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Sample records for maternal heart sound

  1. Maternal sounds elicit lower heart rate in preterm newborns in the first month of life

    PubMed Central

    Rand, Katherine; Lahav, Amir

    2015-01-01

    Background The preferential response to mother’s voice in the fetus and term newborn is well documented. However, the response of preterm neonates is not well understood and more difficult to interpret due to the intensive clinical care and range of medical complications. Aim This study examined the physiological response to maternal sounds and its sustainability in the first month of life in infants born very pretermaturely. Methods Heart rate changes were monitored in 20 hospitalized preterm infants born between 25 and 32 weeks of gestation during 30-minute exposure vs. non-exposure periods of recorded maternal sounds played inside the Neonatal incubator. A total of 13,680 min of HR data was sampled throughout the first month of life during gavage feeds Heart rate with and without exposure to maternal sounds. Results During exposure periods, infants had significantly lower heart rate compared to matched periods of care Auditory without exposure on the same day (p < .0001). This effect was observed in all infants, across the first month of life, irrespective of day of life, gestational age at birth, birth weight, age at testing, Apgar score, caffeine therapy, and requirement for respiratory support. No adverse effects were observed. Conclusion Preterm newborns responded to maternal sounds with decreased heart rate throughout the first month of life. It is possible that maternal sounds improve autonomic stability and provide a more relaxing environment for this population of newborns. Further studies are needed to determine the therapeutic implications of maternal sound exposure for optimizing care practices and developmental outcomes. PMID:25194837

  2. The maverick heart sound.

    PubMed

    Witt, Chance M; Miranda, William R; Newman, Darrell B

    2016-07-01

    An asymptomatic 29-year-old woman presented for prenatal counselling. She had a history of a heart murmur since childhood and a previous echocardiogram suggesting 'enlargement of the heart'. Physical exam revealed normal jugular venous pressure and contour. Precordial palpation was unremarkable. Auscultation, however, was abnormal; findings on inspiration and expiration are presented in Figure 1, sound clip. Based on the phonocardiogram and online supplementary audio clip, which of the following is correct? An early diastolic filling sound (S3) is heard, indicating increased right ventricular filling pressures.An ejection click without respiratory variation and a systolic ejection murmur are heard, consistent with bicuspid aortic valve stenosis.An ejection click with respiratory variation and a systolic ejection murmur are heard, consistent with pulmonic valve stenosis.A holosystolic murmur with inspiratory augmentation is heard, indicating tricuspid regurgitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Heart sounds: are you listening? Part 2.

    PubMed

    Reimer-Kent, Jocelyn

    2013-01-01

    The first of this two-part article on heart sounds was in the Spring 2013 issue of the Canadian Journal of Cardiovascular Nursing (Reimer-Kent, 2013). Part 1 emphasized the importance of all nurses having an understanding of heart sounds and being proficient in cardiac auscultation. The article also focused on an overview of the fundamentals of cardiac auscultation and basic heart sounds. This article provides an overview of the anatomy and pathophysiology related to valvular heart disease and describes the array of heart sounds associated with stenotic or regurgitant aortic and mitral valve conditions.

  4. Heart sound and lung sound separation algorithms: a review.

    PubMed

    Nersisson, Ruban; Noel, Mathew M

    2017-01-01

    Breath and cardiac sounds are two major bio sound signals. In this, heart sounds are produced by movement of some body parts such as heart valve, leaflets and the blood flow through the vessels, whereas lung sounds generates due to the air in and out flow through airways during breathing cycle. These two signals are recorded from chest region. These two signals have very high clinical importance for the patient who is critically ill. The lung functions and the cardiac cycles are continuously monitored for such patients with the help of the bio sound signal captured using suitable sensing mechanism or with auscultation techniques. But these two signals mostly superimpose with each other, so the separation of these heart sound signals (HSS) and the lung sound signals (LSS) is of great research interest. There are so many different techniques proposed for this purpose. In this paper, a study is carried out on different algorithms used for the separation of HSS from LSS, and also the results of major four separation algorithms are compared.

  5. Heart sounds: are you listening? Part 1.

    PubMed

    Reimer-Kent, Jocelyn

    2013-01-01

    All nurses should have an understanding of heart sounds and be proficient in cardiac auscultation. Unfortunately, this skill is not part of many nursing school curricula, nor is it necessarily a required skillfor employment. Yet, being able to listen and accurately describe heart sounds has tangible benefits to the patient, as it is an integral part of a complete cardiac assessment. In this two-part article, I will review the fundamentals of cardiac auscultation, how cardiac anatomy and physiology relate to heart sounds, and describe the various heart sounds. Whether you are a beginner or a seasoned nurse, it is never too early or too late to add this important diagnostic skill to your assessment tool kit.

  6. Denoising method of heart sound signals based on self-construct heart sound wavelet

    NASA Astrophysics Data System (ADS)

    Cheng, Xiefeng; Zhang, Zheng

    2014-08-01

    In the field of heart sound signal denoising, the wavelet transform has become one of the most effective measures. The selective wavelet basis is based on the well-known orthogonal db series or biorthogonal bior series wavelet. In this paper we present a self-construct wavelet basis which is suitable for the heart sound denoising and analyze its constructor method and features in detail according to the characteristics of heart sound and evaluation criterion of signal denoising. The experimental results show that the heart sound wavelet can effectively filter out the noise of the heart sound signals, reserve the main characteristics of the signal. Compared with the traditional wavelets, it has a higher signal-to-noise ratio, lower mean square error and better denoising effect.

  7. Frequency Dynamics of the First Heart Sound

    NASA Astrophysics Data System (ADS)

    Wood, John Charles

    Cardiac auscultation is a fundamental clinical tool but first heart sound origins and significance remain controversial. Previous clinical studies have implicated resonant vibrations of both the myocardium and the valves. Accordingly, the goals of this thesis were threefold, (1) to characterize the frequency dynamics of the first heart sound, (2) to determine the relative contribution of the myocardium and the valves in determining first heart sound frequency, and (3) to develop new tools for non-stationary signal analysis. A resonant origin for first heart sound generation was tested through two studies in an open-chest canine preparation. Heart sounds were recorded using ultralight acceleration transducers cemented directly to the epicardium. The first heart sound was observed to be non-stationary and multicomponent. The most dominant feature was a powerful, rapidly-rising frequency component that preceded mitral valve closure. Two broadband components were observed; the first coincided with mitral valve closure while the second significantly preceded aortic valve opening. The spatial frequency of left ventricular vibrations was both high and non-stationary which indicated that the left ventricle was not vibrating passively in response to intracardiac pressure fluctuations but suggested instead that the first heart sound is a propagating transient. In the second study, regional myocardial ischemia was induced by left coronary circumflex arterial occlusion. Acceleration transducers were placed on the ischemic and non-ischemic myocardium to determine whether ischemia produced local or global changes in first heart sound amplitude and frequency. The two zones exhibited disparate amplitude and frequency behavior indicating that the first heart sound is not a resonant phenomenon. To objectively quantify the presence and orientation of signal components, Radon transformation of the time -frequency plane was performed and found to have considerable potential for pattern

  8. Phonocardiograph system monitors heart sounds

    NASA Technical Reports Server (NTRS)

    1966-01-01

    Phonocardiograph system monitors the mechanical activity of the heart in extreme environments. It uses a piezoelectric-crystal microphone with an integral preamplifier, and a signal conditioner having special frequency characteristics. The output signals can be recorded on tape, presented aurally, or transmitted telemetrically to a remote station.

  9. 21 CFR 870.2860 - Heart sound transducer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Heart sound transducer. 870.2860 Section 870.2860...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2860 Heart sound transducer. (a) Identification. A heart sound transducer is an external transducer that exhibits a change...

  10. 21 CFR 870.2860 - Heart sound transducer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Heart sound transducer. 870.2860 Section 870.2860...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2860 Heart sound transducer. (a) Identification. A heart sound transducer is an external transducer that exhibits a change...

  11. 21 CFR 870.2860 - Heart sound transducer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Heart sound transducer. 870.2860 Section 870.2860...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2860 Heart sound transducer. (a) Identification. A heart sound transducer is an external transducer that exhibits a change...

  12. 21 CFR 870.2860 - Heart sound transducer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Heart sound transducer. 870.2860 Section 870.2860...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2860 Heart sound transducer. (a) Identification. A heart sound transducer is an external transducer that exhibits a change...

  13. 21 CFR 870.2860 - Heart sound transducer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Heart sound transducer. 870.2860 Section 870.2860...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2860 Heart sound transducer. (a) Identification. A heart sound transducer is an external transducer that exhibits a change...

  14. Maternal heart rate changes during labour.

    PubMed

    Söhnchen, N; Melzer, K; Tejada, B Martinez de; Jastrow-Meyer, N; Othenin-Girard, V; Irion, O; Boulvain, M; Kayser, B

    2011-10-01

    Labour and delivery represent a considerable effort for pregnant women. Lack of aerobic fitness may limit pushing efforts during childbirth and represents increased cardiovascular strain and risk. Increasing prevalence of sedentary behaviour and lack of aerobic fitness may reduce heart rate reserve during labour. We quantified maternal heart rate reserve (maximum heart rate minus resting heart rate) of 30 healthy pregnant women during labour and delivery and related it to habitual daily physical activity levels quantified during the third pregnancy trimester by the Pregnancy Physical Activity Questionnaire. Heart rates during labour reached values similar to those observed during moderate to heavy physical exercise. During active pushing one out of five women reached heart rates more than 90% of their heart rate reserve (188 ± 7 beats per min). Half of the women reached more than 70% of heart rate reserve (172 ± 14 beats per min). Physically inactive women used more of their heart rate reserve as physically more active women (87 ± 20% vs. 65 ± 12%, upper and lower tertile respectively, p<0.05). Use of heart rate reserve for the effort of labour is increased in physically inactive women and may potentially limit the intensity and duration of pushing efforts. Such higher cardiovascular strain in physically less active women may represent increased cardiovascular risk during labour. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Maternal valvular heart disease in pregnancy.

    PubMed

    Roeder, Hilary A; Kuller, Jeffrey A; Barker, Piers C A; James, Andra H

    2011-09-01

    Valvular heart disease is common in pregnancy. Maternal physiology changes significantly during gestation with substantial increases in cardiac output and blood volume; this can cause unmasking or worsening of cardiac disease. Acquired valvular lesions most frequently arise from rheumatic fever, especially in patients who have emigrated from developing nations. Congenital lesions are also encountered. The most common conditions seen, mitral stenosis and regurgitation and aortic stenosis and regurgitation, each require a specific evaluation and management and are associated with their own set of possible complications. Patients with prosthetic valves require anticoagulation, and maternal and fetal risks and benefits must be carefully weighed. Patients with heart disease should be meticulously managed preconceptionally up to the postpartum period by maternal-fetal medicine specialists, obstetricians, cardiologists, and anesthesiologists using a multi-disciplinary approach to their cardiac conditions. Obstetricians & Gynecologists and Family Physicians. After the completing the CME activity, physicians should be better able to examine the epidemiology of valvular heart disease in pregnancy, categorize key physiologic parameters that change in the cardiovascular system during pregnancy, classify the pathophysiology of valvular lesions, and evaluate the general principles of maternal and fetal management for cardiac disease.

  16. The loud first heart sound in left atrial myxoma.

    PubMed

    Gershlick, A H; Leech, G; Mills, P G; Leatham, A

    1984-10-01

    The interrelation between the loudness of the first heart sound, the time interval from the Q wave to the onset of the first heart sound (QM1), and the mitral valve closure rate was studied in nine patients presenting with left atrial myxomata. In seven patients the first heart sound was loud preoperatively and was associated with delayed mitral valve closure. After removal of the myxoma the onset of mitral valve closure returned towards normal, the mitral valve closure rate was reduced, and the first heart sound became softer. In two patients the first heart sound was normal before and after operation as were both the time of onset of mitral valve closure and the mitral valve closure rate. In neither of these patients did the myxoma completely fill the mitral orifice during diastole. The loud first heart sound in left atrial myxoma is a useful clinical sign, and intensity is directly related to the delay in onset of closure of mitral leaflets.

  17. 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.

  18. Design of the MEMS Piezoresistive Electronic Heart Sound Sensor.

    PubMed

    Zhang, Guojun; Liu, Mengran; Guo, Nan; Zhang, Wendong

    2016-11-07

    This paper proposes the electronic heart sound sensor, based on the piezoresistive principle and MEMS (Micro-Electro-Mechanical System) technology. Firstly, according to the characteristics of heart sound detection, the double-beam-block microstructure has been proposed, and the theoretical analysis and finite element method (FEM) simulation have been carried out. Combined with the natural frequency response of the heart sound (20~600 Hz), its structure sizes have been determined. Secondly, the processing technology of the microstructure with the stress concentration grooves has been developed. The material and sizes of the package have been determined by the three-layer medium transmission principle. Lastly, the MEMS piezoresistive electronic heart sound sensor has been tested compared with the 3200-type electronic stethoscope from 3M (São Paulo, MN, USA). The test results show that the heart sound waveform tested by the MEMS electronic heart sound sensor are almost the same as that tested by the 3200-type electronic stethoscope. Moreover, its signal-to-noise ratio is significantly higher. Compared with the traditional stethoscope, the MEMS heart sound sensor can provide the first and second heart sounds containing more abundant information about the lesion. Compared with the 3200-type electronic stethoscope from 3M, it has better performance and lower cost.

  19. Design of the MEMS Piezoresistive Electronic Heart Sound Sensor

    PubMed Central

    Zhang, Guojun; Liu, Mengran; Guo, Nan; Zhang, Wendong

    2016-01-01

    This paper proposes the electronic heart sound sensor, based on the piezoresistive principle and MEMS (Micro-Electro-Mechanical System) technology. Firstly, according to the characteristics of heart sound detection, the double-beam-block microstructure has been proposed, and the theoretical analysis and finite element method (FEM) simulation have been carried out. Combined with the natural frequency response of the heart sound (20~600 Hz), its structure sizes have been determined. Secondly, the processing technology of the microstructure with the stress concentration grooves has been developed. The material and sizes of the package have been determined by the three-layer medium transmission principle. Lastly, the MEMS piezoresistive electronic heart sound sensor has been tested compared with the 3200-type electronic stethoscope from 3M (São Paulo, MN, USA). The test results show that the heart sound waveform tested by the MEMS electronic heart sound sensor are almost the same as that tested by the 3200-type electronic stethoscope. Moreover, its signal-to-noise ratio is significantly higher. Compared with the traditional stethoscope, the MEMS heart sound sensor can provide the first and second heart sounds containing more abundant information about the lesion. Compared with the 3200-type electronic stethoscope from 3M, it has better performance and lower cost. PMID:27827981

  20. Maternal DNA hypomethylation and congenital heart defects

    PubMed Central

    Chowdhury, Shimul; Cleves, Mario A.; MacLeod, Stewart L.; James, S. Jill; Zhao, Weizhi; Hobbs, Charlotte A.

    2011-01-01

    Background Congenital heart defects (CHDs) are among the most prevalent and serious of birth defects. Multiple maternal factors are thought to contribute to CHD development including folate intake. Maternal DNA methylation, which is dependent on folate metabolism, may impact the risk of CHDs. Objective Our study was designed to determine whether maternal long interspersed nucleotide elements-1 (LINE-1) DNA hypomethylation is associated with increased occurrence of non-syndromic CHDs and whether maternal folate-dependent metabolites are correlated with DNA methylation status. Design Using a case-control study design, we measured global DNA methylation status among mothers whose pregnancies were affected by non-syndromic CHDs (n=180) and mothers of unaffected pregnancies (n=187). Methylation of LINE-1 was used as a surrogate marker of global DNA methylation status. The association between DNA methylation and CHD risk was determined while adjusting for selected lifestyle factors. Results LINE-1 DNA methylation was significantly lower in cases compared with controls (p=0.049). After covariate adjustments, a significant difference between cases and controls remained (p=0.010). Among women with LINE-1 methylation in the lowest decile of DNA methylation, the estimated risk of having a CHD-affected pregnancy was almost twice that of women in all other deciles (OR=1.91; 95% CI: 1.03, 3.58). Conclusions Our findings indicate that maternal LINE-1 DNA hypomethylation is associated with an increased risk of CHDs. Future studies investigating the association between maternal DNA methylation patterns and CHDs should be pursued. PMID:21254366

  1. Localizing heart sounds in respiratory signals using singular spectrum analysis.

    PubMed

    Ghaderi, Foad; Mohseni, Hamid R; Sanei, Saeid

    2011-12-01

    Respiratory sounds are always contaminated by heart sound interference. An essential preprocessing step in some of the heart sound cancellation methods is localizing primary heart sound components. Singular spectrum analysis (SSA), a powerful time series analysis technique, is used in this paper. Despite the frequency overlap of the heart and lung sound components, two different trends in the eigenvalue spectra are recognizable, which leads to find a subspace that contains more information about the underlying heart sound. Artificially mixed and real respiratory signals are used for evaluating the performance of the method. Selecting the appropriate length for the SSA window results in good decomposition quality and low computational cost for the algorithm. The results of the proposed method are compared with those of well-established methods, which use the wavelet transform and entropy of the signal to detect the heart sound components. The proposed method outperforms the wavelet-based method in terms of false detection and also correlation with the underlying heart sounds. Performance of the proposed method is slightly better than that of the entropy-based method. Moreover, the execution time of the former is significantly lower than that of the latter.

  2. Xinyinqin: a computer-based heart sound simulator.

    PubMed

    Zhan, X X; Pei, J H; Xiao, Y H

    1995-01-01

    "Xinyinqin" is the Chinese phoneticized name of the Heart Sound Simulator (HSS). The "qin" in "Xinyinqin" is the Chinese name of a category of musical instruments, which means that the operation of HSS is very convenient--like playing an electric piano with the keys. HSS is connected to the GAME I/O of an Apple microcomputer. The generation of sound is controlled by a program. Xinyinqin is used as a teaching aid of Diagnostics. It has been applied in teaching for three years. In this demonstration we will introduce the following functions of HSS: 1) The main program has two modules. The first one is the heart auscultation training module. HSS can output a heart sound selected by the student. Another program module is used to test the student's learning condition. The computer can randomly simulate a certain heart sound and ask the student to name it. The computer gives the student's answer an assessment: "correct" or "incorrect." When the answer is incorrect, the computer will output that heart sound again for the student to listen to; this process is repeated until she correctly identifies it. 2) The program is convenient to use and easy to control. By pressing the S key, it is able to output a slow heart rate until the student can clearly identify the rhythm. The heart rate, like the actual rate of a patient, can then be restored by hitting any key. By pressing the SPACE BAR, the heart sound output can be stopped to allow the teacher to explain something to the student. The teacher can resume playing the heart sound again by hitting any key; she can also change the content of the training by hitting RETURN key. In the future, we plan to simulate more heart sounds and incorporate relevant graphs.

  3. Heart Sound Biometric System Based on Marginal Spectrum Analysis

    PubMed Central

    Zhao, Zhidong; Shen, Qinqin; Ren, Fangqin

    2013-01-01

    This work presents a heart sound biometric system based on marginal spectrum analysis, which is a new feature extraction technique for identification purposes. This heart sound identification system is comprised of signal acquisition, pre-processing, feature extraction, training, and identification. Experiments on the selection of the optimal values for the system parameters are conducted. The results indicate that the new spectrum coefficients result in a significant increase in the recognition rate of 94.40% compared with that of the traditional Fourier spectrum (84.32%) based on a database of 280 heart sounds from 40 participants. PMID:23429515

  4. Heart sound biometric system based on marginal spectrum analysis.

    PubMed

    Zhao, Zhidong; Shen, Qinqin; Ren, Fangqin

    2013-02-18

    This work presents a heart sound biometric system based on marginal spectrum analysis, which is a new feature extraction technique for identification purposes. This heart sound identification system is comprised of signal acquisition, pre-processing, feature extraction, training, and identification. Experiments on the selection of the optimal values for the system parameters are conducted. The results indicate that the new spectrum coefficients result in a significant increase in the recognition rate of 94.40% compared with that of the traditional Fourier spectrum (84.32%) based on a database of 280 heart sounds from 40 participants. 

  5. A study of heart sound and lung sound separation by independent component analysis technique.

    PubMed

    Chien, Jen-Chien; Huang, Ming-Chuan; Lin, Yue-Der; Chong, Fok-ching

    2006-01-01

    In the hospital, using percussion and auscultation are the most common ways for physical examination. Recently, in order to develop tele-medicine and home care system and to assist physician getting better auscultation results; electric stethoscope and computer analysis have become an inevitable trend. However, two important physical signals heart sound and lung sound recorded from chest overlap on spectrum chart. Therefore, in order to reduce human factor (ex. misplace or untrained of using) and minimize correlated effect in computer analysis; it's necessary for separated heart sound and lung sound. Independent component analysis can divide these sounds efficiency. In this paper, we use two microphones to collect signals from left and right chest. We have successfully divide heart and lung sounds by fast ICA algorithm. Therefore, it can assist physician examine and also using on tele-medicine and home care by this way.

  6. Sound and vibration: effects on infants' heart rate and heart rate variability during neonatal transport.

    PubMed

    Karlsson, Björn-Markus; Lindkvist, Marie; Lindkvist, Markus; Karlsson, Marcus; Lundström, Ronnie; Håkansson, Stellan; Wiklund, Urban; van den Berg, Johannes

    2012-02-01

    To measure the effect of sound and whole-body vibration on infants' heart rate and heart rate variability during ground and air ambulance transport. Sixteen infants were transported by air ambulance with ground ambulance transport to and from the airports. Whole-body vibration and sound levels were recorded and heart parameters were obtained by ECG signal. Sound and whole-body vibration levels exceeded the recommended limits. Mean whole-body vibration and sound levels were 0.19 m/s(2) and 73 dBA, respectively. Higher whole-body vibration was associated with a lower heart rate (p < 0.05), and higher sound level was linked to a higher heart rate (p = 0.05). The heart rate variability was significantly higher at the end of the transport than at the beginning (p < 0.01). Poorer physiological status was associated with lower heart rate variability (p < 0.001) and a lower heart rate (p < 0.01). Infants wearing earmuffs had a lower heart rate (p < 0.05). Sound and whole-body vibration during neonatal transport exceed recommended levels for adults, and sound seem to have a more stressful effect on the infant than vibrations. Infants should wear earmuffs during neonatal transport because of the stress-reducing effect. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  7. Visualization of Heart Sounds and Motion Using Multichannel Sensor

    NASA Astrophysics Data System (ADS)

    Nogata, Fumio; Yokota, Yasunari; Kawamura, Yoko

    2010-06-01

    As there are various difficulties associated with auscultation techniques, we have devised a technique for visualizing heart motion in order to assist in the understanding of heartbeat for both doctors and patients. Auscultatory sounds were first visualized using FFT and Wavelet analysis to visualize heart sounds. Next, to show global and simultaneous heart motions, a new technique for visualization was established. The visualization system consists of a 64-channel unit (63 acceleration sensors and one ECG sensor) and a signal/image analysis unit. The acceleration sensors were arranged in a square array (8×8) with a 20-mm pitch interval, which was adhered to the chest surface. The heart motion of one cycle was visualized at a sampling frequency of 3 kHz and quantization of 12 bits. The visualized results showed a typical waveform motion of the strong pressure shock due to closing tricuspid valve and mitral valve of the cardiac apex (first sound), and the closing aortic and pulmonic valve (second sound) in sequence. To overcome difficulties in auscultation, the system can be applied to the detection of heart disease and to the digital database management of the auscultation examination in medical areas.

  8. Processing of prosthetic heart valve sounds for classification. Revision 1

    SciTech Connect

    Candy, J.V.; Jones, H.E.

    1994-04-01

    People with serious heart conditions have had their expected life span extended considerably with the development of the prosthetic heart valve especially with the great strides made in valve design. Even though the designs are extremely reliable, the valves are mechanical and operating continuously over a long period, therefore, structural failures can occur due to fatigue. Measuring heart sounds non-invasively in a noisy environment puts more demands on the signal processing to extract the desired signals from the noise. In this paper the authors discuss acoustical signal processing techniques developed to process noisy heart valve sounds measured by a sensitive, surface contact microphone and used for the eventual classification of the valve.

  9. [Synchronous playing and acquiring of heart sounds and electrocardiogram based on labVIEW].

    PubMed

    Dan, Chunmei; He, Wei; Zhou, Jing; Que, Xiaosheng

    2008-12-01

    In this paper is described a comprehensive system, which can acquire heart sounds and electrocardiogram (ECG) in parallel, synchronize the display; and play of heart sound and make auscultation and check phonocardiogram to tie in. The hardware system with C8051F340 as the core acquires the heart sound and ECG synchronously, and then sends them to indicators, respectively. Heart sounds are displayed and played simultaneously by controlling the moment of writing to indicator and sound output device. In clinical testing, heart sounds can be successfully located with ECG and real-time played.

  10. Online estimation of lower and upper bounds for heart sound boundaries in chest sound using Convex-hull algorithm.

    PubMed

    Çağlar, F; Ozbek, I Y

    2012-01-01

    Heart sound localization in chest sound is an essential part for many heart sound cancellation algorithms. The main difficulty for heart sound localization methods is the precise determination of the onset and offset boundaries of the heart sound segment. This paper presents a novel method to estimate lower and upper bounds for the onset and offset of the heart sound segment, which can be used as anchor points for more precise estimation. For this purpose, first chest sound is divided into frames and then entropy and smoothed entropy features of these frames are extracted, and used in the Convex-hull algorithm to estimate the upper and lower bounds for heart sound boundaries. The Convex-hull algorithm constructs a special type of envelope function for entropy features and if the maximal difference between the envelope function and the entropy is larger than a certain threshold, this point is considered as a heart sound bound. The results of the proposed method are compared with a baseline method which is a modified version of a well-known heart sound localization method. The results show that the proposed method outperforms the baseline method in terms of accuracy and detection error rate. Also, the experimental results show that smoothing entropy features significantly improves the performance of both baseline and proposed methods.

  11. A robust method for heart sounds localization using lung sounds entropy.

    PubMed

    Yadollahi, Azadeh; Moussavi, Zahra M K

    2006-03-01

    Heart sounds are the main unavoidable interference in lung sound recording and analysis. Hence, several techniques have been developed to reduce or cancel heart sounds (HS) from lung sound records. The first step in most HS cancellation techniques is to detect the segments including HS. This paper proposes a novel method for HS localization using entropy of the lung sounds. We investigated both Shannon and Renyi entropies and the results of the method using Shannon entropy were superior. Another HS localization method based on multiresolution product of lung sounds wavelet coefficients adopted from was also implemented for comparison. The methods were tested on data from 6 healthy subjects recorded at low (7.5 ml/s/kg) and medium 115 ml/s/kg) flow rates. The error of entropy-based method using Shannon entropy was found to be 0.1 +/- 0.4% and 1.0 +/- 0.7% at low and medium flow rates, respectively, which is significantly lower than that of multiresolution product method and those of other methods reported in previous studies. The proposed method is fully automated and detects HS included segments in a completely unsupervised manner.

  12. Heart sounds as a result of acoustic dipole radiation of heart valves

    NASA Astrophysics Data System (ADS)

    Kasoev, S. G.

    2005-11-01

    Heart sounds are associated with impulses of force acting on heart valves at the moment they close under the action of blood-pressure difference. A unified model for all the valves represents this impulse as an acoustic dipole. The near pressure field of this dipole creates a distribution of the normal velocity on the breast surface with features typical of auscultation practice: a pronounced localization of heart sound audibility areas, an individual area for each of the valves, and a noncoincidence of these areas with the projections of the valves onto the breast surface. In the framework of the dipole theory, the optimum size of the stethoscope’s bell is found and the spectrum of the heart sounds is estimated. The estimates are compared with the measured spectrum.

  13. Autonomous detection of heart sound abnormalities using an auscultation jacket.

    PubMed

    Visagie, C; Scheffer, C; Lubbe, W W; Doubell, A F

    2009-12-01

    This paper presents a study using an auscultation jacket with embedded electronic stethoscopes, and a software classification system capable of differentiating between normal and certain auscultatory abnormalities. The aim of the study is to demonstrate the potential of such a system for semi-automated diagnosis for underserved locations, for instance in rural areas or in developing countries where patients far outnumber the available medical personnel. Using an "auscultation jacket", synchronous data was recorded at multiple chest locations on 31 healthy volunteers and 21 patients with heart pathologies. Electrocardiograms (ECGs) were also recorded simultaneously with phonocardiographic data. Features related to heart pathologies were extracted from the signals and used as input to a feed-forward artificial neural network. The system is able to classify between normal and certain abnormal heart sounds with a sensitivity of 84% and a specificity of 86%. Though the number of training and testing samples presented are limited, the system performed well in differentiating between normal and abnormal heart sounds in the given database of available recordings. The results of this study demonstrate the potential of such a system to be used as a fast and cost-effective screening tool for heart pathologies.

  14. Congenital heart block and maternal systemic lupus erythematosus.

    PubMed Central

    Esscher, E; Scott, J S

    1979-01-01

    The association between infants with congenital heart block (CHB) and the presence or later development of maternal systemic lupus erythematosus or other connective-tissue disease (CTD) was reviewed in 67 cases. In 24 cases CHB was diagnosed at or before birth. Of nine necropsies on affected infants, seven showed endomyocardial fibrosis. The results suggest that one in three mothers who deliver babies with CHB have or will develop CTD. The association is probably explained by placental transfer of a maternal antibody. Awareness of the association may lead to prevention of the birth of children with CHB and better neonatal care of affected children. PMID:455010

  15. A Signal Processing Module for the Analysis of Heart Sounds and Heart Murmurs

    NASA Astrophysics Data System (ADS)

    Javed, Faizan; Venkatachalam, P. A.; H, Ahmad Fadzil M.

    2006-04-01

    In this paper a Signal Processing Module (SPM) for the computer-aided analysis of heart sounds has been developed. The module reveals important information of cardiovascular disorders and can assist general physician to come up with more accurate and reliable diagnosis at early stages. It can overcome the deficiency of expert doctors in rural as well as urban clinics and hospitals. The module has five main blocks: Data Acquisition & Pre-processing, Segmentation, Feature Extraction, Murmur Detection and Murmur Classification. The heart sounds are first acquired using an electronic stethoscope which has the capability of transferring these signals to the near by workstation using wireless media. Then the signals are segmented into individual cycles as well as individual components using the spectral analysis of heart without using any reference signal like ECG. Then the features are extracted from the individual components using Spectrogram and are used as an input to a MLP (Multiple Layer Perceptron) Neural Network that is trained to detect the presence of heart murmurs. Once the murmur is detected they are classified into seven classes depending on their timing within the cardiac cycle using Smoothed Pseudo Wigner-Ville distribution. The module has been tested with real heart sounds from 40 patients and has proved to be quite efficient and robust while dealing with a large variety of pathological conditions.

  16. Influence of sound and light on heart rate variability.

    PubMed

    Hori, Kiyokazu; Yamakawa, Masanobu; Tanaka, Nobuo; Murakami, Hiromi; Kaya, Mitsuharu; Hori, Seiki

    2005-12-01

    The effects of acoustic and visual stimuli and their synergistic effects on heart rate variability including gender differences were investigated. Of particular interest was the influence of visual stimulus on heart rate variability during listening to simple sounds of different characters. Twelve male and 12 female university students were selected as subjects. The subjects listened at rest to 7 different figures of sound at loudness levels averaging 60 dB. Beat-to-beat R-R intervals were continuously recorded under the closed-eye condition (CEC) and the open-eye condition (OEC) prior to, during, and immediately after the exposure to acoustic stimuli. Low frequency (LF) power was defined over 0.04-0.15 Hz and high frequency (HF) power over 0.15-0.40 Hz. Cardiac autonomic function was estimated by plotting LF/HF in standard measure against HF in standard measure and by plotting LF/HF (%) against HF (%), accompanied by a demarcated central area. Values of LF/HF tended to be smaller under CEC than under OEC. Values of HF while listening to a 110 Hz sine wave under CEC were significantly greater than values for 880 Hz and 3520 Hz sine waves, or for 110 Hz or 880 Hz sawtooth waves, under OEC. Under CEC, values of HF for 7 figures of sound were greater in females than in males. The value of HF of sine wave for 110 Hz under CEC and OEC was significantly greater than that for white noise under the OEC. The results suggest that the cardiac parasympathetic nervous activity during auditory excitation increases with elimination of visual stimuli and tends to be greater in females than in males.

  17. Influence of paced maternal breathing on fetal–maternal heart rate coordination

    PubMed Central

    Van Leeuwen, P.; Geue, D.; Thiel, M.; Cysarz, D.; Lange, S.; Romano, M. C.; Wessel, N.; Kurths, J.; Grönemeyer, D. H.

    2009-01-01

    Pregnant mothers often report a special awareness of and bonding with their unborn child. Little is known about this relationship although it may offer potential for the assessment of the fetal condition. Recently we found evidence of short epochs of fetal–maternal heart rate synchronization under uncontrolled conditions with spontaneous maternal breathing. Here, we examine whether the occurrence of such epochs can be influenced by maternal respiratory arrhythmia induced by paced breathing at several different rates (10, 12, 15, and 20 cycles per minute). To test for such weak and nonstationary synchronizations among the fetal–maternal subsystems, we apply a multivariate synchronization analysis technique and test statistics based on twin surrogates. We find a clear increase in synchronization epochs mostly at high maternal respiratory rates in the original but not in the surrogate data. On the other hand, fewer epochs are found at low respiratory rates both in original and surrogate data. The results suggest that the fetal cardiac system seems to possess the capability to adjust its rate of activation in response to external—i.e., maternal—stimulation. Hence, the pregnant mothers' special awareness to the unborn child may also be reflected by fetal–maternal interaction of cardiac activity. Our approach opens up the chance to examine this interaction between independent but closely linked physiological systems. PMID:19597150

  18. Cardiac auscultatory recording database: delivering heart sounds through the Internet.

    PubMed Central

    Tuchinda, C.; Thompson, W. R.

    2001-01-01

    The clinical skill of cardiac auscultation, while known to be sensitive, specific, and inexpensive in screening for cardiac disease among children, has recently been shown to be deficient among residents in training. This decline in clinical skill is partly due to the difficulty in teaching auscultation. Standardization, depth, and breadth of experience has been difficult to reproduce for students due to time constraints and the impracticality of examining large numbers of patients with cardiac pathology. We have developed a web-based multimedia platform that delivers complete heart sound recordings from over 800 different patients seen at the Johns Hopkins Outpatient Pediatric Cardiology Clinic. The database represents more than twenty significant cardiac lesions as well as normal and innocent murmurs. Each patient record is complete with a gold standard echo for diagnostic confirmation and a gold standard auscultatory assessment provided by a pediatric cardiology attending. PMID:11825279

  19. Maternal, Perinatal, and Postneonatal Outcomes in Women With Chronic Heart Disease in Washington State

    PubMed Central

    Leary, Peter J; Leary, Sarah ES; Stout, Karen K; Schwartz, Stephen M; Easterling, Thomas R

    2014-01-01

    Objective To explore the association between the presence of maternal heart disease and maternal, perinatal, and infant outcomes. Methods We conducted a population-based retrospective cohort study using Washington State birth certificates linked with hospital discharge records of mothers noted to have maternal congenital heart disease, ischemic heart disease, heart failure or pulmonary hypertension. Women who gave birth between 1987 and 2009 (n=2,171) were compared to a sample of mothers without these conditions (n=21,710). We described characteristics of pregnant women with heart disease over time. Logistic regression estimated the association between reported chronic maternal heart disease and small for gestational age (SGA) birth, as well as perinatal, post-neonatal and maternal death. Results The proportion of births to women with reported heart disease increased 224% between the 1987-1994 and 2002-2009 calendar periods. Chronic maternal heart disease was associated with increased risk of SGA birth (62 additional SGA infants per 1,000 births, 95% CI 46-78, p <0.001), perinatal death (14 additional deaths per 1,000 births, 95% CI 8-20, p <0.001), postneonatal death (five additional deaths per 1,000 births, 95% CI 2-9, p<0.001) and maternal death (five additional deaths per 1,000 births, 95% CI 2-9, p<0.001). Conclusion The presence of chronic maternal heart disease is associated with elevated risk for poor maternal, perinatal, and postneonatal outcomes. PMID:23168751

  20. The Analysis of Heart Sounds Based on Linear and High Order Statistical Methods

    DTIC Science & Technology

    2007-11-02

    Normal heart sound. (b) Mitral Stenosis . (c) Aortic Stenosis . sequence to an instrumental process derived from the data [10]. The AR estimation...heart sound. (b) Mitral Stenosis . (c) Aortic Stenosis . C. Data Acquisition The database used to evaluate the methods is from a compact disk...modeling methods can be used to detect sound associated with coronary stenosis [1], [3], [8], [7]. The parametric modeling methods in these studies

  1. Processing of Prosthetic Heart Valve Sounds from Anechoic Tank Measurements

    SciTech Connect

    Candy, J V; Meyer, A W

    2001-03-20

    People with serious cardiac problems have had their life span extended with the development of the prosthetic heart valve. However, the valves operate continuously at approximately 39 million cycles per year and are therefore subject to structural failures either by faulty design or material fatigue. The development of a non-invasive technique using an acoustic contact microphone and sophisticated signal processing techniques has been proposed and demonstrated on limited data sets. In this paper we discuss an extension of the techniques to perform the heart valve tests in an anechoic like. Here the objective is to extract a ''pure'' sound or equivalently the acoustical vibration response of the prosthetic valves in a quiet environment. The goal is to demonstrate that there clearly exist differences between values which have a specific mechanical defect known as single leg separation (SLS) and non-defective valves known as intact (INT). We discuss the signal processing and results of anechoic acoustic measurements on 50 prosthetic valves in the tank. Finally, we show the results of the individual runs for each valve, point out any of the meaningful features that could be used to distinguish the SLS from INT and summarize the experiments.

  2. Feto-maternal heart rate ratio in pregnant bitches: effect of gestational age and maternal size.

    PubMed

    Alonge, S; Mauri, M; Faustini, M; Luvoni, G C

    2016-10-01

    Few information is available on parameters that can be used to objectively assess the foetal health during canine pregnancy. To identify a reliable parameter for the evaluation of foetal well-being, the effect of pre-gestational maternal bodyweight and gestational age on foetal heart rate (FHR) and on feto-maternal heart rate ratio (FHR/MHR) was investigated. Seventeen client-owned pregnant bitches of different pre-gestational maternal bodyweight were examined by serial echo colour Doppler. Only data from 11 uncomplicated pregnancies were included in the statistical analysis. The relationship between FHR, and FHR/MHR, and independent variables was analysed by polynomial regression (p ≤ .05). The FHR and the FHR/MHR significantly fitted a multiple quadratic regression for all independent variables. They both increased from 35 to 20 days before parturition and then a decreasing pattern followed. Higher values of both parameters were observed in bitches of lowest and highest bodyweight. Patterns of FHR and FHR/MHR were similar, but the ratio better describes the effect of the independent variables on the data. Thus, the highest significance of FHR/MHR compared to FHR alone encourages the application of this ratio to evaluate foetal well-being. The equation derived by the regression analysis of FHR/MHR could be applied in clinical practice to obtain its expected values in healthy pregnancies. © 2016 Blackwell Verlag GmbH.

  3. Maternal mindfulness and anxiety during pregnancy affect infants' neural responses to sounds.

    PubMed

    van den Heuvel, Marion I; Donkers, Franc C L; Winkler, István; Otte, Renée A; Van den Bergh, Bea R H

    2015-03-01

    Maternal anxiety during pregnancy has been consistently shown to negatively affect offspring neurodevelopmental outcomes. However, little is known about the impact of positive maternal traits/states during pregnancy on the offspring. The present study was aimed at investigating the effects of the mother's mindfulness and anxiety during pregnancy on the infant's neurocognitive functioning at 9 months of age. Mothers reported mindfulness using the Freiburg Mindfulness Inventory and anxiety using the Symptom Checklist (SCL-90) at ± 20.7 weeks of gestation. Event-related brain potentials (ERPs) were measured from 79 infants in an auditory oddball paradigm designed to measure auditory attention-a key aspect of early neurocognitive functioning. For the ERP responses elicited by standard sounds, higher maternal mindfulness was associated with lower N250 amplitudes (P < 0.01, η(2) = 0.097), whereas higher maternal anxiety was associated with higher N250 amplitudes (P < 0.05, η(2) = 0.057). Maternal mindfulness was also positively associated with the P150 amplitudes (P < 0.01, η(2) = 0.130). These results suggest that infants prenatally exposed to higher levels of maternal mindfulness devote fewer attentional resources to frequently occurring irrelevant sounds. The results show that positive traits and experiences of the mother during pregnancy may also affect the unborn child. Emphasizing the beneficial effects of a positive psychological state during pregnancy may promote healthy behavior in pregnant women.

  4. Maternal mindfulness and anxiety during pregnancy affect infants’ neural responses to sounds

    PubMed Central

    van den Heuvel, Marion I.; Donkers, Franc C. L.; Winkler, István; Otte, Renée A.

    2015-01-01

    Maternal anxiety during pregnancy has been consistently shown to negatively affect offspring neurodevelopmental outcomes. However, little is known about the impact of positive maternal traits/states during pregnancy on the offspring. The present study was aimed at investigating the effects of the mother’s mindfulness and anxiety during pregnancy on the infant’s neurocognitive functioning at 9 months of age. Mothers reported mindfulness using the Freiburg Mindfulness Inventory and anxiety using the Symptom Checklist (SCL-90) at ±20.7 weeks of gestation. Event-related brain potentials (ERPs) were measured from 79 infants in an auditory oddball paradigm designed to measure auditory attention—a key aspect of early neurocognitive functioning. For the ERP responses elicited by standard sounds, higher maternal mindfulness was associated with lower N250 amplitudes (P < 0.01, η2 = 0.097), whereas higher maternal anxiety was associated with higher N250 amplitudes (P < 0.05, η2 = 0.057). Maternal mindfulness was also positively associated with the P150 amplitudes (P < 0.01, η2 = 0.130). These results suggest that infants prenatally exposed to higher levels of maternal mindfulness devote fewer attentional resources to frequently occurring irrelevant sounds. The results show that positive traits and experiences of the mother during pregnancy may also affect the unborn child. Emphasizing the beneficial effects of a positive psychological state during pregnancy may promote healthy behavior in pregnant women. PMID:24925904

  5. Robust heart sound detection in respiratory sound using LRT with maximum a posteriori based online parameter adaptation.

    PubMed

    Shamsi, Hamed; Ozbek, I Yucel

    2014-10-01

    This paper investigates the utility of a likelihood ratio test (LRT) combined with an efficient adaptation procedure for the purpose of detecting the heart sound (HS) with lung sound and the lung sound only (non-HS) segments in a respiratory signal. The proposed detection method has four main stages: feature extraction, training of the models, detection, and adaptation of the model parameter. In the first stage, the logarithmic energy features are extracted for each frame of respiratory sound. In the second stage, the probabilistic models for HS and non-HS segments are constructed by training Gaussian mixture models (GMMs) with an expectation maximization algorithm in a subject-independent manner, and then the HS and non-HS segments are detected by the results of the LRT based on the GMMs. In the adaptation stage, the subject-independent trained model parameter is modified online using the observed test data to fit the model parameter of the target subject. Experiments were performed on the database from 24 healthy subjects. The experimental results indicate that the proposed heart sound detection algorithm outperforms two well-known heart sound detection methods in terms of the values of the normalized area under the detection error trade-off curve (NAUC), the false negative rate (FNR), and the false positive rate (FPR). Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Aerobic Exercise during Pregnancy and Presence of Fetal-Maternal Heart Rate Synchronization

    PubMed Central

    Van Leeuwen, Peter; Gustafson, Kathleen M.; Cysarz, Dirk; Geue, Daniel; May, Linda E.; Grönemeyer, Dietrich

    2014-01-01

    It has been shown that short-term direct interaction between maternal and fetal heart rates may take place and that this interaction is affected by the rate of maternal respiration. The aim of this study was to determine the effect of maternal aerobic exercise during pregnancy on the occurrence of fetal-maternal heart rate synchronization. Methods In 40 pregnant women at the 36th week of gestation, 21 of whom exercised regularly, we acquired 18 min. RR interval time series obtained simultaneously in the mothers and their fetuses from magnetocardiographic recordings. The time series of the two groups were examined with respect to their heart rate variability, the maternal respiratory rate and the presence of synchronization epochs as determined on the basis of synchrograms. Surrogate data were used to assess whether the occurrence of synchronization was due to chance. Results In the original data, we found synchronization occurred less often in pregnancies in which the mothers had exercised regularly. These subjects also displayed higher combined fetal-maternal heart rate variability and lower maternal respiratory rates. Analysis of the surrogate data showed shorter epochs of synchronization and a lack of the phase coordination found between maternal and fetal beat timing in the original data. Conclusion The results suggest that fetal-maternal heart rate coupling is present but generally weak. Maternal exercise has a damping effect on its occurrence, most likely due to an increase in beat-to-beat differences, higher vagal tone and slower breathing rates. PMID:25162592

  7. Aerobic exercise during pregnancy and presence of fetal-maternal heart rate synchronization.

    PubMed

    Van Leeuwen, Peter; Gustafson, Kathleen M; Cysarz, Dirk; Geue, Daniel; May, Linda E; Grönemeyer, Dietrich

    2014-01-01

    It has been shown that short-term direct interaction between maternal and fetal heart rates may take place and that this interaction is affected by the rate of maternal respiration. The aim of this study was to determine the effect of maternal aerobic exercise during pregnancy on the occurrence of fetal-maternal heart rate synchronization. In 40 pregnant women at the 36th week of gestation, 21 of whom exercised regularly, we acquired 18 min. RR interval time series obtained simultaneously in the mothers and their fetuses from magnetocardiographic recordings. The time series of the two groups were examined with respect to their heart rate variability, the maternal respiratory rate and the presence of synchronization epochs as determined on the basis of synchrograms. Surrogate data were used to assess whether the occurrence of synchronization was due to chance. In the original data, we found synchronization occurred less often in pregnancies in which the mothers had exercised regularly. These subjects also displayed higher combined fetal-maternal heart rate variability and lower maternal respiratory rates. Analysis of the surrogate data showed shorter epochs of synchronization and a lack of the phase coordination found between maternal and fetal beat timing in the original data. The results suggest that fetal-maternal heart rate coupling is present but generally weak. Maternal exercise has a damping effect on its occurrence, most likely due to an increase in beat-to-beat differences, higher vagal tone and slower breathing rates.

  8. Development of a Smartphone App for Visualizing Heart Sounds and Murmurs.

    PubMed

    Mamorita, Noritaka; Arisaka, Naoya; Isonaka, Risa; Kawakami, Tadashi; Takeuchi, Akihiro

    2017-01-01

    Auscultation is one of the basic techniques for the diagnosis of heart disease. However, the interpretation of heart sounds and murmurs is a highly subjective and difficult skill. To assist the auscultation skill at the bedside, a handy phonocardiogram was developed using a smartphone (Samsung Galaxy J, Android OS 4.4.2) and an external microphone attached to a stethoscope. The Android app used Java classes, "AudioRecord," "AudioTrack," and "View," that recorded sounds, replayed sounds, and plotted sound waves, respectively. Sound waves were visualized in real-time, simultaneously replayed on the smartphone, and saved to WAV files. To confirm the availability of the app, 26 kinds of heart sounds and murmurs sounded on a human patient simulator were recorded using three different methods: a bell-type stethoscope, a diaphragm-type stethoscope, and a direct external microphone without a stethoscope. The recorded waveforms were subjectively confirmed and were found to be similar to the reference waveforms. The real-time visualization of the sound waves on the smartphone may help novices to readily recognize and learn to distinguish the various heart sounds and murmurs in real-time. © 2017 S. Karger AG, Basel.

  9. Improvements in fetal heart rate analysis by the removal of maternal-fetal heart rate ambiguities.

    PubMed

    Pinto, Paula; Costa-Santos, Cristina; Gonçalves, Hernâni; Ayres-De-Campos, Diogo; Bernardes, João

    2015-11-19

    Misinterpretation of the maternal heart rate (MHR) as fetal may lead to significant errors in fetal heart rate (FHR) interpretation. In this study we hypothesized that the removal of these MHR-FHR ambiguities would improve FHR analysis during the final hour of labor. Sixty-one MHR and FHR recordings were simultaneously acquired in the final hour of labor. Removal of MHR-FHR ambiguities was performed by subtracting MHR signals from their FHR counterparts when the absolute difference between the two was less or equal to 5 beats per minute. Major MHR-FHR ambiguities were defined when they exceeded 1% of the tracing. Maternal, fetal and neonatal characteristics were evaluated in cases where major MHR-FHR ambiguities occurred and computer analysis of FHR recordings was compared, before and after removal of the ambiguities. Seventy-two percent of tracings (44/61) exhibited episodes of major MHR-FHR ambiguities, which were not significantly associated with any maternal, fetal or neonatal characteristics, but were associated with MHR accelerations, FHR signal loss and decelerations. Removal of MHR-FHR ambiguities resulted in a significant decrease in FHR decelerations, and improvement in FHR tracing classification. FHR interpretation during the final hour of labor can be significantly improved by the removal of MHR-FHR ambiguities.

  10. Automated Diagnosis of Heart Sounds Using Rule-Based Classification Tree.

    PubMed

    Karar, Mohamed Esmail; El-Khafif, Sahar H; El-Brawany, Mohamed A

    2017-04-01

    In order to assist the diagnosis procedure of heart sound signals, this paper presents a new automated method for classifying the heart status using a rule-based classification tree into normal and three abnormal cases; namely the aortic valve stenosis, aortic insufficient, and ventricular septum defect. The developed method includes three main steps as follows. First, one cycle of the heart sound signals is automatically detected and segmented based on time properties of the heart signals. Second, the segmented cycle is preprocessed with the discrete wavelet transform and then largest Lyapunov exponents are calculated to generate the dynamical features of heart sound time series. Finally, a rule-based classification tree is fed by these Lyapunov exponents to give the final decision of the heart health status. The developed method has been tested successfully on twenty-two datasets of normal heart sounds and murmurs with success rate of 95.5%. The resulting error can be easily corrected by modifying the classification rules; consequently, the accuracy of automated heart sounds diagnosis is further improved.

  11. [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.

  12. Performance of an open-source heart sound segmentation algorithm on eight independent databases.

    PubMed

    Liu, Chengyu; Springer, David; Clifford, Gari D

    2017-08-01

    Heart sound segmentation is a prerequisite step for the automatic analysis of heart sound signals, facilitating the subsequent identification and classification of pathological events. Recently, hidden Markov model-based algorithms have received increased interest due to their robustness in processing noisy recordings. In this study we aim to evaluate the performance of the recently published logistic regression based hidden semi-Markov model (HSMM) heart sound segmentation method, by using a wider variety of independently acquired data of varying quality. Firstly, we constructed a systematic evaluation scheme based on a new collection of heart sound databases, which we assembled for the PhysioNet/CinC Challenge 2016. This collection includes a total of more than 120 000 s of heart sounds recorded from 1297 subjects (including both healthy subjects and cardiovascular patients) and comprises eight independent heart sound databases sourced from multiple independent research groups around the world. Then, the HSMM-based segmentation method was evaluated using the assembled eight databases. The common evaluation metrics of sensitivity, specificity, accuracy, as well as the [Formula: see text] measure were used. In addition, the effect of varying the tolerance window for determining a correct segmentation was evaluated. The results confirm the high accuracy of the HSMM-based algorithm on a separate test dataset comprised of 102 306 heart sounds. An average [Formula: see text] score of 98.5% for segmenting S1 and systole intervals and 97.2% for segmenting S2 and diastole intervals were observed. The [Formula: see text] score was shown to increases with an increases in the tolerance window size, as expected. The high segmentation accuracy of the HSMM-based algorithm on a large database confirmed the algorithm's effectiveness. The described evaluation framework, combined with the largest collection of open access heart sound data, provides essential resources for

  13. [Development of heart sound signal detection system based on USB interface].

    PubMed

    Ji, An; Guo, Xingming; Guo, Weizhen; Xiao, Shouzhong

    2008-10-01

    This paper introduces a type of heart sound recording, analysis and processing system based on USB interface. The system consists of high performance sensor sampling heart sounds, the preprocessing circuit, the A/D conversion module and the USB based high-speed computer communications interface. The experiments show that it is noninvasive, convenient, inexpensive and rapid in detecting the cardiac contractility of patients with heart disease as well as of healthy subjects. This system has provided a reliable technical platform for evaluating the cardiac contractility reserve.

  14. A robust method for online heart sound localization in respiratory sound based on temporal fuzzy c-means.

    PubMed

    Shamsi, Hamed; Ozbek, I Yucel

    2015-01-01

    This work presents a detailed framework to detect the location of heart sound within the respiratory sound based on temporal fuzzy c-means (TFCM) algorithm. In the proposed method, respiratory sound is first divided into frames and for each frame, the logarithmic energy features are calculated. Then, these features are used to classify the respiratory sound as heart sound (HS containing lung sound) and non-HS (only lung sound) by the TFCM algorithm. The TFCM is the modified version fuzzy c-means (FCM) algorithm. While the FCM algorithm uses only the local information about the current frame, the TFCM algorithm uses the temporal information from both the current and the neighboring frames in decision making. To measure the detection performance of the proposed method, several experiments have been conducted on a database of 24 healthy subjects. The experimental results show that the average false-negative rate values are 0.8 ± 1.1 and 1.5 ± 1.4 %, and the normalized area under detection error curves are 0.0145 and 0.0269 for the TFCM method in the low and medium respiratory flow rates, respectively. These average values are significantly lower than those obtained by FCM algorithm and by the other compared methods in the literature, which demonstrates the efficiency of the proposed TFCM algorithm. On the other hand, the average elapsed time of the TFCM for a data with length of 0.2 ± 0.05 s is 0.2 ± 0.05 s, which is slightly higher than that of the FCM and lower than those of the other compared methods.

  15. [The acquisition and analysis of heart sound signals based on DSP].

    PubMed

    Xing, Suxia; Chen, Tianhua

    2011-04-01

    Heart sound signals acquisition is the primary basis for achieving non-invasive diagnosis of coronary heart disease. In this paper, a digital signal processor (DSP)-based on miniaturized circuit of heart sound signals acquisition and analysis platform was designed to achieve the functions of filtering, collecting, processing, displaying and the communicating with PC. With the self-developed experimental platform, we collected 228 cases of heart sounds of clinical data, and processed the signals using de-noising method with wavelet transform. These experimental results indicated that the db6 wavelet has the most obvious de-noising effect among the four most commonly used wavelets, i.e., haar, db6, sym8, and coif5. One wavelet at different levels possessed different de-noising effects, with level-5 db6 decomposition obtaining the most desirable result.

  16. Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability.

    PubMed

    May, Linda E; Knowlton, Jennifer; Hanson, Jessica; Suminski, Richard; Paynter, Christopher; Fang, Xiangming; Gustafson, Kathleen M

    2016-07-01

    Pregnancy is associated with an increased sympathetic state, which can be exacerbated by gestational conditions. Research has shown that exercise during pregnancy lowers heart rate (HR) and can attenuate the symptoms of gestational conditions associated with increased sympathetic control. However, changes in maternal heart autonomic function in response to exercise have not been reported across multiple time points during pregnancy. This analysis is designed to address this gap. To determine if exercise throughout gestation improves maternal cardiac autonomic nervous system functioning, as evidenced by decreased HR and increased heart rate variability (HRV) indices. Case control study. Academic medical institution. A total of 56 women with healthy, singleton, low-risk pregnancies. Participants were asked to complete 3 resting 18-minute HRV recordings at 28, 32, and 36 weeks' gestation, along with a physical activity questionnaire. HRV indices were calculated for time (R peak to R peak interval standard deviation and root mean squared of successive differences) and frequency (very low, low, and high frequency) domain measures. The differences between groups were compared for HRV indices at 28, 32, and 36 weeks. Resting HR was significantly lower in the exercise group at 28 weeks (P < .01) compared with the control group. The exercise group had significantly (P < .05) increased measures of resting HRV time domain measures at 28, 32, and 36 weeks' gestation compared with the control group. Resting HRV power was significantly increased (P < .05) in all frequency domain measures at 32 weeks in the exercise group relative to the control group. No differences occurred in sympathovagal balance (low frequency/high frequency ratio) between groups. Exercise throughout pregnancy can significantly improve cardiac autonomic control. More research is needed to determine if this adaptation to exercise may reduce the risk of adverse outcomes associated with gestational conditions

  17. SEX DIFFERENCES IN THE EFFECTS OF DIVERSE SOUNDS ON HEART RATE VARIABILITY.

    PubMed

    Nozaki, Haruka; Uetake, Teruo; Shimoda, Masahiro

    2015-12-01

    With the goal of facilitating the creation of relaxing sound environments in stressful places, such as offices, we examined differences in the heart rate fluctuations of men and women induced by different sounds. Twenty-three healthy students (13 males and 10 females) aged between 18 and 23 listened to seven different sounds while we collected electrocardiogram data. We extracted the high frequency component (HF) and low frequency component (LF) of the signals using the wavelet method, and calculated LF/HF. We found no statistically significant differences between males and females in the frequency distribution of a no change group, increased group, and decreased group for any sound. However, certain sounds had somewhat similar patterns for men and women for all three groups. Additionally, the pairs of experimental sounds with highly similar effects on individuals were different for men and women.

  18. Prototype electronic stethoscope vs. conventional stethoscope for auscultation of heart sounds.

    PubMed

    Kelmenson, Daniel A; Heath, Janae K; Ball, Stephanie A; Kaafarani, Haytham M A; Baker, Elisabeth M; Yeh, Daniel D; Bittner, Edward A; Eikermann, Matthias; Lee, Jarone

    2014-08-01

    In an effort to decrease the spread of hospital-acquired infections, many hospitals currently use disposable plastic stethoscopes in patient rooms. As an alternative, this study examines a prototype electronic stethoscope that does not break the isolation barrier between clinician and patient and may also improve the diagnostic accuracy of the stethoscope exam. This study aimed to investigate whether the new prototype electronic stethoscope improved auscultation of heart sounds compared to the standard conventional isolation stethoscope. In a controlled, non-blinded, cross-over study, clinicians were randomized to identify heart sounds with both the prototype electronic stethoscope and a conventional stethoscope. The primary outcome was the score on a 10-question heart sound identification test. In total, 41 clinicians completed the study. Subjects performed significantly better in the identification of heart sounds when using the prototype electronic stethoscope (median = 9 [7-10] vs. 8 [6-9] points, p value <0.0001). Subjects also significantly preferred the prototype electronic stethoscope. Clinicians using a new prototype electronic stethoscope achieved greater accuracy in identification of heart sounds and also universally favoured the new device, compared to the conventional stethoscope.

  19. Processing of prosthetic heart valve sounds for single leg separation classification

    SciTech Connect

    Candy, J.V.; Jones, H.E.

    1995-06-01

    Efforts are concentrated on the sounds corresponding to the heart valve opening cycle. Valve opening and closing acoustics present additional information about the outlet strut condition---the structural component implicated in valve failure. The importance of the opening sound for single leg separation detection/classification is based on the fact that as the valve opens, the disk passively hits the outlet strut. The opening sounds thus yield direct information about outlet strut condition with minimal amount of disturbance caused by the energy radiated from the disk. Hence the opening sound is a very desirable acoustic signal to extract. Unfortunately, the opening sounds have much lower signal levels relative to the closing sounds and therefore noise plays a more significant role than during the closing event. Because of this it is necessary to screen the sounds for outliers in order to insure a high sensitivity of classification. Because of the sharp resonances appearing in the corresponding spectrum, a parametric processing approach is developed based on an autoregressive model which was selected to characterize the sounds emitted by the Bjork--Shiley convexo--concave (BSCC) valve during opening cycle. First the basic signals and the extraction process used to create an ensemble of heart valve sounds are briefly discussed. Next, a {ital beat} {ital monitor} capable of rejecting beats that fail to meet an acceptance criteria based on their spectral content is developed. Various approaches that have been utilized to enhance the screened data and produce a reliable {ital heart} {ital valve} {ital spectrogram} which displays the individual sounds (power) as a function of beat number and temporal frequency are discussed. Once estimated, the spectrogram and associated parameters are used to develop features supplied to the various classification schemes. Finally, future work aimed at even further signal enhancement and improved classifier performance is discussed.

  20. Stochastic optimization for the detection of changes in maternal heart rate kinetics during pregnancy

    NASA Astrophysics Data System (ADS)

    Zakynthinaki, M. S.; Barakat, R. O.; Cordente Martínez, C. A.; Sampedro Molinuevo, J.

    2011-03-01

    The stochastic optimization method ALOPEX IV has been successfully applied to the problem of detecting possible changes in the maternal heart rate kinetics during pregnancy. For this reason, maternal heart rate data were recorded before, during and after gestation, during sessions of exercises of constant mild intensity; ALOPEX IV stochastic optimization was used to calculate the parameter values that optimally fit a dynamical systems model to the experimental data. The results not only demonstrate the effectiveness of ALOPEX IV stochastic optimization, but also have important implications in the area of exercise physiology, as they reveal important changes in the maternal cardiovascular dynamics, as a result of pregnancy.

  1. Path Length Entropy Analysis of Diastolic Heart Sounds

    PubMed Central

    Griffel, B.; Zia, M. K.; Fridman, V.; Saponieri, C.; Semmlow, J. L.

    2013-01-01

    Early detection of coronary artery disease (CAD) using the acoustic approach, a noninvasive and cost-effective method, would greatly improve the outcome of CAD patients. To detect CAD, we analyze diastolic sounds for possible CAD murmurs. We observed diastolic sounds to exhibit 1/f structure and developed a new method, path length entropy (PLE) and a scaled version (SPLE), to characterize this structure to improve CAD detection. We compare SPLE results to Hurst exponent, Sample entropy and Multi-scale entropy for distinguishing between normal and CAD patients. SPLE achieved a sensitivity-specificity of 80%–81%, the best of the tested methods. However, PLE and SPLE are not sufficient to prove nonlinearity, and evaluation using surrogate data suggests that our cardiovascular sound recordings do not contain significant nonlinear properties. PMID:23930808

  2. Performance Evaluation of Heart Sound Cancellation in FPGA Hardware Implementation for Electronic Stethoscope

    PubMed Central

    Chao, Chun-Tang

    2014-01-01

    This paper presents the design and evaluation of the hardware circuit for electronic stethoscopes with heart sound cancellation capabilities using field programmable gate arrays (FPGAs). The adaptive line enhancer (ALE) was adopted as the filtering methodology to reduce heart sound attributes from the breath sounds obtained via the electronic stethoscope pickup. FPGAs were utilized to implement the ALE functions in hardware to achieve near real-time breath sound processing. We believe that such an implementation is unprecedented and crucial toward a truly useful, standalone medical device in outpatient clinic settings. The implementation evaluation with one Altera cyclone II–EP2C70F89 shows that the proposed ALE used 45% resources of the chip. Experiments with the proposed prototype were made using DE2-70 emulation board with recorded body signals obtained from online medical archives. Clear suppressions were observed in our experiments from both the frequency domain and time domain perspectives. PMID:24790573

  3. Measurement and classification of heart and lung sounds by using LabView for educational use.

    PubMed

    Altrabsheh, B

    2010-01-01

    This study presents the design, development and implementation of a simple low-cost method of phonocardiography signal detection. Human heart and lung signals are detected by using a simple microphone through a personal computer; the signals are recorded and analysed using LabView software. Amplitude and frequency analyses are carried out for various phonocardiography pathological cases. Methods for automatic classification of normal and abnormal heart sounds, murmurs and lung sounds are presented. Various cases of heart and lung sound measurement are recorded and analysed. The measurements can be saved for further analysis. The method in this study can be used by doctors as a detection tool aid and may be useful for teaching purposes at medical and nursing schools.

  4. Classification of heart valve sounds from experiments in an anechoic water tank

    SciTech Connect

    Axelrod, M C; Clark, G A; Scott, D

    1999-06-01

    In vivo studies in both sheep and humans were plagued by a number of problems including movement artifacts, biological noise, low signal-to-noise ratio (SNR), chest-wall reverberation, and limited bandwidth recordings as discussed by [1]. To overcome these problems it was decided to record heart valve sounds under controlled conditions deep in an anechoic water tank, free from reverberation noise. The main goal of this experiment was to obtain measurements of ''pure'' heart valve sounds free of the scattering effects of the body. Experiments were conducted at the Transdec facility in San Diego [2]. We used a high quality hydrophone together with a wide-band data acquisition system [2]. We recorded sounds from 100 repetitions of the opening-closing cycles on each of 50 different heart valves, including 21 SLS valves and 29 intact valves. The power spectrum of the opening and closing phases of each cycle were calculated and outlier spectra removed as described by Candy [2]. In this report, we discuss the results of our classification of the heart valve sound measurements. The goal of this classification task was to apply the fundamental classification algorithms developed for the clinical data in 1994 and 1996 to the measurements from the anechoic water tank. From the beginning of this project, LLNL's responsibility has been to process and classify the heart valve sounds. For this experiment, however, we processed both the opening sounds and closing sounds for comparison purposes. The results of this experiment show that the classifier did not perform well because of low signal-to-noise ratio and excessive variability in signal power from beat-to-beat for a given valve.

  5. The impoverished brain: disparities in maternal education affect the neural response to sound.

    PubMed

    Skoe, Erika; Krizman, Jennifer; Kraus, Nina

    2013-10-30

    Despite the prevalence of poverty worldwide, little is known about how early socioeconomic adversity affects auditory brain function. Socioeconomically disadvantaged children are underexposed to linguistically and cognitively stimulating environments and overexposed to environmental toxins, including noise pollution. This kind of sensory impoverishment, we theorize, has extensive repercussions on how the brain processes sound. To characterize how this impoverishment affects auditory brain function, we compared two groups of normal-hearing human adolescents who attended the same schools and who were matched in age, sex, and ethnicity, but differed in their maternal education level, a correlate of socioeconomic status (SES). In addition to lower literacy levels and cognitive abilities, adolescents from lower maternal education backgrounds were found to have noisier neural activity than their classmates, as reflected by greater activity in the absence of auditory stimulation. Additionally, in the lower maternal education group, the neural response to speech was more erratic over repeated stimulation, with lower fidelity to the input signal. These weaker, more variable, and noisier responses are suggestive of an inefficient auditory system. By studying SES within a neuroscientific framework, we have the potential to expand our understanding of how experience molds the brain, in addition to informing intervention research aimed at closing the achievement gap between high-SES and low-SES children.

  6. Variation in artificial heart acceleration and sound production with prosthetic valve selection in vitro.

    PubMed

    Pantalos, G M; Kim, C H; Flatau, A

    1996-03-01

    In an attempt to explore methods to reduce total artificial heart (TAH) acceleration and sound production, in vitro measurements of TAH acceleration and sound were made when using a variety of prosthetic valves in a test ventricle. A miniature, uniaxial, high fidelity accelerometer was glued to the housing of a UTAH-100 left ventricle adjacent to the inflow and outflow ports and parallel to the axis of diaphragm excursion. A miniature, high fidelity contact microphone was glued to the opposite side of the ventricular housing between the inflow and outflow ports. Data was collected over a range of heart rates, ventricular filling volumes and control modes while using tilting disc valves (TDV) and polymer trileaflet valves (PTV). For both valve types, the peak systolic acceleration impulse was lower (approximately equal to 50%) when the ventricle was fully rather than partially filled and the peak diastolic acceleration impulse was lower (approximately equal to 50%) when the ventricle was fully rather than partially ejected. The magnitude of the acceleration with PTVs was approximately equal to 20x less than the TDVs (0.5 to 2.2 g vs. 10 to 49g). The magnitude of the sound production was also considerably less with the PTVs (28 to 49 db vs. 50 to 64 db). Diastolic acceleration and sound production was approximately twice the systolic value for the TDVs; the reserse was true for PTV sound production. These data demonstrate the substantial reduction in TAH impulse acceleration and sound production by selecting PTVs over TDSs. With PTVs, the TAH impulse acceleration is the same as the natural heart. Consequently, this ability to lower TAH acceleration and sound production to the level of the natural heart may lead to a reduction in component wear, patient discomfort and other undesirable consequences of TAH implantation.

  7. Teaching Recognition of Normal and Abnormal Heart Sounds Using Computer-Assisted Instruction

    ERIC Educational Resources Information Center

    Musselman, Eugene E.; Grimes, George M.

    1976-01-01

    The computer is being used in an innovative manner to teach the recognition of normal and abnormal canine heart sounds at the University of Chicago. Experience thus far indicates that the PLATO program resources allow the maximum development of the student's proficiency in auscultation. (Editor/LBH)

  8. Teaching Recognition of Normal and Abnormal Heart Sounds Using Computer-Assisted Instruction

    ERIC Educational Resources Information Center

    Musselman, Eugene E.; Grimes, George M.

    1976-01-01

    The computer is being used in an innovative manner to teach the recognition of normal and abnormal canine heart sounds at the University of Chicago. Experience thus far indicates that the PLATO program resources allow the maximum development of the student's proficiency in auscultation. (Editor/LBH)

  9. Classification of prosthetic heart valve sounds. A parametric approach

    SciTech Connect

    Candy, J.V.; Jones, H.E. |

    1995-06-01

    People with heart problems have had their lives extended considerably with the development of the prosthetic heart valve. Great strides have been made in the development of the valves through the use of improved materials as well as efficient mechanical designs. However, since the valves operate continuously over a long period, structural failures can occur-even though they are relatively uncommon. Here the development of techniques to classify the valve either as having intact struts or as having a separated strut, commonly called single leg separation, is discussed. In this paper the signal processing techniques employed to extract the required signals/parameters are briefly reviewed and then it is shown how they can be used to simulate a synthetic heart valve database for eventual Monte Carlo testing. Next, the optimal classifier is developed under assumed conditions and its performance is compared to that of an adpative-type classifier implemented with a probabilistic neural network. Finally, the adaptive classifier is applied to a data set and its performance is analyzed. Based on synthetic data it is shown that excellent performance of the classifiers can be achieved implying a potentially robust solution to this classification problem. 21 refs., 11 figs., 1 tab.

  10. Classification of heart valve sounds from experiments in an anechoic water tank

    SciTech Connect

    Axelrod, M C; Clark, G A; Scott, D

    1999-06-01

    In vivo studies in both sheep and humans were plagued by a number of problems including movement artifacts, biological noise, low signal-to-noise ratio (SNR), chest-wall reverberation, and limited bandwidth recordings as discussed by [1]. To overcome these problems it was decided to record heart valve sounds under controlled conditions deep in an anechoic water tank, free from reverberation noise, including surface reflections. Experiments were conducted in a deep water tank at the Transdec facility in San Diego, which satisfies these requirements. The Transdec measurements are free of reverberations, but not totally free of acoustic and electrical noise. We used a high quality hydrophone together with a wide-band data acquisition system [2]. We recorded sounds from 100 repetitions of the opening-closing cycles on each of 50 different heart valves, including 21 SLS valves and 29 intact valves. The power spectrum of the opening and closing phases of each cycle were calculated and outlier spectra removed as described by Candy [2]. In this report, we discuss the results of our classification of the heart valve sound measurements. The goal of this classification task was to apply the fundamental classification algorithms developed for the clinical data in 1994 and 1996 to the measurements from the anechoic water tank. From the beginning of this project, LLNL's responsibility has been to process and classify the heart valve opening sounds. For this experiment, however, we processed both the opening sounds and closing sounds for comparison purposes. The results of this experiment show that the classifier did not perform well. We believe this is because of low signal-to-noise ratio and excessive variability in signal power from beat-to-beat for a given valve.

  11. An adaptive singular spectrum analysis approach to murmur detection from heart sounds.

    PubMed

    Sanei, Saeid; Ghodsi, Mansoureh; Hassani, Hossein

    2011-04-01

    Murmur is the result of various heart abnormalities. A new robust approach for separation of murmur from heart sound has been suggested in this article. Singular spectrum analysis (SSA) has been adapted to the changes in the statistical properties of the data and effectively used for detection of murmur from single-channel heart sound (HS) signals. Incorporating a cleverly selected a priori within the SSA reconstruction process, results in an accurate separation of normal HS from the murmur segment. Another contribution of this work is selection of the correct subspace of the desired signal component automatically. In addition, the subspace size can be identified iteratively. A number of HS signals with murmur have been processed using the proposed adaptive SSA (ASSA) technique and the results have been quantified both objectively and subjectively. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. [Realization of Heart Sound Envelope Extraction Implemented on LabVIEW Based on Hilbert-Huang Transform].

    PubMed

    Tan, Zhixiang; Zhang, Yi; Zeng, Deping; Wang, Hua

    2015-04-01

    We proposed a research of a heart sound envelope extraction system in this paper. The system was implemented on LabVIEW based on the Hilbert-Huang transform (HHT). We firstly used the sound card to collect the heart sound, and then implemented the complete system program of signal acquisition, pretreatment and envelope extraction on LabVIEW based on the theory of HHT. Finally, we used a case to prove that the system could collect heart sound, preprocess and extract the envelope easily. The system was better to retain and show the characteristics of heart sound envelope, and its program and methods were important to other researches, such as those on the vibration and voice, etc.

  13. Quantifying the Interactions between Maternal and Fetal Heart Rates by Transfer Entropy

    PubMed Central

    Marzbanrad, Faezeh; Kimura, Yoshitaka; Palaniswami, Marimuthu; Khandoker, Ahsan H.

    2015-01-01

    Evidence of the short term relationship between maternal and fetal heart rates has been found in previous studies. However there is still limited knowledge about underlying mechanisms and patterns of the coupling throughout gestation. In this study, Transfer Entropy (TE) was used to quantify directed interactions between maternal and fetal heart rates at various time delays and gestational ages. Experimental results using maternal and fetal electrocardiograms showed significant coupling for 63 out of 65 fetuses, by statistically validating against surrogate pairs. Analysis of TE showed a decrease in transfer of information from fetus to the mother with gestational age, alongside the maturation of the fetus. On the other hand, maternal to fetal TE was significantly greater in mid (26–31 weeks) and late (32–41 weeks) gestation compared to early (16–25 weeks) gestation (Mann Whitney Wilcoxon (MWW) p<0.05). TE further increased from mid to late, for the fetuses with RMSSD of fetal heart rate being larger than 4 msec in the late gestation. This difference was not observed for the fetuses with smaller RMSSD, which could be associated with the quiet sleep state. Delay in the information transfer from mother to fetus significantly decreased (p = 0.03) from mid to late gestation, implying a decrease in fetal response time. These changes occur concomitant with the maturation of the fetal sensory and autonomic nervous systems with advancing gestational age. The effect of maternal respiratory rate derived from maternal ECG was also investigated and no significant relationship was found between breathing rate and TE at any lag. In conclusion, the application of TE with delays revealed detailed information on the fetal-maternal heart rate coupling strength and latency throughout gestation, which could provide novel clinical markers of fetal development and well-being. PMID:26701122

  14. The design of heart sounds and electrocardiogram monitor system based Atmega 128L

    NASA Astrophysics Data System (ADS)

    Cao, Miao; An, Zhiyong; Zhang, Ying

    2006-11-01

    This paper introduces a realtime system which can acquire,process,store and display heart sounds and electrocardiogram(ECG) of the human body at the same time.It is composed of superior microprocessor--Atmega128L,large capacity Flash and the new type LCD.All hardwares adopt low power design and surface mounting package. The specialities of the system are low power, compact, and high intelligence. In consideration of transplant and solidity of the system, at the same time, it ensures that some complicated arithmetic can be realized.The system software applies mold construction and programs in C language. A model for automatic arithmetic is established for the feature extraction of ECG, realtime cardiotach ambulatory analysis is realized. The system is capable of recording ECG and heart sounds information in succession for 48 hours and it stores the no compression data synchronously. More than ten types of familiar heart diseases can be diagnosed in time by it automatically. The testing data achieved from this system is dependable, the diagnosing result is accurate and the waveform is no distortion. It solved a problem within the same kind of products effectively, that is, the dynamic ECG and heart sounds signal are acquired separately. The system do not affect the daily living and working of human being when it is used, so it is suited for clinical and family monitoring.

  15. Congenital heart disease in the offspring and maternal habits and home exposures during pregnancy.

    PubMed

    Tikkanen, J; Heinonen, O P

    1992-11-01

    To test the effect of maternal habits and home exposures during early pregnancy on the occurrence of congenital heart disease in the offspring, 406 cases and 756 controls were studied. The cases included all cardiovascular malformations detected in Finland during 1982-1983, while the healthy controls were randomly selected from all babies born during the same period. Case and control mothers were interviewed after delivery using a structured and pre-tested questionnaire. Maternal overall drug consumption during the first trimester was as prevalent among case mothers (13.3%) as controls (14.6%). Neither was the risk of congenital heart disease associated with maternal use of contraceptive pills, salicylates, diazepam, or sweetening agents separately. Maternal exposures to disinfectants, dyes, lacquers, paints, pesticides, or glues at home were equally prevalent in case and control groups. Several earlier miscarriages was a predictor of an infant born with congenital heart disease (OR = 2.7, CI95 = 1.4-5.3). Maternal ultrasound examination was performed during the first 16 weeks of pregnancy more often among the case group (28.3%) than among the control group (22.0%). However, the association between ultrasound examination and the risk of congenital heart disease in the offspring was not statistically significant (OR = 1.2, 95% confidence interval 0.9-1.7) when adjusted for confounding factors such as the threat of miscarriage in logistic regression analysis. It is concluded that maternal ultrasound examination, intake of some common drugs, and exposure to a number of environmental factors at home during early pregnancy are probably not harmful for the developing fetal heart.

  16. Maternal-fetal monitoring during dental procedure in patients with heart valve disease.

    PubMed

    Neves, Itamara Lucia Itagiba; Avila, Walkiria Samuel; Neves, Ricardo Simões; Giorgi, Dante Marcelo Artigas; Santos, Jorge Francisco Kuhn dos; Oliveira Filho, Ricardo Martins; Grupi, Cesar José; Grinberg, Max; Ramires, José Antonio Franchini

    2009-11-01

    The effects of local dental anesthesia with lidocaine and epinephrine on cardiovascular parameters of pregnant women with heart valve diseases and their fetuses are not fully understood. To assess and analyze cardiotocographic, blood pressure and electrocardiographic parameters of pregnant women with rheumatic heart valve disease undergoing local anesthesia with 1.8mL of lidocaine 2% with or without epinephrine 1:100,000 during restorative dental treatment. Maternal ambulatory blood pressure and electrocardiographic monitoring as well as cardiotocography of 31 patients with rheumatic heart disease were performed between the 28th and 37th week of gestation. The patients were divided into two groups, those with or without vasoconstrictor. A significant reduction in maternal heart rate was shown in both groups during the procedure in comparison with the other periods (p<0.001). Cardiac arrhythmia was observed in nine (29.0%) patients, of which seven (41.8%) were from the group of 17 pregnant women who received anesthesia plus epinephrine. No difference in maternal blood pressure was observed when periods or groups were compared (p>0.05). The same occurred (p>0.05) with the number of uterine contractions, baseline level and variability, and number of accelerations of fetal heart rate. The use of 1.8mL of lidocaine 2% in combination with epinephrine was safe and efficient in restorative dental procedures during pregnancy in women with rheumatic heart valve disease.

  17. Maternal and fetal outcome in women with rheumatic heart disease: a 3-year observational study.

    PubMed

    Rezk, Mohamed; Gamal, Awni

    2016-08-01

    To assess prospectively the maternal and fetal outcome in women with rheumatic heart disease (RHD). This was a prospective 3-year observational study carried out at Menoufia University Hospital, Egypt in which 192 patients out of 9856 pregnant women were diagnosed with RHD and divided into two groups: low- and high-risk groups based on the New York Heart Association (NYHA) functional classification. Enrolled patients were followed to assess the maternal and fetal outcome. Mitral valve disease was the commonest single valve (118/192, 51.4 %) affected by rheumatic fever. Cardiac women with NYHA class I&II characterized by having fewer pulmonary hypertension, taking cardiac medications, prior heart failure and prior cardiac surgery than those with NYHA class III&IV. On the hand, cardiac women with NYHA III&IV have poorer maternal outcome with more complications as heart failure, arrhythmias, thromboembolism, admission to cardiac ICU, delivery by cesarean section and defective lactation. Prematurity and NICU admission were significantly more in NYHA III&IV. RHD still constitutes a major cause of maternal and fetal morbidity and mortality. Multidisciplinary cooperation, proper preconception and antenatal care are the key measures to improve the outcomes of these patients.

  18. Pregnancy complicated by maternal heart disease: a review of 281 women.

    PubMed

    Konar, Hiralal; Chaudhuri, Snehamay

    2012-06-01

    To study maternal heart disease in an Indian setting for: (1) different etiological factors, (2) different types of lesions, and (3) maternal and perinatal outcome. 281 women with heart disease who delivered ≥28 weeks of gestation at different teaching institutions (tertiary care centres) in India were studied. Rheumatic heart disease (n = 195; 69.4 %) with isolated mitral stenosis (n = 75; 26.7 %) were the commonest. Septal defect (n = 27; 9.6 %) was the predominant lesion among the congenital heart disease (n = 60; 21.3 %) patients, whereas in the miscellaneous group (n = 26; 9.2 %), ischemic heart disease (n = 10; 3.6 %) was the leading cause. Multiple cardiac lesions were also diagnosed in 100 (35.58 %) women. In 87 (31 %) women, diagnosis was made first time in labor. Majority n = 131, (46.6 %) had spontaneous vaginal delivery and few (n = 9; 3.3 %) required induction of labor. Cardiac complications were noted in 72 women (25.6 %). There were three (1.06 %) maternal deaths and perinatal mortality was 4 % (n = 11). In this study, rheumatic heart disease in pregnancy is still predominant though acquired cardiac lesions are rising. In rheumatic heart disease, mitral valve involvement was the commonest and multiple valve lesions were a major observation. Most common obstetric complication was small for gestation baby. Maternal morbidities in the unbooked women are high and congestive cardiac failure was the major cardiac complication.

  19. Automatic heart sounds detection and systolic murmur characterization using wavelet transform and AR modeling.

    PubMed

    Ning, Taikang; Hsieh, Kai-Sheng

    2013-01-01

    This paper describes a signal processing procedure that identifies the first and the second heart sounds (S1 and S2), extracts the systole from the diastole, detects and characterizes the systolic murmur found within. The identification of heart sounds was facilitated by discrete wavelet transform (DWT) approximation using the Coiflet wavelet and followed by using indicators that quantify signal activity and strength. The systole was isolated and divided into smaller short segments where the signal activity measure and absolute amplitude were computed. S1 and S2, and the onset and duration of a systolic murmur were marked. Using the indices derived from AR modeling, a systolic murmur can be characterized by its timing, duration, pitch, and shape either as crescendo, decrescendo, crescendo-decrescendo, or plateau. The performance of the proposed procedure was evaluated and proved with clinically recorded systolic murmur episodes.

  20. Testing foetal-maternal heart rate synchronization via model-based analyses.

    PubMed

    Riedl, Maik; van Leeuwen, Peter; Suhrbier, Alexander; Malberg, Hagen; Grönemeyer, Dietrich; Kurths, Jürgen; Wessel, Niels

    2009-04-13

    The investigation of foetal reaction to internal and external conditions and stimuli is an important tool in the characterization of the developing neural integration of the foetus. An interesting example of this is the study of the interrelationship between the foetal and the maternal heart rate. Recent studies have shown a certain likelihood of occasional heart rate synchronization between mother and foetus. In the case of respiratory-induced heart rate changes, the comparison with maternal surrogates suggests that the evidence for detected synchronization is largely statistical and does not result from physiological interaction. Rather, they simply reflect a stochastic, temporary stability of two independent oscillators with time-variant frequencies. We reanalysed three datasets from that study for a more local consideration. Epochs of assumed synchronization associated with short-term regulation of the foetal heart rate were selected and compared with synchronization resulting from white noise instead of the foetal signal. Using data-driven modelling analysis, it was possible to identify the consistent influence of the heartbeat duration of maternal beats preceding the foetal beats during epochs of synchronization. These maternal beats occurred approximately one maternal respiratory cycle prior to the affected foetal beat. A similar effect could not be found in the epochs without synchronization. Simulations based on the fitted models led to a higher likelihood of synchronization in the data segments with assumed foetal-maternal interaction than in the segment without such assumed interaction. We conclude that the data-driven model-based analysis can be a useful tool for the identification of synchronization.

  1. S1 and S2 Heart Sound Recognition using Deep Neural Networks.

    PubMed

    Chen, Tien-En; Yang, Shih-I; Ho, Li-Ting; Tsai, Kun-Hsi; Chen, Yu-Hsuan; Chang, Yun-Fan; Lai, Ying-Hui; Wang, Syu-Siang; Tsao, Yu; Wu, Chau-Chung

    2016-04-27

    This study focuses on the first (S1) and sec-ond (S2) heart sound recognition based only on acoustic charac-teristics; the assumptions of the individual durations of S1 and S2 and time intervals of S1-S2 and S2-S1 are not involved in the recognition process. The main objective is to investigate whether reliable S1 and S2 recognition performance can still be attained under situations where the duration and interval information might not be accessible. A deep neural network (DNN) method is proposed for recognizing S1 and S2 heart sounds. In the proposed method, heart sound signals are first converted into a sequence of Mel-frequency cepstral coefficients (MFCCs). The K-means algorithm is applied to cluster MFCC features into two groups to refine their representation and discriminative capability. The refined features are then fed to a DNN classifier to perform S1 and S2 recognition. We conducted experiments using actual heart sound signals recorded using an electronic stethoscope. Pre-cision, recall, F-measure, and accuracy are used as the evaluation metrics. The proposed DNN-based method can achieve high precision, recall, and F-measure scores with more than 91% accuracy rate. The DNN classifier provides higher evaluation scores compared with other well-known pattern classi-fication methods. The proposed DNN-based method can achieve reliable S1 and S2 recognition performance based on acoustic characteristics without using an ECG reference or incor-porating the assumptions of the individual durations of S1 and S2 and time intervals of S1-S2 and S2-S1.

  2. S1 and S2 Heart Sound Recognition Using Deep Neural Networks.

    PubMed

    Chen, Tien-En; Yang, Shih-I; Ho, Li-Ting; Tsai, Kun-Hsi; Chen, Yu-Hsuan; Chang, Yun-Fan; Lai, Ying-Hui; Wang, Syu-Siang; Tsao, Yu; Wu, Chau-Chung

    2017-02-01

     This study focuses on the first (S1) and second (S2) heart sound recognition based only on acoustic characteristics; the assumptions of the individual durations of S1 and S2 and time intervals of S1-S2 and S2-S1 are not involved in the recognition process. The main objective is to investigate whether reliable S1 and S2 recognition performance can still be attained under situations where the duration and interval information might not be accessible.  A deep neural network (DNN) method is proposed for recognizing S1 and S2 heart sounds. In the proposed method, heart sound signals are first converted into a sequence of Mel-frequency cepstral coefficients (MFCCs). The K-means algorithm is applied to cluster MFCC features into two groups to refine their representation and discriminative capability. The refined features are then fed to a DNN classifier to perform S1 and S2 recognition. We conducted experiments using actual heart sound signals recorded using an electronic stethoscope. Precision, recall, F-measure, and accuracy are used as the evaluation metrics. The proposed DNN-based method can achieve high precision, recall, and F-measure scores with more than 91% accuracy rate. The DNN classifier provides higher evaluation scores compared with other well-known pattern classification methods. The proposed DNN-based method can achieve reliable S1 and S2 recognition performance based on acoustic characteristics without using an ECG reference or incorporating the assumptions of the individual durations of S1 and S2 and time intervals of S1-S2 and S2-S1.

  3. Maternal residential proximity to waste sites and industrial facilities and conotruncal heart defects in offspring.

    PubMed

    Langlois, Peter H; Brender, Jean D; Suarez, Lucina; Zhan, F Benjamin; Mistry, Jatin H; Scheuerle, Angela; Moody, Karen

    2009-07-01

    Most studies of the relationship between maternal residential proximity to sources of environmental pollution and congenital cardiovascular malformations have combined heart defects into one group or broad subgroups. The current case-control study examined whether risk of conotruncal heart defects, including subsets of specific defects, was associated with maternal residential proximity to hazardous waste sites and industrial facilities with recorded air emissions. Texas Birth Defects Registry cases were linked to their birth or fetal death certificate. Controls without birth defects were randomly selected from birth certificates. Distances from maternal addresses at delivery to National Priority List (NPL) waste sites, state superfund waste sites, and Toxic Release Inventory (TRI) facilities were determined for 1244 cases (89.5% of those eligible) and 4368 controls (88.0%). Living within 1 mile of a hazardous waste site was not associated with risk of conotruncal heart defects [adjusted odds ratio (aOR) = 0.83, 95% confidence interval (CI) = 0.54, 1.27]. This was true whether looking at most types of defects or waste sites. Only truncus arteriosus showed statistically elevated ORs with any waste site (crude OR: 2.80, 95% CI 1.19, 6.54) and with NPL sites (crude OR: 4.63, 95% CI 1.18, 13.15; aOR 4.99, 95% CI 1.26, 14.51), but the latter was based on only four exposed cases. There was minimal association between conotruncal heart defects and proximity to TRI facilities (aOR = 1.10, 95% CI = 0.91, 1.33). Stratification by maternal age or race/ethnic group made little difference in effect estimates for waste sites or industrial facilities. In this study population, maternal residential proximity to waste sites or industries with reported air emissions was not associated with conotruncal heart defects or its subtypes in offspring, with the exception of truncus arteriosus.

  4. Perception of binary acoustic events associated with the first heart sound

    NASA Technical Reports Server (NTRS)

    Spodick, D. H.

    1977-01-01

    The resolving power of the auditory apparatus permits discrete vibrations associated with cardiac activity to be perceived as one or more events. Irrespective of the vibratory combinations recorded by conventional phonocardiography, in normal adults and in most adult patients auscultators tend to discriminate only two discrete events associated with the first heart sound S1. It is stressed that the heart sound S4 may be present when a binary acoustic event associated with S1 occurs in the sequence 'low pitched sound preceding high pitched sound', i.e., its components are perceived by auscultation as 'dull-sharp'. The question of S4 audibility arises in those individuals, normal and diseased, in whom the major components of S1 ought to be, at least clinically, at their customary high pitch and indeed on the PCG appear as high frequency oscillations. It is revealed that the apparent audibility of recorded S4 is not related to P-R interval, P-S4 interval, or relative amplitude of S4. The significant S4-LFC (low frequency component of S1) differences can be related to acoustic modification of the early component of S1.

  5. Perception of binary acoustic events associated with the first heart sound

    NASA Technical Reports Server (NTRS)

    Spodick, D. H.

    1977-01-01

    The resolving power of the auditory apparatus permits discrete vibrations associated with cardiac activity to be perceived as one or more events. Irrespective of the vibratory combinations recorded by conventional phonocardiography, in normal adults and in most adult patients auscultators tend to discriminate only two discrete events associated with the first heart sound S1. It is stressed that the heart sound S4 may be present when a binary acoustic event associated with S1 occurs in the sequence 'low pitched sound preceding high pitched sound', i.e., its components are perceived by auscultation as 'dull-sharp'. The question of S4 audibility arises in those individuals, normal and diseased, in whom the major components of S1 ought to be, at least clinically, at their customary high pitch and indeed on the PCG appear as high frequency oscillations. It is revealed that the apparent audibility of recorded S4 is not related to P-R interval, P-S4 interval, or relative amplitude of S4. The significant S4-LFC (low frequency component of S1) differences can be related to acoustic modification of the early component of S1.

  6. 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

  7. Extracting fetal heart beats from maternal abdominal recordings: selection of the optimal principal components.

    PubMed

    Di Maria, Costanzo; Liu, Chengyu; Zheng, Dingchang; Murray, Alan; Langley, Philip

    2014-08-01

    This study presents a systematic comparison of different approaches to the automated selection of the principal components (PC) which optimise the detection of maternal and fetal heart beats from non-invasive maternal abdominal recordings.A public database of 75 4-channel non-invasive maternal abdominal recordings was used for training the algorithm. Four methods were developed and assessed to determine the optimal PC: (1) power spectral distribution, (2) root mean square, (3) sample entropy, and (4) QRS template. The sensitivity of the performance of the algorithm to large-amplitude noise removal (by wavelet de-noising) and maternal beat cancellation methods were also assessed. The accuracy of maternal and fetal beat detection was assessed against reference annotations and quantified using the detection accuracy score F1 [2*PPV*Se / (PPV + Se)], sensitivity (Se), and positive predictive value (PPV). The best performing implementation was assessed on a test dataset of 100 recordings and the agreement between the computed and the reference fetal heart rate (fHR) and fetal RR (fRR) time series quantified.The best performance for detecting maternal beats (F1 99.3%, Se 99.0%, PPV 99.7%) was obtained when using the QRS template method to select the optimal maternal PC and applying wavelet de-noising. The best performance for detecting fetal beats (F1 89.8%, Se 89.3%, PPV 90.5%) was obtained when the optimal fetal PC was selected using the sample entropy method and utilising a fixed-length time window for the cancellation of the maternal beats. The performance on the test dataset was 142.7 beats(2)/min(2) for fHR and 19.9 ms for fRR, ranking respectively 14 and 17 (out of 29) when compared to the other algorithms presented at the Physionet Challenge 2013.

  8. Detection of the Third Heart Sound Based on Nonlinear Signal Decomposition and Time-Frequency Localization.

    PubMed

    Barma, Shovan; Chen, Bo-Wei; Ji, Wen; Rho, Seungmin; Chou, Chih-Hung; Wang, Jhing-Fa

    2016-08-01

    This study presents a precise way to detect the third ( S3 ) heart sound, which is recognized as an important indication of heart failure, based on nonlinear single decomposition and time-frequency localization. The detection of the S3 is obscured due to its significantly low energy and frequency. Even more, the detected S3 may be misunderstood as an abnormal second heart sound with a fixed split, which was not addressed in the literature. To detect such S3, the Hilbert vibration decomposition method is applied to decompose the heart sound into a certain number of subcomponents while intactly preserving the phase information. Thus, the time information of all of the decomposed components are unchanged, which further expedites the identification and localization of any module/section of a signal properly. Next, the proposed localization step is applied to the decomposed subcomponents by using smoothed pseudo Wigner-Ville distribution followed by the reassignment method. Finally, based on the positional information, the S3 is distinguished and confirmed by measuring time delays between the S2 and S3. In total, 82 sets of cardiac cycles collected from different databases including Texas Heart Institute database are examined for evaluation of the proposed method. The result analysis shows that the proposed method can detect the S3 correctly, even when the normalized temporal energy of S3 is larger than 0.16, and the frequency of those is larger than 34 Hz. In a performance analysis, the proposed method demonstrates that the accuracy rate of S3 detection is as high as 93.9%, which is significantly higher compared with the other methods. Such findings prove the robustness of the proposed idea for detecting substantially low-energized S3 .

  9. Association of maternal chronic disease with risk of congenital heart disease in offspring

    PubMed Central

    Chou, Hsin-Hsu; Chiou, Meng-Jiun; Liang, Fu-Wen; Chen, Lea-Hua; Lu, Tsung-Hsueh; Li, Chung-Yi

    2016-01-01

    Background: Information about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring. Methods: The study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan’s National Health Insurance medical claims. We used multivariable logistic regression analysis to assess the associations of all cases and specific types of congenital heart disease with various maternal chronic diseases. Results: For mothers with the following chronic diseases, the overall prevalence of congenital heart disease in their children was significantly higher than for mothers without these diseases: diabetes mellitus type 1 (adjusted odds ratio [OR] 2.32, 95% confidence interval [CI] 1.66–3.25), diabetes mellitus type 2 (adjusted OR 2.85, 95% CI 2.60–3.12), hypertension (adjusted OR 1.87, 95% CI 1.69–2.07), congenital heart defects (adjusted OR 3.05, 95% CI 2.45–3.80), anemia (adjusted OR 1.31, 95% CI 1.25–1.38), connective tissue disorders (adjusted OR 1.39, 95% CI 1.19–1.62), epilepsy (adjusted OR 1.37, 95% CI 1.08–1.74) and mood disorders (adjusted OR 1.25, 95% CI 1.11–1.41). The same pattern held for mild forms of congenital heart disease. A higher prevalence of severe congenital heart disease was seen only among offspring of mothers with congenital heart defects or type 2 diabetes. Interpretation: The children of women with several kinds of chronic disease appear to be at risk for congenital heart disease. Preconception counselling and optimum treatment of pregnant women with chronic disease would seem prudent. PMID:27729382

  10. Association of maternal chronic disease with risk of congenital heart disease in offspring.

    PubMed

    Chou, Hsin-Hsu; Chiou, Meng-Jiun; Liang, Fu-Wen; Chen, Lea-Hua; Lu, Tsung-Hsueh; Li, Chung-Yi

    2016-12-06

    Information about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring. The study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan's National Health Insurance medical claims. We used multivariable logistic regression analysis to assess the associations of all cases and specific types of congenital heart disease with various maternal chronic diseases. For mothers with the following chronic diseases, the overall prevalence of congenital heart disease in their children was significantly higher than for mothers without these diseases: diabetes mellitus type 1 (adjusted odds ratio [OR] 2.32, 95% confidence interval [CI] 1.66-3.25), diabetes mellitus type 2 (adjusted OR 2.85, 95% CI 2.60-3.12), hypertension (adjusted OR 1.87, 95% CI 1.69-2.07), congenital heart defects (adjusted OR 3.05, 95% CI 2.45-3.80), anemia (adjusted OR 1.31, 95% CI 1.25-1.38), connective tissue disorders (adjusted OR 1.39, 95% CI 1.19-1.62), epilepsy (adjusted OR 1.37, 95% CI 1.08-1.74) and mood disorders (adjusted OR 1.25, 95% CI 1.11-1.41). The same pattern held for mild forms of congenital heart disease. A higher prevalence of severe congenital heart disease was seen only among offspring of mothers with congenital heart defects or type 2 diabetes. The children of women with several kinds of chronic disease appear to be at risk for congenital heart disease. Preconception counselling and optimum treatment of pregnant women with chronic disease would seem prudent. © 2016 Canadian Medical Association or its licensors.

  11. The maternal-age-associated risk of congenital heart disease is modifiable.

    PubMed

    Schulkey, Claire E; Regmi, Suk D; Magnan, Rachel A; Danzo, Megan T; Luther, Herman; Hutchinson, Alayna K; Panzer, Adam A; Grady, Mary M; Wilson, David B; Jay, Patrick Y

    2015-04-09

    Maternal age is a risk factor for congenital heart disease even in the absence of any chromosomal abnormality in the newborn. Whether the basis of this risk resides with the mother or oocyte is unknown. The impact of maternal age on congenital heart disease can be modelled in mouse pups that harbour a mutation of the cardiac transcription factor gene Nkx2-5 (ref. 8). Here, reciprocal ovarian transplants between young and old mothers establish a maternal basis for the age-associated risk in mice. A high-fat diet does not accelerate the effect of maternal ageing, so hyperglycaemia and obesity do not simply explain the mechanism. The age-associated risk varies with the mother's strain background, making it a quantitative genetic trait. Most remarkably, voluntary exercise, whether begun by mothers at a young age or later in life, can mitigate the risk when they are older. Thus, even when the offspring carry a causal mutation, an intervention aimed at the mother can meaningfully reduce their risk of congenital heart disease.

  12. Comparison between users of a new methodology for heart sound auscultation.

    PubMed

    Castro, Ana; Gomes, Pedro; Mattos, Sandra S; Coimbra, Miguel T

    2016-08-01

    Auscultation is a routine exam and the first line of screening in heart pathologies. The objective of this study was to assess if using a new data collection system, the DigiScope Collector, with a guided and automatic annotation of heart auscultation, different levels of expertise/experience users could collect similar digital auscultations. Data were collected within the Heart Caravan Initiative (Paraíba, Brasil). Patients were divided into two study groups: Group 1 evaluated by a third year medical student (User 1), and an experienced nurse (User 2); Group 2 evaluated by User 2 and an Information Technology professional (User 3). Patients were auscultated sequentially by the two users, according to the randomization. Features extracted from each data set included the length (HR) of the audio files, the number of repetitions per auscultation area, heart rate, first (S1) and second (S2) heart sound amplitudes, S2/S1, and aortic (A2) and pulmonary (P2) components of the second heart sound and relative amplitudes (P2/A2). Features extracted were compared between users using paired-sample test Wilcoxon test, and Spearman correlations (P<;0.05 considered significant). Twenty-seven patients were included in the study (13 Group 1, and 14 Group 2). No statistical significant differences were found between groups, except in the time of auscultation (User 2 consistently presented longer auscultation time). Correlation analysis showed significant correlations between extracted features from both groups: S2/S1 in Group 1, and S1, S2, A2, P2, P2/A2 amplitudes, and HR in Group 2. Using the DigiScope Collector, we were able to collect similar digital auscultations, according to the features evaluated. This may indicate that in sites with limited access to specialized clinical care, auscultation files may be acquired and used in telemedicine for an expert evaluation.

  13. Fetal manifestations of maternal anti‐Ro and La antibodies – more than complete heart block

    PubMed Central

    2015-01-01

    Abstract Complete heart block (CHB) is a potentially fatal condition occurring in approximately 1:10000 fetuses. Whilst it is well recognised that maternal anti‐Ro and La antibodies are associated with fetal CHB, there are multiple other manifestations of fetal exposure to these autoantibodies which are not widely appreciated and rarely diagnosed. The importance of identifying affected fetuses lies in the significantly increased risk of recurrence in future pregnancies, and the potential for treatments which may modify this risk. This paper presents several cases to highlight the varying fetal presentations of maternal anti‐Ro and La antibodies. PMID:28191254

  14. Heart murmurs

    MedlinePlus

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  15. FFT Techniques for the Spectral Analysis of Prosthetic Heart Valve Sounds

    PubMed Central

    Durand, L.-G.; de Guise, J.; Guardo, R.

    1980-01-01

    Sounds produced by prosthetic heart valves are known to contain diagnostic information regarding the structural and functional integrity of their components. Analog techniques for processing prosthetic valve phonocardiograms have met with limited success in extracting this information, because of their poor spectral resolution and lack of versatility. Numerical methods of signal processing overcome most of these limitations, but the need for a computer to implement numerical methods raises the question of cost-effectiveness in many applications. Numerical analysis of prosthetic valve signals has therefore received very little attention outside the academic and laboratory context. Cost reductions in computer hardware arising from the use of micro-processors, make it possible to envisage dedicated clinical instruments for processing prosthetic valve sounds in view of assessing overall valve performance and detecting component degradation at an early stage. Basic spectral considerations for the design of such instruments are discusses in this paper.

  16. Occlusion of sight, sound and smell during Green Exercise influences mood, perceived exertion and heart rate.

    PubMed

    Wooller, John-James; Barton, Jo; Gladwell, Valerie F; Micklewright, Dominic

    2016-01-01

    This study's aim was to identify the relative contribution of sight, sound and smell to the Green Exercise effect. It was hypothesised that visual occlusion while exercising in a natural environment would have the greatest diminishing effect on perceived exertion and mood compared to auditory and olfactory occlusion. Twenty-nine healthy participants were randomly assigned to one of the three groups: visual (n = 10), auditory (n = 9) and olfactory occlusion (n = 10). Each performed six, 5-min bouts of exercise alternating between full sensory and occlusion. Rate of perceived exertion (RPE), heart rate (HR) and mood were recorded at the end of each bout. Sensory-occlusion increased mood, RPE and HR; effects were strongest when sounds were blocked but virtually absent when vision was blocked. During sensory occlusion, mood changes were characterised by increased Fatigue and Confusion, and reduced Vigour. Reductions in Tension and Vigour and increases in Fatigue were found during full sensory exercise, consistent with previous research findings.

  17. Maternal Cardiac Output and Fetal Doppler Predict Adverse Neonatal Outcomes in Pregnant Women With Heart Disease.

    PubMed

    Wald, Rachel M; Silversides, Candice K; Kingdom, John; Toi, Ants; Lau, Cathy S; Mason, Jennifer; Colman, Jack M; Sermer, Mathew; Siu, Samuel C

    2015-11-23

    The mechanistic basis of the proposed relationship between maternal cardiac output and neonatal complications in pregnant women with heart disease has not been well elucidated. Pregnant women with cardiac disease and healthy pregnant women (controls) were prospectively followed with maternal echocardiography and obstetrical ultrasound scans at baseline, third trimester, and postpartum. Fetal/neonatal complications (death, small-for-gestational-age or low birthweight, prematurity, respiratory distress syndrome, or intraventricular hemorrhage) comprised the primary study outcome. One hundred and twenty-seven women with cardiac disease and 45 healthy controls were enrolled. Neonatal events occurred in 28 pregnancies and were more frequent in the heart disease group as compared with controls (n=26/127 or 21% versus n=2/45 or 4%; P=0.01). Multiple complications in an infant were counted as a single outcome event. Neonatal complications in the heart disease group were small-for-gestational-age/low birthweight (n=18), prematurity (n=14), and intraventricular hemorrhage/respiratory distress syndrome (n=5). Preexisting obstetric risk factors (P=0.003), maternal cardiac output decline from baseline to third trimester (P=0.017), and third trimester umbilical artery Doppler abnormalities (P<0.001) independently predicted neonatal complications and were incorporated into a novel risk index in which 0, 1, and >1 predictor corresponded to expected complication rates of 5%, 30%, and 76%, respectively. Decline in maternal cardiac output during pregnancy and abnormal umbilical artery Doppler flows independently predict neonatal complications. These findings will enhance the identification of higher risk pregnancies that would benefit from close antenatal surveillance. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. Maternal obesity disrupts circadian rhythms of clock and metabolic genes in the offspring heart and liver.

    PubMed

    Wang, Danfeng; Chen, Siyu; Liu, Mei; Liu, Chang

    2015-06-01

    Early life nutritional adversity is tightly associated with the development of long-term metabolic disorders. Particularly, maternal obesity and high-fat diets cause high risk of obesity in the offspring. Those offspring are also prone to develop hyperinsulinemia, hepatic steatosis and cardiovascular diseases. However, the precise underlying mechanisms leading to these metabolic dysregulation in the offspring remain unclear. On the other hand, disruptions of diurnal circadian rhythms are known to impair metabolic homeostasis in various tissues including the heart and liver. Therefore, we investigated that whether maternal obesity perturbs the circadian expression rhythms of clock, metabolic and inflammatory genes in offspring heart and liver by using RT-qPCR and Western blotting analysis. Offspring from lean and obese dams were examined on postnatal day 17 and 35, when pups were nursed by their mothers or took food independently. On P17, genes examined in the heart either showed anti-phase oscillations (Cpt1b, Pparα, Per2) or had greater oscillation amplitudes (Bmal1, Tnf-α, Il-6). Such phase abnormalities of these genes were improved on P35, while defects in amplitudes still existed. In the liver of 17-day-old pups exposed to maternal obesity, the oscillation amplitudes of most rhythmic genes examined (except Bmal1) were strongly suppressed. On P35, the oscillations of circadian and inflammatory genes became more robust in the liver, while metabolic genes were still kept non-rhythmic. Maternal obesity also had a profound influence in the protein expression levels of examined genes in offspring heart and liver. Our observations indicate that the circadian clock undergoes nutritional programing, which may contribute to the alternations in energy metabolism associated with the development of metabolic disorders in early life and adulthood.

  19. Usefulness of the second heart sound for predicting pulmonary hypertension in patients with interstitial lung disease.

    PubMed

    Cobra, Sandra de Barros; Cardoso, Rayane Marques; Rodrigues, Marcelo Palmeira

    2016-01-01

    P2 hyperphonesis is considered to be a valuable finding in semiological diagnoses of pulmonary hypertension (PH). The aim here was to evaluate the accuracy of the pulmonary component of second heart sounds for predicting PH in patients with interstitial lung disease. Cross-sectional study at the University of Brasilia and Hospital de Base do Distrito Federal. Heart sounds were acquired using an electronic stethoscope and were analyzed using phonocardiography. Clinical signs suggestive of PH, such as second heart sound (S2) in pulmonary area louder than in aortic area; P2 > A2 in pulmonary area and P2 present in mitral area, were compared with Doppler echocardiographic parameters suggestive of PH. Sensitivity (S), specificity (Sp) and positive (LR+) and negative (LR-) likelihood ratios were evaluated. There was no significant correlation between S2 or P2 amplitude and PASP (pulmonary artery systolic pressure) (P = 0.185 and 0.115; P= 0.13 and 0.34, respectively). Higher S2 in pulmonary area than in aortic area, compared with all the criteria suggestive of PH, showed S = 60%, Sp= 22%; LR+ = 0.7; LR- = 1.7; while P2> A2 showed S= 57%, Sp = 39%; LR+ = 0.9; LR- = 1.1; and P2 in mitral area showed: S= 68%, Sp = 41%; LR+ = 1.1; LR- = 0.7. All these signals together showed: S= 50%, Sp = 56%. The semiological signs indicative of PH presented low sensitivity and specificity levels for clinically diagnosing this comorbidity.

  20. A novel murmur-based heart sound feature extraction technique using envelope-morphological analysis

    NASA Astrophysics Data System (ADS)

    Yao, Hao-Dong; Ma, Jia-Li; Fu, Bin-Bin; Wang, Hai-Yang; Dong, Ming-Chui

    2015-07-01

    Auscultation of heart sound (HS) signals serves as an important primary approach to diagnose cardiovascular diseases (CVDs) for centuries. Confronting the intrinsic drawbacks of traditional HS auscultation, computer-aided automatic HS auscultation based on feature extraction technique has witnessed explosive development. Yet, most existing HS feature extraction methods adopt acoustic or time-frequency features which exhibit poor relationship with diagnostic information, thus restricting the performance of further interpretation and analysis. Tackling such a bottleneck problem, this paper innovatively proposes a novel murmur-based HS feature extraction method since murmurs contain massive pathological information and are regarded as the first indications of pathological occurrences of heart valves. Adapting discrete wavelet transform (DWT) and Shannon envelope, the envelope-morphological characteristics of murmurs are obtained and three features are extracted accordingly. Validated by discriminating normal HS and 5 various abnormal HS signals with extracted features, the proposed method provides an attractive candidate in automatic HS auscultation.

  1. Is advanced maternal age a risk factor for congenital heart disease?

    PubMed

    Best, Kate E; Rankin, Judith

    2016-06-01

    Studies have reported that advanced maternal age is a risk factor for congenital heart disease (CHD), but none of these have been performed in the United Kingdom. Currently, women in the United Kingdom are not referred for specialist fetal echocardiography based on maternal age alone. The aim of this study is to examine the association between maternal age at delivery and CHD prevalence in the North of England. Singleton cases of CHD notified to the Northern Congenital Abnormality Survey and born between January 1, 1998, to December 31, 2013, were included. Cases with chromosomal anomalies were excluded. The relative risk (RR) of CHD according to maternal age at delivery was estimated using Poisson regression. There were 4024 singleton cases of nonchromosomal CHD, giving a prevalence of 8.1 (95% confidence interval [CI], 7.8-8.3) per 1000 live and stillbirths. There was no association between maternal age at delivery and CHD prevalence (p = 0.97), with no evidence of an increased risk of CHD in mothers aged ≥35 compared to aged 25 to 29 (RR = 0.99; 95% CI, 0.89-1.09). There were no significant associations between maternal age at delivery and severity III CHD (p = 0.84), severity II CHD (p = 0.74), or severity I CHD (p = 0.66), although there was a slight increased risk of severity I CHD in mothers aged ≥35 (RR = 1.27; 95% CI, 0.83-1.95). We found little evidence that advanced maternal age is a risk factor for CHD. There is no evidence that women in the United Kingdom should be referred for specialist prenatal cardiac screening based on their age. Birth Defects Research (Part A) 106:461-467, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring.

    PubMed

    Kim, Jihye; Swartz, Michael D; Langlois, Peter H; Romitti, Paul A; Weyer, Peter; Mitchell, Laura E; Luben, Thomas J; Ramakrishnan, Anushuya; Malik, Sadia; Lupo, Philip J; Feldkamp, Marcia L; Meyer, Robert E; Winston, Jennifer J; Reefhuis, Jennita; Blossom, Sarah J; Bell, Erin; Agopian, A J

    2017-08-08

    Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district's measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects.

  3. Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring

    PubMed Central

    Kim, Jihye; Swartz, Michael D.; Langlois, Peter H.; Romitti, Paul A.; Weyer, Peter; Mitchell, Laura E.; Ramakrishnan, Anushuya; Malik, Sadia; Lupo, Philip J.; Feldkamp, Marcia L.; Meyer, Robert E.; Winston, Jennifer J.; Reefhuis, Jennita; Blossom, Sarah J.; Bell, Erin; Agopian, A. J.

    2017-01-01

    Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district’s measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects. PMID:28786932

  4. Detection of the valvular split within the second heart sound using the reassigned smoothed pseudo Wigner–Ville distribution

    PubMed Central

    2013-01-01

    Background In this paper, we developed a novel algorithm to detect the valvular split between the aortic and pulmonary components in the second heart sound which is a valuable medical information. Methods The algorithm is based on the Reassigned smoothed pseudo Wigner–Ville distribution which is a modified time–frequency distribution of the Wigner–Ville distribution. A preprocessing amplitude recovery procedure is carried out on the analysed heart sound to improve the readability of the time–frequency representation. The simulated S2 heart sounds were generated by an overlapping frequency modulated chirp–based model at different valvular split durations. Results Simulated and real heart sounds are processed to highlight the performance of the proposed approach. The algorithm is also validated on real heart sounds of the LGB–IRCM (Laboratoire de Génie biomédical–Institut de recherches cliniques de Montréal) cardiac valve database. The A2–P2 valvular split is accurately detected by processing the obtained RSPWVD representations for both simulated and real data. PMID:23631738

  5. Detection of the valvular split within the second heart sound using the reassigned smoothed pseudo Wigner-Ville distribution.

    PubMed

    Djebbari, Abdelghani; Bereksi-Reguig, Fethi

    2013-04-30

    In this paper, we developed a novel algorithm to detect the valvular split between the aortic and pulmonary components in the second heart sound which is a valuable medical information. The algorithm is based on the Reassigned smoothed pseudo Wigner-Ville distribution which is a modified time-frequency distribution of the Wigner-Ville distribution. A preprocessing amplitude recovery procedure is carried out on the analysed heart sound to improve the readability of the time-frequency representation. The simulated S2 heart sounds were generated by an overlapping frequency modulated chirp-based model at different valvular split durations. Simulated and real heart sounds are processed to highlight the performance of the proposed approach. The algorithm is also validated on real heart sounds of the LGB-IRCM (Laboratoire de Génie biomédical-Institut de recherches cliniques de Montréal) cardiac valve database. The A2-P2 valvular split is accurately detected by processing the obtained RSPWVD representations for both simulated and real data.

  6. High Order Statistics and Time-Frequency Domain to Classify Heart Sounds for Subjects under Cardiac Stress Test.

    PubMed

    Moukadem, Ali; Schmidt, Samuel; Dieterlen, Alain

    2015-01-01

    This paper considers the problem of classification of the first and the second heart sounds (S1 and S2) under cardiac stress test. The main objective is to classify these sounds without electrocardiogram (ECG) reference and without taking into consideration the systolic and the diastolic time intervals criterion which can become problematic and useless in several real life settings as severe tachycardia and tachyarrhythmia or in the case of subjects being under cardiac stress activity. First, the heart sounds are segmented by using a modified time-frequency based envelope. Then, to distinguish between the first and the second heart sounds, new features, named α(opt), β, and γ, based on high order statistics and energy concentration measures of the Stockwell transform (S-transform) are proposed in this study. A study of the variation of the high frequency content of S1 and S2 over the HR (heart rate) is also discussed. The proposed features are validated on a database that contains 2636 S1 and S2 sounds corresponding to 62 heart signals and 8 subjects under cardiac stress test collected from healthy subjects. Results and comparisons with existing methods in the literature show a large superiority for our proposed features.

  7. High Order Statistics and Time-Frequency Domain to Classify Heart Sounds for Subjects under Cardiac Stress Test

    PubMed Central

    Moukadem, Ali; Schmidt, Samuel; Dieterlen, Alain

    2015-01-01

    This paper considers the problem of classification of the first and the second heart sounds (S1 and S2) under cardiac stress test. The main objective is to classify these sounds without electrocardiogram (ECG) reference and without taking into consideration the systolic and the diastolic time intervals criterion which can become problematic and useless in several real life settings as severe tachycardia and tachyarrhythmia or in the case of subjects being under cardiac stress activity. First, the heart sounds are segmented by using a modified time-frequency based envelope. Then, to distinguish between the first and the second heart sounds, new features, named α opt, β, and γ, based on high order statistics and energy concentration measures of the Stockwell transform (S-transform) are proposed in this study. A study of the variation of the high frequency content of S1 and S2 over the HR (heart rate) is also discussed. The proposed features are validated on a database that contains 2636 S1 and S2 sounds corresponding to 62 heart signals and 8 subjects under cardiac stress test collected from healthy subjects. Results and comparisons with existing methods in the literature show a large superiority for our proposed features. PMID:26089957

  8. Lung sound patterns help to distinguish congestive heart failure, chronic obstructive pulmonary disease, and asthma exacerbations.

    PubMed

    Wang, Zhen; Xiong, Ying Xia

    2012-01-01

    Although congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and asthma patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to rigorous analysis. The aim of this study was to evaluate in detail the distribution of respiratory sound intensity in CHF, COPD, and asthma patients during acute exacerbation. Respiratory sounds throughout the respiratory cycle were captured and displayed using an acoustic-based imaging technique. Breath sound distribution was mapped to create a gray-scale sequence of two-dimensional images based on intensity of sound (vibration). Consecutive CHF (n = 22), COPD (n = 19), and asthma (n = 18) patients were imaged at the time of presentation to the emergency department (ED). Twenty healthy subjects were also enrolled as a comparison group. Geographical area of the images and respiratory sound patterns were quantitatively analyzed. In healthy volunteers and COPD patients, the median (interquartile range [IQR]) geographical areas of the vibration energy images were similar, at 75.6 (IQR = 6.0) and 75.8 (IQR = 10.8) kilopixels, respectively (p > 0.05). Compared to healthy volunteers and COPD patients, areas for CHF and asthma patients were smaller, at 66.9 (IQR = 9.9) and 53.9 (IQR = 15.6) kilopixels, respectively (p < 0.05). The geographic area ratios between the left and right lungs for healthy volunteers and CHF and COPD patients were 1.0 (IQR = 0.2), 1.0 (IQR = 0.2), and 1.0 (IQR = 0.1), respectively. Compared to healthy volunteers, the geographic area ratio between the left and right lungs for asthma patients was 0.5 (IQR = 0.4; p < 0.05). In healthy volunteers and CHF patients, the ratios of vibration energy values at peak inspiration and expiration (peak I/E ratio) were 4.6 (IQR = 4.4) and 4.7 (IQR = 3.5). In marked contrast, the peak I/E ratios of COPD and asthma patients were 3.4 (= 2.1) and 0.1 (IQR = 0.3; p < 0.05), respectively. The

  9. Obstructive heart defects associated with candidate genes, maternal obesity, and folic acid supplementation.

    PubMed

    Tang, Xinyu; Cleves, Mario A; Nick, Todd G; Li, Ming; MacLeod, Stewart L; Erickson, Stephen W; Li, Jingyun; Shaw, Gary M; Mosley, Bridget S; Hobbs, Charlotte A

    2015-06-01

    Right-sided and left-sided obstructive heart defects (OHDs) are subtypes of congenital heart defects, in which the heart valves, arteries, or veins are abnormally narrow or blocked. Previous studies have suggested that the development of OHDs involved a complex interplay between genetic variants and maternal factors. Using the data from 569 OHD case families and 1,644 control families enrolled in the National Birth Defects Prevention Study (NBDPS) between 1997 and 2008, we conducted an analysis to investigate the genetic effects of 877 single nucleotide polymorphisms (SNPs) in 60 candidate genes for association with the risk of OHDs, and their interactions with maternal use of folic acid supplements, and pre-pregnancy obesity. Applying log-linear models based on the hybrid design, we identified a SNP in methylenetetrahydrofolate reductase (MTHFR) gene (C677T polymorphism) with a main genetic effect on the occurrence of OHDs. In addition, multiple SNPs in betaine-homocysteine methyltransferase (BHMT and BHMT2) were also identified to be associated with the occurrence of OHDs through significant main infant genetic effects and interaction effects with maternal use of folic acid supplements. We also identified multiple SNPs in glutamate-cysteine ligase, catalytic subunit (GCLC) and DNA (cytosine-5-)-methyltransferase 3 beta (DNMT3B) that were associated with elevated risk of OHDs among obese women. Our findings suggested that the risk of OHDs was closely related to a combined effect of variations in genes in the folate, homocysteine, or glutathione/transsulfuration pathways, maternal use of folic acid supplements and pre-pregnancy obesity. © 2015 Wiley Periodicals, Inc.

  10. Congenital Heart Block Maternal Sera Autoantibodies Target an Extracellular Epitope on the α1G T-Type Calcium Channel in Human Fetal Hearts

    PubMed Central

    Rath, Arianna; Liu, Jie; Silverman, Earl D.; Liu, Xiaoru; Siragam, Vinayakumar; Ackerley, Cameron; Su, Brenda Bin; Yan, Jane Yuqing; Capecchi, Marco; Biavati, Luca; Accorroni, Alice; Yuen, William; Quattrone, Filippo; Lung, Kalvin; Jaeggi, Edgar T.; Backx, Peter H.; Deber, Charles M.; Hamilton, Robert M.

    2013-01-01

    Background Congenital heart block (CHB) is a transplacentally acquired autoimmune disease associated with anti-Ro/SSA and anti-La/SSB maternal autoantibodies and is characterized primarily by atrioventricular (AV) block of the fetal heart. This study aims to investigate whether the T-type calcium channel subunit α1G may be a fetal target of maternal sera autoantibodies in CHB. Methodology/Principal Findings We demonstrate differential mRNA expression of the T-type calcium channel CACNA1G (α1G gene) in the AV junction of human fetal hearts compared to the apex (18–22.6 weeks gestation). Using human fetal hearts (20–22 wks gestation), our immunoprecipitation (IP), Western blot analysis and immunofluorescence (IF) staining results, taken together, demonstrate accessibility of the α1G epitope on the surfaces of cardiomyocytes as well as reactivity of maternal serum from CHB affected pregnancies to the α1G protein. By ELISA we demonstrated maternal sera reactivity to α1G was significantly higher in CHB maternal sera compared to controls, and reactivity was epitope mapped to a peptide designated as p305 (corresponding to aa305–319 of the extracellular loop linking transmembrane segments S5–S6 in α1G repeat I). Maternal sera from CHB affected pregnancies also reacted more weakly to the homologous region (7/15 amino acids conserved) of the α1H channel. Electrophysiology experiments with single-cell patch-clamp also demonstrated effects of CHB maternal sera on T-type current in mouse sinoatrial node (SAN) cells. Conclusions/Significance Taken together, these results indicate that CHB maternal sera antibodies readily target an extracellular epitope of α1G T-type calcium channels in human fetal cardiomyocytes. CHB maternal sera also show reactivity for α1H suggesting that autoantibodies can target multiple fetal targets. PMID:24039792

  11. Congenital heart block maternal sera autoantibodies target an extracellular epitope on the α1G T-type calcium channel in human fetal hearts.

    PubMed

    Strandberg, Linn S; Cui, Xuezhi; Rath, Arianna; Liu, Jie; Silverman, Earl D; Liu, Xiaoru; Siragam, Vinayakumar; Ackerley, Cameron; Su, Brenda Bin; Yan, Jane Yuqing; Capecchi, Marco; Biavati, Luca; Accorroni, Alice; Yuen, William; Quattrone, Filippo; Lung, Kalvin; Jaeggi, Edgar T; Backx, Peter H; Deber, Charles M; Hamilton, Robert M

    2013-01-01

    Congenital heart block (CHB) is a transplacentally acquired autoimmune disease associated with anti-Ro/SSA and anti-La/SSB maternal autoantibodies and is characterized primarily by atrioventricular (AV) block of the fetal heart. This study aims to investigate whether the T-type calcium channel subunit α1G may be a fetal target of maternal sera autoantibodies in CHB. We demonstrate differential mRNA expression of the T-type calcium channel CACNA1G (α1G gene) in the AV junction of human fetal hearts compared to the apex (18-22.6 weeks gestation). Using human fetal hearts (20-22 wks gestation), our immunoprecipitation (IP), Western blot analysis and immunofluorescence (IF) staining results, taken together, demonstrate accessibility of the α1G epitope on the surfaces of cardiomyocytes as well as reactivity of maternal serum from CHB affected pregnancies to the α1G protein. By ELISA we demonstrated maternal sera reactivity to α1G was significantly higher in CHB maternal sera compared to controls, and reactivity was epitope mapped to a peptide designated as p305 (corresponding to aa305-319 of the extracellular loop linking transmembrane segments S5-S6 in α1G repeat I). Maternal sera from CHB affected pregnancies also reacted more weakly to the homologous region (7/15 amino acids conserved) of the α1H channel. Electrophysiology experiments with single-cell patch-clamp also demonstrated effects of CHB maternal sera on T-type current in mouse sinoatrial node (SAN) cells. Taken together, these results indicate that CHB maternal sera antibodies readily target an extracellular epitope of α1G T-type calcium channels in human fetal cardiomyocytes. CHB maternal sera also show reactivity for α1H suggesting that autoantibodies can target multiple fetal targets.

  12. Fetal heart rate and motor activity associations with maternal organochlorine levels: Results of an exploratory study

    PubMed Central

    DiPietro, Janet A.; Davis, Meghan F.; Costigan, Kathleen A; Barr, Dana Boyd

    2015-01-01

    Contemporaneous associations between circulating maternal organochlorines and measures of fetal heart rate and motor activity were evaluated. A panel of 47 organochlorines (OCs), including pesticides and polychlorinated biphenyls (PCBs), was analyzed from serum of 50 pregnant women at 36 weeks gestation. Data were empirically reduced into four factors and six individual compounds. All participants had detectable concentrations of at least one-quarter of the assayed OCs and, in general, higher socioeconomic level was associated with higher OC concentrations. Fetal heart rate measures were not consistently associated with maternal OCs. In contrast, one or more indicators of greater fetal motor activity were significantly associated with higher levels of the DDT and low chlorinated OC factors and five of the six individual compounds (heptachlor epoxide, trans nonachlor, oxychlordane, and PCBs 18 and 52). This preliminary demonstration of associations between fetal motor activity and maternal concentrations of persistent and pervasive environmental contaminants suggests that fetal assessment may be useful in ascertaining the potential early effects of these compounds on development. PMID:23591698

  13. Fetal heart rate and motor activity associations with maternal organochlorine levels: results of an exploratory study.

    PubMed

    DiPietro, Janet A; Davis, Meghan F; Costigan, Kathleen A; Barr, Dana Boyd

    2014-01-01

    Contemporaneous associations between circulating maternal organochlorines (OCs) and measures of fetal heart rate and motor activity were evaluated. A panel of 47 OCs, including pesticides and polychlorinated biphenyls (PCBs), was analyzed from serum of 50 pregnant women at 36 weeks gestation. Data were empirically reduced into four factors and six individual compounds. All participants had detectable concentrations of at least one-quarter of the assayed OCs and, in general, higher socioeconomic level was associated with higher OC concentrations. Fetal heart rate measures were not consistently associated with maternal OCs. In contrast, one or more indicators of greater fetal motor activity were significantly associated with higher levels of the DDT and low chlorinated OC factors and five of the six individual compounds (heptachlor epoxide, trans nonachlor, oxychlordane, and PCBs 18 and 52). This preliminary demonstration of associations between fetal motor activity and maternal concentrations of persistent and pervasive environmental contaminants suggests that fetal assessment may be useful in ascertaining the potential early effects of these compounds on development.

  14. Intrapartum heart rate ambiguity: a comparison of cardiotocogram and abdominal fetal electrocardiogram with maternal electrocardiogram.

    PubMed

    Reinhard, Joscha; Hayes-Gill, Barrie R; Schiermeier, Sven; Hatzmann, Hendrike; Heinrich, Tomas M; Louwen, Frank

    2013-01-01

    To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery by comparing simultaneous cardiotocogram (CTG), abdominal fetal electrocardiogram (ECG) with continuous maternal ECG. A total of 144 simultaneous CTG (Corometrics 250 series), abdominal fetal ECG (Monica -AN24™) and maternal ECG (Monica AN24™) recordings were evaluated. When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the ECG, it is classified as 'MHR/FHR ambiguity'. Statistical analyses were performed with Fisher's exact test and the Wilcoxon signed-rank test. Comparison of abdominal fetal ECG against CTG demonstrates significantly less 'MHR/FHR ambiguity' in both the first stage (mean 0.70 vs. 1.22%, p < 0.001) and second stage of labour (mean 3.30 vs. 6.20%, p < 0.001). Intrapartum FHR monitoring in daily practice via the CTG modality provides significantly more 'MHR/FHR ambiguity' than abdominal fetal ECG, which also provides additional information on the MHR. Copyright © 2013 S. Karger AG, Basel.

  15. Combining sparse coding and time-domain features for heart sound classification.

    PubMed

    Whitaker, Bradley M; Suresha, Pradyumna B; Liu, Chengyu; Clifford, Gari D; Anderson, David V

    2017-07-31

    This paper builds upon work submitted as part of the 2016 PhysioNet/CinC Challenge, which used sparse coding as a feature extraction tool on audio PCG data for heart sound classification. In sparse coding, preprocessed data is decomposed into a dictionary matrix and a sparse coefficient matrix. The dictionary matrix represents statistically important features of the audio segments. The sparse coefficient matrix is a mapping that represents which features are used by each segment. Working in the sparse domain, we train support vector machines (SVMs) for each audio segment (S1, systole, S2, diastole) and the full cardiac cycle. We train a sixth SVM to combine the results from the preliminary SVMs into a single binary label for the entire PCG recording. In addition to classifying heart sounds using sparse coding, this paper presents two novel modifications. The first uses a matrix norm in the dictionary update step of sparse coding to encourage the dictionary to learn discriminating features from the abnormal heart recordings. The second combines the sparse coding features with time-domain features in the final SVM stage. The original algorithm submitted to the challenge achieved a cross-validated mean accuracy (MAcc) score of 0.8652 (Se  =  0.8669 and Sp  =  0.8634). After incorporating the modifications new to this paper, we report an improved cross-validated MAcc of 0.8926 (Se  =  0.9007 and Sp  =  0.8845). Our results show that sparse coding is an effective way to define spectral features of the cardiac cycle and its sub-cycles for the purpose of classification. In addition, we demonstrate that sparse coding can be combined with additional feature extraction methods to improve classification accuracy.

  16. Maternal obesity and congenital heart defects: a population-based study123

    PubMed Central

    Mills, James L; Troendle, James; Conley, Mary R; Carter, Tonia; Druschel, Charlotte M

    2010-01-01

    Background: Obesity affects almost one-third of pregnant women and causes many complications, including neural tube defects. It is not clear whether the risk of congenital heart defects, the most common malformations, is also increased. Objective: This study was conducted to determine whether obesity is associated with an increased risk of congenital heart defects. Design: A population-based, nested, case-control study was conducted in infants born with congenital heart defects and unaffected controls from the cohort of all births (n = 1,536,828) between 1993 and 2003 in New York State, excluding New York City. The type of congenital heart defect, maternal body mass index (BMI; in kg/m2), and other risk factors were obtained from the Congenital Malformations Registry and vital records. Mothers of 7392 congenital heart defect cases and 56,304 unaffected controls were studied. Results: All obese women (BMI ≥ 30) were significantly more likely than normal-weight women (BMI: 19–24.9) to have children with a congenital heart defect [odds ratio (OR): 1.15; 95% CI: 1.07, 1.23; P < 0.0001]. Overweight women were not at increased risk (OR: 1.00; 95% CI: 0.94, 1.06). The risk in morbidly obese women (BMI ≥ 40) was higher (OR: 1.33; 95% CI: 1.15, 1.54; P = 0.0001) than that in obese women with a BMI of 30–39.9 (OR: 1.11; 95% CI: 1.04, 1.20; P = 0.004). There was a highly significant trend of increasing OR for congenital heart defects with increasing maternal obesity (P < 0.0001). The offspring of obese women had significantly higher ORs for atrial septal defects, hypoplastic left heart syndrome, aortic stenosis, pulmonic stenosis, and tetralogy of Fallot. Conclusions: Obese, but not overweight, women are at significantly increased risk of bearing children with a range of congenital heart defects, and the risk increases with increasing BMI. Weight reduction as a way to reduce risk should be investigated. PMID:20375192

  17. The effects of maternal caffeine and chocolate intake on fetal heart rate.

    PubMed

    Buscicchio, Giorgia; Piemontese, Mariangela; Gentilucci, Lucia; Ferretti, Filippo; Tranquilli, Andrea L

    2012-05-01

    The aim of our study was to analyze the effects of caffeine and chocolate (70% cocoa) on fetal heart rate (FHR). Fifty pregnant women with uncomplicated gestation, matched for age and parity, underwent computerized FHR recording before and after the consumption of caffeine and then, after one week, before and after 70% cocoa chocolate intake. Computerized cardiotocography (cCTG) parameters were expressed as mean and SD. The differences were tested for statistical significance using the paired t-test, with significance at p < 0.05. The number of uterine contraction peaks, the number of small and large accelerations (10 and 15 beats per minute for 15 seconds), the duration of episodes of high variation and the short-term FHR variation were significantly higher (p < 0.001) after maternal coffee intake. The number of large accelerations, the duration of episodes of high variation and the short-term FHR variation were significantly higher (p < 0.001) after maternal consumption of chocolate, whilst no effect of cocoa was found during contractions. Our results suggest that maternal intake of both caffeine and 70% cocoa have a stimulating action on fetal reactivity. This finding is likely due to the pharmacological action of theobromine, a methilxanthine present in coffee and in chocolate. The correlation between maternal caffeine intake and increased uterine contraction peaks is likely due to the effect of caffeine on the uterine muscle.

  18. The influence of physical activity during pregnancy on maternal, fetal or infant heart rate variability: a systematic review.

    PubMed

    Dietz, Pavel; Watson, Estelle D; Sattler, Matteo C; Ruf, Wolfgang; Titze, Sylvia; van Poppel, Mireille

    2016-10-26

    Physical activity (PA) during pregnancy has been shown to be associated with several positive effects for mother, fetus, and offspring. Heart rate variability (HRV) is a noninvasive and surrogate marker to determine fetal overall health and the development of fetal autonomic nervous system. In addition, it has been shown to be significantly influenced by maternal behavior. However, the influence of maternal PA on HRV has not yet been systematically reviewed. Therefore, the aim of this systematic review was to assess the influence of regular maternal PA on maternal, fetal or infant HRV. A systematic literature search following a priori formulated criteria of studies that examined the influence of regular maternal PA (assessed for a minimum period of 6 weeks) on maternal, fetal or infant HRV was performed in the databases Pubmed and SPORTDiscus. Quality of each study was assessed using the standardized Quality Assessment Tool for Quantitative Studies (QATQS). Nine articles were included into the present systematic review: two intervention studies, one prospective longitudinal study, and six post-hoc analysis of subsets of the longitudinal study. Of these articles four referred to maternal HRV, five to fetal HRV, and one to infant HRV. The overall global rating for the standardized quality assessment of the articles was moderate to weak. The articles regarding the influence of maternal PA on maternal HRV indicated contrary results. Five of five articles regarding the influence of maternal PA on fetal HRV showed increases of fetal HRV on most parameters depending on maternal PA. The article referring to infant HRV (measured one month postnatal) showed an increased HRV. Based on the current evidence available, our overall conclusion is that the hypothesis that maternal PA influences maternal HRV cannot be supported, but there is a trend that maternal PA might increase fetal and infant HRV (clinical conclusion). Therefore, we recommend that further, high quality studies

  19. Association between maternal aluminum exposure and the risk of congenital heart defects in offspring.

    PubMed

    Liu, Zhen; Lin, Yuan; Tian, Xiaoxian; Li, Jun; Chen, Xinlin; Yang, Jiaxiang; Li, Xiaohong; Deng, Ying; Li, Nana; Liang, Juan; Li, Shengli; Zhu, Jun

    2016-02-01

    Aluminum (Al) is the third most common element in the earth' s crust and has been reported to be teratogenic. However, there is lack of understanding about the association between maternal aluminum exposure and the risks of birth defects such as congenital heart defects (CHDs). A multi-center, hospital-based case-control study was performed at four maternal and child tertiary hospitals in China. A total of 223 cases with CHDs and 223 controls without any abnormalities were recruited according to the inclusion and matching criteria. Hair samples were prepared and measured by inductively coupled plasma mass spectrometry (ICP-MS). The correlation between CHDs and maternal aluminum concentrations was estimated by a 1:1 conditional logistic regression. The geometric mean and median of hair aluminum levels in isolated or multiple CHD cases was significantly higher than in controls (p < 0.05). A significant association was found between increased hair aluminum concentrations and the risk of total CHDs in offspring (adjusted odds ration [aOR], 2.32; 95% confidence interval [CI], 1.72-3.13), especially in some subtypes of CHDs, such as septal defects (aOR, 2.17; 95% CI, 1.15-4.10), conotruncal defects (aOR, 5.42; 95%CI, 2.43-12.10), and right ventricular outflow track obstruction (aOR, 2.43; 95% CI, 1.08-5.44). However, there was no statistically significant association with left ventricular outflow track obstruction (aOR, 1.66; 95% CI, 0.95-2.88). A high maternal aluminum concentration may significantly increase the risk of delivering a child with a CHD, such as a septal defect, conotruncal heart defect and right-side obstruction. © 2015 Wiley Periodicals, Inc.

  20. Sound

    NASA Astrophysics Data System (ADS)

    Capstick, J. W.

    2013-01-01

    1. The nature of sound; 2. Elasticity and vibrations; 3. Transverse waves; 4. Longitudinal waves; 5. Velocity of longitudinal waves; 6. Reflection and refraction. Doppler's principle; 7. Interference. Beats. Combination tones; 8. Resonance and forced vibrations; 9. Quality of musical notes; 10. Organ pipes; 11. Rods. Plates. Bells; 12. Acoustical measurements; 13. The phonograph, microphone and telephone; 14. Consonance; 15. Definition of intervals. Scales. Temperament; 16. Musical instruments; 17. Application of acoustical principles to military purposes; Questions; Answers to questions; Index.

  1. Postnatal auditory preferences in piglets differ according to maternal emotional experience with the same sounds during gestation

    PubMed Central

    Tallet, Céline; Rakotomahandry, Marine; Guérin, Carole; Lemasson, Alban; Hausberger, Martine

    2016-01-01

    Prenatal sensory experience, notably auditory experience, is a source of fetal memories in many species. The contiguity between sensory stimuli and maternal emotional reactions provides opportunity for associative learning in utero but no clear evidence for this associative learning has been presented to date. Understanding this phenomenon would advance our knowledge of fetal sensory learning capacities. In the present study we tested the hypothesis that sounds (human voice) broadcast to pregnant sows while they experienced positive or negative emotional situations influences postnatal reactions of their offspring to these same sounds. The results show that: 1) from the first testing at the age of 2 days, the experimental piglets were less distressed by a social separation than controls if they heard the “familiar” voice, 2) piglets generalized to any human voice although the influence of novel voices was less pronounced, 3) in a challenging situation, piglets were more distressed if they heard the voice that was associated with maternal negative emotional state in utero. These findings open a whole line of new research on the long term effect of in utero associative learning that goes well beyond pigs, providing a framework for reconsidering the importance of sensory and emotional experiences during gestation. PMID:27857224

  2. Heart sounds at home: feasibility of an ambulatory fetal heart rhythm surveillance program for anti-SSA-positive pregnancies.

    PubMed

    Cuneo, B F; Moon-Grady, A J; Sonesson, S-E; Levasseur, S; Hornberger, L; Donofrio, M T; Krishnan, A; Szwast, A; Howley, L; Benson, D W; Jaeggi, E

    2017-03-01

    Fetuses exposed to anti-SSA (Sjögren's) antibodies are at risk of developing irreversible complete atrioventricular block (CAVB), resulting in death or permanent cardiac pacing. Anti-inflammatory treatment during the transition period from normal heart rhythm (fetal heart rhythm (FHR)) to CAVB (emergent CAVB) can restore sinus rhythm, but detection of emergent CAVB is challenging, because it can develop in ⩽24 h. We tested the feasibility of a new technique that relies on home FHR monitoring by the mother, to surveil for emergent CAVB. We recruited anti-SSA-positive mothers at 16 to 18 weeks gestation (baseline) from 8 centers and instructed them to monitor FHR two times a day until 26 weeks, using a Doppler device at home. FHR was also surveilled by weekly or every other week fetal echo. If FHR was irregular, the mother underwent additional fetal echo. We compared maternal stress/anxiety before and after monitoring. Postnatally, infants underwent a 12-lead electrocardiogram. Among 133 recruited, 125 (94%) enrolled. Among those enrolled, 96% completed the study. Reasons for withdrawal (n=5) were as follows: termination of pregnancy, monitoring too time consuming or moved away. During home monitoring, 9 (7.5%) mothers detected irregular FHR diagnosed by fetal echo as normal (false positive, n=2) or benign atrial arrhythmia (n=7). No CAVB was undetected or developed after monitoring. Questionnaire analysis indicated mothers felt comforted by the experience and would monitor again in future pregnancies. These data suggest ambulatory FHR surveillance of anti-SSA-positive pregnancies is feasible, has a low false positive rate and is empowering to mothers.

  3. Cardiac Corticosteroid Receptors Mediate the Enlargement of the Ovine Fetal Heart Induced by Chronic Increases in Maternal Cortisol

    PubMed Central

    Reini, Seth A.; Dutta, Garima; Wood, Charles E.; Keller-Wood, Maureen

    2009-01-01

    Previous studies have demonstrated that modest, physiologically relevant increases in maternal cortisol in late gestation result in enlargement of the fetal heart. In this study, we investigated the role of mineralocorticoid (MR) or glucocorticoid receptor (GR) in this enlargement. Ewes with single fetuses were randomly assigned at ~ 120d gestation to one of four groups: maternal cortisol infusion (1mg kg−1 day−1, cortisol); maternal cortisol infusion with fetal intrapericardial infusion of the MR antagonist potassium canrenoate (600µg day−1; cortisol + MRa); maternal cortisol infusion with fetal intrapericardial infusion of the GR antagonist mifepristone (50µg day−1, cortisol + GRa); and maternal saline infusion (control). At ~130 days gestation, fetal heart to body weight ratio and right (RV) and left ventricular (LV) free wall thickness were increased in the cortisol group compared to control group. Fetal hearts from the cortisol +MRa group weighed significantly less, with thinner LV, RV and interventricular septum walls, compared to the cortisol group. Fetal hearts from the cortisol + GRa group had significantly thinner RV walls than the cortisol group. Fetal arterial pressure and heart rate were not different among groups at 130 days. Picrosirius red staining of fetal hearts indicated that the increased size was not accompanied by cardiac fibrosis. These results suggest that physiologic increases in maternal cortisol late in gestation induce fetal cardiac enlargement via MR and, to a lesser extent, by GR, and indicate the enlargement is not secondary to an increase in fetal blood pressure or an increase in fibrosis within the fetal heart. PMID:18495945

  4. Product of heart rate and first heart sound amplitude as an index of myocardial metabolic stress during graded exercise.

    PubMed

    Tanaka, Hiroaki; Matsuda, Takuro; Tobina, Takuro; Yamada, Yousuke; Yamagishi, Tamiharu; Sakai, Hideaki; Obara, Shigeru; Higaki, Yasuki; Kiyonaga, Akira; Brubaker, Peter H

    2013-01-01

    The double product (DP) breakpoint of heart rate (HR) and systolic blood pressure has been identified as coincident with anaerobic threshold (AT), but there are no simple methods for measuring cardiac metabolic stress (CMS) during an exercise test. It was hypothesized that the DP of HR and the amplitude of the first heart sound (AHS1) (DP-AHS1) would reflect CMS, and thus, the breakpoint in the DP-AHS1 (DPBP-AHS1) could be an alternative method for determining AT. Subjects (age range, 18-73 years) were recruited to perform a graded exercise test on a cycle ergometer with continuous monitoring of DP-AHS1, with left ventricular pressure (LVP; experiment 1, Ex1), plasma catecholamine and blood lactate (experiment 2, Ex2) and gas exchange (experiment 3, Ex3). Ex1: in all subjects there was a strong correlation between AHS1 and LVdP/dtmax (r=0.94-0.98), and between the DP-AHS1 and the triple product of HR, LVdP/dtmax, and max LVP (r=0.98-0.99). Ex2: DP-AHS1 was strongly correlated with adrenaline (r=0.97-1.00) and lactate (r=0.96-1.00) levels in all subjects. Ex3: there was a strong correlation between DPBP-AHS1, AT and maximum oxygen consumption. The present simple measure of DP-AHS1 can reflect plasma adrenaline and lactate levels during graded exercise testing. Further, DPBP-AHS1 is a surrogate marker of AT and a good index of functional aerobic capacity.

  5. Participants' above-chance recognition of own-heart sound combined with poor metacognitive awareness suggests implicit knowledge of own heart cardiodynamics.

    PubMed

    Azevedo, Ruben T; Aglioti, Salvatore Maria; Lenggenhager, Bigna

    2016-05-23

    Mounting evidence suggests that interoceptive signals are fundamentally important for the experience of the self. Thus far, studies on interoception have mainly focused on the ability to monitor the timing of ongoing heartbeats and on how these influence emotional and self-related processes. However, cardiac afferent signalling is not confined to heartbeat timing and several other cardiac parameters characterize cardiodynamic functioning. Building on the fact that each heart has its own self-specific cardio-dynamics, which cannot be expressed uniquely by heart rate, we devised a novel task to test whether people could recognize the sound of their own heart even when perceived offline and thus not in synchrony with ongoing heartbeats. In a forced-choice paradigm, participants discriminated between sounds of their own heartbeat (previously recorded with a Doppler device) versus another person's heart. Participants identified the sound of their own heart above chance, whereas their metacognition of performance - as calculated by contrasting performance against ratings of confidence - was considerably poorer. These results suggest an implicit access to fine-grained neural representations of elementary cardio-dynamic parameters beyond heartbeat timing.

  6. Participants’ above-chance recognition of own-heart sound combined with poor metacognitive awareness suggests implicit knowledge of own heart cardiodynamics

    PubMed Central

    Azevedo, Ruben T.; Aglioti, Salvatore Maria; Lenggenhager, Bigna

    2016-01-01

    Mounting evidence suggests that interoceptive signals are fundamentally important for the experience of the self. Thus far, studies on interoception have mainly focused on the ability to monitor the timing of ongoing heartbeats and on how these influence emotional and self-related processes. However, cardiac afferent signalling is not confined to heartbeat timing and several other cardiac parameters characterize cardiodynamic functioning. Building on the fact that each heart has its own self-specific cardio-dynamics, which cannot be expressed uniquely by heart rate, we devised a novel task to test whether people could recognize the sound of their own heart even when perceived offline and thus not in synchrony with ongoing heartbeats. In a forced-choice paradigm, participants discriminated between sounds of their own heartbeat (previously recorded with a Doppler device) versus another person’s heart. Participants identified the sound of their own heart above chance, whereas their metacognition of performance – as calculated by contrasting performance against ratings of confidence - was considerably poorer. These results suggest an implicit access to fine-grained neural representations of elementary cardio-dynamic parameters beyond heartbeat timing. PMID:27211283

  7. Comparison of fetal and maternal heart rate measures using electrocardiographic and cardiotocographic methods.

    PubMed

    Kisilevsky, Barbara S; Brown, C Ann

    2016-02-01

    To determine the reliability at term of: (1) two methods of measuring fetal heart rate (HR), electrocardiographic (ECG, the 'gold standard') and cardiotocographic (CTG) and (2) two ECG methods of measuring maternal HR variability over relatively brief periods of time (s-min). During 20 min of rest (N=39) and during 2 min of auditory stimulation (mother's recorded voice, n=19), fetal HR data were collected using an ECG (Monica AN24) and a Hewlett-Packard Model 1351A CTG. Simultaneously, maternal HR data (n=37) were collected using the same ECG device (Monica AN24) and a second stand-alone cardiac monitor (Spacelab 514T cardiac monitor with a QRS detector). During 20 min of maternal rest, correlations of individual fetal CTG with ECG measures of HR at each second were moderate to high (r=.57-.97) for 77% of fetuses. Correlations of HR averaged over fetuses and over each of the 20 min were high (r=.93-.97); fetal HR averaged over 20 min varied between devices from 0.0 to 0.8 bpm. During 2 min of maternal voice presentation, correlations of fetal HR over each second were moderate to high (r=.54-.99) for 95% of fetuses and high (all rs=.99) when averaged across fetuses in 30s or 2 min epochs. Average fetal HR between devices over the 2 min voice varied from 0.0 to 0.6 bpm. Correlations and/or % agreement between the two ECG methods of measuring maternal HR were high. Average maternal HR over 10 min showed 81% of pairs with a difference of ≤ 1 bpm; correlations for HR variability measures varied from r=.89 to .97. Good reliability was demonstrated between individual spontaneous and auditory induced fetal CTG and ECG with high correlations when HR data were averaged over fetuses or in 30-120 s epochs. High reliability of maternal HR measures was obtained using two ECG devices. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Fluid Dynamics of the Generation and Transmission of Heart Sounds: (1) A Cardiothoracic Phantom Based Study of Aortic Stenosis Murmurs

    NASA Astrophysics Data System (ADS)

    Bakhshaee, Hani; Seo, Jung-Hee; Zhu, Chi; Welsh, Nathaniel; Garreau, Guillaume; Tognetti, Gaspar; Andreou, Andreas; Mittal, Rajat

    2015-11-01

    A novel and versatile cardiothoracic phantom has been designed to study the biophysics of heart murmurs associated with aortic stenosis. The key features of the cardiothoracic phantom include the use of tissue-mimetic gel to model the sound transmission through the thorax and the embedded fluid circuit that is designed to mimic the heart sound mechanisms in large vessels with obstructions. The effect of the lungs on heart murmur propagation can also be studied through the insertion of lung-mimicking material into gel. Sounds on the surface of the phantom are measured using a variety of sensors and the spectrum of the recorded signal and the streamwise variation in total signal strength is recorded. Based on these results, we provide insights into the biophysics of heart murmurs and the effect of lungs on sound propagation through the thorax. Data from these experiments is also used to validate the results of a companion computational study. Authors want to acknowledge the financial supports for this study by SCH grant (IIS 1344772) from National Science Foundation.

  9. A mobile phone-based ecg and heart sound monitoring system - biomed 2011.

    PubMed

    Iwamoto, Junichi; Ogawa, Hidekuni; Maki, Hiromichi; Yonezawa, Yoshiharu; Hahn, Allen W; Caldwell, W Morton

    2011-01-01

    We have developed a telemedicine system to monitor a patient’s electrocardiogram (ECG) and heart sounds (PCG) during daily activity. The complete system, consisting of an ECG recorder, an accelerometer and a 2.4 GHz low power mobile phone, is mounted on three chest sensing electrodes. The accelerometer records the PCG produced by closing of the mitral and aortic valves (S1 and S2). The sampled ECG and PCG are stored in the system for two minutes and continuously updated. When a patient feels heart discomfort such as angina or an arrhythmia, he/she pushes the data transmission switch on the system. The ECG and PCG for the next two minutes are stored in the system, and then the system then sends the four minutes of stored data directly to a hospital server computer via the 1.9 GHz low power mobile phone. These data are stored on the server and then downloaded to the physician’s Java configured mobile phone. The physician can then check the patient’s cardiac condition, regardless of patient or physician locations, and then take appropriate actions.

  10. Detection of Heart Sounds in Children with and without Pulmonary Arterial Hypertension―Daubechies Wavelets Approach

    PubMed Central

    Elgendi, Mohamed; Kumar, Shine; Guo, Long; Rutledge, Jennifer; Coe, James Y.; Zemp, Roger; Schuurmans, Dale; Adatia, Ian

    2015-01-01

    Background Automatic detection of the 1st (S1) and 2nd (S2) heart sounds is difficult, and existing algorithms are imprecise. We sought to develop a wavelet-based algorithm for the detection of S1 and S2 in children with and without pulmonary arterial hypertension (PAH). Method Heart sounds were recorded at the second left intercostal space and the cardiac apex with a digital stethoscope simultaneously with pulmonary arterial pressure (PAP). We developed a Daubechies wavelet algorithm for the automatic detection of S1 and S2 using the wavelet coefficient ‘D6’ based on power spectral analysis. We compared our algorithm with four other Daubechies wavelet-based algorithms published by Liang, Kumar, Wang, and Zhong. We annotated S1 and S2 from an audiovisual examination of the phonocardiographic tracing by two trained cardiologists and the observation that in all subjects systole was shorter than diastole. Results We studied 22 subjects (9 males and 13 females, median age 6 years, range 0.25–19). Eleven subjects had a mean PAP < 25 mmHg. Eleven subjects had PAH with a mean PAP ≥ 25 mmHg. All subjects had a pulmonary artery wedge pressure ≤ 15 mmHg. The sensitivity (SE) and positive predictivity (+P) of our algorithm were 70% and 68%, respectively. In comparison, the SE and +P of Liang were 59% and 42%, Kumar 19% and 12%, Wang 50% and 45%, and Zhong 43% and 53%, respectively. Our algorithm demonstrated robustness and outperformed the other methods up to a signal-to-noise ratio (SNR) of 10 dB. For all algorithms, detection errors arose from low-amplitude peaks, fast heart rates, low signal-to-noise ratio, and fixed thresholds. Conclusion Our algorithm for the detection of S1 and S2 improves the performance of existing Daubechies-based algorithms and justifies the use of the wavelet coefficient ‘D6’ through power spectral analysis. Also, the robustness despite ambient noise may improve real world clinical performance. PMID:26629704

  11. Fluid Dynamics of the Generation and Transmission of Heart Sounds: (2): Direct Simulation using a Coupled Hemo-Elastodynamic Method

    NASA Astrophysics Data System (ADS)

    Seo, Jung-Hee; Bakhshaee, Hani; Zhu, Chi; Mittal, Rajat

    2015-11-01

    Patterns of blood flow associated with abnormal heart conditions generate characteristic sounds that can be measured on the chest surface using a stethoscope. This technique of `cardiac auscultation' has been used effectively for over a hundred years to diagnose heart conditions, but the mechanisms that generate heart sounds, as well as the physics of sound transmission through the thorax, are not well understood. Here we present a new computational method for simulating the physics of heart murmur generation and transmission and use it to simulate the murmurs associated with a modeled aortic stenosis. The flow in the model aorta is simulated by the incompressible Navier-Stokes equations and the three-dimensional elastic wave generation and propagation on the surrounding viscoelastic structure are solved with a high-order finite difference method in the time domain. The simulation results are compared with experimental measurements and show good agreement. The present study confirms that the pressure fluctuations on the vessel wall are the source of these heart murmurs, and both compression and shear waves likely plan an important role in cardiac auscultation. Supported by the NSF Grants IOS-1124804 and IIS-1344772, Computational resource by XSEDE NSF grant TG-CTS100002.

  12. Development and evaluation of an algorithm for computer analysis of maternal heart rate during labor.

    PubMed

    Pinto, Paula; Bernardes, João; Costa-Santos, Cristina; Amorim-Costa, Célia; Silva, Maria; Ayres-de-Campos, Diogo

    2014-06-01

    Maternal heart rate (MHR) recordings are morphologically similar and sometimes coincident with fetal heart rate (FHR) recordings and may be useful for maternal-fetal monitoring if appropriately interpreted. However, similarly to FHR, visual interpretation of MHR features may be poorly reproducible. A computer algorithm for on-line MHR analysis was developed based on a previously existing version for FHR analysis. Inter-observer and computer-observer agreement and reliability were assessed in 40 one-hour recordings obtained from 20 women during the last 2h of labor. Agreement and reliability were evaluated for the detection of basal MHR, long-term variability (LTV), accelerations and decelerations, using proportions of agreement (PA) and Kappa statistic (K), with 95% confidence intervals (95% CI). Changes in MHR characteristics between the first and the second hour of the tracings were also evaluated. There was a statistically significant inter-observer and computer-observer agreement and reliability in estimation of basal MHR, accelerations, decelerations and LTV, with PA values ranging from 0.72 (95% CI: 0.62-0.79) to 1.00 (95% CI: 0.99-1.00), and K values ranging from 0.44 (95% CI: 0.28-0.60) to 0.89 (95% CI: 0.82-0.96). Moreover, basal MHR, number of accelerations and LTV were significantly higher in the last hour of labor, when compared to the initial hour. The developed algorithm for on-line computer analysis of MHR recordings provided good to excellent computer-observer agreement and reliability. Moreover, it allowed an objective detection of MHR changes associated with labor progression, providing more information about the interpretation of maternal-fetal monitoring during labor. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. [Effect of Music Intervention on Maternal Anxiety and Fetal Heart Rate Pattern During Non-Stress Test].

    PubMed

    Oh, Myung Ok; Kim, Young Jeoum; Baek, Cho Hee; Kim, Ju Hee; Park, No Mi; Yu, Mi Jeong; Song, Han Sol

    2016-06-01

    The purpose of this cross-over experimental study was to examine effects of music intervention on maternal anxiety, fetal heart rate pattern and testing time during non-stress tests (NST) for antenatal fetal assessment. Sixty pregnant women within 28 to 40 gestational weeks were randomly assigned to either the experimental group (n=30) or control group (n=30). Music intervention was provided to pregnant women in the experimental group during NST. Degree of maternal anxiety and fetal heart rate pattern were our primary outcomes. State-trait anxiety inventory, blood pressure, pulse rate, and changes in peripheral skin temperature were assessed to determine the degree of maternal anxiety. Baseline fetal heart rate, frequency of acceleration in fetal heart rate, fetal movement test and testing time for reactive NST were assessed to measure the fetal heart rate pattern. The experimental group showed significantly lower scores in state anxiety than the control group. There were no significant differences in systolic blood pressure and pulse rate between the two groups. Baseline fetal heart rate was significantly lower in the experimental group than in the control group. Frequency of acceleration in fetal heart rate was significantly increased in the experimental group compared to the control group. There were no significant differences in fetal movement and testing time for reactive NST between the two groups. Present results suggest that music intervention could be an effective nursing intervention for alel viating anxiety during non-stress test.

  14. Maternal Diabetes, Birth Weight, and Neonatal Risk of Congenital Heart Defects in Norway, 1994-2009.

    PubMed

    Leirgul, Elisabeth; Brodwall, Kristoffer; Greve, Gottfried; Vollset, Stein E; Holmstrøm, Henrik; Tell, Grethe S; Øyen, Nina

    2016-11-01

    To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project. The relative risk (RR) compared offspring risk of cardiac defects for maternal diabetes with offspring risk in nondiabetic mothers adjusted for year of birth, maternal age, and parity. Among 914,427 births (live births, stillbirths, terminated pregnancies), 5,618 (0.61%) were complicated by maternal pregestational diabetes and 9,726 (1.06%) by gestational diabetes. Congenital heart defects were identified in 10,575 offspring. The prevalence of cardiac defects differed between groups: 344 of 10,000 births to women with pregestational diabetes, 172 of 10,000 to women with gestational diabetes, and 114 of 10,000 in women without diabetes (adjusted RRs 2.92, 95% confidence interval [CI] 2.54-3.36 and 1.47, 95% CI 1.26-1.71). During the study period, the adjusted RRs for congenital heart defects did not change. The risk of cardiac defects in neonates very large for gestational age (birth weight greater than 3 standard deviations above the mean) was compared with neonates with birth weight appropriate for gestational age. For pregestational diabetes, the prevalences of offspring cardiac defects were 561 compared with 248 per 10,000 births (adjusted RR 2.23, 95% CI 1.39-3.59) and for gestational diabetes 388 compared with 132 per 10,000 (adjusted RR 2.73, 95% CI 1.53-4.85). The increased risk of having a child with a congenital heart defect has not changed for diabetic women in Norway since 1994. Among women with pregestational or gestational diabetes, having a

  15. Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease.

    PubMed

    Bukowski, Radek; Davis, Karen E; Wilson, Peter W F

    2012-01-01

    Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.

  16. Self-representation of children suffering from congenital heart disease and maternal competence

    PubMed Central

    Perricone, Giovanna; Polizzi, Concetta; De Luca, Francesco

    2013-01-01

    Child development may be subject to forms of motor, physical, cognitive and self-representation impairments when complex congenital heart disease (CHD) occurs. In some cases, inadequacy of both self-representation as well as the family system are displayed. It seems to be important to search the likely internal and external resources of the CHD child, and the possible connections among such resources, which may help him/her to manage his/her own risk condition. The research project inquires the possible resources related to the self-representation and self-esteem levels of the CHD child, and those related to maternal self-perception as competent mothers. A group of 25 children (mean age = 10.2; SD=1.8) suffering from specific forms of CHD, and a group made up of their relative mothers (mean age = 38.2; SD=5) were studied. The tools used were the Human Figure Drawing, to investigate child body-related self-representation; the TMA scale (Self-esteem Multidimensional Test), to investigate the child's self-esteem; and the Q-sort questionnaire, to assess how mothers perceived their maternal competence. Data concerning the likely correlations between the child's self-representation and the maternal role competence show [that] positive correlations between some indicators of maternal competence, specific aspects of CHD children's self-representation (mothers' emotional coping and children's self-image adequacy) and self-esteem (mothers' emotional scaffolding and children's self-esteem at an emotional level). By detecting the occurrence of specific correlations among resources of both child and mother, the study provides cardiologists with information that is useful for building a relationship with the families concerned, which would seem to enhance the quality of the process of the cure itself. PMID:23667730

  17. Delivery of a Small for Gestational Age Infant and Greater Maternal Risk of Ischemic Heart Disease

    PubMed Central

    Bukowski, Radek; Davis, Karen E.; Wilson, Peter W. F.

    2012-01-01

    Background Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Methods and Findings Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999–2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Conclusions Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD. PMID:22431995

  18. Self-representation of children suffering from congenital heart disease and maternal competence.

    PubMed

    Perricone, Giovanna; Polizzi, Concetta; De Luca, Francesco

    2013-02-05

    Child development may be subject to forms of motor, physical, cognitive and self-representation impairments when complex congenital heart disease (CHD) occurs. In some cases, inadequacy of both self-representation as well as the family system are displayed. It seems to be important to search the likely internal and external resources of the CHD child, and the possible connections among such resources, which may help him/her to manage his/her own risk condition. The research project inquires the possible resources related to the self-representation and self-esteem levels of the CHD child, and those related to maternal self-perception as competent mothers. A group of 25 children (mean age = 10.2; SD=1.8) suffering from specific forms of CHD, and a group made up of their relative mothers (mean age = 38.2; SD=5) were studied. The tools used were the Human Figure Drawing, to investigate child body-related self-representation; the TMA scale (Self-esteem Multidimensional Test), to investigate the child's self-esteem; and the Q-sort questionnaire, to assess how mothers perceived their maternal competence. Data concerning the likely correlations between the child's self-representation and the maternal role competence show [that] positive correlations between some indicators of maternal competence, specific aspects of CHD children's self-representation (mothers' emotional coping and children's self-image adequacy) and self-esteem (mothers' emotional scaffolding and children's self-esteem at an emotional level). By detecting the occurrence of specific correlations among resources of both child and mother, the study provides cardiologists with information that is useful for building a relationship with the families concerned, which would seem to enhance the quality of the process of the cure itself.

  19. Simultaneous monitoring of maternal and fetal heart rate variability during labor in relation with fetal gender.

    PubMed

    Gonçalves, Hernâni; Fernandes, Diana; Pinto, Paula; Ayres-de-Campos, Diogo; Bernardes, João

    2017-08-21

    Male gender is considered a risk factor for several adverse perinatal outcomes. Fetal gender effect on fetal heart rate (FHR) has been subject of several studies with contradictory results. The importance of maternal heart rate (MHR) monitoring during labor has also been investigated, but less is known about the effect of fetal gender on MHR. The aim of this study is to simultaneously assess maternal and FHR variability during labor in relation with fetal gender. Simultaneous MHR and FHR recordings were obtained from 44 singleton term pregnancies during the last 2 hr of labor (H1, H2 ). Heart rate tracings were analyzed using linear (time- and frequency-domain) and nonlinear indices. Both linear and nonlinear components were considered in assessing FHR and MHR interaction, including cross-sample entropy (cross-SampEn). Mothers carrying male fetuses (n = 22) had significantly higher values for linear indices related with MHR average and variability and sympatho-vagal balance, while the opposite occurred in the high-frequency component and most nonlinear indices. Significant differences in FHR were only observed in H1 with higher entropy values in female fetuses. Assessing the differences between FHR and MHR, statistically significant differences were obtained in most nonlinear indices between genders. A significantly higher cross-SampEn was observed in mothers carrying female fetuses (n = 22), denoting lower synchrony or similarity between MHR and FHR. The variability of MHR and the synchrony/similarity between MHR and FHR vary with respect to fetal gender during labor. These findings suggest that fetal gender needs to be taken into account when simultaneously monitoring MHR and FHR. © 2017 Wiley Periodicals, Inc.

  20. Maternal and Fetal Outcomes in Pregnant Women with a Prosthetic Mechanical Heart Valve

    PubMed Central

    Ayad, Sherif W.; Hassanein, Mahmoud M.; Mohamed, Elsayed A.; Gohar, Ahmed M.

    2016-01-01

    BACKGROUND Pregnancy is associated with several cardiocirculatory changes that can significantly impact underlying cardiac disease. These changes include an increase in cardiac output, sodium, and water retention leading to blood volume expansion, and reductions in systemic vascular resistance and systemic blood pressure. In addition, pregnancy results in a hypercoagulable state that increases the risk of thromboembolic complications. OBJECTIVES The aim of this study is to assess the maternal and fetal outcomes of pregnant women with mechanical prosthetic heart valves (PHVs). METHODS This is a prospective observational study that included 100 pregnant patients with cardiac mechanical valve prostheses on anticoagulant therapy. The main maternal outcomes included thromboembolic or hemorrhagic complications, prosthetic valve thrombosis, and acute decompensated heart failure. Fetal outcomes included miscarriage, fetal death, live birth, small-for-gestational age, and warfarin embryopathy. The relationship between the following were observed: – Maternal and fetal complications and the site of the replaced valve (mitral, aortic, or double)– Maternal and fetal complications and warfarin dosage (≤5 mg, >5 mg)– Maternal and fetal complications and the type of anticoagulation administered during the first trimester RESULTS This study included 60 patients (60%) with mitral valve replacement (MVR), 22 patients (22%) with aortic valve replacement (AVR), and 18 patients (18%) with double valve replacement (DVR). A total of 65 patients (65%) received >5 mg of oral anticoagulant (warfarin), 33 patients (33%) received ≤5 mg of warfarin, and 2 patients (2%) received low-molecular-weight heparin (LMWH; enoxaparin sodium) throughout the pregnancy. A total of 17 patients (17%) received oral anticoagulant (warfarin) during the first trimester: 9 patients received a daily warfarin dose of >5 mg while the remaining 8 patients received a daily dose of ≤5 mg. Twenty

  1. Complete right bundle-branch block: echophonocardiographic study of first heart sound and right ventricular contraction times.

    PubMed Central

    Brooks, N; Leech, G; Leatham, A

    1979-01-01

    High speed enchocardiograms of the mitral, tricuspid, and pulmonary valves were recorded with a simultaneous electrocardiogram and phonocardiogram in 20 patients with complete right bundle-branch block and in 67 normal subjects. Late opening of the pulmonary valve indicating late right ventricular ejection was found in all patients. In 8 patients with wide splitting of the first heart sound the late ejection was related mainly to delay in tricuspid valve closure, suggesting a late onset of the right ventricular pressure pulse. In 10 patients with a single first heart sound the delayed ejection was associated with a long interval between tricuspid valve closure and pulmonary valve opening, suggesting a slow rising right ventricular pressure pulse; 3 of these patients also had late tricuspid valve closure but the tricuspid component of the first sound was absent. Late onset of pressure rise is thought to result from block in the main right bundle-branch, and a slow rising pulse from block in the distal Purkinje network. These findings explain the conflicting results in previous studies of the first heart sound and right ventricular pressure pulse in patients with right bundle-branch block, and may have prognostic significance. Images PMID:465238

  2. Maternal and infant genetic variants, maternal periconceptional use of selective serotonin reuptake inhibitors, and risk of congenital heart defects in offspring: population based study.

    PubMed

    Nembhard, Wendy N; Tang, Xinyu; Hu, Zhuopei; MacLeod, Stewart; Stowe, Zachary; Webber, Daniel

    2017-03-06

    Objective To evaluate whether the association between maternal periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and increased risk of congenital heart defects in offspring is modified by maternal or infant genetic variants in folate, homocysteine, or transsulfuration pathways.Design Population based study. DNA from mothers, fathers, and infants was genotyped with an Illumina GoldenGate custom single nucleotide polymorphism panel. A hybrid design based on a log linear model was used to calculate relative risks and Bayesian false discovery probabilities (BFDP) to identify polymorphisms associated with congenital heart defects modified by SSRI use.Data sources Data from the US National Birth Defects Prevention Study on 1180 liveborn infants with congenital heart defects and 1644 controls, born 1997-2008.Main outcome measures Cases included infants with selected congenital heart defects and control infants had no major defects. SSRI use was obtained from telephone interviews with mothers.Results For women who reported taking SSRIs periconceptionally, maternal SHMT1 (rs9909104) GG and AGgenotypes were associated with a 5.9 and 2.4 increased risk of select congenital heart defects in offspring, respectively, versus the AA genotype (BFDP=0.69). Compared with the AA genotype, BHMT (rs492842 and rs542852) GG and AG genotypes were associated with twice the riskof congenital heart defects (BFDP=0.74 and 0.79, respectively). MGST1 (rs2075237) CC and ACgenotypes were associated with an increased risk compared with the GG genotype (8.0 and 2.8, respectively; BFDP=0.79). Single nucleotide polymorphism in infant genes in the folate (MTHFS rs12438477), homocysteine (TRDMT1 rs6602178 and GNMT rs11752813) and transsulfuration (GSTP1 rs7941395 and MGST1 rs7294985) pathways were also associated with an increased risk of congenital heart defects.Conclusions Common maternal or infant genetic variants in folate, homocysteine, or transsulfuration pathways are

  3. A study of the first heart sound spectra in normal anesthetized cats: possible origins and chest wall influences.

    PubMed

    Fazzalari, N L; Mazumdar, J; Ghista, D N; Allen, D G; de Bruin, H

    1984-01-01

    Heart sound recordings were taken from cats. The heart sounds were recorded directly from the chest wall and through an esophageal tube. The phono transducer and the esophageal tube were both placed over the base of the heart. Ultrasound M-mode, or motion-mode, recordings were taken to study the mitral valve dynamics. After analogue to digital conversion, electrocardiogram gated first heart sounds of each phono record were analyzed by the fast Fourier transform to obtain a frequency spectrum. Relative energies in 15 Hz bandwidths up to 150 Hz were correlated with the mitral valve closing velocity of the anterior mitral leaflet, obtained from the M-mode echocardiograms. The closing velocity correlated best with the energy in the 30-45 Hz bandwidth and 60-75 Hz bandwidth for the externally and internally monitored phonocardiogram respectively. The chest wall acted as a low pass filter, that is, the wall favoured the transmission of low frequencies and the energy transmitted decreased as wall thickness increased.

  4. An Intelligent Pattern Recognition System Based on Neural Network and Wavelet Decomposition for Interpretation of Heart Sounds

    DTIC Science & Technology

    2007-11-02

    sound Apex 1.13 2 S3 Apex 1.13 3 S4 Apex 0.9 4 Aortic stenosis Right base 0.9 5 Mitral regurgitation Apex 0.79 6 Midsystolic click Apex 1.13 7...Ventricular septal defect Lower left sternal border 0.9 8 Atrial septal defect Left base 0.9 9 Mitral stenosis Apex 1.13 10 Aortic regurgitation Mid...Number ARP (%) Normal heart sound 9 98 1 92 S3 10 99 -- -- S4 9 99 1 99 Aortic stenosis 10 99 -- -- Mitral regurgitation 10 99 -- -- Midsystolic

  5. Conotruncal heart defects and common variants in maternal and fetal genes in folate, homocysteine, and transsulfuration pathways.

    PubMed

    Hobbs, Charlotte A; Cleves, Mario A; Macleod, Stewart L; Erickson, Stephen W; Tang, Xinyu; Li, Jingyun; Li, Ming; Nick, Todd; Malik, Sadia

    2014-02-01

    We investigated the association between conotruncal heart defects (CTDs) and maternal and fetal single nucleotide polymorphisms (SNPs) in 60 genes in the folate, homocysteine, and transsulfuration pathways. We also investigated whether periconceptional maternal folic acid supplementation modified associations between CTDs and SNPs Participants were enrolled in the National Birth Defects Prevention Study between 1997 and 2008. DNA samples from 616 case-parental triads affected by CTDs and 1645 control-parental triads were genotyped using an Illumina® Golden Gate custom SNP panel. A hybrid design analysis, optimizing data from case and control trios, was used to identify maternal and fetal SNPs associated with CTDs Among 921 SNPs, 17 maternal and 17 fetal SNPs had a Bayesian false-discovery probability of <0.8. Ten of the 17 maternal SNPs and 2 of the 17 fetal SNPs were found within the glutamate-cysteine ligase, catalytic subunit (GCLC) gene. Fetal SNPs with the lowest Bayesian false-discovery probability (rs2612101, rs2847607, rs2847326, rs2847324) were found within the thymidylate synthetase (TYMS) gene. Additional analyses indicated that the risk of CTDs associated with candidate SNPs was modified by periconceptional folic acid supplementation. Nineteen maternal and nine fetal SNPs had a Bayesian false-discovery probability <0.8 for gene-by-environment (G × E) interactions with maternal folic acid supplementation. These results support previous studies suggesting that maternal and fetal SNPs within folate, homocysteine, and transsulfuration pathways are associated with CTD risk. Maternal use of supplements containing folic acid may modify the impact of SNPs on the developing heart. Copyright © 2014 Wiley Periodicals, Inc.

  6. Feto-maternal outcomes of urgent open-heart surgery during pregnancy.

    PubMed

    Hosseini, Saeid; Kashfi, Fahimeh; Samiei, Niloufar; Khamoushi, Amirjamshid; Ghavidel, Alireza Alizadeh; Yazdanian, Forouzan; Mirmesdagh, Yalda; Mestres, Carlos A

    2015-03-01

    Cardiac surgery during pregnancy is rarely required and potentially increases feto-maternal mortality. The study aim was to evaluate pregnancy outcomes in females who underwent open-heart surgery with cardiopulmonary bypass (CPB) during pregnancy. Between 1999 and 2014, a total of 16 pregnant women (mean age 27 ± 7 years; mean gestational age 13 ± 7.7 weeks) underwent urgent cardiac surgery using CPB. The preoperative diagnosis included prosthetic valve dysfunction in 12 women (five aortic, seven mitral), native valve endocarditis and critical aortic stenosis each in one woman, and intracardiac masses in two women. Eleven patients were in the first trimester, three in the second trimester, and two in the third trimester. A retrospective analysis was conducted that included maternal variables of age, gestational age, cardiac diagnosis, prior operations, surgical details, maternal morbidity and mortality and type of delivery, while fetal variables included incidence of low birth weight, prematurity, and fetal malformation. Patients were allocated to two groups: Group A (n = 9) included pregnant women with living neonates, while group B (n = 7) included pregnant women with an aborted fetus or dead neonate. All data were compared between the groups. There was no in-hospital maternal mortality. There were no significant differences between the two groups regarding age, gestational age, previous cardiac operation, type of surgery, duration of operation, perfusion pressure and core temperature during CPB. The CPB time was longer in group B (110.3 ± 57.1 min) than in group A (62 ± 15.7 min) (p = 0.028), as was the aortic cross-clamp time (54.3 ± 27.2 min and 38.7 ± 9.3 min in groups A and B, respectively) (p = 0.014). Group B patients received higher doses of inotropes perioperatively. No congenital abnormalities were identified in any of the living neonates. The durations of CPB and aortic cross-clamping may not affect maternal outcome, but shorter CPB and aortic

  7. Automated signal quality assessment of mobile phone-recorded heart sound signals.

    PubMed

    Springer, David B; Brennan, Thomas; Ntusi, Ntobeko; Abdelrahman, Hassan Y; Zühlke, Liesl J; Mayosi, Bongani M; Tarassenko, Lionel; Clifford, Gari D

    Mobile phones, due to their audio processing capabilities, have the potential to facilitate the diagnosis of heart disease through automated auscultation. However, such a platform is likely to be used by non-experts, and hence, it is essential that such a device is able to automatically differentiate poor quality from diagnostically useful recordings since non-experts are more likely to make poor-quality recordings. This paper investigates the automated signal quality assessment of heart sound recordings performed using both mobile phone-based and commercial medical-grade electronic stethoscopes. The recordings, each 60 s long, were taken from 151 random adult individuals with varying diagnoses referred to a cardiac clinic and were professionally annotated by five experts. A mean voting procedure was used to compute a final quality label for each recording. Nine signal quality indices were defined and calculated for each recording. A logistic regression model for classifying binary quality was then trained and tested. The inter-rater agreement level for the stethoscope and mobile phone recordings was measured using Conger's kappa for multiclass sets and found to be 0.24 and 0.54, respectively. One-third of all the mobile phone-recorded phonocardiogram (PCG) signals were found to be of sufficient quality for analysis. The classifier was able to distinguish good- and poor-quality mobile phone recordings with 82.2% accuracy, and those made with the electronic stethoscope with an accuracy of 86.5%. We conclude that our classification approach provides a mechanism for substantially improving auscultation recordings by non-experts. This work is the first systematic evaluation of a PCG signal quality classification algorithm (using a separate test dataset) and assessment of the quality of PCG recordings captured by non-experts, using both a medical-grade digital stethoscope and a mobile phone.

  8. Does maternal race influence the short-term variation of the fetal heart rate? An historical cohort study.

    PubMed

    Marie, Cécile; Sinoquet, Céline; Barasinski, Chloé; Lémery, Didier; Vendittelli, Françoise

    2015-10-01

    The main aim of this article was to analyze short-term variation (STV) of the fetal heart rate according to maternal race. The secondary aim was to study the baseline fetal heart rate according to this factor. This single-center historical cohort study covered the period from November 2008 through December 2011 (n=182). The inclusion criteria were: black women from sub-Saharan Africa or white European women, with a singleton pregnancy ≥34 weeks and fetal heart rate recorded by computerized analysis (Oxford Sonicaid System 8002) at a prenatal visit. The exclusion criteria were: medication likely to modify fetal heart rate, abnormal fetal heart rate tracing, and being in labor. A multiple linear regression analysis was used to study the association between maternal race and STV. STV was lower by 2.6ms in fetuses of black women (n=55) compared to those of white women (n=127) (8.9±2.1ms vs. 11.4±3.4ms) (p<0.001). The basal fetal heart rate was higher (p=0.001), and the recording criteria were met less often for the black women (p=0.04). After adjustment for maternal age, body mass index at the beginning of pregnancy, maternal cigarette smoking, parity, gestational diabetes, gestational age at the time of the fetal heart rate recording, and the time between the last meal and the recording, mean STV was lower by 3.1±0.6ms in fetuses of black compared with white women (p<0.001). STV is lower in fetuses of black women compared to those of white women in a low-risk population. A study of black and white women with high-risk pregnancies is necessary to assess the impact of medical practices on perinatal outcome after STV analysis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease.

    PubMed

    Hayward, Robert M; Foster, Elyse; Tseng, Zian H

    2017-06-01

    Women with congenital heart disease (CHD) may be at increased risk for adverse events during pregnancy and delivery. To compare delivery outcomes between women with and without CHD. This retrospective study of inpatient delivery admissions in the Healthcare Cost and Utilization Project's California State Inpatient Database compared maternal and fetal outcomes between women with and without CHD by using multivariate logistic regression. Female patients with codes for delivery from the International Classification of Diseases, Ninth Revision, from January 1, 2005, through December 31, 2011, were included. The association of CHD with readmission was assessed to 7 years after delivery. Cardiovascular morbidity and mortality were hypothesized to be higher among women with CHD. Data were analyzed from April 4, 2014, through January 23, 2017. Noncomplex and complex CHD. Maternal outcomes included in-hospital arrhythmias, eclampsia or preeclampsia, congestive heart failure (CHF), length of stay, preterm labor, anemia complicating pregnancy, placental abnormalities, infection during labor, maternal readmission at 1 year, and in-hospital mortality. Fetal outcomes included growth restriction, distress, and death. Among 3 642 041 identified delivery admissions, 3189 women had noncomplex CHD (mean [SD] age, 28.6 [7.6] years) and 262 had complex CHD (mean [SD] age, 26.5 [6.8] years). Women with CHD were more likely to undergo cesarean delivery (1357 [39.3%] vs 1 164 509 women without CHD [32.0%]; P < .001). Incident CHF, atrial arrhythmias, ventricular arrhythmias, and maternal mortality were uncommon during hospitalization, with each occurring in fewer than 10 women with noncomplex or complex CHD (<0.5% each). After multivariate adjustment, noncomplex CHD (odds ratio [OR], 9.7; 95% CI, 4.7-20.0) and complex CHD (OR, 56.6; 95% CI, 17.6-182.5) were associated with greater odds of incident CHF. Similar odds were found for atrial arrhythmias in noncomplex (OR, 8.2; 95% CI

  10. Maternal heart rate patterns in the first and second stages of labor.

    PubMed

    VAN Veen, Teelkien R; Belfort, Michael A; Kofford, Shalece

    2012-05-01

    Objective. To analyze typical maternal heart rate (MHR) patterns in the first and second stages of labor. Design. Observational study. Setting. Tertiary care community hospital. Population. Normal term parturients with epidural anesthesia. Methods. Confirmed MHR and uterine activity were simultaneously recorded. The average MHR was analyzed 10 seconds before, as well as at the peak of, each contraction and/or pushing effort. Each woman contributed one datapoint at each time point to the analysis. Main outcome measure. Change in MHR during contractions. Results. First stage: 7.6±2.1 contractions per woman (n=18) were analyzed. Average MHR decreased during contractions: from 83±13 to 74±10bpm; p<0.001). In 56% (10/18) of the women, 'early' type decelerations were seen in at least 50% of contractions. Second stage: 3.5±1.5 contractions per woman. All women (n=15) showed MHR accelerations during every pushing effort (ΔMHR: +35±13bpm; 88±14 to 123±17bpm; p<0.001). MHR was persistently >100bpm in three women (17%) in the first stage, and in four women (27%) in the second stage. Peak MHR >140bpm occurred during pushing in 20%. Conclusion. Decreases in MHR during contractions in the first stage of labor can mimic fetal heart rate (FHR) accelerations as well as early type decelerations. Thus, first stage tracings with a low baseline and early type decelerations may be maternal in origin and FHR should be independently confirmed in such tracings. Because second stage MHR accelerations generally show greater amplitude than FHR accelerations, tracings with repetitive accelerations during contractions (especially when Δ >20bpm) should be considered MHR until proven otherwise. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Associations between maternal genotypes and metabolites implicated in congenital heart defects

    PubMed Central

    Chowdhury, Shimul; Hobbs, Charlotte A.; MacLeod, Stewart L.; Cleves, Mario A.; Melnyk, Stepan; James, S. Jill; Hu, Ping; Erickson, Stephen W.

    2012-01-01

    Background The development of non-syndromic congenital heart defects (CHDs) involves a complex interplay of genetics, metabolism, and lifestyle. Previous studies have implicated maternal single nucleotide polymorphisms (SNPs) and altered metabolism in folate-related pathways as CHD risk factors. Objective We sought to discover associations between maternal SNPs and metabolites involved in the homocysteine, folate, and transsulfuration pathways, and determine if these associations differ between CHD cases and controls. Design Genetic, metabolic, demographic, and lifestyle information was available for 335 mothers with CHD-affected pregnancies and 263 mothers with unaffected pregnancies. Analysis was conducted on 1160 SNPs, 13 plasma metabolites, and 2 metabolite ratios. A two-stage multiple linear regression was fitted to each combination of SNP and metabolite/ratio. Results We identified 4 SNPs in the methionine adenosyltransferase II alpha (MAT2A) gene that were associated with methionine levels. Three SNPs in tRNA aspartic acid methyltransferase 1 (TRDMT1) gene were associated with total plasma folate levels. Glutamylcysteine (GluCys) levels were associated with multiple SNPs within the glutathione peroxidase 6 (GPX6) and O-6-methylguanine-DNA methyltransferase (MGMT) genes. The regression model revealed interactions between genotype and case-control status in the association of total plasma folate, total glutathione (GSH), and free GSH, to SNPs within the MGMT, 5,10-methenyltetrahydrofolate synthetase (MTHFS), and catalase (CAT) genes, respectively. Conclusions Our study provides further evidence that genetic variation within folate-related pathways accounts for inter-individual variability in key metabolites. We identified specific SNP-metabolite relationships that differed in mothers with CHD-affected pregnancies, compared to controls. Our results underscore the importance of multifactorial studies to define maternal CHD risk. PMID:23059056

  12. Elevated hsa-miR-99a levels in maternal plasma may indicate congenital heart defects

    PubMed Central

    KEHLER, LARS; BIRO, ORSOLYA; LAZAR, LEVENTE; RIGO, JANOS; NAGY, BALINT

    2015-01-01

    The current standard for prenatal screening is mostly based on biochemical marker tests and the use of ultrasonography. There is no secure stand-alone screening marker for congenital heart defects (CHDs). MicroRNAs (miRNAs) that are associated with cardiogenesis enter the maternal peripheral bloodstream during pregnancy and allow non-invasive prenatal testing (NIPT). The present study investigated the plasma expression profile of fetal hsa-miR-99a in maternal blood. Peripheral blood samples were collected from 39 pregnant patients, comprising 22 with CHD-positive fetuses and 17 with CHD-free controls. miRNAs were isolated from the maternal serum and reverse transcription-quantitative polymerase chain reaction was carried out to determine the expression of hsa-miR-99a. While the miRNA concentrations were almost identical among the affected and control groups (5.54 vs. 6.40 ng/µl), significantly upregulated hsa-miR-99a levels were identified in the affected group (1.78×10−2±3.53×10−2 vs. 1.09×10−3±3.55×10−3 ng/µl, P=0.038). In conclusion, according to the present study, hsa-miR-99a is involved in cardiac malformation and may serve as a biomarker during fetal development, and therefore presents as a candidate for monitoring cardiomyogenesis and potential use as a NIPT-biomarker for fetal CHD. PMID:26623032

  13. [Possible mechanism of production of the musical second heart sound and its clinical significance].

    PubMed

    Fukuda, N; Hosoi, K; Iuchi, A; Ogawa, S; Kageji, Y; Hayashi, M; Yoshimoto, K; Tanimoto, M; Oki, T

    1991-01-01

    To investigate the predisposing factors and the clinical significance of the musical aortic component of the second heart sound (musical S2), 18 patients with musical S2 (musical group) among the consecutive 2,000 patients with phonocardiographic examination were noninvasively studied by analyzing underlying diseases, phonocardiographic findings, organic changes of the aortic valve, severity of aortic regurgitation and left ventricular dysfunction. Organic changes of the aortic valve were assessed by two-dimensional echocardiography, and aortic regurgitation was assessed by color Doppler flow imaging. Twenty-two normal subjects (normal group) and 17 patients with essential hypertension (hypertensive group) served as controls. Mean ages were matched among the three groups. 1. Left ventricular dilatation (seven patients) and hypertension (six patients) were the dominant part of underlying disease in the musical group. 2. Musical S2 was classified in the following two types based on the phonocardiographic characteristics; musical vibrations followed immediately after the accentuated S2, and the S2 which was replaced by regular vibratory waves. 3. Frequency of the musical vibrations ranged from 120 to 200 Hz, and its duration ranged from 60 to 120 msec. Amplitude of the musical vibrations decreased by inhalation of amyl nitrite, but increased by infusion of methoxamine. In a case with mild rheumatic valve disease, methoxamine induced marked intensification of the amplitude and prolongation of the duration of the musical vibrations, finally giving a typical cooing murmur. 4. Echo intensity of the aortic valve tended to be higher in the musical group than in the other two groups. 5. Echocardiographically, aortic regurgitation appeared more frequently in the musical group (88%) than in the normal (36%) and hypertensive (41%) groups. Area of the aortic regurgitant signal was significantly larger in the musical group (4.1 +/- 1.4 cm2) than in the normal (1.2 +/- 0.8 cm2

  14. [Assessment of undiagnosed critical congenital heart disease before discharge from the maternity hospital].

    PubMed

    Zhao, Q M; Liu, F; Wu, L; Ye, M; Jia, B; Ma, X J; Huang, G Y

    2017-04-02

    Objective: Undiagnosed critical congenital heart disease (CCHD) was assessed before discharge from maternity hospital.Basic information was provided for screening CCHD in the early neonatal stage.Chi-squared test was used for comparison of categorical variables(detection rate of different types of CCHD). Method: A retrospective cohort study was conducted in neonates with CCHD who were admitted to Children's Hospital of Fudan University between 1 January 2012 and 31 December 2015. For comparing with the previously reported undiagnosed rate of CCHD at discharge, CCHD was defined as all duct dependent congenital heart disease (DDCHD) and any cyanotic CHD that required early surgery. Result: A total of 1 036 infants with CCHD were included. The prenatal detection rate of CCHD was 14.04%(122/869). As a whole, 52.51% (544/1 036) of CCHD cases were undiagnosed at discharge, and 14.09%(146/1 036)were still missed after 6-week examination. The diagnoses most likely to be unrecognized at discharge included critical coarctation of the aorta (COA) (75.00%), total anomalous pulmonary venous connection (61.54%), pulmonary atresia (PA) with ventricle septal defect (VSD) (61.45%), single ventricle (SV) (60.10%) and critical aortic stenosis (52.94%). Among newborns diagnosed prior to discharge, 54.88% (270/492) due to symptom or prenatal ultrasonographic diagnosis, 45.12% (222/492) due to abnormal findings in routine examination. Among asymptomatic CCHD cases without prenatal diagnosis, 71.02% (544/766) were undiagnosed and the most common delayed diagnosis was SV (82.78%), interrupted aortic arch (81.82%), transposition of the great arteries with intact ventricular septum (79.63%), PA/VSD (79.07%), and critical COA (78.57%). Newborns with DDC were more likely to develop symptoms within the first few days after birth, in comparison with non-DDC cases. However, their detection rates were close to each other. Conclusion: The rate of misdiagnosis of CCHD before discharge from

  15. Toward the improvement in fetal monitoring during labor with the inclusion of maternal heart rate analysis.

    PubMed

    Gonçalves, Hernâni; Pinto, Paula; Silva, Manuela; Ayres-de-Campos, Diogo; Bernardes, João

    2016-04-01

    Fetal heart rate (FHR) monitoring is used routinely in labor, but conventional methods have a limited capacity to detect fetal hypoxia/acidosis. An exploratory study was performed on the simultaneous assessment of maternal heart rate (MHR) and FHR variability, to evaluate their evolution during labor and their capacity to detect newborn acidemia. MHR and FHR were simultaneously recorded in 51 singleton term pregnancies during the last two hours of labor and compared with newborn umbilical artery blood (UAB) pH. Linear/nonlinear indices were computed separately for MHR and FHR. Interaction between MHR and FHR was quantified through the same indices on FHR-MHR and through their correlation and cross-entropy. Univariate and bivariate statistical analysis included nonparametric confidence intervals and statistical tests, receiver operating characteristic curves and linear discriminant analysis. Progression of labor was associated with a significant increase in most MHR and FHR linear indices, whereas entropy indices decreased. FHR alone and in combination with MHR as FHR-MHR evidenced the highest auROC values for prediction of fetal acidemia, with 0.76 and 0.88 for the UAB pH thresholds 7.20 and 7.15, respectively. The inclusion of MHR on bivariate analysis achieved sensitivity and specificity values of nearly 100 and 89.1%, respectively. These results suggest that simultaneous analysis of MHR and FHR may improve the identification of fetal acidemia compared with FHR alone, namely during the last hour of labor.

  16. Maternal diabetes induces congenital heart defects in mice by altering the expression of genes involved in cardiovascular development.

    PubMed

    Kumar, Srinivasan Dinesh; Dheen, S Thameem; Tay, Samuel Sam Wah

    2007-10-30

    Congenital heart defects are frequently observed in infants of diabetic mothers, but the molecular basis of the defects remains obscure. Thus, the present study was performed to gain some insights into the molecular pathogenesis of maternal diabetes-induced congenital heart defects in mice. We analyzed the morphological changes, the expression pattern of some genes, the proliferation index and apoptosis in developing heart of embryos at E13.5 from streptozotocin-induced diabetic mice. Morphological analysis has shown the persistent truncus arteriosus combined with a ventricular septal defect in embryos of diabetic mice. Several other defects including defective endocardial cushion (EC) and aberrant myofibrillogenesis have also been found. Cardiac neural crest defects in experimental embryos were analyzed and validated by the protein expression of NCAM and PGP 9.5. In addition, the protein expression of Bmp4, Msx1 and Pax3 involved in the development of cardiac neural crest was found to be reduced in the defective hearts. The mRNA expression of Bmp4, Msx1 and Pax3 was significantly down-regulated (p < 0.001) in the hearts of experimental embryos. Further, the proliferation index was significantly decreased (p < 0.05), whereas the apoptotic cells were significantly increased (p < 0.001) in the EC and the ventricular myocardium of the experimental embryos. It is suggested that the down-regulation of genes involved in development of cardiac neural crest could contribute to the pathogenesis of maternal diabetes-induced congenital heart defects.

  17. Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study.

    PubMed

    Wang, Zhen; Baumann, Brigitte M; Slutsky, Karen; Gruber, Karen N; Jean, Smith

    2010-01-15

    Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 +/- 15% (p < 0.05) and 25 +/- 16% (p < 0.05), respectively. With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

  18. Maternal Exposure to Nitrogen Dioxide, Intake of Methyl Nutrients, and Congenital Heart Defects in Offspring.

    PubMed

    Stingone, Jeanette A; Luben, Thomas J; Carmichael, Suzan L; Aylsworth, Arthur S; Botto, Lorenzo D; Correa, Adolfo; Gilboa, Suzanne M; Langlois, Peter H; Nembhard, Wendy N; Richmond-Bryant, Jennifer; Shaw, Gary M; Olshan, Andrew F

    2017-09-15

    Nutrients that regulate methylation processes may modify susceptibility to the effects of air pollutants. Data from the National Birth Defects Prevention Study (United States, 1997-2006) were used to estimate associations between maternal exposure to nitrogen dioxide (NO2), dietary intake of methyl nutrients, and the odds of congenital heart defects in offspring. NO2 concentrations, a marker of traffic-related air pollution, averaged across postconception weeks 2-8, were assigned to 6,160 nondiabetic mothers of cases and controls using inverse distance-squared weighting of air monitors within 50 km of maternal residences. Intakes of choline, folate, methionine, and vitamins B6 and B12 were assessed using a food frequency questionnaire. Hierarchical regression models, which accounted for similarities across defects, were constructed, and relative excess risks due to interaction were calculated. Relative to women with the lowest NO2 exposure and high methionine intake, women with the highest NO2 exposure and lowest methionine intake had the greatest odds of offspring with a perimembranous ventricular septal defect (odds ratio = 3.23, 95% confidence interval: 1.74, 6.01; relative excess risk due to interaction = 2.15, 95% confidence interval: 0.39, 3.92). Considerable departure from additivity was not observed for other defects. These results provide modest evidence of interaction between nutrition and NO2 exposure during pregnancy. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Electrocardiography versus photoplethysmography in assessment of maternal heart rate variability during labor.

    PubMed

    Gonçalves, Hernâni; Pinto, Paula; Silva, Manuela; Ayres-de-Campos, Diogo; Bernardes, João

    2016-01-01

    Evaluation of maternal heart rate (MHR) variability provides useful information on the maternal-fetal clinical state. Electrocardiography (ECG) is the most accurate method to monitor MHR but it may not always be available, and pulse oximetry using photoplethysmography (PPG) can be an alternative. In this study we compared ECG and PPG signals, obtained with conventional fetal monitors, to evaluate signal loss, MHR variability indices, and the ability of the latter to predict fetal acidemia and operative delivery. Both signals were simultaneously acquired in 51 term pregnancies during the last 2 h of labor (H1 and H2). Linear time- and frequency-domain, and nonlinear MHR variability indices were estimated, and the dataset was divided into normal and acidemic cases, as well as into normal and operative deliveries. Differences between ECG and PPG signals were assessed using non-parametric confidence intervals, hypothesis testing, correlation coefficient and a measure of disagreement. Prediction of fetal acidemia and operative delivery was assessed using areas under the receiver operating characteristic curve (auROC). Signal loss was higher with ECG during the first segments of H1, and higher with PPG in the last segment of H2, and it increased in both signals with labour progression. MHR variability indices were significantly different when acquired with ECG and PPG signals, with low correlation coefficients and high disagreement for entropy and fast oscillation-based indices, and low disagreement for the mean MHR and slow oscillation-based indices. However, both acquisition modes evidenced significant differences between H1 and H2 and comparable auROC values were obtained in the detection of fetal acidemia and operative vaginal delivery. Although PPG captures the faster oscillations of the MHR signal less well than ECG and is prone to have higher signal loss in the last 10-min preceding delivery, it can be considered an alternative for MHR monitoring during labor

  20. Modification of the association between maternal smoke exposure and congenital heart defects by polymorphisms in glutathione S-transferase genes.

    PubMed

    Li, Xiaohong; Liu, Zhen; Deng, Ying; Li, Shengli; Mu, Dezhi; Tian, Xiaoxian; Lin, Yuan; Yang, Jiaxiang; Li, Jun; Li, Nana; Wang, Yanping; Chen, Xinlin; Deng, Kui; Zhu, Jun

    2015-10-12

    Congenital heart defects (CHDs) arise through various combinations of genetic and environmental factors. Our study explores how polymorphisms in the glutathione S-transferase (GST) genes affect the association between cigarette smoke exposure and CHDs. We analysed 299 mothers of children with CHDs and 284 mothers of children without any abnormalities who were recruited from six hospitals. The hair nicotine concentration (HNC) was used to quantify maternal smoke exposure, and the maternal GSTT1, and GSTM1 and GSTP1 genes were sequenced. We found a trend of higher adjusted odds ratios with higher maternal HNC levels, suggesting a dose-response relationship between maternal smoke exposure and CHDs. The lowest HNC range associated with an increased risk of CHDs was 0.213-0.319 ng/mg among the mothers with functional deletions of GSTM1 or GSTT1and 0.319-0.573 ng/mg among the mothers with normal copies of GSTM1 and GSTT1. In addition, the adjusted odds ratio for an HNC of >0.573 ng/mg was 38.53 among the mothers with the GSTP1 AG or GG genotype, which was 7.76 (χ(2) = 6.702, p = 0.010) times greater than the AOR in the mothers with GSTP1 AA genotype. Our study suggests that polymorphisms of maternal GST genes may modify the association of maternal smoke exposure with CHDs.

  1. Modification of the association between maternal smoke exposure and congenital heart defects by polymorphisms in glutathione S-transferase genes

    PubMed Central

    Li, Xiaohong; Liu, Zhen; Deng, Ying; Li, Shengli; Mu, Dezhi; Tian, Xiaoxian; Lin, Yuan; Yang, Jiaxiang; Li, Jun; Li, Nana; Wang, Yanping; Chen, Xinlin; Deng, Kui; Zhu, Jun

    2015-01-01

    Congenital heart defects (CHDs) arise through various combinations of genetic and environmental factors. Our study explores how polymorphisms in the glutathione S-transferase (GST) genes affect the association between cigarette smoke exposure and CHDs. We analysed 299 mothers of children with CHDs and 284 mothers of children without any abnormalities who were recruited from six hospitals. The hair nicotine concentration (HNC) was used to quantify maternal smoke exposure, and the maternal GSTT1, and GSTM1 and GSTP1 genes were sequenced. We found a trend of higher adjusted odds ratios with higher maternal HNC levels, suggesting a dose-response relationship between maternal smoke exposure and CHDs. The lowest HNC range associated with an increased risk of CHDs was 0.213–0.319 ng/mg among the mothers with functional deletions of GSTM1 or GSTT1and 0.319–0.573 ng/mg among the mothers with normal copies of GSTM1 and GSTT1. In addition, the adjusted odds ratio for an HNC of >0.573 ng/mg was 38.53 among the mothers with the GSTP1 AG or GG genotype, which was 7.76 (χ2 = 6.702, p = 0.010) times greater than the AOR in the mothers with GSTP1 AA genotype. Our study suggests that polymorphisms of maternal GST genes may modify the association of maternal smoke exposure with CHDs. PMID:26456689

  2. Effect of maternal anxiety and music on fetal movements and fetal heart rate patterns.

    PubMed

    Kafali, Hasan; Derbent, Aysel; Keskin, Esra; Simavli, Serap; Gözdemir, Elif

    2011-03-01

    Aimed to investigate (a) the effect of non-stress test (NST) and music on maternal anxiety (b) the effect of maternal anxiety and music on fetal heart rate (FHR) changes. The two hundred and one pregnant women coming for routine prenatal care were randomized to receive either music (n=96) or no music (n=105) during NST. Before and after the test, these women were asked to complete the Spielberg State-Trait Anxiety Inventory on two interviews; primary outcome was considered as a maternal state anxiety score before and after NST. Secondary outcome was the baseline FHR, the number of fetal movement, large accelerations, dubious NST, variable decelerations, and the minimum procedure time. Before NST, the mean state anxiety score of the music and control groups was found as 38.1 +/- 8.8 and 38.08 +/-8.2, respectively (p>0.05). On the other hand, after NST, the mean state anxiety score of the music and control groups was found as 35.5 +/- 8.2 and 40.2 +/- 9.2, respectively (p<0.001). While in control group, NST brought about a statistically significant increase in a state anxiety score (38.08 +/- 8.2 versus 40.2 +/- 9.2, p<0.001), listening to music during NST resulted in decrease in a state anxiety score of the study group but it was not statistically significant (38.1 +/- 8.8 versus 35.5 +/- 8.2, p>0.05). The baseline FHR of the music group was significantly higher than that of the control group (134.09 +/- 7.2 versus 130.3 +/- 5.7, p<0.001).The number of fetal movement in the music group was significantly higher than that of the control group (8.9 +/- 4.7 versus 5.9 +/- 3.9, p<0.001). The number of large accelerations in music group was significantly higher than that of the control group (5.7 +/- 2.1 versus 4.5 +/- 2.04, p<0.001). The minimum procedure time in music group was significantly lower than that of control group (13.4 +/- 5.2 versus 15.6 +/- 6.1, p<0.05). The number of dubious NST and variable decelerations was found to be similar for both groups (p>0

  3. Effect of maternal position on fetal behavioural state and heart rate variability in healthy late gestation pregnancy.

    PubMed

    Stone, Peter R; Burgess, Wendy; McIntyre, Jordan P R; Gunn, Alistair J; Lear, Christopher A; Bennet, Laura; Mitchell, Edwin A; Thompson, John M D

    2017-02-15

    Fetal behavioural state in healthy late gestation pregnancy is affected by maternal position. Fetal state 1F is more likely to occur in maternal supine or right lateral positions. Fetal state 4F is less likely to occur when the woman lies supine or semi-recumbent. Fetal state change is more likely when the woman is supine or semi-recumbent. Fetal heart rate variability is affected by maternal position with variability reduced in supine and semi-recumbent positions. Fetal behavioural states (FBS) are measures of fetal wellbeing. In acute hypoxaemia, the human fetus adapts to a lower oxygen consuming state with changes in the cardiotocograph and reduced fetal activity. Recent studies of late gestation stillbirth described the importance of sleep position in the risk of intrauterine death. We designed this study to assess the effects of different maternal positions on FBS in healthy late gestation pregnancies under controlled conditions. Twenty-nine healthy women had continuous fetal ECG recordings under standardized conditions in four randomly allocated positions, left lateral, right lateral, supine and semi-recumbent. Two blinded observers, assigned fetal states in 5 min blocks. Measures of fetal heart rate variability were calculated from ECG beat to beat data. Compared to state 2F, state 4F was less likely to occur when women were semi-recumbent [odds ratio (OR) = 0.11, 95% confidence interval (95% CI) 0.02, 0.55], and supine (OR = 0.27, 95% CI 0.07, 1.10). State 1F was more likely on the right (OR = 2.36, 95% CI 1.11, 5.04) or supine (OR = 4.99, 95% CI 2.41, 10.43) compared to the left. State change was more likely when the mother was semi-recumbent (OR = 2.17, 95% CI 1.19, 3.95) or supine (OR = 2.67, 95% CI 1.46, 4.85). There was a significant association of maternal position to mean fetal heart rate. The measures of heart rate variability (SDNN and RMSSD) were reduced in both semi-recumbent and supine positions. In healthy late gestation pregnancy

  4. Maternal blood pressure and heart rate response to pelvic floor muscle training during pregnancy.

    PubMed

    Ferreira, Cristine H; Naldoni, Luciane M V; Ribeiro, Juliana Dos Santos; Meirelles, Maria Cristina C C; Cavalli, Ricardo de Carvalho; Bø, Kari

    2014-07-01

    To assess whether maternal blood pressure (BP) and heart rate (HR) change significantly in response to pelvic floor muscle training during pregnancy. Longitudinal exploratory study with repeated measurements. Twenty-seven nulliparous healthy women of mean age 23.3 years (range 18-36) and mean body mass index 23.4 (range 23.1-29.5). Individual supervised pelvic floor muscle training from gestational week 20 till 36 with assessment of BP and HR at gestational weeks 20, 24, 28, 32 and 36. Systolic and diastolic BP was measured before and after each training session and HR was monitored during each session. Pelvic floor muscle training did not change BP. 77% (n = 21) of participants exceeded 70% of estimated maximum HR during at least one session. The time for exceeding 70% of estimated maximum HR was between 2.2 and 3.2 % of the total exercise session. Increases in BP and HR from gestational weeks 20 till 36 were within normal limits for pregnant women. Pelvic floor muscle training in nulliparous sedentary pregnant women does not increase BP. It significantly increases HR during the exercise sessions, but only for a limited period of time and with no negative long-term effect on BP or HR. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. The Effects of Maternal Opium Abuse on Fetal Heart Rate using Non-Stress Test

    PubMed Central

    Keikha, Fatemeh; Vahdani, Fahimeh Ghotbizadeh; Latifi, Sahar

    2016-01-01

    Background: Opium is one of the most commonly abused opiates in developing countries including Iran. Considering the importance of maternal health on the newborn, we aimed to assess the effect of opium abuse on fetal heart rate (FHR) characteristics in a sample of pregnant women in Zahedan, Southeast Iran. Methods: This cross-sectional study was done on 100 pregnant women referring to Ali-Ibn-Abi Talib Hospital in Zahedan, during 2011-2013. The participants were divided into two groups comprising of opium abusers and healthy individuals. The participants received 500cc intravenous fluid containing dextrose and then non-stress test results were recorded for 20 minutes. Results: We found no significant difference between the two groups with respect to their demographic characteristics. Fetal movements, variability, acceleration, and reactivity were significantly higher among addicted women (P<0.0001 for all). Periodic change was 9.8 times higher among opium abusers compared with the healthy women. Abnormal variability or oscillations of <15 beats/min, which indicates lack of beat-to-beat variability, was significantly higher in the fetuses of addicted mothers (P<0.0001). Conclusion: Considering significant abnormal patterns in FHR characteristics among the opium abuser group, mothers addicted to opium need specific prenatal care. PMID:27853327

  6. Maternal exposure to arsenic and cadmium and the risk of congenital heart defects in offspring.

    PubMed

    Jin, Xi; Tian, Xiaoxian; Liu, Zhen; Hu, Hui; Li, Xiaohong; Deng, Ying; Li, Nana; Zhu, Jun

    2016-01-01

    Hair arsenic and cadmium from 339 women with congenital heart defect (CHD)-affected pregnancies (case women) and 333 women with normal live births (control women) in China were estimated using inductively coupled plasma mass spectrometry. The median levels of hair arsenic and cadmium in the case women were 98.30 (74.30-136.30)ng/g and 14.60 (8.30-32.50)ng/g, respectively, which were significantly higher than the levels in the control group (P<0.05). Arsenic concentrations ≥62.03ng/g were associated with increased risk for almost every CHD subtype, with a dose-response relationship. However, only the group with the highest cadmium levels (≥25.85ng/g) displayed an increased risk of CHDs (AOR 1.96; 95% CI 1.24-3.09), with a 2.81-fold increase found for the occurrence of conotruncal defects in their offspring. Furthermore, an interaction between arsenic and cadmium was observed. Our findings suggest that maternal exposure to arsenic and cadmium may be a significant risk factor for CHDs in offspring. Cadmium may have an enhancing effect on the association between arsenic and the risk of CHDs in offspring.

  7. Computer analysis of maternal-fetal heart rate recordings during labor in relation with maternal-fetal attachment and prediction of newborn acidemia.

    PubMed

    Pinto, Paula; Costa-Santos, Cristina; Ayres-de-Campos, Diogo; Bernardes, João

    2016-01-01

    To assess combined maternal (MHR) and fetal heart rate (FHR) recordings during labor, in relation with maternal-fetal attachment and prediction of newborn acidemia. Fifty-nine simultaneous MHR and FHR recordings were acquired in the final minutes of labor. Computer analysis followed the FIGO guidelines with estimation of MHR and FHR baselines, accelerations, decelerations, short- (STV) and long-term variabilities. MHR and FHR characteristics, their differences and correlations were assessed in relation to labor progression and to newborn umbilical artery blood (UAB) pH lower than 7.15 and 7.20. To assess prediction of acidemia, areas under ROC curves (auROC) were calculated. Progression of labor was associated with a significant increase in MHR accelerations and FHR decelerations both in the non-acidemic and acidemic fetuses (p < 0.01). At the same time there was an increase in MHR-FHR correlations and differences in accelerations and decelerations in acidemic fetuses. The auROC ranged between 0.50 for FHR accelerations and 0.77 for MHR baseline plus FHR STV. MHR and FHR respond differently during labor with signs of increased maternal-fetal attachment during labor progression in acidemic fetuses. Combined MHR-FHR analysis may help to improve prediction of newborn acidemia compared with FHR analysis alone.

  8. The Effect of Maternal Relaxation Training on Reactivity of Non-Stress Test, Basal Fetal Heart Rate, and Number of Fetal Heart Accelerations: A Randomized Controlled Trial

    PubMed Central

    Akbarzade, Marzieh; Rafiee, Bahare; Asadi, Nasrin; Zare, Najaf

    2015-01-01

    Background: Relaxation-training, as an anxiety-reducer intervention, plays an important role in fetal health. The present study aimed to analyze the effect of maternal relaxation on stress test (NST), basal fetal heart rate, and number of fetal heart accelerations. Methods: In this randomized controlled trial, 84 pregnant women were randomly divided into two groups of teaching relaxation and control groups in 2012. In the intervention group, 60-90 minute classes were held every week lasting for 4 weeks. Besides, home practice charts were given to the mothers and researchers controlled the home practices by phone calls every week. The control group received routine prenatal care. In the 4th week, NST was performed in the intervention group 30 minutes before and after the 4th session. In the control group, NST was done in the 4th week. The quantitative variables in the two groups were compared through ANOVA and Chi-square test. Results: The results of paired t-test showed that relaxation could improve the NST results (P=0.01). Mean and standard deviation of basal fetal heart rate was 138.95±8.18 before the intervention and 133.07±6.9 after the intervention. Paired t-test also showed that relaxation reduced the basal fetal heart rate (P=0.001). Mean and standard deviation of the number of fetal heart accelerations was 1.5±0.8 before the intervention and 2.2±0.9 after it. The results of paired t-test also showed that relaxation increased the number of fetal heart accelerations (P=0.001). Conclusions: Relaxation could improve the NST results, reduce the basal fetal heart rate, and increase the number of fetal heart accelerations. Therefore, relaxation is recommended during pregnancy. Trial Registration Number: IRCT2012072810418N1 PMID:25553334

  9. Maternal inflammation activated ROS-p38 MAPK predisposes offspring to heart damages caused by isoproterenol via augmenting ROS generation

    PubMed Central

    Zhang, Qi; Deng, Yafei; Lai, Wenjing; Guan, Xiao; Sun, Xiongshan; Han, Qi; Wang, Fangjie; Pan, Xiaodong; Ji, Yan; Luo, Hongqin; Huang, Pei; Tang, Yuan; Gu, Liangqi; Dan, Guorong; Yu, Jianhua; Namaka, Michael; Zhang, Jianxiang; Deng, Youcai; Li, Xiaohui

    2016-01-01

    Maternal inflammation contributes to the increased incidence of adult cardiovascular disease. The current study investigated the susceptibility of cardiac damage responding to isoproterenol (ISO) in adult offspring that underwent maternal inflammation (modeled by pregnant Sprague-Dawley rats with lipopolysaccharides (LPS) challenge). We found that 2 weeks of ISO treatment in adult offspring of LPS-treated mothers led to augmented heart damage, characterized by left-ventricular systolic dysfunction, cardiac hypertrophy and myocardial fibrosis. Mechanistically, prenatal exposure to LPS led to up-regulated expression of nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, antioxidant enzymes, and p38 MAPK activity in left ventricular of adult offspring at resting state. ISO treatment exaggerated ROS generation, p38 MAPK activation but down-regulated reactive oxygen species (ROS) elimination capacity in the left ventricular of offspring from LPS-treated mothers, while antioxidant N-acetyl-L-cysteine (NAC) reversed these changes together with improved cardiac functions. The p38 inhibitor SB202190 alleviated the heart damage only via inhibiting the expression of NADPH oxidases. Collectively, our data demonstrated that prenatal inflammation programs pre-existed ROS activation in the heart tissue, which switches on the early process of oxidative damages on heart rapidly through a ROS-p38 MAPK-NADPH oxidase-ROS positive feedback loop in response to a myocardial hypertrophic challenge in adulthood. PMID:27443826

  10. Lower rate of selected congenital heart defects with better maternal diet quality: a population-based study.

    PubMed

    Botto, Lorenzo D; Krikov, Sergey; Carmichael, Suzan L; Munger, Ronald G; Shaw, Gary M; Feldkamp, Marcia L

    2016-01-01

    To evaluate whether better diet quality in mothers is associated with lower risk for major non-syndromic congenital heart defects in their children. Multicentre population-based case-control study, the National Birth Defects Prevention Study. Ten sites in the USA. Mothers of babies with major non-syndromic congenital heart defects (n=9885) and mothers with unaffected babies (n=9468) with estimated date of delivery from 1997 to 2009. Adjusted ORs for specific major congenital heart defects by quartiles of maternal diet quality in the year before pregnancy, assessed by the Diet Quality Index for pregnancy (DQI-P) and the Mediterranean Diet Score. Quartile 1 (Q1) reflecting the worst diet quality and Q4 the best diet quality. Better diet quality was associated with reduced risk for some conotruncal and atrial septal heart defects. For DQI-P, estimated risks reductions (Q4 vs Q1) for conotruncal defects were 37% for tetralogy of Fallot (OR 0.63, 95% CI 0.49 to 0.80) and 24% overall (OR 0.76, 95% CI 0.64 to 0.91); and for septal defects, 23% for atrial septal defects (OR 0.77, 95% CI 0.63 to 0.94) and 14% overall (OR 0.86, 95% CI 0.75 to 1.00). Risk reductions were weaker or minimal for most other major congenital heart defects. Better diet quality is associated with a reduced occurrence of some conotruncal and septal heart defects. This finding suggests that a reduction in certain cardiac malformations may be an additional benefit of improved maternal diet quality, reinforcing current preconception care recommendations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Effect of maternal age and cardiac disease severity on outcome of pregnancy in women with congenital heart disease.

    PubMed

    Furenäs, Eva; Eriksson, Peter; Wennerholm, Ulla-Britt; Dellborg, Mikael

    2017-09-15

    There is an increasing prevalence of women with congenital heart defects reaching childbearing age. In western countries women tend to give birth at a higher age compared to some decades ago. We evaluated the CARdiac disease in PREGnancy (CARPREG) and modified World Health Organization (mWHO) risk classifications for cardiac complications during pregnancies in women with congenital heart defects and analyzed the impact of age on risk of obstetric and fetal outcome. A single-center observational study of cardiac, obstetric, and neonatal complications with data from cardiac and obstetric records of pregnancies in women with congenital heart disease. Outcomes of 496 pregnancies in 232 women, including induced abortion, miscarriage, stillbirth, and live birth were analyzed regarding complications, maternal age, mode of delivery, and two risk classifications: CARPREG and mWHO. There were 28 induced abortions, 59 fetal loss, 409 deliveries with 412 neonates. Cardiac (14%), obstetric (14%), and neonatal (15%) complications were noted, including one maternal death and five stillbirths. The rate of cesarean section was 19%. Age above 35years was of borderline importance for cardiac complications (p=0.054) and was not a significant additional risk factor for obstetric or neonatal complications. Both risk classifications had moderate clinical utility, with area under the curve (AUC) 0.71 for CARPREG and 0.65 for mWHO on cardiac complications. Pregnancy complications in women with congenital heart disease are common but severe complications are rare. Advanced maternal age does not seem to affect complication rate. Existing risk classification systems are insufficient in predicting complications. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Vasoreactive Response to Maternal Hyperoxygenation (MH) in the Fetus with Hypoplastic Left Heart Syndrome (HLHS)

    PubMed Central

    Szwast, Anita; Tian, Zhiyun; McCann, Margaret; Donaghue, Denise; Rychik, Jack

    2011-01-01

    Background Cardio-pulmonary interactions play an important role in the pathophysiology of hypoplastic left heart syndrome (HLHS). Pulmonary vasculopathy has been identified, especially in those with restrictive/intact atrial septum (R/IAS). Responsiveness of the pulmonary vasculature to maternal hyperoxygenation (MH) may provide a tool to assess the degree of pulmonary vasculopathy present prior to birth. Methods and Results Doppler echocardiography was performed in 27 normal and 43 HLHS fetuses. In HLHS, sampling was repeated after 10 minutes of MH with 60% FiO2, and after 5 minutes of recovery. Sampling was performed in the proximal, mid-portion, and distal branch pulmonary artery (PA). Pulsatility index (PI) was used as a measure of vascular impedance. Of the HLHS fetuses, 34 had an open inter-atrial septum and 9 had a R/IAS. At birth, 5 fetuses underwent immediate intervention on the inter-atrial septum. Middle cerebral artery PI was lower in HLHS vs. normals (p<0.001). There was no difference in umbilical artery, ductus arteriosus, or branch PA PI between normals and HLHS. MH led to a significant decrease in PI at each of the PA sites sampled in fetuses with an open atrial septum (p<0.001); however, there no was significant change in the PI in fetuses that required immediate intervention on the atrial septum at birth. Using a cutoff value of <10% vasoreactivity, the sensitivity of MH testing for determining need for immediate intervention at birth is 100% [0.46-1.0], specificity 94% [0.78-.99], positive predictive value 71% [0.30-0.95], and negative predictive value 100% [0.86-1.0]. No untoward effects were seen with MH. Conclusions PA vasoreactivity to MH occurs in the fetus with HLHS. MH testing accurately identifies fetuses requiring urgent postnatal intervention at birth and may be used to select candidates for fetal atrial septoplasty. PMID:20044513

  13. Prenatal and maternal characteristics and later risk for coronary heart disease among women.

    PubMed

    Eriksson, Johan G; Kajantie, Eero; Thornburg, Kent; Osmond, Clive

    2016-03-01

    The pace and pathways of early growth have major influences on later health. Coronary heart disease (CHD) is a major killer and kills more women than men, but usually manifests about 10 years later in women. Therefore there are fewer studies of early growth and CHD amongst women than men. The Helsinki Birth Cohort Study includes 9817 women born during 1924-1944. We used national registers to identify hospital admissions and deaths from CHD during 1971-2010. We used a Cox model to obtain hazard ratios (HRs) for CHD. Altogether 967 women (9.9%) developed CHD. Socioeconomic factors were strongly and inversely associated with CHD. Neither maternal age nor body mass index (BMI) was associated with CHD in the daughters. There were inverse associations of birth weight (p = 0.07) and length (p = 0.02) with CHD in adult life. We divided the mothers according to parity. Daughters of primiparous women had lower birth weight and shorter birth length than the offspring of multiparous women (both p-values < 0.001). Birth weight (p = 0.008), birth length (p = 0.05) and birth BMI (p = 0.02) were all inversely associated with CHD. Among first-born women, a 1 kg increase in birth weight was associated with a 25% lower risk for CHD (HR 0.75, 95% confidence interval (CI) 0.60-0.93). The findings changed little after adjustment for socioeconomic factors. Among later-born women none of the birth characteristics was associated with CHD. Small birth size is associated with CHD among women. First-born women with high birth weight appear to be at lower risk for CHD compared with later born women. © The European Society of Cardiology 2015.

  14. [Mode of splitting of the second heart sound in patients with hypertrophic cardiomyopathy].

    PubMed

    Fukuda, N; Oki, T; Sakai, H; Asai, M; Ohshima, C; Kusaka, Y; Tominaga, T; Murao, A; Niki, T; Mori, H

    1983-06-01

    Mode of the splitting of the second heart sound ( IIs ) and left ventricular systolic time intervals (STIs) in patients (pts) with hypertrophic cardiomyopathy were compared with those in hypertension (HT) with the global hypertrophy of the left ventricular wall. Forty-seven pts with hypertrophic cardiomyopathy [non-obstructive type (HCM, 30 pts), obstructive type (HOCM, 17 pts)] and 21 pts with HT were studied. The pts with HCM were classified as septal hypertrophic type (19 pts) and apical hypertrophic type (11 pts) on the basis of the echocardiographic findings. The pts with HOCM were classified as resting type (13 pts) and latent type (provoked by amyl nitrite: 4 pts) on the basis of the obstructive sign at rest. Mode of the splitting of the IIs : a) The pts with HCM showed a wide splitting of the IIs . The mean split interval during held expiration (IIA-IIP) was 41.0 +/- 9.9 msec. Twenty pts (67%) showed abnormal respiratory splitting. The mean IIA-IIP interval in septal hypertrophic type (45.3 +/- 9.0 msec) was significantly wider than that in apical hypertrophic type (33.6 +/- 6.7 msec) (p less than 0.05). There was a positive correlation between IIA-IIP interval and the thickness of the upper portion of the interventricular septum (r = 0.63). b) Nine out of 13 pts with resting type of HOCM showed a paradoxical (reversed) splitting with a mean IIA-IIP interval of -23.8 +/- 24.4 msec. On the other hand, pts with latent type showed a wide splitting similar to HCM with a mean IIA-IIP interval of 35.0 +/- 7.1 msec. c) The pts with HT showed a single IIs or physiological splitting. The mean IIA-IIP interval was 14.5 +/- 9.3 msec, which was significantly decreased than that of normals or the pts with HCM (p less than 0.01). Left ventricular systolic time intervals: a) The pts with an either type of HCM showed a short corrected left ventricular electromechanical systole [(Q-IIA)c] due to the shortening of the corrected left ventricular ejection time (LVETc). b) The

  15. Maternal Hypertension During Pregnancy and the Risk of Congenital Heart Defects in Offspring: A Systematic Review and Meta-analysis.

    PubMed

    Ramakrishnan, Anushuya; Lee, Laura J; Mitchell, Laura E; Agopian, A J

    2015-10-01

    Maternal hypertension is common during pregnancy, and multiple studies have reported on an association between maternal hypertension and congenital heart defects (CHDs) in offspring; however, there is variability in the quality of these studies. A systematic review and meta-analysis was conducted on the associations between untreated and treated maternal hypertension and the risk of CHDs, evaluating CHDs overall as well as specific CHD subtypes. A systematic search of peer-reviewed articles published before August 2013 identified 16 studies evaluating the associations between untreated and treated maternal hypertension and CHDs. Summary relative risk (RR) estimates were calculated using fixed-effects models and random-effects models. Significant associations were observed between maternal hypertension and overall CHDs, for both treated [RR 2.0; 95 % confidence interval (CI) 1.5, 2.7] and untreated (RR 1.4; 95 % CI 1.2, 1.7) hypertension, as well as for overall hypertension regardless of treatment status (RR 1.8; 95 % CI 1.5, 2.2). The magnitude of effect was similar for the majority of CHD subtypes evaluated. The effects were also similar among women with hypertension who used one of multiple specific hypertension medications. There was no evidence of publication bias, and our results were robust to several factors considered in sensitivity analyses (e.g., source of exposure data, adjustment for potential confounders, and study design). Maternal hypertension was associated with CHDs. By understanding the specific mechanisms involved, appropriate strategies may be developed to reduce this risk, in order to prevent CHDs.

  16. Recovery after aerobic exercise is manipulated by tempo change in a rhythmic sound pattern, as indicated by autonomic reaction on heart functioning.

    PubMed

    Wallert, John; Madison, Guy

    2014-01-01

    Physical prowess is associated with rapid recovery from exhaustion. Here we examined whether recovery from aerobic exercise could be manipulated with a rhythmic sound pattern that either decreased or increased in tempo. Six men and six women exercised repeatedly for six minutes on a cycle ergometer at 60 percent of their individual maximal oxygen consumption, and then relaxed for six minutes while listening to one of two sound pattern conditions, which seemed to infinitely either decrease or increase in tempo, during which heart and breathing activity was measured. Participants exhibited more high-frequent heart rate variability when listening to decreasing tempo than when listening to increasing tempo, accompanied by a non-significant trend towards lower heart rate. The results show that neuropsychological entrainment to a sound pattern may directly affect the autonomic nervous system, which in turn may facilitate physiological recovery after exercise. Applications using rhythmic entrainment to aid physical recovery are discussed.

  17. Recovery after aerobic exercise is manipulated by tempo change in a rhythmic sound pattern, as indicated by autonomic reaction on heart functioning

    PubMed Central

    Wallert, John; Madison, Guy

    2014-01-01

    Physical prowess is associated with rapid recovery from exhaustion. Here we examined whether recovery from aerobic exercise could be manipulated with a rhythmic sound pattern that either decreased or increased in tempo. Six men and six women exercised repeatedly for six minutes on a cycle ergometer at 60 percent of their individual maximal oxygen consumption, and then relaxed for six minutes while listening to one of two sound pattern conditions, which seemed to infinitely either decrease or increase in tempo, during which heart and breathing activity was measured. Participants exhibited more high-frequent heart rate variability when listening to decreasing tempo than when listening to increasing tempo, accompanied by a non-significant trend towards lower heart rate. The results show that neuropsychological entrainment to a sound pattern may directly affect the autonomic nervous system, which in turn may facilitate physiological recovery after exercise. Applications using rhythmic entrainment to aid physical recovery are discussed. PMID:25285076

  18. Fetal echocardiographic assessment of endocardial fibroelastosis in maternal anti-SSA antibody-associated complete heart block.

    PubMed

    Aoki, Hisaaki; Inamura, Noboru; Kawazu, Yukiko; Nakayama, Masahiro; Kayatani, Futoshi

    2011-01-01

    There are few reports describing the features of maternal anti-SSA antibody-associated congenital complete heart block (CCHB) patients developing endocardial fibroelastosis (EFE). The aim of this study was to describe the clinical features and the outcome of patients with CCHB, with or without EFE. Over a 20-year period, 12 consecutive patients diagnosed with maternal anti-SSA antibody-associated CCHB were identified. The maternal anti-SSA antibody levels were measured and fetal echocardiographic findings were reviewed. The ratios of the thickness of the endocardium to that of the whole wall of the left ventricle (LE/W) and right ventricle (RE/W) were measured to investigate the degree of endocardial thickening. A total of 7 patients survived (living group) and were not diagnosed as having EFE. The remaining 5 patients died and were diagnosed with EFE during autopsy (dead group). Fetal echocardiography of the patients showed differences in the thickening and hyperintensity of the endocardium. The RE/W value was significantly higher in the dead group than in the living group. The titers of both maternal anti-52-kDa and anti-60-kDa SSA antibodies were high, but showed no significant differences between the 2 patient groups. EFE was the major negative prognostic factor for CCHB. Myocardial damage, predominantly in the right ventricle, was related to the outcome of CCHB associated with EFE.

  19. Foetal heart rate deceleration with combined spinal-epidural analgesia during labour: a maternal haemodynamic cardiac study.

    PubMed

    Valensise, Herbert; Lo Presti, Damiano; Tiralongo, Grazia Maria; Pisani, Ilaria; Gagliardi, Giulia; Vasapollo, Barbara; Frigo, Maria Grazia

    2016-01-01

    To understand the mechanisms those are involved in the appearance of foetal heart rate decelerations (FHR) after the combined epidural analgesia in labour. Observational study done at University Hospital for 86-term singleton pregnant women with spontaneous labour. Serial bedside measurement of the main cardiac maternal parameters with USCOM technique; stroke volume (SV), heart rate (HR), cardiac output (CO) and total vascular resistances (TVR) inputting systolic and diastolic blood pressure before combined epidural analgesia and after 5', 10', 15' and 20 min. FHR was continuously recorded though cardiotocography before and after the procedure. Correlation between the appearance of foetal heart rate decelerations and the modification of maternal haemodynamic parameters. Fourteen out of 86 foetuses showed decelerations after the combined spino epidural procedure. No decelerations occurred in the women with low TVR (<1000 dyne/s/cm(-5)) at the basal evaluation. FHR abnormalities were concentrated in 39 women who presented elevated TVR values at the basal evaluation (>1200 dyne/s/cm(-5)). Soon after the epidural procedure, the absence of increase in SV and CO was observed in these women. No variations in systolic and diastolic blood pressure values were found. The level of TVR before combined epidural analgesia in labour may indicate the risk of FHR abnormalities after the procedure. Low TVR (<1000 dyne/s/cm(-5)) showed a reduced risk of FHR abnormalities. FHR decelerations seem to occur in women without the ability to upregulate SV and CO in response to the initial effects of analgesia.

  20. Lack of maternal folic acid supplementation is associated with heart defects in Down syndrome: a report from the National Down Syndrome Project

    PubMed Central

    Bean, Lora J. H.; Allen, Emily G.; Tinker, Stuart W.; Hollis, NaTasha D.; Locke, Adam E.; Druschel, Charlotte; Hobbs, Charlotte A.; O’Leary, Leslie; Romitti, Paul A.; Royle, Marjorie H.; Torfs, Claudine P.; Dooley, Kenneth J.; Freeman, Sallie B.; Sherman, Stephanie L.

    2011-01-01

    BACKGROUND Maternal folic acid supplementation has been associated with a reduced risk for neural tube defects, and may be associated with a reduced risk for congenital heart defects, and other birth defects. Individuals with Down syndrome are at high risk for congenital heart defects and have been shown to have abnormal folate metabolism. METHODS As part of the population-based case-control National Down Syndrome Project, 1011 mothers of infants with Down syndrome reported their use of folic acid-containing supplements. These data were used to determine whether lack of periconceptional maternal folic acid supplementation is associated with congenital heart defects in Down syndrome. We used logistic regression to test the relationship between maternal folic acid supplementation and the frequency of specific heart defects correcting for maternal race/ethnicity, proband sex, maternal use of alcohol and cigarettes, and maternal age at conception. RESULTS Lack of maternal folic acid supplementation was more frequent among infants with Down syndrome and atrioventricular septal defects (OR=1.69; 95% CI, 1.08–2.63; P=0.011) or atrial septal defects (OR=1.69; 95% CI, 1.11–2.58; P=0.007) than among infants with Down syndrome and no heart defect. Preliminary evidence suggests that the patterns of association differ by race/ethnicity and sex of the proband. There was no statistically significant association with ventricular septal defects (OR=1.26; 95% CI, 0.85–1.87; P=0.124). CONCLUSIONS Our results suggest that lack of maternal folic acid supplementation is associated with septal defects in infants with Down syndrome. PMID:21987466

  1. Heart failure and dysrhythmias after maternal placental syndromes: HAD MPS Study.

    PubMed

    Ray, Joel G; Schull, Michael J; Kingdom, John C; Vermeulen, Marian J

    2012-08-01

    Maternal placental syndromes (MPS)-gestational hypertension, pre-eclampsia and placental abruption/infarction-are more prevalent in women with features of the metabolic syndrome (MetSyn). Both MPS and the MetSyn predispose to left ventricular impairment and sympathetic dominance after delivery. Whether this translates into a higher risk of heart failure (HF) and cardiac dysrhythmias is not known. To determine the risk of new onset of HF and dysrhythmias among women after a prior MPS-affected pregnancy. A retrospective cohort study was carried out of 1,130,764 individual women with a delivery in Ontario between 1992 and 2009, excluding those with cardiac or thyroid disease 1 year before delivery. The risk of a composite outcome of a hospitalisation for HF or an atrial or ventricular dysrhythmia was compared in women with and without MPS, starting 1 year after delivery. 75,242 individuals (6.7%) experienced a MPS. After a median duration of 7.8 years, the composite outcome occurred in 148 women with MPS (2.54 per 10,000 person-years) and 1062 women without MPS (1.28 per 10,000 person-years) (crude HR=2.00, 95% CI 1.68 to 2.38). The mean age at composite outcome was 37.8 years. The HR was 1.61 (95% CI 1.35 to 1.91) after adjustment for demographic characteristics, diabetes, obesity, dyslipidaemia and drug dependence or tobacco use, as well as coronary artery disease or thyroid disease >1 year after delivery. The adjusted HRs were minimally reduced by further adjusting for chronic hypertension (1.51, 95% CI 1.26 to 1.80) and were higher in women with MPS plus preterm delivery and poor fetal growth (2.42, 95% CI 1.25 to 4.67). Women with MPS are at higher risk of premature HF and dysrhythmias, especially when perinatal morbidity is present.

  2. Atrial and ventricular rate response and patterns of heart rate acceleration during maternal-fetal terbutaline treatment of fetal complete heart block.

    PubMed

    Cuneo, Bettina F; Zhao, Hui; Strasburger, Janette F; Ovadia, Marc; Huhta, James C; Wakai, Ronald T

    2007-08-15

    Terbutaline is used to treat fetal bradycardia in the setting of complete heart block (CHB); however, little is known of its effects on atrial and ventricular beat rates or patterns of heart rate (HR) acceleration. Fetal atrial and ventricular beat rates were compared before and after transplacental terbutaline treatment (10 to 30 mg/day) by fetal echocardiography in 17 fetuses with CHB caused by immune-mediated damage to a normal conduction system (isoimmune, n = 8) or a congenitally malformed conduction system associated with left atrial isomerism (LAI, n = 9). While receiving terbutaline, 9 of the 17 fetuses underwent fetal magnetocardiography (fMCG) to assess maternal HR and rhythm, patterns of fetal HR acceleration, and correlation between fetal atrial and ventricular accelerations (i.e., AV correlation). Maternal HR and fetal atrial and ventricular beat rates increased with terbutaline. However, terbutaline's effects were greater on the atrial pacemaker(s) in fetuses with isoimmune CHB and greater on the ventricular pacemaker(s) in those with LAI-associated CHB. Patterns of fetal HR acceleration also differed between isoimmune and LAI CHB. Finally, despite increasing HR, terbutaline did not restore the normal coordinated response between atrial and ventricular accelerations in isoimmune or LAI CHB. In conclusion, the pathophysiologic heterogeneity of CHB is reflected in the differing effect of terbutaline on the atrial and ventricular pacemaker(s) and varying patterns of HR acceleration. However, regardless of the cause of CHB, terbutaline augments HR but not AV correlation, suggesting that its effects are determined by the conduction system defect rather than the autonomic control of the developing heart.

  3. Superoxide Dismutase 1 in vivo Ameliorates Maternal Diabetes-Induced Apoptosis and Heart Defects through Restoration of Impaired Wnt Signaling

    PubMed Central

    Wang, Fang; Fisher, Steven A.; Zhong, Jianxiang; Wu, Yanqing; Yang, Peixin

    2015-01-01

    Background Oxidative stress is manifested in embryos exposed to maternal diabetes, yet specific mechanisms for diabetes-induced heart defects are not defined. Gene deletion of intermediates of Wingless-related integration (Wnt) signaling causes heart defects similar to those observed in embryos from diabetic pregnancies. We tested the hypothesis that diabetes-induced oxidative stress impairs Wnt signaling thereby causing heart defects, and that these defects can be rescued by transgenic overexpression of the reactive oxygen species scavenger SOD1. Methods and Results Wild-type (WT) and superoxide dismutase 1 (SOD1) overexpressing embryos from nondiabetic WT control dams and nondiabetic/diabetic WT female mice mated with SOD1 transgenic male mice were analyzed. No heart defects were observed in WT and SOD1 embryos under nondiabetic conditions. WT embryos of diabetic dams had a 26% incidence of cardiac outlet defects that were suppressed by SOD1 overexpression. Insulin treatment reduced blood glucose levels and heart defects. Diabetes increased superoxide production, canonical Wnt antagonist expression, caspase activation, and apoptosis, and suppressed cell proliferation. Diabetes suppressed Wnt signaling intermediates and Wnt target gene expression in the embryonic heart, each of which were reversed by SOD1 overexpression. Hydrogen peroxide and peroxynitrite mimicked the inhibitory effect of high glucose on Wnt signaling, which was abolished by the SOD1 mimetic, tempol. Conclusions The oxidative stress of diabetes impairs Wnt signaling and causes cardiac outlet defects that are rescued by SOD1 overexpression. This suggests that targeting of components of the Wnt5a signaling pathway may be a viable strategy for suppression of CHDs in fetuses of diabetic pregnancies. PMID:26232087

  4. Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

    PubMed Central

    2010-01-01

    Background The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School. Methods In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test. Results At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training. Conclusions Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training. PMID:20082701

  5. Maternal Antihypertensive Medication Use and Congenital Heart Defects: Updated Results From the National Birth Defects Prevention Study.

    PubMed

    Fisher, Sarah C; Van Zutphen, Alissa R; Werler, Martha M; Lin, Angela E; Romitti, Paul A; Druschel, Charlotte M; Browne, Marilyn L

    2017-05-01

    Previous NBDPS (National Birth Defects Prevention Study) findings from 1997 to 2003 suggested that maternal antihypertensive use was associated with congenital heart defects (CHDs). We re-examined associations between specific antihypertensive medication classes and specific CHDs with additional NBDPS data from 2004 to 2011. After excluding mothers missing hypertension information or who reported pregestational diabetes mellitus, a multiple birth, or antihypertensive use but no hypertension, we compared self-reported maternal exposure data on 10 625 CHD cases and 11 137 nonmalformed controls. We calculated adjusted odds ratios [95% confidence intervals] to estimate the risk of specific CHDs associated with antihypertensive use during the month before conception through the third month of pregnancy, controlling for maternal age, race/ethnicity, body mass index, first trimester cigarette smoking, and NBDPS site. Overall, 164 (1.5%) case mothers and 102 (0.9%) control mothers reported early pregnancy antihypertensive use for their hypertension. We observed increased risk of 4 CHD phenotypes, regardless of antihypertensive medication class reported: coarctation of the aorta (2.50 [1.52-4.11]), pulmonary valve stenosis (2.19 [1.44-3.34]), perimembranous ventricular septal defect (1.90 [1.09-3.31]), and secundum atrial septal defect (1.94 [1.36-2.79]). The associations for these phenotypes were statistically significant for mothers who reported β-blocker use or renin-angiotensin system blocker use; estimates for other antihypertensive medication classes were generally based on fewer exposed cases and were less stable but remained elevated. Our results support and expand on earlier NBDPS findings that antihypertensive medication use may be associated with increased risk of specific CHDs, although we cannot completely rule out confounding by underlying disease characteristics. © 2017 American Heart Association, Inc.

  6. Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study

    PubMed Central

    Luben, Thomas J.; Daniels, Julie L.; Fuentes, Montserrat; Richardson, David B.; Aylsworth, Arthur S.; Herring, Amy H.; Anderka, Marlene; Botto, Lorenzo; Correa, Adolfo; Gilboa, Suzanne M.; Langlois, Peter H.; Mosley, Bridget; Shaw, Gary M.; Siffel, Csaba; Olshan, Andrew F.

    2014-01-01

    Background: Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development. Objectives: We investigated maternal exposures to air pollutants during weeks 2–8 of pregnancy and their associations with congenital heart defects. Methods: Mothers from the National Birth Defects Prevention Study, a nine-state case–control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context. Results: Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels. Conclusions: Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy. Citation: Stingone JA, Luben TJ

  7. Bayesian multinomial probit modeling of daily windows of susceptibility for maternal PM2.5 exposure and congenital heart defects.

    PubMed

    Warren, Joshua L; Stingone, Jeanette A; Herring, Amy H; Luben, Thomas J; Fuentes, Montserrat; Aylsworth, Arthur S; Langlois, Peter H; Botto, Lorenzo D; Correa, Adolfo; Olshan, Andrew F

    2016-07-20

    Epidemiologic studies suggest that maternal ambient air pollution exposure during critical periods of pregnancy is associated with adverse effects on fetal development. In this work, we introduce new methodology for identifying critical periods of development during post-conception gestational weeks 2-8 where elevated exposure to particulate matter less than 2.5 µm (PM2.5 ) adversely impacts development of the heart. Past studies have focused on highly aggregated temporal levels of exposure during the pregnancy and have failed to account for anatomical similarities between the considered congenital heart defects. We introduce a multinomial probit model in the Bayesian setting that allows for joint identification of susceptible daily periods during pregnancy for 12 types of congenital heart defects with respect to maternal PM2.5 exposure. We apply the model to a dataset of mothers from the National Birth Defect Prevention Study where daily PM2.5 exposures from post-conception gestational weeks 2-8 are assigned using predictions from the downscaler pollution model. This approach is compared with two aggregated exposure models that define exposure as the average value over post-conception gestational weeks 2-8 and the average over individual weeks, respectively. Results suggest an association between increased PM2.5 exposure on post-conception gestational day 53 with the development of pulmonary valve stenosis and exposures during days 50 and 51 with tetralogy of Fallot. Significant associations are masked when using the aggregated exposure models. Simulation study results suggest that the findings are robust to multiple sources of error. The general form of the model allows for different exposures and health outcomes to be considered in future applications. Copyright © 2016 John Wiley & Sons, Ltd.

  8. [Experimental research on heart rate variability analysis with application of acquisition system of R peak of electrocardiosignal based on sound card].

    PubMed

    Zhou, Fang; Jia, Xiaoning; Shen, Dai; Zhou, Peng

    2013-08-01

    This study designed an audio signal acquisition system to achieve real-time detection of R peak for heart rate variability (HRV) analysis, substituting ECG-specific data acquisition board with sound card. It is proved that the R peak with low frequency can be gathered by sound card. The comparison with PowerLab signal acquisition system has shown that the acquisition system of R peak could accurately detect the R peak. The R peak detected by sound card and PowerLab signal acquisition system completely overlap each other, while RR intervals has no difference. The HRV analysis was accurate and reliable with the RR interval from sound card. This low cost, high performance, strong compatibility and easy upgraded acquisition system of R peak compared with the traditional data acquisition board has the value of practical uses and might have broad applications in the future.

  9. Maternal cardiac and obstetric performance in consecutive pregnancies in women with heart disease.

    PubMed

    Gelson, E; Curry, R; Gatzoulis, M A; Swan, L; Lupton, M; Steer, P J; Johnson, M R

    2015-10-01

    Second pregnancies are usually less complicated than first pregnancies, and have a better outcome in terms of fetal growth. We studied a group of women with heart disease to assess whether their second pregnancy was less complicated and resulted in a larger baby. Retrospective case control study. Tertiary referral academic obstetric unit. First and second pregnancies in 77 women with congenital and acquired heart disease and in 154 control women were identified. Data were collected from medical and obstetric records. Cardiac complications, obstetric complications, intra-partum events, birthweight and perinatal complications. The rate of obstetric complication was greater in first pregnancies in both the heart disease and the control groups (38% versus 26%, cf. 20% versus 17%). In the heart disease group, the rate of cardiac complications was similar in first and second pregnancies (9% versus 6%). Overall, significantly more perinatal complications were seen in the heart disease group, with no significant difference between first and second pregnancies (36% versus 27%, cf. 14% versus 12%). Median birthweight was significantly higher in second pregnancies in the control group (3308 versus 3519 g P < 0.001), but not significantly different between pregnancies in the heart disease group (3014 versus 3133 g, P = 0.19). This case control study demonstrates that women with mild to moderate heart disease have similar pregnancy outcomes in consecutive pregnancies. However, while the median birthweight was higher in the control second pregnancies, it was not increased in the women with heart disease. A study of women with heart disease to assess whether their second pregnancy was less complicated. © 2015 Royal College of Obstetricians and Gynaecologists.

  10. At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease.

    PubMed

    Morales, Ana; Allain, Dawn C; Arscott, Patricia; James, Emily; MacCarrick, Gretchen; Murray, Brittney; Tichnell, Crystal; Shikany, Amy R; Spencer, Sara; Fitzgerald-Butt, Sara M; Kushner, Jessica D; Munn, Christi; Smith, Emily; Spoonamore, Katherine G; Tandri, Harikrishna S; Kay, W Aaron

    2017-03-10

    In the last decade, an increasing number of cardiac conditions have been shown to have a genetic basis. Cardiovascular genetic counseling has emerged as a subspecialty aiming to identify unaffected at-risk individuals. An important sector of this at-risk population also includes expectant mothers, in whom unique clinical challenges may arise. Genetic counselors, especially those in cardiovascular and prenatal settings, have an opportunity to identify and assist women who may benefit from cardiovascular care during pregnancy. This paper provides basic management and genetic evaluation principles for affected women, as well as guidance on identifying those who are at risk. We provide considerations for cardiac surveillance in pregnancy and the post-partum period. Finally, key psychosocial issues that appraise how to best provide support to at risk women as they make informed decisions are discussed. We propose that a team approach including cardiology, maternal fetal medicine, and genetic counseling best serves this patient population. Ongoing questions addressing an evidence based approach to cardiovascular genetic conditions in pregnancy still remain. Thus, well-designed research protocols are essential to mark progress in this area.

  11. Effect of Caffeine Chronically Consumed During Pregnancy on Adenosine A1 and A2A Receptors Signaling in Both Maternal and Fetal Heart from Wistar Rats.

    PubMed

    Iglesias, Inmaculada; Albasanz, Jose Luis; Martín, Mairena

    2014-12-01

    Background: Caffeine is the most widely consumed psychoactive substance in the world, even during pregnancy. Its stimulatory effects are mainly due to antagonism of adenosine actions by blocking adenosine A1 and A2A receptors. Previous studies have shown that caffeine can cross the placenta and therefore modulate these receptors not only in the fetal brain but also in the heart. Methods: In the present work, the effect of caffeine chronically consumed during pregnancy on A1 and A2A receptors in Wistar rat heart, from both mothers and their fetuses, were studied using radioligand binding, Western-blotting, and adenylyl cyclase activity assays, as well as reverse transcription polymerase chain reaction. Results: Caffeine did not significantly alter A1R neither at protein nor at gene expression level in both the maternal and fetal heart. On the contrary, A2AR significantly decreased in the maternal heart, although mRNA was not affected. Gi and Gs proteins were also preserved. Finally, A1R-mediated inhibition of adenylyl cyclase activity did not change in the maternal heart, but A2AR mediated stimulation of this enzymatic activity significantly decreased according to the detected loss of this receptor. Conclusions: Opposite to the downregulation and desensitization of the A1R/AC pathway previously reported in the brain, these results show that this pathway is not affected in rat heart after caffeine exposure during pregnancy. In addition, A2AR is downregulated and desensitized in the maternal heart, suggesting a differential modulation of these receptor-mediated pathways by caffeine.

  12. Effect of Caffeine Chronically Consumed During Pregnancy on Adenosine A1 and A2A Receptors Signaling in Both Maternal and Fetal Heart from Wistar Rats

    PubMed Central

    Iglesias, Inmaculada; Albasanz, Jose Luis

    2014-01-01

    Background: Caffeine is the most widely consumed psychoactive substance in the world, even during pregnancy. Its stimulatory effects are mainly due to antagonism of adenosine actions by blocking adenosine A1 and A2A receptors. Previous studies have shown that caffeine can cross the placenta and therefore modulate these receptors not only in the fetal brain but also in the heart. Methods: In the present work, the effect of caffeine chronically consumed during pregnancy on A1 and A2A receptors in Wistar rat heart, from both mothers and their fetuses, were studied using radioligand binding, Western-blotting, and adenylyl cyclase activity assays, as well as reverse transcription polymerase chain reaction. Results: Caffeine did not significantly alter A1R neither at protein nor at gene expression level in both the maternal and fetal heart. On the contrary, A2AR significantly decreased in the maternal heart, although mRNA was not affected. Gi and Gs proteins were also preserved. Finally, A1R-mediated inhibition of adenylyl cyclase activity did not change in the maternal heart, but A2AR mediated stimulation of this enzymatic activity significantly decreased according to the detected loss of this receptor. Conclusions: Opposite to the downregulation and desensitization of the A1R/AC pathway previously reported in the brain, these results show that this pathway is not affected in rat heart after caffeine exposure during pregnancy. In addition, A2AR is downregulated and desensitized in the maternal heart, suggesting a differential modulation of these receptor-mediated pathways by caffeine. PMID:25538864

  13. Maternal Occupational Pesticide Exposure and Risk of Congenital Heart Defects in the National Birth Defects Prevention Study

    PubMed Central

    Rocheleau, Carissa M.; Bertke, Stephen J.; Lawson, Christina C.; Romitti, Paul A.; Sanderson, Wayne T.; Malik, Sadia; Lupo, Philip J.; Desrosiers, Tania A.; Bell, Erin; Druschel, Charlotte; Correa, Adolfo; Reefhuis, Jennita

    2015-01-01

    BACKGROUND Congenital heart defects (CHDs) are common birth defects, affecting approximately 1% of live births. Pesticide exposure has been suggested as an etiologic factor for CHDs, but previous results were inconsistent. METHODS We examined maternal occupational exposure to fungicides, insecticides, and herbicides for 3328 infants with CHDs and 2988 unaffected control infants of employed mothers using data for 1997 through 2002 births from the National Birth Defects Prevention Study, a population-based multisite case-control study. Potential pesticide exposure from 1 month before conception through the first trimester of pregnancy was assigned by an expert-guided task-exposure matrix and job history details self-reported by mothers. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression. RESULTS Maternal occupational exposure to pesticides was not associated with CHDs overall. In examining specific CHD subtypes compared with controls, some novel associations were observed with higher estimated pesticide exposure: insecticides only and secundum atrial septal defect (OR =1.8; 95% CI, 1.3–2.7, 40 exposed cases); both insecticides and herbicides and hypoplastic left heart syndrome (OR =5.1; 95% CI, 1.7–15.3, 4 exposed cases), as well as pulmonary valve stenosis (OR =3.6; 95% CI, 1.3–10.1, 5 exposed cases); and insecticides, herbicides, and fungicides and tetralogy of Fallot (TOF) (OR =2.2; 95% CI, 1.2–4.0, 13 exposed cases). CONCLUSION Broad pesticide exposure categories were not associated with CHDs overall, but examining specific CHD subtypes revealed some increased odds ratios. These results highlight the importance of examining specific CHDs separately. Because of multiple comparisons, additional work is needed to verify these associations. PMID:26033688

  14. Maternal understanding of infective endocarditis after hospitalization: assessing the knowledge of mothers of children with congenital heart disease and the practical implications.

    PubMed

    Knöchelmann, Anja; Geyer, Siegfried; Grosser, Urte

    2014-02-01

    This study aimed to examine the knowledge of mothers of children with congenital heart disease as well as the association of cardiological factors and maternal characteristics with maternal understanding. Mothers of 135 children (≤2 years old) were interviewed to assess maternal knowledge of infective endocarditis (IE) using the Hannover Inventory of Parental Knowledge of Congenital Heart Disease. Two subscales, endocarditis and risk factors, were used. Cardiological data as well as maternal characteristics were collected. Two-thirds of the mothers achieved only low scores, answering 0-20 % of the questions correctly (endocarditis = 64.4 %; risk factors = 71.1 %). Mothers with higher education recalled the correct definition of IE (P = 0.001) and the importance of dental hygiene (P = 0.004) more often. Mothers with only one child were more likely to know the most typical symptom (P = 0.007). The severity of the heart disease and the requirement of endocarditis prophylaxis did not influence maternal understanding. Yet, mothers assessing the heart disease as severe showed better knowledge (typical symptom P = 0.021; importance of dental hygiene P = 0.007). If mothers learned the diagnosis before their child's birth, they remembered relevant information more often. Mothers receiving information by the medical staff and from the Internet showed better knowledge (definition P = 0.014; importance of dental hygiene P = 0.001). Due to low levels of knowledge, more efforts must be put into the education of mothers. Educational programs should take maternal characteristics into account, providing written material and thereby keeping the instruction of lower-educated persons in mind. Furthermore, education should be focused on mothers of children requiring IE prophylaxis.

  15. [Maternal complications related to the mode of delivery in pregnant women with heart disease in a specialist high risk delivery hospital in Fortaleza, CE].

    PubMed

    Cavalcante, Maria do Socorro; Guanabara, Everardo de Macêdo; Nadai, Camila Pinto de

    2012-03-01

    To determine the association between maternal complications and type of delivery in women with heart disease and to identify the possible clinical and obstetrical factors implicated in the determination of the route of delivery. This was a retrospective and descriptive study of the medical records of pregnant women with heart disease admitted to a tertiary reference hospital in the municipality of Fortaleza, Ceará, from 2006 to 2007. The study population included all pregnant women with an antepartum diagnosis of heart disease admitted for delivery, while women who received a diagnosis of heart disease after delivery were excluded, regardless of age and gestational week. A semi-structured questionnaire regarding sociodemographic, clinical and obstetrical variables was used. A descriptive analysis was first performed based on simple frequencies and proportions of the sociodemographic variables. Next, possible associations between clinical and obstetrical aspects and type of delivery were analyzed, with the verification of association between maternal complications and type of delivery. The Fisher exact test was applied for this analysis, with the level of significance set at p<0.05. The collected data were processed and analyzed using the Epi-InfoTM software version 6.04 (Atlanta, USA). Seventy-three pregnant women with heart disease were included in the study. Interatrial communication was the condition most frequently observed among congenital diseases (11.0%) and mitral calcification among the acquired ones (24.6%). The proportion of cesarean deliveries was higher than the proportion of vaginal deliveries, except for women with acquired heart disease. An association was detected between type of heart disease and type of delivery (p=0.01). There were 13 cases of maternal complications (17.8%). Among them, ten (76.9%) occurred during cesarean section and three during vaginal delivery. No association mas detected between maternal complications and type of delivery

  16. Early maternal separation has mild effects on cardiac autonomic balance and heart structure in adult male rats.

    PubMed

    Trombini, M; Hulshof, H J; Graiani, G; Carnevali, L; Meerlo, P; Quaini, F; Sgoifo, A

    2012-07-01

    Early life adverse experiences have long-term physiologic and behavioral effects and enhance stress sensitivity. This study examined the effects of maternal separation (MS) on cardiac stress responsivity and structure in adulthood. Male Wistar rats were separated from the dams for 3 h per day from postnatal days 2 through 15. When exposed to 5-day intermittent restraint stress (IRS) as adults, MS, and control rats showed similar acute modifications of cardiac sympathovagal balance, quantified via heart rate variability analysis. In addition, MS had no effect on cardiac pacemaker intrinsic activity (as revealed by autonomic blockade with scopolamine and atenolol) and did not affect the circadian rhythmicity of heart rate, neither before nor after IRS. However, MS differed from control rats in cardiac parasympathetic drive following IRS, which was heightened in the latter but remained unchanged in the former, both during the light and dark phases of the daily rhythm. The evaluation of adult cardiac structure indicated that stress experienced during a crucial developmental period induced only modest changes, involving cardiomyocyte hypertrophy, increased density of vascular structures, and myocardial fibrosis. The mildness of these functional-structural effects questions the validity of MS as a model for early stress-induced cardiac disease in humans.

  17. Maternal melatonin administration mitigates coronary stiffness and endothelial dysfunction, and improves heart resilience to insult in growth restricted lambs

    PubMed Central

    Tare, Marianne; Parkington, Helena C; Wallace, Euan M; Sutherland, Amy E; Lim, Rebecca; Yawno, Tamara; Coleman, Harold A; Jenkin, Graham; Miller, Suzanne L

    2014-01-01

    Intrauterine growth restriction (IUGR) is associated with impaired cardiac function in childhood and is linked to short- and long-term morbidities. Placental dysfunction underlies most IUGR, and causes fetal oxidative stress which may impact on cardiac development. Accordingly, we investigated whether antenatal melatonin treatment, which possesses antioxidant properties, may afford cardiovascular protection in these vulnerable fetuses. IUGR was induced in sheep fetuses using single umbilical artery ligation on day 105–110 of pregnancy (term 147). Study 1: melatonin (2 mg h−1) was administered i.v. to ewes on days 5 and 6 after surgery. On day 7 fetal heart function was assessed using a Langendorff apparatus. Study 2: a lower dose of melatonin (0.25 mg h−1) was administered continuously following IUGR induction and the ewes gave birth normally at term. Lambs were killed when 24 h old and coronary vessels studied. Melatonin significantly improved fetal oxygenation in vivo. Contractile function in the right ventricle and coronary flow were enhanced by melatonin. Ischaemia–reperfusion-induced infarct area was 3-fold greater in IUGR hearts than in controls and this increase was prevented by melatonin. In isolated neonatal coronary arteries, endothelium-dependent nitric oxide (NO) bioavailability was reduced in IUGR, and was rescued by modest melatonin treatment. Melatonin exposure also induced the emergence of an indomethacin-sensitive vasodilation. IUGR caused marked stiffening of the coronary artery and this was prevented by melatonin. Maternal melatonin treatment reduces fetal hypoxaemia, improves heart function and coronary blood flow and rescues cardio-coronary deficit induced by IUGR. PMID:24710061

  18. Complete heart block in a fetus associated with maternal Sjögren's syndrome.

    PubMed

    Veille, J C; Sunderland, C; Bennett, R M

    1985-03-01

    This report illustrates the case of a fetus who was diagnosed by M-mode echocardiography, at the twentieth week of gestation, as having a complete heart block. The mother had a positive antinuclear antibody test result with antibodies directed against the Ro (SSA) and La (SSB) antigen system consistent with the diagnosis of Sjögren's syndrome. Management and outcome of the pregnancy are discussed.

  19. Association Between Fetal Congenital Heart Defects and Maternal Risk of Hypertensive Disorders of Pregnancy in the Same Pregnancy and Across Pregnancies.

    PubMed

    Boyd, Heather Allison; Basit, Saima; Behrens, Ida; Leirgul, Elisabeth; Bundgaard, Henning; Wohlfahrt, Jan; Melbye, Mads; Øyen, Nina

    2017-07-04

    Both pregnant women carrying fetuses with heart defects and women with hypertensive disorders of pregnancy often exhibit angiogenic imbalances, suggesting that the same mechanisms are involved in the pathogenesis of the former and the pathophysiology of the latter. We conducted a register-based cohort study to determine whether offspring congenital heart defects are associated with an increased risk of hypertensive disorders of pregnancy and whether the mechanisms driving any association are primarily maternal or fetal. Among singleton pregnancies without chromosomal abnormalities lasting ≥20 weeks in Denmark from 1978 to 2011 (n= 1 972 857), we identified pregnancies complicated by offspring congenital heart defects or early preterm preeclampsia, late preterm preeclampsia, term preeclampsia, and gestational hypertension. We used polytomous logistic regression to estimate odds ratios (ORs) for associations between offspring congenital heart defects and maternal hypertensive disorders of pregnancy overall and for specific heart defects. Offspring congenital heart defects were strongly associated with early preterm preeclampsia (OR, 7.00; 95% confidence interval [CI], 6.11-8.03) and late preterm preeclampsia (OR, 2.82; 95% CI, 2.38-3.34) in the same pregnancy and weakly associated with term preeclampsia (OR, 1.16; 95% CI, 1.06-1.27), but they were not associated with gestational hypertension (OR, 1.07; 95% CI, 0.92-1.25). Association strengths were consistent across heart defect types. Offspring congenital heart defects in a previous pregnancy were also strongly associated with preterm preeclampsia in subsequent pregnancies (early preterm preeclampsia: OR, 2.37; 95% CI, 1.68-3.34; late preterm preeclampsia: OR, 2.04; 95% CI, 1.52-2.75) but were only modestly associated with term preeclampsia and not associated with gestational hypertension. Similarly, preterm preeclampsia in a previous pregnancy, but not term preeclampsia or gestational hypertension, was

  20. Congenital heart block related to maternal autoantibodies: descriptive analysis of a series of 18 cases from a single center.

    PubMed

    Doti, Pamela I; Escoda, Ona; Cesar-Díaz, Sergi; Palasti, Silvia; Teixidó, Irene; Sarquella-Brugada, Georgia; Gómez, Olga; Martínez, Josep M; Espinosa, Gerard

    2016-02-01

    The objective of this study was to describe the clinical and immunological characteristics of maternal autoimmune-mediated fetal congenital heart block (CHB) in a cohort of pregnant women from an autoimmune disease pregnancy clinic. This is a retrospective observational study of all women presenting with CHB in our autoimmune disease pregnancy clinic from January 1997 to December 2014. In addition, perinatal outcome is also described. Fourteen patients accounting for 18 fetuses with CHB were identified. The median age was 32.5 years (range, 22-40). Seven (50 %) patients had Sjögren's syndrome, and the remaining seven were asymptomatic carriers of autoantibodies. All patients had anti-Ro/SSA antibodies, and 11/13 (85 %) had anti-La/SSB antibodies. The median gestational age at the time of CHB was 22 weeks (range 18-28). Complete third degree CHB was detected in 12 (67 %). Seven cases of CHB were treated with dexamethasone, two with ritodrine, and one with the association of dexamethasone, ritodrine, and terbutaline. In 9 (50 %) cases that presented with, or developed, very poor prognosis factors, such as a ventricular rate below 50-55 bpm and/or the presence of fetal hydrops, parents opted for the termination of pregnancy, after dedicated counseling. Finally, there were nine newborns (seven males [78 %]) with median age at delivery of 37 weeks (range, 32-39). A definitive epicardial pacemaker was placed in six newborns, four of them within 2 weeks of life. CHB is a severe complication related to maternal anti-Ro/SSA and anti-La/SSB antibodies. Our results confirm previous data showing that therapy is ineffective, and most of the surviving patients will require neonatal pacemaker.

  1. A case of maternal subclinical Sjögren's syndrome associated with congenital heart block.

    PubMed

    Imai, F; Suzuki, T; Katagiri, T; Ohno, S; Tanaka, M; Dohi, Y

    1991-01-01

    A case of subclinical Sjögren's syndrome was diagnosed when the patient delivered a baby with SSA antibody-positive congenital heart block (CHB). The mother had been asymptomatic throughout her life. The laboratory findings including sialography, lip biopsy, Schirmer's test and a Rose-Bengal test showed Sjögren's syndrome. Such an asymptomatic case is termed subclinical Sjögren's syndrome. Thus, it was important to investigate an asymptomatic mother who delivers a SSA antibody-positive CHB baby.

  2. The effect of maternal methadone use on the fetal heart pattern: a computerised CTG analysis.

    PubMed

    Navaneethakrishnan, R; Tutty, S; Sinha, C; Lindow, S W

    2006-08-01

    Using a computerised analysis, the cardiotocograph (CTG) from women who use methadone (n= 25) when compared with women who do not use methadone (n= 25) showed a significant reduction in the fetal heart baseline rate, with a significant reduction in number of accelerations and episodes of high variation. The short-term variation, number of decelerations and episodes of low variation were not different between the two groups. The time taken to meet the standardised criteria was not different, and it is possible that a computer-assisted CTG analysis could be more accurate than a naked eye interpretation.

  3. Feto-maternal outcome in pregnancies complicated by isolated fetal congenital complete heart block.

    PubMed

    Roy, K K; Subbaiah, M; Kumar, S; Sharma, J B; Singh, N

    2014-08-01

    A retrospective analysis of eleven pregnancies complicated by isolated fetal congenital complete heart block (CCHB) in anti-SSA/Ro antibody positive women was carried out at a tertiary hospital in India to study the perinatal outcome. The mean gestational age at the time of detection of fetal CCHB was 24.5 ± 3.1weeks. Six mothers were asymptomatic; two had Sjögren's syndrome and three had systemic lupus erythematosus. Oral dexamethasone was given to all the patients after the diagnosis was made. There was one case of intrauterine death. Seven (63.6%) neonates needed a permanent pacemaker. There was no significant difference in the perinatal outcome in asymptomatic women with fetal CCHB and in women with connective tissue disorder and fetal CCHB. To conclude, fetal CCHB is associated with high morbidity but the presence of underlying connective disorder in the mother does not worsen the prognosis of the affected neonate.

  4. Mechanisms for the adverse effects of late gestational increases in maternal cortisol on the heart revealed by transcriptomic analyses of the fetal septum.

    PubMed

    Richards, Elaine M; Wood, Charles E; Rabaglino, Maria Belen; Antolic, Andrew; Keller-Wood, Maureen

    2014-08-01

    We have previously shown in sheep that 10 days of modest chronic increase in maternal cortisol resulting from maternal infusion of cortisol (1 mg/kg/day) caused fetal heart enlargement and Purkinje cell apoptosis. In subsequent studies we extended the cortisol infusion to term, finding a dramatic incidence of stillbirth in the pregnancies with chronically increased cortisol. To investigate effects of maternal cortisol on the heart, we performed transcriptomic analyses on the septa using ovine microarrays and Webgestalt and Cytoscape programs for pathway inference. Analyses of the transcriptomic effects of maternal cortisol infusion for 10 days (130 day cortisol vs 130 day control), or ∼25 days (140 day cortisol vs 140 day control) and of normal maturation (140 day control vs 130 day control) were performed. Gene ontology terms related to immune function and cytokine actions were significantly overrepresented as genes altered by both cortisol and maturation in the septa. After 10 days of cortisol, growth factor and muscle cell apoptosis pathways were significantly overrepresented, consistent with our previous histologic findings. In the term fetuses (∼25 days of cortisol) nutrient pathways were significantly overrepresented, consistent with altered metabolism and reduced mitochondria. Analysis of mitochondrial number by mitochondrial DNA expression confirmed a significant decrease in mitochondria. The metabolic pathways modeled as altered by cortisol treatment to term were different from those modeled during maturation of the heart to term, and thus changes in gene expression in these metabolic pathways may be indicative of the fetal heart pathophysiologies seen in pregnancies complicated by stillbirth, including gestational diabetes, Cushing's disease and chronic stress.

  5. Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects in Offspring: A Meta-Analysis of Epidemiological Observational Studies

    NASA Astrophysics Data System (ADS)

    Feng, Yu; Wang, Song; Chen, Runsen; Tong, Xing; Wu, Zeyu; Mo, Xuming

    2015-02-01

    Epidemiological studies have reported conflicting results regarding the association between maternal folic acid supplementation and the risk of congenital heart defects (CHDs). However, a meta-analysis of the association between maternal folic acid supplementation and CHDs in offspring has not been conducted. We searched the MEDLINE and EMBASE databases for articles cataloged between their inceptions and October 10, 2014 and identified relevant published studies that assessed the association between maternal folate supplementation and the risk of CHDs. Study-specific relative risk estimates were pooled using random-effects or fixed-effects models. Out of the 1,606 articles found in our initial literature searches, a total of 1 randomized controlled trial, 1 cohort study, and 16 case-control studies were included in our final meta-analysis. The overall results of this meta-analysis provide evidence that maternal folate supplementation is associated with a significantly decreased risk of CHDs (RR = 0.72, 95% CI: 0.63-0.82). Statistically significant heterogeneity was detected (Q = 82.48, P < 0.001, I2 = 79.4%). We conducted stratified and meta-regression analyses to identify the origin of the heterogeneity among the studies, and a Galbraith plot was generated to graphically assess the sources of heterogeneity. This meta-analysis provides a robust estimate of the positive association between maternal folate supplementation and a decreased risk of CHDs.

  6. The genetics of folate metabolism and maternal risk of birth of a child with Down syndrome and associated congenital heart defects

    PubMed Central

    Coppedè, Fabio

    2015-01-01

    Almost 15 years ago it was hypothesized that polymorphisms of genes encoding enzymes involved in folate metabolism could lead to aberrant methylation of peri-centromeric regions of chromosome 21, favoring its abnormal segregation during maternal meiosis. Subsequently, more than 50 small case-control studies investigated whether or not maternal polymorphisms of folate pathway genes could be risk factors for the birth of a child with Down syndrome (DS), yielding conflicting and inconclusive results. However, recent meta-analyses of those studies suggest that at least three of those polymorphisms, namely MTHFR 677C>T, MTRR 66A>G, and RFC1 80G>A, are likely to act as maternal risk factors for the birth of a child with trisomy 21, revealing also complex gene-nutrient interactions. A large-cohort study also revealed that lack of maternal folic acid supplementation at peri-conception resulted in increased risk for a DS birth due to errors occurred at maternal meiosis II in the aging oocyte, and it was shown that the methylation status of chromosome 21 peri-centromeric regions could favor recombination errors during meiosis leading to its malsegregation. In this regard, two recent case-control studies revealed association of maternal polymorphisms or haplotypes of the DNMT3B gene, coding for an enzyme required for the regulation of DNA methylation at centromeric and peri-centromeric regions of human chromosomes, with risk of having a birth with DS. Furthermore, congenital heart defects (CHD) are found in almost a half of DS births, and increasing evidence points to a possible contribution of lack of folic acid supplementation at peri-conception, maternal polymorphisms of folate pathway genes, and resulting epigenetic modifications of several genes, at the basis of their occurrence. This review summarizes available case-control studies and literature meta-analyses in order to provide a critical and up to date overview of what we currently know in this field. PMID:26161087

  7. Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects.

    PubMed

    Smedts, Huberdina P M; Rakhshandehroo, Maryam; Verkleij-Hagoort, Anna C; de Vries, Jeanne H M; Ottenkamp, Jaap; Steegers, Eric A P; Steegers-Theunissen, Régine P M

    2008-10-01

    With the exception of studies on folic acid, little evidence is available concerning other nutrients in the pathogenesis of congenital heart defects (CHDs). Fatty acids play a central role in embryonic development, and the B-vitamins riboflavin and nicotinamide are co-enzymes in lipid metabolism. To investigate associations between the maternal dietary intake of fats, riboflavin and nicotinamide, and CHD risk in the offspring. A case-control family study was conducted in 276 mothers of a child with a CHD comprising of 190 outflow tract defects (OTD) and 86 non-outflow tract defects (non-OTD) and 324 control mothers of a non-malformed child. Mothers filled out general and food frequency questionnaires at 16 months after the index-pregnancy, as a proxy of the habitual food intake in the preconception period. Nutrient intakes (medians) were compared between cases and controls by Mann-Whitney U test. Odds ratios (OR) for the association between CHDs and nutrient intakes were estimated in a logistic regression model. Case mothers, in particular mothers of a child with OTD, had higher dietary intakes of saturated fat, 30.9 vs. 29.8 g/d; P < 0.05. Dietary intakes of riboflavin and nicotinamide were lower in mothers of a child with an OTD than in controls (1.32 vs. 1.41 mg/d; P < 0.05 and 14.6 vs. 15.1 mg/d; P < 0.05, respectively). Energy, unsaturated fat, cholesterol and folate intakes were comparable between the groups. Low dietary intakes of both riboflavin (<1.20 mg/d) and nicotinamide (<13.5 mg/d) increased more than two-fold the risk of a child with an OTD, especially in mothers who did not use vitamin supplements in the periconceptional period (OR 2.4, 95%CI 1.4-4.0). Increasing intakes of nicotinamide (OR 0.8, 95%CI 0.7-1.001, per unit standard deviation increase) decreased CHD risk independent of dietary folate intake. A maternal diet high in saturated fats and low in riboflavin and nicotinamide seems to contribute to CHD risk, in particular OTDs.

  8. Suppression of placental metallothionein 1 and zinc transporter 1 mRNA expressions contributes to fetal heart malformations caused by maternal zinc deficiency.

    PubMed

    Liu, Chaobin; He, Xiaoyu; Hong, Xinru; Kang, Fenhong; Chen, Suqing; Wang, Qing; Chen, Xiaoqiu; Hu, Dian; Sun, Qinghua

    2014-12-01

    Zinc has been implicated to have a protective role against heart malformations during fetal development. Metallothionein 1 (MT-1) and zinc transporter 1 (ZnT-1) are two major metabolic factors that are associated with zinc metabolism. The present work aimed to investigate the association of placental MT-1 and ZnT-1 expressions with fetal heart malformations resulting from maternal zinc deficiency. Sprague-Dawley female rats were randomly divided into five groups of extremely low-zinc, low-zinc, moderately low-zinc, marginally low-zinc and normal zinc (n = 9-12), and were fed diets with controlled zinc content at 1.0 ± 0.3, 8.4 ± 1.8, 15.4 ± 2.8, 22.4 ± 4.1 and 29.4 ± 5.3 [mean ± standard deviation (SD)] mg of zinc/kg, respectively, from day 25 of preconception until day 19 of gestation. The female rats were bred, their fetuses were harvested at day 19 of gestation after killing the dams, and fetal hearts were morphologically examined. Zinc concentration and alkaline phosphatase (ALP) activity in maternal venous blood sera were tested, and MT-1 and ZnT-1 mRNA expressions in the placenta were assayed. Zinc concentrations and ALP activities in the blood were low in all zinc-deficient diet groups in a dose-dependent fashion. The incidences of heart malformations were increased, and the levels of placental MT-1 and ZnT-1 mRNA expressions were decreased in the extremely low-zinc, low-zinc and moderately low-zinc groups compared with the normal zinc group. Specifically, mRNA levels of placental MT-1 or ZnT-1 were significantly decreased and were lower than the specific threshold values in the fetuses with heart malformations but not in the fetuses without heart malformations in all the groups. These data indicate that maternal zinc deficiency resulted in an elevated incidence of fetal heart malformations, which was associated with significant decreases in placental MT-1 and ZnT-1 mRNA expressions to the levels below the threshold values that may be a

  9. Maternal depression and the heart of parenting: respiratory sinus arrhythmia and affective dynamics during parent-adolescent interactions.

    PubMed

    Connell, Arin M; Hughes-Scalise, Abigail; Klostermann, Susan; Azem, Talla

    2011-10-01

    Maternal depression is associated with problematic parenting and the development of emotional and behavior problems in children and adolescents. While emotional regulatory abilities are likely to influence emotional exchanges between parents and teens, surprisingly little is known about the role of emotion regulation during parent-child interactions, particularly in high-risk families. Respiratory sinus arrhythmia (RSA) has been widely linked to emotion regulatory abilities in recent research, and the current study investigated RSA and maternal depression in relation to dyadic flexibility, as well as mutuality of negative and positive affect displayed during three discussion tasks between 59 mother-adolescent pairs (age 11-17 years). Dyadic flexibility was predicted by the interaction of maternal depression, maternal RSA, and teen RSA, with higher maternal RSA predicting greater dyadic flexibility, particularly in highest risk dyads (i.e., elevated maternal depression and lower teen RSA). Teen RSA interacted with maternal depression to predict mutual negative affect, serving as a protective factor. Finally, maternal and teen RSA interacted to predict mutual positive affect, with maternal RSA buffering against low teen RSA to predict higher mutual positive affect. Results support the role of RSA in affectively laden interactions between parents and adolescents, particularly in the face of maternal depression.

  10. Association between maternal occupational exposure to organic solvents and congenital heart defects, National Birth Defects Prevention Study, 1997–2002

    PubMed Central

    Gilboa, SM; Desrosiers, TA; Lawson, CC; Lupo, PJ; Riehle-Colarusso, T; Stewart, PA; van Wijngaarden, E; Waters, MA; Correa, A

    2015-01-01

    Objective To examine the relation between congenital heart defects (CHDs) in offspring and estimated maternal occupational exposure to chlorinated solvents, aromatic solvents, and Stoddard solvent during the period from one month before conception through the first trimester. Methods The study population included mothers of infants with simple, isolated CHDs and mothers of control infants who delivered from 1997 through 2002 and participated in the National Birth Defects Prevention Study. Two methods to assess occupational solvent exposure were employed: an expert consensus-based approach and a literature-based approach. Multiple logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between solvent classes and CHDs. Results 2,951 control mothers and 2,047 CHD case mothers were included. Using the consensus-based approach, associations were observed for exposure to any solvent and any chlorinated solvent with perimembranous ventricular septal defects (OR 1.6; 95% CI 1.0 to 2.6 and OR 1.7; 95% CI 1.0 to 2.8 respectively). Using the literature-based approach, associations were observed for: any solvent exposure with aortic stenosis (OR 2.1; 95% CI 1.1 to 4.1); and Stoddard solvent exposure with d-transposition of the great arteries (OR 2.0; 95% CI 1.0 to 4.2), right ventricular outflow tract obstruction defects (OR 1.9; 95% CI 1.1 to 3.3), and pulmonary valve stenosis (OR 2.1; 95% CI 1.1 to 3.8). Conclusions We found evidence of associations between occupational exposure to solvents and several types of CHDs. These results should be interpreted in light of the potential for misclassification of exposure. PMID:22811060

  11. Automatic heart sound detection in pediatric patients without electrocardiogram reference via pseudo-affine Wigner-Ville distribution and Haar wavelet lifting.

    PubMed

    Gavrovska, Ana; Bogdanović, Vesna; Reljin, Irini; Reljin, Branimir

    2014-02-01

    Having in mind the availability of electronic stethoscopes, phonocardiograms (PCGs) have become popular for cardiovascular functionality monitoring and signal processing applications. Detection of fundamental heart sounds (HSs), S1s and S2s, is considered to be a crucial step in PCG analysis. Electrocardiogram (ECG), noted as a reference signal, is often synchronously recorded in order to simplify the S1/S2 detection process. Nevertheless, electronic stethoscopes are frequently used without additional ECG equipment. We propose a new algorithm for automatic fundamental HSs detection via: joint time-frequency representation based on pseudo affine Wigner-Ville distribution (PAWVD), Haar wavelet lifting scheme (Haar-LS), normalized average Shannon energy (NASE) and autocorrelation. The performance of the proposed algorithm was calculated on both normal (50) and pathological (75) PCG recordings, eight seconds long each, contributed by 125 different pediatric patients. The algorithm showed relatively high recall (90.41%) and precision (96.39%) rates of S1/S2 detection procedure in a variety of PCG signals, without ECG as a reference. Furthermore, it indicated the ability to overcome splitting within the S1/S2 heart sounds. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Closing sounds and related complaints after heart valve replacement with St Jude Medical, Duromedics Edwards, Björk-Shiley Monostrut, and Carbomedics prostheses.

    PubMed Central

    Moritz, A; Steinseifer, U; Kobinia, G; Neuwirth-Riedl, K; Wolters, H; Reul, H; Wolner, E

    1992-01-01

    OBJECTIVE--To measure the noise produced and related subjective complaints after implantation of four different mechanical heart valve prostheses and to identify further factors related to the patient and prosthesis that influence noise generation and complaints. DESIGN--Sound pressure was measured 5 and 10 cm and 1 m from the point of maximal impulse on the body surface by a calibrated meter in quiet rooms with either a decibel(A) filter or octave filters. The patients were asked about their complaints and examined physically. SETTING--The measurements were conducted in silent rooms of ear, nose, and throat departments. The patients had been operated on either in a university hospital or a community hospital. MAIN OUTCOME MEASURES--Sound pressures of frequency bands and sound pressures measured in dB(A) at various distances. Complaints registerd were: sleep disturbance, disturbance during daytime, "wants a less noisy prosthesis," and "can hear the closing click". PATIENTS--143 patients after heart valve replacement with St Jude Medical (n = 35), Duromedics Edwards (n = 38), Carbomedics (n = 34) and Björk-Shiley Monostrut (n = 36) prostheses operated on between 1984 and 1988 were matched for valve position, ring size, and body surface area. RESULTS--Duromedics Edwards (33.5 (6) dB(A)) and Björk-Shiley Monostrut valves (31 (4) dB(A)) were significantly louder than St Jude Medical (24 (4) dB(A)) and Carbomedics (25 (6) dB(A)) prostheses (p = 0.0001) (mean (SD)). The louder valves were significantly more often heard by the patients (p = 0.0012) and caused more complaints both during sleep (p = 0.024) and during the daytime (p = 0.07). Patients with these valves were more likely to want a less noisy valve (p = 0.0047). Patients with symptoms were younger, had better hearing, and were more likely to be in sinus rhythm. As well as the type of prostheses, the valve diameter and body height also had an effect on sound emission. CONCLUSIONS--The intensity of the closing

  13. Maternal antibody-associated fetal second-degree heart block and atrial flutter: case report and review.

    PubMed

    Sacks, Jeffrey H; Samai, Cyrus; Gomez, Kevin; Kanaan, Usama

    2013-01-01

    Exposure to maternal anti-Ro (SS-A) and anti-La (SS-B) antibodies is a well-described risk factor for the development of fetal atrioventricular (AV) block. The role of maternal fluorinated steroids in the treatment and prevention of antibody-mediated fetal AV block is controversial. Fetal atrial flutter has rarely been described in association with maternal antibodies. This report describes a case of fetal exposure to maternal anti-Ro antibodies with associated second-degree AV block and atrial flutter. Interestingly, the reported patient had 2:1 AV conduction during both normal atrial rates (consistent with AV node conduction disease) and episodes of flutter (consistent with physiologic AV node functionality). The fetus was treated with transplacental digoxin and dexamethasone, which resolved both rhythm disturbances. The case report is followed by a brief discussion of AV block and atrial flutter associated with maternal antibody exposure.

  14. Prediction of Fluid Responsiveness by a Non-invasive Respiratory Systolic Time Interval Variation Using Heart Sound Signals in Recipients Undergoing Liver Transplantation.

    PubMed

    Kim, S-H; Moon, Y-J; Kim, J-W; Song, J-G; Hwang, G-S

    2017-06-01

    The fluid management of cirrhotic patients undergoing liver transplantation (LT) is challenging. Phonocardiography, a graphic recording of heart sounds, provides valuable information concerning heart function and hemodynamic condition. We assessed whether the systolic time interval (STI) and its respiratory variation could predict fluid responsiveness in cirrhotic patients undergoing LT. Thirty LT recipients who needed volume expansion were included. The fluid challenge consisted of 500 mL 5% albumin administered over a period of 10 minutes. STI was measured as the time interval between the maximal amplitude of each heart sound corrected with the corresponding RR interval (cSTI). The respiratory variation in STI (STV) induced by mechanical ventilation was calculated. Responders were defined as those showing a ≥10% increase in stroke volume index after volume expansion. In all, 14 of the 30 patients were responders. Significant increases in cSTI were observed after volume expansion in both responders (P < .001) and non-responders (P = .008). Responders showed significant decreases in STV (11.1% ± 4.3% vs 6.1% ± 2.6%, P < .001) after fluid loading, whereas STV in non-responders remained unchanged (6.4% ± 2.6% vs 6.4% ± 4.2%, P = .86). A cut-off value of ≥7.5% STV from baseline could predict fluid responsiveness with an area under the receiver operating characteristic curve of 0.804 (95% confidence interval, 0.618-0.925). Intra-operative STV can predict fluid responsiveness in patients undergoing LT. Beat-to-beat monitoring of STI and STV may be useful as a non-invasive hemodynamic index and for fluid management. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Association between maternal exposure to housing renovation and offspring with congenital heart disease: a multi-hospital case-control study.

    PubMed

    Liu, Zhen; Li, Xiaohong; Li, Nana; Li, Shengli; Deng, Kui; Lin, Yuan; Chen, Xinlin; You, Fengzhi; Li, Jun; Mu, Dezhi; Wang, Yanping; Zhu, Jun

    2013-03-25

    Congenital heart disease (CHD) is one of the most prevalent birth defects. Housing renovations are a newly recognized source of indoor environmental pollution that is detrimental to health. A growing body of research suggests that maternal occupational exposure to renovation materials may be associated with an increased risk of giving birth to fetuses with CHD. However, the effect of indoor housing renovation exposure on CHD occurrence has not been reported. A multi-hospital case-control study was designed to investigate the association between maternal periconceptional housing renovation exposure and the risk of CHD for offspring. In total, 346 cases and 408 controls were enrolled in this study from four hospitals in China. Exposure information was based on a questionnaire given to women during pregnancy. The association between housing renovation exposure and CHD occurrence was assessed by estimating odds ratios (OR) with logistic regression models adjusted for potential confounders. The risk for CHD in offspring was significantly associated with maternal exposure to housing renovations (AOR: 1.89, 95% CI: 1.29-2.77). There were similar risks for cardiac defects with or without extra-cardiac malformation (AOR of 2.65 and 1.76, respectively). Maternal housing renovation exposure may increase the fetus' risk of suffering from conotruncal defect or anomalous venous return. There were significant risks for cardiac defects if the pregnant woman moved into a new house within one month after decoration at either 3 months before pregnancy (AOR: 2.38, 95% CI: 1.03 to 5.48) or during first trimester (AOR: 4.00, 95% CI: 1.62 to 9.86). Maternal exposure to housing renovations may have an increased risk of giving birth to fetuses with some selected types of CHD. This relationship was stronger for women who moved into a newly decorated house. However, considering the limited number of subjects and the problem of multiple exposures, more research is needed to clarify the

  16. Maternal Parity and the Risk of Congenital Heart Defects in Offspring: A Dose-Response Meta-Analysis of Epidemiological Observational Studies

    PubMed Central

    Chen, Tao; Liu, Jin; Tong, Xing; Yang, Lei; Da, Min; Shen, Shutong; Fan, Changfeng; Wang, Song; Mo, Xuming

    2014-01-01

    Background Epidemiological studies have reported conflicting results regarding maternal parity and the risk of congenital heart defects (CHDs). However, a meta-analysis of the association between maternal parity and CHDs in offspring has not been conducted. Methods We searched MEDLINE and EMBASE for articles catalogued between their inception and March 8, 2014; we identified relevant published studies that assessed the association between maternal parity and CHD risk. Two authors independently assessed the eligibility of the retrieved articles and extracted data from them. Study-specific relative risk estimates were pooled by random-effects or fixed-effects models. From the 11272 references, a total of 16 case-control studies and 3 cohort studies were enrolled in this meta-analysis. Results The overall relative risk of CHD in parous versus nulliparous women was 1.01 (95% CI, 0.97–1.06; Q = 32.34; P = 0.006; I2 = 53.6%). Furthermore, we observed a significant association between the highest versus lowest parity number, with an overall RR = 1.20 (95% CI, 1.10–1.31; (Q = 74.61, P<0.001, I2 = 82.6%). A dose–response analysis also indicated a positive effect of maternal parity on CHD risk, and the overall increase in relative risk per one live birth was 1.06 (95% CI, 1.02–1.09); Q = 68.09; P<0.001; I2 = 80.9%). We conducted stratified and meta-regression analyses to identify the origin of the heterogeneity among studies. A Galbraith plot was created to graphically assess the sources of heterogeneity. Conclusion In summary, this meta-analysis provided a robust estimate of the positive association between maternal parity and risk of CHD. PMID:25295723

  17. Bayesian multinomial probit modeling of daily windows of susceptibility for maternal PM2.5 exposure and congenital heart defects

    EPA Science Inventory

    Past epidemiologic studies suggest maternal ambient air pollution exposure during critical periods of the pregnancy is associated with fetal development. We introduce a multinomial probit model that allows for the joint identification of susceptible daily periods during the pregn...

  18. Bayesian multinomial probit modeling of daily windows of susceptibility for maternal PM2.5 exposure and congenital heart defects

    EPA Science Inventory

    Past epidemiologic studies suggest maternal ambient air pollution exposure during critical periods of the pregnancy is associated with fetal development. We introduce a multinomial probit model that allows for the joint identification of susceptible daily periods during the pregn...

  19. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    PubMed

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  20. Effects of maternal anxiety and depression during pregnancy in Chinese women on children's heart rate and blood pressure response to stress.

    PubMed

    Fan, F; Zou, Y; Tian, H; Zhang, Y; Zhang, J; Ma, X; Meng, Y; Yue, Y; Liu, K; Dart, A M

    2016-03-01

    Psychological disturbances, including anxiety and depression, are common during human pregnancy. Our objective was to determine whether these maternal disturbances influence cardiovascular responses of the offspring. The psychological status of 231 pregnant women was determined. Offspring (216) of these women were subsequently exposed to a video challenge stress when aged 7-9 years. Heart rate (HR) and blood pressure (BP) of the children were determined at rest, in response to video stress and during subsequent recovery. Children's resting and stress-induced increases in HR (bpm), systolic (SBP, mm Hg) and diastolic (DBP, mm Hg) BP were all greater in children whose mothers reported anxiety during pregnancy. Values (mean±s.d.) for resting HR, SBP and DBP were 75.15±5.87, 95.37±2.72 and 66.39±4.74 for children whose mothers reported no anxiety and an average of 81.62±6.71, 97.26±2.90 and 68.86±2.82 for children whose mothers reported anxiety at any level. Respective values for stress-induced increments in HR, SBP and DBP were 14.83.±2.14, 16.41±1.97 and 12.72±2.69 for children whose mothers reported no anxiety and 17.95±3.46, 18.74±2.46 and 14.86±2.02 for children whose mothers reported any level of anxiety. Effects of maternal depression were less consistent. The effects of maternal anxiety remained in multivariate analyses, which also included children's birth weight. The results indicate a long-term influence of maternal psychological status during pregnancy on the cardiovascular responses to stress among offspring. These effects may contribute to prenatal influences on subsequent health of the offspring.

  1. Ultrasound findings in fetal congenital heart block associated with maternal anti-Ro/SSA and Anti-La/SSB antibodies.

    PubMed

    Lai, Jasmine; Clark, Toshi J; Tan, Justin H; Delaney, Shani; Jolley, Jennifer A

    2015-03-01

    We present the sonographic features of a second-trimester fetus diagnosed with a bradyarrhythmia at 19 weeks' gestation. The mother carried a diagnosis of Sjögren syndrome, including the presence of SSA and SSB antibodies. Ultrasound M-mode and fetal echocardiogram revealed the etiology of the bradycardia to be a complete fetal congenital heart block, likely due to transplacental passage of autoimmune anti-Ro/SSA and anti-La/SSB antibodies. Consequential to the congenital heart block, the fetus developed hydrops fetalis at 21 weeks' gestational age. We discuss the 2 major etiologies of congenital heart block and the implications in subsequent pregnancies.

  2. [Eclampsia, obstetric hemorrhage and heart disease as a cause of maternal mortality in 15 years of analysis].

    PubMed

    Veloz-Martínez, María Guadalupe; Martínez-Rodríguez, Oscar Arturo; Ahumada-Ramírez, Elías; Puello-Tamara, Edgardo Rafael; Amezcua-Galindo, Francisco Javier; Hernández-Valencia, Marcelino

    2010-04-01

    It has been described that 70% of all maternal deaths are provoked by obstetrical hemorrhage, infections, abortions, hypertension and delivery dystocies. Poverty, social exclusion, low level education and violence are important causes of maternal mortality. To establish the changes in the maternal mortality in a term of 15 years in a hospital of assistance obstetrical complicated. A retrospective and descriptive study, in which the number and causes of obstetrical death was analyzed, occurred from 1991 to 2005. The comparison was done by five-year periods using descriptive statistics to analyze frequency of results. The number of maternal deaths was 105, 97 and 42 by each one of the three five-year periods, the mortality rate x 10,000 decreased from 28.7 to 16.4 in the last quinquennium and was found from 6.1 just including the last year. In the first and second quinquennia the eclampsia occupied the first place as cause of death, followed by the hemorrhage and the infections. In the third quinquennium the eclampsia also occupied the first place with a rate of 8.6, followed by the cardiopathy (2.3) and the infections (1.9), but the hemorrhage with a rate of 1.5 was displaced to the fourth place. The maternal mortality has diminished in a general way; the eclampsia has occupied the first place as cause of death from 1991 to 2005. The death by obstetrical hemorrhage has diminished in important form, possibly due to the specific groups of medical attention by modules, which has also helps the decrease of mortality by other causes. The increment of the deaths by cardiopathy should be considered as a possibility of risk, associate undoubtedly to the present style of life from our society.

  3. Association between maternal exposure to housing renovation and offspring with congenital heart disease: a multi-hospital case–control study

    PubMed Central

    2013-01-01

    Background Congenital heart disease (CHD) is one of the most prevalent birth defects. Housing renovations are a newly recognized source of indoor environmental pollution that is detrimental to health. A growing body of research suggests that maternal occupational exposure to renovation materials may be associated with an increased risk of giving birth to fetuses with CHD. However, the effect of indoor housing renovation exposure on CHD occurrence has not been reported. Methods A multi-hospital case–control study was designed to investigate the association between maternal periconceptional housing renovation exposure and the risk of CHD for offspring. In total, 346 cases and 408 controls were enrolled in this study from four hospitals in China. Exposure information was based on a questionnaire given to women during pregnancy. The association between housing renovation exposure and CHD occurrence was assessed by estimating odds ratios (OR) with logistic regression models adjusted for potential confounders. Results The risk for CHD in offspring was significantly associated with maternal exposure to housing renovations (AOR: 1.89, 95% CI: 1.29-2.77). There were similar risks for cardiac defects with or without extra-cardiac malformation (AOR of 2.65 and 1.76, respectively). Maternal housing renovation exposure may increase the fetus’ risk of suffering from conotruncal defect or anomalous venous return. There were significant risks for cardiac defects if the pregnant woman moved into a new house within one month after decoration at either 3 months before pregnancy (AOR: 2.38, 95% CI: 1.03 to 5.48) or during first trimester (AOR: 4.00, 95% CI: 1.62 to 9.86). Conclusions Maternal exposure to housing renovations may have an increased risk of giving birth to fetuses with some selected types of CHD. This relationship was stronger for women who moved into a newly decorated house. However, considering the limited number of subjects and the problem of multiple exposures

  4. Prolongation of the atrioventricular conduction in fetuses exposed to maternal anti-Ro/SSA and anti-La/SSB antibodies did not predict progressive heart block. A prospective observational study on the effects of maternal antibodies on 165 fetuses.

    PubMed

    Jaeggi, Edgar T; Silverman, Earl D; Laskin, Carl; Kingdom, John; Golding, Fraser; Weber, Roland

    2011-03-29

    We prospectively examined the prevalence and outcome of untreated fetal atrioventricular (AV) prolongation in the presence of maternal anti-Ro antibodies. It has been suggested that antibody-mediated congenital complete atrioventricular block (CAVB) may be preventable if detected and treated early when low-grade block is present. With this rationale in mind, dexamethasone has been advocated by others to treat prolonged fetal AV conduction >2 z-scores, consistent with first-degree heart block. Between July 2003 and June 2009, 165 fetuses of 142 anti-Ro/La antibody-positive women were referred to our center for serial echocardiography. Our protocol included weekly evaluation of the fetal AV conduction between 19 (range 17 to 23) and 24 (range 23 to 35) gestational weeks. AV times were compared with institutional reference data and with post-natal electrocardiograms. Of 150 fetuses with persistently normal AV conduction throughout the observation period, a diagnosis of CAVB was subsequently made in 1 at 28 weeks, after the serial evaluation had ended. Of 15 untreated fetuses either with AV prolongation between 2 and 6 z-scores or with type 1 second-degree block, progressive heart block developed in none of them. Three of these 15 fetuses (20%) had a neonatal diagnosis of first-degree block that spontaneously resolved (n = 2) or has not progressed (n = 1) on follow-up examinations. No other cardiac complications were detected. Fetal AV prolongation did not predict progressive heart block to birth. Our findings question the rationale of a management strategy that relies on the early identification and treatment of fetal AV prolongation to prevent CAVB. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. The association of maternal lymphatic markers and critical congenital heart defects in the fetus-A population based case-control study.

    PubMed

    Steurer, Martina A; Norton, Mary E; Baer, Rebecca J; Shaw, Gary M; Keating, Sheila; Moon-Grady, Anita J; Chambers, Christina D; Jelliffe-Pawlowski, Laura L

    2017-03-21

    The objective ot this study was to investigate whether lymphatic markers measured in women during the second trimester are associated with critical congenital heart defects (CCHDs) in offspring. This is a retrospective cohort study of pregnant women who participated in the California Prenatal Screening Program. CCHD data in the offspring was captured by linking birth certificate data with hospital patient discharge records. Second trimester samples were assayed for vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF) AA/BB, and PDGF AB. Logistic models were used to evaluate the association between lymphatic biomarkers and CCHD. Models were adjusted for other serum biomarkers and maternal characteristics. Results are presented in odds ratios (OR) with 95% confidence intervals (CI). We identified 93 cases with CCHDs and 194 controls without CCHDs. The crude and adjusted OR for log (ln) VEGF was 1.07 (95%CI 0.94-1.22) and 1.08 (95%CI 0.94-1.24), respectively; for ln PDGF AB/BB was 0.93 (95%CI 0.6-1.35) and 0.58 (95%CI 0.32-1.05), respectively. There was a significant association between ln PDFG AA and CCHDs (crude OR 1.83 (95%CI 1.05-3.2); adjusted OR 2.41 (95%CI 1.06-5.44)). Levels of circulating PDGF AA were highest in cases with hypoplastic left heart syndrome (HLHS) (mean 8.78 +/- 1.54 pg/ml). In this study, increased mid-pregnancy maternal serum levels of PDGF AA were associated with CCHDs in offspring. The highest PDGF AA levels were found in mothers of fetuses with HLHS. These findings may be useful in screening for CCHDs and offer insight into their association with nuchal translucency.

  6. Reliability of Lagged Poincaré Plot parameters in ultra-short Heart Rate Variability series: Application on Affective Sounds.

    PubMed

    Nardelli, Mimma; Greco, Alberto; Bolea, Juan; Valenza, Gaetano; Scilingo, Enzo Pasquale; Bailon, Raquel

    2017-04-18

    The number of studies about ultra-short cardiovascular time series is increasing because of the demand for mobile applications in telemedicine and e-health monitoring. However, the current literature still needs a proper validation of heartbeat nonlinear dynamics assessment from ultra-short time series. This paper reports on the reliability of the Lagged Poincaré Plot (LPP) parameters - calculated from ultra-short cardiovascular time series. Reliability is studied on simulated as well as on real RR series. Simulated RR series are generated and LPP parameters estimated for ultra-short time series (from 15 to 60 s) are compared to those estimated from 1 hour. All LPP parameters estimated from time series longer than 35 s presented a Spearman's correlation coefficient higher than 0.99. RR series acquired from 32 healthy subjects during 5-minutes resting state sessions are used to test the LPP approach in experimental data. The usefulness of ultra short term parameters in real data is accomplished also studying their ability to discriminate positive and negative valence of auditory stimuli taken from the International Affective Digitized Sound System (IADS) dataset. The achieved accuracies in the recognition of elicitation along the valence dimension, using only the LPP parameters, were of 77.78% for 1 minute 28 second series, and of 79.17% for 35 second series.

  7. Heart failure - tests

    MedlinePlus

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... An echocardiogram (echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain ...

  8. Maternal apolipoprotein E genotype as a potential risk factor for poor birth outcomes: The Bogalusa Heart Study

    PubMed Central

    Jacobs, Marni B.; Harville, Emily W.; Kelly, Tanika N.; Bazzano, Lydia A.; Chen, Wei

    2016-01-01

    Objective To assess the association between apolipoprotein E (apoE) genotype and preterm birth (PTB) and small for gestational age (SGA). Study Design ApoE phenotyping was performed on 680 women linked to 1 065 births. Allele frequencies were compared and PTB and SGA risk was estimated using log-binomial regression. Results The ε2 allele was more common in SGA births (p < 0.01). SGA risk was increased among ε2 carriers compared to genotype ε3/ε3, though associations were attenuated following adjustment for maternal age, education, race, smoking, and prenatal visits. Stronger associations were observed for term SGA (first birth: aRR = 1.78, 95% CI 1.06 – 2.98; any birth: aRR = 1.52, 95% CI 0.96 – 2.40) and among whites specifically (first: aRR = 2.88, 95% CI 1.45 – 5.69; any: aRR = 2.75, 95% CI 1.46 – 5.22). Conclusions Associations between maternal apoE genotype and SGA may represent decreased fetal growth in women with lower circulating cholesterol levels. PMID:26890557

  9. Indigenous Ethnicity and Low Maternal Education Are Associated with Delayed Diagnosis and Mortality in Infants with Congenital Heart Defects in Panama

    PubMed Central

    Zúñiga, Julio; Higuera, Gladys; Carrión Donderis, María; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    Background This is the first study in Panama and Central America that has included indigenous populations in an assessment of the association between socioeconomic variables with delayed diagnosis and mortality due to congenital heart defects (CHD). Methods A retrospective observational study was conducted. A sample calculation was performed and 954 infants born from 2010 to 2014 were randomly selected from clinical records of all Panamanian public health institutions with paediatric cardiologists. Critical CHD was defined according to the defects listed as targets of newborn pulse oximetry screening. Diagnoses were considered delayed when made after the third day of life for the critical CHD and after the twentieth day of life for the non-critical. A logistic regression model was performed to examine the association between socioeconomic variables and delayed diagnosis. A Cox proportional hazards model was used to assess the relationship between socioeconomic features and mortality. Results An increased risk of delayed diagnosis was observed in infants with indigenous ethnicity (AOR, 1.56; 95% CI, 1.03–2.37), low maternal education (AOR, 1.57; 95% CI, 1.09–2.25) and homebirth (AOR, 4.32; 95% CI, 1.63–11.48). Indigenous infants had a higher risk of dying due to CHD (HR, 1.43; 95% CI, 1.03–1.99), as did those with low maternal education (HR, 1.95; 95% CI, 1.45–2.62). Conclusion Inequalities in access to health care, conditioned by unfavourable socioeconomic features, may play a key role in delayed diagnosis and mortality of CHD patients. Further studies are required to study the relationship between indigenous ethnicity and these adverse health outcomes. PMID:27648568

  10. Indigenous Ethnicity and Low Maternal Education Are Associated with Delayed Diagnosis and Mortality in Infants with Congenital Heart Defects in Panama.

    PubMed

    Castro, Franz; Zúñiga, Julio; Higuera, Gladys; Carrión Donderis, María; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    This is the first study in Panama and Central America that has included indigenous populations in an assessment of the association between socioeconomic variables with delayed diagnosis and mortality due to congenital heart defects (CHD). A retrospective observational study was conducted. A sample calculation was performed and 954 infants born from 2010 to 2014 were randomly selected from clinical records of all Panamanian public health institutions with paediatric cardiologists. Critical CHD was defined according to the defects listed as targets of newborn pulse oximetry screening. Diagnoses were considered delayed when made after the third day of life for the critical CHD and after the twentieth day of life for the non-critical. A logistic regression model was performed to examine the association between socioeconomic variables and delayed diagnosis. A Cox proportional hazards model was used to assess the relationship between socioeconomic features and mortality. An increased risk of delayed diagnosis was observed in infants with indigenous ethnicity (AOR, 1.56; 95% CI, 1.03-2.37), low maternal education (AOR, 1.57; 95% CI, 1.09-2.25) and homebirth (AOR, 4.32; 95% CI, 1.63-11.48). Indigenous infants had a higher risk of dying due to CHD (HR, 1.43; 95% CI, 1.03-1.99), as did those with low maternal education (HR, 1.95; 95% CI, 1.45-2.62). Inequalities in access to health care, conditioned by unfavourable socioeconomic features, may play a key role in delayed diagnosis and mortality of CHD patients. Further studies are required to study the relationship between indigenous ethnicity and these adverse health outcomes.

  11. Misidentification of maternal heart rate as fetal on cardiotocography during the second stage of labor: the role of the fetal electrocardiograph.

    PubMed

    Nurani, Raisha; Chandraharan, Edwin; Lowe, Virginia; Ugwumadu, Austin; Arulkumaran, Sabaratnam

    2012-12-01

    To identify the incidence of fetal heart rate (FHR) accelerations in the second stage of labor and the role of fetal electrocardiograph (ECG) in avoiding misidentification of maternal heart rate (MHR) as FHR. Retrospective observational study. University hospital labor ward, London, UK. Cardiotocograph (CTG) tracings of 100 fetuses monitored using external transducers and internal scalp electrodes. CTG traces that fulfilled inclusion criteria were selected from an electronic FHR monitoring database. Rate of accelerations during external and internal monitoring as well as decelerations for a period of 60 minutes prior to delivery were determined. The role of fetal ECG in differentiating between MHR and FHR trace was explored. Decelerations occurred in 89% of CTG traces during the second stage of labor. Accelerations indicating possible recording of FHR or MHR were found in 28.1 and 10.9% of cases recorded by an external ultrasound transducer as well as internal scalp electrode, respectively. Accelerations coinciding with uterine contractions occurred only in 11.7 and 4% of external and internal recording of FHR, respectively. Absence of 'p-wave' of the ECG waveform was associated with MHR trace. Decelerations were the commonest CTG feature during the second stage of labor. The incidence of accelerations coinciding with uterine contractions was less than half in fetuses monitored using a fetal scalp electrode. Analysing the ECG waveform for the absence of 'p-wave' helps in differentiating MHR from FHR. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Maternal pulse pressure at admission is a risk factor for fetal heart rate changes after initial dosing of a labor epidural: a retrospective cohort study.

    PubMed

    Miller, Nathaniel R; Cypher, Rebecca L; Nielsen, Peter E; Foglia, Lisa M

    2013-10-01

    To examine low maternal admission pulse pressure (PP) as a risk factor for new onset postepidural fetal heart rate (FHR) abnormalities. Retrospective cohort study of nulliparous, singleton, vertex-presenting women admitted to labor and delivery after 37 0/7 weeks that received an epidural during labor. Women with a low admission PP were compared with those with a normal admission PP. The primary outcome was new onset FHR abnormalities defined as recurrent late or prolonged FHR decelerations in the first hour after initial dosing of a labor epidural. New onset FHR abnormalities, defined as recurrent late decelerations and/or prolonged decelerations, occurred in 6% of subjects in the normal PP cohort compared with 27% in the low PP cohort (odds ratio, 5.6; 95% confidence interval, 2.1-14.3; P < .001). A multivariate logistic regression analysis generated an adjusted odds ratio of 28.9 (95% confidence interval, 3.7-221.4; P < .001). New onset FHR abnormalities after initial labor epidural dosing occur more frequently in women with a low admission PP than those with a normal admission pulse. Admission PP appears to be a novel predictor of new onset postepidural FHR abnormalities. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Sound Symbolism.

    ERIC Educational Resources Information Center

    Hinton, Leanne, Ed.; And Others

    Sound symbolism is the study of the relationship between the sound of an utterance and its meaning. In this interdisciplinary collection of new studies, 24 leading scholars discuss the role of sound symbolism in a theory of language. Contributions and authors include the following: "Sound-Symbolic Processes" (Leanne Hinton, Johanna…

  14. Sound Symbolism.

    ERIC Educational Resources Information Center

    Hinton, Leanne, Ed.; And Others

    Sound symbolism is the study of the relationship between the sound of an utterance and its meaning. In this interdisciplinary collection of new studies, 24 leading scholars discuss the role of sound symbolism in a theory of language. Contributions and authors include the following: "Sound-Symbolic Processes" (Leanne Hinton, Johanna…

  15. Increased risk for congenital heart defects in children carrying the ABCB1 Gene C3435T polymorphism and maternal periconceptional toxicants exposure.

    PubMed

    Wang, Chuan; Xie, Liang; Zhou, Kaiyu; Zhan, Yalan; Li, Yifei; Li, Huaying; Qiao, Lina; Wang, Fang; Hua, Yimin

    2013-01-01

    The etiology of congenital heart defect (CHD) is commonly believed to involve the interaction of multiple environmental and genetic factors. This study aimed to explore the joint effects of the ABCB1 gene C3435T polymorphism and maternal periconceptional toxicants exposure on the CHD risk in a Han Chinese population. An age and gender matched case-control study with standardized data collection involving 201 pairs was conducted. Periconceptional toxicants exposure was obtained through a structured questionnaire. A job exposure matrix (JEM) was used for toxicants exposure assessment. Genotyping of the ABCB1 C3435T polymorphism was performed by sequencing. Logistic regression analysis was performed to assess the joint effects of the ABCB1 gene C3435T polymorphism and toxicants exposure on the risk of CHD. Placenta tissues and umbilical cords were collected to investigate the impact of C3435T polymorphism on the transcription and translation activities of ABCB1 gene. MATERNAL PERICONCEPTIONAL EXPOSURES TO PHTHALATES (ADJUSTED OR: 1.6; 95%CI: 1.0-2.6) and alkylphenolic compounds (adjusted OR:1.8; 95%CI:1.1-3.0) were associated with a higher incidence of CHDs in general. More cases were carriers of the ABCB1 CC/CT genotypes (OR: 2.0, 95%CI: 1.1-3.5, P-value: 0.021). Children carrying the CC/CT genotype and periconceptionally exposed to phthalates and alkylphenolic compounds suffered almost 3.5-fold increased risk of having CHD than non-exposed children with TT genotype (adjusted OR: 3.5, 95%CI: 1.5-7.9, P-value: 0.003), and the OR changed to 4.4 for septal defects (adjusted OR: 4.4,95%CI:1.8-10.9,P-value:0.001). The ABCB1 mRNA expression of the TT genotype was significantly higher than that of the CC genotype (P = 0.03). Compared with TT genotype, lower P-glycoprotein expression was observed for the CC/CT genotypes. The C3435T polymorphism in the ABCB1 gene of fetus increases the risks of CHD in a Han Chinese population when the mothers are exposed to phthalates and

  16. Increased Risk for Congenital Heart Defects in Children Carrying the ABCB1 Gene C3435T Polymorphism and Maternal Periconceptional Toxicants Exposure

    PubMed Central

    Zhou, Kaiyu; Zhan, Yalan; Li, Yifei; Li, Huaying; Qiao, Lina; Wang, Fang; Hua, Yimin

    2013-01-01

    Backgrounds The etiology of congenital heart defect (CHD) is commonly believed to involve the interaction of multiple environmental and genetic factors. This study aimed to explore the joint effects of the ABCB1 gene C3435T polymorphism and maternal periconceptional toxicants exposure on the CHD risk in a Han Chinese population. Methods An age and gender matched case-control study with standardized data collection involving 201 pairs was conducted. Periconceptional toxicants exposure was obtained through a structured questionnaire. A job exposure matrix (JEM) was used for toxicants exposure assessment. Genotyping of the ABCB1 C3435T polymorphism was performed by sequencing. Logistic regression analysis was performed to assess the joint effects of the ABCB1 gene C3435T polymorphism and toxicants exposure on the risk of CHD. Placenta tissues and umbilical cords were collected to investigate the impact of C3435T polymorphism on the transcription and translation activities of ABCB1 gene. Results Maternal periconceptional exposures to phthalates (adjusted OR: 1.6; 95%CI: 1.0–2.6) and alkylphenolic compounds (adjusted OR:1.8; 95%CI:1.1–3.0) were associated with a higher incidence of CHDs in general. More cases were carriers of the ABCB1 CC/CT genotypes (OR: 2.0, 95%CI: 1.1–3.5, P-value: 0.021). Children carrying the CC/CT genotype and periconceptionally exposed to phthalates and alkylphenolic compounds suffered almost 3.5-fold increased risk of having CHD than non-exposed children with TT genotype (adjusted OR: 3.5, 95%CI: 1.5–7.9, P-value: 0.003), and the OR changed to 4.4 for septal defects (adjusted OR: 4.4,95%CI:1.8–10.9,P-value:0.001). The ABCB1 mRNA expression of the TT genotype was significantly higher than that of the CC genotype (P = 0.03). Compared with TT genotype, lower P-glycoprotein expression was observed for the CC/CT genotypes. Conclusion The C3435T polymorphism in the ABCB1 gene of fetus increases the risks of CHD in a Han Chinese

  17. Accumulation and maternal transfer of polychlorinated biphenyls in Steller Sea Lions (Eumetopias jubatus) from Prince William Sound and the Bering Sea, Alaska.

    PubMed

    Wang, Jun; Hülck, Kathrin; Hong, Su-Myeong; Atkinson, Shannon; Li, Qing X

    2011-01-01

    The western stock of the Steller sea lion (Eumetopias jubatus) in the northern Pacific Ocean has declined by approximately 80% over the past 30 years. This led to the listing of this sea lion population as an endangered species in 1997. Chemical pollution is [corrected] one of several contributing causes. In the present study, 145 individual PCBs were determined in tissues of male sea lions from Tatitlek (Prince William Sound) and St. Paul Island (Bering Sea), and placentae from the Aleutian Islands. PCBs 90/101, 118, and 153 were abundant in all the samples. The mean toxic equivalents (TEQ) were 2.6, 4.7 and 7.4 pg/g lw in the kidney, liver, and blubber samples, respectively. The mean TEQ in placentae was 8 pg/g lw. Total PCBs concentrations (2.6-7.9 μg/g lw) in livers of some males were within a range known to cause physiological effects, further [corrected] suggesting the possibility of adverse effects on this stock. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Abdominal sounds

    MedlinePlus

    ... may be a sign of early bowel obstruction. Causes Most of the sounds you hear in your stomach and intestines are ... a list of more serious conditions that can cause abnormal bowel sounds. Hyperactive, hypoactive, or missing bowel sounds may be ...

  19. Panic Attack or Heart Attack?

    MedlinePlus

    ... factors for heart disease. Echocardiography uses sound waves technology to give detailed information about the heart muscle, ... investigation as possible new diagnostic tools to determine coronary artery disease and may become available in the future. Angiography ...

  20. Screening for trisomies 21, 18 and 13 by maternal age, fetal nuchal translucency, fetal heart rate, free beta-hCG and pregnancy-associated plasma protein-A.

    PubMed

    Kagan, Karl O; Wright, Dave; Valencia, Catalina; Maiz, Nerea; Nicolaides, Kypros H

    2008-09-01

    A beneficial consequence of screening for trisomy 21 is the early diagnosis of trisomies 18 and 13. Our objective was to examine the performance of first-trimester screening for trisomies 21, 18 and 13 by maternal age, fetal nuchal translucency (NT) thickness, fetal heart rate (FHR) and maternal serum-free beta-hCG and pregnancy-associated plasma protein-A (PAPP-A). Prospective screening for trisomy 21 by maternal age, fetal NT, free beta-hCG and PAPP-A at 11(+0)-13(+6) weeks in singleton pregnancies, including 56 376 normal cases, 395 with trisomy 21, 122 with trisomy 18 and 61 with trisomy 13. Risk algorithms were developed for the calculation of patient-specific risks for each of the three trisomies based on maternal age, NT, FHR, free beta-hCG and PAPP-A. Detection (DR) and false positive rates (FPR) were calculated and adjusted according to the maternal age distribution of pregnancies in England and Wales in 2000-2002. The DR and FPR were 90% and 3%, respectively, for trisomy 21, 91% and 0.2% for trisomy 18 and 87% and 0.2% for trisomy 13. When screen positivity was defined by an FPR of 3% on the risk for trisomy 21 in conjunction with an FPR of 0.2% on the maximum of the risks for trisomies 13 and 18, the overall FPR was 3.1% and the DRs of trisomies 21, 18 and 13 were 91%, 97% and 94%, respectively. As a side effect of first-trimester screening for trisomy 21, approximately 95% of trisomy 13 and 18 fetuses can be detected with an 0.1% increase in the FPR.

  1. Heart valve surgery - series (image)

    MedlinePlus

    There are four valves in the heart: aortic valve, mitral valve, tricuspid valve, and pulmonary valve. The valves are designed to control the direction of blood flow through the heart. The opening and closing of the heart valves produce the heart-beat sounds.

  2. Categorizing Sounds

    DTIC Science & Technology

    1988-09-30

    Classification) CatemorizinR Sounds 12. PERSONAL AUTHOR(S) Dr. Gremory R. Lockhead 13a. TYPE OF REPORT 13b. TIME COVERED 14. DATE OF REPORT (Year, Month,Day) S...variability in judgments of univariate sounds depends on what stimuli occurred recently (sequence effects), what stimuli might occur (set and range effects...CLASSIFICATION OF TH IS PAGE UNCLASSIFIED CATEGORIZING SOUNDS =- Gregory R. Lockhead Department of Psychology 3 Duke University -4 Durham, North Carolina 27706

  3. Heart failure in pregnancy.

    PubMed

    Rutherford, John D

    2012-12-01

    With increasing maternal age and the presence of comorbid conditions such as hypertension, cardiovascular assessment and monitoring is the responsibility of all clinicians caring for pregnant patients. Furthermore, there are specific conditions, such as mitral stenosis, peripartum cardiomyopathy, and preeclampsia, that can be associated with heart failure and secondary maternal (and fetal) mortality and morbidity. The important causes of heart failure in pregnancy are discussed.

  4. Maternal cardiac metabolism in pregnancy

    PubMed Central

    Liu, Laura X.; Arany, Zolt

    2014-01-01

    Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

  5. Sound Absorbers

    NASA Astrophysics Data System (ADS)

    Fuchs, H. V.; Möser, M.

    Sound absorption indicates the transformation of sound energy into heat. It is, for instance, employed to design the acoustics in rooms. The noise emitted by machinery and plants shall be reduced before arriving at a workplace; auditoria such as lecture rooms or concert halls require a certain reverberation time. Such design goals are realised by installing absorbing components at the walls with well-defined absorption characteristics, which are adjusted for corresponding demands. Sound absorbers also play an important role in acoustic capsules, ducts and screens to avoid sound immission from noise intensive environments into the neighbourhood.

  6. Dual transmission model of the fetal heart tone

    NASA Astrophysics Data System (ADS)

    Baker, Donald A.; Zuckerwar, Allan J.

    2004-05-01

    Detection of the fetal heart tone by auscultation is sometimes easy, other times very difficult. In the model proposed here, the level of difficulty depends upon the position of the fetus within the maternal abdomen. If the fetus lies in the classical left/right occiput anterior position (head down, back against the maternal abdominal wall), detection by a sensor or stethoscope on the maternal abdominal surface is easy. In this mode, named here the ``direct contact'' mode, the heartbeat pushes the fetus against the detecting sensor. The motion generates pressure by impact and does not involve acoustic propagation at all. If the fetus lies in a persistent occiput posterior position (spine-to-spine, fetus facing forward), detection is difficult. In this, the ``fluid propagation'' mode, sound generated by the fetal heart and propagating across the amniotic fluid produces extremely weak signals at the maternal surface, typically 30 dB lower than those of the direct contact mode. This reduction in tone level can be compensated by judicious selection of detection frequency band and by exploiting the difference between the background noise levels of the two modes. Experimental clinical results, demonstrating the tones associated with the two respective modes, will be presented.

  7. Sound Advice.

    ERIC Educational Resources Information Center

    Popke, Michael

    2000-01-01

    Discusses the planning and decision-making process in acquiring sound equipment for sports stadiums that will help make the experience of fans more pleasurable. The bidding process and use of consultants is explored. (GR)

  8. Sound Advice.

    ERIC Educational Resources Information Center

    Popke, Michael

    2000-01-01

    Discusses the planning and decision-making process in acquiring sound equipment for sports stadiums that will help make the experience of fans more pleasurable. The bidding process and use of consultants is explored. (GR)

  9. [Maternity blues].

    PubMed

    Gonidakis, F

    2007-04-01

    Maternity blues is a transient change of mood that occurs mainly between the 1st and 10th day of puerpartum and is characterized by bursts of tears, mild depressive mood, anxiety and liability of mood. The frequency of maternity blues varies in different studies form 4% to 80%. A number of biological and psychosocial parameters have been studied in order to determine their correlation with maternity blues. The most well studied biological parameters are progesterone and cortizol although their relation with maternity blues has not yet been clearly defined. Stress and the emotional state of the woman during pregnancy as well as history of mood disorders or maternity blues in a previous birth are the psychosocial parameters that are more likely to correlate with the occurrence of maternity blues. Most of the authors suggest that information on maternity blues and reassurance of the woman are the best way to deal with maternity blues both on preventive and therapeutical basis.

  10. Sound Guard

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Lubrication technology originally developed for a series of NASA satellites has produced a commercial product for protecting the sound fidelity of phonograph records. Called Sound Guard, the preservative is a spray-on fluid that deposits a microscopically thin protective coating which reduces friction and prevents the hard diamond stylus from wearing away the softer vinyl material of the disc. It is marketed by the Consumer Products Division of Ball Corporation, Muncie, Indiana. The lubricant technology on which Sound Guard is based originated with NASA's Orbiting Solar Observatory (OSO), an Earth-orbiting satellite designed and built by Ball Brothers Research Corporation, Boulder, Colorado, also a division of Ball Corporation. Ball Brothers engineers found a problem early in the OSO program: known lubricants were unsuitable for use on satellite moving parts that would be exposed to the vacuum of space for several months. So the company conducted research on the properties of materials needed for long life in space and developed new lubricants. They worked successfully on seven OSO flights and attracted considerable attention among other aerospace contractors. Ball Brothers now supplies its "Vac Kote" lubricants and coatings to both aerospace and non-aerospace industries and the company has produced several hundred variations of the original technology. Ball Corporation expanded its product line to include consumer products, of which Sound Guard is one of the most recent. In addition to protecting record grooves, Sound Guard's anti-static quality also retards particle accumulation on the stylus. During comparison study by a leading U.S. electronic laboratory, a record not treated by Sound Guard had to be cleaned after 50 plays and the stylus had collected a considerable number of small vinyl particles. The Sound Guard-treated disc was still clean after 100 plays, as was its stylus.

  11. Geophysical Sounding

    NASA Astrophysics Data System (ADS)

    Blake, E.

    1998-01-01

    Of the many geophysical remote-sensing techniques available today, a few are suitable for the water ice-rich, layered material expected at the north martian ice cap. Radio echo sounding has been used for several decades to determine ice thickness and internal structure. Selection of operating frequency is a tradeoff between signal attenuation (which typically increases with frequency and ice temperature) and resolution (which is proportional to wavelength). Antenna configuration and size will be additional considerations for a mission to Mars. Several configurations for ice-penetrating radar systems are discussed: these include orbiter-borne sounders, sounding antennas trailed by balloons and penetrators, and lander-borne systems. Lander-borne systems could include short-wave systems capable of resolving fine structure and layering in the upper meters beneath the lander. Spread-spectrum and deconvolution techniques can be used to increase the depth capability of a radar system. If soundings over several locations are available (e.g., with balloons, rovers, or panning short-wave systems), then it will be easier to resolve internal layering, variations in basal reflection coefficient (from which material properties may be inferred), and the geometry of nonhorizontal features. Sonic sounding has a long history in oil and gas exploration. It is, however, unlikely that large explosive charges, or even swept-frequency techniques such as Vibroseis, would be suitable for a Polar lander -- these systems are capable of penetrating several kilometers of material at frequencies of 10-200 Hz, but the energy required to generate the sound waves is large and potentially destructive. The use of audio-frequency and ultrasonic sound generated by piezoelectric crystals is discussed as a possible method to explore layering and fine features in the upper meters of the ice cap. Appropriate choice of transducer(s) will permit operation over a range of fixed or modulated frequencies

  12. Breath sounds

    MedlinePlus

    ... Over-inflation of a part of the lungs ( emphysema can cause this) Reduced airflow to part of ... bronchitis Asthma Bronchiectasis Chronic bronchitis Congestive heart failure Emphysema Interstitial lung disease Foreign body obstruction of the ...

  13. Sound Solutions

    ERIC Educational Resources Information Center

    Starkman, Neal

    2007-01-01

    Poor classroom acoustics are impairing students' hearing and their ability to learn. However, technology has come up with a solution: tools that focus voices in a way that minimizes intrusive ambient noise and gets to the intended receiver--not merely amplifying the sound, but also clarifying and directing it. One provider of classroom audio…

  14. Sound Solutions

    ERIC Educational Resources Information Center

    Starkman, Neal

    2007-01-01

    Poor classroom acoustics are impairing students' hearing and their ability to learn. However, technology has come up with a solution: tools that focus voices in a way that minimizes intrusive ambient noise and gets to the intended receiver--not merely amplifying the sound, but also clarifying and directing it. One provider of classroom audio…

  15. [Maternal phenylketonuria].

    PubMed

    Bókay, János; Kiss, Erika; Simon, Erika; Szőnyi, László

    2013-05-05

    Elevated maternal phenylalanine levels during pregnancy are teratogenic, and may result in embryo-foetopathy, which could lead to stillbirth, significant psychomotor handicaps and birth defects. This foetal damage is known as maternal phenylketonuria. Women of childbearing age with all forms of phenylketonuria, including mild variants such as hyperphenylalaninaemia, should receive detailed counselling regarding their risks for adverse foetal effects, optimally before contemplating pregnancy. The most assured way to prevent maternal phenylketonuria is to maintain the maternal phenylalanine levels within the optimal range already before conception and throughout the whole pregnancy. Authors review the comprehensive programme for prevention of maternal phenylketonuria at the Metabolic Center of Budapest, they survey the practical approach of the continuous maternal metabolic control and delineate the outcome of pregnancies of mothers with phenylketonuria from the introduction of newborn screening until most recently.

  16. PREFACE: Aerodynamic sound Aerodynamic sound

    NASA Astrophysics Data System (ADS)

    Akishita, Sadao

    2010-02-01

    The modern theory of aerodynamic sound originates from Lighthill's two papers in 1952 and 1954, as is well known. I have heard that Lighthill was motivated in writing the papers by the jet-noise emitted by the newly commercialized jet-engined airplanes at that time. The technology of aerodynamic sound is destined for environmental problems. Therefore the theory should always be applied to newly emerged public nuisances. This issue of Fluid Dynamics Research (FDR) reflects problems of environmental sound in present Japanese technology. The Japanese community studying aerodynamic sound has held an annual symposium since 29 years ago when the late Professor S Kotake and Professor S Kaji of Teikyo University organized the symposium. Most of the Japanese authors in this issue are members of the annual symposium. I should note the contribution of the two professors cited above in establishing the Japanese community of aerodynamic sound research. It is my pleasure to present the publication in this issue of ten papers discussed at the annual symposium. I would like to express many thanks to the Editorial Board of FDR for giving us the chance to contribute these papers. We have a review paper by T Suzuki on the study of jet noise, which continues to be important nowadays, and is expected to reform the theoretical model of generating mechanisms. Professor M S Howe and R S McGowan contribute an analytical paper, a valuable study in today's fluid dynamics research. They apply hydrodynamics to solve the compressible flow generated in the vocal cords of the human body. Experimental study continues to be the main methodology in aerodynamic sound, and it is expected to explore new horizons. H Fujita's study on the Aeolian tone provides a new viewpoint on major, longstanding sound problems. The paper by M Nishimura and T Goto on textile fabrics describes new technology for the effective reduction of bluff-body noise. The paper by T Sueki et al also reports new technology for the

  17. Physiological Reactivity to Infant Crying and Observed Maternal Sensitivity

    ERIC Educational Resources Information Center

    Joosen, Katharina J.; Mesman, Judi; Bakermans-Kranenburg, Marian J.; Pieper, Suzanne; Zeskind, Philip S.; van IJzendoorn, Marinus H.

    2013-01-01

    Relations between maternal sensitivity and physiological reactivity to infant crying were examined using measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) in 49 mothers of second-born infants. Using the Ainsworth Sensitivity Scale, an independent assessment of maternal sensitivity was made during maternal free play and bathing of…

  18. Healing sounds.

    PubMed

    Brewer, J F

    1998-02-01

    This article explores Guzzetta's (1988) notion that musical vibrations that are in tune with our human vibratory pattern could have a profound healing effect on the entire body. The question of why music therapy works for some and not others is addressed in the paper and solutions are offered. Central to utilizing therapeutic music and healing sounds with positive effects is an understanding of the principles and theories of sound and harmonics, in order to comprehend its capacity to achieve therapeutic, psychological and physical change. Some of these principles and theories are explored in this article. There is a focus on strategies for the holistic nurse who wishes to use this knowledge to facilitate communication and balance between the mind and body of the patient.

  19. Reversible ductus arteriosus constriction due to maternal indomethacin after fetal intervention for hypoplastic left heart syndrome with intact/restrictive atrial septum.

    PubMed

    Vogel, Melanie; Wilkins-Haug, Louise E; McElhinney, Doff B; Marshall, Audrey C; Benson, Carol B; Silva, Virginia; Tworetzky, Wayne

    2010-01-01

    Fetal cardiac intervention (FCI) has been performed at our center in selected fetuses with complex congenital heart disease since 2000. Most interventions are performed in fetuses with a ductus arteriosus (DA)-dependent circulation. Indomethacin promotes closure of the DA in newborns and in fetal life, a potentially life threatening complication in fetuses with ductus-dependent congenital heart disease. We reviewed our experience with FCI with a focus on the frequency, features, and clinical course of ductal constriction. Fetuses undergoing FCI receive comprehensive pre- and postoperative cardiac and cerebral ultrasound evaluation, approximately 24 hours before and after the procedure, including imaging of DA flow and Doppler assessment of the umbilical artery and vein, ductus venosus, and, since 2004, the middle cerebral artery. Among 113 fetuses that underwent FCI, 24 of which were older than 28 0/7 weeks gestation, 2 were found to have DA constriction due to indomethacin therapy within 24 hours of intervention. Both of these were 30-week fetuses with hypoplastic left heart syndrome and restrictive or intact atrial septum. The DA was stenotic by spectral and color Doppler, and middle cerebral and umbilical artery pulsatility indexes were depressed. After discontinuation of indomethacin, the Doppler indices improved or normalized. Close echocardiographic monitoring of fetal Doppler flow velocities is very important after fetal intervention and indomethacin treatment, as the consequences of DA constriction in a fetus with hypoplastic left heart syndrome are potentially lethal. Sonographic evaluation should include measurement of cerebral and umbilical arterial flow velocities as well as color and spectral Doppler interrogation of the DA. Copyright 2009 S. Karger AG, Basel.

  20. Comparison of Immune Profiles in Fetal Hearts with Idiopathic Dilated Cardiomyopathy, Maternal Autoimmune-Associated Dilated Cardiomyopathy and the Normal Fetus.

    PubMed

    Nield, Lynne E; von Both, Ingo; Popel, Najla; Strachan, Kate; Manlhiot, Cedric; Shannon, Patrick; McCrindle, Brian W; Atkinson, Adelle; Miner, Steven E S; Jaeggi, Edgar T; Taylor, Glenn P

    2016-02-01

    The etiology of idiopathic dilated cardiomyopathy (iDCM) remains unknown. Immune therapies have improved outcome in fetuses with DCM born to mothers with autoimmune disease (aDCM). The purpose of this retrospective study was to compare the myocardial B and T cell profiles in fetuses and neonates with idiopathic DCM (iDCM) versus autoimmune-mediated DCM (aDCM) and to describe the normal cell maturation within the human fetal myocardium. Of 60 fetal autopsy cases identified from institutional databases, 10 had aDCM (18-38 weeks), 12 iDCM (19-37 weeks) and 38 had normal hearts (11-40 weeks). Paraffin-embedded myocardium sections were stained for all lymphocyte (CD45), B cells (CD20, CD79a), T cells (CD3, CD4, CD7, CD8) and monocyte (CD68) surface markers. Two independent, blinded cell counts were performed. Normal hearts expressed all B and T cell markers in a bimodal fashion, with peaks at 22 and 37 weeks of gestation. The aDCM cohort was most distinct from normal hearts, with less overall T cell markers [EST -9.1 (2.6) cells/mm(2), p = 0.001], CD4 [EST -2.0 (0.6), p = 0.001], CD3 [EST -3.9 (1.0), p < 0.001], CD7 [EST -3.0 (1.1), p = 0.01] overall B cell markers [EST -4.9 (1.8), p = 0.01] and CD79a counts [EST -2.3 (0.9), p = 0.01]. The iDCM group had less overall B cell markers [EST -4.0 (1.8), p = 0.03] and CD79a [EST -1.7 (0.9), p = 0.05], but no difference in T cell markers. Autoimmune-mediated DCM fetuses have less B and T cell markers, whereas iDCM fetuses have less B cell markers compared with normal fetal hearts. The fetal immune system may play a role in the normal development of the heart and evolution of dilated cardiomyopathy.

  1. Maternal Immunization

    PubMed Central

    Chu, Helen Y.; Englund, Janet A.

    2014-01-01

    Maternal immunization has the potential to protect the pregnant woman, fetus, and infant from vaccine-preventable diseases. Maternal immunoglobulin G is actively transported across the placenta, providing passive immunity to the neonate and infant prior to the infant's ability to respond to vaccines. Currently inactivated influenza, tetanus toxoid, and acellular pertussis vaccines are recommended during pregnancy. Several other vaccines have been studied in pregnancy and found to be safe and immunogenic and to provide antibody to infants. These include pneumococcus, group B Streptococcus, Haemophilus influenzae type b, and meningococcus vaccines. Other vaccines in development for potential maternal immunization include respiratory syncytial virus, herpes simplex virus, and cytomegalovirus vaccines. PMID:24799324

  2. Heart Health - Brave Heart

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  3. Maternal psychological impact of fetal echocardiography.

    PubMed

    Sklansky, Mark; Tang, Alvin; Levy, Denis; Grossfeld, Paul; Kashani, Iraj; Shaughnessy, Robin; Rothman, Abraham

    2002-02-01

    The maternal psychological impact of fetal echocardiography may be deleterious in the face of newly diagnosed congenital heart disease. This questionnaire-based study prospectively examined the psychological impact of both normal and abnormal fetal echocardiography. Normal fetal echocardiography decreased maternal anxiety, increased happiness, and increased the closeness women felt toward their unborn children. In contrast, when fetal echocardiography detected congenital heart disease, maternal anxiety typically increased, and mothers commonly felt less happy about being pregnant. However, among women who had recently delivered infants with congenital heart disease, those who had had fetal echocardiography during the pregnancy felt less responsible for their infants' defects and tended to have improved their relationships with the infants' fathers after the prenatal diagnosis of congenital heart disease. Further study of the psychological and medical impact of fetal echocardiography will be necessary to define and optimize the clinical value of this powerful diagnostic tool.

  4. Maternal buprenorphine treatment and fetal neurobehavioral development.

    PubMed

    Jansson, Lauren M; Velez, Martha; McConnell, Krystle; Spencer, Nancy; Tuten, Michelle; Jones, Hendree E; King, Van L; Gandotra, Neeraj; Milio, Lorraine A; Voegtline, Kristin; DiPietro, Janet A

    2017-05-01

    Gestational opioid use/misuse is escalating in the United States; however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. Forty-nine buprenorphine-maintained women who attended a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels. Data were collected at 24, 28, 32, and 36 weeks gestation. Fetal neurobehavioral indicators (ie, heart rate, motor activity, and their integration [fetal movement-fetal heart rate coupling]) were collected via an actocardiograph, digitized and quantified. Longitudinal data analysis relied on hierarchic linear modeling. Fetal heart rate, heart rate variability, and heart rate accelerations were significantly reduced at peak vs trough maternal buprenorphine levels. Effects were significant either by or after 28 weeks gestation and tended to intensify with advancing gestation. Fetal motor activity and fetal movement-fetal heart rate coupling were depressed from peak to trough at 36 weeks gestation. Polysubstance exposure did not significantly affect fetal neurobehavioral parameters, with the exception that fetuses of heavier smokers moved significantly less than those of lighter smokers at 36 weeks gestation. By the end of gestation, higher maternal buprenorphine dose was related to depression of baseline fetal cardiac measures at trough. Maternal buprenorphine administration has acute suppressive effects on fetal heart rate and movement, and the magnitude of these effects increases as gestation progresses. Higher dose (≥13 mg) appears to exert greater depressive effects on measures of fetal heart rate and variability. These findings should be balanced against comparisons to gestational methadone effects

  5. Heart Failure

    MedlinePlus

    ... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump enough ... failure often experience tiredness and shortness of breath. Heart Failure is Serious Heart failure is a serious and ...

  6. Method of sound synthesis

    DOEpatents

    Miner, Nadine E.; Caudell, Thomas P.

    2004-06-08

    A sound synthesis method for modeling and synthesizing dynamic, parameterized sounds. The sound synthesis method yields perceptually convincing sounds and provides flexibility through model parameterization. By manipulating model parameters, a variety of related, but perceptually different sounds can be generated. The result is subtle changes in sounds, in addition to synthesis of a variety of sounds, all from a small set of models. The sound models can change dynamically according to changes in the simulation environment. The method is applicable to both stochastic (impulse-based) and non-stochastic (pitched) sounds.

  7. Heart MRI

    MedlinePlus

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  8. Wavelet Packet Entropy for Heart Murmurs Classification

    PubMed Central

    Safara, Fatemeh; Doraisamy, Shyamala; Azman, Azreen; Jantan, Azrul; Ranga, Sri

    2012-01-01

    Heart murmurs are the first signs of cardiac valve disorders. Several studies have been conducted in recent years to automatically differentiate normal heart sounds, from heart sounds with murmurs using various types of audio features. Entropy was successfully used as a feature to distinguish different heart sounds. In this paper, new entropy was introduced to analyze heart sounds and the feasibility of using this entropy in classification of five types of heart sounds and murmurs was shown. The entropy was previously introduced to analyze mammograms. Four common murmurs were considered including aortic regurgitation, mitral regurgitation, aortic stenosis, and mitral stenosis. Wavelet packet transform was employed for heart sound analysis, and the entropy was calculated for deriving feature vectors. Five types of classification were performed to evaluate the discriminatory power of the generated features. The best results were achieved by BayesNet with 96.94% accuracy. The promising results substantiate the effectiveness of the proposed wavelet packet entropy for heart sounds classification. PMID:23227043

  9. Calculating Speed of Sound

    NASA Astrophysics Data System (ADS)

    Bhatnagar, Shalabh

    2017-01-01

    Sound is an emerging source of renewable energy but it has some limitations. The main limitation is, the amount of energy that can be extracted from sound is very less and that is because of the velocity of the sound. The velocity of sound changes as per medium. If we could increase the velocity of the sound in a medium we would be probably able to extract more amount of energy from sound and will be able to transfer it at a higher rate. To increase the velocity of sound we should know the speed of sound. If we go by the theory of classic mechanics speed is the distance travelled by a particle divided by time whereas velocity is the displacement of particle divided by time. The speed of sound in dry air at 20 °C (68 °F) is considered to be 343.2 meters per second and it won't be wrong in saying that 342.2 meters is the velocity of sound not the speed as it's the displacement of the sound not the total distance sound wave covered. Sound travels in the form of mechanical wave, so while calculating the speed of sound the whole path of wave should be considered not just the distance traveled by sound. In this paper I would like to focus on calculating the actual speed of sound wave which can help us to extract more energy and make sound travel with faster velocity.

  10. Sounds Exaggerate Visual Shape

    ERIC Educational Resources Information Center

    Sweeny, Timothy D.; Guzman-Martinez, Emmanuel; Ortega, Laura; Grabowecky, Marcia; Suzuki, Satoru

    2012-01-01

    While perceiving speech, people see mouth shapes that are systematically associated with sounds. In particular, a vertically stretched mouth produces a /woo/ sound, whereas a horizontally stretched mouth produces a /wee/ sound. We demonstrate that hearing these speech sounds alters how we see aspect ratio, a basic visual feature that contributes…

  11. The Sound of Science

    ERIC Educational Resources Information Center

    Merwade, Venkatesh; Eichinger, David; Harriger, Bradley; Doherty, Erin; Habben, Ryan

    2014-01-01

    While the science of sound can be taught by explaining the concept of sound waves and vibrations, the authors of this article focused their efforts on creating a more engaging way to teach the science of sound--through engineering design. In this article they share the experience of teaching sound to third graders through an engineering challenge…

  12. Sound Insulation in Buildings

    NASA Astrophysics Data System (ADS)

    Gösele, K.; Schröder, E.

    Sound insulation between the different rooms inside a building or to the outside is a very complex problem. First, the airborne sound insulation of ceilings, walls, doors and windows is important. Second, a sufficient structure-borne sound insulation, also called impact sound insulation, for the ceilings, has to be provided especially. Finally, the service equipment should be sufficiently quiet.

  13. Sounds Exaggerate Visual Shape

    ERIC Educational Resources Information Center

    Sweeny, Timothy D.; Guzman-Martinez, Emmanuel; Ortega, Laura; Grabowecky, Marcia; Suzuki, Satoru

    2012-01-01

    While perceiving speech, people see mouth shapes that are systematically associated with sounds. In particular, a vertically stretched mouth produces a /woo/ sound, whereas a horizontally stretched mouth produces a /wee/ sound. We demonstrate that hearing these speech sounds alters how we see aspect ratio, a basic visual feature that contributes…

  14. The Sound of Science

    ERIC Educational Resources Information Center

    Merwade, Venkatesh; Eichinger, David; Harriger, Bradley; Doherty, Erin; Habben, Ryan

    2014-01-01

    While the science of sound can be taught by explaining the concept of sound waves and vibrations, the authors of this article focused their efforts on creating a more engaging way to teach the science of sound--through engineering design. In this article they share the experience of teaching sound to third graders through an engineering challenge…

  15. Making Sound Connections

    ERIC Educational Resources Information Center

    Deal, Walter F., III

    2007-01-01

    Sound provides and offers amazing insights into the world. Sound waves may be defined as mechanical energy that moves through air or other medium as a longitudinal wave and consists of pressure fluctuations. Humans and animals alike use sound as a means of communication and a tool for survival. Mammals, such as bats, use ultrasonic sound waves to…

  16. Making Sound Connections

    ERIC Educational Resources Information Center

    Deal, Walter F., III

    2007-01-01

    Sound provides and offers amazing insights into the world. Sound waves may be defined as mechanical energy that moves through air or other medium as a longitudinal wave and consists of pressure fluctuations. Humans and animals alike use sound as a means of communication and a tool for survival. Mammals, such as bats, use ultrasonic sound waves to…

  17. Non-invasive diagnosis methods of coronary disease based on wavelet denoising and sound analyzing.

    PubMed

    Chen, Tianhua; Zhao, Shuo; Shao, Siqi; Zheng, Siqun

    2017-03-01

    The heart sound is the characteristic signal of cardiovascular health status. The objective of this project is to explore the correlation between Wavelet Transform and noise performance of heart sound and the adaptability of classifying heart sound using bispectrum estimation. Since the wavelet has multi-scale and multi-resolution characteristics, in this paper, the heart sound signal with different frequency ranges is decomposed through wavelet and displayed on different scales of the resolving wavelet result. According to distribution features of frequency of heart sound signals, the interference components in heart sound signal can be eliminated by selecting reconstruction coefficients. Comparing de-noising effects of four wavelets which are haar, db6, sym8 and coif6, the db6 wavelet has achieved an optimal denoising effect to heart sound signals. The de-noising result of contrasting different layers in the db6 wavelet shows that decomposing with five layers in db6 provide the optimal performance. In practice, the db6 wavelet also shows commendable denoising effects when applying to 51 clinical heart signals. Furthermore, through the clinic analyses of 29 normal signals from healthy people and 22 abnormal heart signals from coronary heart disease patients, this method can fairly distinguish abnormal signals from normal signals by applying bispectrum estimation to denoised signals via ARMA coefficients model.

  18. Evaluation and Management of Maternal Cardiac Arrhythmias.

    PubMed

    Metz, Torri D; Khanna, Amber

    2016-12-01

    Pregnant women often complain of palpitations. The differential diagnosis for new-onset palpitations in pregnancy ranges from benign conditions to life-threatening arrhythmias. Maternal arrhythmias can occur in isolation or in the setting of underlying structural heart disease. Optimal management of maternal cardiac arrhythmias includes identification of the specific arrhythmia, diagnosis of comorbid conditions, and appropriate intervention. In general, management of maternal cardiac arrhythmias is similar to that of the general population. Special consideration must be given as to the effects of medications and procedures on both the mother and fetus to optimize outcomes. The importance of multidisciplinary care with cardiology, obstetrics, and anesthesia is emphasized.

  19. On Categorizing Sounds

    DTIC Science & Technology

    1991-08-07

    PAasmum 200vwimW Context is important when people judge sounds , or attributes of sounds , or other stimuli. It is shown how judgments depend on what... sounds recently occurred (sequence effects), on how those sounds differ from one another (range effects), on the dis- tribution of those differences (set...results are consistent with a model havin two simple assumptions: Successive sounds (not just their attributes) assimilate toward one another in memory

  20. Use of Maternal Early Warning Trigger tool reduces maternal morbidity.

    PubMed

    Shields, Laurence E; Wiesner, Suzanne; Klein, Catherine; Pelletreau, Barbara; Hedriana, Herman L

    2016-04-01

    Maternal mortality in the United States has increased unabated for the past 20 years. Maternal morbidity is also affecting an increasingly large number of women in the United States. A number of national and state organizations have recommend the use of maternal early warning tools as a method to combat this problem. There are limited data suggesting that the use of these types of clinical assessment tools can reduce maternal morbidity. We sought to determine if maternal morbidity could be reduced with the implementation of a clinical pathway-specific Maternal Early Warning Trigger (MEWT) tool. The tool was developed internally and prospectively implemented as a pilot project in 6 of 29 hospitals within a large hospital system. The primary goal was early assessment and treatment of patients suspected of clinical deterioration. The tool addressed the 4 most common areas of maternal morbidity: sepsis, cardiopulmonary dysfunction, preeclampsia-hypertension, and hemorrhage. To be considered positive, triggers needed to be sustained for >20 minutes and were defined as severe (single abnormal value): maternal heart rate (HR) >130 beats/min (bpm), respiratory rate >30/min, mean arterial pressure <55 mm Hg, oxygen saturation <90%, or nurse concern; or nonsevere (required 2 abnormal values): temperature >38 or <36°C, blood pressure >160/110 or <85/45 mm Hg, HR >110 or <50 bpm, respiratory rate >24 or <10/min, oxygen saturation <93%, fetal HR >160 bpm, altered mental status, or disproportionate pain. Within each group, recommended management or assessment was also provided. Outcome measures were Centers for Disease Control and Prevention (CDC)-defined severe maternal morbidity, composite maternal morbidity, and intensive care unit (ICU) admissions. Two time intervals were used to analyze the effect of the MEWT tool: a 24-month baseline control period and a 13-month MEWT study period. To determine that the findings noted were not simply changes that would have occurred

  1. Design and evaluation of a parametric model for cardiac sounds.

    PubMed

    Ibarra-Hernández, Roilhi F; Alonso-Arévalo, Miguel A; Cruz-Gutiérrez, Alejandro; Licona-Chávez, Ana L; Villarreal-Reyes, Salvador

    2017-08-09

    Heart sound analysis plays an important role in the auscultative diagnosis process to detect the presence of cardiovascular diseases. In this paper we propose a novel parametric heart sound model that accurately represents normal and pathological cardiac audio signals, also known as phonocardiograms (PCG). The proposed model considers that the PCG signal is formed by the sum of two parts: one of them is deterministic and the other one is stochastic. The first part contains most of the acoustic energy. This part is modeled by the Matching Pursuit (MP) algorithm, which performs an analysis-synthesis procedure to represent the PCG signal as a linear combination of elementary waveforms. The second part, also called residual, is obtained after subtracting the deterministic signal from the original heart sound recording and can be accurately represented as an autoregressive process using the Linear Predictive Coding (LPC) technique. We evaluate the proposed heart sound model by performing subjective and objective tests using signals corresponding to different pathological cardiac sounds. The results of the objective evaluation show an average Percentage of Root-Mean-Square Difference of approximately 5% between the original heart sound and the reconstructed signal. For the subjective test we conducted a formal methodology for perceptual evaluation of audio quality with the assistance of medical experts. Statistical results of the subjective evaluation show that our model provides a highly accurate approximation of real heart sound signals. We are not aware of any previous heart sound model rigorously evaluated as our proposal. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Heart Disease

    MedlinePlus

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  3. Early sound symbolism for vowel sounds.

    PubMed

    Spector, Ferrinne; Maurer, Daphne

    2013-01-01

    Children and adults consistently match some words (e.g., kiki) to jagged shapes and other words (e.g., bouba) to rounded shapes, providing evidence for non-arbitrary sound-shape mapping. In this study, we investigated the influence of vowels on sound-shape matching in toddlers, using four contrasting pairs of nonsense words differing in vowel sound (/i/ as in feet vs. /o/ as in boat) and four rounded-jagged shape pairs. Crucially, we used reduplicated syllables (e.g., kiki vs. koko) rather than confounding vowel sound with consonant context and syllable variability (e.g., kiki vs. bouba). Toddlers consistently matched words with /o/ to rounded shapes and words with /i/ to jagged shapes (p < 0.01). The results suggest that there may be naturally biased correspondences between vowel sound and shape.

  4. Passive Fetal Heart Monitoring System

    NASA Technical Reports Server (NTRS)

    Zuckerwar, Allan J. (Inventor); Mowrey, Dennis L. (Inventor)

    2003-01-01

    A fetal heart monitoring system and method for detecting and processing acoustic fetal heart signals transmitted by different signal transmission modes. One signal transmission mode, the direct contact mode, occurs in a first frequency band when the fetus is in direct contact with the maternal abdominal wall. Another signal transmission mode, the fluid propagation mode, occurs in a second frequency band when the fetus is in a recessed position with no direct contact with the maternal abdominal wall. The second frequency band is relatively higher than the first frequency band. The fetal heart monitoring system and method detect and process acoustic fetal heart signals that are in the first frequency band and in the second frequency band.

  5. Molecular cytogenetic characterization of Xp22.32→pter deletion and Xq26.3→qter duplication in a male fetus associated with 46,Y,rec(X)dup(Xq) inv(X)(p22.3q26.3), a hypoplastic left heart, short stature, and maternal X chromosome pericentric inversion.

    PubMed

    Chen, Chih-Ping; Chen, Chen-Yu; Chern, Schu-Rern; Wu, Peih-Shan; Chen, Yen-Ni; Chen, Shin-Wen; Lee, Chen-Chi; Town, Dai-Dyi; Lee, Meng-Shan; Yang, Chien-Wen; Wang, Wayseen

    2016-10-01

    We present molecular cytogenetic characterization of an Xp22.32→pter deletion and an Xq26.3→qter duplication in a male fetus with congenital malformations and maternal X chromosome pericentric inversion. A 22-year-old woman underwent amniocentesis at 17 weeks of gestation because of an abnormal maternal serum screening result. Prenatal ultrasound revealed a hypoplastic left heart and short limbs. Amniocentesis revealed a karyotype of 46,Y,der(X) t(X;?)(p22.31;?). The pregnancy was subsequently terminated, and a malformed fetus was delivered with short stature and facial dysmorphism. Repeat amniocentesis was performed before termination of the pregnancy. Array comparative genomic hybridization was performed on uncultured amniocytes and maternal blood. Conventional cytogenetic analysis was performed on cultured amniocytes, cord blood, and blood from both parents. Fluorescence in situ hybridization was performed on cultured amniocytes. The maternal karyotype was 46,X,inv(X)(p22.3q26.3). The fetal karyotype was 46,Y, rec(X)dup(Xq)inv(X)(p22.3q26.3) or 46,Y, rec(X)(qter→q26.3::p22.3→qter). Array comparative genomic hybridization on uncultured amniocytes revealed a 4.56-Mb deletion of Xp22.33-p22.32 encompassing SHOX, CSF2RA, and ARSE, and a 19.22-Mb duplication of Xq26.3-q28 encompassing SOX3, FMR1, MECP2, RAB39B, and CLIC2 in the fetus. The mother did not have X chromosome imbalance. Detection of X chromosome aberration in a male fetus should give suspicion of a recombinant X chromosome derived from maternal X chromosome pericentric inversion. Copyright © 2016. Published by Elsevier B.V.

  6. Sound wave transmission (image)

    MedlinePlus

    When sounds waves reach the ear, they are translated into nerve impulses. These impulses then travel to the brain where they are interpreted by the brain as sound. The hearing mechanisms within the inner ear, can ...

  7. Enlarge Your Sound Repertory

    ERIC Educational Resources Information Center

    Carle, Irmgard Lehrer; Martin, Isaiah

    1975-01-01

    Authors served up a variety of techniques for investigating sound sources and sound patterns. Have you considered creating a composition from breathing sounds? Or constructing a conversation in percussion? These ideas are included along with step-by-step directions for making nine percussion instruments. (Editor)

  8. Maternal cardiovascular adaptations to twin pregnancy.

    PubMed

    Veille, J C; Morton, M J; Burry, K J

    1985-10-01

    Multiple pregnancy places increased demands on the maternal circulation. Maternal left ventricular size and performance were measured with M-mode echocardiography in women with twin pregnancy in the second and third trimesters, and the findings were compared to those in normal singleton pregnancies. As expected, cardiac output was greater during twin than during singleton pregnancy; however, end-diastolic ventricular dimension was not. Output was increased in twin pregnancy during the second and third trimesters by heart rate and also during the third trimester by stroke volume. Increased stroke volume was effected by increased shortening, thus strongly suggesting increased contractility. Increased maternal heart rate and contractility during multiple gestations suggest that cardiovascular reserve is reduced.

  9. Sound of sonoluminescence

    NASA Astrophysics Data System (ADS)

    Elze, H.-Thomas; Kodama, Takeshi; Rafelski, Johann

    1998-04-01

    We consider an air bubble in water under conditions of single-bubble sonoluminescence (SBSL) and evaluate the emitted sound field nonperturbatively for subsonic gas-liquid interface motion. Sound emission being the dominant damping mechanism, we also implement the nonperturbative sound damping in the Rayleigh-Plesset equation for the interface motion. We evaluate numerically the sound pulse emitted during bubble collapse and compare the nonperturbative and perturbative results, showing that the usual perturbative description leads to an overestimate of the maximal surface velocity and maximal sound pressure. The radius vs time relation for a full SBSL cycle remains deceptively unaffected.

  10. Near-term fetal response to maternal spoken voice

    PubMed Central

    Voegtline, Kristin M.; Costigan, Kathleen A.; Pater, Heather A.; DiPietro, Janet A.

    2013-01-01

    Knowledge about prenatal learning has been largely predicated on the observation that newborns appear to recognize the maternal voice. Few studies have examined the process underlying this phenomenon; that is, whether and how the fetus responds to maternal voice in situ. Fetal heart rate and motor activity were recorded at 36 weeks gestation (n = 69) while pregnant women read aloud from a neutral passage. Compared to a baseline period, fetuses responded with a decrease in motor activity in the 10-seconds following onset of maternal speech and a trend level decelerative heart rate response, consistent with an orienting response. Subsequent analyses revealed that the fetal response was modified by both maternal and fetal factors. Fetuses of women who were previously awake and talking (n = 40) showed an orienting response to onset of maternal reading aloud, while fetuses of mothers who had previously been resting and silent (n = 29) responded with elevated heart rate and increased movement. The magnitude of the fetal response was further dependent on baseline fetal heart rate variability such that largest response was demonstrated by fetuses with low variability of mothers who were previously resting and silent. Results indicate that fetal responsivity is affected by both maternal and fetal state and have implications for understanding fetal learning of the maternal voice under naturalistic conditions. PMID:23748167

  11. Priming Gestures with Sounds

    PubMed Central

    Lemaitre, Guillaume; Heller, Laurie M.; Navolio, Nicole; Zúñiga-Peñaranda, Nicolas

    2015-01-01

    We report a series of experiments about a little-studied type of compatibility effect between a stimulus and a response: the priming of manual gestures via sounds associated with these gestures. The goal was to investigate the plasticity of the gesture-sound associations mediating this type of priming. Five experiments used a primed choice-reaction task. Participants were cued by a stimulus to perform response gestures that produced response sounds; those sounds were also used as primes before the response cues. We compared arbitrary associations between gestures and sounds (key lifts and pure tones) created during the experiment (i.e. no pre-existing knowledge) with ecological associations corresponding to the structure of the world (tapping gestures and sounds, scraping gestures and sounds) learned through the entire life of the participant (thus existing prior to the experiment). Two results were found. First, the priming effect exists for ecological as well as arbitrary associations between gestures and sounds. Second, the priming effect is greatly reduced for ecologically existing associations and is eliminated for arbitrary associations when the response gesture stops producing the associated sounds. These results provide evidence that auditory-motor priming is mainly created by rapid learning of the association between sounds and the gestures that produce them. Auditory-motor priming is therefore mediated by short-term associations between gestures and sounds that can be readily reconfigured regardless of prior knowledge. PMID:26544884

  12. Exposure to maternal voice in preterm infants: a review.

    PubMed

    Krueger, Charlene

    2010-02-01

    The mother's voice, along with other developmentally appropriate sensory events (ie, touch, light, smells), stimulates maturation of the sensory systems and helps shape normal fetal development. While vast changes in the neonatal intensive care unit have occurred over the last 2 decades, little research has addressed the loss of exposure to maternal voice for the preterm infant. To address this gap, we compared studies that directly investigated effects of exposure to maternal voice on preterm infants. Studies reviewed were conducted between 1972 and 2007. All presented recordings of maternal voice at sound levels above current recommendations, and few of the findings reached statistical significance. Some potentially positive developmental effects were indicated. Future study of the effects of exposure to maternal voice on preterm infants using recommended sound levels is needed.

  13. Fetal responses to induced maternal relaxation during pregnancy

    PubMed Central

    DiPietro, Janet A.; Costigan, Kathleen A.; Nelson, Priscilla; Gurewitsch, Edith D.; Laudenslager, Mark L.

    2008-01-01

    Fetal responses to induced maternal relaxation during the 32nd week of pregnancy were recorded in 100 maternal-fetal pairs using a digitized data collection system. The 18-minute guided imagery relaxation manipulation generated significant changes in maternal heart rate, skin conductance, respiration period, and respiratory sinus arrhythmia. Significant alterations in fetal neurobehavior were observed, including decreased fetal heart rate (FHR), increased FHR variability, suppression of fetal motor activity (FM), and increased FM-FHR coupling. Attribution of the two fetal cardiac responses to the guided imagery procedure itself, as opposed to simple rest or recumbency, is tempered by the observed pattern of response. Evaluation of correspondence between changes within individual maternal-fetal pairs revealed significant associations between maternal autonomic measures and fetal cardiac patterns, lower umbilical and uterine artery resistance and increased FHR variability, and declining salivary cortisol and FM activity. Potential mechanisms that may mediate the observed results are discussed. PMID:17919804

  14. Heart Failure

    MedlinePlus

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  15. Heart Attack Recovery FAQs

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  16. About Heart Attacks

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  17. Menopause and Heart Disease

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  18. Development of heart rate responses to acoustic stimuli in Muscovy duck embryos.

    PubMed

    Höchel, Joachim; Pirow, Ralph; Nichelmann, Martin

    2002-04-01

    Heart rate (HR) of Muscovy duck embryos (Cairina moschata f. domestica) was continuously recorded from the 21st day of incubation (E21) until hatching (E35). During that period, embryos were exposed to different acoustic stimuli (species-specific maternal and duckling calls, music, rectangular and sine waves, white noise). Sudden HR changes occurred at the onset of acoustic stimulation (on-response), as well as spontaneously. From E27 onwards, the response rate was significantly higher than the rate of spontaneous HR changes. The on-response rate increased further until E30. Most responses were elicited by maternal calls and music, but rarely by duckling calls. On-responses could be classified into: HR increase (36.4%), HR decrease (37.9%) and an increase in instantaneous HR variability (23.2%). The increase in HR variability occurred only in response to sounds, but not spontaneously. HR increases were mainly observed when the baseline HR was lower than the long-term HR trend. On-response duration was no longer than 3 min in 90% of all observations. The hourly mean HR and standard deviation did not change, even during phonoperiods composed of several sound patterns and lasting several hours. We conclude that Muscovy duck embryos are able to perceive exogenous acoustic stimuli, and that the acousto-sensory-->cardiac axis is functional from E27.

  19. Maternal infanticides in Fiji.

    PubMed

    Adinkrah, M

    2000-12-01

    This essay contributes to the cross-cultural literature on childhood homicides by examining 16 infanticidal homicides that occurred in Fiji over an 11-year period. The results are compared with infanticide studies conducted in other societies. Official police data recorded in a Homicide and Manslaughter register are analyzed. These are supplemented by newspaper reports of infanticides and semi-structured interviews conducted with key criminal justice and medical personnel intimately associated with infanticide cases. The findings show that most infanticide defendants were young, poor, Fijian, with little formal education, living with nonparental kin at the time of the crime. The infanticides were precipitated by unwanted pregnancies brought on by nonmarital and extramarital sex. Pregnancy is carried to full gestation without knowledge of family, friends and neighbors of offenders and the infant is killed immediately following birth. The current findings demonstrate that the patterns of maternal infant killings in Fiji are congruous in many significant ways with those in advanced industrialized societies. It is concluded that additional research in non-Western, nonindustrialized nations is imperative to contribute to the development of sound conclusions about, and remedies for infanticide.

  20. Heart attack

    MedlinePlus

    ... infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack ... made up of cholesterol and other cells. A heart attack may occur when: A tear in the ...

  1. The sound of distance.

    PubMed

    Rabaglia, Cristina D; Maglio, Sam J; Krehm, Madelaine; Seok, Jin H; Trope, Yaacov

    2016-07-01

    Human languages may be more than completely arbitrary symbolic systems. A growing literature supports sound symbolism, or the existence of consistent, intuitive relationships between speech sounds and specific concepts. Prior work establishes that these sound-to-meaning mappings can shape language-related judgments and decisions, but do their effects generalize beyond merely the linguistic and truly color how we navigate our environment? We examine this possibility, relating a predominant sound symbolic distinction (vowel frontness) to a novel associate (spatial proximity) in five studies. We show that changing one vowel in a label can influence estimations of distance, impacting judgment, perception, and action. The results (1) provide the first experimental support for a relationship between vowels and spatial distance and (2) demonstrate that sound-to-meaning mappings have outcomes that extend beyond just language and can - through a single sound - influence how we perceive and behave toward objects in the world. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Sound Power Determination Using Sound Intensity Measurements: Applications and Extensions

    NASA Astrophysics Data System (ADS)

    Yang, Shaobo

    1995-01-01

    The determination of sound power using sound intensity measurements is one of the most important developments in acoustics since the advent of digital signal processing techniques and FFT (fast Fourier transform) techniques in 1970's. Sound power determination using sound intensity measurements is the only way to precisely determine the sound power of noise sources in operating conditions when other noise sources are operating simultaneously. Sound power determination from sound intensity measurements largely obviates the need for special purpose test facilities, such as an anechoic room or a reverberation room. The determination of sound power from sound intensity measurements has many distinct advantages over the traditional determination of the sound power from sound pressure, and it will soon become the dominant method in the determination of the sound power of noise sources in-situ. Sound intensity measurements have been successfully applied to the determination of the sound power levels of noise sources in laboratory conditions, and of small machinery noise sources. The full scale application of this new technique to industrial machinery noise sources is certainly of importance for practical purposes. This dissertation mainly describes progress made in research on the application of sound intensity measurements for the determination of the sound power of noise sources. Results concerning the sound power determination from sound intensity measurements in the following areas are discussed: sound power determination from sound intensity measurements at low frequency, error analysis of sound intensity estimates at low frequency, and sound power determination from sound intensity measurements in the presence of air flow, sound power determination from sound intensity measurements in the presence of strong background noise and some practical considerations on the application of the sound intensity technique to in-situ sound power determination.

  3. Frequency shifting approach towards textual transcription of heartbeat sounds.

    PubMed

    Arvin, Farshad; Doraisamy, Shyamala; Safar Khorasani, Ehsan

    2011-10-04

    Auscultation is an approach for diagnosing many cardiovascular problems. Automatic analysis of heartbeat sounds and extraction of its audio features can assist physicians towards diagnosing diseases. Textual transcription allows recording a continuous heart sound stream using a text format which can be stored in very small memory in comparison with other audio formats. In addition, a text-based data allows applying indexing and searching techniques to access to the critical events. Hence, the transcribed heartbeat sounds provides useful information to monitor the behavior of a patient for the long duration of time. This paper proposes a frequency shifting method in order to improve the performance of the transcription. The main objective of this study is to transfer the heartbeat sounds to the music domain. The proposed technique is tested with 100 samples which were recorded from different heart diseases categories. The observed results show that, the proposed shifting method significantly improves the performance of the transcription.

  4. Maternal cardiac arrest: a practical and comprehensive review.

    PubMed

    Jeejeebhoy, Farida M; Morrison, Laurie J

    2013-01-01

    Cardiac arrest during pregnancy is a dedicated chapter in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; however, a robust maternal cardiac arrest knowledge translation strategy and emergency response plan is not usually the focus of institutional emergency preparedness programs. Although maternal cardiac arrest is rare, the emergency department is a high-risk area for receiving pregnant women in either prearrest or full cardiac arrest. It is imperative that institutions review and update emergency response plans for a maternal arrest. This review highlights the most recent science, guidelines, and recommended implementation strategies related to a maternal arrest. The aim of this paper is to increase the understanding of the important physiological differences of, and management strategies for, a maternal cardiac arrest, as well as provide institutions with the most up-to-date literature on which they can build emergency preparedness programs for a maternal arrest.

  5. Location matters: left heart obstruction in pregnancy.

    PubMed

    Fuchs, Margaret; Zaidi, Ali N; Rose, Justin; Sisk, Tracey; Daniels, Curt J; Bradley, Elisa A

    2016-01-01

    Left heart obstruction in pregnancy is associated with higher rates of morbidity/mortality. The primary aim of this study was to evaluate maternal cardiovascular, obstetric, and fetal/infant events in pregnant women with left heart obstruction. Pregnant women with current or repaired left heart obstruction were retrospectively analyzed (2000-2014): mitral stenosis, left ventricular outflow tract obstruction (subvalvar, valvar, supravalvar), and coarctation of the aorta. Maternal cardiovascular events were defined as: heart failure, arrhythmia, urgent/emergent cardiac surgery or percutaneous transcatheter intervention, transient ischemic attack/cerebrovascular accident, and death up to 6 months postpartum. There were 90 pregnancies in 67 women (29±7 years old) who had 15 maternal cardiovascular events. Isolated mitral stenosis (n=6) or >1 serial left heart obstructive lesion (n=6) were the source of the event in the majority pregnancies. Women with isolated mitral stenosis had increased cardiovascular events compared to other single left heart obstructive lesions (OR 18.6, 95% CI: 3.8-91.1). If >1 serial obstructive lesion was present, there was also an increased risk of maternal cardiovascular events (OR 6.8, 95% CI: 1.6-29.1), however isolated mitral stenosis carried similar risk to serial left heart obstructive lesions (OR 2.7, 95% CI: 0.7-11.2). Baseline characteristics associated with events included: New York Heart Association functional class >2 (27% vs. 0, p<0.001), any current left heart obstruction (73% vs. 36%, p=0.01), severe left heart obstruction (40% vs. 29%, p<0.001), and higher Cardiac Disease in Pregnancy ("CARPREG") score (1.2±0.7 vs. 0.5±0.7, p=0.01). There was no difference in rate of obstetric/fetal/infant complications in women with cardiovascular events; however, term birth weight was lower (2.7±0.5 vs. 3.1±0.6kg, p=0.01). There was no maternal mortality. Isolated mitral stenosis and serial (>1) left heart obstructive lesions carry the

  6. Early sound symbolism for vowel sounds

    PubMed Central

    Spector, Ferrinne; Maurer, Daphne

    2013-01-01

    Children and adults consistently match some words (e.g., kiki) to jagged shapes and other words (e.g., bouba) to rounded shapes, providing evidence for non-arbitrary sound–shape mapping. In this study, we investigated the influence of vowels on sound–shape matching in toddlers, using four contrasting pairs of nonsense words differing in vowel sound (/i/ as in feet vs. /o/ as in boat) and four rounded–jagged shape pairs. Crucially, we used reduplicated syllables (e.g., kiki vs. koko) rather than confounding vowel sound with consonant context and syllable variability (e.g., kiki vs. bouba). Toddlers consistently matched words with /o/ to rounded shapes and words with /i/ to jagged shapes (p < 0.01). The results suggest that there may be naturally biased correspondences between vowel sound and shape. PMID:24349684

  7. Breaking the Sound Barrier

    ERIC Educational Resources Information Center

    Brown, Tom; Boehringer, Kim

    2007-01-01

    Students in a fourth-grade class participated in a series of dynamic sound learning centers followed by a dramatic capstone event--an exploration of the amazing Trashcan Whoosh Waves. It's a notoriously difficult subject to teach, but this hands-on, exploratory approach ignited student interest in sound, promoted language acquisition, and built…

  8. School Sound Level Study.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    California has conducted on-site sound surveys of 36 different schools to determine the degree of noise, and thus disturbance, within the learning environment. This report provides the methodology and results of the survey, including descriptive charts and graphs illustrating typical desirable and undesirable sound levels. Results are presented…

  9. Categorization of Sounds

    ERIC Educational Resources Information Center

    Smits, Roel; Sereno, Joan; Jongman, Allard

    2006-01-01

    The authors conducted 4 experiments to test the decision-bound, prototype, and distribution theories for the categorization of sounds. They used as stimuli sounds varying in either resonance frequency or duration. They created different experimental conditions by varying the variance and overlap of 2 stimulus distributions used in a training phase…

  10. Exploring Noise: Sound Pollution.

    ERIC Educational Resources Information Center

    Rillo, Thomas J.

    1979-01-01

    Part one of a three-part series about noise pollution and its effects on humans. This section presents the background information for teachers who are preparing a unit on sound. The next issues will offer learning activities for measuring the effects of sound and some references. (SA)

  11. The sounds of nanotechnology

    NASA Astrophysics Data System (ADS)

    Campbell, Norah; Deane, Cormac; Murphy, Padraig

    2017-07-01

    Public perceptions of nanotechnology are shaped by sound in surprising ways. Our analysis of the audiovisual techniques employed by nanotechnology stakeholders shows that well-chosen sounds can help to win public trust, create value and convey the weird reality of objects on the nanoscale.

  12. Categorization of Sounds

    ERIC Educational Resources Information Center

    Smits, Roel; Sereno, Joan; Jongman, Allard

    2006-01-01

    The authors conducted 4 experiments to test the decision-bound, prototype, and distribution theories for the categorization of sounds. They used as stimuli sounds varying in either resonance frequency or duration. They created different experimental conditions by varying the variance and overlap of 2 stimulus distributions used in a training phase…

  13. Operational sounding algorithms

    NASA Technical Reports Server (NTRS)

    Smith, W. L.

    1980-01-01

    The analytical equations used to interpret TIROS-N sounding radiances for operational applications are presented. Both the National Environmental Satellite System (NESS) Global Operational Synoptic Scale and the NESS/University of Wisconsin (UW) North American Mesoscale Sounding Production Systems are considered.

  14. Inferring Agency from Sound

    ERIC Educational Resources Information Center

    Knoblich, Gunther; Repp, Bruno H.

    2009-01-01

    In three experiments we investigated how people determine whether or not they are in control of sounds they hear. The sounds were either triggered by participants' taps or controlled by a computer. The task was to distinguish between self-control and external control during active tapping, and during passive listening to a playback of the sounds…

  15. The Bosstown Sound.

    ERIC Educational Resources Information Center

    Burns, Gary

    Based on the argument that (contrary to critical opinion) the musicians in the various bands associated with Bosstown Sound were indeed talented, cohesive individuals and that the bands' lack of renown was partially a result of ill-treatment by record companies and the press, this paper traces the development of the Bosstown Sound from its…

  16. Heart Diseases

    MedlinePlus

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

  17. Heart Transplantation

    MedlinePlus

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  18. Effect of maternal fasting on ovine fetal and maternal branched-chain amino acid transaminase activities.

    PubMed

    Liechty, E A; Barone, S; Nutt, M

    1987-01-01

    Activities of branched-chain amino acid transaminase were assayed in maternal skeletal muscle, liver and fetal skeletal muscle, cardiac muscle, liver, kidney and placenta obtained from fed and 5-day-fasted late gestation ewes. Very high activities were found in placenta; fetal skeletal muscle also had high activity. Fetal brain had intermediate activity, followed by cardiac muscle and kidney. Fetal liver possessed negligible activity. Activities were low in both maternal liver and skeletal muscle. Trends were seen for fasting to increase activities in fetal placenta, skeletal muscle, brain, kidney, heart and maternal liver, but these changes were statistically significant only for fetal brain and placental tissue. Fetal skeletal muscle activity was 100 times that of maternal skeletal muscle. These data imply differences in the metabolism of the branched-chain amino acids by fetal and adult ruminants and expand the thesis that branched-chain amino acids are important to the metabolism of the ovine fetus.

  19. [Acquired and congenital heart diseases during pregancy].

    PubMed

    De Feo, Stefania; Iacovoni, Attilio; Faggiano, Pompilio

    2012-05-01

    Heart diseases are the leading cause of maternal morbidity and mortality. The number of patients with congenital heart diseases reaching childbearing age, as well as the proportion of women with acquired conditions, such as ischemic heart disease, becoming pregnant is constantly increasing. All women with known heart disease should have pre-pregnancy counseling, to assess maternal and fetal risk. Women at moderate or high risk should be under the care of a specialist prenatal team with experience in managing women with heart disease during pregnancy. Conditions that are considered at particularly high risk (mortality >10%) include Marfan syndrome with dilated aortic root, severe left ventricular dysfunction, severe left heart obstructive lesions, and pulmonary hypertension. Peripartum cardiomyopathy is a rare and potentially fatal disease related to pregnancy and the postnatal period that presents with symptoms of congestion and/or hypoperfusion and may rapidly progress to acute and life-threatening heart failure. However, the majority of women with heart disease can tolerate pregnancy; therefore an adequate multidisciplinary approach with the gynecologist, anesthesiologist and cardiologist should be advocated in order to reduce maternal and fetal risks associated with pregnancy.

  20. Stress Recovery during Exposure to Nature Sound and Environmental Noise

    PubMed Central

    Alvarsson, Jesper J; Wiens, Stefan; Nilsson, Mats E

    2010-01-01

    Research suggests that visual impressions of natural compared with urban environments facilitate recovery after psychological stress. To test whether auditory stimulation has similar effects, 40 subjects were exposed to sounds from nature or noisy environments after a stressful mental arithmetic task. Skin conductance level (SCL) was used to index sympathetic activation, and high frequency heart rate variability (HF HRV) was used to index parasympathetic activation. Although HF HRV showed no effects, SCL recovery tended to be faster during natural sound than noisy environments. These results suggest that nature sounds facilitate recovery from sympathetic activation after a psychological stressor. PMID:20617017

  1. Goodbye, Mandatory Maternity Leaves

    ERIC Educational Resources Information Center

    Nation's Schools, 1972

    1972-01-01

    In precedent-setting decrees, courts and federal and State authorities have branded compulsory maternity leaves either unconstitutional or illegal. School administrators are urged to prod boards of education to adopt more lenient maternity leave policies -- now. (Author)

  2. The Impact of Cardiac Diseases during Pregnancy on Severe Maternal Morbidity and Mortality in Brazil

    PubMed Central

    Campanharo, Felipe F.; Cecatti, Jose G.; Haddad, Samira M.; Parpinelli, Mary A.; Born, Daniel; Costa, Maria L.; Mattar, Rosiane

    2015-01-01

    Background To evaluate maternal heart disease as a cause or complicating factor for severe morbidity in the setting of the Brazilian Network for Surveillance of Severe Maternal Morbidity. Methods and Findings Secondary data analysis of this multicenter cross-sectional study was implemented in 27 referral obstetric units in Brazil. From July 2009 to June 2010, a prospective surveillance was conducted among all delivery hospitalizations to identify cases of severe maternal morbidity (SMM), including Potentially Life-Threatening Conditions (PLTC) and Maternal Near Miss (MNM), using the new criteria established by the WHO. The variables studied included: sociodemographic characteristics, clinical and obstetric history of the women; perinatal outcome and the occurrence of maternal outcomes (PLTC, MNM, MD) between groups of cardiac and non-cardiac patients. Only heart conditions with hemodynamic impact characterizing severity of maternal morbidity were considered. 9555 women were included in the Network with severe pregnancy-related complications: 770 maternal near miss cases and 140 maternal death cases. A total of 293 (3.6%) cases were related to heart disease and the condition was known before pregnancy in 82.6% of cases. Maternal near miss occurred in 15% of cardiac disease patients (most due to clinical-surgical causes, p<0.001) and 7.7% of non-cardiac patients (hemorrhagic and hypertensive causes, p<0.001). Maternal death occurred in 4.8% of cardiac patients and in 1.2% of non-cardiac patients, respectively. Conclusions In this study, heart disease was significantly associated with a higher occurrence of severe maternal outcomes, including maternal death and maternal near miss, among women presenting with any severe maternal morbidity. PMID:26650684

  3. Maternal anxiety, maternal sensitivity, and attachment.

    PubMed

    Stevenson-Hinde, Joan; Chicot, Rebecca; Shouldice, Anne; Hinde, Camilla A

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels (N = 98). Following Mary Ainsworth's lead, our maternal sensitivity measures were primarily based on ratings of direct observations. Six sets of measures were obtained: positive maternal style at home (a mean of four different ratings); providing a sensitive framework, limit setting, allowing autonomy, criticizing/cutting in (each a mean over two laboratory joint tasks); and tension-making (a mean of three different ratings in a fear-inducing task). Regression analyses showed firstly that maternal anxiety rather than behavioral inhibition or sex of child was the significant predictor of each maternal sensitivity measure; and secondly that these measures rather than maternal anxiety or sex were the significant predictors of security of attachment. Finally, ANOVA's indicated which sets of maternal ratings were associated with each pattern of attachment (Avoidant, Secure, Ambivalent, or Controlling).

  4. The sound manifesto

    NASA Astrophysics Data System (ADS)

    O'Donnell, Michael J.; Bisnovatyi, Ilia

    2000-11-01

    Computing practice today depends on visual output to drive almost all user interaction. Other senses, such as audition, may be totally neglected, or used tangentially, or used in highly restricted specialized ways. We have excellent audio rendering through D-A conversion, but we lack rich general facilities for modeling and manipulating sound comparable in quality and flexibility to graphics. We need coordinated research in several disciplines to improve the use of sound as an interactive information channel. Incremental and separate improvements in synthesis, analysis, speech processing, audiology, acoustics, music, etc. will not alone produce the radical progress that we seek in sonic practice. We also need to create a new central topic of study in digital audio research. The new topic will assimilate the contributions of different disciplines on a common foundation. The key central concept that we lack is sound as a general-purpose information channel. We must investigate the structure of this information channel, which is driven by the cooperative development of auditory perception and physical sound production. Particular audible encodings, such as speech and music, illuminate sonic information by example, but they are no more sufficient for a characterization than typography is sufficient for characterization of visual information. To develop this new conceptual topic of sonic information structure, we need to integrate insights from a number of different disciplines that deal with sound. In particular, we need to coordinate central and foundational studies of the representational models of sound with specific applications that illuminate the good and bad qualities of these models. Each natural or artificial process that generates informative sound, and each perceptual mechanism that derives information from sound, will teach us something about the right structure to attribute to the sound itself. The new Sound topic will combine the work of computer

  5. Maternal singing during kangaroo care led to autonomic stability in preterm infants and reduced maternal anxiety.

    PubMed

    Arnon, Shmuel; Diamant, Chagit; Bauer, Sofia; Regev, Rivka; Sirota, Gisela; Litmanovitz, Ita

    2014-10-01

    Kangaroo care (KC) and maternal singing benefit preterm infants, and we investigated whether combining these benefitted infants and mothers. A prospective randomised, within-subject, crossover, repeated-measures study design was used, with participants acting as their own controls. We evaluated the heart rate variability (HRV) of stable preterm infants receiving KC, with and without maternal singing. This included low frequency (LF), high frequency (HF) and the LF/HF ratio during baseline (10 min), singing or quiet phases (20 min) and recovery (10 min). Physiological parameters, maternal anxiety and the infants' behavioural state were measured. We included 86 stable preterm infants, with a postmenstrual age of 32-36 weeks. A significant change in LF and HF, and lower LF/HF ratio, was observed during KC with maternal singing during the intervention and recovery phases, compared with just KC and baseline (all p-values <0.05). Maternal anxiety was lower during singing than just KC (p = 0.04). No differences in the infants' behavioural states or physiological parameters were found, with or without singing. Maternal singing during KC reduces maternal anxiety and leads to autonomic stability in stable preterm infants. This effect is not detected in behavioural state or physiological parameters commonly used to monitor preterm infants. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Maternity Protection at Work.

    ERIC Educational Resources Information Center

    World of Work, 1998

    1998-01-01

    Discusses the need for maternity benefits for working women. Suggests that although most countries provide paid maternity leave by law, there is a gap between that law and practice. Includes a chart depicting maternity protection (length of leave, cash benefits, who pays) around the world. (JOW)

  7. Photoacoustic Sounds from Meteors

    NASA Astrophysics Data System (ADS)

    Spalding, Richard; Tencer, John; Sweatt, William; Conley, Benjamin; Hogan, Roy; Boslough, Mark; Gonzales, Gigi; Spurný, Pavel

    2017-02-01

    Concurrent sound associated with very bright meteors manifests as popping, hissing, and faint rustling sounds occurring simultaneously with the arrival of light from meteors. Numerous instances have been documented with -11 to -13 brightness. These sounds cannot be attributed to direct acoustic propagation from the upper atmosphere for which travel time would be several minutes. Concurrent sounds must be associated with some form of electromagnetic energy generated by the meteor, propagated to the vicinity of the observer, and transduced into acoustic waves. Previously, energy propagated from meteors was assumed to be RF emissions. This has not been well validated experimentally. Herein we describe experimental results and numerical models in support of photoacoustic coupling as the mechanism. Recent photometric measurements of fireballs reveal strong millisecond flares and significant brightness oscillations at frequencies ≥40 Hz. Strongly modulated light at these frequencies with sufficient intensity can create concurrent sounds through radiative heating of common dielectric materials like hair, clothing, and leaves. This heating produces small pressure oscillations in the air contacting the absorbers. Calculations show that -12 brightness meteors can generate audible sound at ~25 dB SPL. The photoacoustic hypothesis provides an alternative explanation for this longstanding mystery about generation of concurrent sounds by fireballs.

  8. Photoacoustic Sounds from Meteors

    PubMed Central

    Spalding, Richard; Tencer, John; Sweatt, William; Conley, Benjamin; Hogan, Roy; Boslough, Mark; Gonzales, GiGi; Spurný, Pavel

    2017-01-01

    Concurrent sound associated with very bright meteors manifests as popping, hissing, and faint rustling sounds occurring simultaneously with the arrival of light from meteors. Numerous instances have been documented with −11 to −13 brightness. These sounds cannot be attributed to direct acoustic propagation from the upper atmosphere for which travel time would be several minutes. Concurrent sounds must be associated with some form of electromagnetic energy generated by the meteor, propagated to the vicinity of the observer, and transduced into acoustic waves. Previously, energy propagated from meteors was assumed to be RF emissions. This has not been well validated experimentally. Herein we describe experimental results and numerical models in support of photoacoustic coupling as the mechanism. Recent photometric measurements of fireballs reveal strong millisecond flares and significant brightness oscillations at frequencies ≥40 Hz. Strongly modulated light at these frequencies with sufficient intensity can create concurrent sounds through radiative heating of common dielectric materials like hair, clothing, and leaves. This heating produces small pressure oscillations in the air contacting the absorbers. Calculations show that −12 brightness meteors can generate audible sound at ~25 dB SPL. The photoacoustic hypothesis provides an alternative explanation for this longstanding mystery about generation of concurrent sounds by fireballs. PMID:28145486

  9. Photoacoustic sounds from meteors

    DOE PAGES

    Spalding, Richard; Tencer, John; Sweatt, William; ...

    2017-02-01

    Concurrent sound associated with very bright meteors manifests as popping, hissing, and faint rustling sounds occurring simultaneously with the arrival of light from meteors. Numerous instances have been documented with –11 to –13 brightness. These sounds cannot be attributed to direct acoustic propagation from the upper atmosphere for which travel time would be several minutes. Concurrent sounds must be associated with some form of electromagnetic energy generated by the meteor, propagated to the vicinity of the observer, and transduced into acoustic waves. Previously, energy propagated from meteors was assumed to be RF emissions. This has not been well validated experimentally.more » Herein we describe experimental results and numerical models in support of photoacoustic coupling as the mechanism. Recent photometric measurements of fireballs reveal strong millisecond flares and significant brightness oscillations at frequencies ≥40 Hz. Strongly modulated light at these frequencies with sufficient intensity can create concurrent sounds through radiative heating of common dielectric materials like hair, clothing, and leaves. This heating produces small pressure oscillations in the air contacting the absorbers. Calculations show that –12 brightness meteors can generate audible sound at ~25 dB SPL. As a result, the photoacoustic hypothesis provides an alternative explanation for this longstanding mystery about generation of concurrent sounds by fireballs.« less

  10. Sound as artifact

    NASA Astrophysics Data System (ADS)

    Benjamin, Jeffrey L.

    A distinguishing feature of the discipline of archaeology is its reliance upon sensory dependant investigation. As perceived by all of the senses, the felt environment is a unique area of archaeological knowledge. It is generally accepted that the emergence of industrial processes in the recent past has been accompanied by unprecedented sonic extremes. The work of environmental historians has provided ample evidence that the introduction of much of this unwanted sound, or "noise" was an area of contestation. More recent research in the history of sound has called for more nuanced distinctions than the noisy/quiet dichotomy. Acoustic archaeology tends to focus upon a reconstruction of sound producing instruments and spaces with a primary goal of ascertaining intentionality. Most archaeoacoustic research is focused on learning more about the sonic world of people within prehistoric timeframes while some research has been done on historic sites. In this thesis, by way of a meditation on industrial sound and the physical remains of the Quincy Mining Company blacksmith shop (Hancock, MI) in particular, I argue for an acceptance and inclusion of sound as artifact in and of itself. I am introducing the concept of an individual sound-form, or sonifact , as a reproducible, repeatable, representable physical entity, created by tangible, perhaps even visible, host-artifacts. A sonifact is a sound that endures through time, with negligible variability. Through the piecing together of historical and archaeological evidence, in this thesis I present a plausible sonifactual assemblage at the blacksmith shop in April 1916 as it may have been experienced by an individual traversing the vicinity on foot: an 'historic soundwalk.' The sensory apprehension of abandoned industrial sites is multi-faceted. In this thesis I hope to make the case for an acceptance of sound as a primary heritage value when thinking about the industrial past, and also for an increased awareness and acceptance

  11. GPS Sounding Rocket Developments

    NASA Technical Reports Server (NTRS)

    Bull, Barton

    1999-01-01

    Sounding rockets are suborbital launch vehicles capable of carrying scientific payloads several hundred miles in altitude. These missions return a variety of scientific data including; chemical makeup and physical processes taking place in the atmosphere, natural radiation surrounding the Earth, data on the Sun, stars, galaxies and many other phenomena. In addition, sounding rockets provide a reasonably economical means of conducting engineering tests for instruments and devices used on satellites and other spacecraft prior to their use in more expensive activities. This paper addresses the NASA Wallops Island history of GPS Sounding Rocket experience since 1994 and the development of highly accurate and useful system.

  12. GPS Sounding Rocket Developments

    NASA Technical Reports Server (NTRS)

    Bull, Barton

    1999-01-01

    Sounding rockets are suborbital launch vehicles capable of carrying scientific payloads several hundred miles in altitude. These missions return a variety of scientific data including; chemical makeup and physical processes taking place in the atmosphere, natural radiation surrounding the Earth, data on the Sun, stars, galaxies and many other phenomena. In addition, sounding rockets provide a reasonably economical means of conducting engineering tests for instruments and devices used on satellites and other spacecraft prior to their use in more expensive activities. This paper addresses the NASA Wallops Island history of GPS Sounding Rocket experience since 1994 and the development of highly accurate and useful system.

  13. Sounding the Sun

    DTIC Science & Technology

    1998-09-30

    Sounding the Sun Antony Fraser-Smith STAR Laboratory Stanford University Stanford, CA 94305 phone: (650) 723-3684 fax: (650) 723-9251 email...TITLE AND SUBTITLE Sounding the Sun 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...systems. The objective of our “Sounding the sun ” experiment is to detect earth-directed CME’s by using existing earth-based HF (3- 30 MHz) radar systems

  14. Characteristics of the audio sound generated by ultrasound imaging systems.

    PubMed

    Fatemi, Mostafa; Alizad, Azra; Greenleaf, James F

    2005-03-01

    Medical ultrasound scanners use high-energy pulses to probe the human body. The radiation force resulting from the impact of such pulses on an object can vibrate the object, producing a localized high-intensity sound in the audible range. Here, a theoretical model for the audio sound generated by ultrasound scanners is presented. This model describes the temporal and spectral characteristics of the sound. It has been shown that the sound has rich frequency components at the pulse repetition frequency and its harmonics. Experiments have been conducted in a water tank to measure the sound generated by a clinical ultrasound scanner in various operational modes. Results are in general agreement with the theory. It is shown that a typical ultrasound scanner with a typical spatial-peak pulse-average intensity value at 2 MHz may generate a localized sound-pressure level close to 100 dB relative to 20 microPa in the audible (< 20 kHz) range under laboratory conditions. These findings suggest that fetuses may become exposed to a high-intensity audio sound during maternal ultrasound examinations. Therefore, contrary to common beliefs, ultrasound may not be considered a passive tool in fetal imaging.

  15. Characteristics of the audio sound generated by ultrasound imaging systems

    NASA Astrophysics Data System (ADS)

    Fatemi, Mostafa; Alizad, Azra; Greenleaf, James F.

    2005-03-01

    Medical ultrasound scanners use high-energy pulses to probe the human body. The radiation force resulting from the impact of such pulses on an object can vibrate the object, producing a localized high-intensity sound in the audible range. Here, a theoretical model for the audio sound generated by ultrasound scanners is presented. This model describes the temporal and spectral characteristics of the sound. It has been shown that the sound has rich frequency components at the pulse repetition frequency and its harmonics. Experiments have been conducted in a water tank to measure the sound generated by a clinical ultrasound scanner in various operational modes. Results are in general agreement with the theory. It is shown that a typical ultrasound scanner with a typical spatial-peak pulse-average intensity value at 2 MHz may generate a localized sound-pressure level close to 100 dB relative to 20 μPa in the audible (<20 kHz) range under laboratory conditions. These findings suggest that fetuses may become exposed to a high-intensity audio sound during maternal ultrasound examinations. Therefore, contrary to common beliefs, ultrasound may not be considered a passive tool in fetal imaging..

  16. Sound Visualization and Holography

    ERIC Educational Resources Information Center

    Kock, Winston E.

    1975-01-01

    Describes liquid surface holograms including their application to medicine. Discusses interference and diffraction phenomena using sound wave scanning techniques. Compares focussing by zone plate to holographic image development. (GH)

  17. Velocity of Sound

    ERIC Educational Resources Information Center

    Gillespie, A.

    1975-01-01

    Describes a method for the determination of the velocity of sound using a dual oscilloscope on which is displayed the sinusoidal input into a loudspeaker and the signal picked up by a microphone. (GS)

  18. Velocity of Sound

    ERIC Educational Resources Information Center

    Gillespie, A.

    1975-01-01

    Describes a method for the determination of the velocity of sound using a dual oscilloscope on which is displayed the sinusoidal input into a loudspeaker and the signal picked up by a microphone. (GS)

  19. Signal processing of Shiley heart valve data for fracture detection

    SciTech Connect

    Mullenhoff, C.

    1993-04-01

    Given digital acoustic data emanating from the heart sounds of the beating heart measured from laboratory sheep with implanted Bjoerk-Shiley Convexo-Concave heart valves, it is possible to detect and extract the opening and closing heart beats from the data. Once extracted, spectral or other information can then obtained from the heartbeats and passed on to feature extraction algorithms, neutral networks, or pattern recognizers so that the valve condition, either fractured or intact, may be determined.

  20. Signal processing of Shiley heart valve data for fracture detection

    SciTech Connect

    Mullenhoff, C.

    1993-09-01

    Given digital acoustic data emanating from the heart sounds of the beating heart measured from laboratory sheep with implanted Bjoerk-Shiley Convexo-Concave heart valves, it is possible to detect and extract the opening and closing heart beats from the data. Once extracted, spectral or other information can then obtained from the heartbeats and passed on to feature extraction algorithms, neural networks, or pattern recognizers so that the valve condition, either fractured or intact, may be determined.

  1. The Sounds of Sentences: Differentiating the Influence of Physical Sound, Sound Imagery, and Linguistically Implied Sounds on Physical Sound Processing.

    PubMed

    Dudschig, Carolin; Mackenzie, Ian Grant; Strozyk, Jessica; Kaup, Barbara; Leuthold, Hartmut

    2016-10-01

    Both the imagery literature and grounded models of language comprehension emphasize the tight coupling of high-level cognitive processes, such as forming a mental image of something or language understanding, and low-level sensorimotor processes in the brain. In an electrophysiological study, imagery and language processes were directly compared and the sensory associations of processing linguistically implied sounds or imagined sounds were investigated. Participants read sentences describing auditory events (e.g., "The dog barks"), heard a physical (environmental) sound, or had to imagine such a sound. We examined the influence of the 3 sound conditions (linguistic, physical, imagery) on subsequent physical sound processing. Event-related potential (ERP) difference waveforms indicated that in all 3 conditions, prime compatibility influenced physical sound processing. The earliest compatibility effect was observed in the physical condition, starting in the 80-110 ms time interval with a negative maximum over occipital electrode sites. In contrast, the linguistic and the imagery condition elicited compatibility effects starting in the 180-220 ms time window with a maximum over central electrode sites. In line with the ERPs, the analysis of the oscillatory activity showed that compatibility influenced early theta and alpha band power changes in the physical, but not in the linguistic and imagery, condition. These dissociations were further confirmed by dipole localization results showing a clear separation between the source of the compatibility effect in the physical sound condition (superior temporal area) and the source of the compatibility effect triggered by the linguistically implied sounds or the imagined sounds (inferior temporal area). Implications for grounded models of language understanding are discussed.

  2. Orcas in Puget Sound

    DTIC Science & Technology

    2007-01-01

    de Fuca Strait, Puget Sound and the Strait of Georgia ) for a considerable time of the year, predominantly from early spring until late fall (Ford and...the south- ern part of Georgia Strait, Boundary Passage, the southern Gulf Islands and the eastern end of Juan de Fuca Strait (Heimlich- Boran 1988...Figure 2. Distribution of SRKW during September 2006 in Puget Sound and the southern Strait of Georgia (Advanced Satellite Productions, Orca Network

  3. Heart Attack

    MedlinePlus

    ... it as instructed while awaiting emergency help. Take aspirin, if recommended . Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting. Aspirin can interact with other medications, however, so don' ...

  4. Heart pacemaker

    MedlinePlus

    ... 28 grams). Most pacemakers have 2 parts: The generator contains the battery and the information to control ... are wires that connect the heart to the generator and carry the electrical messages to the heart. ...

  5. Heart Failure

    MedlinePlus

    ... your body. An ejection fraction is an important measurement of how well your heart is pumping and ... catheterization and cardiac MRI. This is an important measurement of how well your heart is pumping and ...

  6. Heart Block

    MedlinePlus

    ... refers to the number of times your heart beats per minute. "Rhythm" refers to the pattern of regular or irregular pulses produced as the heart beats.) With each heartbeat, an electrical signal spreads across ...

  7. Ecological sounds affect breath duration more than artificial sounds.

    PubMed

    Murgia, Mauro; Santoro, Ilaria; Tamburini, Giorgia; Prpic, Valter; Sors, Fabrizio; Galmonte, Alessandra; Agostini, Tiziano

    2016-01-01

    Previous research has demonstrated that auditory rhythms affect both movement and physiological functions. We hypothesized that the ecological sounds of human breathing can affect breathing more than artificial sounds of breathing, varying in tones for inspiration and expiration. To address this question, we monitored the breath duration of participants exposed to three conditions: (a) ecological sounds of breathing, (b) artificial sounds of breathing having equal temporal features as the ecological sounds, (c) no sounds (control). We found that participants' breath duration variability was reduced in the ecological sound condition, more than in the artificial sound condition. We suggest that ecological sounds captured the timing of breathing better than artificial sounds, guiding as a consequence participants' breathing. We interpreted our results according to the Theory of Event Coding, providing further support to its validity, and suggesting its possible extension in the domain of physiological functions which are both consciously and unconsciously controlled.

  8. Maternally-mediated developmental lithium toxicity in the mouse.

    PubMed

    Messiha, F S

    1993-01-01

    1. Breast fed maternally-mediated developmental LiCl toxicity was determined in mice offspring as a function of offspring's gender and duration of maternal intake of LiCl (1 mEq). 2. The female offspring were more sensitive than the males to major organ weight changes by maternal exposure to LiCl. 3. Maternal intake of LiCl from preconception until weaning of the nurslings induced offspring hepatic alcohol dehydrogenase and heart lactate dehydrogenase in both sexes which was isoenzyme specific for the latter. 4. The offspring also showed induction of liver aldehyde dehydrogenase but only as consequences of postnatal exposure to LiCl. 5. The results indicate offspring developmental toxicity as a consequence of maternal exposure to Li salts and breast feeding.

  9. Applying cybernetic technology to diagnose human pulmonary sounds.

    PubMed

    Chen, Mei-Yung; Chou, Cheng-Han

    2014-06-01

    Chest auscultation is a crucial and efficient method for diagnosing lung disease; however, it is a subjective process that relies on physician experience and the ability to differentiate between various sound patterns. Because the physiological signals composed of heart sounds and pulmonary sounds (PSs) are greater than 120 Hz and the human ear is not sensitive to low frequencies, successfully making diagnostic classifications is difficult. To solve this problem, we constructed various PS recognition systems for classifying six PS classes: vesicular breath sounds, bronchial breath sounds, tracheal breath sounds, crackles, wheezes, and stridor sounds. First, we used a piezoelectric microphone and data acquisition card to acquire PS signals and perform signal preprocessing. A wavelet transform was used for feature extraction, and the PS signals were decomposed into frequency subbands. Using a statistical method, we extracted 17 features that were used as the input vectors of a neural network. We proposed a 2-stage classifier combined with a back-propagation (BP) neural network and learning vector quantization (LVQ) neural network, which improves classification accuracy by using a haploid neural network. The receiver operating characteristic (ROC) curve verifies the high performance level of the neural network. To expand traditional auscultation methods, we constructed various PS diagnostic systems that can correctly classify the six common PSs. The proposed device overcomes the lack of human sensitivity to low-frequency sounds and various PS waves, characteristic values, and a spectral analysis charts are provided to elucidate the design of the human-machine interface.

  10. Acoustic heart. Interpretation of Phonocardiograms by computer

    NASA Astrophysics Data System (ADS)

    Granados, J.; Tavera, F.; Velázquez, J. M.; López, G.; Hernández, R. T.; Morales, A.

    2015-01-01

    In the field of Cardiology have been identified several heart pathologies associated with problems in valves and narrowing in veins. Each case is associated with a specific sound emitted by the heart, detected in cardiac auscultation. On the Phonocardiogram, sound is visualized as a peak in the wave. In the Optics Laboratory of the Universidad Autonoma Metropolitana - Azcapotzalco, we have developed a simulation of the Phonocardiograms of heart sounds associated with the main pathologies and a computer program of recognition of images that allows you to quickly identify the respective diseases. This is a novel way to analyze Phonocardiograms and the foundation for building a portable non-invasive cardiac diagnostic computerized analyzer system.

  11. Heart Disease

    MedlinePlus

    ... wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart rhythm ... your doctor to make sure you're properly managing your heart condition. ... making the same lifestyle changes that can improve your heart disease, such ...

  12. Heart Attack

    MedlinePlus

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  13. Physiological and psychological assessment of sound

    NASA Astrophysics Data System (ADS)

    Yanagihashi, R.; Ohira, Masayoshi; Kimura, Teiji; Fujiwara, Takayuki

    The psycho-physiological effects of several sound stimulations were investigated to evaluate the relationship between a psychological parameter, such as subjective perception, and a physiological parameter, such as the heart rate variability (HRV). Eight female students aged 21-22 years old were tested. Electrocardiogram (ECG) and the movement of the chest-wall for estimating respiratory rate were recorded during three different sound stimulations; (1) music provided by a synthesizer (condition A); (2) birds twitters (condition B); and (3) mechanical sounds (condition C). The percentage power of the low-frequency (LF; 0.05<=0.15 Hz) and high-frequency (HF; 0.15<=0.40 Hz) components in the HRV (LF%, HF%) were assessed by a frequency analysis of time-series data for 5 min obtained from R-R intervals in the ECG. Quantitative assessment of subjective perception was also described by a visual analog scale (VAS). The HF% and VAS value for comfort in C were significantly lower than in either A and/or B. The respiratory rate and VAS value for awakening in C were significantly higher than in A and/or B. There was a significant correlation between the HF% and the value of the VAS, and between the respiratory rate and the value of the VAS. These results indicate that mechanical sounds similar to C inhibit the para-sympathetic nervous system and promote a feeling that is unpleasant but alert, also suggesting that the HRV reflects subjective perception.

  14. Technology, Sound and Popular Music.

    ERIC Educational Resources Information Center

    Jones, Steve

    The ability to record sound is power over sound. Musicians, producers, recording engineers, and the popular music audience often refer to the sound of a recording as something distinct from the music it contains. Popular music is primarily mediated via electronics, via sound, and not by means of written notes. The ability to preserve or modify…

  15. Sound modes in holographic superfluids

    SciTech Connect

    Herzog, Christopher P.; Yarom, Amos

    2009-11-15

    Superfluids support many different types of sound waves. We investigate the relation between the sound waves in a relativistic and a nonrelativistic superfluid by using hydrodynamics to calculate the various sound speeds. Then, using a particular holographic scalar gravity realization of a strongly interacting superfluid, we compute first, second, and fourth sound speeds as a function of the temperature. The relativistic low temperature results for second sound differ from Landau's well known prediction for the nonrelativistic, incompressible case.

  16. GPS Sounding Rocket Developments

    NASA Technical Reports Server (NTRS)

    Bull, Barton

    1999-01-01

    Sounding rockets are suborbital launch vehicles capable of carrying scientific payloads several hundred miles in altitude. These missions return a variety of scientific data including; chemical makeup and physical processes taking place In the atmosphere, natural radiation surrounding the Earth, data on the Sun, stars, galaxies and many other phenomena. In addition, sounding rockets provide a reasonably economical means of conducting engineering tests for instruments and devices used on satellites and other spacecraft prior to their use in more expensive activities. The NASA Sounding Rocket Program is managed by personnel from Goddard Space Flight Center Wallops Flight Facility (GSFC/WFF) in Virginia. Typically around thirty of these rockets are launched each year, either from established ranges at Wallops Island, Virginia, Poker Flat Research Range, Alaska; White Sands Missile Range, New Mexico or from Canada, Norway and Sweden. Many times launches are conducted from temporary launch ranges in remote parts of the world requi6ng considerable expense to transport and operate tracking radars. An inverse differential GPS system has been developed for Sounding Rocket. This paper addresses the NASA Wallops Island history of GPS Sounding Rocket experience since 1994 and the development of a high accurate and useful system.

  17. Meteor fireball sounds identified

    NASA Technical Reports Server (NTRS)

    Keay, Colin

    1992-01-01

    Sounds heard simultaneously with the flight of large meteor fireballs are electrical in origin. Confirmation that Extra/Very Low Frequency (ELF/VLF) electromagnetic radiation is produced by the fireball was obtained by Japanese researchers. Although the generation mechanism is not fully understood, studies of the Meteorite Observation and Recovery Project (MORP) and other fireball data indicate that interaction with the atmosphere is definitely responsible and the cut-off magnitude of -9 found for sustained electrophonic sounds is supported by theory. Brief bursts of ELF/VLF radiation may accompany flares or explosions of smaller fireballs, producing transient sounds near favorably placed observers. Laboratory studies show that mundane physical objects can respond to electrical excitation and produce audible sounds. Reports of electrophonic sounds should no longer be discarded. A catalog of over 300 reports relating to electrophonic phenomena associated with meteor fireballs, aurorae, and lightning was assembled. Many other reports have been cataloged in Russian. These may assist the full solution of the similar long-standing and contentious mystery of audible auroral displays.

  18. On categorizing sounds

    NASA Astrophysics Data System (ADS)

    Lockhead, Gregory R.

    1991-08-01

    Context is important when people judge sounds, or attributes of sounds, or other stimuli. It is shown how judgments depend on what sounds recently occurred (sequence effects), on how those sounds differ from one another (range effects), on the distribution of those differences (set effects), on what subjects are told about the situation (task effects), and on what subjects are told about their performance (feedback effects). Each of these factors determines the overall mean and variability of response times and response choices, which are the standard measures, when people judge attribute amounts. Trial-by-trial analysis of the data show these factors also determine performance on individual trials. Moreover, these momentary data cannot be predicted from the overall data. The opposite is not true; the averaged data can be predicted from the momentary details. These results are consistent with a model having two simple assumptions: successive sounds (not just their attributes) assimilate toward one another in memory, and judgments are based on comparisons of these remembered events. It is suggested that relations between attributes, rather than the magnitudes of the attributes themselves, are the basis for judgment.

  19. GPS Sounding Rocket Developments

    NASA Technical Reports Server (NTRS)

    Bull, Barton

    1999-01-01

    Sounding rockets are suborbital launch vehicles capable of carrying scientific payloads several hundred miles in altitude. These missions return a variety of scientific data including; chemical makeup and physical processes taking place In the atmosphere, natural radiation surrounding the Earth, data on the Sun, stars, galaxies and many other phenomena. In addition, sounding rockets provide a reasonably economical means of conducting engineering tests for instruments and devices used on satellites and other spacecraft prior to their use in more expensive activities. The NASA Sounding Rocket Program is managed by personnel from Goddard Space Flight Center Wallops Flight Facility (GSFC/WFF) in Virginia. Typically around thirty of these rockets are launched each year, either from established ranges at Wallops Island, Virginia, Poker Flat Research Range, Alaska; White Sands Missile Range, New Mexico or from Canada, Norway and Sweden. Many times launches are conducted from temporary launch ranges in remote parts of the world requi6ng considerable expense to transport and operate tracking radars. An inverse differential GPS system has been developed for Sounding Rocket. This paper addresses the NASA Wallops Island history of GPS Sounding Rocket experience since 1994 and the development of a high accurate and useful system.

  20. Heart-to-Heart

    NASA Image and Video Library

    2017-06-26

    NASA didn’t miss a (heart)beat when the opportunity arose to study the cardiovascular systems of identical twin astronauts, one aboard the International Space Station and the other on Earth. Results from the Cardio Ox investigation, part of the research of the One Year Mission of astronaut Scott Kelly, may provide a better understanding of cardiovascular disease risk that astronauts encounter during and after long-duration spaceflight. Stuart Lee, the lead scientist for the Cardiovascular and Vision Laboratory at NASA’s Johnson Space Center, explains the importance of spaceflight weightlessness research on the cardiovascular system and how results could be used to create countermeasures, preventing potential health consequences for future space travelers as well as those of us on Earth. For more on ISS science, follow us on Twitter: @ISS_research or at https://twitter.com/ISS_Research or at: https://www.nasa.gov/mission_pages/station/research/index.html

  1. Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association.

    PubMed

    Jeejeebhoy, Farida M; Zelop, Carolyn M; Lipman, Steve; Carvalho, Brendan; Joglar, Jose; Mhyre, Jill M; Katz, Vern L; Lapinsky, Stephen E; Einav, Sharon; Warnes, Carole A; Page, Richard L; Griffin, Russell E; Jain, Amish; Dainty, Katie N; Arafeh, Julie; Windrim, Rory; Koren, Gideon; Callaway, Clifton W

    2015-11-03

    This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation.

  2. Proceedings of the National Conference for the Prevention of Mental Retardation through Improved Maternity Care.

    ERIC Educational Resources Information Center

    Gold, Edwin M., Ed.

    The conference proceedings on the prevention of mental retardation through improved maternity care consist of six major papers which are followed by panel discussions with two to five participants. Epidemiology of prematurity, topic of the first paper, is discussed in terms of cigarette smoking, asymptomatic bacertiuria, maternal heart volume,…

  3. Maternal cardiovascular function at 35-37 weeks' gestation: relation to maternal characteristics.

    PubMed

    Guy, G P; Ling, H Z; Garcia, P; Poon, L C; Nicolaides, K H

    2017-01-01

    To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. In 3013 singleton pregnancies at 35-37 weeks, maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters among gestational age (GA), maternal characteristics and medical history. Multivariable regression analysis demonstrated that significant independent prediction of log10 cardiac output and log10 cardiac power was provided by GA, maternal age, weight, weight gain from the first trimester, height, racial origin, smoking, assisted conception and previous neonatal birth-weight Z-score in parous women. For log10 total peripheral resistance, significant prediction was provided by GA, maternal age, height, racial origin, chronic hypertension, diabetes mellitus, assisted conception, previous neonatal birth-weight Z-score and prior pre-eclampsia (PE) in parous women. For log10 stroke volume, significant prediction was provided by maternal age, height, racial origin, smoking, chronic hypertension and diabetes mellitus. For heart rate, significant prediction was provided by GA, weight, weight gain, height, racial origin, chronic hypertension, previous neonatal birth-weight Z-score and prior PE in parous women. For log10 MAP, significant prediction was provided by maternal weight, racial origin, family history of PE, chronic hypertension and diabetes mellitus. For log10 thoracic fluid capacity, significant prediction was provided by GA, maternal age, weight, height, racial origin and systemic lupus erythematosus or antiphospholipid syndrome. For log10 ventricular ejection time, significant prediction was provided by GA, weight, height and racial origin. Maternal cardiovascular parameters are

  4. Maternal mortality in Sirur.

    PubMed

    Shrotri, A; Pratinidhi, A; Shah, U

    1990-01-01

    The research aim was 1) to determine the incidence of maternal mortality in a rural health center area in Sirur, Maharashtra state, India; 2) to determine the relative risk; and 3) to make suggestions about reducing maternal mortality. The data on deliveries was obtained between 1981 and 1984. Medical care at the Rural Training Center was supervised by the Department of Preventive and Social Medicine, the B.J. Medical College in Pune. Deliveries numbered 5994 singleton births over the four years; 5919 births were live births. 15 mothers died: 14 after delivery and 1 predelivery. The maternal mortality rate was 2.5/1000 live births. The maternal causes of death included 9 direct obstetric causes, 3 from postpartum hemorrhage of anemic women, and 3 from puerperal sepsis of anemic women with prolonged labor. 2 deaths were due to eclampsia, and 1 death was unexplained. There were 5 (33.3%) maternal deaths due to indirect causes (3 from hepatitis and 2 from thrombosis). One woman died of undetermined causes. Maternal jaundice during pregnancy was associated with the highest relative risk of maternal death: 106.4. Other relative risk factors were edema, anemia, and prolonged labor. Attributable risk was highest for anemia, followed by jaundice, edema, and maternal age of over 30 years. Maternal mortality at 30 years and older was 3.9/1000 live births. Teenage maternal mortality was 3.3/1000. Maternal mortality among women 20-29 years old was lowest at 2.1/1000. Maternal mortality for women with a parity of 5 or higher was 3.6/1000. Prima gravida women had a maternal mortality rate of 2.9/1000. Parities between 1 and 4 had a maternal mortality rate of 2.3/1000. The lowest maternal mortality was at parity of 3. Only 1 woman who died had received more than 3 prenatal visits. 11 out of 13 women medically examined prenatally were identified with the following risk factors: jaundice, edema, anemia, young or old maternal age, parity, or poor obstetric history. The local

  5. Atmospheric sound propagation

    NASA Technical Reports Server (NTRS)

    Cook, R. K.

    1969-01-01

    The propagation of sound waves at infrasonic frequencies (oscillation periods 1.0 - 1000 seconds) in the atmosphere is being studied by a network of seven stations separated geographically by distances of the order of thousands of kilometers. The stations measure the following characteristics of infrasonic waves: (1) the amplitude and waveform of the incident sound pressure, (2) the direction of propagation of the wave, (3) the horizontal phase velocity, and (4) the distribution of sound wave energy at various frequencies of oscillation. Some infrasonic sources which were identified and studied include the aurora borealis, tornadoes, volcanos, gravity waves on the oceans, earthquakes, and atmospheric instability waves caused by winds at the tropopause. Waves of unknown origin seem to radiate from several geographical locations, including one in the Argentine.

  6. Active stereo sound localization.

    PubMed

    Reid, Greg L; Milios, Evangelos

    2003-01-01

    Estimating the direction of arrival of sound in three-dimensional space is typically performed by generalized time-delay processing on a set of signals from a fixed array of omnidirectional microphones. This requires specialized multichannel A/D hardware, and careful arrangement of the microphones into an array. This work is motivated by the desire to instead only use standard two-channel audio A/D hardware and portable equipment. To estimate direction of arrival of persistent sound, the position of the microphones is made variable by mounting them on one or more computer-controlled pan-and-tilt units. In this paper, we describe the signal processing and control algorithm of a device with two omnidirectional microphones on a fixed baseline and two rotational degrees of freedom. Experimental results with real data are reported with both impulsive and speech sounds in an untreated, normally reverberant indoor environment.

  7. Monaural Sound Localization Revisited

    NASA Technical Reports Server (NTRS)

    Wightman, Frederic L.; Kistler, Doris J.

    1997-01-01

    Research reported during the past few decades has revealed the importance for human sound localization of the so-called 'monaural spectral cues.' These cues are the result of the direction-dependent filtering of incoming sound waves accomplished by the pinnae. One point of view about how these cues are extracted places great emphasis on the spectrum of the received sound at each ear individually. This leads to the suggestion that an effective way of studying the influence of these cues is to measure the ability of listeners to localize sounds when one of their ears is plugged. Numerous studies have appeared using this monaural localization paradigm. Three experiments are described here which are intended to clarify the results of the previous monaural localization studies and provide new data on how monaural spectral cues might be processed. Virtual sound sources are used in the experiments in order to manipulate and control the stimuli independently at the two ears. Two of the experiments deal with the consequences of the incomplete monauralization that may have contaminated previous work. The results suggest that even very low sound levels in the occluded ear provide access to interaural localization cues. The presence of these cues complicates the interpretation of the results of nominally monaural localization studies. The third experiment concerns the role of prior knowledge of the source spectrum, which is required if monaural cues are to be useful. The results of this last experiment demonstrate that extraction of monaural spectral cues can be severely disrupted by trial-to-trial fluctuations in the source spectrum. The general conclusion of the experiments is that, while monaural spectral cues are important, the monaural localization paradigm may not be the most appropriate way to study their role.

  8. Eliciting Sound Memories.

    PubMed

    Harris, Anna

    2015-11-01

    Sensory experiences are often considered triggers of memory, most famously a little French cake dipped in lime blossom tea. Sense memory can also be evoked in public history research through techniques of elicitation. In this article I reflect on different social science methods for eliciting sound memories such as the use of sonic prompts, emplaced interviewing, and sound walks. I include examples from my research on medical listening. The article considers the relevance of this work for the conduct of oral histories, arguing that such methods "break the frame," allowing room for collaborative research connections and insights into the otherwise unarticulatable.

  9. The Imagery of Sound

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Automated Analysis Corporation's COMET is a suite of acoustic analysis software for advanced noise prediction. It analyzes the origin, radiation, and scattering of noise, and supplies information on how to achieve noise reduction and improve sound characteristics. COMET's Structural Acoustic Foam Engineering (SAFE) module extends the sound field analysis capability of foam and other materials. SAFE shows how noise travels while airborne, how it travels within a structure, and how these media interact to affect other aspects of the transmission of noise. The COMET software reduces design time and expense while optimizing a final product's acoustical performance. COMET was developed through SBIR funding and Langley Research Center for Automated Analysis Corporation.

  10. Tracking speech sound acquisition.

    PubMed

    Powell, Thomas W

    2011-11-01

    This article describes a procedure to aid in the clinical appraisal of child speech. The approach, based on the work by Dinnsen, Chin, Elbert, and Powell (1990; Some constraints on functionally disordered phonologies: Phonetic inventories and phonotactics. Journal of Speech and Hearing Research, 33, 28-37), uses a railway idiom to track gains in the complexity of speech sound production. A clinical case study is reviewed to illustrate application of the procedure. The procedure is intended to facilitate application of an evidence-based procedure to the clinical management of developmental speech sound disorders.

  11. Alteration of adults' subjective feeling of familiarity toward infants' sounds.

    PubMed

    Shimada, Y; Itakura, S

    2008-08-01

    Many adults may have lower subjective feelings of familiarity toward infants' vocalizations since infants' sounds are different from those of adults. However, mothers frequently exposed to infants' vocalizations may be more familiar and less averse. To test this hypothesis, 21 mothers (M age = 31.1 yr., SD = 4.3) of infants (M age = 8.2 mo., SD = 3.5), 18 mothers (M age = 34.4 yr., SD = 4.8) of children between two and five years of age (M age = 2.8 yr., SD = 1.0), and 17 women (M age = 29.2 yr., SD = ll.1) with no children were exposed to 20 types of sounds. Of these sounds, 14 were produced by infants. Although the mothers of infants did not recognize sounds as those of an infant's vocalization, they showed higher subjective feelings of familiarity toward the timbres of the vowel-like stimuli than did the other groups. By contrast, the subjective feelings of familiarity for nonspeech sounds did not differ among groups. Maternal experiences may change women's recognition of perceived sounds.

  12. Developmental Change in Fetal Response to Repeated Low-Intensity Sound

    ERIC Educational Resources Information Center

    Morokuma, Seiichi; Doria, Valentina; Ierullo, Antonio; Kinukawa, Naoko; Fukushima, Kotaro; Nakano, Hitoo; Arulkumaran, Sabaratnam; Papageorghiou, Aris T.

    2008-01-01

    The aim of this study was to investigate developmental changes in heart rate response to repeated low-intensity (85 dB) sound stimulation in fetuses between 32 and 37 weeks of gestation. We measured amplitude changes in heart rate as our index of fetal response. At 35 to 37 weeks of gestation, the majority of fetuses showed a deceleratory response…

  13. Developmental Change in Fetal Response to Repeated Low-Intensity Sound

    ERIC Educational Resources Information Center

    Morokuma, Seiichi; Doria, Valentina; Ierullo, Antonio; Kinukawa, Naoko; Fukushima, Kotaro; Nakano, Hitoo; Arulkumaran, Sabaratnam; Papageorghiou, Aris T.

    2008-01-01

    The aim of this study was to investigate developmental changes in heart rate response to repeated low-intensity (85 dB) sound stimulation in fetuses between 32 and 37 weeks of gestation. We measured amplitude changes in heart rate as our index of fetal response. At 35 to 37 weeks of gestation, the majority of fetuses showed a deceleratory response…

  14. Nonlinear analysis of heart murmurs using wavelet-based higher-order spectral parameters.

    PubMed

    Taplidou, Styliani A; Hadjileontiadis, Leontios J

    2006-01-01

    The aim of this study was to reveal and analyze the nonlinear characteristics of heart sounds, reflected in the quadrature phase coupling of the contained frequencies, as they evolve over time. To achieve this, the continuous wavelet transform was combined with third-order statistics/spectra in order to analyze their non Gaussian character, taking into account their non-stationarity. Heart sounds from patients with several pathologies that exhibit murmurs were drawn from a heart sound database and analyzed in the time-bi-frequency domain. The analysis results justified the efficient performance of this combinatory approach to reveal and quantify the evolution of heart murmurs nonlinearities with time.

  15. Psychological and psychophysiological considerations regarding the maternal-fetal relationship

    PubMed Central

    DiPietro, Janet A.

    2009-01-01

    The earliest relationship does not begin with birth. Pregnant women construct mental representations of the fetus, and feelings of affiliation or “maternal-fetal attachment” generally increase over the course of gestation. While there is a fairly substantial literature on the development and moderation of psychological features of the maternal-fetal relationship, including the role of ultrasound imaging, relatively little is known about the manner in which maternal psychological functioning influences the fetus. Dispositional levels of maternal stress and anxiety are modestly associated with aspects of fetal heart rate and motor activity. Both induced maternal arousal and relaxation generate fairly immediate alterations to fetal neurobehaviors; the most consistently observed fetal response to changes in maternal psychological state involves suppression of motor activity. These effects may be mediated, in part, by an orienting response of the fetus to changes in the intrauterine environment. Conversely, there is evidence that fetal behaviors elicit maternal physiological responses. Integration of this finding into a more dynamic model of the maternal-fetal dyad, and implications for the postnatal relationship are discussed. Research on the period before birth affords tremendous opportunity for developmental scientists to advance understanding of the origins of human attachment. PMID:20228872

  16. Measuring maternal mortality.

    PubMed

    Royston, E; AbouZahr, C

    1992-07-01

    There are various methods of measuring maternal mortality each with its own advantages and disadvantages. Most official maternal mortality statistics underestimate true maternal mortality levels. Major reasons for underestimates depend on death certification practices and the advancement of the vital registration system. Only 35% of the world's population routinely record cause of death. Misclassification of the cause of death accounts for much of the bias in areas with good vital registration. In France, clerks miscode maternal-related causes of death as something else, e.g., they misclassified cerebral hemorrhages as diseases of the circulatory system and not complications of pregnancy, childbirth, and the puerperium. In countries with few maternal deaths, pregnant or puerperium women in life-threatening conditions are transferred from obstetric departments so cause of death on the certificate may not be the obstetric condition which precipitated the fatal series of events. Governments must determine the type of measurement method for maternal mortality by balancing precision against human and financial costs. Statisticians can measure the maternal mortality rate using several methods. They can include questions about maternal mortality such as maternal deaths of sisters of the adult women or of any women they know who had died from maternal causes in the last year in ongoing household surveys. These surveys tend to be expensive, however . A more cost-effective and successful method is reproductive age mortality surveys which consist of investigating the causes of all deaths of women of reproductive age. If civil registration or other population-based data do not exist, researchers can use hospital data despite their limitations. They can also use records at the primary care level. They can use incomplete data to estimate maternal mortality and to evaluate rates obtained from civil registers, studies, or other sources.

  17. Heart regeneration.

    PubMed

    Breckwoldt, Kaja; Weinberger, Florian; Eschenhagen, Thomas

    2016-07-01

    Regenerating an injured heart holds great promise for millions of patients suffering from heart diseases. Since the human heart has very limited regenerative capacity, this is a challenging task. Numerous strategies aiming to improve heart function have been developed. In this review we focus on approaches intending to replace damaged heart muscle by new cardiomyocytes. Different strategies for the production of cardiomyocytes from human embryonic stem cells or human induced pluripotent stem cells, by direct reprogramming and induction of cardiomyocyte proliferation are discussed regarding their therapeutic potential and respective advantages and disadvantages. Furthermore, different methods for the transplantation of pluripotent stem cell-derived cardiomyocytes are described and their clinical perspectives are discussed. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  18. Hypoplastic left heart syndrome

    MedlinePlus

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in females. As ...

  19. Depressed Mothers’ Newborns Show Less Discrimination of Other Newborns’ Cry Sounds

    PubMed Central

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria; Fernandez, Mercedes

    2007-01-01

    Newborns’ crying in response to the cry of another newborn has been called an empathetic response. The purpose of this study was to determine whether newborns of depressed mothers showed the same response. Newborns of depressed and non-depressed mothers were presented with cry sounds of themselves or other infants, and their sucking and heart rate were recorded. The newborns of non-depressed mothers responded to the cry sounds of other infants with reduced sucking and decreased heart rate. In contrast, the newborns of depressed mothers did not show a change in their sucking or heart rate to the cry sound of other infants. This lesser attentiveness/responsiveness to other infants’ cry sounds may predict their later lack of empathy. PMID:17412424

  20. [Pregnancy and congenital heart disease].

    PubMed

    Manso, Begoña; Gran, Ferrán; Pijuán, Antonia; Giralt, Gemma; Ferrer, Queralt; Betrián, Pedro; Albert, Dimpna; Rosés, Ferrán; Rivas, Nuria; Parra, Montserrat; Girona, Josep; Farrán, Inmaculada; Casaldáliga, Jaume

    2008-03-01

    Since the creation of the Adult Congenital Heart Disease Units and of the High Obstetric Risk Units, there has been increasing interest in hemodynamic and obstetric outcomes in pregnant woman with congenital heart disease. Retrospective descriptive study of 56 women with congenital heart disease aged (mean [range]) 25 (18-40) years, who experienced a total of 84 pregnancies between January 1992 and August 2006. The women were divided into three pregnancy risk groups: A, low-risk; B, moderate-risk, and C, high-risk. The incidence of complications during pregnancy was 1.6%, 15%, and 20% in groups A, B, and C, respectively; the incidence during the puerperium was 2%, 23%, and 50%, respectively; and maternal mortality was 0%, 7.6%, and 25%, respectively. Overall, 69 children were born, and the prematurity rates in the three groups were 11%, 15%, and 100%, respectively. The following risk factors were studied: pulmonary hypertension, cyanosis, arrhythmia, left ventricular outflow tract obstruction, right ventricular dilatation, systemic right ventricle, and anticoagulation therapy. The risk factor most significantly associated with maternal or fetal morbidity or mortality was found to be pulmonary hypertension. Risk stratification in pregnant women with congenital heart disease provides prognostic information that can help multidisciplinary teams to target care to achieve the best results.

  1. Heart palpitations

    MedlinePlus

    ... or longer Echocardiogram Electrophysiology study (EPS) Coronary angiography ... E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  2. Exploring Sound with Insects

    ERIC Educational Resources Information Center

    Robertson, Laura; Meyer, John R.

    2010-01-01

    Differences in insect morphology and movement during singing provide a fascinating opportunity for students to investigate insects while learning about the characteristics of sound. In the activities described here, students use a free online computer software program to explore the songs of the major singing insects and experiment with making…

  3. Making Sense of Sound

    ERIC Educational Resources Information Center

    Menon, Deepika; Lankford, Deanna

    2016-01-01

    From the earliest days of their lives, children are exposed to all kinds of sound, from soft, comforting voices to the frightening rumble of thunder. Consequently, children develop their own naïve explanations largely based upon their experiences with phenomena encountered every day. When new information does not support existing conceptions,…

  4. Creative Sound Dramatics

    ERIC Educational Resources Information Center

    Hendrix, Rebecca; Eick, Charles

    2014-01-01

    Sound propagation is not easy for children to understand because of its abstract nature, often best represented by models such as wave drawings and particle dots. Teachers Rebecca Hendrix and Charles Eick wondered how science inquiry, when combined with an unlikely discipline like drama, could produce a better understanding among their…

  5. Sound and Sense.

    ERIC Educational Resources Information Center

    Fleischman, Paul

    1986-01-01

    Claims that in metrical prose, rhythm can convey sense or express and underline what a writer is saying, and sound can be exploited to add a strong aural element that provides pleasure to the ears over and above the pleasure given by the sense of story. (SRT)

  6. Exploring Sound with Insects

    ERIC Educational Resources Information Center

    Robertson, Laura; Meyer, John R.

    2010-01-01

    Differences in insect morphology and movement during singing provide a fascinating opportunity for students to investigate insects while learning about the characteristics of sound. In the activities described here, students use a free online computer software program to explore the songs of the major singing insects and experiment with making…

  7. Creative Sound Dramatics

    ERIC Educational Resources Information Center

    Hendrix, Rebecca; Eick, Charles

    2014-01-01

    Sound propagation is not easy for children to understand because of its abstract nature, often best represented by models such as wave drawings and particle dots. Teachers Rebecca Hendrix and Charles Eick wondered how science inquiry, when combined with an unlikely discipline like drama, could produce a better understanding among their…

  8. Differential sound level meter

    NASA Technical Reports Server (NTRS)

    Zuckerwar, A. J. (Inventor)

    1977-01-01

    Small differences between relatively high sound pressure levels at two different microphone sites are measured by a device which provides electrical insertion voltages (pilot voltages) as a a means for continuously monitoring the gains of two acoustical channels. The difference between two pilot voltages is utilized to force the gain of one channel to track the other channel.

  9. Making Sense of Sound

    ERIC Educational Resources Information Center

    Menon, Deepika; Lankford, Deanna

    2016-01-01

    From the earliest days of their lives, children are exposed to all kinds of sound, from soft, comforting voices to the frightening rumble of thunder. Consequently, children develop their own naïve explanations largely based upon their experiences with phenomena encountered every day. When new information does not support existing conceptions,…

  10. Sight/Sound System.

    ERIC Educational Resources Information Center

    Cooper, Richard

    This guide explains the purpose, components, and use of the Sight/Sound System, which is an alternative reading instruction approach designed to meet the individual needs of learners of all ages who have poor decoding skills. Described in the first section are the ways in which the system works to accomplish the following goals: develop…

  11. Quality Sound: A Handbook for Additional Duty Sound Men.

    DTIC Science & Technology

    1986-04-01

    and identdfy by block number) Contemporary musical performance by Air Force bands necessitates heavy reliance on amplified sound . Operation of sound ...bands with no support slots authorized. Consequently, bandsmer perform non- musical functions as additional duties. The function of sound man, therefore...arena, doing without is not a viable option. The performance media today center around light and sound . Most contemporary music is vocal in nature

  12. [Rheumatic heart disease behind life-threatening heart failure in pregnancy].

    PubMed

    Ek, Michelle; Vladic-Stjernholm, Ylva; Günther, Anders; Hällsjö-Sander, Caroline; Jacobsen, Per-Herman

    2016-05-17

    Valvular heart disease constitutes the majority of all causes of heart disease in pregnancy. In the presence of valvular heart disease, the necessary haemodynamic changes of pregnancy might cause heart failure, leading to severe maternal and fetal morbidity and even mortality. In lower-income countries, rheumatic heart disease remains one of the major causes of death related to pregnancy [6]. In low-income countries, rheumatic heart disease is found in 60% to 80% of the pregnant women with heart disease, and 10% to 30% have a congenital disorder including congenital valve disorders [4]. The most common valvular lesion of rheumatic heart disease is mitral stenosis. This valvular lesion can be the cause of extreme disability and even mortality during pregnancy due to an increase in the transvalvular gradient and a rise in left atrial pressure. The maternal mortality associated with mitral stenosis is stratified by New York Heart Association (NYHA) classification: class I, 0.1%; class II, 0.3%; class III, 5.5%; and class IV, 6.0%. Most patients are in class I or II at presentation, but 12% to 25% of patients are in class III or IV [14].

  13. Congenital fetal heart block: a potential therapeutic role for intravenous immunoglobulin.

    PubMed

    David, Anna L; Ataullah, Ifat; Yates, Rob; Sullivan, Ian; Charles, Peter; Williams, David

    2010-08-01

    Congenital heart block affects 2% of all mothers with anti-Ro/La antibodies, can cause heart failure in utero, and has a 20% mortality rate in the first 3 years of life. Maternal fluorinated steroids to prevent or reverse congenital heart block can cause pregnancy complications. Intravenous immunoglobulin (IVIG) has been given with maternal steroids to prevent the recurrence of congenital heart block, although its efficacy is unproven. We report the use of IVIG to prevent progression of 2:1 congenital heart block with intermittent complete heart block. After two maternal infusions of IVIG (0.4 g/kg) at 31 weeks of gestation, the fetal heart rate reverted to long periods of sinus rhythm, which was sustained until postnatal life. Our case supports investigating IVIG in the prevention or treatment of this life-threatening condition.

  14. Maternal representation of the self as parent: connections with maternal sensitivity and maternal structuring.

    PubMed

    Biringen, Z; Matheny, A; Bretherton, I; Renouf, A; Sherman, M

    2000-09-01

    Maternal representations of the self as parent were assessed via the Parent Attachment and Peer Relationship Interviews (Bretherton, Biringen, Ridgeway, Maslin-Cole, & Sherman, 1989; Biringen & Bretherton, 1988) when children were 39 months of age. Maternal sensitivity and maternal structuring during mother-child interactions were assessed at 18, 24 and 39 months. The central question of this study was whether maternal representations were related to aspects of observed maternal sensitivity and maternal structuring. We found that maternal sensitivity at 18 months predicted later maternal representations of the self as parent. But beginning at 24 months and continuing to 39 months maternal structuring proved to be a more important predictor of maternal representations of the self, in particular maternal self-esteem, even after controlling for maternal sensitivity.

  15. Radiometric sounding system

    SciTech Connect

    Whiteman, C.D.; Anderson, G.A.; Alzheimer, J.M.; Shaw, W.J.

    1995-04-01

    Vertical profiles of solar and terrestrial radiative fluxes are key research needs for global climate change research. These fluxes are expected to change as radiatively active trace gases are emitted to the earth`s atmosphere as a consequence of energy production and industrial and other human activities. Models suggest that changes in the concentration of such gases will lead to radiative flux divergences that will produce global warming of the earth`s atmosphere. Direct measurements of the vertical variation of solar and terrestrial radiative fluxes that lead to these flux divergences have been largely unavailable because of the expense of making such measurements from airplanes. These measurements are needed to improve existing atmospheric radiative transfer models, especially under the cloudy conditions where the models have not been adequately tested. A tethered-balloon-borne Radiometric Sounding System has been developed at Pacific Northwest Laboratory to provide an inexpensive means of making routine vertical soundings of radiative fluxes in the earth`s atmospheric boundary layer to altitudes up to 1500 m above ground level. Such vertical soundings would supplement measurements being made from aircraft and towers. The key technical challenge in the design of the Radiometric Sounding System is to develop a means of keeping the radiometers horizontal while the balloon ascends and descends in a turbulent atmospheric environment. This problem has been addressed by stabilizing a triangular radiometer-carrying platform that is carried on the tetherline of a balloon sounding system. The platform, carried 30 m or more below the balloon to reduce the balloon`s effect on the radiometric measurements, is leveled by two automatic control loops that activate motors, gears and pulleys when the platform is off-level. The sensitivity of the automatic control loops to oscillatory motions of various frequencies and amplitudes can be adjusted using filters.

  16. Sounds of Space

    NASA Astrophysics Data System (ADS)

    Gurnett, D. A.

    2005-12-01

    Starting in the early 1960s, spacecraft-borne plasma wave instruments revealed that space is filled with an astonishing variety of radio and plasma wave sounds, which have come to be called "sounds of space." For over forty years these sounds have been collected and played to a wide variety of audiences, often as the result of press conferences or press releases involving various NASA projects for which the University of Iowa has provided plasma wave instruments. This activity has led to many interviews on local and national radio programs, and occasionally on programs haviang world-wide coverage, such as the BBC. As a result of this media coverage, we have been approached many times by composers requesting copies of our space sounds for use in their various projects, many of which involve electronic synthesis of music. One of these collaborations led to "Sun Rings," which is a musical event produced by the Kronos Quartet that has played to large audiences all over the world. With the availability of modern computer graphic techniques we have recently been attempting to integrate some of these sound of space into an educational audio/video web site that illustrates the scientific principles involved in the origin of space plasma waves. Typically I try to emphasize that a substantial gas pressure exists everywhere in space in the form of an ionized gas called a plasma, and that this plasma can lead to a wide variety of wave phenomenon. Examples of some of this audio/video material will be presented.

  17. About sound mufflers sound-absorbing panels aircraft engine

    NASA Astrophysics Data System (ADS)

    Dudarev, A. S.; Bulbovich, R. V.; Svirshchev, V. I.

    2016-10-01

    The article provides a formula for calculating the frequency of sound absorbed panel with a perforated wall. And although the sound absorbing structure is a set of resonators Helmholtz, not individual resonators should be considered in acoustic calculations, and all the perforated wall panel. The analysis, showing how the parameters affect the size and sound-absorbing structures in the absorption rate.

  18. Congenital heart disease in pregnancy.

    PubMed

    Swan, Lorna

    2014-05-01

    The story of congenital heart disease is one of the major successes of medicine in the last 50 years. Heart conditions previously associated with early death are now successfully treated. Many of these women are now in their child-bearing years wishing to have children of their own. All of these women should be offered comprehensive pre-conception counselling by a dedicated multi-disciplinary team. Each woman will present a unique set of cardiac and obstetric challenges that require an individualised assessment of risk and a carefully documented care plan. In this chapter, I describe the most common forms of congenital heart disease and the specific issues that should be assessed before conception. I present a systematic approach to risk stratification and care planning. These lesions range from mild disease with little implications for pregnancy to those with a sizable risk of maternal mortality or complications. I will also discuss fetal risk factors.

  19. Valvular heart disease in pregnancy.

    PubMed

    Windram, Jonathan D; Colman, Jack M; Wald, Rachel M; Udell, Jacob A; Siu, Samuel C; Silversides, Candice K

    2014-05-01

    In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling from a cardiologist with expertise in pregnancy. For women with moderate- and high-risk valve lesions, appropriate risk stratification and management during pregnancy will optimise outcomes. Pregnancy in women with high-risk lesions, such as severe aortic stenosis, severe mitral stenosis and those with mechanical valves, requires careful planning and coordination of antenatal care by a multidisciplinary team. The purpose of this overview is to describe the expected haemodynamic changes in pregnancy, review pregnancy risks for women with valvular heart disease and discuss strategies for management.

  20. Reversal of foetal hydrops and foetal tachyarrhythmia associated with maternal diabetic coma.

    PubMed

    Greco, P; Vimercati, A; Giorgino, F; Loverro, G; Selvaggi, L

    2000-11-01

    Foetal hydrops is always a challenge for the clinician. We report a case of tachycardia associated with hydrops and hydramnios in a pregnancy complicated with diabetic coma at 28 weeks gestation. Normal foetal heart rate was recorded immediately after correction of maternal acidotic status and hydrops eventually disappeared. The woman was delivered at 32 weeks and the baby had an uncomplicated postnatal course. We hypothesise that maternal ketoacidosis has been the precipitating factor of tachycardia and congestive heart failure and that this case is conceptually similar to the "late death" phenomenon, reported in cases of poorly controlled maternal diabetes.

  1. Heart Attack Symptoms in Women

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  2. Sounds of the Ancient Universe

    NASA Image and Video Library

    2013-03-21

    Tones represents sound waves that traveled through the early universe, and were later heard by ESA Planck space telescope. The primordial sound waves have been translated into frequencies we can hear.

  3. Light aircraft sound transmission study

    NASA Technical Reports Server (NTRS)

    Heitman, K.; Bernhard, R. J.

    1983-01-01

    The plausibility of using the two microphone sound intensity technique to study noise transmission into light aircraft was investigated. In addition, a simple model to predict the interior sound pressure level of the cabin was constructed.

  4. Modeling the Transmission of Sound.

    ERIC Educational Resources Information Center

    Palmer, David H.

    2003-01-01

    Introduces a functional model of sound transmission through solids and gases. Describes procedures of an activity to model how sound travels faster through solid materials than gases. Use dominoes to represent the particles of solids and gases. (KHR)

  5. Heart failure in pregnant women: is it peripartum cardiomyopathy?

    PubMed

    Dennis, Alicia Therese

    2015-03-01

    Peripartum cardiomyopathy is a rare but important cause of maternal morbidity and mortality. Women with peripartum cardiomyopathy often present with symptoms and signs of heart failure. The diagnosis of peripartum cardiomyopathy is made after all other causes of heart failure are excluded. Emphasis is on the immediate recognition of an unwell pregnant or recently pregnant woman, early diagnosis with the use of echocardiography, and the correct treatment of heart failure.

  6. Logging the Heart with Microcomputer-Based Labs

    ERIC Educational Resources Information Center

    van Eijck, Michiel; Goedhart, Martin; Ellermeijer, Ton

    2005-01-01

    A single heartbeat is a complicated process. In Dutch upper secondary biology textbooks this process is illustrated by the classical Wiggers diagram, which usually shows different heart-related quantities, like voltage (ECG), blood pressure, and the heart sounds. It may help students to understand the nature of the Wiggers diagram if they perform…

  7. Logging the Heart with Microcomputer-Based Labs

    ERIC Educational Resources Information Center

    van Eijck, Michiel; Goedhart, Martin; Ellermeijer, Ton

    2005-01-01

    A single heartbeat is a complicated process. In Dutch upper secondary biology textbooks this process is illustrated by the classical Wiggers diagram, which usually shows different heart-related quantities, like voltage (ECG), blood pressure, and the heart sounds. It may help students to understand the nature of the Wiggers diagram if they perform…

  8. Heart Truth

    MedlinePlus

    ... overall health and will allow you to enjoy quality time with your loved ones. Make a commitment to yourself and share it with a loved one for support. Learn more about The Heart Truth program, the risk factors for heart disease, and the stories of other ...

  9. Heart Attack

    MedlinePlus

    ... test your blood several times during the first 24 hours to 48 hours after yours symptoms start.Other ... do to help prevent heart attack?A healthy lifestyle can help prevent heart attack. This ... your stress.Controlling your blood pressure.Managing your ...

  10. Heart Anatomy

    MedlinePlus

    ... español An Incredible Machine Bonus poster (PDF) The Human Heart Anatomy Blood The Conduction System The Coronary Arteries The Heart Valves The Heartbeat Vasculature of the Arm Vasculature of the Head Vasculature of the Leg Vasculature of the Torso ...

  11. THE SOUND PATTERN OF ENGLISH.

    ERIC Educational Resources Information Center

    CHOMSKY, NOAM; HALLE, MORRIS

    "THE SOUND PATTERN OF ENGLISH" PRESENTS A THEORY OF SOUND STRUCTURE AND A DETAILED ANALYSIS OF THE SOUND STRUCTURE OF ENGLISH WITHIN THE FRAMEWORK OF GENERATIVE GRAMMAR. IN THE PREFACE TO THIS BOOK THE AUTHORS STATE THAT THEIR "WORK IN THIS AREA HAS REACHED A POINT WHERE THE GENERAL OUTLINES AND MAJOR THEORETICAL PRINCIPLES ARE FAIRLY CLEAR" AND…

  12. Just How Does Sound Wave?

    ERIC Educational Resources Information Center

    Shipman, Bob

    2006-01-01

    When children first hear the term "sound wave" perhaps they might associate it with the way a hand waves or perhaps the squiggly line image on a television monitor when sound recordings are being made. Research suggests that children tend to think sound somehow travels as a discrete package, a fast-moving invisible thing, and not something that…

  13. Just How Does Sound Wave?

    ERIC Educational Resources Information Center

    Shipman, Bob

    2006-01-01

    When children first hear the term "sound wave" perhaps they might associate it with the way a hand waves or perhaps the squiggly line image on a television monitor when sound recordings are being made. Research suggests that children tend to think sound somehow travels as a discrete package, a fast-moving invisible thing, and not something that…

  14. Sounds Alive: A Noise Workbook.

    ERIC Educational Resources Information Center

    Dickman, Donna McCord

    Sarah Screech, Danny Decibel, Sweetie Sound and Neil Noisy describe their experiences in the world of sound and noise to elementary students. Presented are their reports, games and charts which address sound measurement, the effects of noise on people, methods of noise control, and related areas. The workbook is intended to stimulate students'…

  15. Data sonification and sound visualization.

    SciTech Connect

    Kaper, H. G.; Tipei, S.; Wiebel, E.; Mathematics and Computer Science; Univ. of Illinois

    1999-07-01

    Sound can help us explore and analyze complex data sets in scientific computing. The authors describe a digital instrument for additive sound synthesis (Diass) and a program to visualize sounds in a virtual reality environment (M4Cave). Both are part of a comprehensive music composition environment that includes additional software for computer-assisted composition and automatic music notation.

  16. Algorithm for heart rate extraction in a novel wearable acoustic sensor

    PubMed Central

    Imtiaz, Syed Anas; Aguilar–Pelaez, Eduardo; Rodriguez–Villegas, Esther

    2015-01-01

    Phonocardiography is a widely used method of listening to the heart sounds and indicating the presence of cardiac abnormalities. Each heart cycle consists of two major sounds – S1 and S2 – that can be used to determine the heart rate. The conventional method of acoustic signal acquisition involves placing the sound sensor at the chest where this sound is most audible. Presented is a novel algorithm for the detection of S1 and S2 heart sounds and the use of them to extract the heart rate from signals acquired by a small sensor placed at the neck. This algorithm achieves an accuracy of 90.73 and 90.69%, with respect to heart rate value provided by two commercial devices, evaluated on more than 38 h of data acquired from ten different subjects during sleep in a pilot clinical study. This is the largest dataset for acoustic heart sound classification and heart rate extraction in the literature to date. The algorithm in this study used signals from a sensor designed to monitor breathing. This shows that the same sensor and signal can be used to monitor both breathing and heart rate, making it highly useful for long-term wearable vital signs monitoring. PMID:26609401

  17. Algorithm for heart rate extraction in a novel wearable acoustic sensor.

    PubMed

    Chen, Guangwei; Imtiaz, Syed Anas; Aguilar-Pelaez, Eduardo; Rodriguez-Villegas, Esther

    2015-02-01

    Phonocardiography is a widely used method of listening to the heart sounds and indicating the presence of cardiac abnormalities. Each heart cycle consists of two major sounds - S1 and S2 - that can be used to determine the heart rate. The conventional method of acoustic signal acquisition involves placing the sound sensor at the chest where this sound is most audible. Presented is a novel algorithm for the detection of S1 and S2 heart sounds and the use of them to extract the heart rate from signals acquired by a small sensor placed at the neck. This algorithm achieves an accuracy of 90.73 and 90.69%, with respect to heart rate value provided by two commercial devices, evaluated on more than 38 h of data acquired from ten different subjects during sleep in a pilot clinical study. This is the largest dataset for acoustic heart sound classification and heart rate extraction in the literature to date. The algorithm in this study used signals from a sensor designed to monitor breathing. This shows that the same sensor and signal can be used to monitor both breathing and heart rate, making it highly useful for long-term wearable vital signs monitoring.

  18. [Congenital atrioventricular block and maternal autoimmune diseases].

    PubMed

    Herreman, G; Sauvaget, F; Généreau, T; Galezowski, N

    1990-01-01

    Congenital heart block is rare; it is acquired in utero, definitive and, more often than not, complete. It can be diagnosed by the appearance of fetal bradycardia around the 23rd week of gestation, during ultrasonographic monitoring of pregnancy. Heart block is usually associated with the presence of anti-Ro and/or anti-La antibodies in the mother's serum. These maternal immunological abnormalities can be isolated or associated with an autoimmune disease, usually systemic lupus erythematosus, but also Sjögren's syndrome, or more rarely still, an as yet unclassified connective tissue disease. Anti-Ro and anti-La antibodies cross the placental barrier and react with a fetal heart, leading to acute fetal myocarditis by the 17th week of gestation. When severe, it is lethal, otherwise it can result in degeneration and endocardial fibroelastosis, disrupting conduction and leading to congenital heart block. The ideal treatment would be prevention with corticosteroids. When the mother is Ro or La antibody-positive before pregnancy, elimination of these circulating antibodies can be attempted by treatment with 0.5 mg/kg body wt/d of prednisolone for 3 months. If the treatment is successful, corticotherapy can be prescribed early in the pregnancy to try to protect the fetus. However, there is not always a relationship between maternal anti-Ro antibodies and fetal heart block. If the Ro/La antibody-positive woman is already pregnant, but before her 17th week, it is possible to prescribe dexamethasone, which crosses the placenta and remains active, sometimes in association with plasmapheresis.

  19. Sepsis and maternal mortality.

    PubMed

    Acosta, Colleen D; Knight, Marian

    2013-04-01

    Despite global progress towards reducing maternal mortality, sepsis remains a leading cause of preventable maternal death. This review focuses on current measurement challenges, trends, causes and efforts to curb maternal death from sepsis in high and low-income countries. Under-reporting using routine registration data, compounded by misclassification and unreported deaths, results in significant underestimation of the burden of maternal death from sepsis. In the UK and the Netherlands the recent increase in maternal death from sepsis is mainly attributed to an increase in invasive group A streptococcal infections. Susceptibility to infection may be complicated by modulation of maternal immune response and increasing rates of risk factors such as caesarean section and obesity. Failure to recognize severity of infection is a major universal risk factor. Standardized Surviving Sepsis Campaign (SSC) recommendations for management of severe maternal sepsis are continuing to be implemented worldwide; however, outcomes differ according to models of intensive care resourcing and use. The need for robust data with subsequent analyses is apparent. This will significantly increase our understanding of risk factors and their causal pathways, which are critical to informing effective treatment strategies in consideration of resource availability.

  20. Breast-feeding and maternal cardiovascular function.

    PubMed

    Mezzacappa, E S; Kelsey, R M; Myers, M M; Katkin, E S

    2001-11-01

    Two studies examined the effects of breast-feeding on maternal cardiovascular function. In the first experiment, groups of breast-feeding and bottle-feeding women were compared on preejection period (PEP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) recorded for 1-min periods before and during standard laboratory stressors. Compared with bottle-feeders, breast-feeders had higher CO throughout the session, and greater decreases in CO and increases in TPR during cold pressor. In the second experiment, HR and blood pressure (BP) were compared before and after one breast-feeding and one bottle-feeding session in a within-subjects design. Both feeding methods increased BP but decreased HR, and systolic BP was higher for the breast-feeding than the bottle-feeding condition. Both studies support the notion that breast-feeding alters maternal cardiovascular function, possibly through the actions of oxytocin.

  1. Environmentally sound manufacturing

    NASA Technical Reports Server (NTRS)

    Caddy, Larry A.; Bowman, Ross; Richards, Rex A.

    1994-01-01

    The NASA/Thiokol/industry team has developed and started implementation of an environmentally sound manufacturing plan for the continued production of solid rocket motors. They have worked with other industry representatives and the U.S. Environmental Protection Agency to prepare a comprehensive plan to eliminate all ozone depleting chemicals from manufacturing processes and to reduce the use of other hazardous materials used to produce the space shuttle reusable solid rocket motors. The team used a classical approach for problem solving combined with a creative synthesis of new approaches to attack this problem. As our ability to gather data on the state of the Earth's environmental health increases, environmentally sound manufacturing must become an integral part of the business decision making process.

  2. Synchronization of Sound Sources

    NASA Astrophysics Data System (ADS)

    Abel, Markus; Ahnert, Karsten; Bergweiler, Steffen

    2009-09-01

    Sound generation and interaction are highly complex, nonlinear, and self-organized. Nearly 150 years ago Rayleigh raised the following problem: two nearby organ pipes of different fundamental frequencies sound together almost inaudibly with identical pitch. This effect is now understood qualitatively by modern synchronization theory M. Abel et al. [J. Acoust. Soc. Am. 119, 2467 (2006)JASMAN0001-496610.1121/1.2170441]. For a detailed investigation, we substituted one pipe by an electric speaker. We observe that even minute driving signals force the pipe to synchronization, thus yielding three decades of synchronization—the largest range ever measured to our knowledge. Furthermore, a mutual silencing of the pipe is found, which can be explained by self-organized oscillations, of use for novel methods of noise abatement. Finally, we develop a reconstruction method which yields a perfect quantitative match of experiment and theory.

  3. Environmentally sound manufacturing

    NASA Astrophysics Data System (ADS)

    Caddy, Larry A.; Bowman, Ross; Richards, Rex A.

    The NASA/Thiokol/industry team has developed and started implementation of an environmentally sound manufacturing plan for the continued production of solid rocket motors. They have worked with other industry representatives and the U.S. Environmental Protection Agency to prepare a comprehensive plan to eliminate all ozone depleting chemicals from manufacturing processes and to reduce the use of other hazardous materials used to produce the space shuttle reusable solid rocket motors. The team used a classical approach for problem solving combined with a creative synthesis of new approaches to attack this problem. As our ability to gather data on the state of the Earth's environmental health increases, environmentally sound manufacturing must become an integral part of the business decision making process.

  4. Wood for sound.

    PubMed

    Wegst, Ulrike G K

    2006-10-01

    The unique mechanical and acoustical properties of wood and its aesthetic appeal still make it the material of choice for musical instruments and the interior of concert halls. Worldwide, several hundred wood species are available for making wind, string, or percussion instruments. Over generations, first by trial and error and more recently by scientific approach, the most appropriate species were found for each instrument and application. Using material property charts on which acoustic properties such as the speed of sound, the characteristic impedance, the sound radiation coefficient, and the loss coefficient are plotted against one another for woods. We analyze and explain why spruce is the preferred choice for soundboards, why tropical species are favored for xylophone bars and woodwind instruments, why violinists still prefer pernambuco over other species as a bow material, and why hornbeam and birch are used in piano actions.

  5. Underwater Sound Transmission

    DTIC Science & Technology

    1970-04-10

    OVER SPHERICAL DIVERGENCE LOSS VERSUS HORIZONTAL RANGE 49 20 ABSORPTION IN SEA WATER 51 21 ABSORPTION IN SEA WATER IN DEEP SOUND CHANNEL 52 22...isospeed condition. In warm water , a negative temperature gradient of greater magnitude is required to balance pressure increase with depth than in...cold water . Any combination of temperature and temperature gradient above the curve produces upward refraction. Any combination below the curve produces

  6. Sound categories or phonemes?

    PubMed

    Redford, Melissa A

    2017-02-01

    Vihman emphasizes the importance of early word production to the emergence of phonological knowledge. This emphasis, consistent with the generative function of phonology, provides insight into the concurrent representation of phonemes and words. At the same time, Vihman's focus on phonology leads her to possibly overstate the influence of early word acquisition on the emergence of sound categories that are probably purely phonetic in nature at the outset of learning.

  7. The Aries sounding rocket

    NASA Astrophysics Data System (ADS)

    Dooling, D.

    1980-02-01

    A family of sounding rockets called Aries, using the motors from obsolete Minuteman ICBMs, is described. Payloads for Aries range from 1,500 to 3,500 lb (with a payload diameter of 44 in.) and include various instruments (magnetospheric tracers, X-ray and extreme ultraviolet astronomy and a large X-ray telescope). Prospects for future launching of a two and even three-stage Aries are discussed.

  8. Marine Animal SOUND Database

    DTIC Science & Technology

    1991-08-01

    ontogeny of learned signals) in selected species (sperm whales , finbacks, bowheads, bottlenose dolphins, etc). For example, our 1954-1968 sperm whale ...recordings led to specific studies of their activities, which in turn opened the way to work focused on coda signals produced by these whales , and...then to analyses of distinctions between codas from individuals and those shared by the members a particular whale group. 8--8- Marine Animal SOUND

  9. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block...

  10. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block...

  11. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block...

  12. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block...

  13. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block...

  14. Maternal mortality in Cameroon: a university teaching hospital report.

    PubMed

    Tebeu, Pierre-Marie; Pierre-Marie, Tebeu; Halle-Ekane, Gregory; Gregory, Halle-Ekane; Da Itambi, Maxwell; Maxwell, Da Itambi; Enow Mbu, Robinson; Robinson, Enow Mbu; Mawamba, Yvette; Yvette, Mawamba; Fomulu, Joseph Nelson; Nelson, Fomulu Joseph

    2015-01-01

    More than 550,000 women die yearly from pregnancy-related causes. Fifty percent (50%) of the world estimate of maternal deaths occur in sub-Saharan Africa alone. There is insufficient information on the risk factors of maternal mortality in Cameroon. This study aimed at establishing causes and risk factors of maternal mortality. This was a case-control study from 1st January, 2006 to 31st December, 2010 after National Ethical Committee Approval. Cases were maternal deaths; controls were women who delivered normally. Maternal deaths were obtained from the delivery room registers and in-patient registers. Controls for each case were two normal deliveries following identified maternal deaths on the same day. Variables considered were socio-demographic and reproductive health characteristics. Epi Info 3.5.1 was used for analysis. The mean MMR was 287.5/100,000 live births. Causes of deaths were: postpartum hemorrhage (229.2%), unsafe abortion (25%), ectopic pregnancy (12.5%), hypertension in pregnancy (8.3%), malaria (8.3%), anemia (8.3%), heart disease (4.2%), and pneumonia (4.2%), and placenta praevia (4.2%). Ages ranged from 18 to 41 years, with a mean of 27.7 ± 5.14 years. Lack of antenatal care was a risk factor for maternal death (OR=78.33; CI: (8.66- 1802.51)). The mean MMR from 2006 to 2010 was 287.5/100,000 live births. Most of the causes of maternal deaths were preventable. Lack of antenatal care was a risk factor for maternal mortality. Key words: Maternal mortality, causes, risk factors, Cameroon.

  15. Maternal mortality in Cameroon: a university teaching hospital report

    PubMed Central

    Tebeu, Pierre-Marie; Halle-Ekane, Gregory; Da Itambi, Maxwell; Mbu, Robinson Enow; Mawamba, Yvette; Fomulu, Joseph Nelson

    2015-01-01

    More than 550,000 women die yearly from pregnancy-related causes. Fifty percent (50%) of the world estimate of maternal deaths occur in sub-Saharan Africa alone. There is insufficient information on the risk factors of maternal mortality in Cameroon. This study aimed at establishing causes and risk factors of maternal mortality. This was a case-control study from 1st January, 2006 to 31st December, 2010 after National Ethical Committee Approval. Cases were maternal deaths; controls were women who delivered normally. Maternal deaths were obtained from the delivery room registers and in-patient registers. Controls for each case were two normal deliveries following identified maternal deaths on the same day. Variables considered were socio-demographic and reproductive health characteristics. Epi Info 3.5.1 was used for analysis. The mean MMR was 287.5/100,000 live births. Causes of deaths were: postpartum hemorrhage (229.2%), unsafe abortion (25%), ectopic pregnancy (12.5%), hypertension in pregnancy (8.3%), malaria (8.3%), anemia (8.3%), heart disease (4.2%), and pneumonia (4.2%), and placenta praevia (4.2%). Ages ranged from 18 to 41 years, with a mean of 27.7 ± 5.14 years. Lack of antenatal care was a risk factor for maternal death (OR=78.33; CI: (8.66- 1802.51)). The mean MMR from 2006 to 2010 was 287.5/100,000 live births. Most of the causes of maternal deaths were preventable. Lack of antenatal care was a risk factor for maternal mortality. Key words: Maternal mortality, causes, risk factors, Cameroon. PMID:26401210

  16. The Sounds of Space

    NASA Astrophysics Data System (ADS)

    Gurnett, Donald

    2009-11-01

    The popular concept of space is that it is a vacuum, with nothing of interest between the stars, planets, moons and other astronomical objects. In fact most of space is permeated by plasma, sometimes quite dense, as in the solar corona and planetary ionospheres, and sometimes quite tenuous, as is in planetary radiation belts. Even less well known is that these space plasmas support and produce an astonishing large variety of waves, the ``sounds of space.'' In this talk I will give you a tour of these space sounds, starting with the very early discovery of ``whistlers'' nearly a century ago, and proceeding through my nearly fifty years of research on space plasma waves using spacecraft-borne instrumentation. In addition to being of scientific interest, some of these sounds can even be described as ``musical,'' and have served as the basis for various musical compositions, including a production called ``Sun Rings,'' written by the well-known composer Terry Riley, that has been performed by the Kronos Quartet to audiences all around the world.

  17. Auscultation of the heart: The Basics with Anatomical Correlation.

    PubMed

    Voin, Vlad; Oskouian, Rod J; Loukas, Marios; Tubbs, R Shane

    2017-01-01

    Proficiency in heart auscultation continues to be important even in an era of modern technology. However, many physicians and health care providers are uncomfortable and often inaccurate in their ability to identify normal and abnormal heart sounds. The following review was performed to provide a basis that health care providers can use to strengthen their understanding and improve their techniques when auscultating the human heart. Clin. Anat. 30:58-60, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Judging sound rotation when listeners and sounds rotate: Sound source localization is a multisystem process.

    PubMed

    Yost, William A; Zhong, Xuan; Najam, Anbar

    2015-11-01

    In four experiments listeners were rotated or were stationary. Sounds came from a stationary loudspeaker or rotated from loudspeaker to loudspeaker around an azimuth array. When either sounds or listeners rotate the auditory cues used for sound source localization change, but in the everyday world listeners perceive sound rotation only when sounds rotate not when listeners rotate. In the everyday world sound source locations are referenced to positions in the environment (a world-centric reference system). The auditory cues for sound source location indicate locations relative to the head (a head-centric reference system), not locations relative to the world. This paper deals with a general hypothesis that the world-centric location of sound sources requires the auditory system to have information about auditory cues used for sound source location and cues about head position. The use of visual and vestibular information in determining rotating head position in sound rotation perception was investigated. The experiments show that sound rotation perception when sources and listeners rotate was based on acoustic, visual, and, perhaps, vestibular information. The findings are consistent with the general hypotheses and suggest that sound source localization is not based just on acoustics. It is a multisystem process.

  19. Critical sound propagation in mixtures

    NASA Astrophysics Data System (ADS)

    Folk, R.; Moser, G.

    1998-01-01

    We calculate critical effects in the sound propagation in mixtures near consolute or plait points within a non-asymptotic renormalization group theory and derive general expressions for the frequency-dependent sound velocity and sound attenuation. The critical non-asymptotic time scale in the sound mode in mixtures is set by an effective order parameter Onsager coefficient containing a dynamical parameter related to the enhancement of the thermal conductivity in the mixture, not considered so far. The differences in the critical behavior near the consolute and plait point are due to the different non-asymptotic behavior of the zero-frequency sound velocity. We compare our predictions for the sound velocity and sound absorption near the plait point in 3He-4He mixtures.

  20. Sound naming in neurodegenerative disease.

    PubMed

    Chow, Maggie L; Brambati, Simona M; Gorno-Tempini, Maria Luisa; Miller, Bruce L; Johnson, Julene K

    2010-04-01

    Modern cognitive neuroscientific theories and empirical evidence suggest that brain structures involved in movement may be related to action-related semantic knowledge. To test this hypothesis, we examined the naming of environmental sounds in patients with corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP), two neurodegenerative diseases associated with cognitive and motor deficits. Subjects were presented with 56 environmental sounds: 28 sounds were of objects that required manipulation when producing the sound, and 28 sounds were of objects that required no manipulation. Subjects were asked to provide the name of the object that produced the sound and also complete a sound-picture matching condition. Subjects included 33 individuals from four groups: CBD/PSP, Alzheimer disease, frontotemporal dementia, and normal controls. We hypothesized that CBD/PSP patients would exhibit impaired naming performance compared with controls, but the impairment would be most apparent when naming sounds associated with actions. We also explored neural correlates of naming environmental sounds using voxel-based morphometry (VBM) of brain MRI. As expected, CBD/PSP patients scored lower on environmental sounds naming (p<0.007) compared with the controls. In particular, the CBD/PSP patients scored the lowest when naming sounds of manipulable objects (p<0.05), but did not show deficits in naming sounds of non-manipulable objects. VBM analysis across all groups showed that performance in naming sounds of manipulable objects correlated with atrophy in the left pre-motor region, extending from area six to the middle and superior frontal gyrus. These results indicate an association between impairment in the retrieval of action-related names and the motor system, and suggest that difficulty in naming manipulable sounds may be related to atrophy in the pre-motor cortex. Our results support the hypothesis that retrieval of action-related semantic knowledge involves motor

  1. Wine and heart health

    MedlinePlus

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  2. What Is Heart Failure?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  3. Effects of Sound Frequency on Behavioral and Cardiac Orienting in Newborn and Five-Month-Old Infants.

    ERIC Educational Resources Information Center

    Morrongiello, Barbara A.; Clifton, Rachel K.

    1984-01-01

    Examines alert newborn and five-month-old infants' responsivity to variations in spectral composition of a rattle sound. Head orientation and cardiac responses to sound were recorded. Heart rate change did not vary as a function of frequency at either age, suggesting that all stimuli were equally effective in eliciting the infant's attention.…

  4. Effects of Sound Frequency on Behavioral and Cardiac Orienting in Newborn and Five-Month-Old Infants.

    ERIC Educational Resources Information Center

    Morrongiello, Barbara A.; Clifton, Rachel K.

    1984-01-01

    Examines alert newborn and five-month-old infants' responsivity to variations in spectral composition of a rattle sound. Head orientation and cardiac responses to sound were recorded. Heart rate change did not vary as a function of frequency at either age, suggesting that all stimuli were equally effective in eliciting the infant's attention.…

  5. Heart Attack

    MedlinePlus

    ... yourself MedlinePlus for More Information National Institute on Aging Related Topics Heart Failure High Blood Cholesterol High ... us | Customer Support | site map National Institute on Aging | U.S. National Library of Medicine | National Institutes of ...

  6. Hearts Wish.

    ERIC Educational Resources Information Center

    Jones, Lethonee A.

    1989-01-01

    Investigates characteristics and themes in 102 drawings by sexually abused children. Themes of the drawings included genitalia, the absence of specific body parts, phallic symbols, inappropriate smiles, distorted body images, kinetic activity, prominent hands and fingers, and hearts. (RJC)

  7. Heart Transplant

    MedlinePlus

    ... of this information Order our Heart Transplant brochure Video: Preparing For Your Surgery Find helpful tips from ... how to plan and prepare for your surgery. Video: Recovering From Your Surgery Find helpful tips from ...

  8. What Is a Heart Murmur?

    MedlinePlus

    ... Heart Murmur Related Topics Anemia Congenital Heart Defects Heart Valve Disease Holes in the Heart How the Heart Works ... heart defect that is present since birth or heart valve disease. Depending on the heart problem causing the abnormal ...

  9. Interpolated Sounding and Gridded Sounding Value-Added Products

    SciTech Connect

    M. P. Jensen; Toto, T.

    2016-03-01

    Standard Atmospheric Radiation Measurement (ARM) Climate Research Facility sounding files provide atmospheric state data in one dimension of increasing time and height per sonde launch. Many applications require a quick estimate of the atmospheric state at higher time resolution. The INTERPOLATEDSONDE (i.e., Interpolated Sounding) Value-Added Product (VAP) transforms sounding data into continuous daily files on a fixed time-height grid, at 1-minute time resolution, on 332 levels, from the surface up to a limit of approximately 40 km. The grid extends that high so the full height of soundings can be captured; however, most soundings terminate at an altitude between 25 and 30 km, above which no data is provided. Between soundings, the VAP linearly interpolates atmospheric state variables in time for each height level. In addition, INTERPOLATEDSONDE provides relative humidity scaled to microwave radiometer (MWR) observations.

  10. Source Separation of Heartbeat Sounds for Effective E-Auscultation

    NASA Astrophysics Data System (ADS)

    Geethu, R. S.; Krishnakumar, M.; Pramod, K. V.; George, Sudhish N.

    2016-03-01

    This paper proposes a cost effective solution for improving the effectiveness of e-auscultation. Auscultation is the most difficult skill for a doctor, since it can be acquired only through experience. The heart sound mixtures are captured by placing the four numbers of sensors at appropriate auscultation area in the body. These sound mixtures are separated to its relevant components by a statistical method independent component analysis. The separated heartbeat sounds can be further processed or can be stored for future reference. This idea can be used for making a low cost, easy to use portable instrument which will be beneficial to people living in remote areas and are unable to take the advantage of advanced diagnosis methods.

  11. Heart failure

    PubMed Central

    2011-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of multidisciplinary interventions for heart failure? What are the effects of exercise in people with heart failure? What are the effects of drug treatments for heart failure? What are the effects of devices for treatment of heart failure? What are the effects of coronary revascularisation for treatment of heart failure? What are the effects of drug treatments in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium

  12. Rural maternity care.

    PubMed

    Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

    2012-10-01

    To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

  13. Maternal high-fat diet is associated with impaired fetal lung development.

    PubMed

    Mayor, Reina S; Finch, Katelyn E; Zehr, Jordan; Morselli, Eugenia; Neinast, Michael D; Frank, Aaron P; Hahner, Lisa D; Wang, Jason; Rakheja, Dinesh; Palmer, Biff F; Rosenfeld, Charles R; Savani, Rashmin C; Clegg, Deborah J

    2015-08-15

    Maternal nutrition has a profound long-term impact on infant health. Poor maternal nutrition influences placental development and fetal growth, resulting in low birth weight, which is strongly associated with the risk of developing chronic diseases, including heart disease, hypertension, asthma, and type 2 diabetes, later in life. Few studies have delineated the mechanisms by which maternal nutrition affects fetal lung development. Here, we report that maternal exposure to a diet high in fat (HFD) causes placental inflammation, resulting in placental insufficiency, fetal growth restriction (FGR), and inhibition of fetal lung development. Notably, pre- and postnatal exposure to maternal HFD also results in persistent alveolar simplification in the postnatal period. Our novel findings provide a strong association between maternal diet and fetal lung development.

  14. Maternal directiveness in interactions with mentally handicapped children: an analytical commentary.

    PubMed

    Marfo, K

    1990-05-01

    Maternal directiveness is portrayed as a negative interactional phenomenon in the mental retardation literature. Based on the speculation that a directive interactional style is causally related to poor developmental outcomes, the reduction of maternal directive behaviour is becoming a major thrust in early intervention work. This paper questions the characterization of directiveness as an inherently negative interactional phenomenon and highlights limitations in our current understanding of directiveness. Critical issues requiring attention in future research are identified and early interventionists cautioned that management of maternal directive behaviour must be founded on sound, empirically validated principles.

  15. Women's perceptions of informed choice in maternity care.

    PubMed

    O'Cathain, Alicia; Thomas, Kate; Walters, Stephen J; Nicholl, Jon; Kirkham, Mavis

    2002-06-01

    to describe the extent to which women using maternity services perceive that they have exercised informed choice. twelve maternity units in Wales. postal survey of women using maternity services, covering women's views of the extent to which they exercised informed choice overall, and at eight decision points during their care. 1386 women at approximately 28 weeks gestation (antenatal sample) and 1741 women at approximately 8 weeks post delivery (postnatal sample). 54% of women perceived that they exercised informed choice overall in the antenatal sample (95% CI: 51-57%) and 54% overall in the postnatal sample (95% CI: 52-56%). Perceptions of informed choice differed by decision point, varying between 31% for fetal heart monitoring during labour and 73% for the screening test for Down's syndrome and spina bifida in the baby. There were differences by maternity unit, even when the characteristics of women attending these units were taken into account. Multiparous women, women from manual occupations and women with lower educational status were more likely to feel that they exercised informed choice during antenatal care. These sub-groups of women were also more likely to report a preference for not sharing decision-making with health professionals. a large minority of women felt that they had not exercised informed choice overall in their maternity care. The perception of informed choice differed by decision point, maternity unit and characteristics of the woman. attaining informed choice is more of a challenge for some decision points in maternity care than others, particularly fetal monitoring. The difference in levels of informed choice between maternity units highlights the importance of maternity unit policy in the promotion of informed choice. Copyright 2002 Elsevier Science Ltd.

  16. Discovery of Sound in the Sea (DOSITS) Website Development

    DTIC Science & Technology

    2013-03-04

    life affect ocean sound levels? • Science of Sound > Sounds in the Sea > How will ocean acidification affect ocean sound levels? • Science of Sound...Science of Sound > Sounds in the Sea > How does shipping affect ocean sound levels? • Science of Sound > Sounds in the Sea > How does marine

  17. The pregnant heart: cardiac emergencies during pregnancy.

    PubMed

    McGregor, Alyson J; Barron, Rebecca; Rosene-Montella, Karen

    2015-04-01

    Cardiovascular emergencies in pregnant patients are often considered a rare event; however, heart disease as a cause of maternal mortality is steadily increasing. In this article, we review 3 common cardiovascular emergencies and the important subtle differences in their treatment in the pregnant patient: peripartum/postpartum cardiomyopathy, acute myocardial infarction, and cardiac resuscitation. Managing these conditions in the emergency department setting requires a high index of suspicion, knowledge of anatomical and physiologic changes associated with pregnancy, and updated management strategies related to optimizing maternal and fetal health. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Sounds in the Sea

    NASA Astrophysics Data System (ADS)

    Medwin, Herman

    2005-07-01

    Underwater acousticians and acoustical oceanographers use sound as the premier tool to determine the detailed characteristics of physical and biological bodies and processes at sea. Sounds in the Sea is a comprehensive and accessible textbook on ocean acoustics and acoustical oceanography. Chapters 1 9 provide the basic tools of ocean acoustics. The following fifteen chapters are written by many of the world's most successful ocean researchers. These chapters describe modern developments, and are divided into four sections: Studies of the Near Surface Ocean; Bioacoustical Studies; Studies of Ocean Dynamics; Studies of the Ocean Bottom. This is an invaluable textbook for any course in ocean acoustics for the physical and biological ocean sciences, and engineering. It will also serve as a reference for researchers and professionals in ocean acoustics, and an excellent introduction to the topic for scientists from related fields. Will become THE advanced but accessible textbook on all aspects of ocean acoustics for students in oceanography, engineering, and physics, and will also serve as a reference for researchers and professionals Contains fifteen chapters by many of the world's most successful ocean researchers, describing modern research developments Main author Medwin is world-renowned in ocean acoustics

  19. Respiratory sounds compression.

    PubMed

    Yadollahi, Azadeh; Moussavi, Zahra

    2008-04-01

    Recently, with the advances in digital signal processing, compression of biomedical signals has received great attention for telemedicine applications. In this paper, an adaptive transform coding-based method for compression of respiratory and swallowing sounds is proposed. Using special characteristics of respiratory sounds, the recorded signals are divided into stationary and nonstationary portions, and two different bit allocation methods (BAMs) are designed for each portion. The method was applied to the data of 12 subjects and its performance in terms of overall signal-to-noise ratio (SNR) values was calculated at different bit rates. The performance of different quantizers was also considered and the sensitivity of the quantizers to initial conditions has been alleviated. In addition, the fuzzy clustering method was examined for classifying the signal into different numbers of clusters and investigating the performance of the adaptive BAM with increasing the number of classes. Furthermore, the effects of assigning different numbers of bits for encoding stationary and nonstationary portions of the signal were studied. The adaptive BAM with variable number of bits was found to improve the SNR values of the fixed BAM by 5 dB. Last, the possibility of removing the training part for finding the parameters of adaptive BAMs for each individual was investigated. The results indicate that it is possible to use a predefined set of BAMs for all subjects and remove the training part completely. Moreover, the method is fast enough to be implemented for real-time application.

  20. Puget Sound telecommuting demonstration

    SciTech Connect

    Quaid, M.; Heifetz, L.; Farley, M.; Christensen, D.; Ulberg, C.; Gordon, A.; Spain, D.; Whitaker, B.

    1992-04-01

    This report discusses the Puget Sound Telecommuting demonstration project. This is a part-time work and transportation alternative that substitutes the normal work commute with the choice of working at home or at an office close to home. According to Link Resources, a research and consulting firm located in New York, there were 4.6 million part-time home telecommuters in the United States in 1991. This figure, which included only company employees who work at home during normal business hours, is up from 3.4 million in 1990, an increase of 35 percent in one year. Part-time telecommuters average 2.5 days per week at home. (There are also about 876,000 full-time telecommuters in the US.) The study done by Link Resources estimates that 4.5 percent of the civilian work force age 18 or older is telecommuting. The Washington State Energy Office (WSEO) began exploring telecommuting as an alternate route to work for Washington, first through The Governor`s Conference on Telecommuting in June 1989. The conference raised corporate and government awareness of telecommuting, and set the stage for further investigation. In 1990, WSEO launched the Puget Sound Telecommuting Demonstration to explore the environmental, organizational, and personal sides of telecommuting. This report presents the interim research results.

  1. Puget Sound telecommuting demonstration

    SciTech Connect

    Quaid, M.; Heifetz, L.; Farley, M.; Christensen, D. ); Ulberg, C.; Gordon, A.; Spain, D.; Whitaker, B. )

    1992-04-01

    This report discusses the Puget Sound Telecommuting demonstration project. This is a part-time work and transportation alternative that substitutes the normal work commute with the choice of working at home or at an office close to home. According to Link Resources, a research and consulting firm located in New York, there were 4.6 million part-time home telecommuters in the United States in 1991. This figure, which included only company employees who work at home during normal business hours, is up from 3.4 million in 1990, an increase of 35 percent in one year. Part-time telecommuters average 2.5 days per week at home. (There are also about 876,000 full-time telecommuters in the US.) The study done by Link Resources estimates that 4.5 percent of the civilian work force age 18 or older is telecommuting. The Washington State Energy Office (WSEO) began exploring telecommuting as an alternate route to work for Washington, first through The Governor's Conference on Telecommuting in June 1989. The conference raised corporate and government awareness of telecommuting, and set the stage for further investigation. In 1990, WSEO launched the Puget Sound Telecommuting Demonstration to explore the environmental, organizational, and personal sides of telecommuting. This report presents the interim research results.

  2. Sound Localization in Multisource Environments

    DTIC Science & Technology

    2009-03-01

    D. (1997). Factors affecting the relative salience of sound localization cues. In Gilkey, R. and Anderson, T., editors, Binaural and Spatial Hearing...AFRL-RH-WP-TR-2009-0032 Sound Localization in Multisource Environments Nandini Iyer Douglas S. Brungart Brian D. Simpson Warfighter...From - To) October 2004 – September 2008 4. TITLE AND SUBTITLE Sound Localization in Multisource Environments 5a. CONTRACT NUMBER In-House 5b

  3. Analysis of environmental sounds

    NASA Astrophysics Data System (ADS)

    Lee, Keansub

    Environmental sound archives - casual recordings of people's daily life - are easily collected by MPS players or camcorders with low cost and high reliability, and shared in the web-sites. There are two kinds of user generated recordings we would like to be able to handle in this thesis: Continuous long-duration personal audio and Soundtracks of short consumer video clips. These environmental recordings contain a lot of useful information (semantic concepts) related with activity, location, occasion and content. As a consequence, the environment archives present many new opportunities for the automatic extraction of information that can be used in intelligent browsing systems. This thesis proposes systems for detecting these interesting concepts on a collection of these real-world recordings. The first system is to segment and label personal audio archives - continuous recordings of an individual's everyday experiences - into 'episodes' (relatively consistent acoustic situations lasting a few minutes or more) using the Bayesian Information Criterion and spectral clustering. The second system is for identifying regions of speech or music in the kinds of energetic and highly-variable noise present in this real-world sound. Motivated by psychoacoustic evidence that pitch is crucial in the perception and organization of sound, we develop a noise-robust pitch detection algorithm to locate speech or music-like regions. To avoid false alarms resulting from background noise with strong periodic components (such as air-conditioning), a new scheme is added in order to suppress these noises in the domain of autocorrelogram. In addition, the third system is to automatically detect a large set of interesting semantic concepts; which we chose for being both informative and useful to users, as well as being technically feasible. These 25 concepts are associated with people's activities, locations, occasions, objects, scenes and sounds, and are based on a large collection of

  4. Sounds like Team Spirit

    NASA Technical Reports Server (NTRS)

    Hoffman, Edward

    2002-01-01

    I recently accompanied my son Dan to one of his guitar lessons. As I sat in a separate room, I focused on the music he was playing and the beautiful, robust sound that comes from a well-played guitar. Later that night, I woke up around 3 am. I tend to have my best thoughts at this hour. The trouble is I usually roll over and fall back asleep. This time I was still awake an hour later, so I got up and jotted some notes down in my study. I was thinking about the pure, honest sound of a well-played instrument. From there my mind wandered into the realm of high-performance teams and successful projects. (I know this sounds weird, but this is the sort of thing I think about at 3 am. Maybe you have your own weird thoughts around that time.) Consider a team in relation to music. It seems to me that a crack team can achieve a beautiful, perfect unity in the same way that a band of brilliant musicians can when they're in harmony with one another. With more than a little satisfaction I have to admit, I started to think about the great work performed for you by the Knowledge Sharing team, including this magazine you are reading. Over the past two years I personally have received some of my greatest pleasures as the APPL Director from the Knowledge Sharing activities - the Masters Forums, NASA Center visits, ASK Magazine. The Knowledge Sharing team expresses such passion for their work, just like great musicians convey their passion in the music they play. In the case of Knowledge Sharing, there are many factors that have made this so enjoyable (and hopefully worthwhile for NASA). Three ingredients come to mind -- ingredients that have produced a signature sound. First, through the crazy, passionate playing of Alex Laufer, Michelle Collins, Denise Lee, and Todd Post, I always know that something startling and original is going to come out of their activities. This team has consistently done things that are unique and innovative. For me, best of all is that they are always

  5. [Artificial heart and heart transplantation].

    PubMed

    Moosdorf, R

    2012-12-01

    The advances in the treatment of many different heart diseases have on the one side led to a significant prolongation of life expectancy but have also contributed to an increase of patients with heart failure. This tendency is supported even more so by the demographic development of our population. The replacement of insufficient organs has always been in the focus of medical research. In the 1960's Shumway and Lower developed the technique of cardiac transplantation and also worked intensively on the treatment and diagnosis of rejection. However, it was Barnard who, in 1967 performed the first human cardiac transplantation. Other centers followed worldwide but the mortality was high and the new therapy was controversially discussed in many journals. By the introduction of cyclosporin as a new immunosuppressive agent in 1978, results improved rapidly and cardiac transplantation became an accepted therapeutic option for patients with end stage heart failure and also for children and newborns with congenital heart defects. Today, with newer immunosuppressive regimens and improved techniques, cardiac transplantation offers excellent results with a long-term survival of nearly 50% of patients after 15 years and among the pediatric population even after 20 years. However, the donor organ shortage as well as the increasing number of elderly patients with end stage heart failure has necessitated work on other alternatives. Neither stem cell transplantation nor xenotransplantation of animal organs are yet an option and there are still some obstacles to be overcome. In contrast, the development of so-called artificial hearts has made significant progress. While the first implants of totally artificial hearts were associated with many comorbidities and patients were seriously debilitated, new devices today offer a reasonable quality of life and long-term survival. Most of these systems are no longer replacing but mainly assisting the heart, which remains in place. These

  6. Maternal mortality--Pumwani Maternity Hospital--1975-1984.

    PubMed

    Ngoka, W M; Bansal, Y P

    1987-04-01

    The study is purpose was to identify the avoidable factors responsible for the high maternal mortality in the Pumwani Maternity Hospital in Nairobi, Kenya and to determine how the available facilities could be used to reduce the mortality. A retrospective study of maternal deaths was carried out at the hospital for the period 1975-1984. During this period, there were 223,111 births and 150 maternal deaths, giving an incidence of maternal mortality of 67.2/100,000 births. Eclampsia and severe preeclampsia, puerperal sepsis, ruptured uterus, and postpartum hemorrhage were among the leading causes of maternal deaths. The authors also concluded that the following factors contributed to the increased maternal mortality: high maternal age; primigravidy; grandmultiparity; lack of good antenatal, intranatal, and postnatal care; lack of investigations; lack of good transfusion services; lack of better skilled anesthetic staff; and lack of discipline among the medical personnel.

  7. Bilateral sound propagation characteristics in electronic TMJ sound recording.

    PubMed

    Yang, K P; Koh, K H; Williams, W J; Widmalm, S E; Djurdjanovic, D

    1999-01-01

    Temporomandibular Joint (TMJ) sounds, clicking and crepitation, are important signs of possible TM disorder or dysfunction (TMD). The sound are usually recorded and observed by stethoscope auscultation or palpation. Sound from one TMJ may propagate through head tissues and be recorded on the contra lateral side misleading the examiner to classify both joints as non-silent. Errors in localization of sound source may lead to an erroneous diagnosis. Widmalm et al. (1997) suggested a mathematical model for estimation of the sound propagation characteristics through the head tissues. A modified model applying the auto-spectral density and cross-spectral density of the signal was used to estimate the bilateral sound propagation characteristics of temporomandibular joint sounds from two subjects. The result indicates that the head tissues act as a bandpass filter causing strong attenuation in some frequency areas with little attenuation in others. The phase response of the transfer function provides a good mean to estimate the latency in time between sounds.

  8. Interpolated Sounding and Gridded Sounding Value-Added Products

    SciTech Connect

    Toto, T.; Jensen, M.

    2016-03-01

    Standard Atmospheric Radiation Measurement (ARM) Climate Research Facility sounding files provide atmospheric state data in one dimension of increasing time and height per sonde launch. Many applications require a quick estimate of the atmospheric state at higher time resolution. The INTERPOLATEDSONDE (i.e., Interpolated Sounding) Value-Added Product (VAP) transforms sounding data into continuous daily files on a fixed time-height grid, at 1-minute time resolution, on 332 levels, from the surface up to a limit of approximately 40 km. The grid extends that high so the full height of soundings can be captured; however, most soundings terminate at an altitude between 25 and 30 km, above which no data is provided. Between soundings, the VAP linearly interpolates atmospheric state variables in time for each height level. In addition, INTERPOLATEDSONDE provides relative humidity scaled to microwave radiometer (MWR) observations.The INTERPOLATEDSONDE VAP, a continuous time-height grid of relative humidity-corrected sounding data, is intended to provide input to higher-order products, such as the Merged Soundings (MERGESONDE; Troyan 2012) VAP, which extends INTERPOLATEDSONDE by incorporating model data. The INTERPOLATEDSONDE VAP also is used to correct gaseous attenuation of radar reflectivity in products such as the KAZRCOR VAP.

  9. Heart failure

    PubMed Central

    2010-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug treatments, and of drug and invasive treatments, for heart failure? What are the effects of angiotensin-converting enzyme inhibitors in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 85 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium channel blockers, cardiac resynchronisation therapy, digoxin (in people already receiving diuretics and angiotensin-converting enzyme inhibitors), exercise, hydralazine plus isosorbide dinitrate, implantable cardiac

  10. Maternal hypoxia and caffeine exposure depress fetal cardiovascular function during primary organogenesis

    PubMed Central

    Momoi, Nobuo; Tinney, Joseph P.; Keller, Bradley B.; Tobita, Kimimasa

    2012-01-01

    Aims Hypoxia is known to influence cardiovascular (CV) function, in part, through adenosine receptor activation. We have shown in a mouse model that during primary cardiac morphogenesis, acute maternal hypoxia negatively affects fetal heart rate, and recurrent maternal caffeine exposure reduces fetal cardiac output (CO) and down-regulates fetal adenosine A2A receptor gene expression. In the present study, we investigated whether maternal caffeine dosing exacerbates the fetal CV response to acute maternal hypoxia during the primary morphogenesis period. Methods Gestational day 11.5 pregnant mice were exposed to hypoxia (45 second duration followed by 10 minutes of recovery and repeated 3 times) while simultaneously monitoring maternal and fetal CO using high-resolution echocardiography. Results Following maternal hypoxia exposure, maternal CO transiently decreased and then returned to pre-hypoxia baseline values. In contrast to a uniform maternal cardiac response to each exposure to hypoxia, the fetal CO recovery time to the baseline decreased, and CO rebounded above baseline following the 2nd and 3rd episodes of maternal hypoxia. Maternal caffeine treatment inhibited the fetal CO recovery to maternal hypoxia by lengthening the time to CO recovery and eliminating the CO rebound post-recovery. Selective treatment with an adenosine A2A receptor antagonist, but not an adenosine A1 receptor antagonist, reproduced the altered fetal CO response to maternal hypoxia created by caffeine exposure. Conclusions Results suggest an additive negative effect of maternal caffeine on the fetal CV response to acute maternal hypoxia, potentially mediated via adenosine A2A receptor inhibition during primary cardiovascular morphogenesis. PMID:22612345

  11. The Effect of Sound Delivery Methods on a User’s Sense of Presence in a Virtual Environment

    DTIC Science & Technology

    2002-03-01

    a virtual environment was investigated. Second, the physiological responses of electrodermal activity , heart rate, and temperature were measured and... electrodermal activity and temperature and questionnaire scores. Also, significant changes occurred between the speaker and headphone sound delivery...delivery on a user’s sense of presence in a virtual environment was investigated. Second, the physiological responses of electrodermal activity , heart

  12. Maternal and neonatal tetanus

    PubMed Central

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2017-01-01

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  13. Healthy Heart Quizzes

    MedlinePlus

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  14. Maternal Competition in Women.

    PubMed

    Linney, Catherine; Korologou-Linden, Laurel; Campbell, Anne

    2017-03-01

    We examined maternal competition, an unexplored form of competition between women. Given women's high investment in offspring and mothers' key role in shaping their reproductive, social, and cultural success as adults, we might expect to see maternal competition between women as well as mate competition. Predictions about the effect of maternal characteristics (age, relationship status, educational background, number of children, investment in the mothering role) and child variables (age, sex) were drawn from evolutionary theory and sociological research. Mothers of primary school children (in two samples: N = 210 and 169) completed a series of questionnaires. A novel nine-item measure of maternal competitive behavior (MCQ) and two subscales assessing Covert (MCQ-C) and Face-to-Face (MCQ-FF) forms of competition were developed using confirmatory factor analysis. Competitiveness (MCQ score) was predicted by maternal investment, single motherhood, fewer children, and (marginally) child's older age. The effect of single motherhood (but not other predictors) was partially mediated by greater maternal investment. In response to a scenario of their child underperforming relative to their peers, a mother's competitive distress was a positive function of the importance she ascribed to their success and her estimation of her child's ability. Her competitive distress was highly correlated with the distress she attributed to a female friend, hinting at bidirectional dyadic effects. Qualitative responses indicated that nonspecific bragging and boasting about academic achievements were the most common irritants. Although 40% of women were angered or annoyed by such comments, less than 5% endorsed a direct hostile response. Instead, competitive mothers were conversationally shunned and rejected as friends. We suggest that the interdependence of mothers based on reciprocal childcare has supported a culture of egalitarianism that is violated by explicit competitiveness.

  15. Sound and computer information presentation

    SciTech Connect

    Bly, S

    1982-03-01

    This thesis examines the use of sound to present data. Computer graphics currently offers a vast array of techniques for communicating data to analysts. Graphics is limited, however, by the number of dimensions that can be perceived at one time, by the types of data that lend themselves to visual representation, and by the necessary eye focus on the output. Sound offers an enhancement and an alternative to graphic tools. Multivariate, logarithmic, and time-varying data provide examples for aural representation. For each of these three types of data, the thesis suggests a method of encoding the information into sound and presents various applications. Data values were mapped to sound characteristics such as pitch and volume so that information was presented as sets or sequences of notes. In all cases, the resulting sounds conveyed information in a manner consistent with prior knowledge of the data. Experiments showed that sound does convey information accurately and that sound can enhance graphic presentations. Subjects were tested on their ability to distinguish between two sources of test items. In the first phase of the experiments, subjects discriminated between two 6-dimensional data sets represented in sound. In the second phase of the experiment, 75 subjects were selected and assigned to one of three groups. The first group of 25 heard test items, the second group saw test items, and the third group both heard and saw the test items. The average percentage correct was 64.5% for the sound-only group, 62% for the graphics-only group, and 69% for the sound and graphics group. In the third phase, additional experiments focused on the mapping between data values and sound characteristics and on the training methods.

  16. Steady-state maternal and fetal plasma concentrations of glyceryl trinitrate (GTN) in the preterm sheep.

    PubMed

    Bustard, Mark A; Farley, Anne E; Bennett, Brian M; Smith, Graeme N

    2003-09-01

    The administration of glyceryl trinitrate (GTN; nitroglycerin) is increasing during preterm pregnancies, yet its disposition and, importantly, the extent of fetal exposure remain to be elucidated. When used as a tocolytic (pharmacological agent that stops uterine contractions), it is administered transdermally (24-48 h). Here, we quantified the maternal and fetal steady-state plasma concentrations of maternal intravenous GTN in preterm sheep and continuously monitored maternal and fetal vascular parameters to observe possible dose-dependent vascular effects. Preterm (120 days gestation) pregnant sheep (n = 6) were instrumented with maternal femoral arterial (MA) and venous (MV) and fetal femoral arterial (FA) and umbilical venous (UV) polyethylene blood-sampling catheters. During maternal GTN infusion (3.0 micro g.kg-1.min-1, 60-min duration) the steady-state GTN concentrations ([GTN]) were as follows: MA, 98.6 +/- 9.0 nM; UV, 17.4 +/- 7.6 nM; and FA, <5 nM. There were no changes in maternal and fetal mean arterial pressure and heart rate or in uterine activity. Overall, the steady-state [GTN] was established by 5 min, and the UV/MA ratio of [GTN] was 0.18. The FA [GTN] (<5 nM) indicates that the fetus cleared essentially all GTN in the UV, and the maternal and fetal heart rate and mean arterial pressure appear to be independent of maternal GTN infusion.

  17. The monster sound pipe

    NASA Astrophysics Data System (ADS)

    Ruiz, Michael J.; Perkins, James

    2017-03-01

    Producing a deep bass tone by striking a large 3 m (10 ft) flexible corrugated drainage pipe immediately grabs student attention. The fundamental pitch of the corrugated tube is found to be a semitone lower than a non-corrugated smooth pipe of the same length. A video (https://youtu.be/FU7a9d7N60Y) of the demonstration is included, which illustrates how an Internet keyboard can be used to estimate the fundamental pitches of each pipe. Since both pipes have similar end corrections, the pitch discrepancy between the smooth pipe and drainage tube is due to the corrugations, which lower the speed of sound inside the flexible tube, dropping its pitch a semitone.

  18. Sounding out science

    SciTech Connect

    Holloway, M.

    1996-10-01

    The Exxon Valdez catastrophe, which soiled Alaska`s Prince William Sound in 1989, was the most studied oil spill in history. But because of how they framed their inquiries, investigators have learned less than they could about how nature heals itself. The studies of Exxon and the state of Alaska - including the departments of Fish and Game and of Environmental Conservation - conducted to prove their respective points, were kept largely secret untill legal settlements were reached. This secrecy reduced most of the pillars of science to rubble: out went scientific dialog, data sharing, and for some parties, peer view. Millions of dollars were shelled out in duplicate studies that reached opposite conclusions. Beyond the quality of science lies the public interpretation of science. Even though NOAA has shown that cleaning up can do more harm than good, demands to clean up persist. 7 figs.

  19. Deep-sea soundings

    NASA Astrophysics Data System (ADS)

    Brooks, David A.

    Bathymetric charts for many areas of the ocean are cheap and accurate, and we usually take their availability for granted. In these times of abundant information, it is easy to forget the wonder and excitement of the last century, when mechanical sounding machines revealed for the first time the major features of the ocean depths. Who would not be awed by the graceful sweep of the Blake Plateau or the plunging depths of the Puerto Rico Trench, and who could remain unimpressed by undersea mountain ranges more majestic than any in view? In his 1888 book, entitled Three Cruises of the Blake, Alexander Agassiz has this to say about the spectacular Caribbean bottom topography: “Compared to such panoramas the finest views of the range of the Alps sink into insignificance; it is only when we get a view of portions of the Andes from the sea-coast…that we get anything approximating to it in grandeur.”

  20. The Sounds of Earth

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Flying board Voyagers 1 and 2 are identical 'golden' records, carrying the story of Earth far into deep space. The 12 inch gold-plated copper discs contain greetings in 60 languages, samples of music from different cultures and eras, and natural and man-made sounds from Earth. They also contain electronic information that an advanced technological civilization could convert into diagrams and photographs. The cover of each gold plated aluminum jacket, designed to protect the record from micrometeorite bombardment, also serves a double purpose in providing the finder a key to playing the record. The explanatory diagram appears on both the inner and outer surfaces of the cover, as the outer diagram will be eroded in time. Currently, both Voyager probes are sailing adrift in the black sea of interplanetary space, having left our solar system years ago.

  1. Timing sight and sound.

    PubMed

    Arnold, Derek H; Johnston, Alan; Nishida, Shinya

    2005-05-01

    It has been proposed that there is a perceptual compensation for the difference between the speeds of light and sound. We examined this possibility using a range of auditory-visual tasks, in which performance depends on the relative timing of auditory and visual information, and manipulated viewing distance to test for perceptual compensation. We explored auditory-visual integration, cross modal causal attributions, and auditory-visual temporal order judgments. We observed timing shifts with viewing distance following loudspeaker, but not headphone, presentations. We were unable to find reliable evidence of perceptual compensation. Our findings suggest that auditory and visual signals of an event that reach an observer at the same point in time tend to become perceptually bound, even when the sources of those signals could not have occurred together.

  2. Sounds Clear Enough

    NASA Technical Reports Server (NTRS)

    Zak, Alan

    2004-01-01

    I'm a vice president at Line6, where we produce electronics for musical instruments. My company recently developed a guitar that can be programmed to sound like twenty-five different classic guitars - everything from a 1928 National 'Tricone' to a 1970 Martin. It is quite an amazing piece of technology. The guitar started as a research project because we needed to know if the technology was going to be viable and if the guitar design was going to be practical. I've been in this business for about twenty years now, and I still enjoy starting up projects whenever the opportunity presents itself. During the research phase, I headed up the project myself. Once we completed our preliminary research and made the decision to move into development, that's when I handed the project off - and that's where this story really begins.

  3. Korean speech sound development in children from bilingual Japanese-Korean environments.

    PubMed

    Kim, Jeoung Suk; Lee, Jun Ho; Choi, Yoon Mi; Kim, Hyun Gi; Kim, Sung Hwan; Lee, Min Kyung; Kim, Sun Jun

    2010-09-01

    This study investigates Korean speech sound development, including articulatory error patterns, among the Japanese-Korean children whose mothers are Japanese immigrants to Korea. The subjects were 28 Japanese-Korean children with normal development born to Japanese women immigrants who lived in Jeonbuk province, Korea. They were assessed through Computerized Speech Lab 4500. The control group consisted of 15 Korean children who lived in the same area. The values of the voice onset time of consonants /p(h)/, /t/, /t(h)/, and /k(*)/ among the children were prolonged. The children replaced the lenis sounds with aspirated or fortis sounds rather than replacing the fortis sounds with lenis or aspirated sounds, which are typical among Japanese immigrants. The children showed numerous articulatory errors for /c/ and /l/ sounds (similar to Koreans) rather than errors on /p/ sounds, which are more frequent among Japanese immigrants. The vowel formants of the children showed a significantly prolonged vowel /o/ as compared to that of Korean children (P<0.05). The Japanese immigrants and their children showed a similar substitution /n/ for /ɧ/ [Japanese immigrants (62.5%) vs Japanese-Korean children (14.3%)], which is rarely seen among Koreans. The findings suggest that Korean speech sound development among Japanese-Korean children is influenced not only by the Korean language environment but also by their maternal language. Therefore, appropriate language education programs may be warranted not only or immigrant women but also for their children.

  4. Phonocardiogram signal compression using sound repetition and vector quantization.

    PubMed

    Tang, Hong; Zhang, Jinhui; Sun, Jian; Qiu, Tianshuang; Park, Yongwan

    2016-04-01

    A phonocardiogram (PCG) signal can be recorded for long-term heart monitoring. A huge amount of data is produced if the time of a recording is as long as days or weeks. It is necessary to compress the PCG signal to reduce storage space in a record and play system. In another situation, the PCG signal is transmitted to a remote health care center for automatic analysis in telemedicine. Compression of the PCG signal in that situation is necessary as a means for reducing the amount of data to be transmitted. Since heart beats are of a cyclical nature, compression can make use of the similarities in adjacent cycles by eliminating repetitive elements as redundant. This study proposes a new compression method that takes advantage of these repetitions. Data compression proceeds in two stages, a training stage followed by the compression as such. In the training stage, a section of the PCG signal is selected and its sounds and murmurs (if any) decomposed into time-frequency components. Basic components are extracted from these by clustering and collected to form a dictionary that allows the generative reconstruction and retrieval of any heart sound or murmur. In the compression stage, the heart sounds and murmurs are reconstructed from the basic components stored in the dictionary. Compression is made possible because only the times of occurrence and the dictionary indices of the basic components need to be stored, which greatly reduces the number of bits required to represent heart sounds and murmurs. The residual that cannot be reconstructed in this manner appears as a random sequence and is further compressed by vector quantization. What we propose are quick search parameters for this vector quantization. For normal PCG signals the compression ratio ranges from 20 to 149, for signals with median murmurs it ranges from 14 to 35, and for those with heavy murmurs, from 8 to 20, subject to a degree of distortion of ~5% (in percent root-mean-square difference) and a sampling

  5. Designing a Sound Reducing Wall

    ERIC Educational Resources Information Center

    Erk, Kendra; Lumkes, John; Shambach, Jill; Braile, Larry; Brickler, Anne; Matthys, Anna

    2015-01-01

    Acoustical engineers use their knowledge of sound to design quiet environments (e.g., classrooms and libraries) as well as to design environments that are supposed to be loud (e.g., concert halls and football stadiums). They also design sound barriers, such as the walls along busy roadways that decrease the traffic noise heard by people in…

  6. Applications of Sound Spectrum Analysis

    ERIC Educational Resources Information Center

    Moran, Timothy

    2007-01-01

    The physics of sound is often studied in introductory physics class experiments involving a tube of resonating air. In typical setups, pistons control the length of a cylindrical space or a microphone is moved within a tube. While these activities are useful and can be made very quantitative, they don't directly demonstrate the sounds that are…

  7. Letter Recognition and Sound Identification.

    ERIC Educational Resources Information Center

    Prior, Jennifer

    This lesson, which is most appropriate for kindergartners, reviews letter names and their sounds through a group letter recognition activity, a picture book activity, and alphabet practice with several online activities. During three 30-minute sessions, students will: identify the letters of the alphabet; identify the sounds of letters; identify…

  8. BATHYMETRIC RECONNAISSANCE OF EXUMA SOUND

    DTIC Science & Technology

    A bathymetric survey was undertaken with an expanded scale Precision Depth Recorder in Exuma Sound which is the easternmost trough cut in the...structural pattern for the area and how this pattern evolved. Exuma Sound resembles the other two features, all three are deeply incised on the Florida

  9. Applications of Sound Spectrum Analysis

    ERIC Educational Resources Information Center

    Moran, Timothy

    2007-01-01

    The physics of sound is often studied in introductory physics class experiments involving a tube of resonating air. In typical setups, pistons control the length of a cylindrical space or a microphone is moved within a tube. While these activities are useful and can be made very quantitative, they don't directly demonstrate the sounds that are…

  10. Sound Standards for Schools "Unsound."

    ERIC Educational Resources Information Center

    Davis, Don

    2002-01-01

    Criticizes new classroom sound standard proposed by the American National Standards Institute that sets maximum background sound level at 35 decibels (described as "a whisper at 2 meters"). Argues that new standard is too costly for schools to implement, is not recommended by the medical community, and cannot be achieved by construction…

  11. Designing a Sound Reducing Wall

    ERIC Educational Resources Information Center

    Erk, Kendra; Lumkes, John; Shambach, Jill; Braile, Larry; Brickler, Anne; Matthys, Anna

    2015-01-01

    Acoustical engineers use their knowledge of sound to design quiet environments (e.g., classrooms and libraries) as well as to design environments that are supposed to be loud (e.g., concert halls and football stadiums). They also design sound barriers, such as the walls along busy roadways that decrease the traffic noise heard by people in…

  12. Women's Heart Disease: Heart Attack Symptoms

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  13. Women's Heart Disease: Heart Disease Risk Factors

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

  14. Heart Health: The Heart Truth Campaign 2009

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  15. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  16. Heart failure in children - overview

    MedlinePlus

    Congestive heart failure - children; Cor pulmonale - children; Cardiomyopathy - children; CHF - children; Congenital heart defect - heart failure in children; Cyanotic heart disease - heart failure in children; Birth defect of the heart - heart ...

  17. The impact of sound in modern multiline video slot machine play.

    PubMed

    Dixon, Mike J; Harrigan, Kevin A; Santesso, Diane L; Graydon, Candice; Fugelsang, Jonathan A; Collins, Karen

    2014-12-01

    Slot machine wins and losses have distinctive, measurable, physiological effects on players. The contributing factors to these effects remain under-explored. We believe that sound is one of these key contributing factors. Sound plays an important role in reinforcement, and thus on arousal level and stress response of players. It is the use of sound for positive reinforcement in particular that we believe influences the player. In the current study, we investigate the role that sound plays in psychophysical responses to slot machine play. A total of 96 gamblers played a slot machine simulator with and without sound being paired with reinforcement. Skin conductance responses and heart rate, as well as subjective judgments about the gambling experience were examined. The results showed that the sound influenced the arousal of participants both psychophysically and psychologically. The sound also influenced players' preferences, with the majority of players preferring to play slot machines that were accompanied by winning sounds. The sounds also caused players to significantly overestimate the number of times they won while playing the slot machine.

  18. Getting a New Heart

    MedlinePlus

    ... 22, 2002 December 2006 March 2012 Getting A New Heart Facts About Heart Transplants American Society of ... represent the views of the Society. ________________________________________________________ Getting a New Heart Facts About Heart Transplants When you have ...

  19. Who Needs Heart Surgery?

    MedlinePlus

    ... signs of a previous or current heart attack. Stress Test Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing , you exercise to make your heart work ...

  20. American Heart Association

    MedlinePlus

    ... Heart.org Media for Heart.org American Heart Association An office pop-in from a coworker came ... employers for help. Why does the American Heart Association name a top college football coach? For Bear ...