Journal articles: 'Cardiac health measurements'

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Geelhoed, Miranda J. J., Sonja P. E. Snijders, Veronica E. Kleyburg-Linkers, Eric A. P. Steegers, Lennie van Osch-Gevers, and Vincent W. V. Jaddoe. "Reliability of echocardiographic measurements of left cardiac structures in healthy children." Cardiology in the Young 19, no. 5 (August 20, 2009): 494–500. http://dx.doi.org/10.1017/s1047951109990862.

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AbstractBackgroundEchocardiographic measurements are widely used as outcomes of different studies. The aim of this study was to assess intraobserver and interobserver reliability of echocardiographic measurements in healthy children.Materials and methodsWe studied 28 children, with a median age of 7.5 years, and inter-quartile range from 3 to 11 years. Intraobserver and interobserver reliability were assessed by repeated measurements of the diameters of the aortic root, the left atrium, and left ventricular end-diastolic structure. We also measured the ventricular end-diastolic septal thickness and the end-diastolic thickness of the left ventricular posterior wall. We calculated intraclass correlation coefficients, with corresponding 95% confidence intervals, and computed Bland and Altman plots, permitting us to derive limits of agreement plus or minus 2 standard deviations for the mean differences in cardiac measurements.ResultsWe found high intraobserver and interobserver intraclass correlation coefficient, ranging from 0.91 for ventricular septal thickness, with 95% confidence intervals from 0.78 to 0.96, to 0.99 for the diameter of the aortic root, 95% confidence interval from 0.97 to 1.00. Limits of agreement in the Bland and Altman plots ranged from zero millimetres for left ventricular end-diastolic posterior wall thickness to 1.60 millimeters (6.3%) for left atrial diameter.ConclusionsOur study demonstrated good repeatability and reproducibility for ultrasonic measurements of left cardiac structures in children, showing that values obtained for measurement of these structures in both clinical and epidemiological research projects can be confidently accepted.

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Abellán-Aynés, Oriol, Pedro Manonelles, and Fernando Alacid. "Cardiac Parasympathetic Withdrawal and Sympathetic Activity: Effect of Heat Exposure on Heart Rate Variability." International Journal of Environmental Research and Public Health 18, no. 11 (May 31, 2021): 5934. http://dx.doi.org/10.3390/ijerph18115934.

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Background: Research on heart rate variability has increased in recent years and the temperature has not been controlled in some studies assessing repeated measurements. This study aimed to analyze how heart rate variability may change based on environmental temperature during measurement depending on parasympathetic and sympathetic activity variations. Methods: A total of 22 volunteers participated in this study divided into an experimental (n = 12) and control group (n = 10). Each participant was assessed randomly under two different environmental conditions for the experimental group (19 °C and 35 °C) and two identical environmental conditions for the control group (19 °C). During the procedure, heart rate variability measurements were carried out for 10 min. Results: Significantly changes were observed for time and frequency domains as well as Poincaré plot variables after heat exposure (p < 0.05). These findings were not observed in the control group, whose conditions between measurements did not change. Conclusions: The reduction of heart rate variability due to exposure to hot conditions appears to be produced mostly by a parasympathetic withdrawal rather than a sympathetic activation. Therefore, if consecutive measurements have to be carried out, these should always be done under the same temperature conditions.

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Firstenberg, Michael S., Neil L. Greenberg, Mario J. Garcia, Annitta J. Morehead, Lisa A. Cardon, Allan L. Klein, and James D. Thomas. "Internet-based transfer of cardiac ultrasound images." Journal of Telemedicine and Telecare 6, no. 3 (June 1, 2000): 168–71. http://dx.doi.org/10.1258/1357633001935275.

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A drawback to large-scale multicentre studies is the time required for the centralized evaluation of diagnostic images. We evaluated the feasibility of digital transfer of echocardiographic images to a central laboratory for rapid and accurate interpretation. Ten patients undergoing trans-oesophageal echocardiographic scanning at three sites had representative single images and multiframe loops stored digitally. The images were analysed in the ordinary way. All images were then transferred via the Internet to a central laboratory and reanalysed by a different observer. The file sizes were 1.5-72 MByte and the transfer rates achieved were 0.6-4.8 Mbit/min. Quantitative measurements were similar between most on-site and central laboratory measurements (all P > 0.25), although measurements differed for left atrial width and pulmonary venous systolic velocities (both P < 0.05). Digital transfer of echocardiographic images and data to a central laboratory may be useful for multicentre trials.

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Wetzel, Glenn T., Fuhua Chen, William F. Friedman, and Thomas S. Klitzner. "Calcium Current Measurements in Acutely Isolated Neonatal Cardiac Myocytes." Pediatric Research 30, no. 1 (July 1991): 83–88. http://dx.doi.org/10.1203/00006450-199107000-00017.

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WETZEL, GLENN T., FUHUA CHEN, WILLIAM F. FRIEDMAN, and THOMAS S. KLITZNER. "Calcium Current Measurements in Acutely Isolated Neonatal Cardiac Myocytes." Pediatric Research 30, no. 1 (July 1991): 83???88. http://dx.doi.org/10.1203/00006450-199107010-00015.

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Renner, LE, and LT Meyer. "Injectate port selection affects accuracy and reproducibility of cardiac output measurements with multiport thermodilution pulmonary artery catheters." American Journal of Critical Care 3, no. 1 (January 1, 1994): 55–61. http://dx.doi.org/10.4037/ajcc1994.3.1.55.

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OBJECTIVE: To compare the accuracy and reproducibility of thermodilution cardiac output measurements obtained from the injectate and infusion ports of a multilumen pulmonary artery catheter. The thermodilution results were compared with an independent measure of flow obtained from an electromagnetic flow meter. METHODS: In an experimental study conducted at an animal research laboratory of a health sciences university, two virgin western breed ewes were surgically instrumented with an inferior vena cava occluder, which reduced venous return and thus lowered cardiac output, and an ascending aortic electromagnetic flow probe, which provided an independent reference measure of cardiac output. On the day of study, a multilumen pulmonary artery catheter was inserted. Cardiac output was manipulated over a range of 2.9 to 12.1 L/min with i.v. isoproterenol or inferior vena cava occlusion. Approximately 30 simultaneous thermodilution and electromagnetic flow meter measurements of cardiac output were obtained from both the infusion and injectate ports in each of the two subjects. RESULTS: Correlation coefficients were lower and standard error of the estimates was higher for the infusion port (r = .83; SEE = 1.19 L/min) vs the injectate port (r = .94; SEE = .74 L/min), indicating reduced reproducibility with infusion port thermodilution cardiac output determinations. Accuracy was also adversely influenced in the infusion port results. The linear regression for the infusion port data intercepted the Y axis at +2.64 L/min, indicating significant overestimation of cardiac output at flows of less than 5 L/min and underestimation of flow when cardiac output exceeded 8 L/min. CONCLUSIONS: The use of the infusion port for the measurement of thermodilution cardiac output measurements may result in nonreproducible and inaccurate results.

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Doi, Matsuyuki, Koji Morita, and Kazuyuki Ikeda. "Frequently repeated fick cardiac output measurements during anesthesia." Journal of Clinical Monitoring 6, no. 2 (April 1990): 107–12. http://dx.doi.org/10.1007/bf02828286.

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D’Mello, Skoric, Xu, Roche, Lortie, Gagnon, and Plant. "Real-Time Cardiac Beat Detection and Heart Rate Monitoring from Combined Seismocardiography and Gyrocardiography." Sensors 19, no. 16 (August 8, 2019): 3472. http://dx.doi.org/10.3390/s19163472.

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Cardiography is an indispensable element of health care. However, the accessibility of at-home cardiac monitoring is limited by device complexity, accuracy, and cost. We have developed a real-time algorithm for heart rate monitoring and beat detection implemented in a custom-built, affordable system. These measurements were processed from seismocardiography (SCG) and gyrocardiography (GCG) signals recorded at the sternum, with concurrent electrocardiography (ECG) used as a reference. Our system demonstrated the feasibility of non-invasive electro-mechanical cardiac monitoring on supine, stationary subjects at a cost of $100, and with the SCG–GCG and ECG algorithms decoupled as standalone measurements. Testing was performed on 25 subjects in the supine position when relaxed, and when recovering from physical exercise, to record 23,984 cardiac cycles at heart rates in the range of 36–140 bpm. The correlation between the two measurements had r2 coefficients of 0.9783 and 0.9982 for normal (averaged) and instantaneous (beat identification) heart rates, respectively. At a sampling frequency of 250 Hz, the average computational time required was 0.088 s per measurement cycle, indicating the maximum refresh rate. A combined SCG and GCG measurement was found to improve accuracy due to fundamentally different noise rejection criteria in the mutually orthogonal signals. The speed, accuracy, and simplicity of our system validated its potential as a real-time, non-invasive, and affordable solution for outpatient cardiac monitoring in situations with negligible motion artifact.

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Jarolim, Petr, Purvish P. Patel, Michael J. Conrad, Lei Chang, Vojtech Melenovsky, and David H. Wilson. "Fully Automated Ultrasensitive Digital Immunoassay for Cardiac Troponin I Based on Single Molecule Array Technology." Clinical Chemistry 61, no. 10 (October 1, 2015): 1283–91. http://dx.doi.org/10.1373/clinchem.2015.242081.

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Abstract BACKGROUND The association between increases in cardiac troponin and adverse cardiac outcomes is well established. There is a growing interest in exploring routine cardiac troponin monitoring as a potential early indicator of adverse heart health trends. Prognostic use of cardiac troponin measurements requires an assay with very high sensitivity and outstanding analytical performance. We report development and preliminary validation of an investigational assay meeting these requirements and demonstrate its applicability to cohorts of healthy individuals and patients with heart failure. METHODS On the basis of single molecule array technology, we developed a 45-min immunoassay for cardiac troponin I (cTnI) for use on a novel, fully automated digital analyzer. We characterized its analytical performance and measured cTnI in healthy individuals and heart failure patients in a preliminary study of assay analytical efficacy. RESULTS The assay exhibited a limit of detection of 0.01 ng/L, a limit of quantification of 0.08 ng/L, and a total CV of 10% at 2.0 ng/L. cTnI concentrations were well above the assay limit of detection for all samples tested, including samples from healthy individuals. cTnI was significantly higher in heart failure patients, and exhibited increasing median and interquartile concentrations with increasing New York Heart Association classification of heart failure severity. CONCLUSIONS The robust 2-log increase in sensitivity relative to contemporary high-sensitivity cardiac troponin immunoassays, combined with full automation, make this assay suitable for exploring cTnI concentrations in cohorts of healthy individuals and for the potential prognostic application of serial cardiac troponin measurements in both apparently healthy and diseased individuals.

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Collins, C., S. Drew, J. Holberton, and C. Calado. "Reference Echocardiographic Measurements in Very Low Birth Weight Preterm Infants." American Journal of Perinatology 36, no. 03 (August 6, 2018): 303–10. http://dx.doi.org/10.1055/s-0038-1667070.

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Background Echocardiography is an important technique in neonatal care. The heart of a premature baby is known to be different from that of a term baby, and there is a paucity of literature regarding reference cardiac measurements for this population, especially for the very low birth weight (VLBW) infants. Objective We aimed to present reference values for echocardiography in VLBW preterm infants. Study Design This was a retrospective observational study taking place over an 11-year period. We collected data from the reports of echocardiographic examinations performed in a population of preterm infants born with gestational age ≤ 32 weeks and birth weight (BW) ≤ 1,500 g in the first week of life. Results Our study population included 1,244 preterm infants. We found BW to be an adequate and practical variable to use in relation to the cardiac measurements. We propose reference values for seven cardiac measurements presented in tables for each 100 g weight subgroup. Conclusion Our study, to the best of our knowledge, has the largest sample of VLBW preterm infants and provides easy-to-use information on cardiac measurements by echocardiography for both pediatric cardiologists and neonatologists.

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Meyer, Sascha, David Todd, and Bruce Shadboldt. "Assessment of portable continuous wave Doppler ultrasound (ultrasonic cardiac output monitor) for cardiac output measurements in neonates." Journal of Paediatrics and Child Health 45, no. 7-8 (July 2009): 464–68. http://dx.doi.org/10.1111/j.1440-1754.2009.01535.x.

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Hafid, Abdelakram, Sara Benouar, Malika Kedir-Talha, Mokhtar Attari, and Fernando Seoane. "Simultaneous Recording of ICG and ECG Using Z-RPI Device with Minimum Number of Electrodes." Journal of Sensors 2018 (November 29, 2018): 1–7. http://dx.doi.org/10.1155/2018/3269534.

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Impedance cardiography (ICG) is a noninvasive method for monitoring mechanical function of the heart with the use of electrical bioimpedance measurements. This paper presents the feasibility of recording an ICG signal simultaneously with electrocardiogram signal (ECG) using the same electrodes for both measurements, for a total of five electrodes rather than eight electrodes. The device used is the Z-RPI. The results present good performance and show waveforms presenting high similarity with the different signals reported using different electrodes for acquisition; the heart rate values were calculated and they present accurate evaluation between the ECG and ICG heart rates. The hemodynamics and cardiac parameter results present similitude with the physiological parameters for healthy people reported in the literature. The possibility of reducing number of electrodes used for ICG measurement is an encouraging step to enabling wearable and personal health monitoring solutions.

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Ahmed, N., V. Sundaram, and P. Kumar. "1098 Cardiac Output Measurements in Preterm Neonates Requiring Resuscitation at Birth." Archives of Disease in Childhood 97, Suppl 2 (October 1, 2012): A315. http://dx.doi.org/10.1136/archdischild-2012-302724.1098.

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Hudson, I., A. Houston, T. Aitchison, B. Holland, and T. Turner. "Reproducibility of measurements of cardiac output in newborn infants by Doppler ultrasound." Archives of Disease in Childhood 65, no. 1 Spec No (January 1, 1990): 15–19. http://dx.doi.org/10.1136/adc.65.1_spec_no.15.

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Osborne, R. J., M. L. Slevin, R. W. Hunter, and J. Hamer. "Cardiac Arrhythmias during Cytotoxic Chemotherapy: Role of Domperidone." Human Toxicology 4, no. 6 (November 1985): 617–23. http://dx.doi.org/10.1177/096032718500400608.

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1 Four patients receiving platinum-containing chemotherapy were treated with domperidone (20 mg) by slow intravenous injection followed by a continuous infusion for 24 h at a dose of 10 mg 24 h-1 kg-1. Cardiac monitoring and plasma potassium and domperidone concentration measurements were performed. Severe cardiac arrhythmias occurred in two patients. 2 A control group of 14 patients treated with similar chemotherapy, without domperidone, also underwent cardiac and plasma potassium monitoring. No significant arrhythmias were seen. 3 The electrophysiologic effects of domperidone are discussed. 4 It is concluded that treatment with intravenous domperidone is associated with the occurrence of cardiac arrhythmias.

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Oyer, Calvin E., C. James Sung, Rebecca Friedman, Katrine Hansen, Monique De Paepe, Halit Pinar, and Don B. Singer. "Reference Values for Valve Circumferences and Ventricular Wall Thicknesses of Fetal and Neonatal Hearts." Pediatric and Developmental Pathology 7, no. 5 (September 2004): 499–505. http://dx.doi.org/10.1007/s10024-004-1117-6.

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To evaluate valvular stenosis, cardiac dilation, and/or cardiac hypertrophy, measurements of valve circumference and ventricular wall thickness are of importance. To establish reference values in fetuses and neonates, we reviewed pathology reports at Women and Infants Hospital from 1978 through 2002 and found measurements in 776 cases that were suitable for analysis. Gestational ages (GA) ranged from 15 to 42 wk. The tabulated data include the mean, standard deviation, and 10th and 90th percentile values for foot length, body weight, body length, heart weight, valve measurements, and ventricular wall thicknesses for each week of GA. In cases in which clinical dating is not reliable, we estimated the GA by the mean value nearest that of the observed foot length. All linear measurements increased in a linear fashion throughout the second and third trimesters of development. The circumferences of cardiac valves at all ages, in descending order of magnitude, are: tricuspid, mitral, pulmonary, and aortic. Mean left ventricular (LV) wall thickness is greater than mean right ventricular (RV) wall thickness throughout gestation. The tables offer a means of determining valvular stenosis, or cardiac dilation and/or hypertrophy, based on various gestational ages.

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Łagoda, Katarzyna, Regina Sierżantowicz, Klaudiusz Nadolny, Jerzy Robert Ładny, and Hady Razak Hady. "Cardiac function in patients with coronary artery disease prepared for coronary angiography." Emergency Medical Service 7, no. 1 (March 2020): 5–12. http://dx.doi.org/10.36740/emems202001101.

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© ALUNA Publishing HouseEmerg Med Serv, 2020; VII, 1: 5-12ORIGINAL ARTICLE5DOI: 10.36740/EmeMS202001101carDIac FUnctIon In PatIents wItH coronarY arterY DIsease PrePareD For coronarY angIograPHYKatarzyna Łagoda1, Regina Sierżantowicz2, Klaudiusz Nadolny4,5, Jerzy Robert Ładny3,4, Hady Razak Hady3Introduction: Cardiovascular diseases are one of the major health issues in the world. One of the factors that adversely affects the cardiovascular system is the acceleration of heart rate.the aim: Assessment of heart rate in patients with coronary heart disease depending on age and gender, as well as determination of patients ability to measure heart rate and to interpret the results.Material and methods: The study included 100 patients, both genders (62% men), aged from 45 to 84 years (67.61 ± 9.22 years) with diagnosed coronary heart disease, directed to coronarography, hospitalized in the Department of Invasive Cardiology of the University Hospital in Białystok. The data has been gathered using own questionnaire (38 questions), NYHA and CCS scale.results: The majority of patients do not know how to measure their heart rate correctly. Subjects with higher education level and under 65 years of age more often declared the knowledge about the correct heart rate value. Only 7.9% of women and 11.3% of men performed heart rate measurements by themselves. Elderly patients less frequently per-formed heart rate measurements (p=0.017) than those under 65 years of age. As many as 84.2% of women and 75.8% of men believed that the value of the heart rate affects their health.conclusions: 1. Lack of patients’ knowledge about the impact of heart rate on the cardiovascular status and lack of self-monitoring may lead to further disease development and deterioration of health. 2. Therapeutic education performed systematically on the subject of heart rate measurement, proper lifestyle and diet are important elements in improving the health of patients with coronary heart disease.

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Lalla-Edward, Samanta Tresha, Alex Emilio Fischer, W. D. Francois Venter, Karine Scheuermaier, Ruchika Meel, Catherine Hankins, Gabriela Gomez, Kerstin Klipstein-Grobusch, Melvin Draaijer, and Alinda G. Vos. "Cross-sectional study of the health of southern African truck drivers." BMJ Open 9, no. 10 (October 2019): e032025. http://dx.doi.org/10.1136/bmjopen-2019-032025.

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ObjectivesLifestyle and working conditions of truck drivers predisposes them to risk-factors associated with communicable and non-communicable diseases, but little is known about the health status of African truck driver. This study aims to assess a cross-section of truckers in South Africa to describe their health information.SettingThe study took place across three truck-stop rest areas in the South African provinces of Free State and Gauteng.ParticipantsEligibility criteria included being males aged 18 years and older, full-time employment as a long-distance truck driver. A total of 614 male truck drivers participated; 384 (63%) were Zimbabwean and 325 (55%) completed high-school.Primary and secondary outcome measuresThe trucker survey explored demographics; working conditions; sexual, eating and sleeping behaviours; mental health status, medical history and cardiac risk-factors. Medical assessments included physical measurements, glucose and lipid measurements, ECG, carotid intima-media thickness (CIMT) and cardiac ultrasound.ResultsIn the previous month, 554 (91%) participants were sexually active; 522 (86%) had sex with a regular partner; 174 (27%) with a casual partner; 87 (14%) with a sex worker. Average time driving was 10 hours/day, 20 days/month, 302 (50%) never worked night shifts and 74 (12%) worked nights approximately four times per week. 112 (18%) experienced daytime sleepiness and 59 (10%) were ever hospitalised from an accident. Forty-seven (8%, 95% CI 5.3 to 9.5) were HIV-positive, with half taking antiretrovirals. Forty-eight (8%) truckers had some moderate depression, while 21 (4%) suffered from post-traumatic stress disorder. Reported tuberculosis, myocardial infarction, and diabetes were <3%. Prominent cardiac risk-factors included smoking (n=63, 11%), consuming alcohol (>15 drinks/week) (n=54, 9%), overweight/obesity (n=417, 69%), and hypertension (n=220, 36%,95% CI 32.1 to 39.7). ECG results showed 23 (4.9%) and 29 (5.3%) drivers had left ventricular hypertrophy using the Cornell criterion and product, respectively. CIMT measurements indicated nine (4.2%) drivers had a carotid atherosclerotic plaque.ConclusionThis first holistic assessment of health among southern African male truck drivers demonstrates substantial addressable cardiovascular risk factors, mental health issues and sexual risk behaviours.

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Carlson, K. H., R. K. Wolff, R. L. Tielking, P. A. Franklin, H. K. Yeager, and M. A. Dorato. "Real-Time Measurements of Cardiac Effects During Inhalation Exposures of Monkeys or Dogs." Inhalation Toxicology 5, no. 3 (January 1993): 291–301. http://dx.doi.org/10.3109/08958379308998386.

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Meinich-Bache, Øyvind, Kjersti Engan, Tonje Søraas Birkenes, and Helge Myklebust. "Real-Time Chest Compression Quality Measurements by Smartphone Camera." Journal of Healthcare Engineering 2018 (October 28, 2018): 1–12. http://dx.doi.org/10.1155/2018/6241856.

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Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested.

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Gradidge, Eleanor A., Lisa M. Grimaldi, Katherine Cashen, Keshava M. N. Gowda, Kurt D. Piggott, Michael Wilhelm, John M. Costello, and Christopher W. Mastropietro. "Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery." Cardiology in the Young 29, no. 06 (June 2019): 787–92. http://dx.doi.org/10.1017/s1047951119000829.

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AbstractIntroduction:Reliable predictors of extubation readiness are needed and may reduce morbidity related to extubation failure. We aimed to examine the relationship between changes in pre-extubation near-infrared spectroscopy measurements from baseline and extubation outcomes after neonatal cardiac surgery.Materials and Methods:In this retrospective cross-sectional multi-centre study, a secondary analysis of prospectively collected data from neonates who underwent cardiac surgery at seven tertiary-care children’s hospitals in 2015 was performed. Extubation failure was defined as need for re-intubation within 72 hours of the first planned extubation attempt. Near-infrared spectroscopy measurements obtained before surgery and before extubation in patients who failed extubation were compared to those of patients who extubated successfully using t-tests.Results:Near-infrared spectroscopy measurements were available for 159 neonates, including 52 with single ventricle physiology. Median age at surgery was 6 days (range: 1–29 days). A total of 15 patients (9.4 %) failed extubation. Baseline cerebral and renal near-infrared spectroscopy measurements were not statistically different between those who were successfully extubated and those who failed, but pre-extubation cerebral and renal values were significantly higher in neonates who extubated successfully. An increase from baseline to time of extubation values in cerebral oximetry saturation by ≥ 5 % had a positive predictive value for extubation success of 98.6 % (95%CI: 91.1–99.8 %).Conclusion:Pre-extubation cerebral near-infrared spectroscopy measurements, when compared to baseline, were significantly associated with extubation outcomes. These findings demonstrate the potential of this tool as a valuable adjunct in assessing extubation readiness after paediatric cardiac surgery and warrant further evaluation in a larger prospective study.

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Lamberigts, Marie, Lucas Van Hoof, Tine Proesmans, Pieter Vandervoort, Lars Grieten, Peter Haemers, and Filip Rega. "Remote Heart Rhythm Monitoring by Photoplethysmography-Based Smartphone Technology After Cardiac Surgery: Prospective Observational Study." JMIR mHealth and uHealth 9, no. 4 (April 15, 2021): e26519. http://dx.doi.org/10.2196/26519.

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Background Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery, yet the precise incidence and significance of arrhythmias after discharge home need to be better defined. Photoplethysmography (PPG)-based smartphone apps are promising tools to enable early detection and follow-up of arrhythmias. Objective By using a PPG-based smartphone app, we aimed to gain more insight into the prevalence of AF and other rhythm-related complications upon discharge home after cardiac surgery and evaluate the implementation of this app into routine clinical care. Methods In this prospective, single-center trial, patients recovering from cardiac surgery were asked to register their heart rhythm 3 times daily using a Food and Drug Administration–approved PPG-based app, for either 30 or 60 days after discharge home. Patients with permanent AF or a permanent pacemaker were excluded. Results We included 24 patients (mean age 60.2 years, SD 12 years; 15/23, 65% male) who underwent coronary artery bypass grafting and/or valve surgery. During hospitalization, 39% (9/23) experienced postoperative AF. After discharge, the PPG app reported AF or atrial flutter in 5 patients. While the app notified flutter in 1 patient, this was a false positive, as electrocardiogram revealed a 2nd-degree, 2:1 atrioventricular block necessitating a permanent pacemaker. AF was confirmed in 4 patients (4/23, 17%) and interestingly, was associated with an underlying postoperative complication in 2 participants (pneumonia n=1, pericardial tamponade n=1). A significant increase in the proportion of measurements indicating sinus rhythm was observed when comparing the first to the second month of follow-up (P<.001). In the second month of follow-up, compliance was significantly lower with 2.2 (SD 0.7) measurements per day versus 3.0 (SD 0.8) measurements per day in the first month (P=.002). The majority of participants (17/23, 74%), as well as the surveyed primary care physicians, experienced positive value by using the app as they felt more involved in the postoperative rehabilitation. Conclusions Implementation of smartphone-based PPG technology enables detection of AF and other rhythm-related complications after cardiac surgery. An association between AF detection and an underlying complication was found in 2 patients. Therefore, smartphone-based PPG technology may supplement rehabilitation after cardiac surgery by acting as a sentinel for underlying complications, rhythm-related or otherwise.

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Faust, Oliver, Ningrong Lei, Eng Chew, Edward J. Ciaccio, and U. Rajendra Acharya. "A Smart Service Platform for Cost Efficient Cardiac Health Monitoring." International Journal of Environmental Research and Public Health 17, no. 17 (August 30, 2020): 6313. http://dx.doi.org/10.3390/ijerph17176313.

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Aim: In this study we have investigated the problem of cost effective wireless heart health monitoring from a service design perspective. Subject and Methods: There is a great medical and economic need to support the diagnosis of a wide range of debilitating and indeed fatal non-communicable diseases, like Cardiovascular Disease (CVD), Atrial Fibrillation (AF), diabetes, and sleep disorders. To address this need, we put forward the idea that the combination of Heart Rate (HR) measurements, Internet of Things (IoT), and advanced Artificial Intelligence (AI), forms a Heart Health Monitoring Service Platform (HHMSP). This service platform can be used for multi-disease monitoring, where a distinct service meets the needs of patients having a specific disease. The service functionality is realized by combining common and distinct modules. This forms the technological basis which facilitates a hybrid diagnosis process where machines and practitioners work cooperatively to improve outcomes for patients. Results: Human checks and balances on independent machine decisions maintain safety and reliability of the diagnosis. Cost efficiency comes from efficient signal processing and replacing manual analysis with AI based machine classification. To show the practicality of the proposed service platform, we have implemented an AF monitoring service. Conclusion: Having common modules allows us to harvest the economies of scale. That is an advantage, because the fixed cost for the infrastructure is shared among a large group of customers. Distinct modules define which AI models are used and how the communication with practitioners, caregivers and patients is handled. That makes the proposed HHMSP agile enough to address safety, reliability and functionality needs from healthcare providers.

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Fundora, Michael P., Asaad G. Beshish, Nikita Rao, Christopher M. Berry, Janet Figueroa, Courtney McCracken, and Kevin O. Maher. "Comparison of Invasive and Oscillometric Blood Pressure Measurement in Obese and Nonobese Children." American Journal of Hypertension 34, no. 6 (March 8, 2021): 619–25. http://dx.doi.org/10.1093/ajh/hpab049.

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Abstract BACKGROUND Obesity and hypertension are public health priorities, with obesity considered to be a potential cause of hypertension. Accurate blood pressure (BP) determination is required and often obtained by automated oscillometric cuff devices. We sought to determine the correlation of oscillometric measurement in children, and if obesity was associated with worse correlation between methods than nonobese children. METHODS Retrospective matched case-controlled study of 100 obese (97–99th percentile) and 100 nonobese (25–70th percentile) children after cardiac surgery with simultaneous systolic, diastolic, and mean invasive and oscillometric measurements. Matching was 1:1 for age, sex, race, and Risk Adjustment for Congenital Heart Surgery-1 score. Intraclass correlation coefficients and Bland–Altman plots were used to determine agreement with 0.75 as threshold. RESULTS Median age was 13 years (10–15). Agreement was low for systolic (0.65 and 0.61), diastolic (0.68 and 0.61), and mean measurements (0.73 and 0.69) (obese/nonobese). Bland–Altman plots demonstrated oscillometric BP measurements underestimated systolic hypertension (oscillometric readings lower than intra-arterial). Oscillometric measurements underestimated hypotension (systolic oscillometric measurements were higher than intra-arterial). This occurred in obese and nonobese patients. Correlation of oscillometric measurements was similar for nonobese and obese patients. CONCLUSIONS In this first ever study of simultaneous BP measurement by oscillometric vs. intra-arterial in obese and nonobese children, correlation is below accepted norms. The correlation of oscillometric cuff measurements is not affected by habitus in children. There is less correlation between oscillometric measurements and intra-arterial measurements during hypertension or hypotension. Healthcare providers should be aware of the limitations of oscillometric measurements.

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Alehagen, Urban, Göran Lindstedt, Henry Eriksson, and Ulf Dahlström. "Utility of the Amino-Terminal Fragment of Pro-Brain Natriuretic Peptide in Plasma for the Evaluation of Cardiac Dysfunction in Elderly Patients in Primary Health Care." Clinical Chemistry 49, no. 8 (August 1, 2003): 1337–46. http://dx.doi.org/10.1373/49.8.1337.

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Abstract Background: The aims of this study were to measure the N-terminal fragment of pro-brain natriuretic peptide (proBNP) in plasma in medical conditions commonly found in primary care and to evaluate the utility of these measurements in identifying impaired cardiac function in elderly patients with symptoms associated with heart failure. Methods: We studied 415 patients (221 men and 194 women; mean age, 72 years) who had contacted a primary healthcare center for dyspnea, fatigue, and/or peripheral edema. One cardiologist evaluated the patients in terms of history, physical examination, functional capacity, electrocardiography, and suspicion of heart failure. Plasma N-terminal proBNP was measured by an in-house RIA. An ejection fraction ≤40% by Doppler echocardiography was regarded as reduced cardiac function. Abnormal diastolic function was defined as an abnormal mitral inflow defined as reduced ratio of peak early diastolic filling velocity to peak filling velocity at atrial contraction (E/A ratio), or as abnormal pulmonary venous flow pattern. Results: Patients with impaired functional capacity, impaired systolic function, and/or impaired renal function had significantly increased N-terminal proBNP concentrations. By multiple regression analysis, N-terminal proBNP concentrations were also influenced by ischemic heart disease, cardiac enlargement, and certain medications but not by increased creatinine. No gender differences were observed. Patients with isolated diastolic dysfunction attributable to relaxation abnormali-ties had lower concentrations than those with normal cardiac function, whereas those with pseudonormal E/A ratios or restrictive filling patterns had higher concentrations. Conclusions: Plasma N-terminal proBNP concentrations increase as a result of impaired systolic function, age, impaired renal function, cardiac ischemia and enlargement, and certain medications. Values are high in diastolic dysfunction with pseudonormal patterns, but not in patients with relaxation abnormalities. An increase in plasma N-terminal proBNP might be an earlier sign of abnormal cardiac function than abnormalities identified by currently used echocardiographic measurements.

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Uguz, Durmus Umutcan, Rosalia Dettori, Andreas Napp, Marian Walter, Nikolaus Marx, Steffen Leonhardt, and Christoph Hoog Antink. "Car Seats with Capacitive ECG Electrodes Can Detect Cardiac Pacemaker Spikes." Sensors 20, no. 21 (November 4, 2020): 6288. http://dx.doi.org/10.3390/s20216288.

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The capacitive electrocardiograph (cECG) has been tested for several measurement scenarios, including hospital beds, car seats and chairs since it was first proposed. The inferior signal quality of the cECG compared to the gold standard ECG guides the ongoing research in the direction of out-of-hospital applications, where unobtrusiveness is sought and high-level diagnostic signal quality is not essential. This study aims to expand the application range of cECG not in terms of the measurement scenario but in the profile of the subjects by including subjects with implanted cardiac pacemakers. Within this study, 20 patients with cardiac pacemakers were recruited during their clinical device follow-up and cECG measurements were conducted using a seat equipped with integrated cECG electrodes. The multichannel cECG recordings of active unipolar and bipolar pacemaker stimulation were analyzed offline and evaluated in terms of Fβ scores using a pacemaker spike detection algorithm. Fβ scores from 3652 pacing events, varying from 0.62 to 0.78, are presented with influencing parameters in the algorithm and the comparison of cECG channels. By tuning the parameters of the algorithm, different ranges of Fβ scores were found as 0.32 to 0.49 and 0.78 to 0.88 for bipolar and unipolar stimulations, respectively. For the first time, this study shows the feasibility of a cECG system allowing health monitoring in daily use on subjects wearing cardiac pacemakers.

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Gaze, David C., and Paul O. Collinson. "Interpretation of Cardiac Troponin Measurements in Neonates – The Devil Is in the Details." Neonatology 89, no. 3 (2006): 194–96. http://dx.doi.org/10.1159/000089549.

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Rhodes, John F., Madalsa Patel, and Redmond P. Burke. "Smart Graft Monitoring After the Fontan Operation." World Journal for Pediatric and Congenital Heart Surgery 10, no. 5 (September 2019): 628–31. http://dx.doi.org/10.1177/2150135119852586.

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The Fontan operation for children with congenital heart disease places them in a physiological state of mildly elevated systemic venous pressure and low-normal cardiac output. Consequently, close follow-up is imperative, yet currently no method is available to obtain Fontan pressures without direct measurements in the cardiac catheterization laboratory while supine and sedated. We hypothesize that by suturing the CardioMEMS sensor device into the Fontan conduit during the standard Fontan operation for a child with single ventricular physiology, clinicians can accurately retrieve Fontan pathway pressure measurements noninvasively during normal physiological states.

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Strieper, Margaret J., Shiva Sharma, Kenneth J. Dooley, J. Devn Cornish, and Reese H. Clark. "Effects of venovenous extracorporeal membrane oxygenation on cardiac performance as determined by echocardiographic measurements." Journal of Pediatrics 122, no. 6 (June 1993): 950–55. http://dx.doi.org/10.1016/s0022-3476(09)90026-9.

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Ronco, Ricardo. "Minimally invasive cardiac output measurements in children: An encouraging but ongoing chronicle*." Pediatric Critical Care Medicine 7, no. 6 (November 2006): 604–5. http://dx.doi.org/10.1097/01.pcc.0000244098.36794.59.

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Katz, Ian A., Les Irwig, John D. Vinen, Lyn March, Lindsay E. Wyndham, Tuan Luu, and Greg I. C. Nelson. "Biochemical Markers of Acute Myocardial Infarction: Strategies for Improving Their Clinical Usefulness." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 35, no. 3 (May 1998): 393–99. http://dx.doi.org/10.1177/000456329803500308.

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We investigated the early diagnostic utility, including incremental value, of the serum cardiac markers creatine kinase (CK), CK-MB (mass and activity measurements), cardiac troponin T, and myoglobin in the diagnosis of acute myocardial infarction (AMI) in patients presenting to a major teaching hospital with chest pain and non-diagnostic electrocardiographs (ECG). The reference diagnosis of acute myocardial infarction was made by a single, independent cardiologist using World Health Organization criteria. CK and CK-MB mass were the only significant predictors of AMI at presentation to the Emergency Department. Logistic regression analysis revealed that CK did not significantly predict ( P = 0·23) myocardial infarction once CK-MB mass was in the model. Using test results on follow up, in addition to presentation CK-MB mass, change in CK-MB mass was the only other significant independent predictor of AMI. Likelihood ratios for various levels of the significant markers in the logistic regression are given. In conclusion, CK-MB mass measurement was the only useful serum cardiac marker for the diagnosis of AMI in patients presenting with chest pain with non-diagnostic ECGs.

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von Rosenberg, Wilhelm, Theerasak Chanwimalueang, Valentin Goverdovsky, Nicholas S. Peters, Christos Papavassiliou, and Danilo P. Mandic. "Hearables: feasibility of recording cardiac rhythms from head and in-ear locations." Royal Society Open Science 4, no. 11 (November 2017): 171214. http://dx.doi.org/10.1098/rsos.171214.

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Mobile technologies for the recording of vital signs and neural signals are envisaged to underpin the operation of future health services. For practical purposes, unobtrusive devices are favoured, such as those embedded in a helmet or incorporated onto an earplug. However, these locations have so far been underexplored, as the comparably narrow neck impedes the propagation of vital signals from the torso to the head surface. To establish the principles behind electrocardiogram (ECG) recordings from head and ear locations, we first introduce a realistic three-dimensional biophysics model for the propagation of cardiac electric potentials to the head surface, which demonstrates the feasibility of head-ECG recordings. Next, the proposed biophysics propagation model is verified over comprehensive real-world experiments based on head- and in-ear-ECG measurements. It is shown both that the proposed model is an excellent match for the recordings, and that the quality of head- and ear-ECG is sufficient for a reliable identification of the timing and shape of the characteristic P-, Q-, R-, S- and T-waves within the cardiac cycle. This opens up a range of new possibilities in the identification and management of heart conditions, such as myocardial infarction and atrial fibrillation, based on 24/7 continuous in-ear measurements. The study therefore paves the way for the incorporation of the cardiac modality into future ‘hearables’, unobtrusive devices for health monitoring.

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Sickan, Jaganathan, Tar Choon Aw, Shaoqing X. Du, Jian Li, Janel Huang, and Agim Beshiri. "CARDIOVASCULAR DISEASE RISK ASSESSMENT WITH HIGH-SENSITIVITY CARDIAC TROPONIN I AND OTHER BIOMARKERS: AN OBSERVATIONAL COHORT STUDY IN JOHOR, MALAYSIA." Malaysian Journal of Public Health Medicine 20, no. 2 (October 1, 2020): 27–36. http://dx.doi.org/10.37268/mjphm/vol.20/no.2/art.30.

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Although cardiovascular disease (CVD) is a major health challenge in Malaysia, many Malaysians are unaware of their CVD risk. The measurement of biomarkers in the general population may help to identify at-risk individuals before the onset of symptomatic CVD. The aim of this community health screening project was to determine the distribution of high-sensitivity troponin I (hsTnI) and other biomarkers of CVD risk in the general population of Johor, Malaysia. A sampling of self-declared healthy volunteers was conducted during the 2016 Kembara Mahkota community event in Johor. Levels of hsTnI, B-type natriuretic peptide (BNP) and homocysteine (HCY) were analyzed using the ARCHITECT immunoassay and clinical chemistry platforms utilizing fresh venous blood samples. Based on previous data, biomarker levels indicative of high risk were >10 and >12 ng/mL for hsTnI in women and men, respectively, BNP >50 pg/mL in the overall population, and HCY >13.6 µmol/L in women and >16.2 µmol/L in men. A total of 2744 volunteers participated in biomarker testing. Biomarker measurements showed that up to 10% of participants had moderate or high CVD risk based on hsTnI, approximately 2% were above the BNP threshold and >50% of subjects were above the HCY threshold. General population biomarker testing shows distribution of biomarker levels that may be indicative of CVD risk or the presence of disease and suggests that biomarker-guided risk strategies should be more widely implemented to determine the impact they would have on early detection and prevention of disease.

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Scrimgeour, Gemma E., Michael J. Griksaitis, John V. Pappachan, and Andrew J. Baldock. "The Accuracy of Noninvasive Peripheral Pulse Oximetry After Palliative Cardiac Surgery in Patients With Cyanotic Congenital Heart Disease." World Journal for Pediatric and Congenital Heart Surgery 8, no. 1 (December 29, 2016): 32–38. http://dx.doi.org/10.1177/2150135116673016.

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Background: Children with cyanotic congenital heart disease (CCHD) live with oxyhemoglobin saturations that are typically expressed as percentages in the range of 70s and 80s. Peripheral pulse oximetry (measurement of SpO2) performs poorly in this range and yet is widely used to inform clinical decisions in these patients. The reference standard is co-oximetry of arterial samples (SaO2). Methods: In this study, 515 paired measurements of SpO2 and SaO2 were taken from 19 children who had undergone palliative cardiac surgery. Results: SpO2 (Masimo SET LNCS Neo pulse oximeter) overestimated oxyhemoglobin saturation in 82% of measurements (mean 4.6% ± 6.6%). There was a strong negative correlation between mean bias and SaO2 ( r = −.96, P = .002, 95% confidence interval: −0.99 to −0.68). Conclusion: The results raise a concern that critical hypoxemia may go undetected and untreated if pulse oximetry is relied upon as the primary means of assessing oxyhemoglobin saturation in children with CCHD. Strong preference must be given to co-oximetry of arterial samples.

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Elkiran, Ozlem, Cemsit Karakurt, Gulendam Kocak, and Ahmet Karadag. "Tissue Doppler, strain, and strain rate measurements assessed by two-dimensional speckle-tracking echocardiography in healthy newborns and infants." Cardiology in the Young 24, no. 2 (February 7, 2013): 201–11. http://dx.doi.org/10.1017/s1047951112002284.

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AbstractObjectivesTo evaluate cardiac maturational and haemodynamic alteration in healthy newborns and infants and determine reference values in this period using tissue Doppler, strain, and strain rate echocardiography.Material and MethodsThe study included 149 healthy subjects. Babies from 1 day to 3 months were selected from the well-baby nursery department, and infants were selected from paediatric clinics during routine visits for health maintenance. Subjects were allocated to four groups: preterm (36–37 weeks, n = 32), term (≥38 weeks, n = 32), 1 month of age (n = 47), and 3 months of age (n = 38). Standard echocardiographic evaluations, pulsed wave Doppler, tissue Doppler echocardiography, strain, and strain rate studies were applied by the same person using a MyLab50 echo machine. Longitudinal and circumferential systolic strain and strain rate measurements were assessed by two-dimensional speckle-tracking echocardiography in all subjects.ResultsThe longitudinal systolic velocity, strain, and strain rate values derived from left ventricle apical four-, three-, and two-chamber images, and circumferential systolic velocity, strain, and strain rate values derived from left ventricle short-axis images decreased from the base to the apex in all subjects (p < 0.001).ConclusionSignificant cardiac haemodynamic alterations occurred during the newborn and early infancy periods and were detected by tissue Doppler, strain, and strain rate echocardiography. Although two-dimensional speckle-tracking echocardiography is useful and can produce improved, reliable results in clinical practice, it has some limitations. Therefore, more studies on this issue are required.

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Martin, Christopher, Thomas Hansen, Jan Goddard-Fineqold, and Adrian Leblanc. "1449 RELIABILITY OF TWO-DIMENSIONAL, PULSED DOPPLER MEASUREMENTS OF BRAIN BLOOD FLOW AND CARDIAC OUTPUT." Pediatric Research 19, no. 4 (April 1985): 352A. http://dx.doi.org/10.1203/00006450-198504000-01473.

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Lee, Hyoung Youn, Kamoljon Shamsiev, Najmiddin Mamadjonov, Yong Hun Jung, Kyung Woon Jeung, Jin Woong Kim, Tag Heo, and Yong Il Min. "Effect of Epinephrine Administered during Cardiopulmonary Resuscitation on Cerebral Oxygenation after Restoration of Spontaneous Circulation in a Swine Model with a Clinically Relevant Duration of Untreated Cardiac Arrest." International Journal of Environmental Research and Public Health 18, no. 11 (May 31, 2021): 5896. http://dx.doi.org/10.3390/ijerph18115896.

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Severe neurological impairment was more prevalent in cardiac arrest survivors who were administered epinephrine than in those administered placebo in a randomized clinical trial; short-term reduction of brain tissue O2 tension (PbtO2) after epinephrine administration in swine following a short duration of untreated cardiac arrest has also been reported. We investigated the effects of epinephrine administered during cardiopulmonary resuscitation (CPR) on cerebral oxygenation after restoration of spontaneous circulation (ROSC) in a swine model with a clinically relevant duration of untreated cardiac arrest. After 7 min of ventricular fibrillation, 24 pigs randomly received either epinephrine or saline placebo during CPR. Parietal cortex measurements during 60-min post-resuscitation period showed that the area under the curve (AUC) for PbtO2 was smaller in the epinephrine group than in the placebo group during the initial 10-min period and subsequent 50-min period (both p < 0.05). The AUC for number of perfused cerebral capillaries was smaller in the epinephrine group during the initial 10-min period (p = 0.005), but not during the subsequent 50-min period. In conclusion, epinephrine administered during CPR reduced PbtO2 for longer than 10 min following ROSC in a swine model with a clinically relevant duration of untreated cardiac arrest.

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Gayes, James M. "Intra-aortic balloon pump prevents transtracheal Doppler endotracheal tube measurements of cardiac output." Journal of Clinical Monitoring 7, no. 4 (October 1991): 348. http://dx.doi.org/10.1007/bf01619357.

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Ince, Jonathan, Meshal Alharbi, Jatinder S. Minhas, and Emma ML Chung. "Ultrasound measurement of brain tissue movement in humans: A systematic review." Ultrasound 28, no. 2 (December 19, 2019): 70–81. http://dx.doi.org/10.1177/1742271x19894601.

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Introduction It has long been suggested that ultrasound could be used to measure brain tissue pulsations in humans, but potential clinical applications are relatively unexplored. The aim of this systematic review was to explore and synthesise available literature on ultrasound measurement of brain tissue motion in humans. Methods Our systematic review was designed to include predefined study selection criteria, quality evaluation, and a data extraction pro-forma, registered prospectively on PROSPERO (CRD42018114117). The systematic review was conducted by two independent reviewers. Results Ten studies were eligible for the evidence synthesis and qualitative evaluation. All eligible studies confirmed that brain tissue motion over the cardiac cycle could be measured using ultrasound; however, data acquisition, analysis, and outcomes varied. The majority of studies used tissue pulsatility imaging, with the right temporal window as the acquisition point. Currently available literature is largely exploratory, with measurements of brain tissue displacement over a narrow range of health conditions and ages. Explored health conditions include orthostatic hypotension and depression. Conclusion Further studies are needed to assess variability in brain tissue motion estimates across larger cohorts of healthy subjects and in patients with various medical conditions. This would be important for informing sample size estimates to ensure future studies are appropriately powered. Future research would also benefit from a consistent framework for data analysis and reporting, to facilitate comparative research and meta-analysis. Following standardisation and further healthy participant studies, future work should focus on assessing the clinical utility of brain tissue pulsation measurements in cerebrovascular disease states.

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Benaissa, Fatima, Cara Nichole Maesano, Rezak Alkama, and Isabella Annesi-Maesano. "Short-Term Health Impact Assessment of Urban PM10in Bejaia City (Algeria)." Canadian Respiratory Journal 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/8209485.

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We used Health Impact Assessment (HIA) to analyze the impact on a given population’s health outcomes in terms of all-causes mortality and respiratory and cardiovascular hospitalizations attributable to short-term exposure to particulate matter less than 10 μm diameter (PM10) in Bejaia city, for which health effects of air pollution have never been investigated. Two scenarios of PM10reduction were considered: first, a scenario where the PM10annual mean is decreased by 5 µg/m3, and then a scenario where this PM10mean is decreased to 20 µg/m3(World Health Organization annual air quality guideline (WHO-AQG)). Annual mean level of PM10(81.7 µg/m3) was calculated from objective measurements assessedin situ. Each year, about 4 and 55 deaths could be postponed with the first and the second scenarios successfully. Furthermore, decreasing PM10annual mean by 5 µg/m3would avoid 5 and 3 respiratory and cardiac hospitalizations, respectively, and not exceeding the PM10WHO-AQG (20 µg/m3) would result in a potential gain of 36 and 23 per 100000 respiratory and cardiac hospitalizations, respectively. Lowering in current levels of PM10has a nonnegligible impact in terms of public health that it is expected to be higher in the case of long-term effects.

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Schleich, Jean-Marc, Jean-Louis Dillenseger, Laurence Loeuillet, Jacques-Philippe Moulinoux, and Claude Almange. "Three-Dimensional Reconstruction and Morphologic Measurements of Human Embryonic Hearts: A New Diagnostic and Quantitative Method Applicable to Fetuses Younger than 13 Weeks of Gestation." Pediatric and Developmental Pathology 8, no. 4 (July 2005): 463–73. http://dx.doi.org/10.1007/s10024-005-0017-8.

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Improvements in the diagnosis of congenital malformations explain the increasing early termination of pregnancies. Before 13 weeks of gestation, an accurate in vivo anatomic diagnosis cannot currently be made in all fetuses with current imaging instrumentation. Anatomopathologic examinations remain the gold standard to make accurate diagnoses, although they reach limits between 9 and 13 weeks of gestation. We present the first results of a methodology that can be applied routinely, using standard histologic section, thus enabling the reconstruction, visual estimate, and quantitative analysis of 13-week human embryonic cardiac structures. The cardiac blocks were fixed, embedded in paraffin, and entirely sliced by a microtome. One of 10 slices was topographically colored and digitized on an optical microscope. Cardiac volume was recovered by semiautomatic realignment of the sections. Another semiautomatic procedure allowed extracting and labeling of cardiac structures from the volume. Structures were studied with display tools, which disclosed the internal and external cardiac components and enabled determination of size, thickness, and precise positioning of ventricles, atria, and large vessels. This pilot study confirmed that a new 3-dimensional reconstruction and visualization method enables accurate diagnoses, including in embryos younger than 13 weeks. Its implementation at earlier stages of embryogenesis will provide a clearer view of cardiac development.

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Hua, Jing, Hua Zhang, Jizhong Liu, Yilu Xu, and Fumin Guo. "Direct Arrhythmia Classification from Compressive ECG Signals in Wearable Health Monitoring System." Journal of Circuits, Systems and Computers 27, no. 06 (February 22, 2018): 1850088. http://dx.doi.org/10.1142/s0218126618500883.

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Due to the capacity of processing signal with low energy consumption, compressive sensing (CS) has been widely used in wearable health monitoring system for arrhythmia classification of electrocardiogram (ECG) signals. However, most existing works focus on compressive sensing reconstruction, in other words, the ECG signals must be reconstructed before use. Hence, these methods have high computational complexity. In this paper, the authors propose a cardiac arrhythmia classification scheme that performs classification task directly in the compressed domain, skipping the reconstruction stage. The proposed scheme first employs the Pan–Tompkins algorithm to preprocess the ECG signals, including denoising and QRS detection, and then compresses the ECG signals by CS to obtain the compressive measurements. The features are extracted directly from these measurements based on principal component analysis (PCA), and are used to classify the ECG signals into different types by the proposed semi-supervised learning algorithm based on support vector machine (SVM). Extensive simulations have been performed to validate the effectiveness of the proposed scheme. Experimental results have shown that the proposed scheme achieves an average accuracy of [Formula: see text] at a sensing rate of 0.7, compared to an accuracy of [Formula: see text] for noncompressive ECG data.

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Punn, Rajesh, John J. Lamberti, Raymond R. Balise, and Stephen P. Seslar. "QTc prolongation in children following congenital cardiac disease surgery." Cardiology in the Young 21, no. 4 (March 2, 2011): 400–410. http://dx.doi.org/10.1017/s1047951111000175.

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AbstractIntroductionQTc prolongation has been reported in adults following cardiopulmonary bypass; however, this phenomenon has not been studied in children with congenital cardiac disease. This study's aim was to formally assess QTc in children undergoing cardiac surgery.MethodsPre-operative and post-operative electrocardiograms during hospital stays were prospectively analysed on 107 consecutive patients under 18 years of age undergoing cardiac surgery. QTc was measured manually in leads II, V4, and V5. Measurements of 440 and 480 milliseconds were used to categorise patients. Peri-procedural data included bypass and cross-clamp time, medications, and electrolyte measurements. Outcome data included arrhythmias, length of mechanical ventilation, and hospital stay. Patients with post-operative new bundle branch block or ventricularly paced rhythm were excluded.ResultsIn all, 59 children were included, out of which 26 had new QTc over 440 milliseconds and 6 of 59 had new QTc over 480 milliseconds post-operatively. The mean increase in post-operative QTc was 25 milliseconds, p=0.0001. QTc over 480 was associated with longer cross-clamp time, p=0.003. Other risk factors were not associated with post-operative QTc prolongation. This phenomenon was transient with normalisation occurring in 67% of patients over 60 hours on average. One patient with post-operative QTc over 440 milliseconds developed ventricular tachycardia. There was no correlation between prolonged QTc and duration of mechanical ventilation, or hospital stay.ConclusionA significant number of children undergoing cardiac surgery showed transient QTc prolongation. The precise aetiology of QT prolongation was not discerned, though new QTc over 480 milliseconds was associated with longer cross-clamp time. In this cohort, transient QTc prolongation was not associated with adverse sequela.

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Isakow, Warren, and Daniel P. Schuster. "Extravascular lung water measurements and hemodynamic monitoring in the critically ill: bedside alternatives to the pulmonary artery catheter." American Journal of Physiology-Lung Cellular and Molecular Physiology 291, no. 6 (December 2006): L1118—L1131. http://dx.doi.org/10.1152/ajplung.00277.2006.

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The recently completed Fluid and Catheter Treatment Trial conducted by the National Institutes of Health ARDSNetwork casts doubt on the value of routine pulmonary artery catheterization for hemodynamic management of the critically ill. Several alternatives are available, and, in this review, we evaluate the theoretical, validation, and empirical databases for two of these: transpulmonary thermodilution measurements (yielding estimates of cardiac output, intrathoracic blood volume, and extravascular lung water) that do not require a pulmonary artery catheter, and hemodynamic measurements (including estimates of cardiac output and ejection time, a variable sensitive to intravascular volume) obtained by esophageal Doppler analysis of blood flow through the descending aorta. We conclude that both deserve serious consideration as a means of acquiring useful hemodynamic data for managing shock and fluid resuscitation in the critically ill, especially in those with acute lung injury and pulmonary edema, but that additional study, including carefully performed, prospective clinical trials demonstrating outcome benefit, is needed.

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Hart, Michael R., Wendy Whiteside, Sunkyung Yu, Ray Lowery, Adam L. Dorfman, Maryam Ghadimi Mahani, Prachi P. Agarwal, and Jimmy C. Lu. "Differences in Pulmonary and Systemic Flow Measurements by Cardiac Magnetic Resonance vs Cardiac Catheterization and Relation to Collateral Flow in Single Ventricle Patients." Pediatric Cardiology 41, no. 5 (February 25, 2020): 885–91. http://dx.doi.org/10.1007/s00246-020-02327-w.

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Loke, Yue-Hin, Francesco Capuano, Jason Mandell, Russell R. Cross, Ileen Cronin, Paige Mass, Elias Balaras, and Laura J. Olivieri. "Abnormal Pulmonary Artery Bending Correlates With Increased Right Ventricular Afterload Following the Arterial Switch Operation." World Journal for Pediatric and Congenital Heart Surgery 10, no. 5 (September 2019): 572–81. http://dx.doi.org/10.1177/2150135119861358.

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Purpose: In transposition of great arteries, increased right ventricular (RV) afterload is observed following arterial switch operation (ASO), which is not always related to pulmonary artery (PA) stenosis. We hypothesize that abnormal PA bending from the Lecompte maneuver may affect RV afterload in the absence of stenosis. Thus, we sought to identify novel measurements of three-dimensional cardiac magnetic resonance (CMR) images of the pulmonary arteries and compare with conventional measurements in their ability to predict RV afterload. Methods: Conventional measurements and novel measurements of the pulmonary arteries were performed using CMR data from 42 ASO patients and 13 age-matched controls. Novel measurements included bending angle, normalized radius of curvature ( Rc), and normalized weighted radius of curvature ( Rc- w). Right ventricular systolic pressures (as the surrogate for RV afterload) were measured by either recent echocardiogram or cardiac catheterization. Results: Conventional measurements of proximal PA size correlated with differential pulmonary blood flow ( r = 0.49, P = .001), but not with RV peak systolic pressures ( r = −0.26, P = .18). In ASO patients, Rc- w correlated with higher RV systolic pressures ( r = −0.57, P = .002). Larger neoaortic areas and rightward bending angles correlated with smaller right pulmonary artery Rc ( r = −0.48, P = .001; r = 0.41, P = .01, respectively). Finally, both pulmonary arteries had significantly smaller Rc compared to normal controls. Conclusions: Pulmonary arteries exhibit abnormal bends following ASO that correlate with increased RV afterload, independent of PA stenosis. Future work should focus on clinical and hemodynamic contributions of these shape parameters.

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Fontecave-Jallon, Julie, Pierre-Yves Guméry, Pascale Calabrese, Raphaël Briot, and Pierre Baconnier. "A Wearable Technology Revisited for Cardio-Respiratory Functional Exploration." International Journal of E-Health and Medical Communications 4, no. 1 (January 2013): 12–22. http://dx.doi.org/10.4018/jehmc.2013010102.

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The objective of the present study is to extract new information from complex signals generated by Respiratory Inductive Plethysmography (RIP). This indirect cardio-respiratory (CR) measure is a well-known wearable solution. The authors applied time-scale analysis to estimate cardiac activity from thoracic volume variations, witnesses of CR interactions. Calibrated RIP signals gathered from 4 healthy volunteers in resting conditions are processed by Ensemble Empirical Mode Decomposition to extract cardiac volume signals and estimate stroke volumes. Averaged values of these stroke volumes (SVRIP) are compared with averaged values of stroke volumes determined simultaneously by electrical impedance cardiography (SVICG). There is a satisfactory correlation between SVRIP and SVICG (r=0.76, p<0.001) and the limits of agreement between the 2 types of measurements (±23%) satisfies the required criterion (±30%). The observed under-estimation (-58%) is argued. This validates the use of RIP for following stroke volume variations and suggests that one simple transducer can provide a quantitative exploration of both ventilatory and cardiac volumes.

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Demircan, Tulay, Zuhal Onder Sivis, Burçak Tatlı Güneş, and Cem Karadeniz. "Evaluation of electrocardiographic markers of cardiac arrhythmic events and their correlation with cardiac iron overload in patients with β-thalassemia major." Cardiology in the Young 30, no. 11 (September 4, 2020): 1666–71. http://dx.doi.org/10.1017/s1047951120002498.

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AbstractIron overload is associated with an increased risk of atrial and ventricular arrhythmias. Data regarding the relationship between electrocardiographic parameters of atrial depolarisation and ventricular repolarisation with cardiac T2* MRI are scarce. Therefore, we aimed to investigate these electrocardiographic parameters and their relationship with cardiac T2* value in patients with β-thalassemia major. In this prospective study, 52 patients with β-thalassemia major and 52 age- and gender-matched healthy patients were included. Electrocardiographic measurements of QT, T peak to end interval, and P wave intervals were performed by one cardiologist who was blind to patients’ data. All patients underwent MRI for cardiac T2* evaluation. Cardiac T2* scores less than 20 ms were considered as iron overload. P wave dispersion, QTc interval, and the dispersions of QT and QTc were significantly prolonged in β-thalassemia major patients compared to controls. Interestingly, we found prolonged P waves, QT and T peak to end dispersions, T peak to end intervals, and increased T peak to end/QT ratios in patients with T2* greater than 20 ms. No significant correlation was observed between electrocardiographic parameters and cardiac T2* values and plasma ferritin levels. In conclusion, our study demonstrated that atrial depolarisation and ventricular repolarisation parameters are affected in β-thalassemia major patients and that these parameters are not correlated with cardiac iron load.

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Gürses, Cemil, Burak Karadağ, and Onur Erol. "Quantitative measurements of celeration times and indexes in the ductus venosus spectral Doppler waveforms in normal fetuses." Journal of Perinatal Medicine 48, no. 3 (March 26, 2020): 274–79. http://dx.doi.org/10.1515/jpm-2019-0430.

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AbstractBackgroundDuctus venosus spectral waveform has two peaks and two nadirs: S, v, D and a velocities, which are obtained after to some extent of accelerations or decelerations throughout a cardiac cycle. It is aimed to define the actual celeration times and indexes and their relationships with the fetal heart rate (FHR).MethodsThe acceleration times and indexes were measured in 357 patients between 11 and 40 weeks of pregnancies with low risk.ResultsThe FHR has a gradual increasing negative correlation from time for S to time for a with each of the cardiac times of phases according to the statistical analysis (correlations were minus 190, 269, 407 and 541 for S, v, D and a phase times, respectively). The acceleration aS and the deceleration Da have positive correlations with the FHR; however, the deceleration Sv and the acceleration vD do not correlate with the FHR.ConclusionThe deceleration Da time and index are the main components for determining the FHR in fetuses. Therefore, the atrial contraction is the strongest component for determining the FHR in fetuses.

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Kurmanavichius, Juozas, Hans Baumann, Renate Huch, and Albert Huch. "Determination of the minimum number of cardiac cycles necessary to ensure representative blood flow velocity measurements." Journal of Perinatal Medicine 17, no. 1 (January 1989): 33–39. http://dx.doi.org/10.1515/jpme.1989.17.1.33.

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Journal articles on the topic 'Cardiac health measurements'

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