entering pulmonary rehabilitation are at risk of unreported prior MI. Elevated resting heart rate seems to be an indicator of prior MI in CLD patients; therefore, careful adjustment of training intensity such as intermittent training is recommended under these circumstances. III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Echocardiographic assessment of right ventricular function in routine practice: Which parameters are useful to predict one-year outcome in advanced heart failure patients with dilated cardiomyopathy?

PubMed

Kawata, Takayuki; Daimon, Masao; Kimura, Koichi; Nakao, Tomoko; Lee, Seitetsu L; Hirokawa, Megumi; Kato, Tomoko S; Watanabe, Masafumi; Yatomi, Yutaka; Komuro, Issei

2017-10-01

Right ventricular (RV) function has recently gained attention as a prognostic predictor of outcome even in patients who have left-sided heart failure. Since several conventional echocardiographic parameters of RV systolic function have been proposed, our aim was to determine if any of these parameters (tricuspid annular plane systolic excursion: TAPSE, tissue Doppler derived systolic tricuspid annular motion velocity: S', fractional area change: FAC) are associated with outcome in advanced heart failure patients with dilated cardiomyopathy (DCM). We retrospectively enrolled 68 DCM patients, who were New York Heart Association (NYHA) Class III or IV and had a left ventricular (LV) ejection fraction <35%. All patients were undergoing evaluation for heart transplantation or management of heart failure. Primary outcomes were defined as LV assist device implantation or cardiac death within one year. Thirty-nine events occurred (5 deaths, 32 LV assist devices implanted). Univariate analysis showed that age, systolic blood pressure, heart rate, NYHA functional class IV, plasma brain natriuretic peptide concentration, intravenous inotrope use, left atrial volume index, and FAC were associated with outcome, whereas TAPSE and S' were not. Receiver-operating characteristic curve analysis showed that the optimal FAC cut-off value to identify patients with an event was <26.7% (area under the curve=0.74). The event-free rate determined by Kaplan-Meier analysis was significantly higher in patients with FAC≥26.7% than in those with FAC<26.7% (log-lank, p=0.0003). Moreover, the addition of FAC<26.7% improved the prognostic utility of a model containing clinical variables and conventional echocardiographic indexes. FAC may provide better prognostic information than TAPSE or S' in advanced heart failure patients with DCM. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Determinants of heart rate turbulence in individuals without apparent heart disease and in patients with stable coronary artery disease.

PubMed

Pinnacchio, Gaetano; Lanza, Gaetano Antonio; Stazi, Alessandra; Careri, Giulia; Coviello, Ilaria; Mollo, Roberto; Crea, Filippo

2015-12-01

To assess the characteristics and determinants of heart rate turbulence (HRT) in individuals without any apparent heart disease and in patients with coronary artery disease (CAD). Heart rate turbulence parameters, turbulence onset (TO), and turbulence slope (TS) were calculated on 24 h electrocardiogram recordings in 209 individuals without any heart disease (group 1) and in 157 CAD patients (group 2). In group 1, only age independently predicted abnormal TO (≥0%) [odds ratio (OR), 1.05; P<0.001], while predictors of abnormal TS (≤2.5 ms/RR) were age (OR, 0.85; P < 0.001) and hypertension (OR, 0.19; P = 0.028). In group 2 patients, only age independently predicted TO (OR, 1.03; P = 0.038), while age (OR, 0.90; P = 0.001) and left ventricular ejection fraction (LVEF; OR, 1.07; P = 0.008) predicted TS. Heart rate turbulence values were different in groups 1 and 2. Turbulence onset was (mean, standard deviation) -1.80 ± 2.24 vs. -0.73 ± 1.61%, respectively (P < 0.001), whereas TS was (median, interquartile interval) 5.83 (3.25-10.55) vs. 2.93 (1.73-5.81) ms/RR, respectively (P < 0.001). Coronary artery disease group, however, did not predict abnormal HRT parameters in multivariable analyses, both in the whole population and when comparing two subgroups matched for age and gender. Age and (for TS) LVEF, indeed, were the only independent predictors of abnormal HRT. Age is a major HRT determinant both in subjects without any apparent heart disease and in stable CAD patients. Hypertension and LVEF contribute independently to HRT in these two groups, respectively. Coronary artery disease group was not by itself associated with abnormal HRT parameters in multivariable analyses. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Failure of platelet parameters and biomarkers to correlate platelet function to severity and etiology of heart failure in patients enrolled in the EPCOT trial. With special reference to the Hemodyne hemostatic analyzer. Whole Blood Impedance Aggregometry for the Assessment of Platelet Function in Patients with Congestive Heart Failure.

PubMed

Serebruany, Victor L; McKenzie, Marcus E; Meister, Andrew F; Fuzaylov, Sergey Y; Gurbel, Paul A; Atar, Dan; Gattis, Wendy A; O'Connor, Christopher M

2002-01-01

Data from small studies have suggested the presence of platelet abnormalities in patients with congestive heart failure (CHF). We sought to characterize the diagnostic utility of different platelet parameters and platelet-endothelial biomarkers in a random outpatient CHF population investigated in the EPCOT ('Whole Blood Impedance Aggregometry for the Assessment of Platelet Function in Patients with Congestive Heart Failure') Trial. Blood samples were obtained for measurement of platelet contractile force (PCF), whole blood aggregation, shear-induced closure time, expression of glycoprotein (GP) IIb/IIIa, and P-selectin in 100 consecutive patients with CHF. Substantial interindividual variability of platelet characteristics exists in patients with CHF. There were no statistically significant differences when patients were grouped according to incidence of vascular events, emergency revascularization needs, survival, or etiology of heart failure. Aspirin use did not affect instrument readings either. PCF correlates very poorly with whole blood aggregometry (r(2) = 0.023), closure time (r(2) = 0.028), platelet GP IIb/IIIa (r(2) = 0.0028), and P-selectin (r(2) = 0.002) expression. Furthermore, there was no correlation with brain natriuretic peptide concentrations, a marker of severity and prognosis in heart failure reflecting the neurohumoral status. Patients with heart failure enrolled in the EPCOT Trial exhibited a marginal, sometimes oppositely directed change in platelet function, challenging the diagnostic utility of these platelet parameters and biomarkers to serve as useful tools for the identification of platelet abnormalities, for predicting clinical outcomes, or for monitoring antiplatelet strategies in this population. The usefulness of these measurements for assessing platelets in the different clinical settings remains to be explored. Taken together, opposite to our expectations, major clinical characteristics of heart failure did not correlate well with the platelet characteristics investigated in this study. Copyright 2002 S. Karger AG, Basel

Facial Vibrotactile Stimulation Activates the Parasympathetic Nervous System: Study of Salivary Secretion, Heart Rate, Pupillary Reflex, and Functional Near-Infrared Spectroscopy Activity

PubMed Central

Hiraba, Hisao; Inoue, Motoharu; Gora, Kanako; Sato, Takako; Nishimura, Satoshi; Yamaoka, Masaru; Kumakura, Ayano; Ono, Shinya; Wakasa, Hirotugu; Nakayama, Enri; Abe, Kimiko; Ueda, Koichiro

2014-01-01

We previously found that the greatest salivation response in healthy human subjects is produced by facial vibrotactile stimulation of 89 Hz frequency with 1.9 μm amplitude (89 Hz-S), as reported by Hiraba et al. (2012, 20011, and 2008). We assessed relationships between the blood flow to brain via functional near-infrared spectroscopy (fNIRS) in the frontal cortex and autonomic parameters. We used the heart rate (HRV: heart rate variability analysis in RR intervals), pupil reflex, and salivation as parameters, but the interrelation between each parameter and fNIRS measures remains unknown. We were to investigate the relationship in response to established paradigms using simultaneously each parameter-fNIRS recording in healthy human subjects. Analysis of fNIRS was examined by a comparison of various values between before and after various stimuli (89 Hz-S, 114 Hz-S, listen to classic music, and “Ahh” vocalization). We confirmed that vibrotactile stimulation (89 Hz) of the parotid glands led to the greatest salivation, greatest increase in heart rate variability, and the most constricted pupils. Furthermore, there were almost no detectable differences between fNIRS during 89 Hz-S and fNIRS during listening to classical music of fans. Thus, vibrotactile stimulation of 89 Hz seems to evoke parasympathetic activity. PMID:24511550

A mobile phone based telemonitoring concept for the simultaneous acquisition of biosignals physiological parameters.

PubMed

Kumpusch, Hannes; Hayn, Dieter; Kreiner, Karl; Falgenhauer, Markus; Mor, Jürgen; Schreier, Günter

2010-01-01

Congestive Heart Failure (CHF) is a common chronic heart disease with high socioeconomic impact. Conventional treatment of CHF is often ineffective and inefficient, since self-management is complex and patients are insufficiently involved in therapy management. With telemedical concepts, continuous monitoring of the health status can be ensured, and consequently therapy management can be adapted to the individual requirements of every individual patient. Therefore, a mobile phone based patient terminal for the concurrent acquisition of biosignals (e.g. ECG) and bioparameters (e.g. blood pressure) for patients with CHF has been developed and prototypically implemented. Usability and interoperability aspects were especially considered by using Bluetooth and Near Field Communication (NFC) technology for data acquisition and standardized data formats for transmission of the data to a central monitoring centre. Results indicated that even complicated measurements like the acquisition of ECG signals could be accomplished autonomously by the patients in an intuitive and easy-to-use way. Through the usage of IHE conform HL7 messages, self-measured data could easily be integrated into a higher-ranking eHealth infrastructure.

ENVIRONMENTAL IMPACT ON PHYSIOLOGICAL RESPONSES OF UNDERGROUND COAL MINERS IN THE EASTERN PART OF INDIA.

PubMed

Dey, Netai Chandra; Nath, Suva; Sharma, Gourab Dhara; Mallik, Avijit

2014-12-01

Coal in India is extracted generally by semi-mechanized and mechanized underground mining methods. The Bord and Pillar (B & P) mining method still continues to be popular where deployment of manual miners is more than that of other mining methods. The study is conducted at haulage based mine of Eastern Coalfields of West Bengal. Underground miners confront with a lot of hazards like extreme hostile environment, awkward working posture, dust, noise as well as low luminosity. It is difficult to delay the onset of fatigue. In order to study the physiological responses of trammers, various parameters like working heart rates, net cardiac cost and relative cardiac cost including recovery heart rate patterns are recorded during their work at site. Workload classification of trammers has been done following various scales of heaviness. The effect of environment on the physiological responses has been observed and suitable recommendations are made. The work tasks are bound to induce musculoskeletal problems and those problems could be better managed through rationalizing the work-rest scheduling.

Day-night variation in heart rate variability changes induced by endotoxaemia in healthy volunteers.

PubMed

Alamili, M; Rosenberg, J; Gögenur, I

2015-04-01

Morbidity and mortality in response to sepsis may be dependent on clock time for the initiation of sepsis. Endotoxaemia, an experimental model for systemic inflammation, induces alterations in sympatico-vagal balance in the autonomic nervous system (ANS). The activity of sympathetic and parasympathetic activity can be estimated by measuring heart rate variability (HRV). Based on the intimate link between ANS and the inflammatory response, we hypothesized, that HRV changes seen during endotoxaemia would be different based on time of the day the endotoxaemia is initiated. We investigated day/night variation in endotoxaemia-induced changes in HRV. A randomized, crossover study with 12 healthy men (age 18-31) was conducted. Endotoxaemia were induced by lipopolysaccharide (LPS) endotoxin 0.3 ng/kg b.w. in two visits (day visit and night visit). At the day visit, endotoxaemia were induced at 12:00 h, and at the night visit it was induced at 24:00 h. Holter recordings were started 1 h before administration of LPS, and continued for 10 h. Time-domain and frequency-domain parameters of HRV were analysed. A total of nine persons finished the study with valid recordings. Endotoxaemia at both night and day resulted in a significant depression in HRV parameters high-frequency power (HF), low-frequency power (LF), standard deviation of normal-to-normal (NN) intervals, root mean square of successive differences and proportion of NN50 divided by total number of NNs (P<0.001). The ratio LF/HF and mean heart rate significantly increased by endotoxaemia (P<0.001). At night-time endotoxaemia, a more pronounced depression of LF, HF and SDNN (P<0.01) and a more pronounced increase in the ratio of LF/HF and mean heart rate (P<0.01) occurred compared with day-time endotoxaemia. Endotoxaemia induced changes in HRV exhibit a day-night difference. This difference may have clinical consequences in patients with sepsis. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

The effects of Ramadan fasting on heart rate variability in healthy individuals: a prospective study.

PubMed

Cansel, Mehmet; Taşolar, Hakan; Yağmur, Jülide; Ermiş, Necip; Açıkgöz, Nusret; Eyyüpkoca, Ferhat; Pekdemir, Hasan; Ozdemir, Ramazan

2014-08-01

Ramadan fasting is one of the five fundamental rituals of Islam. Heart rate variability (HRV) is an independent predictor of increased mortality of patients with myocardial infarction and congestive heart failure. Although many patients in this region fast once a year, the effects of fasting on the HRV, which has a prognostic significance for patients with myocardial infarction and congestive heart failure, are not known. Therefore, the study on the effects of one month fast of HRV in healthy volunteers seems to be reasonable to address. Our study is a prospective cohort study that includes a total of 40 healthy volunteers with sinus rhythm between 19 and 40 years of age (16 female and 24 male). HRV was determined twice by ambulatory 24-hour Holter recordings at fasting in the middle of Ramadan and first week after Ramadan month. Mean values of continuous variables were compared by using the Student t-test or Mann-Whitney U test. Paired t-test or Wilcoxon test were used for comparison of variables between groups. When two groups compared, statistically significant differences were found in terms of RR (p=0.049), SDNNI (p=0.010), rMSSD (p=0.009), pNN50 (p=0.015), T power (p=0.009), LF (p=0.008), Lfnu (p=0.002), HF (p=0.022) and Hfnu (p=0.013) values. In our study, HRV parameters were found to be increased in Ramadan month, so we think that Ramadan fasting enhances the activity of the parasympathetic system.

A method for automatically optimizing medical devices for treating heart failure: designing polymeric injection patterns.

PubMed

Wenk, Jonathan F; Wall, Samuel T; Peterson, Robert C; Helgerson, Sam L; Sabbah, Hani N; Burger, Mike; Stander, Nielen; Ratcliffe, Mark B; Guccione, Julius M

2009-12-01

Heart failure continues to present a significant medical and economic burden throughout the developed world. Novel treatments involving the injection of polymeric materials into the myocardium of the failing left ventricle (LV) are currently being developed, which may reduce elevated myofiber stresses during the cardiac cycle and act to retard the progression of heart failure. A finite element (FE) simulation-based method was developed in this study that can automatically optimize the injection pattern of the polymeric "inclusions" according to a specific objective function, using commercially available software tools. The FE preprocessor TRUEGRID((R)) was used to create a parametric axisymmetric LV mesh matched to experimentally measured end-diastole and end-systole metrics from dogs with coronary microembolization-induced heart failure. Passive and active myocardial material properties were defined by a pseudo-elastic-strain energy function and a time-varying elastance model of active contraction, respectively, that were implemented in the FE software LS-DYNA. The companion optimization software LS-OPT was used to communicate directly with TRUEGRID((R)) to determine FE model parameters, such as defining the injection pattern and inclusion characteristics. The optimization resulted in an intuitive optimal injection pattern (i.e., the one with the greatest number of inclusions) when the objective function was weighted to minimize mean end-diastolic and end-systolic myofiber stress and ignore LV stroke volume. In contrast, the optimization resulted in a nonintuitive optimal pattern (i.e., 3 inclusions longitudinallyx6 inclusions circumferentially) when both myofiber stress and stroke volume were incorporated into the objective function with different weights.

The immediate and short-term chemosensory impacts of coffee and caffeine on cardiovascular activity.

PubMed

McMullen, Michael K; Whitehouse, Julie M; Shine, Gillian; Whitton, Peter A; Towell, Anthony

2011-09-01

The immediate and short-term chemosensory impacts of coffee and caffeine on cardiovascular activity. Caffeine is detected by 5 of the 25 gustatory bitter taste receptors (hTAS2Rs) as well as by intestinal STC-1 cell lines. Thus there is a possibility that caffeine may elicit reflex autonomic responses via chemosensory stimulation. The cardiovascular impacts of double-espresso coffee, regular (130 mg caffeine) and decaffeinated, and encapsulated caffeine (134 mg) were compared with a placebo-control capsule. Measures of four post-ingestion phases were extracted from a continuous recording of cardiovascular parameters and contrasted with pre-ingestion measures. Participants (12 women) were seated in all but the last phase when they were standing. Both coffees increased heart rate immediately after ingestion by decreasing both the diastolic interval and ejection time. The increases in heart rate following the ingestion of regular coffee extended for 30 min. Encapsulated caffeine decreased arterial compliance and increased diastolic pressure when present in the gut and later in the standing posture. These divergent findings indicate that during ingestion the caffeine in coffee can elicit autonomic arousal via the chemosensory stimulation of the gustatory receptors which extends for at least 30 min. In contrast, encapsulated caffeine can stimulate gastrointestinal receptors and elicit vascular responses involving digestion. Research findings on caffeine are not directly applicable to coffee and vice versa. The increase of heart rate resulting from coffee drinking is a plausible pharmacological explanation for the observation that coffee increases risk for coronary heart disease in the hour after ingestion. This journal is © The Royal Society of Chemistry 2011

Spatio-temporal Organization During Ventricular Fibrillation in the Human Heart.

PubMed

Robson, Jinny; Aram, Parham; Nash, Martyn P; Bradley, Chris P; Hayward, Martin; Paterson, David J; Taggart, Peter; Clayton, Richard H; Kadirkamanathan, Visakan

2018-06-01

In this paper, we present a novel approach to quantify the spatio-temporal organization of electrical activation during human ventricular fibrillation (VF). We propose three different methods based on correlation analysis, graph theoretical measures and hierarchical clustering. Using the proposed approach, we quantified the level of spatio-temporal organization during three episodes of VF in ten patients, recorded using multi-electrode epicardial recordings with 30 s coronary perfusion, 150 s global myocardial ischaemia and 30 s reflow. Our findings show a steady decline in spatio-temporal organization from the onset of VF with coronary perfusion. We observed transient increases in spatio-temporal organization during global myocardial ischaemia. However, the decline in spatio-temporal organization continued during reflow. Our results were consistent across all patients, and were consistent with the numbers of phase singularities. Our findings show that the complex spatio-temporal patterns can be studied using complex network analysis.

Isolated heart models: cardiovascular system studies and technological advances.

PubMed

Olejnickova, Veronika; Novakova, Marie; Provaznik, Ivo

2015-07-01

Isolated heart model is a relevant tool for cardiovascular system studies. It represents a highly reproducible model for studying broad spectrum of biochemical, physiological, morphological, and pharmaceutical parameters, including analysis of intrinsic heart mechanics, metabolism, and coronary vascular response. Results obtained in this model are under no influence of other organ systems, plasma concentration of hormones or ions and influence of autonomic nervous system. The review describes various isolated heart models, the modes of heart perfusion, and advantages and limitations of various experimental setups. It reports the improvements of perfusion setup according to Langendorff introduced by the authors.

A novel combination technique of cold crystalloid perfusion but not cold storage facilitates transplantation of canine hearts donated after circulatory death.

PubMed

Rosenfeldt, Franklin; Ou, Ruchong; Salamonsen, Robert; Marasco, Silvana; Zimmet, Adam; Byrne, Joshua; Cosic, Filip; Saxena, Pankaj; Esmore, Donald

2016-11-01

Donation after circulatory death (DCD) represents a potential new source of hearts to increase the donor pool. We showed previously that DCD hearts in Greyhound dogs could be resuscitated and preserved by continuous cold crystalloid perfusion but not by cold static storage and could demonstrate excellent contractile and metabolic function on an in vitro system. In the current study, we demonstrate that resuscitated DCD hearts are transplantable. Donor Greyhound dogs (n = 12) were divided into perfusion (n = 8) and cold static storage (n = 4) groups. General anesthesia was induced and ventilation ceased for 30 minutes to achieve circulatory death. Donor cardiectomy was performed, and for 4 hours the heart was preserved by controlled reperfusion, followed by continuous cold perfusion with an oxygenated crystalloid perfusate or by static cold storage, after which orthotopic heart transplantation was performed. Recovery was assessed over 4 hours by hemodynamic monitoring. During cold perfusion, hearts showed continuous oxygen consumption and low lactate levels, indicating aerobic metabolism. The 8 dogs in the perfusion group were weaned off bypass, and 4 hours after bypass produced cardiac output of 4.73 ± 0.51 liters/min, left ventricular power of 7.63 ± 1.32 J/s, right ventricular power of 1.40 ± 0.43 J/s, and left ventricular fractional area shortening of 39.1% ± 5.2%, all comparable to pre-transplant values. In the cold storage group, 3 of 4 animals could not be weaned from cardiopulmonary bypass, and the fourth exhibited low-level function. Cold crystalloid perfusion, but not cold static storage, can resuscitate and preserve the DCD donor heart in a canine model of heart transplantation, thus rendering it transplantable. Controlled reperfusion and cold crystalloid perfusion have potential for clinical application in DCD transplantation. Copyright © 2016. Published by Elsevier Inc.

Simultaneously extracting multiple parameters via multi-distance and multi-exposure diffuse speckle contrast analysis

PubMed Central

Liu, Jialin; Zhang, Hongchao; Lu, Jian; Ni, Xiaowu; Shen, Zhonghua

2017-01-01

Recent advancements in diffuse speckle contrast analysis (DSCA) have opened the path for noninvasive acquisition of deep tissue microvasculature blood flow. In fact, in addition to blood flow index αDB, the variations of tissue optical absorption μa, reduced scattering coefficients μs′, as well as coherence factor β can modulate temporal fluctuations of speckle patterns. In this study, we use multi-distance and multi-exposure DSCA (MDME-DSCA) to simultaneously extract multiple parameters such as μa, μs′, αDB, and β. The validity of MDME-DSCA has been validated by the simulated data and phantoms experiments. Moreover, as a comparison, the results also show that it is impractical to simultaneously obtain multiple parameters by multi-exposure DSCA (ME-DSCA). PMID:29082083

Almanac 2015: atrial fibrillation research in Heart

PubMed Central

Jawad-Ul-Qamar, Muhammad; Kirchhof, Paulus

2016-01-01

Atrial fibrillation continues to attract interest in the cardiovascular community and in Heart. Over 60 original research and review papers published in Heart in 2014–2015 cover various aspects of atrial fibrillation, from associated conditions and precipitating factors to new approaches to management. Here, we provide an overview of articles on atrial fibrillation published in Heart in 2014–2015, highlighting new developments, emerging concepts and novel approaches to treatment. PMID:26791994

Localized states in an unbounded neural field equation with smooth firing rate function: a multi-parameter analysis.

PubMed

Faye, Grégory; Rankin, James; Chossat, Pascal

2013-05-01

The existence of spatially localized solutions in neural networks is an important topic in neuroscience as these solutions are considered to characterize working (short-term) memory. We work with an unbounded neural network represented by the neural field equation with smooth firing rate function and a wizard hat spatial connectivity. Noting that stationary solutions of our neural field equation are equivalent to homoclinic orbits in a related fourth order ordinary differential equation, we apply normal form theory for a reversible Hopf bifurcation to prove the existence of localized solutions; further, we present results concerning their stability. Numerical continuation is used to compute branches of localized solution that exhibit snaking-type behaviour. We describe in terms of three parameters the exact regions for which localized solutions persist.

Characteristics of Extra Narrow Gap Weld of HSLA Steel Welded by Single-Seam per Layer Pulse Current GMA Weld Deposition

NASA Astrophysics Data System (ADS)

Agrawal, B. P.; Ghosh, P. K.

2017-03-01

Butt weld joints are produced using pulse current gas metal arc welding process by employing the technique of centrally laid multi-pass single-seam per layer weld deposition in extra narrow groove of thick HSLA steel plates. The weld joints are prepared by using different combination of pulse parameters. The selection of parameter of pulse current gas metal arc welding is done considering a summarized influence of simultaneously interacting pulse parameters defined by a dimensionless hypothetical factor ϕ. The effect of diverse pulse parameters on the characteristics of weld has been studied. Weld joint is also prepared by using commonly used multi-pass multi-seam per layer weld deposition in conventional groove. The extra narrow gap weld joints have been found much superior to the weld joint prepared by multi-pass multi-seam per layer deposition in conventional groove with respect to its metallurgical characteristics and mechanical properties.

Real-time Retrieving Atmospheric Parameters from Multi-GNSS Constellations

NASA Astrophysics Data System (ADS)

Li, X.; Zus, F.; Lu, C.; Dick, G.; Ge, M.; Wickert, J.; Schuh, H.

2016-12-01

The multi-constellation GNSS (e.g. GPS, GLONASS, Galileo, and BeiDou) bring great opportunities and challenges for real-time retrieval of atmospheric parameters for supporting numerical weather prediction (NWP) nowcasting or severe weather event monitoring. In this study, the observations from different GNSS are combined together for atmospheric parameter retrieving based on the real-time precise point positioning technique. The atmospheric parameters retrieved from multi-GNSS observations, including zenith total delay (ZTD), integrated water vapor (IWV), horizontal gradient (especially high-resolution gradient estimates) and slant total delay (STD), are carefully analyzed and evaluated by using the VLBI, radiosonde, water vapor radiometer and numerical weather model to independently validate the performance of individual GNSS and also demonstrate the benefits of multi-constellation GNSS for real-time atmospheric monitoring. Numerous results show that the multi-GNSS processing can provide real-time atmospheric products with higher accuracy, stronger reliability and better distribution, which would be beneficial for atmospheric sounding systems, especially for nowcasting of extreme weather.

Self-adaptive multi-objective harmony search for optimal design of water distribution networks

NASA Astrophysics Data System (ADS)

Choi, Young Hwan; Lee, Ho Min; Yoo, Do Guen; Kim, Joong Hoon

2017-11-01

In multi-objective optimization computing, it is important to assign suitable parameters to each optimization problem to obtain better solutions. In this study, a self-adaptive multi-objective harmony search (SaMOHS) algorithm is developed to apply the parameter-setting-free technique, which is an example of a self-adaptive methodology. The SaMOHS algorithm attempts to remove some of the inconvenience from parameter setting and selects the most adaptive parameters during the iterative solution search process. To verify the proposed algorithm, an optimal least cost water distribution network design problem is applied to three different target networks. The results are compared with other well-known algorithms such as multi-objective harmony search and the non-dominated sorting genetic algorithm-II. The efficiency of the proposed algorithm is quantified by suitable performance indices. The results indicate that SaMOHS can be efficiently applied to the search for Pareto-optimal solutions in a multi-objective solution space.

A reagentless real-time method for the multiparameter analysis of nanoparticles as a potential 'trigger' device

NASA Astrophysics Data System (ADS)

Carr, Bob; Knowles, John; Warren, Jeremy

2008-10-01

We describe the continuing development of a laser-based, light scattering detector system capable of detecting and analysing liquid-borne nanoparticles. Using a finely focussed and specially configured laser beam to illuminate a suspension of nanoparticles in a small (250ul) sample and videoing the Brownian motion of each and every particle in the detection zone should allow individual but simultaneous detection and measurement of particle size, scattered light intensity, electrophoretic mobility and, where applicable, shape asymmetry. This real-time, multi-parameter analysis capability offers the prospect of reagentlessly differentiating between different particle types within a complex sample of potentially high and variable background. Employing relatively low powered (50-100mW) laser diode modules and low resolution CCD arrays, each component could be run off battery power, allowing distributed/remote or personal deployment. Voltages needed for electrophoresis measurement s would be similarly low (e.g. 20V, low current) and 30second videos (exported at mobile/cell phone download speeds) analysed remotely. The potential of such low-cost technology as a field-deployable grid of remote, battery powered and reagentless, multi-parameter sensors for use as trigger devices is discussed.

Metoprolol vs ivabradine in patients with mitral stenosis in sinus rhythm.

PubMed

Agrawal, Vikas; Kumar, Niraj; Lohiya, Balalji; Sihag, Bhupendra K; Prajapati, Rajpal; Singh, T B; Subramanian, Geetha

2016-10-15

Severe mitral stenosis is usually symptomatic and is treated by BMV or surgery, whereas mild to moderate mitral stenosis is usually asymptomatic or mildly symptomatic and managed medically. Patients in the later group may become symptomatic during episodes of exercise and increased heart rate. Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to investigate the comparative efficacy of ivabradine versus metoprolol in patients with mitral stenosis in sinus rhythm. We studied 97 patients of mitral stenosis in sinus rhythm presented with exertional symptoms. The effectiveness of Metoprolol was compared with ivabradine in alleviating these exertional symptoms in a randomized, open label non crossover study. We also assessed various stress ECG parameters, 24 hour Holter parameters and 2D Echo parameters to objectively compare the effects of ivabradine and metoprolol in these patients. Ivabradine and metoprolol both were effective in controlling exertional symptoms. Significant improvement in objective parameters like TMT (work capacity, baseline heart rate and maximal heart rate) and 2D echocardiography (right ventricular systolic pressure) are seen with both drugs. Ivabradine controls the exertional symptoms significantly more than metoprolol. On head to head comparison there was a significant benefit of working capacity and heart rate at maximal exercise in favour of ivabradine. Ivabradine should be strongly considered in medical management of mitral stenosis patients where beta blockers are contraindicated such as reactive airway disease. The cost of ivabradine is higher than metoprolol which might possess constraints as most of the rheumatic heat disease patients belong to low socio economic status. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Effect of Adenotonsillectomy for Childhood Sleep Apnea on Cardiometabolic Measures.

PubMed

Quante, Mirja; Wang, Rui; Weng, Jia; Rosen, Carol L; Amin, Raouf; Garetz, Susan L; Katz, Eliot; Paruthi, Shalini; Arens, Raanan; Muzumdar, Hiren; Marcus, Carole L; Ellenberg, Susan; Redline, Susan

2015-09-01

Obstructive sleep apnea syndrome (OSAS) has been associated with cardiometabolic disease in adults. In children, this association is unclear. We evaluated the effect of early adenotonsillectomy (eAT) for treatment of OSAS on blood pressure, heart rate, lipids, glucose, insulin, and C-reactive protein. We also analyzed whether these parameters at baseline and changes at follow-up correlated with polysomnographic indices. Data collected at baseline and 7-mo follow-up were analyzed from a randomized controlled trial, the Childhood Adenotonsillectomy Trial (CHAT). Clinical referral setting from multiple centers. There were 464 children, ages 5 to 9.9 y with OSAS without severe hypoxemia. Randomization to eAT or Watchful Waiting with Supportive Care (WWSC). There was no significant change of cardiometabolic parameters over the 7-mo interval in the eAT group compared to WWSC group. However, overnight heart rate was incrementally higher in association with baseline OSAS severity (average heart rate increase of 3 beats per minute [bpm] for apnea-hypopnea index [AHI] of 2 versus 10; [standard error = 0.60]). Each 5-unit improvement in AHI and 5 mmHg improvement in peak end-tidal CO2 were estimated to reduce heart rate by 1 and 1.5 bpm, respectively. An increase in N3 sleep also was associated with small reductions in systolic blood pressure percentile. There is little variation in standard cardiometabolic parameters in children with obstructive sleep apnea syndrome (OSAS) but without severe hypoxemia at baseline or after intervention. Of all measures, overnight heart rate emerged as the most sensitive parameter of pediatric OSAS severity. Clinicaltrials.gov (#NCT00560859). © 2015 Associated Professional Sleep Societies, LLC.

STUDIES IN RESUSCITATION: I. THE GENERAL CONDITIONS AFFECTING RESUSCITATION, AND THE RESUSCITATION OF THE BLOOD AND OF THE HEART

PubMed Central

Pike, F. H.; Guthrie, C. C.; Stewart, G. N.

1908-01-01

Our results may be briefly summarized: 1. Blood, when defibrinated, soon loses its power to maintain the activity of the higher nervous centers, and its nutritive properties for all tissues quickly diminish. 2. Artificial fluids, as a substitute for blood, are not satisfactory. 3. The proper oxygenation of the blood is an indispensable adjunct in the resuscitation of an animal. 4. The heart usually continues to beat for some minutes after it ceases to affect a mercury manometer, and resuscitation of it within this period by extra-thoracic massage and artificial respiration is sometimes successful. 5. Resuscitation of the heart by direct massage is the most certain method at our command. 6. A proper blood-pressure is an indispensable condition for the continued normal activity of the heart. 7. Anæsthetics, hemorrhage and induced currents applied to the heart render resuscitation more difficult than asphyxia alone. PMID:19867138

Current Expectations for Cardiac Transplantation in Patients With Congenital Heart Disease.

PubMed

Kirklin, James K; Carlo, Waldemar F; Pearce, F Bennett

2016-11-01

Congenital heart disease accounts for 40% of pediatric heart transplants and presents unique challenges to the transplant team. Suitability for transplantation is defined in part by degree of sensitization, pulmonary vascular resistance, and hepatic reserves. The incremental transplant risk for patients with congenital heart disease occurs within the first 3 months, after which survival is equivalent to transplantation for cardiomyopathy. Single ventricle with prior palliation, and especially the failing Fontan, carry the highest risk for transplantation and are least amenable to bridging with mechanical circulatory support. More effective bridging to transplant with mechanical circulatory support will require improvements in the adverse event profile of available pumps and the introduction of miniaturized continuous flow technology. The major barriers to routine long-term survival are chronic allograft failure and allograft vasculopathy. Despite these many challenges, continuing improvements in the care of pediatric heart transplant patients have pushed the median posttransplant survival past 15 years for children and to 20 years for infants. © The Author(s) 2016.

Cuffless and Continuous Blood Pressure Estimation from the Heart Sound Signals

PubMed Central

Peng, Rong-Chao; Yan, Wen-Rong; Zhang, Ning-Ling; Lin, Wan-Hua; Zhou, Xiao-Lin; Zhang, Yuan-Ting

2015-01-01

Cardiovascular disease, like hypertension, is one of the top killers of human life and early detection of cardiovascular disease is of great importance. However, traditional medical devices are often bulky and expensive, and unsuitable for home healthcare. In this paper, we proposed an easy and inexpensive technique to estimate continuous blood pressure from the heart sound signals acquired by the microphone of a smartphone. A cold-pressor experiment was performed in 32 healthy subjects, with a smartphone to acquire heart sound signals and with a commercial device to measure continuous blood pressure. The Fourier spectrum of the second heart sound and the blood pressure were regressed using a support vector machine, and the accuracy of the regression was evaluated using 10-fold cross-validation. Statistical analysis showed that the mean correlation coefficients between the predicted values from the regression model and the measured values from the commercial device were 0.707, 0.712, and 0.748 for systolic, diastolic, and mean blood pressure, respectively, and that the mean errors were less than 5 mmHg, with standard deviations less than 8 mmHg. These results suggest that this technique is of potential use for cuffless and continuous blood pressure monitoring and it has promising application in home healthcare services. PMID:26393591

Cuffless and Continuous Blood Pressure Estimation from the Heart Sound Signals.

PubMed

Peng, Rong-Chao; Yan, Wen-Rong; Zhang, Ning-Ling; Lin, Wan-Hua; Zhou, Xiao-Lin; Zhang, Yuan-Ting

2015-09-17

Cardiovascular disease, like hypertension, is one of the top killers of human life and early detection of cardiovascular disease is of great importance. However, traditional medical devices are often bulky and expensive, and unsuitable for home healthcare. In this paper, we proposed an easy and inexpensive technique to estimate continuous blood pressure from the heart sound signals acquired by the microphone of a smartphone. A cold-pressor experiment was performed in 32 healthy subjects, with a smartphone to acquire heart sound signals and with a commercial device to measure continuous blood pressure. The Fourier spectrum of the second heart sound and the blood pressure were regressed using a support vector machine, and the accuracy of the regression was evaluated using 10-fold cross-validation. Statistical analysis showed that the mean correlation coefficients between the predicted values from the regression model and the measured values from the commercial device were 0.707, 0.712, and 0.748 for systolic, diastolic, and mean blood pressure, respectively, and that the mean errors were less than 5 mmHg, with standard deviations less than 8 mmHg. These results suggest that this technique is of potential use for cuffless and continuous blood pressure monitoring and it has promising application in home healthcare services.

Heart Rate Detection Using Microsoft Kinect: Validation and Comparison to Wearable Devices.

PubMed

Gambi, Ennio; Agostinelli, Angela; Belli, Alberto; Burattini, Laura; Cippitelli, Enea; Fioretti, Sandro; Pierleoni, Paola; Ricciuti, Manola; Sbrollini, Agnese; Spinsante, Susanna

2017-08-02

Contactless detection is one of the new frontiers of technological innovation in the field of healthcare, enabling unobtrusive measurements of biomedical parameters. Compared to conventional methods for Heart Rate (HR) detection that employ expensive and/or uncomfortable devices, such as the Electrocardiograph (ECG) or pulse oximeter, contactless HR detection offers fast and continuous monitoring of heart activities and provides support for clinical analysis without the need for the user to wear a device. This paper presents a validation study for a contactless HR estimation method exploiting RGB (Red, Green, Blue) data from a Microsoft Kinect v2 device. This method, based on Eulerian Video Magnification (EVM), Photoplethysmography (PPG) and Videoplethysmography (VPG), can achieve performance comparable to classical approaches exploiting wearable systems, under specific test conditions. The output given by a Holter, which represents the gold-standard device used in the test for ECG extraction, is considered as the ground-truth, while a comparison with a commercial smartwatch is also included. The validation process is conducted with two modalities that differ for the availability of a priori knowledge about the subjects' normal HR. The two test modalities provide different results. In particular, the HR estimation differs from the ground-truth by 2% when the knowledge about the subject's lifestyle and his/her HR is considered and by 3.4% if no information about the person is taken into account.

Heart Rate Detection Using Microsoft Kinect: Validation and Comparison to Wearable Devices

PubMed Central

Agostinelli, Angela; Belli, Alberto; Cippitelli, Enea; Fioretti, Sandro; Pierleoni, Paola; Ricciuti, Manola

2017-01-01

Contactless detection is one of the new frontiers of technological innovation in the field of healthcare, enabling unobtrusive measurements of biomedical parameters. Compared to conventional methods for Heart Rate (HR) detection that employ expensive and/or uncomfortable devices, such as the Electrocardiograph (ECG) or pulse oximeter, contactless HR detection offers fast and continuous monitoring of heart activities and provides support for clinical analysis without the need for the user to wear a device. This paper presents a validation study for a contactless HR estimation method exploiting RGB (Red, Green, Blue) data from a Microsoft Kinect v2 device. This method, based on Eulerian Video Magnification (EVM), Photoplethysmography (PPG) and Videoplethysmography (VPG), can achieve performance comparable to classical approaches exploiting wearable systems, under specific test conditions. The output given by a Holter, which represents the gold-standard device used in the test for ECG extraction, is considered as the ground-truth, while a comparison with a commercial smartwatch is also included. The validation process is conducted with two modalities that differ for the availability of a priori knowledge about the subjects’ normal HR. The two test modalities provide different results. In particular, the HR estimation differs from the ground-truth by 2% when the knowledge about the subject’s lifestyle and his/her HR is considered and by 3.4% if no information about the person is taken into account. PMID:28767091

[Severe hypotension as a complication of intramyometrial injection of vasopressin: a case report].

PubMed

Kitamura, Takayuki; Saito, Yuichiro; Yamada, Yoshitsugu

2008-12-01

A thirty-year-old woman was scheduled for laparoscopic myomectomy. After insertion of an epidural catheter at the L4-5 interspace, general anesthesia was induced with thiopental 250 mg followed by vecuronium 8mg intravenously to facilitate tracheal intubation. General anesthesia was maintained with sevoflurane and nitrous oxide. Just after intramyometrial injection of vasopressin, blood pressure decreased from 122/66 to 45/25 mmHg, and heart rate decreased from 52 to 45 beats x min(-1). The patient was ventilated with 100% oxygen, and we administered atropine 0.25 mg and ephedrine 16 mg intravenously. Blood pressure increased to 150/100 mmHg and heart rate increased to 135 beats x min(-1). Since electrocardiogram showed ST-segment depression and premature ventricular contraction, we administered nicorandil 3 mg followed by continuous infusion at a rate of 3 mg x hr(-1), and lidocaine 60 mg, intravenously. The ST depression and premature ventricular contraction disappeared immediately. To decrease blood pressure and heart rate, we increased inspiratory concentrations of sevoflurane and nitrous oxide and administered local anesthetics via epidural catheter, and hemodynamic parameters became gradually stable. We estimate that severe hypotension observed in this case is associated with intramyometrial injection of vasopressin. Increased blood concentration of vasopressin might cause vasoconstriction of coronary artery, increases in afterload, and/or direct myocardial depression resulting in decreased cardiac output.

[Effects of Monochord Music on Heart Rate Variability and Self-Reports of Relaxation in Healthy Adults].

PubMed

Gäbel, Christine; Garrido, Natalia; Koenig, Julian; Hillecke, Thomas Karl; Warth, Marco

Music-based interventions are considered an effective and low-cost treatment option for stress-related symptoms. The present study aimed to examine the trajectories of the psychophysiological response in apparently healthy participants during a music-based relaxation intervention compared to a verbal relaxation exercise. 70 participants were assigned to either receptive live music (experimental group) or a prerecorded verbal relaxation exercise (control group). Self-ratings of relaxation were assessed before and after each intervention on visual analogue scales and the Relaxation Inventory (RI). The heart rate variability (HRV) was continuously recorded throughout the sessions. Statistical analysis focused on HRV parameters indicative of parasympathetic cardiovascular outflow. We found significant quadratic main effects for time on the mean R-R interval (heart rate), the high-frequency power of HRV (indicative of parasympathetic activity), and the self-ratings of relaxation in both groups. A significant group × time interaction was observed for the cognitive tension subscale of the RI. Participants in both groups showed psychophysiological changes indicative of greater relaxation over the course of the interventions. However, differences between groups were only marginal. Music might be effective in relieving stress and promoting relaxation by altering the autonomic nervous system function. Future studies need to explore the long-term outcomes of such interventions. © 2017 S. Karger GmbH, Freiburg.

Cardiovascular regulation during sleep quantified by symbolic coupling traces

NASA Astrophysics Data System (ADS)

Suhrbier, A.; Riedl, M.; Malberg, H.; Penzel, T.; Bretthauer, G.; Kurths, J.; Wessel, N.

2010-12-01

Sleep is a complex regulated process with short periods of wakefulness and different sleep stages. These sleep stages modulate autonomous functions such as blood pressure and heart rate. The method of symbolic coupling traces (SCT) is used to analyze and quantify time-delayed coupling of these measurements during different sleep stages. The symbolic coupling traces, defined as the symmetric and diametric traces of the bivariate word distribution matrix, allow the quantification of time-delayed coupling. In this paper, the method is applied to heart rate and systolic blood pressure time series during different sleep stages for healthy controls as well as for normotensive and hypertensive patients with sleep apneas. Using the SCT, significant different cardiovascular mechanisms not only between the deep sleep and the other sleep stages but also between healthy subjects and patients can be revealed. The SCT method is applied to model systems, compared with established methods, such as cross correlation, mutual information, and cross recurrence analysis and demonstrates its advantages especially for nonstationary physiological data. As a result, SCT proves to be more specific in detecting delays of directional interactions than standard coupling analysis methods and yields additional information which cannot be measured by standard parameters of heart rate and blood pressure variability. The proposed method may help to indicate the pathological changes in cardiovascular regulation and also the effects of continuous positive airway pressure therapy on the cardiovascular system.

Asphyxia-activated corticocardiac signaling accelerates onset of cardiac arrest

PubMed Central

Li, Duan; Mabrouk, Omar S.; Liu, Tiecheng; Tian, Fangyun; Xu, Gang; Rengifo, Santiago; Choi, Sarah J.; Mathur, Abhay; Crooks, Charles P.; Kennedy, Robert T.; Wang, Michael M.; Ghanbari, Hamid; Borjigin, Jimo

2015-01-01

The mechanism by which the healthy heart and brain die rapidly in the absence of oxygen is not well understood. We performed continuous electrocardiography and electroencephalography in rats undergoing experimental asphyxia and analyzed cortical release of core neurotransmitters, changes in brain and heart electrical activity, and brain–heart connectivity. Asphyxia stimulates a robust and sustained increase of functional and effective cortical connectivity, an immediate increase in cortical release of a large set of neurotransmitters, and a delayed activation of corticocardiac functional and effective connectivity that persists until the onset of ventricular fibrillation. Blocking the brain’s autonomic outflow significantly delayed terminal ventricular fibrillation and lengthened the duration of detectable cortical activities despite the continued absence of oxygen. These results demonstrate that asphyxia activates a brainstorm, which accelerates premature death of the heart and the brain. PMID:25848007

Double-outlet right ventricle revisited.

PubMed

Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

2017-08-01

Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

Method for Correction of Consequences of Radiation-Induced Heart Disease using Low-Intensity Electromagnetic Emission under Experimental Conditions.

PubMed

Bavrina, A P; Monich, V A; Malinovskaya, S L; Yakovleva, E I; Bugrova, M L; Lazukin, V F

2015-05-01

Effects of successive exposure to ionizing irradiation and low-intensity broadband red light on electrical activity of the heart and myocardium microstructure were studied in rats. Lowintensity red light corrected some ECG parameters, in particular, it normalized QT and QTc intervals and voltage of R and T waves. Changes in ECG parameters were followed by alterations in microstructure of muscle fi laments in the myocardium of treatment group animals comparing to control group.

Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom.

PubMed

Begemann, Philipp G C; van Stevendaal, Udo; Koester, Ralph; Mahnken, Andreas H; Koops, Andreas; Adam, Gerhard; Grass, Michael; Nolte-Ernsting, Claus

2007-08-01

A calcium-scoring phantom with hydroxyapatite-filled cylindrical holes (0.5 to 4 mm) was used. High-resolution scans were performed for an accuracy baseline. The phantom was mounted to a moving heart phantom. Non-moving data with the implementation of an ECG-signal were acquired for different pitches (0.2/0.3), heart rates (60/80/95 bpm) and collimations (16 x 0.75/16 x 1.5 mm). Images were reconstructed with a cone-beam multi-cycle algorithm at a standard thickness/increment of 3 mm/1.5 mm and the thinnest possible thickness (0.8/0.4 and 2/1). Subsequently, ECG-gated moving calcium-scoring phantom data were acquired. The calcium volume and Agatston score were measured. The temporal resolution and reconstruction cycles were calculated. High-resolution scans determine the calcium volume with a high accuracy (mean overestimation, 0.8%). In the non-moving measurements, the volume underestimation ranged from about 6% (16 x 0.75 mm; 0.8/0.4 mm) to nearly 25% (16 x 1.5 mm; 3/1.5 mm). Moving scans showed increased measurement errors depending on the reconstructed RR interval, collimation, pitch, heart rate and gantry rotation time. Also, a correlation with the temporal resolution could be found. The reliability of calcium-scoring results can be improved with the use of a narrower collimation, a lower pitch and the reconstruction of thinner images, resulting in higher patient doses. The choice of the correct cardiac phase within the RR interval is essential to minimize measurement errors.

Evaluating oxidation-reduction properties of dissolved organic matter from Chinese milk vetch (Astragalus sinicus L.): a comprehensive multi-parametric study.

PubMed

Liu, Yong; Lou, Jun; Li, Fang-Bai; Xu, Jian-Ming; Yu, Xiong-Sheng; Zhu, Li-An; Wang, Feng

2014-08-01

Green manuring is a common practice in replenishment of soil organic matter and nutrients in rice paddy field. Owing to the complex interplay of multiple factors, the oxidation--reduction (redox) properties of dissolved organic matter (DOM) from green manure crops are presently not fully understood. In this study, a variety of surrogate parameters were used to evaluate the redox capacity and redox state of DOM derived from Chinese milk vetch (CMV, Astragalus sinicus L.) via microbial decomposition under continuously flooded (CF) and non-flooded (NF) conditions. Additionally, the correlation between the surrogate parameters of CMV-DOM and the kinetic parameters of relevant redox reactions was evaluated in a soil-water system containing CMV-DOM. Results showed that the redox properties of CMV-DOM were substantially different between the fresh and decomposed CMV-DOM treatments. Determination of the surrogate parameters via ultraviolet-visible/Fourier transform infrared absorption spectroscopy and gel permeation chromatography generally provided high-quality data for predicting the redox capacity of CMV-DOM, while the surrogate parameters determined by elemental analysis were suitable for predicting the redox state of CMV-DOM. Depending on the redox capacity and redox state of various moieties/components, NF-decomposed CMV-DOM could easily accelerate soil reduction by shuttling electrons to iron oxides, because it contained more reversible redox-active functional groups (e.g. quinone and hydroquinone pairs) than CF-decomposed CMV-DOM. This work demonstrates that a single index cannot interpret complex changes in multiple factors that jointly determine the redox reactivity of CMV-DOM. Thus, a multi-parametric study is needed for providing comprehensive information on the redox properties of green manure DOM.

Multi-modality Imaging: Bird's eye view from the 2015 American Heart Association Scientific Sessions.

PubMed

Einstein, Andrew J; Lloyd, Steven G; Chaudhry, Farooq A; AlJaroudi, Wael A; Hage, Fadi G

2016-04-01

Multiple novel studies were presented at the 2015 American Heart Association Scientific Sessions which was considered a successful conference at many levels. In this review, we will summarize key studies in nuclear cardiology, cardiac magnetic resonance, echocardiography, and cardiac computed tomography that were presented at the Sessions. We hope that this bird's eye view will keep readers updated on the newest imaging studies presented at the meeting whether or not they were able to attend the meeting.

Automatic segmentation of the left ventricle cavity and myocardium in MRI data.

PubMed

Lynch, M; Ghita, O; Whelan, P F

2006-04-01

A novel approach for the automatic segmentation has been developed to extract the epi-cardium and endo-cardium boundaries of the left ventricle (lv) of the heart. The developed segmentation scheme takes multi-slice and multi-phase magnetic resonance (MR) images of the heart, transversing the short-axis length from the base to the apex. Each image is taken at one instance in the heart's phase. The images are segmented using a diffusion-based filter followed by an unsupervised clustering technique and the resulting labels are checked to locate the (lv) cavity. From cardiac anatomy, the closest pool of blood to the lv cavity is the right ventricle cavity. The wall between these two blood-pools (interventricular septum) is measured to give an approximate thickness for the myocardium. This value is used when a radial search is performed on a gradient image to find appropriate robust segments of the epi-cardium boundary. The robust edge segments are then joined using a normal spline curve. Experimental results are presented with very encouraging qualitative and quantitative results and a comparison is made against the state-of-the art level-sets method.

A multi-state approach to patients affected by chronic heart failure : The value added by administrative data.

PubMed

Grossetti, Francesco; Ieva, Francesca; Paganoni, Anna Maria

2018-06-01

Healthcare administrative databases are becoming more and more important and reliable sources of clinical and epidemiological information. They are able to track several interactions between a patient and the public healthcare system. In the present study, we make use of data extracted from the administrative data warehouse of Regione Lombardia, a region located in the northern part of Italy whose capital is Milan. Data are within a project aiming at providing a description of the epidemiology of Heart Failure (HF) patients at regional level, to profile health service utilization over time, and to investigate variations in patient care according to geographic area, socio-demographic characteristic and other clinical variables. We use multi-state models to estimate the probability of transition from (re)admission to discharge and death adjusting for covariates which are state dependent. To the best of our knowledge, this is the first Italian attempt of investigating which are the effects of pharmacological and outpatient cares covariates on patient's readmissions and death. This allows to better characterise disease progression and possibly identify what are the main determinants of a hospital admission and death in patients with Heart Failure.

MIMIC II: a massive temporal ICU patient database to support research in intelligent patient monitoring

NASA Technical Reports Server (NTRS)

Saeed, M.; Lieu, C.; Raber, G.; Mark, R. G.

2002-01-01

Development and evaluation of Intensive Care Unit (ICU) decision-support systems would be greatly facilitated by the availability of a large-scale ICU patient database. Following our previous efforts with the MIMIC (Multi-parameter Intelligent Monitoring for Intensive Care) Database, we have leveraged advances in networking and storage technologies to develop a far more massive temporal database, MIMIC II. MIMIC II is an ongoing effort: data is continuously and prospectively archived from all ICU patients in our hospital. MIMIC II now consists of over 800 ICU patient records including over 120 gigabytes of data and is growing. A customized archiving system was used to store continuously up to four waveforms and 30 different parameters from ICU patient monitors. An integrated user-friendly relational database was developed for browsing of patients' clinical information (lab results, fluid balance, medications, nurses' progress notes). Based upon its unprecedented size and scope, MIMIC II will prove to be an important resource for intelligent patient monitoring research, and will support efforts in medical data mining and knowledge-discovery.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shirai, Katsuyuki, E-mail: katu.shirai@gmail.com; Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi; Tamaki, Yoshio

Purpose: To investigate the dose-volume histogram parameters and clinical factors as predictors of pleural effusion in esophageal cancer patients treated with concurrent chemoradiotherapy (CRT). Methods and Materials: Forty-three esophageal cancer patients treated with definitive CRT from January 2001 to March 2007 were reviewed retrospectively on the basis of the following criteria: pathologically confirmed esophageal cancer, available computed tomography scan for treatment planning, 6-month follow-up after CRT, and radiation dose {>=}50 Gy. Exclusion criteria were lung metastasis, malignant pleural effusion, and surgery. Mean heart dose, mean total lung dose, and percentages of heart or total lung volume receiving {>=}10-60 Gy (Heart-V{submore » 10} to V{sub 60} and Lung-V{sub 10} to V{sub 60}, respectively) were analyzed in relation to pleural effusion. Results: The median follow-up time was 26.9 months (range, 6.7-70.2) after CRT. Of the 43 patients, 15 (35%) developed pleural effusion. By univariate analysis, mean heart dose, Heart-V{sub 10} to V{sub 60}, and Lung-V{sub 50} to V{sub 60} were significantly associated with pleural effusion. Poor performance status, primary tumor of the distal esophagus, and age {>=}65 years were significantly related with pleural effusion. Multivariate analysis identified Heart-V{sub 50} as the strongest predictive factor for pleural effusion (p = 0.01). Patients with Heart-V{sub 50} <20%, 20%{<=} Heart-V{sub 50} <40%, and Heart-V{sub 50} {>=}40% had 6%, 44%, and 64% of pleural effusion, respectively (p < 0.01). Conclusion: Heart-V{sub 50} is a useful parameter for assessing the risk of pleural effusion and should be reduced to avoid pleural effusion.« less

Optimizing risk stratification in heart failure and the selection of candidates for heart transplantation.

PubMed

Pereira-da-Silva, Tiago; M Soares, Rui; Papoila, Ana Luísa; Pinto, Iola; Feliciano, Joana; Almeida-Morais, Luís; Abreu, Ana; Cruz Ferreira, Rui

2018-02-01

Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejection fraction ≤40% prospectively underwent a comprehensive baseline assessment including clinical, laboratory, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters. All patients were followed for 60 months. The combined endpoint was cardiac death, urgent heart transplantation or need for mechanical circulatory support, up to 36 months. In the 263 enrolled patients (75% male, age 54±12 years), 54 events occurred. The independent predictors of adverse outcome were ventilatory efficiency (VE/VCO 2 ) slope (HR 1.14, 95% CI 1.11-1.18), creatinine level (HR 2.23, 95% CI 1.14-4.36), and left ventricular ejection fraction (HR 0.96, 95% CI 0.93-0.99). VE/VCO 2 slope was the most accurate risk predictor at any follow-up time analyzed (up to 60 months). The threshold of 39.0 yielded high specificity (97%), discriminated a worse or better prognosis than that reported for post-heart transplantation, and outperformed peak oxygen consumption thresholds of 10.0 or 12.0 ml/kg/min. For low-risk patients (VE/VCO 2 slope <39.0), sodium and creatinine levels and variations in end-tidal carbon dioxide partial pressure on exercise identified those with excellent prognosis. VE/VCO 2 slope was the most accurate parameter for risk stratification in patients with heart failure and reduced ejection fraction. Those with VE/VCO 2 slope ≥39.0 may benefit from heart transplantation. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Multivariate Normal Tissue Complication Probability Modeling of Heart Valve Dysfunction in Hodgkin Lymphoma Survivors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cella, Laura, E-mail: laura.cella@cnr.it; Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples; Liuzzi, Raffaele

Purpose: To establish a multivariate normal tissue complication probability (NTCP) model for radiation-induced asymptomatic heart valvular defects (RVD). Methods and Materials: Fifty-six patients treated with sequential chemoradiation therapy for Hodgkin lymphoma (HL) were retrospectively reviewed for RVD events. Clinical information along with whole heart, cardiac chambers, and lung dose distribution parameters was collected, and the correlations to RVD were analyzed by means of Spearman's rank correlation coefficient (Rs). For the selection of the model order and parameters for NTCP modeling, a multivariate logistic regression method using resampling techniques (bootstrapping) was applied. Model performance was evaluated using the area under themore » receiver operating characteristic curve (AUC). Results: When we analyzed the whole heart, a 3-variable NTCP model including the maximum dose, whole heart volume, and lung volume was shown to be the optimal predictive model for RVD (Rs = 0.573, P<.001, AUC = 0.83). When we analyzed the cardiac chambers individually, for the left atrium and for the left ventricle, an NTCP model based on 3 variables including the percentage volume exceeding 30 Gy (V30), cardiac chamber volume, and lung volume was selected as the most predictive model (Rs = 0.539, P<.001, AUC = 0.83; and Rs = 0.557, P<.001, AUC = 0.82, respectively). The NTCP values increase as heart maximum dose or cardiac chambers V30 increase. They also increase with larger volumes of the heart or cardiac chambers and decrease when lung volume is larger. Conclusions: We propose logistic NTCP models for RVD considering not only heart irradiation dose but also the combined effects of lung and heart volumes. Our study establishes the statistical evidence of the indirect effect of lung size on radio-induced heart toxicity.« less

Heart rate turbulence after ventricular premature beats in healthy Doberman pinschers and those with dilated cardiomyopathy.

PubMed

Harris, J D; Little, C J L; Dennis, J M; Patteson, M W

2017-10-01

To describe the measurement of heart rate turbulence (HRT) after ventricular premature beats and compare HRT in healthy Doberman pinschers and those with dilated cardiomyopathy (DCM), with and without congestive heart failure (CHF). Sixty-five client-owned Dobermans: 20 healthy (NORMAL), 31 with preclinical DCM and 14 with DCM and CHF (DCM + CHF). A retrospective study of data retrieved from clinical records and ambulatory ECG (Holter) archives, including data collected previously for a large-scale prospective study of Dobermans with preclinical DCM. Holter data were reanalysed quantitatively, including conventional time-domain heart rate variability and the HRT parameters turbulence onset and turbulence slope. Heart rate turbulence could be measured in 58/65 dogs. Six Holter recordings had inadequate ventricular premature contractions (VPCs) and one exhibited VPCs too similar to sinus morphology. Heart rate turbulence parameter, turbulence onset, was significantly reduced in DCM dogs, whereas conventional heart rate variability measures were not. Heart rate variability and HRT markers were reduced in DCM + CHF dogs as expected. Heart rate turbulence can be measured from the majority of good quality standard canine 24-hour Holter recordings with >5 VPCs. Turbulence onset is significantly reduced in Dobermans with preclinical DCM which indicates vagal withdrawal early in the course of disease. Heart rate turbulence is a powerful prognostic indicator in human cardiac disease which can be measured from standard 24-hour ambulatory ECG (Holter) recordings using appropriate computer software. Further studies are warranted to assess whether HRT may be of prognostic value in dogs with preclinical DCM and in other canine cardiac disease. Copyright © 2017 Elsevier B.V. All rights reserved.

Cardiac autonomic profile in different sports disciplines during all-day activity.

PubMed

Sztajzel, J; Jung, M; Sievert, K; Bayes De Luna, A

2008-12-01

Physical training and sport activity have a beneficial effect on cardiac autonomic activity. However, the exact impact of different types of sports disciplines on cardiac autonomic function is still unclear. The aim of this study was to evaluate the cardiac autonomic profile in different sports discplines and to determine their impact on cardiac autonomic function by using heart rate variability (HRV), a noninvasive electrocardiographic (ECG) analysis of the sympatho-vagal balance. Temporal and spectral HRV parameters determined from 24-hour continuous ECG monitoring were studied in 40 subjects, including 12 endurance athletes, 14 hockey players and 14 untrained male volunteers (control group). Each participant had to wear a Holter recorder during 24 hours and to continue his everyday activities. All HRV parameters were compared between the 3 study groups. All heart rate values were lower and all parasympathetic-related time domain indices, including root mean square of successive differences (RMSSD) and pNN50 (NN50 count divided by the total number of all NN intervals), were higher in both athletes groups as compared with controls (P<0.05). However, standard deviation of all NN intervals (SDNN) values, which determine global HRV, were significantly higher only in endurance athletes (P<0.05). Furthermore, the power spectral components low frequency (LF), a mixture of both autonomic inputs, and HF (high frequency), a marker of vagal modulation, were significantly higher with a resulting lower LF/HF ratio in both athletes groups as compared to controls (P<0.05). Both endurance and team playing athletic activity induce during all-day a high parasympathetic tone (higher RMSSD, pNN50 and HF, and lower LF/HF ratio). However, only endurance athletic activity has a particularly high global HRV (higher SDNN), indicating thereby that this type sports discipline may have a more substantially favorable effect on the cardiac autonomic profile.

First report of 90-day support of 2 calves with a continuous-flow total artificial heart.

PubMed

Karimov, Jamshid H; Moazami, Nader; Kobayashi, Mariko; Sale, Shiva; Such, Kimberly; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Gao, Shengqiang; Kuban, Barry; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-09-01

The Cleveland Clinic continuous-flow total artificial heart (CFTAH) is a compact, single-piece, valveless, pulsatile pump providing self-regulated hemodynamic output to left/right circulation. We evaluated chronic in vivo pump performance, physiologic and hemodynamic parameters, and biocompatibility of the CFTAH in a well-established calf model. CFTAH pumps have been implanted in 17 calves total. Hemodynamic parameters, pump performance, and device-related adverse events were evaluated during studies and at necropsy. In vivo experiments demonstrated good hemodynamic performance (pump flow, 7.3 ± 0.7 L/min; left atrial pressure, 16 ± 3 mm Hg; right atrial pressure, 17 ± 3 mm Hg; right atrial pressure-left atrial pressure difference, 1 ± 2 mm Hg; mean arterial pressure, 103 ± 7 mm Hg; arterial pulse pressure, 30 ± 11 mm Hg; and pulmonary arterial pressure, 34 ± 5 mm Hg). The CFTAH has operated within design specifications and never failed. With ever-improving pump design, the implants have shown no chronic hemolysis. Three animals with recent CFTAH implantation recovered well, with no postoperative anticoagulation, during planned in vivo durations of 30, 90, and 90 days (last 2 were intended to be 90-day studies). All these longest-surviving cases showed good biocompatibility, with no thromboembolism in organs. The current CFTAH has demonstrated reliable self-regulation of hemodynamic output and acceptable biocompatibility without anticoagulation throughout 90 days of chronic implantation in calves. Meeting these milestones is in accord with our strategy to achieve transfer of this unique technology to human surgical practice, thus filling the urgent need for cardiac replacement devices as destination therapy. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Geopotential Field Anomaly Continuation with Multi-Altitude Observations

NASA Technical Reports Server (NTRS)

Kim, Jeong Woo; Kim, Hyung Rae; von Frese, Ralph; Taylor, Patrick; Rangelova, Elena

2012-01-01

Conventional gravity and magnetic anomaly continuation invokes the standard Poisson boundary condition of a zero anomaly at an infinite vertical distance from the observation surface. This simple continuation is limited, however, where multiple altitude slices of the anomaly field have been observed. Increasingly, areas are becoming available constrained by multiple boundary conditions from surface, airborne, and satellite surveys. This paper describes the implementation of continuation with multi-altitude boundary conditions in Cartesian and spherical coordinates and investigates the advantages and limitations of these applications. Continuations by EPS (Equivalent Point Source) inversion and the FT (Fourier Transform), as well as by SCHA (Spherical Cap Harmonic Analysis) are considered. These methods were selected because they are especially well suited for analyzing multi-altitude data over finite patches of the earth such as covered by the ADMAP database. In general, continuations constrained by multi-altitude data surfaces are invariably superior to those constrained by a single altitude data surface due to anomaly measurement errors and the non-uniqueness of continuation.

Geopotential Field Anomaly Continuation with Multi-Altitude Observations

NASA Technical Reports Server (NTRS)

Kim, Jeong Woo; Kim, Hyung Rae; vonFrese, Ralph; Taylor, Patrick; Rangelova, Elena

2011-01-01

Conventional gravity and magnetic anomaly continuation invokes the standard Poisson boundary condition of a zero anomaly at an infinite vertical distance from the observation surface. This simple continuation is limited, however, where multiple altitude slices of the anomaly field have been observed. Increasingly, areas are becoming available constrained by multiple boundary conditions from surface, airborne, and satellite surveys. This paper describes the implementation of continuation with multi-altitude boundary conditions in Cartesian and spherical coordinates and investigates the advantages and limitations of these applications. Continuations by EPS (Equivalent Point Source) inversion and the FT (Fourier Transform), as well as by SCHA (Spherical Cap Harmonic Analysis) are considered. These methods were selected because they are especially well suited for analyzing multi-altitude data over finite patches of the earth such as covered by the ADMAP database. In general, continuations constrained by multi-altitude data surfaces are invariably superior to those constrained by a single altitude data surface due to anomaly measurement errors and the non-uniqueness of continuation.

The treatment with pyridostigmine improves the cardiocirculatory function in rats with chronic heart failure.

PubMed

Sabino, João Paulo J; da Silva, Carlos Alberto Aguiar; de Melo, Rubens Fernando; Fazan, Rubens; Salgado, Helio C

2013-01-01

Sympathetic hyperactivity and its outcome in heart failure have been thoroughly investigated to determine the focus of pharmacologic approaches targeting the sympathetic nervous system in the treatment of this pathophysiological condition. On the other hand, therapeutic approaches aiming to protect the reduced cardiac parasympathetic function have not received much attention. The present study evaluated rats with chronic heart failure (six to seven weeks after coronary artery ligation) and the effects of an increased parasympathetic function by pyridostigmine (an acetylcholinesterase inhibitor) on the following aspects: arterial pressure (AP), heart rate (HR), baroreceptor and Bezold-Jarisch reflex, pulse interval (PI) and AP variability, cardiac sympathetic and parasympathetic tonus, intrinsic heart rate (i-HR) and cardiac function. Conscious rats with heart failure exhibited no change in HR, Bezold-Jarisch reflex, PI variability and cardiac sympathetic tonus. On the other hand, these animals presented hypotension and reduced baroreflex sensitivity, power in the low frequency (LF) band of the systolic AP spectrum, cardiac parasympathetic tonus and i-HR, while anesthetized rats exhibited reduced cardiac performance. Pyridostigmine prevented the attenuation of all the parameters examined, except basal AP and cardiac performance. In conclusion, the blockade of acetylcholinesterase with pyridostigmine was revealed to be an important pharmacological approach, which could be used to increase parasympathetic function and to improve a number of cardiocirculatory parameters in rats with heart failure. Copyright © 2012 Elsevier B.V. All rights reserved.

Expansion of the Multi-Link Frontier™ Coronary Bifurcation Stent: Micro-Computed Tomographic Assessment in Human Autopsy and Porcine Heart Samples

PubMed Central

Kralev, Stefan; Haag, Benjamin; Spannenberger, Jens; Lang, Siegfried; Brockmann, Marc A.; Bartling, Soenke; Marx, Alexander; Haase, Karl-Konstantin; Borggrefe, Martin; Süselbeck, Tim

2011-01-01

Background Treatment of coronary bifurcation lesions remains challenging, beyond the introduction of drug eluting stents. Dedicated stent systems are available to improve the technical approach to the treatment of these lesions. However dedicated stent systems have so far not reduced the incidence of stent restenosis. The aim of this study was to assess the expansion of the Multi-Link (ML) Frontier™ stent in human and porcine coronary arteries to provide the cardiologist with useful in-vitro information for stent implantation and selection. Methodology/Principal Findings Nine ML Frontier™ stents were implanted in seven human autopsy heart samples with known coronary artery disease and five ML Frontier™ stents were implanted in five porcine hearts. Proximal, distal and side branch diameters (PD, DD, SBD, respectively), corresponding opening areas (PA, DA, SBA) and the mean stent length (L) were assessed by micro-computed tomography (micro-CT). PD and PA were significantly smaller in human autopsy heart samples than in porcine heart samples (3.54±0.47 mm vs. 4.04±0.22 mm, p = 0.048; 10.00±2.42 mm2 vs. 12.84±1.38 mm2, p = 0.034, respectively) and than those given by the manufacturer (3.54±0.47 mm vs. 4.03 mm, p = 0.014). L was smaller in human autopsy heart samples than in porcine heart samples, although data did not reach significance (16.66±1.30 mm vs. 17.30±0.51 mm, p = 0.32), and significantly smaller than that given by the manufacturer (16.66±1.30 mm vs. 18 mm, p = 0.015). Conclusions/Significance Micro-CT is a feasible tool for exact surveying of dedicated stent systems and could make a contribution to the development of these devices. The proximal diameter and proximal area of the stent system were considerably smaller in human autopsy heart samples than in porcine heart samples and than those given by the manufacturer. Special consideration should be given to the stent deployment procedure (and to the follow-up) of dedicated stent systems, considering final intravascular ultrasound or optical coherence tomography to visualize (and if necessary optimize) stent expansion. PMID:21814552

Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol.

PubMed

Zuazagoitia, Ana; Grandes, Gonzalo; Torcal, Jesús; Lekuona, Iñaki; Echevarria, Pilar; Gómez, Manuel A; Domingo, Mar; de la Torre, Maria M; Ramírez, Jose I; Montoya, Imanol; Oyanguren, Juana; Pinilla, Ricardo Ortega-Sánchez

2010-01-25

Quality of life (QoL) decreases as heart failure worsens, which is one of the greatest worries of these patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR), additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and control of cardiovascular risk factors. Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network (redIAPP), patients are followed for 1 year after the beginning of the intervention. Both groups receive the optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals) and a strength component; and the programme continues linked with community resources for 9 months. The main outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides), muscle strength and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential confounding and predictor variables. A key challenges of this study is to guarantee the safety of the patients; however, the current scientific evidence supports the notion of there being no increase in the risk of decompensation, cardiac events, hospitalizations and deaths associated with exercise, but rather the opposite. Safety assurance will be based on an optimized standardised pharmacological therapy and health education for all the participants. Clinical Trials.gov Identifier: NCT01033591.

Left ventricular, systemic arterial, and baroreflex responses to ketamine and TEE in chronically instrumented monkeys

NASA Technical Reports Server (NTRS)

Koenig, S. C.; Ludwig, D. A.; Reister, C.; Fanton, J. W.; Ewert, D.; Convertino, V. A.

2001-01-01

Effects of prescribed doses of ketamine five minutes after application and influences of transesophageal echocardiography (TEE) on left ventricular, systemic arterial, and baroreflex responses were investigated to test the hypothesis that ketamine and/or TEE probe insertion alter cardiovascular function. Seven rhesus monkeys were tested under each of four randomly selected experimental conditions: (1) intravenous bolus dose of ketamine (0.5 ml), (2) continuous infusion of ketamine (500 mg/kg/min), (3) continuous infusion of ketamine (500 mg/kg/min) with TEE, and (4) control (no ketamine or TEE). Monkeys were chronically instrumented with a high fidelity, dual-sensor micromanometer to measure left ventricular and aortic pressure and a transit-time ultrasound probe to measure aortic flow. These measures were used to calculate left ventricular function. A 4-element Windkessel lumped-parameter model was used to estimate total peripheral resistance and systemic arterial compliance. Baroreflex response was calculated as the change in R-R interval divided by the change in mean aortic pressure measured during administration of graded concentrations of nitroprusside. The results indicated that five minutes after ketamine application heart rate and left ventricular diastolic compliance decreased while TEE increased aortic systolic and diastolic pressure. We conclude that ketamine may be administered as either a bolus or continuous infusion without affecting cardiovascular function 5 minutes after application while the insertion of a TEE probe will increase aortic pressure. The results for both ketamine and TEE illustrate the classic "Hawthorne Effect," where the observed values are partly a function of the measurement process. Measures of aortic pressure, heart rate, and left ventricular diastolic pressure should be viewed as relative, as opposed to absolute, when organisms are sedated with ketamine or instrumented with a TEE probe.

Ride comfort analysis with physiological parameters for an e-health train.

PubMed

Lee, Youngbum; Shin, Kwangsoo; Lee, Sangjoon; Song, Yongsoo; Han, Sungho; Lee, Myoungho

2009-12-01

Transportation by train has numerous advantages over road transportation, especially with regard to energy efficiency, ecological features, safety, and punctuality. However, the contrast in ride comfort between standard road transportation and train travel has become a competitive issue. The ride comfort enhancement technology of tilting trains (TTX) is a particularly important issue in the development of the Korean high-speed railroad business. Ride comfort is now defined in international standards such as UIC13 and ISO2631. The Korean standards such as KSR9216 mainly address physical parameters such as vibration and noise. In the area of ride comfort, living quality parameter techniques have recently been considered in Korea, Japan, and Europe. This study introduces biological parameters, particularly variations in heart rate, as a more direct measure of comfort. Biological parameters are based on physiological responses rather than on purely external mechanical parameters. Variability of heart rate and other physiological parameters of passengers are measured in a simulation involving changes in the tilting angle of the TTX. This research is a preliminary study for the implementation of an e-health train, which would provide passengers with optimized ride comfort. The e-health train would also provide feedback on altered ride comfort situations that can improve a passenger's experience and provide a healthcare service on the train. The aim of this research was to develop a ride comfort evaluation system for the railway industry, the automobile industry, and the air industry. The degree of tilt correlated with heart rate, fatigue, and unrelieved alertness.

Evaluation for Bearing Wear States Based on Online Oil Multi-Parameters Monitoring

PubMed Central

Hu, Hai-Feng

2018-01-01

As bearings are critical components of a mechanical system, it is important to characterize their wear states and evaluate health conditions. In this paper, a novel approach for analyzing the relationship between online oil multi-parameter monitoring samples and bearing wear states has been proposed based on an improved gray k-means clustering model (G-KCM). First, an online monitoring system with multiple sensors for bearings is established, obtaining oil multi-parameter data and vibration signals for bearings through the whole lifetime. Secondly, a gray correlation degree distance matrix is generated using a gray correlation model (GCM) to express the relationship of oil monitoring samples at different times and then a KCM is applied to cluster the matrix. Analysis and experimental results show that there is an obvious correspondence that state changing coincides basically in time between the lubricants’ multi-parameters and the bearings’ wear states. It also has shown that online oil samples with multi-parameters have early wear failure prediction ability for bearings superior to vibration signals. It is expected to realize online oil monitoring and evaluation for bearing health condition and to provide a novel approach for early identification of bearing-related failure modes. PMID:29621175

Evaluation for Bearing Wear States Based on Online Oil Multi-Parameters Monitoring.

PubMed

Wang, Si-Yuan; Yang, Ding-Xin; Hu, Hai-Feng

2018-04-05

As bearings are critical components of a mechanical system, it is important to characterize their wear states and evaluate health conditions. In this paper, a novel approach for analyzing the relationship between online oil multi-parameter monitoring samples and bearing wear states has been proposed based on an improved gray k-means clustering model (G-KCM). First, an online monitoring system with multiple sensors for bearings is established, obtaining oil multi-parameter data and vibration signals for bearings through the whole lifetime. Secondly, a gray correlation degree distance matrix is generated using a gray correlation model (GCM) to express the relationship of oil monitoring samples at different times and then a KCM is applied to cluster the matrix. Analysis and experimental results show that there is an obvious correspondence that state changing coincides basically in time between the lubricants' multi-parameters and the bearings' wear states. It also has shown that online oil samples with multi-parameters have early wear failure prediction ability for bearings superior to vibration signals. It is expected to realize online oil monitoring and evaluation for bearing health condition and to provide a novel approach for early identification of bearing-related failure modes.