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Sample records for heart beat intervals

  1. Effect of Missing Inter-Beat Interval Data on Heart Rate Variability Analysis Using Wrist-Worn Wearables.

    Science.gov (United States)

    Baek, Hyun Jae; Shin, JaeWook

    2017-08-15

    Most of the wrist-worn devices on the market provide a continuous heart rate measurement function using photoplethysmography, but have not yet provided a function to measure the continuous heart rate variability (HRV) using beat-to-beat pulse interval. The reason for such is the difficulty of measuring a continuous pulse interval during movement using a wearable device because of the nature of photoplethysmography, which is susceptible to motion noise. This study investigated the effect of missing heart beat interval data on the HRV analysis in cases where pulse interval cannot be measured because of movement noise. First, we performed simulations by randomly removing data from the RR interval of the electrocardiogram measured from 39 subjects and observed the changes of the relative and normalized errors for the HRV parameters according to the total length of the missing heart beat interval data. Second, we measured the pulse interval from 20 subjects using a wrist-worn device for 24 h and observed the error value for the missing pulse interval data caused by the movement during actual daily life. The experimental results showed that mean NN and RMSSD were the most robust for the missing heart beat interval data among all the parameters in the time and frequency domains. Most of the pulse interval data could not be obtained during daily life. In other words, the sample number was too small for spectral analysis because of the long missing duration. Therefore, the frequency domain parameters often could not be calculated, except for the sleep state with little motion. The errors of the HRV parameters were proportional to the missing data duration in the presence of missing heart beat interval data. Based on the results of this study, the maximum missing duration for acceptable errors for each parameter is recommended for use when the HRV analysis is performed on a wrist-worn device.

  2. Comparison of three methods for beat-to-beat-interval extraction from continuous blood pressure and electrocardiogram with respect to heart rate variability analysis.

    Science.gov (United States)

    Suhrbier, Alexander; Heringer, Rafael; Walther, Thomas; Malberg, Hagen; Wessel, Niels

    2006-07-01

    In recent years the analysis of heart rate variability (HRV) has become a suitable method for characterizing autonomous cardiovascular regulation. The aim of this study was to investigate the differences in HRV estimated from continuous blood pressure (BP) measurement by different methods in comparison to electrocardiogram (ECG) signals. The beat-to-beat intervals (BBI) were simultaneously extracted from the ECG and blood pressure of 9 cardiac patients (10 min, Colin system, 1000-Hz sampling frequency). For both data types, slope, peak, and correlation detection algorithms were applied. The short-term variability was calculated using concurrent 10-min BP and ECG segments. The root mean square errors in comparison to ECG slope detection were: 1.74 ms for ECG correlation detection; 5.42 ms for ECG peak detection; 5.45 ms for BP slope detection; 5.75 ms for BP correlation detection; and 11.96 ms for BP peak detection. Our results show that the variability obtained with ECG is the most reliable. Moreover, slope detection is superior to peak detection and slightly superior to correlation detection. In particular, for ECG signals with higher frequency characteristics, peak detection often exhibits more artificial variability. Besides measurement noise, respiratory modulation and pulse transit time play an important role in determining BBI. The slope detection method applied to ECG should be preferred, because it is more robust as regards morphological changes in the signals, as well as physiological properties. As the ECG is not recorded in most animal studies, distal pulse wave measurement in combination with correlation or slope detection may be considered an acceptable alternative.

  3. The cerebellum's contribution to beat interval discrimination.

    Science.gov (United States)

    Paquette, S; Fujii, S; Li, H C; Schlaug, G

    2017-12-01

    From expert percussionists to individuals who cannot dance, there are widespread differences in people's abilities to perceive and synchronize with a musical beat. The aim of our study was to identify candidate brain regions that might be associated with these abilities. For this purpose, we used Voxel-Based-Morphometry to correlate inter-individual differences in performance on the Harvard Beat Assessment Tests (H-BAT) with local inter-individual variations in gray matter volumes across the entire brain space in 60 individuals. Analysis revealed significant co-variations between performances on two perceptual tasks of the Harvard Beat Assessment Tests associated with beat interval change discrimination (faster, slower) and gray matter volume variations in the cerebellum. Participant discrimination thresholds for the Beat Finding Interval Test (quarter note beat) were positively associated with gray matter volume variation in cerebellum lobule IX in the left hemisphere and crus I bilaterally. Discrimination thresholds for the Beat Interval Test (simple series of tones) revealed the tendency for a positive association with gray matter volume variations in crus I/II of the left cerebellum. Our results demonstrate the importance of the cerebellum in beat interval discrimination skills, as measured by two perceptual tasks of the Harvard Beat Assessment Tests. Current findings, in combination with evidence from patients with cerebellar degeneration and expert dancers, suggest that cerebellar gray matter and overall cerebellar integrity are important for temporal discrimination abilities. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The heart that beats

    Directory of Open Access Journals (Sweden)

    Kashvi Gupta, MBBS

    2017-03-01

    Full Text Available An intern narrates her encounter with a 19 year old girl recently diagnosed with giant cell myocarditis and shortlisted for a heart transplant. Inspired by the young girl’s eagerness to live despite the looming difficulties inherent in the future of a transplant recipient, she reflects on her own life and comes to an understanding of why heart transplant surgery, despite making people dependent on life-long medication, also, more importantly, gives them another chance at life.

  5. Comparison of Polar® RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs.

    Science.gov (United States)

    Essner, Ann; Sjöström, Rita; Ahlgren, Erik; Gustås, Pia; Edge-Hughes, Laurie; Zetterberg, Lena; Hellström, Karin

    2015-01-01

    The aim of the present study was to assess the criterion validity, relative reliability and level of agreement of Polar® RS800CX heart rate monitor measuring inter-beat intervals (IBIs), compared to simultaneously recorded electrocardiogram (ECG) in dogs. Five continuous minutes of simultaneously recorded IBIs from Polar® RS800CX and Cardiostore ECG in 11 adult healthy dogs maintaining standing position were analyzed. Polar® data was statistically compared to ECG data to assess for systematic differences between the methods. Three different methods for handling missing IBI data were used. Criterion validities were calculated by intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). Relative reliabilities and levels of agreement were calculated by ICCs and the Bland and Altman analysis for repeated measurements per subject. Correlation coefficients between IBI data from ECG and Polar® RS800CX varied between 0.73 and 0.84 depending on how missing values were handled. Polar® was over- and underestimating IBI data compared to ECG. The mean difference in log transformed (base10) IBI data was 0.8%, and 93.2% of the values were within the limits of agreement. Internally excluding three subjects presenting IBI series containing more than 5% erroneous IBIs resulted in ICCs between 0.97 and 0.99. Bland and Altman analysis (n=8) showed mean difference was 1.8ms, and 98.5% of the IBI values were plotted inside limits of agreement. This study showed that Polar® systematically biased recorded IBI series and that it was fundamental to detect measurement errors. For Polar® RS800CX heart rate monitor to be used interchangeably to ECG, by showing excellent criterion validity and reliable IBI measures in group and individual samples, only less than 5% of artifacts could be accepted. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Enhancing Heart-Beat-Based Security for mHealth Applications

    NARCIS (Netherlands)

    Seepers, Robert M; Strydis, Christos; Sourdis, Ioannis; De Zeeuw, Chris I

    In heart-beat-based security, a security key is derived from the time difference between consecutive heart beats (the inter-pulse interval, IPI), which may, subsequently, be used to enable secure communication. While heart-beat-based security holds promise in mobile health (mHealth) applications,

  7. Directional Estimation for Robotic Beating Heart Surgery

    OpenAIRE

    Kurz, Gerhard

    2015-01-01

    In robotic beating heart surgery, a remote-controlled robot can be used to carry out the operation while automatically canceling out the heart motion. The surgeon controlling the robot is shown a stabilized view of the heart. First, we consider the use of directional statistics for estimation of the phase of the heartbeat. Second, we deal with reconstruction of a moving and deformable surface. Third, we address the question of obtaining a stabilized image of the heart.

  8. Peak misdetection in heart-beat-based security : Characterization and tolerance

    NARCIS (Netherlands)

    Seepers, Robert M; Strydis, Christos; Peris-Lopez, Pedro; Sourdis, Ioannis; De Zeeuw, Chris I

    The Inter-Pulse-Interval (IPI) of heart beats has previously been suggested for security in mobile health (mHealth) applications. In IPI-based security, secure communication is facilitated through a security key derived from the time difference between heart beats. However, there currently exists no

  9. Correlations in heart beat data as quantitative characterization of heart pathology

    Energy Technology Data Exchange (ETDEWEB)

    Ulbikas, J.; Cenys, A. [Semiconductor Physics Institute, Gostauto 11, 2600 Vilnius (Lithuania); Zemaityte, D.; Varoneckas, G. [Institute of Psychophysiology and Rehabilitation, Vyduno 4, 5720 Palanga (Lithuania)

    1996-06-01

    Correlation between heart pathology and statistical properties of heart beat data has been studied. It is shown that heart beat data has different scaling behavior for healthy and disease cases. Possibilities to develop new monitoring technique based on the permanent control of the correlations in heart beat data are discussed. {copyright} {ital 1996 American Institute of Physics.}

  10. Reversed-J inferior sternotomy for beating heart coronary surgery

    NARCIS (Netherlands)

    Grandjean, JG; Canosa, C; Mariani, MA; Boonstra, PW

    Median sternotomy or combined multiple minimally invasive approaches are currently used to revascularize patients with multivessel coronary artery disease on the beating heart. We present here a new alternative approach for minimally invasive coronary surgery on the beating heart: the reversed-J

  11. Robust Detection of Heart Beats in Multimodal Data

    OpenAIRE

    Aliyev, Taghi

    2017-01-01

    Final report of the 'Robust Heart Beat Detection in Multimodal Data' as part of the Masters in Operations Research. Project was done together with other group members, as can be found in the report itself.

  12. Heart Motion Prediction in Robotic-Assisted Beating Heart Surgery: A Nonlinear Fast Adaptive Approach

    OpenAIRE

    Fan Liang; Yang Yu; Haizhong Wang; Xiaofeng Meng

    2013-01-01

    Off-pump Coronary Artery Bypass Graft (CABG) surgery outperforms traditional on-pump surgery because the assisted robotic tools can alleviate the relative motion between the beating heart and robotic tools. Therefore, it is possible for the surgeon to operate on the beating heart and thus lessens post surgery complications for the patients. Due to the highly irregular and non-stationary nature of heart motion, it is critical that the beating heart motion is predicted in the model-based track ...

  13. Non-heart-beating donation in Spain.

    Science.gov (United States)

    Gomez-de-Antonio, David; Varela, Andres

    2011-01-01

    The aim of our study was to describe our protocol of non-heart-beating-donor (NHBD) lung transplantation and discuss data regarding the situation of NHBD and lung transplantation in Spain. Experimental work regarding NHBD led our National Organization of Transplants to develop several working groups with the objective of investigating the possibility of using uncontrolled NHBD in our country. This turned into a flexible and useful legal mechanism that allowed immediate judicial permission to preserve-and harvest-those organs. Several harvesting programs for mainly abdominal organs (kidney and liver) started in Spain during the late 1980s, with good mid-term results. The collaboration between two hospitals in Madrid-Hospital Clinico San Carlos and Hospital Puerta de Hierro as transplantation hospital-led to the development of a successful NHBD lung program for uncontrolled donors that is a pioneer in the world. In Spain, donation after cardiac arrest represents 6.7% of all transplants, mainly from types I (dead on arrival) and II (unsuccessful resuscitation) donors. NHBD for lung transplantation is concentrated in Madrid, with approximately 60 potential NHBDs per year. With this additional source of organs we have so far been able to perform 32 lung transplantations, which represents an increase of 13% of our annual transplantation rates. NHBD is no longer just a promising source of organs for lung transplantations, it is a real one. We hope that in the near future many other units will develop similar protocols to improve the use of these grafts and decrease the mortality rate among those on the waiting lists.

  14. Autonomic Modulation in Patients with Heart Failure Increases Beat-to-Beat Variability of Ventricular Action Potential Duration.

    Science.gov (United States)

    Porter, Bradley; Bishop, Martin J; Claridge, Simon; Behar, Jonathan; Sieniewicz, Benjamin J; Webb, Jessica; Gould, Justin; O'Neill, Mark; Rinaldi, Christopher A; Razavi, Reza; Gill, Jaswinder S; Taggart, Peter

    2017-01-01

    Background: Exaggerated beat-to-beat variability of ventricular action potential duration (APD) is linked to arrhythmogenesis. Sympathetic stimulation has been shown to increase QT interval variability, but its effect on ventricular APD in humans has not been determined. Methods and Results: Eleven heart failure patients with implanted bi-ventricular pacing devices had activation-recovery intervals (ARI, surrogate for APD) recorded from LV epicardial electrodes under constant RV pacing. Sympathetic activity was increased using a standard autonomic challenge (Valsalva) and baroreceptor indices were applied to determine changes in sympathetic stimulation. Two Valsalvas were performed for each study and were repeated, both off and on bisoprolol. In addition sympathetic nerve activity (SNA) was measured from skin electrodes on the thorax using a novel validated method. Autonomic modulation significantly increased mean short-term variability in ARI; off bisoprolol mean STV increased from 3.73 ± 1.3 to 5.27 ± 1.04 ms ( p = 0.01), on bisoprolol mean STV of ARI increased from 4.15 ± 1.14 to 4.62 ± 1 ms ( p = 0.14). Adrenergic indices of the Valsalva demonstrated significantly reduced beta-adrenergic function when on bisoprolol (Δ pressure recovery time, p = 0.04; Δ systolic overshoot in Phase IV, p = 0.05). Corresponding increases in SNA from rest both off (1.4 uV, p < 0.01) and on (0.7 uV, p < 0.01) bisoprolol were also seen. Conclusions: Beat-to-beat variability of ventricular APD increases during brief periods of increased sympathetic activity in patients with heart failure. Bisoprolol reduces, but does not eliminate, these effects. This may be important in the genesis of ventricular arrhythmias in heart failure patients.

  15. Reduced ischemia-reperfusion injury with isoproterenol in non-heart-beating donor lungs.

    Science.gov (United States)

    Jones, D R; Hoffmann, S C; Sellars, M; Egan, T M

    1997-05-01

    Transplantation of lungs retrieved from non-heart-beating donors could expand the donor pool. Recent studies suggest that the ischemia-reperfusion injury (IRI) to the lung can be attenuated by increasing intracellular cAMP concentrations. The purpose of this study was to determine the effect of IRI on capillary permeability, as measured by Kfc, in lungs retrieved from non-heart-beating donors and reperfused with or without isoproterenol (iso). Using an in situ isolated perfused lung model, lungs were retrieved from non-heart-beating donor rats ventilated with O2 or not at varying intervals after death. The lungs were reperfused with or without iso (10 microM). Kfc, lung viability, and pulmonary hemodynamics were measured, and tissue levels of adenine nucleotides and cAMP were measured by HPLC. Iso-reperfusion decreased Kfc significantly (P Kfc in non-iso-reperfused (r = 0.65) and iso-perfused (r = 0.84) lungs. cAMP levels increased significantly with iso-reperfusion. cAMP levels correlated with Kfc (r = 0.87) in iso-reperfused lungs. Iso-reperfusion of lungs retrieved from non-heart-beating donor rats results in decreased capillary permeability and increased lung tissue cAMP levels. Pharmacologic augmentation of tissue TAN and cAMP levels may further ameliorate the increased capillary permeability seen in lungs retrieved from non-heart-beating donors.

  16. Beat-to-beat variability of QT intervals is increased in patients with drug-induced long-QT syndrome

    DEFF Research Database (Denmark)

    Hinterseer, Martin; Thomsen, Morten Bækgaard; Beckmann, Britt-Maria

    2008-01-01

    Torsades de pointes arrhythmias (TdP) occur by definition in the setting of prolonged QT intervals. Animal models of drug induced Long-QT syndrome (dLQTS) have shown higher predictive value for proarrhythmia with beat-to-beat variability of repolarization duration (BVR) when compared with QT...... intervals. Here, we evaluate variability of QT intervals in patients with a history of drug-induced long QT syndrome (dLQTS) and TdP in absence of a mutation in any of the major LQTS genes....

  17. Using Complexity Metrics With R-R Intervals and BPM Heart Rate Measures

    DEFF Research Database (Denmark)

    Wallot, Sebastian; Fusaroli, Riccardo; Tylén, Kristian

    2013-01-01

    on variability of the data, different choices regarding the kind of measures can have a substantial impact on the results. In this article we compare linear and non-linear statistics on two prominent types of heart beat data, beat-to-beat intervals (R-R interval) and beats-per-minute (BPM). As a proof...... of interpersonal coordination. However, there is no consensus about which measurements and analytical tools are most appropriate in mapping the temporal dynamics of heart rate and quite different metrics are reported in the literature. As complexity metrics of heart rate variability depend critically......-of-concept, we employ a simple rest-exercise-rest task and show that non-linear statistics – fractal (DFA) and recurrence (RQA) analyses – reveal information about heart beat activity above and beyond the simple level of heart rate. Non-linear statistics unveil sustained post-exercise effects on heart rate...

  18. Enhancing Heart-Beat-Based Security for mHealth Applications.

    Science.gov (United States)

    Seepers, Robert M; Strydis, Christos; Sourdis, Ioannis; De Zeeuw, Chris I

    2017-01-01

    In heart-beat-based security, a security key is derived from the time difference between consecutive heart beats (the inter-pulse interval, IPI), which may, subsequently, be used to enable secure communication. While heart-beat-based security holds promise in mobile health (mHealth) applications, there currently exists no work that provides a detailed characterization of the delivered security in a real system. In this paper, we evaluate the strength of IPI-based security keys in the context of entity authentication. We investigate several aspects that should be considered in practice, including subjects with reduced heart-rate variability (HRV), different sensor-sampling frequencies, intersensor variability (i.e., how accurate each entity may measure heart beats) as well as average and worst-case-authentication time. Contrary to the current state of the art, our evaluation demonstrates that authentication using multiple, less-entropic keys may actually increase the key strength by reducing the effects of intersensor variability. Moreover, we find that the maximal key strength of a 60-bit key varies between 29.2 bits and only 5.7 bits, depending on the subject's HRV. To improve security, we introduce the inter-multi-pulse interval (ImPI), a novel method of extracting entropy from the heart by considering the time difference between nonconsecutive heart beats. Given the same authentication time, using the ImPI for key generation increases key strength by up to 3.4 × (+19.2 bits) for subjects with limited HRV, at the cost of an extended key-generation time of 4.8 × (+45 s).

  19. Non-heart beating organ donation : overview and future perspectives

    NARCIS (Netherlands)

    Moers, Cyril; Leuvenink, Henri G. D.; Ploeg, Rutger J.

    New indications for organ transplantation combined with a stagnating number of available donor grafts have severely lengthened the waiting list for almost all types of transplantations. This has led to a renewed interest in non-heart beating (NHB) donation, as a possible solution to bridge the gap

  20. Analysis of heart rate variability in the presence of ectopic beats using the heart timing signal.

    Science.gov (United States)

    Mateo, Javier; Laguna, Pablo

    2003-03-01

    The time-domain signals representing the heart rate variability (HRV) in the presence of an ectopic beat exhibit a sharp transient at the position of the ectopic beat, which corrupts the signal, particularly the power spectral density (PSD) of the HRV. Consequently, there is a need for correction of this type of beat prior to any HRV analysis. This paper deals with the PSD estimation of the HRV by means of the heart timing (HT) signal when ectopic beats are present. These beat occurrence times are modeled from a generalized, continuous time integral pulse frequency modulation model and, from this point of view, a specific method for minimizing the effect of the presence of ectopic beats is presented to work together with the HT signal. By using both, a white noise driven autoregressive model of the HRV signal with artificially introduced ectopic beats and actual heart rate series including ectopic beats, the more usual methods of HRV spectral estimation are compared. Results of the PSD estimation error function of the number of ectopic beats are presented. These results demonstrate that the proposed method has one order of magnitude lower error than usual ectopic beats removal strategies in preserving PSD, thus, this strategy better recovers the original clinical indexes of interest.

  1. Connection forms for beating the heart

    DEFF Research Database (Denmark)

    Mensch, Arthur; Piuze, Emmanuel; Lehnert, Lucas

    2014-01-01

    We combine recent work on modeling cardiac mechanics using a finite volume method with the insight that heart wall myofiber orientations exhibit a particular volumetric geometry. In our finite vol- ume mechanical simulation we use Maurer-Cartan one-forms to add a geometrical consistency term...... to control the rate at which myofiber ori- entation changes in the direction perpendicular to the heart wall. This allows us to estimate material properties related to both the passive and active parameters in our model. We have obtained preliminary results on the 4 canine datasets of the 2014 mechanics...... challenge using the FEBio software suite. In ongoing work we are validating and improving the model using rat heart (ex-vivo DTI and in-vivo tagging) MRI datasets, from which we have estimated strain tensors....

  2. Peak misdetection in heart-beat-based security: Characterization and tolerance.

    Science.gov (United States)

    Seepers, Robert M; Strydis, Christos; Peris-Lopez, Pedro; Sourdis, Ioannis; De Zeeuw, Chris I

    2014-01-01

    The Inter-Pulse-Interval (IPI) of heart beats has previously been suggested for security in mobile health (mHealth) applications. In IPI-based security, secure communication is facilitated through a security key derived from the time difference between heart beats. However, there currently exists no work which considers the effect on security of imperfect heart-beat (peak) detection. This is a crucial aspect of IPI-based security and likely to happen in a real system. In this paper, we evaluate the effects of peak misdetection on the security performance of IPI-based security. It is shown that even with a high peak detection rate between 99.9% and 99.0%, a significant drop in security performance may be observed (between -70% and -303%) compared to having perfect peak detection. We show that authenticating using smaller keys yields both stronger keys as well as potentially faster authentication in case of imperfect heart beat detection. Finally, we present an algorithm which tolerates the effect of a single misdetected peak and increases the security performance by up to 155%.

  3. Towards active tracking of beating heart motion in the presence of arrhythmia for robotic assisted beating heart surgery.

    Science.gov (United States)

    Tuna, E Erdem; Karimov, Jamshid H; Liu, Taoming; Bebek, Özkan; Fukamachi, Kiyotaka; Çavuşoğlu, M Cenk

    2014-01-01

    In robotic assisted beating heart surgery, the control architecture for heart motion tracking has stringent requirements in terms of bandwidth of the motion that needs to be tracked. In order to achieve sufficient tracking accuracy, feed-forward control algorithms, which rely on estimations of upcoming heart motion, have been proposed in the literature. However, performance of these feed-forward motion control algorithms under heart rhythm variations is an important concern. In their past work, the authors have demonstrated the effectiveness of a receding horizon model predictive control-based algorithm, which used generalized adaptive predictors, under constant and slowly varying heart rate conditions. This paper extends these studies to the case when the heart motion statistics change abruptly and significantly, such as during arrhythmias. A feasibility study is carried out to assess the motion tracking capabilities of the adaptive algorithms in the occurrence of arrhythmia during beating heart surgery. Specifically, the tracking performance of the algorithms is evaluated on prerecorded motion data, which is collected in vivo and includes heart rhythm irregularities. The algorithms are tested using both simulations and bench experiments on a three degree-of-freedom robotic test bed. They are also compared with a position-plus-derivative controller as well as a receding horizon model predictive controller that employs an extended Kalman filter algorithm for predicting future heart motion.

  4. Towards active tracking of beating heart motion in the presence of arrhythmia for robotic assisted beating heart surgery.

    Directory of Open Access Journals (Sweden)

    E Erdem Tuna

    Full Text Available In robotic assisted beating heart surgery, the control architecture for heart motion tracking has stringent requirements in terms of bandwidth of the motion that needs to be tracked. In order to achieve sufficient tracking accuracy, feed-forward control algorithms, which rely on estimations of upcoming heart motion, have been proposed in the literature. However, performance of these feed-forward motion control algorithms under heart rhythm variations is an important concern. In their past work, the authors have demonstrated the effectiveness of a receding horizon model predictive control-based algorithm, which used generalized adaptive predictors, under constant and slowly varying heart rate conditions. This paper extends these studies to the case when the heart motion statistics change abruptly and significantly, such as during arrhythmias. A feasibility study is carried out to assess the motion tracking capabilities of the adaptive algorithms in the occurrence of arrhythmia during beating heart surgery. Specifically, the tracking performance of the algorithms is evaluated on prerecorded motion data, which is collected in vivo and includes heart rhythm irregularities. The algorithms are tested using both simulations and bench experiments on a three degree-of-freedom robotic test bed. They are also compared with a position-plus-derivative controller as well as a receding horizon model predictive controller that employs an extended Kalman filter algorithm for predicting future heart motion.

  5. Heart Motion Prediction in Robotic-Assisted Beating Heart Surgery: A Nonlinear Fast Adaptive Approach

    National Research Council Canada - National Science Library

    Liang, Fan; Yu, Yang; Wang, Haizhong; Meng, Xiaofeng

    2013-01-01

    Off-pump Coronary Artery Bypass Graft (CABG) surgery outperforms traditional on-pump surgery because the assisted robotic tools can alleviate the relative motion between the beating heart and robotic tools...

  6. Multivariate Autoregressive Model Based Heart Motion Prediction Approach for Beating Heart Surgery

    Directory of Open Access Journals (Sweden)

    Fan Liang

    2013-02-01

    Full Text Available A robotic tool can enable a surgeon to conduct off-pump coronary artery graft bypass surgery on a beating heart. The robotic tool actively alleviates the relative motion between the point of interest (POI on the heart surface and the surgical tool and allows the surgeon to operate as if the heart were stationary. Since the beating heart's motion is relatively high-band, with nonlinear and nonstationary characteristics, it is difficult to follow. Thus, precise beating heart motion prediction is necessary for the tracking control procedure during the surgery. In the research presented here, we first observe that Electrocardiography (ECG signal contains the causal phase information on heart motion and non-stationary heart rate dynamic variations. Then, we investigate the relationship between ECG signal and beating heart motion using Granger Causality Analysis, which describes the feasibility of the improved prediction of heart motion. Next, we propose a nonlinear time-varying multivariate vector autoregressive (MVAR model based adaptive prediction method. In this model, the significant correlation between ECG and heart motion enables the improvement of the prediction of sharp changes in heart motion and the approximation of the motion with sufficient detail. Dual Kalman Filters (DKF estimate the states and parameters of the model, respectively. Last, we evaluate the proposed algorithm through comparative experiments using the two sets of collected vivo data.

  7. Measuring Cosmic Distances with Stellar Heart Beats

    Science.gov (United States)

    2004-10-01

    .5 days, a fairly wide interval and an important advantage to properly calibrate the Period-Luminosity relation. The distances to four of the stars (Eta Aql, W Sgr, Beta Dor and L Car) were derived using the interferometric Baade-Wesselink method, as their pulsation is detected by the VLTI. ESO PR Photo 30c/04 shows the angular diameter measurements and the fitted radius curve of L Car (P = 35.5 days); this measures its distance with a relative precision better than 5%. For the remaining three objects of the sample (X Sgr, Zeta Gem and Y Oph), a hybrid method was applied to derive their distances, based on their average angular diameter and pre-existing estimations of their linear diameters. The new calibration ESO PR Photo 30d/04 ESO PR Photo 30d/04 Title [Preview - JPEG: 400 x 365 pix - 80k] [Normal - JPEG: 800 x 730 pix - 168k] Caption: ESO PR Photo 30d/04 represents the Period-Luminosity relation in the V band, as deduced from the interferometric observations of Cepheids and the HST parallax measurement of Delta Cep. The green line is the fitted P-L relation, assuming the slope from previous authors (Gieren et al.; 1998, ApJ, 496, 17). The agreement between the model and the measurements is excellent, in particular for the high-precision measurements of Delta Cep and L Car. Combining the distances measured by this programme with the apparent magnitudes of the stars, the astronomers determined the absolute magnitude (intrinsic brightness) of these stars and arrived at a very precise calibration of the zero-point of the Period-Luminosity relation (assuming the slope from previous work). It turned out that this new and independently derived value of the zero-point is exactly the same as the one obtained during previous work based on a large number of relatively low-precision Cepheid distance measurements by the ESA Hipparcos astrometric satellite. The agreement between these two independent, geometrical calibrations is remarkable and greatly increases the confidence in

  8. Robotic tissue tracking for beating heart mitral valve surgery.

    Science.gov (United States)

    Yuen, Shelten G; Vasilyev, Nikolay V; del Nido, Pedro J; Howe, Robert D

    2013-12-01

    The rapid motion of the heart presents a significant challenge to the surgeon during intracardiac beating heart procedures. We present a 3D ultrasound-guided motion compensation system that assists the surgeon by synchronizing instrument motion with the heart. The system utilizes the fact that certain intracardiac structures, like the mitral valve annulus, have trajectories that are largely constrained to translation along one axis. This allows the development of a real-time 3D ultrasound tissue tracker that we integrate with a 1 degree-of-freedom (DOF) actuated surgical instrument and predictive filter to devise a motion tracking system adapted to mitral valve annuloplasty. In vivo experiments demonstrate that the system provides highly accurate tracking (1.0 mm error) with 70% less error than manual tracking attempts. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Ion channels and beating heart: the players and the music

    Directory of Open Access Journals (Sweden)

    Charles Antzelevitch

    2011-12-01

    Full Text Available Soft gentle music accompanies us throughout our lifetime; it is the music of our heart beating. Although at times it is questionable as to who serves as conductor of the orchestra, there is little doubt that our ion channels are the main players. Whenever one of them plays too loudly, too softly or simply off key, disharmony results, sometimes leading to total disruption of the rate and rhythm. Ion channels can disrupt the music of our heart by different mechanisms. Sometimes their function is correct, but their expression is altered by underlying cardiac diseases (i.e. heart failure; sometimes the defect is in their structure, because of an underlying genetic defect, and in this case a channelopathy is present.

  10. In vivo electroporation mediated gene delivery to the beating heart.

    Directory of Open Access Journals (Sweden)

    Erick L Ayuni

    Full Text Available Gene therapy may represent a promising alternative strategy for cardiac muscle regeneration. In vivo electroporation, a physical method of gene transfer, has recently evolved as an efficient method for gene transfer. In the current study, we investigated the efficiency and safety of a protocol involving in vivo electroporation for gene transfer to the beating heart. Adult male rats were anesthetised and the heart exposed through a left thoracotomy. Naked plasmid DNA was injected retrograde into the transiently occluded coronary sinus before the electric pulses were applied. Animals were sacrificed at specific time points and gene expression was detected. Results were compared to the group of animals where no electric pulses were applied. No post-procedure arrhythmia was observed. Left ventricular function was temporarily altered only in the group were high pulses were applied; CK-MB (Creatine kinase and TNT (Troponin T were also altered only in this group. Histology showed no signs of toxicity. Gene expression was highest at day one. Our results provide evidence that in vivo electroporation with an optimized protocol is a safe and effective tool for nonviral gene delivery to the beating heart. This method may be promising for clinical settings especially for perioperative gene delivery.

  11. Heart Motion Prediction in Robotic-Assisted Beating Heart Surgery: A Nonlinear Fast Adaptive Approach

    Directory of Open Access Journals (Sweden)

    Fan Liang

    2013-01-01

    Full Text Available Off-pump Coronary Artery Bypass Graft (CABG surgery outperforms traditional on-pump surgery because the assisted robotic tools can alleviate the relative motion between the beating heart and robotic tools. Therefore, it is possible for the surgeon to operate on the beating heart and thus lessens post surgery complications for the patients. Due to the highly irregular and non-stationary nature of heart motion, it is critical that the beating heart motion is predicted in the model-based track control procedures. It is technically preferable to model heart motion in a nonlinear way because the characteristic analysis of 3D heart motion data through Bi-spectral analysis and Fourier methods demonstrates the involved nonlinearity of heart motion. We propose an adaptive nonlinear heart motion model based on the Volterra Series in this paper. We also design a fast lattice structure to achieve computational-efficiency for real-time online predictions. We argue that the quadratic term of the Volterra Series can improve the prediction accuracy by covering sharp change points and including the motion with sufficient detail. The experiment results indicate that the adaptive nonlinear heart motion prediction algorithm outperforms the autoregressive (AR and the time-varying Fourier-series models in terms of the root mean square of the prediction error and the prediction error in extreme cases.

  12. Beat-to-beat analysis of the relation between RT and RR intervals in newborns.

    Science.gov (United States)

    Pladys, Patrick; Senhadji, Lotfi; Blanche, Pierre Maison; Beuchée, Alain; Bétrémieux, Pierre; Carré, François

    2003-01-01

    To evaluate the dynamic RT (QRS apex-end of T wave) rate dependence in newborns. A Digital Holter ECG was acquired on day 15 in nine full-term and eight preterm infants. Ten-minute periods were recorded during wakefulness and sleep. The accuracy of fit with RT-RR pairs was individually assessed by 14 regression formulas (r coefficient, Akaike score, residual analysis). The medians of RT and Bazett's RT correction were calculated for each 10 milliseconds of RR. The mean RR and RT were 429+/-51 and 263+/-18 milliseconds. None of the prediction formulas were sufficiently accurate to describe RT over the whole range of RR (r<0.56). The Bazett correction produced differences of more than 50 milliseconds at different RR. Prematurity, sleep state and heart rate variability did not influence RT-RR relation. None of the parametric formulas were found to be accurate in describing RT rate dependence in newborns.

  13. Increased Short-Term Beat-to-Beat QT Interval Variability in Patients with Impaired Glucose Tolerance

    Directory of Open Access Journals (Sweden)

    Andrea Orosz

    2017-06-01

    Full Text Available Prediabetic states and diabetes are important risk factors for cardiovascular morbidity and mortality. Determination of short-term QT interval variability (STVQT is a non-invasive method for assessment of proarrhythmic risk. The aim of the study was to evaluate the STVQT in patients with impaired glucose tolerance (IGT. 18 IGT patients [age: 63 ± 11 years, body mass index (BMI: 31 ± 6 kg/m2, fasting glucose: 6.0 ± 0.4 mmol/l, 120 min postload glucose: 9.0 ± 1.0 mmol/l, hemoglobin A1c (HbA1c: 5.9 ± 0.4%; mean ± SD] and 18 healthy controls (age: 56 ± 9 years, BMI: 27 ± 5 kg/m2, fasting glucose: 5.2 ± 0.4 mmol/l, 120 min postload glucose: 5.5 ± 1.3 mmol/l, HbA1c: 5.4 ± 0.3% were enrolled into the study. ECGs were recorded, processed, and analyzed off-line. The RR and QT intervals were expressed as the average of 30 consecutive beats, the temporal instability of beat-to-beat repolarization was characterized by calculating STVQT as follows: STVQT = Σ|QTn + 1 − QTn| (30x√2−1. Autonomic function was assessed by means of standard cardiovascular reflex tests. There were no differences between IGT and control groups in QT (411 ± 43 vs 402 ± 39 ms and QTc (431 ± 25 vs 424 ± 19 ms intervals or QT dispersion (44 ± 13 vs 42 ± 17 ms. However, STVQT was significantly higher in IGT patients (5.0 ± 0.7 vs 3.7 ± 0.7, P < 0.0001. The elevated temporal STVQT in patients with IGT may be an early indicator of increased instability of cardiac repolarization during prediabetic conditions.

  14. Increased Short-Term Beat-to-Beat QT Interval Variability in Patients with Impaired Glucose Tolerance.

    Science.gov (United States)

    Orosz, Andrea; Baczkó, István; Nyiraty, Szabolcs; Körei, Anna E; Putz, Zsuzsanna; Takács, Róbert; Nemes, Attila; Várkonyi, Tamás T; Balogh, László; Ábrahám, György; Kempler, Péter; Papp, Julius Gy; Varró, András; Lengyel, Csaba

    2017-01-01

    Prediabetic states and diabetes are important risk factors for cardiovascular morbidity and mortality. Determination of short-term QT interval variability (STVQT) is a non-invasive method for assessment of proarrhythmic risk. The aim of the study was to evaluate the STVQT in patients with impaired glucose tolerance (IGT). 18 IGT patients [age: 63 ± 11 years, body mass index (BMI): 31 ± 6 kg/m2, fasting glucose: 6.0 ± 0.4 mmol/l, 120 min postload glucose: 9.0 ± 1.0 mmol/l, hemoglobin A1c (HbA1c): 5.9 ± 0.4%; mean ± SD] and 18 healthy controls (age: 56 ± 9 years, BMI: 27 ± 5 kg/m2, fasting glucose: 5.2 ± 0.4 mmol/l, 120 min postload glucose: 5.5 ± 1.3 mmol/l, HbA1c: 5.4 ± 0.3%) were enrolled into the study. ECGs were recorded, processed, and analyzed off-line. The RR and QT intervals were expressed as the average of 30 consecutive beats, the temporal instability of beat-to-beat repolarization was characterized by calculating STVQT as follows: STVQT = Σ|QTn + 1 - QTn| (30x√2)-1. Autonomic function was assessed by means of standard cardiovascular reflex tests. There were no differences between IGT and control groups in QT (411 ± 43 vs 402 ± 39 ms) and QTc (431 ± 25 vs 424 ± 19 ms) intervals or QT dispersion (44 ± 13 vs 42 ± 17 ms). However, STVQT was significantly higher in IGT patients (5.0 ± 0.7 vs 3.7 ± 0.7, P < 0.0001). The elevated temporal STVQT in patients with IGT may be an early indicator of increased instability of cardiac repolarization during prediabetic conditions.

  15. The first non-heart-beating organ donor in Hawaii--medical and ethical considerations.

    Science.gov (United States)

    Cheung, A H; Kailani, H K; Limm, W M

    2000-09-01

    The shortage of organ donors remains a major obstacle in transplantation in Hawaii. Some patients die while waiting for a life-saving organ. Across the nation, "marginal" donors, including non-heart-beating donors are used. The authors describe the first successful non-heart-beating organ donor transplant in Hawaii, and include medical and ethical considerations.

  16. Non-heart beating organ donation: overview and future perspectives.

    Science.gov (United States)

    Moers, Cyril; Leuvenink, Henri G D; Ploeg, Rutger J

    2007-07-01

    New indications for organ transplantation combined with a stagnating number of available donor grafts have severely lengthened the waiting list for almost all types of transplantations. This has led to a renewed interest in non-heart beating (NHB) donation, as a possible solution to bridge the gap between supply and demand. In this review, we present an overview of current NHB donation practice, outcome, existing problems and future perspectives. We focus on possible improvements in donor management, recipient care and new methods of organ preservation that may be better suited for these marginal organs. Successful institution of NHB protocols depends on adapting current transplantation practice at all levels, which is one of the greatest challenges for researchers and professionals in this interesting re-emerging field.

  17. A Quadratic Nonlinear Prediction-Based Heart Motion Model Following Control Algorithm in Robotic-Assisted Beating Heart Surgery

    OpenAIRE

    Fan Liang; Xiaofeng Meng

    2013-01-01

    Off-pump coronary artery bypass graft surgery outperforms the traditional on-pump surgery because the assisted robotic tools can cancel the relative motion between the beating heart and the robotic tools, which reduces post-surgery complications for patients. The challenge for the robot assisted tool when tracking the beating heart is the abrupt change caused by the nonlinear nature of heart motion and high precision surgery requirements. A characteristic analysis of 3D heart motion data thro...

  18. Using Complexity Metrics With R-R Intervals and BPM Heart Rate Measures

    Directory of Open Access Journals (Sweden)

    Sebastian eWallot

    2013-08-01

    Full Text Available Lately, growing attention in the health sciences has been paid to the dynamics of heart rate as indicator of impending failures and for prognoses. Likewise, in social and cognitive sciences, heart rate is increasingly employed as a measure of arousal, emotional engagement and as a marker of interpersonal coordination. However, there is no consensus about which measurements and analytical tools are most appropriate in mapping the temporal dynamics of heart rate and quite different metrics are reported in the literature. As complexity metrics of heart rate variability depend critically on variability of the data, different choices regarding the kind of measures can have a substantial impact on the results. In this article we compare linear and non-linear statistics on two prominent types of heart beat data, beat-to-beat intervals (R-R interval and beats-per-minute (BPM. As a proof-of-concept, we employ a simple rest-exercise-rest task and show that non-linear statistics – fractal (DFA and recurrence (RQA analyses – reveal information about heart beat activity above and beyond the simple level of heart rate. Non-linear statistics unveil sustained post-exercise effects on heart rate dynamics, but their power to do so critically depends on the type data that is employed: While R-R intervals are very susceptible to nonlinear analyses, the success of nonlinear methods for BPM data critically depends on their construction. Generally, ‘oversampled’ BPM time-series can be recommended as they retain most of the information about nonlinear aspects of heart beat dynamics.

  19. Using complexity metrics with R-R intervals and BPM heart rate measures.

    Science.gov (United States)

    Wallot, Sebastian; Fusaroli, Riccardo; Tylén, Kristian; Jegindø, Else-Marie

    2013-01-01

    Lately, growing attention in the health sciences has been paid to the dynamics of heart rate as indicator of impending failures and for prognoses. Likewise, in social and cognitive sciences, heart rate is increasingly employed as a measure of arousal, emotional engagement and as a marker of interpersonal coordination. However, there is no consensus about which measurements and analytical tools are most appropriate in mapping the temporal dynamics of heart rate and quite different metrics are reported in the literature. As complexity metrics of heart rate variability depend critically on variability of the data, different choices regarding the kind of measures can have a substantial impact on the results. In this article we compare linear and non-linear statistics on two prominent types of heart beat data, beat-to-beat intervals (R-R interval) and beats-per-min (BPM). As a proof-of-concept, we employ a simple rest-exercise-rest task and show that non-linear statistics-fractal (DFA) and recurrence (RQA) analyses-reveal information about heart beat activity above and beyond the simple level of heart rate. Non-linear statistics unveil sustained post-exercise effects on heart rate dynamics, but their power to do so critically depends on the type data that is employed: While R-R intervals are very susceptible to non-linear analyses, the success of non-linear methods for BPM data critically depends on their construction. Generally, "oversampled" BPM time-series can be recommended as they retain most of the information about non-linear aspects of heart beat dynamics.

  20. Heart rate dependency of JT interval sections.

    Science.gov (United States)

    Hnatkova, Katerina; Johannesen, Lars; Vicente, Jose; Malik, Marek

    2017-08-09

    Little experience exists with the heart rate correction of J-Tpeak and Tpeak-Tend intervals. In a population of 176 female and 176 male healthy subjects aged 32.3±9.8 and 33.1±8.4years, respectively, curve-linear and linear relationship to heart rate was investigated for different sections of the JT interval defined by the proportions of the area under the vector magnitude of the reconstructed 3D vectorcardiographic loop. The duration of the JT sub-section between approximately just before the T peak and almost the T end was found heart rate independent. Most of the JT heart rate dependency relates to the beginning of the interval. The duration of the terminal T wave tail is only weakly heart rate dependent. The Tpeak-Tend is only minimally heart rate dependent and in studies not showing substantial heart rate changes does not need to be heart rate corrected. For any correction formula that has linear additive properties, heart rate correction of JT and JTpeak intervals is practically the same as of the QT interval. However, this does not apply to the formulas in the form of Int/RR(a) since they do not have linear additive properties. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. An efficient method of addressing ectopic beats: new insight into data preprocessing of heart rate variability analysis*

    Science.gov (United States)

    Wen, Feng; He, Fang-tian

    2011-01-01

    Heart rate variability (HRV) analysis is affected by ectopic beats. An efficient method was proposed to deal with the ectopic beats. The method was based on trend correlation of the heart timing signal. Predictor of R-R interval (RRI) value at ectopic beat time was constructed by the weight calculation and the slope estimation of preceding normal RRI. The type of ectopic beat was detected and replaced by the predictor of RRI. The performance of the simulated signal after ectopic correction was tested by the standard value using power spectrum density (PSD) estimation, whereas the results of clinical data with ectopic beats were compared with the adjacent ectopic-free data. The result showed the frequency indexes after ectopy corrected had less error than other methods with the test of simulated signal and clinical data. It indicated our method could improve the PSD estimation in HRV analysis. The method had advantages of high accuracy and real time properties to recover the sinus node modulation. PMID:22135146

  2. An efficient method of addressing ectopic beats: new insight into data preprocessing of heart rate variability analysis.

    Science.gov (United States)

    Wen, Feng; He, Fang-Tian

    2011-12-01

    Heart rate variability (HRV) analysis is affected by ectopic beats. An efficient method was proposed to deal with the ectopic beats. The method was based on trend correlation of the heart timing signal. Predictor of R-R interval (RRI) value at ectopic beat time was constructed by the weight calculation and the slope estimation of preceding normal RRI. The type of ectopic beat was detected and replaced by the predictor of RRI. The performance of the simulated signal after ectopic correction was tested by the standard value using power spectrum density (PSD) estimation, whereas the results of clinical data with ectopic beats were compared with the adjacent ectopic-free data. The result showed the frequency indexes after ectopy corrected had less error than other methods with the test of simulated signal and clinical data. It indicated our method could improve the PSD estimation in HRV analysis. The method had advantages of high accuracy and real time properties to recover the sinus node modulation.

  3. Estimating 'lost heart beats' rather than reductions in heart rate during the intubation of critically-ill children.

    Science.gov (United States)

    Jones, Peter; Ovenden, Nick; Dauger, Stéphane; Peters, Mark J

    2014-01-01

    Reductions in heart rate occur frequently in children during critical care intubation and are currently considered the gold standard for haemodynamic instability. Our objective was to estimate loss of heart beats during intubation and compare this to reduction in heart rate alone whilst testing the impact of atropine pre-medication. Data were extracted from a prospective 2-year cohort study of intubation ECGs from critically ill children in PICU/Paediatric Transport. A three step algorithm was established to exclude variation in pre-intubation heart rate (using a 95%CI limit derived from pre-intubation heart rate variation of the children included), measure the heart rate over time and finally the estimate the numbers of lost beats. 333 intubations in children were eligible for inclusion of which 245 were available for analysis (74%). Intubations where the fall in heart rate was less than 50 bpm were accompanied almost exclusively by less than 25 lost beats (n = 175, median 0 [0-1]). When there was a reduction of >50 bpm there was a poor correlation with numbers of lost beats (n = 70, median 42 [15-83]). During intubation the median number of lost beats was 8 [1]-[32] when atropine was not used compared to 0 [0-0] when atropine was used (pheart rate during intubation of heart rate was >50 bpm the heart rate was poorly predictive of lost beats. A study looking at the relationship between lost beats and cardiac output needs to be performed. Atropine reduces both fall in heart rate and loss of beats. Similar area-under-the-curve methodology may be useful for estimating risk when biological parameters deviate outside normal range.

  4. Low-Cost, Take-Home, Beating Heart Simulator for Health-Care Education

    OpenAIRE

    Berg, Devin

    2013-01-01

    Abstract: Intended for medical students studying the evaluation and diagnosis of heart arrhythmias, the beating heart arrhythmia simulator combines visual, auditory, and tactile stimuli to enhance the student's retention of the subtle differences between various conditions of the heart necessary for diagnosis. Unlike existing heart arrhythmia simulators, our simulator is low cost and easily deployable in the classroom setting. A design consisting of solenoid actuators, a silicon heart mode...

  5. A Quadratic Nonlinear Prediction-Based Heart Motion Model following Control Algorithm in Robotic-Assisted Beating Heart Surgery

    National Research Council Canada - National Science Library

    Liang, Fan; Meng, Xiaofeng

    2013-01-01

    Off-pump coronary artery bypass graft surgery outperforms the traditional on-pump surgery because the assisted robotic tools can cancel the relative motion between the beating heart and the robotic...

  6. Efficient physics-based tracking of heart surface motion for beating heart surgery robotic systems.

    Science.gov (United States)

    Bogatyrenko, Evgeniya; Pompey, Pascal; Hanebeck, Uwe D

    2011-05-01

    Tracking of beating heart motion in a robotic surgery system is required for complex cardiovascular interventions. A heart surface motion tracking method is developed, including a stochastic physics-based heart surface model and an efficient reconstruction algorithm. The algorithm uses the constraints provided by the model that exploits the physical characteristics of the heart. The main advantage of the model is that it is more realistic than most standard heart models. Additionally, no explicit matching between the measurements and the model is required. The application of meshless methods significantly reduces the complexity of physics-based tracking. Based on the stochastic physical model of the heart surface, this approach considers the motion of the intervention area and is robust to occlusions and reflections. The tracking algorithm is evaluated in simulations and experiments on an artificial heart. Providing higher accuracy than the standard model-based methods, it successfully copes with occlusions and provides high performance even when all measurements are not available. Combining the physical and stochastic description of the heart surface motion ensures physically correct and accurate prediction. Automatic initialization of the physics-based cardiac motion tracking enables system evaluation in a clinical environment.

  7. Short-term beat-to-beat variability of the QT interval is increased and correlates with parameters of left ventricular hypertrophy in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Orosz, Andrea; Baczkó, István; Nagy, Viktória; Gavallér, Henriette; Csanády, Miklós; Forster, Tamás; Papp, Julius Gy; Varró, András; Lengyel, Csaba; Sepp, Róbert

    2015-09-01

    Stratification models for the prediction of sudden cardiac death (SCD) are inappropriate in patients with hypertrophic cardiomyopathy (HCM). We investigated conventional electrocardiogram (ECG) repolarization parameters and the beat-to-beat short-term QT interval variability (QT-STV), a new parameter of proarrhythmic risk, in 37 patients with HCM (21 males, average age 48 ± 15 years). Resting ECGs were recorded for 5 min and the frequency corrected QT interval (QTc), QT dispersion (QTd), beat-to-beat short-term variability of QT interval (QT-STV), and the duration of terminal part of T waves (Tpeak-Tend) were calculated. While all repolarization parameters were significantly increased in patients with HCM compared with the controls (QTc, 488 ± 61 vs. 434 ± 23 ms, p < 0.0001; QT-STV, 4.5 ± 2 vs. 3.2 ± 1 ms, p = 0.0002; Tpeak-Tend duration, 107 ± 27 vs. 91 ± 10 ms, p = 0.0015; QTd, 47 ± 17 vs. 34 ± 9 ms, p = 0.0002), QT-STV had the highest relative increase (+41%). QT-STV also showed the best correlation with indices of left ventricular (LV) hypertrophy, i.e., maximal LV wall thickness normalized for body surface area (BSA; r = 0.461, p = 0.004) or LV mass (determined by cardiac magnetic resonance imaging) normalized for BSA (r = 0.455, p = 0.015). In summary, beat-to-beat QT-STV showed the most marked increase in patients with HCM and may represent a novel marker that merits further testing for increased SCD risk in HCM.

  8. Speckle variance optical coherence tomography of blood flow in the beating mouse embryonic heart.

    Science.gov (United States)

    Grishina, Olga A; Wang, Shang; Larina, Irina V

    2017-05-01

    Efficient separation of blood and cardiac wall in the beating embryonic heart is essential and critical for experiment-based computational modelling and analysis of early-stage cardiac biomechanics. Although speckle variance optical coherence tomography (SV-OCT) relying on calculation of intensity variance over consecutively acquired frames is a powerful approach for segmentation of fluid flow from static tissue, application of this method in the beating embryonic heart remains challenging because moving structures generate SV signal indistinguishable from the blood. Here, we demonstrate a modified four-dimensional SV-OCT approach that effectively separates the blood flow from the dynamic heart wall in the beating mouse embryonic heart. The method takes advantage of the periodic motion of the cardiac wall and is based on calculation of the SV signal over the frames corresponding to the same phase of the heartbeat cycle. Through comparison with Doppler OCT imaging, we validate this speckle-based approach and show advantages in its insensitiveness to the flow direction and velocity as well as reduced influence from the heart wall movement. This approach has a potential in variety of applications relying on visualization and segmentation of blood flow in periodically moving structures, such as mechanical simulation studies and finite element modelling. Picture: Four-dimensional speckle variance OCT imaging shows the blood flow inside the beating heart of an E8.5 mouse embryo. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Heart motion uncertainty compensation prediction method for robot assisted beating heart surgery - Master-slave Kalman Filters approach.

    Science.gov (United States)

    Liang, Fan; Yu, Yang; Cui, Shigang; Zhao, Li; Wu, Xingli

    2014-05-01

    Robot Assisted Coronary Artery Bypass Graft (CABG) allows the heart keep beating in the surgery by actively eliminating the relative motion between point of interest (POI) on the heart surface and surgical tool. The inherited nonlinear and diverse nature of beating heart motion gives a huge obstacle for the robot to meet the demanding tracking control requirements. In this paper, we novelty propose a Master-slave Kalman Filter based on beating heart motion Nonlinear Adaptive Prediction (NAP) algorithm. In the study, we describe the beating heart motion as the combination of nonlinearity relating mathematics part and uncertainty relating non-mathematics part. Specifically, first, we model the nonlinearity of the heart motion via quadratic modulated sinusoids and estimate it by a Master Kalman Filter. Second, we involve the uncertainty heart motion by adaptively change the covariance of the process noise through the slave Kalman Filter. We conduct comparative experiments to evaluate the proposed approach with four distinguished datasets. The results indicate that the new approach reduces prediction errors by at least 30 μm. Moreover, the new approach performs well in robustness test, in which two kinds of arrhythmia datasets from MIT-BIH arrhythmia database are assessed.

  10. Relationship between heart rate and quiescent interval of the cardiac cycle in children using MRI.

    Science.gov (United States)

    Zhang, Wei; Bogale, Saivivek; Golriz, Farahnaz; Krishnamurthy, Rajesh

    2017-11-01

    Imaging the heart in children comes with the challenge of constant cardiac motion. A prospective electrocardiography-triggered CT scan allows for scanning during a predetermined phase of the cardiac cycle with least motion. This technique requires knowing the optimal quiescent intervals of cardiac cycles in a pediatric population. To evaluate high-temporal-resolution cine MRI of the heart in children to determine the relationship of heart rate to the optimal quiescent interval within the cardiac cycle. We included a total of 225 consecutive patients ages 0-18 years who had high-temporal-resolution cine steady-state free-precession sequence performed as part of a magnetic resonance imaging (MRI) or magnetic resonance angiography study of the heart. We determined the location and duration of the quiescent interval in systole and diastole for heart rates ranging 40-178 beats per minute (bpm). We performed the Wilcoxon signed rank test to compare the duration of quiescent interval in systole and diastole for each heart rate group. The duration of the quiescent interval at heart rates bpm and >90 bpm was significantly longer in diastole and systole, respectively (Pbpm [P=.02]). For heart rates 80-89 bpm, diastolic interval was longer than systolic interval, but the difference was not statistically significant (P=.06). We created a chart depicting optimal quiescent intervals across a range of heart rates that could be applied for prospective electrocardiography-triggered CT imaging of the heart. The optimal quiescent interval at heart rates bpm is in diastole and at heart rates ≥90 bpm is in systole. The period of quiescence at heart rates 80-89 bpm is uniformly short in systole and diastole.

  11. Simulation of the Beating Heart Based on Physically Modeling aDeformable Balloon

    Energy Technology Data Exchange (ETDEWEB)

    Rohmer, Damien; Sitek, Arkadiusz; Gullberg, Grant T.

    2006-07-18

    The motion of the beating heart is complex and createsartifacts in SPECT and x-ray CT images. Phantoms such as the JaszczakDynamic Cardiac Phantom are used to simulate cardiac motion forevaluationof acquisition and data processing protocols used for cardiacimaging. Two concentric elastic membranes filled with water are connectedto tubing and pump apparatus for creating fluid flow in and out of theinner volume to simulate motion of the heart. In the present report, themovement of two concentric balloons is solved numerically in order tocreate a computer simulation of the motion of the moving membranes in theJaszczak Dynamic Cardiac Phantom. A system of differential equations,based on the physical properties, determine the motion. Two methods aretested for solving the system of differential equations. The results ofboth methods are similar providing a final shape that does not convergeto a trivial circular profile. Finally,a tomographic imaging simulationis performed by acquiring static projections of the moving shape andreconstructing the result to observe motion artifacts. Two cases aretaken into account: in one case each projection angle is sampled for ashort time interval and the other case is sampled for a longer timeinterval. The longer sampling acquisition shows a clear improvement indecreasing the tomographic streaking artifacts.

  12. Low-cost, take-home, beating heart simulator for health-care education.

    Science.gov (United States)

    Berg, Devin R; Carlson, Andrew; Durfee, William K; Sweet, Robert M; Reihsen, Troy

    2011-01-01

    Intended for medical students studying the evaluation and diagnosis of heart arrhythmias, the beating heart arrhythmia simulator combines visual, auditory, and tactile stimuli to enhance the student's retention of the subtle differences between various conditions of the heart necessary for diagnosis. Unlike existing heart arrhythmia simulators, our simulator is low cost and easily deployable in the classroom setting. A design consisting of solenoid actuators, a silicon heart model, and a graphical user interface has been developed and prototyped. Future design development and conceptual validation is necessary prior to deployment.

  13. A new beating-heart off-pump coronary artery bypass grafting training model

    NARCIS (Netherlands)

    Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E.; Koene, Bart M.; Erasmus, Michiel E.; Natour, Ehsan; Mariani, Massimo A.

    OBJECTIVES: Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. METHODS: Human cadavers were embalmed according to the

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

    Science.gov (United States)

    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.

  15. Novel Approach for Automatic Detection of Atrial Fibrillation Based on Inter Beat Intervals and Support Vector Machine

    DEFF Research Database (Denmark)

    Andersen, Rasmus S.; Poulsen, Erik S.; Puthusserypady, Sadasivan

    2017-01-01

    for AF detection based on Inter Beat Intervals (IBI) extracted from long term electrocardiogram (ECG) recordings. Five time-domain features are extracted from the IBIs and a Support Vector Machine (SVM) is used for classification. The results are compared to a state of the art algorithm based on raw ECG...

  16. Separation of Beating Cardiac Myocytes from Suspensions of Heart Cells

    Science.gov (United States)

    Pretlow, Thomas G.; Glick, Melvin R.; Reddy, William J.

    1972-01-01

    Heart cells were obtained in suspension after incubation with collagenase and hyaluronidase in Saline A. Cardiac myocytes were separated by isopycnic centrifugation in 88.6 to 92.4% purity from other heart cells with different densities, and by velocity or rate-zonal sedimentation, in 92.8 to 97.4% purity from heart cells with different diameters. A previously described computer integration of the differential sedimentation equation was used to determine the centrifugal force, duration of centrifugation and gradient design, which would permit the separation of cardiac myocytes from other heart cells by velocity sedimentation. The myocytes continued to contract rhythmically after being recovered from the density gradients. Velocity sedimentation was superior to isopycnic sedimentation for the separation of cardiac myocytes from heart cell suspensions because it gave the most highly purified myocytes, resulted in recovery of the largest proportion of myocytes in purified fractions from the gradient and required lower centrifugal forces for shorter periods of time. The potential significance of the availability of pure cardiac myocytes is discsused. ImagesFig 2Fig 1 PMID:4336547

  17. A Quadratic Nonlinear Prediction-Based Heart Motion Model following Control Algorithm in Robotic-Assisted Beating Heart Surgery

    Directory of Open Access Journals (Sweden)

    Fan Liang

    2013-01-01

    Full Text Available Off-pump coronary artery bypass graft surgery outperforms the traditional on-pump surgery because the assisted robotic tools can cancel the relative motion between the beating heart and the robotic tools, which reduces post-surgery complications for patients. The challenge for the robot assisted tool when tracking the beating heart is the abrupt change caused by the nonlinear nature of heart motion and high precision surgery requirements. A characteristic analysis of 3D heart motion data through bi-spectral analysis demonstrates the quadratic nonlinearity in heart motion. Therefore, it is necessary to introduce nonlinear heart motion prediction into the motion tracking control procedures. In this paper, the heart motion tracking problem is transformed into a heart motion model following problem by including the adaptive heart motion model into the controller. Moreover, the model following algorithm with the nonlinear heart motion model embedded inside provides more accurate future reference by the quadratic term of sinusoid series, which could enhance the tracking accuracy of sharp change point and approximate the motion with sufficient detail. The experiment results indicate that the proposed algorithm outperforms the linear prediction-based model following controller in terms of tracking accuracy (root mean square.

  18. Robust feature tracking on the beating heart for a robotic-guided endoscope.

    Science.gov (United States)

    Elhawary, Haytham; Popovic, Aleksandra

    2011-12-01

    Visualization during minimally invasive bypass surgery on the beating heart can be enhanced by using a robotic-guided endoscope and visual servoing from the endoscopic images. In order to achieve these objectives, this work has focused on developing and testing algorithms for accurate, robust and real-time motion tracking of features on the beating heart, using marker-less approaches and an uncalibrated endoscope. Lucas-Kanade pyramidal optical flow-based algorithms and speeded-up robust features (SURF)-based methods have been extensively evaluated, using a range of developed metrics, in order to quantify accuracy, robustness and drift under a variety of circumstances. Three sets of experiments are reported: the first set compared the two tracking methods, using a beating-heart phantom and a static endoscope; the second set evaluated the methods when images were taken using a moving robotic-guided endoscope; and finally, the Lucas-Kanade optical flow algorithm was extensively tested in a visual servoing application, using a robotic endoscope. The combination of a Lucas-Kanade tracking algorithm and a SURF-based feature detection method gave the best performance in terms of accuracy and robustness of tracking, while preserving real-time computation requirements. The optimal parameters consist of a window size of 51 × 51 pixels and an interframe motion threshold of 20 pixels. Feature tracking was successfully integrated into uncalibrated visual servoing or a robotic-guided endoscope. Robust feature tracking on a beating heart with endoscopic video can be achieved in real-time and may facilitate robotically-assisted, minimally invasive bypass surgery and conventional laparoscopic surgery. Copyright © 2011 John Wiley & Sons, Ltd.

  19. Sudden cardiac death in dogs with remodeled hearts is associated with larger beat-to-beat variability of repolarization

    DEFF Research Database (Denmark)

    Thomsen, Morten Bækgaard; Truin, Michiel; van Opstal, Jurren M

    2005-01-01

    Increased proarrhythmia in dogs with chronic AV block (AVB) has been explained by ventricular remodeling causing a decrease in repolarization reserve. Beat-to-beat variability of repolarization (BVR) has been suggested to reflect repolarization reserve, in which high variability represents dimini...

  20. From beat rate variability in induced pluripotent stem cell-derived pacemaker cells to heart rate variability in human subjects.

    Science.gov (United States)

    Ben-Ari, Meital; Schick, Revital; Barad, Lili; Novak, Atara; Ben-Ari, Erez; Lorber, Avraham; Itskovitz-Eldor, Joseph; Rosen, Michael R; Weissman, Amir; Binah, Ofer

    2014-10-01

    We previously reported that induced pluripotent stem cell-derived cardiomyocytes manifest beat rate variability (BRV) resembling heart rate variability (HRV) in the human sinoatrial node. We now hypothesized the BRV-HRV continuum originates in pacemaker cells. To investigate whether cellular BRV is a source of HRV dynamics, we hypothesized 3 levels of interaction among different cardiomyocyte entities: (1) single pacemaker cells, (2) networks of electrically coupled pacemaker cells, and (3) the in situ sinoatrial node. We measured BRV/HRV properties in single pacemaker cells, induced pluripotent stem cell-derived contracting embryoid bodies (EBs), and electrocardiograms from the same individual. Pronounced BRV/HRV was present at all 3 levels. The coefficient of variance of interbeat intervals and Poincaré plot indices SD1 and SD2 for single cells were 20 times greater than those for EBs (P heart (the latter two were similar; P > .05). We also compared BRV magnitude among single cells, small EBs (~5-10 cells), and larger EBs (>10 cells): BRV indices progressively increased with the decrease in the cell number (P heart rhythm. The decreased BRV magnitude in transitioning from the single cell to the EB suggests that the HRV of in situ hearts originates from the summation and integration of multiple cell-based oscillators. Hence, complex interactions among multiple pacemaker cells and intracellular Ca(2+) handling determine HRV in humans and cardiomyocyte networks. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  1. A new beating-heart off-pump coronary artery bypass grafting training model.

    Science.gov (United States)

    Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E; Koene, Bart M; Erasmus, Michiel E; Natour, Ehsan; Mariani, Massimo A

    2015-01-01

    Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. Human cadavers were embalmed according to the 'Thiel method' which allows their long-term and repeated use. The training model was constructed by bilateral ligation of the pulmonary veins, cross-clamping of the aorta, positioning of an intra-aortic balloon pump (IABP) in the left ventricle (LV) through the apex (tightened with pledget-reinforced purse strings) and finally placing of a fluid line in the LV through the left atrial appendage (tightened with a pledget-reinforced purse string). The LV was filled with saline to the desired pressure through the fluid line and the IABP was switched on and set to a desired frequency [usually 60-80 beats per minute (bpm)]. A high-fidelity simulation has known limitations, but a more complex, realistic training environment with an actual beating (human) heart strengthens the entire training exercise and is of incremental value. All types of coronary artery anastomosis can be trained with this model. Training should be performed under the supervision of an experienced OPCAB surgeon and training progress is best evaluated with serial Objective Structured Assessment of Technical Skills (OSATS). A score of at least 48 points on the final OSATS ('good' on all components) is recommended before trainees can start their training on patients. The entire set-up provides a versatile training model to help develop and improve the skills required to safely perform beating heart OPCAB anastomoses. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Beat-to-beat QT dynamics in healthy subjects

    DEFF Research Database (Denmark)

    Jensen, Berit T; Larroude, Charlotte E; Rasmussen, Lars P

    2004-01-01

    BACKGROUND: Measures of QT dynamics express repolarization abnormalities that carry prognostic information, but the reproducibility of beat-to-beat QT dynamics has never been established. The QT interval is prolonged at night, but how the circadian rhythm and heart rate influence the dynamic QT...... measurements is still unsettled. The aims of the present study were: (1) to describe the reproducibility of beat-to-beat QT dynamics with respect to intrasubject, between-subject, and between-observer variability and (2) to describe the normal range, circadian variation, and heart rate dependence of QT...... dynamics. METHODS: Ambulatory Holter recordings were performed three times on 20 healthy volunteers and were analyzed by two experienced cardiologists. Slope and intercept of the QT/RR regression, the variability of QT and R-R intervals expressed as the standard deviation, and the relation between QT...

  3. Autoregulation of coronary blood flow in the isolated beating pig heart.

    Science.gov (United States)

    Schampaert, Stéphanie; van 't Veer, Marcel; Rutten, Marcel C M; van Tuijl, Sjoerd; de Hart, Jurgen; van de Vosse, Frans N; Pijls, Nico H J

    2013-08-01

    The isolated beating pig heart model is an accessible platform to investigate the coronary circulation in its truly morphological and physiological state, whereas its use is beneficial from a time, cost, and ethical perspective. However, whether the coronary autoregulation is still intact is not known. Here, we study the autoregulation of coronary blood flow in the working isolated pig heart in response to brief occlusions of the coronary artery, to step-wise changes in left ventricular loading conditions and contractile states, and to pharmacologic vasodilating stimuli. Six slaughterhouse pig hearts (473 ± 40 g) were isolated, prepared, and connected to an external circulatory system. Through coronary reperfusion and controlled cardiac loading, physiological cardiac performance was achieved. After release of a coronary occlusion, coronary blood flow rose rapidly to an equal (maximum) level as the flow during control beats, independent of the duration of occlusion. Moreover, a linear relation was found between coronary blood flow and coronary driving pressure for a wide variation of preload, afterload, and contractility. In addition, intracoronary administration of papaverine did not yield a transient increase in blood flow indicating the presence of maximum coronary hyperemia. Together, this indicates that the coronary circulation in the isolated beating pig heart is in a permanent state of maximum hyperemia. This makes the model excellently suitable for testing and validating cardiovascular devices (i.e., heart valves, stent grafts, and ventricular assist devices) under well-controlled circumstances, whereas it decreases the necessity of sacrificing large mammalians for performing classical animal experiments. © 2013, Copyright the Authors. Artificial Organs © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  4. Performance of a novel bipolar/monopolar radiofrequency ablation device on the beating heart in an acute porcine model.

    Science.gov (United States)

    Saint, Lindsey L; Lawrance, Christopher P; Okada, Shoichi; Kazui, Toshinobu; Robertson, Jason O; Schuessler, Richard B; Damiano, Ralph J

    2013-01-01

    Although the advent of ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the beating heart. Currently, there are no devices capable of reproducibly creating the long linear lesions in the right and left atria needed to perform a Cox-Maze procedure. This study evaluated the performance of a novel suction-assisted radiofrequency device that uses both bipolar and monopolar energy to create lesions from an epicardial approach on the beating heart. Six domestic pigs underwent median sternotomy. A dual bipolar/monopolar radiofrequency ablation device was used to create epicardial linear lesions on the superior and inferior vena cavae, the right and left atrial free walls, and the right and left atrial appendages. The heart was stained with 2,3,5-triphenyl-tetrazolium chloride, and each lesion was cross-sectioned at 5-mm intervals. Lesion depth and transmurality were determined. Transmurality was documented in 94% of all cross sections, and 68% of all ablation lines were transmural along their entire length. Tissue thickness was not different between the transmural and nontransmural cross sections (3.1 ± 1.3 and 3.4 ± 2.1, P = 0.57, respectively), nor was the anatomic location on the heart (P = 0.45 for the distribution). Of the cross sections located at the end of the ablation line, 11% (8/75) were found to be nontransmural, whereas only 4% (8/195) of the cross sections located within the line of ablation were found to be nontransmural (P = 0.04). Logistic regression analysis demonstrated that failure of the device to create transmural lesions was associated with low body temperature (P = 0.006) but not with cardiac output (P = 0.54). This novel device was able to consistently create transmural epicardial lesions on the beating heart, regardless of anatomic location, cardiac output, or tissue thickness. The performance of this device was improved over most

  5. Heart rate recovery and heart rate variability are unchanged in patients with coronary artery disease following 12 weeks of high-intensity interval and moderate-intensity endurance exercise training.

    Science.gov (United States)

    Currie, Katharine D; Rosen, Lee M; Millar, Philip J; McKelvie, Robert S; MacDonald, Maureen J

    2013-06-01

    Decreased heart rate variability and attenuated heart rate recovery following exercise are associated with an increased risk of mortality in cardiac patients. This study investigated the effects of 12 weeks of moderate-intensity endurance exercise (END) and a novel low-volume high-intensity interval exercise protocol (HIT) on measures of heart rate recovery and heart rate variability in patients with coronary artery disease (CAD). Fourteen males with CAD participated in 12 weeks of END or HIT training, each consisting of 2 supervised exercise sessions per week. END consisted of 30-50 min of continuous cycling at 60% peak power output (PPO). HIT involved ten 1-min intervals at 88% PPO separated by 1-min intervals at 10% PPO. Heart rate recovery at 1 min and 2 min was measured before and after training (pre- and post-training, respectively) using a submaximal exercise bout. Resting time and spectral and nonlinear domain measures of heart rate variability were calculated. Following 12 weeks of END and HIT, there was no change in heart rate recovery at 1 min (END, 40 ± 12 beats·min(-1) vs. 37 ± 19 beats·min(-1); HIT, 31 ± 8 beats·min(-1) vs. 35 ± 8 beats·min(-1); p ≥ 0.05 for pre- vs. post-training) or 2 min (END, 44 ± 18 beats·min(-1) vs. 43 ± 19 beats·min(-1); HIT, 42 ± 10 beats·min(-1) vs. 50 ± 6 beats·min(-1); p ≥ 0.05 for pre- vs. post-training). All heart rate variability indices were unchanged following END and HIT training. In conclusion, neither END nor HIT exercise programs elicited training-induced improvements in cardiac autonomic function in patients with CAD. The absence of improvements with training may be attributed to the optimal medical management and normative pretraining state of our sample.

  6. Power Spectrum Analysis of Heart Rate Fluctuation: A Quantitative Probe of Beat-to-Beat Cardiovascular Control

    Science.gov (United States)

    1981-01-01

    renm-angMiemin system activity trrimgh f.uumliites the umpUtude of the speitrjl peak located at OM hertz. Our data iherefim provide evuleme that...fluctuations in peripheral vascular ccsist- ance resulting from the autoregulation of local blood flow in tissue beds. The sympathetic and parasympalhctic...maintain cardiovascular homeostasis by responding to beat-to-beat perturbations that are sensed by a variety of pressorc- ceplors and chemoreceptors . The

  7. Comparison of methods for editing of ectopic beats in measurements of short-term non-linear heart rate dynamics.

    Science.gov (United States)

    Tarkiainen, Tuula H; Kuusela, Tom A; Tahvanainen, Kari U O; Hartikainen, Juha E K; Tiittanen, Pekka; Timonen, Kirsi L; Vanninen, Esko J

    2007-03-01

    Non-linear heart rate (HR) dynamics characterizes the fractal properties and complexity of the variations in HR. Ventricular and supraventricular ectopic beats might introduce a mathematical artefact to the analyses on sinus rhythm. We therefore evaluated the effects of different editing practices for ectopic beats such that 753 40-min ECG recordings were (i) not edited for the ectopic beats, or the ectopic beats were edited with (ii) an interpolation or with (iii) a deletion method before the analyses of non-linear HR dynamics. The non-linear HR dynamics analyses included detrended fluctuation analysis (DFA), approximate entropy, symbolic dynamics (SymDyn), fractal dimension and return map (RM). We found that the short-term scaling exponent (alpha1) of DFA, forbidden words of SymDyn and RM were sensitive measurements to the ectopic beats and there were strong correlations between these measurements and the number of ectopic beats. In addition, the unedited ectopic beats significantly lowered the stability of these measurements. However, the editing either with interpolation or deletion method corrected the measurements for the bias caused by the ectopic beats. On the contrary, the entropy measurements were not as sensitive to the ectopic beats. In conclusion, the ectopic beats affect the non-linear HR dynamics of sinus rhythm differently, causing a more marked bias in fractal than in complexity measurements of non-linear HR dynamics. This erroneous effect of ectopic beats can be corrected with a proper editing of these measurements. Therefore, there is an obvious need for standardized editing practices for ectopic beats before the analysis of non-linear HR dynamics.

  8. What makes the heart of Boa constrictor (Squamata: Boidae beat faster?

    Directory of Open Access Journals (Sweden)

    João Fabrício Mota Rodrigues

    2015-02-01

    Full Text Available Body size is highly correlated with metabolism, which in turn influences physiological rates such as heart rate. In general, heart rate is negatively influenced by the size of animal's body, but there is insufficient data corroborating this pattern in snakes. This study evaluated how body size affects heart rate in captive Boa constrictor Linnaeus, 1758. We measured the heart rate of 30 snakes using digital palpation and evaluated how this rate is influenced by body mass and sex using Analysis of Covariance (ANCOVA. The heart rate of the snakes was 58.8 ± 6.7 bpm (beats per minute. Body size, estimated as log-transformed body mass, negatively influenced heart rate (F1,28 = 10.27, p = 0.003, slope = -0.00004, R2 = 0.27, but sex had no effect (F1,27 = 0.07, p = 0.80. In conclusion, this result corroborates the negative relationship between body size and heart rate for snakes and reinforces the influence of related metabolic characteristics, such as body size, on the physiological parameters of snakes.

  9. Experimental small bowel transplantation from non-heart-beating donors: a large-animal study.

    Science.gov (United States)

    Cobianchi, L; Zonta, S; Vigano, J; Dominioni, T; Ciccocioppo, R; Morbini, P; Bottazzi, A; Mazzilli, M; De Martino, M; Vicini, E; Filisetti, C; Botrugno, I; Dionigi, P; Alessiani, M

    2009-01-01

    The shortage of organs in the last 20 years is stimulating the development of new strategies to expand the pool of donors. The harvesting of a graft from non-heart-beating donors (NHBDs) has been successfully proposed for kidney and liver transplantation. To our knowledge, no studies are available for small bowel transplantation using NHBDs. In an experimental setting of small bowel transplantation, we studied the feasibility of using intestinal grafts retrieved from NHBDs. Twenty five Large White piglets underwent total orthotopic small bowel transplantation and were randomly divided as follow: NHBD group (n = 15) received grafts from NHBDs; heart-beating donor (HBD) group (n = 10) received grafts from HBDs. The NHBD pigs were sacrificed inducing the cardiac arrest by a lethal potassium injection. After 20 minutes (no touch period = warm ischemia), they underwent cardiac massage, laparotomy, and aorta cannulation for flushing and cooling the abdominal organs. In HBDs, the cardiac arrest was induced at the time of organ cold perfusion. In both groups, immunosuppression was based on tacrolimus oral monotherapy. The animals were observed for 30 days. The graft absorptive function was studied at day 30 using the D-xylose absorption test. Histological investigation included HE (Hematoxilin and Eosin) microscopical analysis and immunohistological staining. Animals in the NHBD group died due to infection (n = 3), acute cellular rejection (n = 2), technical complications (n = 2), and intestinal failure (n = 8). In the HBD group, all animals but two were alive at the end of the study. The D-xylose absorption was significantly lower among the NHBD compared with the HBD group (P mucosa is sensitive to ischemic injury. When the intestinal graft is harvested from NHBDs, the infectious-related mortality was higher and the absorptive function lower. Histological examination confirmed a higher grade of ischemic injury in the NHBD grafts that correlated with the clinical data

  10. Comparison of heart rate response to an epinephrine test dose and painful stimulus in children during sevoflurane anesthesia: heart rate variability and beat-to-beat analysis.

    Science.gov (United States)

    Wodey, Eric; Senhadji, Lotfi; Bansard, Jean Yves; Terrier, Anne; Carré, François; Ecoffey, Claude

    2003-01-01

    During regional anesthesia, various stimuli leading to an adrenergic response can occur. However, simulation of an epidural test dose by using intravenous administration of epinephrine (EPI) has always been compared with an intravenous saline infusion as the control. The aim of this study was to evaluate the possibility of distinguishing in children the effect on HR by an intravascular epinephrine infusion and a painful stimulus, using heart rate variability (HRV) and beat-to-beat analysis of HR. Thirty American Society of Anesthesiologists physical status P I children who required elective surgery were studied. At 1 minimum alveolar concentration (MAC) of sevoflurane, electrocardiogram was recorded continuously. Systolic blood pressure (SBP) was measured every minute. Measurements were performed after an intravenous administration of 0.5 microg/kg of epinephrine and during a small skin surgical incision (SI). Time-varying auto-regressive modeling of the interpolated RR sequences was performed for estimating power spectrum (msec(2)). The HF bands were defined by (0.15-0.4 Hz). Median (range) age and weight of all children were 3.5 (1-10) years and 16 (9-30) kg. EPI produced a lower increase in HR than did SI. SBP increased significantly more than did after SI. T-wave amplitude increased significantly after EPI but not after SI. Sixty seconds after the first change in HR, a secondary decrease (in comparison to control value) can be detected with EPI in contrast to SI. HF spectral power increased significantly after EPI administration but decreased after SI. The sensitivity, specificity, and positive and negative predictive value were respectively for DeltaHR >10 beats per minuteof 56%, 26%, 43%, and 38%; for DeltaSBP >15 mm Hg of 60%, 86%, 81%, and 67%; and for DeltaT-wave amplitude >25% of 86%, 73%, 76%, and 84%. Using detection of the secondary decrease of HR, 60 seconds after the first change in HR, sensitivity, specificity, and positive and a negative predictive

  11. Recent heart rate history affects QT interval duration in atrial fibrillation

    Science.gov (United States)

    Riad, Fady S.; Razak, Eathar; Saba, Samir; Shalaby, Alaa; Nemec, Jan

    2017-01-01

    QT interval prolongation is associated with a risk of polymorphic ventricular tachycardia. QT interval shortens with increasing heart rate and correction for this effect is necessary for meaningful QT interval assessment. We aim to improve current methods of correcting the QT interval during atrial fibrillation (AF). Digitized Holter recordings were analyzed from patients with AF. Models of QT interval dependence on RR intervals were tested by sorting the beats into 20 bins based on corrected RR interval and assessing ST-T variability within the bins. Signal-averaging within bins was performed to determine QT/RR dependence. Data from 30 patients (29 men, 69.3±7.3 years) were evaluated. QT behavior in AF is well described by a linear function (slope ~0.19) of steady-state corrected RR interval. Corrected RR is calculated as a combination of an exponential weight function with time-constant of 2 minutes and a smaller “immediate response” component (weight ~ 0.18). This model performs significantly (pQT response to heart rate changes in AF is similar to previously published QT dynamics during atrial pacing and in sinus rhythm. PMID:28273109

  12. Usefulness of one-stage coronary artery bypass grafting on the beating heart and abdominal aortic aneurysm repair.

    Science.gov (United States)

    Morimoto, Keisuke; Taniguchi, Iwao; Miyasaka, Shigeto; Aoki, Tetsuya; Kato, Ippei; Yamaga, Takeshi

    2004-02-01

    Abdominal aortic aneurysm (AAA) is commonly associated with coronary artery disease (CAD). Simultaneous coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under cardiac arrest and AAA repair may be considerably invasive. Recently CABG under the beating heart without CPB has been reported as a less invasive method. We report the combined operation of CABG on a beating heart and AAA repair for AAA patients with CAD, and compare it with a separate operation. A retrospective review of the records of consecutive patients who underwent elective combined procedure or single operation for CABG on a beating heart and/or repair of the AAA between May 1999 and October 2001 was carried out. Ten patients underwent combined procedures. A single operation, CABG on a beating heart or repair of AAA, were performed in 27 or 19 patients. There were no significant differences with regard to intraoperative blood loss, transfusion and postoperative intubation time among the three groups. There was no operative mortality for any of the three groups. All cases were discharged without severe complications and with patent coronary bypass grafts. There was a decrease in mean total hospital costs for the combined operation group compared with the CABG group plus AAA repair group (3.34 million versus 5.87 million yen). Combined CABG on a beating heart and AAA repair on a one-step approach appears to be a safe and useful therapeutic strategy for AAA patients with CAD.

  13. Heart rate turbulence after ventricular premature beats in healthy Doberman pinschers and those with dilated cardiomyopathy.

    Science.gov (United States)

    Harris, J D; Little, C J L; Dennis, J M; Patteson, M W

    2017-10-01

    To describe the measurement of heart rate turbulence (HRT) after ventricular premature beats and compare HRT in healthy Doberman pinschers and those with dilated cardiomyopathy (DCM), with and without congestive heart failure (CHF). Sixty-five client-owned Dobermans: 20 healthy (NORMAL), 31 with preclinical DCM and 14 with DCM and CHF (DCM + CHF). A retrospective study of data retrieved from clinical records and ambulatory ECG (Holter) archives, including data collected previously for a large-scale prospective study of Dobermans with preclinical DCM. Holter data were reanalysed quantitatively, including conventional time-domain heart rate variability and the HRT parameters turbulence onset and turbulence slope. Heart rate turbulence could be measured in 58/65 dogs. Six Holter recordings had inadequate ventricular premature contractions (VPCs) and one exhibited VPCs too similar to sinus morphology. Heart rate turbulence parameter, turbulence onset, was significantly reduced in DCM dogs, whereas conventional heart rate variability measures were not. Heart rate variability and HRT markers were reduced in DCM + CHF dogs as expected. Heart rate turbulence can be measured from the majority of good quality standard canine 24-hour Holter recordings with >5 VPCs. Turbulence onset is significantly reduced in Dobermans with preclinical DCM which indicates vagal withdrawal early in the course of disease. Heart rate turbulence is a powerful prognostic indicator in human cardiac disease which can be measured from standard 24-hour ambulatory ECG (Holter) recordings using appropriate computer software. Further studies are warranted to assess whether HRT may be of prognostic value in dogs with preclinical DCM and in other canine cardiac disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Validation of four-dimensional ultrasound for targeting in minimally-invasive beating-heart surgery

    Science.gov (United States)

    Pace, Danielle F.; Wiles, Andrew D.; Moore, John; Wedlake, Chris; Gobbi, David G.; Peters, Terry M.

    2009-02-01

    Ultrasound is garnering significant interest as an imaging modality for surgical guidance, due to its affordability, real-time temporal resolution and ease of integration into the operating room. Minimally-invasive intracardiac surgery performed on the beating-heart prevents direct vision of the surgical target, and procedures such as mitral valve replacement and atrial septal defect closure would benefit from intraoperative ultrasound imaging. We propose that placing 4D ultrasound within an augmented reality environment, along with a patient-specific cardiac model and virtual representations of tracked surgical tools, will create a visually intuitive platform with sufficient image information to safely and accurately repair tissue within the beating heart. However, the quality of the imaging parameters, spatial calibration, temporal calibration and ECG-gating must be well characterized before any 4D ultrasound system can be used clinically to guide the treatment of moving structures. In this paper, we describe a comprehensive accuracy assessment framework that can be used to evaluate the performance of 4D ultrasound systems while imaging moving targets. We image a dynamic phantom that is comprised of a simple robot and a tracked phantom to which point-source, distance and spherical objects of known construction can be attached. We also follow our protocol to evaluate 4D ultrasound images generated in real-time by reconstructing ECG-gated 2D ultrasound images acquired from a tracked multiplanar transesophageal probe. Likewise, our evaluation framework allows any type of 4D ultrasound to be quantitatively assessed.

  15. Animal model for liver cell banking from non-heart beating donors after prolonged ischaemia time.

    Science.gov (United States)

    Porretti, L; Gatti, S; Gramignoli, R; Colombo, F; Lopa, R; Cattaneo, A; Scalamogna, M; Colombo, G; Rossi, G; Bonino, F; Rebulla, P; Prati, D

    2006-12-01

    Although there is a growing interest on the use of non-heart beating donors to enlarge the liver donor pool, livers with prolonged warm ischaemia time are not currently considered for organ transplantation. We hypothesised that these organs may represent a source of hepatocytes for cell transplantation and/or use in bioartificial liver devices. Thus, we investigated if prolonged ischaemia could influence the recovery and viability of functional hepatocytes dissociated from rat livers. Hepatocytes were isolated from the liver within 15 min after death (t=15 min) and after 4, 8 and 12h of ischaemia. Cells were either maintained in culture or cryopreserved. In all products, we evaluated cell recovery and viability, hepatocyte markers and cellular functions, including albumin and urea production. The number of cells per gram of tissue was similar at 15 min, 4 and 8h, while it was significantly decreased at 12h. About 0.2 x 10(6) viable cells expressing hepatocyte markers and producing albumin and urea were isolated up to 8h of ischaemia per gram of tissue. Recovery of viable and functional hepatocytes seems possible after prolonged ischaemia time. These data warrant the evaluation of hepatocyte isolation from human livers of non-heart beating donors.

  16. Surgical correction of ruptured aneurysms of the sinus of Valsalva using on-pump beating-heart technique

    Directory of Open Access Journals (Sweden)

    Lin Hui

    2010-05-01

    Full Text Available Abstract Background Rupture of aneurysms of the sinus of Valsalva results in abrupt onset of congestive heart failure. On-pump beating-heart surgery may reduce cardiac impairment by maintaining coronary blood flow and avoiding cardioplegia. Herein, we report the operative correction of thirty-one patients of ruptured aneurysms of the sinus of Valsalva, using the on-pump beating-heart technique. Methods Thirty-one patients with ruptured aneurysms of the sinus of Valsalva underwent operative corrections using the on-pump beating-heart technique. In patients with fistula diameter less than 1 cm and no aortic regurgitation, the aorta was unclamped throughout cardiopulmonary bypass(CPB while receiving antegrade heart perfusion. In remainder of patients, retrograde perfusion was used. Results After intracardiac manipulation was complete and the nasopharyngeal temperature was raised to 36-37°C, the patients were smoothly weaned off CPB. There were no early or late postoperative deaths. All patients were in New York Heart Association functional class I at follow-up (range, 0.5-1 year. Mild-to-moderate aortic valve regurgitation was observed in one patient. No recurrence of the left-to-right shunt from ruptured aneurysms of the sinus of Valsalva was observed. Conclusions Beating heart on pump allows adequate examination of the aortic lesion under near-physiologic conditions, allows decrease in ischemia-reperfusion injury and potentially decreases the risk of serious or fatal rhythm disturbances. On-pump beating-heart technique for repair of ruptured aneurysm of sinus of Valsalva is feasible and promising. Antegrade heart perfusion is suitable for patients with a fistula diameter

  17. Ultrasound functional imaging in an ex vivo beating porcine heart platform

    Science.gov (United States)

    Petterson, Niels J.; Fixsen, Louis S.; Rutten, Marcel C. M.; Pijls, Nico H. J.; van de Vosse, Frans N.; Lopata, Richard G. P.

    2017-12-01

    In recent years, novel ultrasound functional imaging (UFI) techniques have been introduced to assess cardiac function by measuring, e.g. cardiac output (CO) and/or myocardial strain. Verification and reproducibility assessment in a realistic setting remain major issues. Simulations and phantoms are often unrealistic, whereas in vivo measurements often lack crucial hemodynamic parameters or ground truth data, or suffer from the large physiological and clinical variation between patients when attempting clinical validation. Controlled validation in certain pathologies is cumbersome and often requires the use of lab animals. In this study, an isolated beating pig heart setup was adapted and used for performance assessment of UFI techniques such as volume assessment and ultrasound strain imaging. The potential of performing verification and reproducibility studies was demonstrated. For proof-of-principle, validation of UFI in pathological hearts was examined. Ex vivo porcine hearts (n  =  6, slaughterhouse waste) were resuscitated and attached to a mock circulatory system. Radio frequency ultrasound data of the left ventricle were acquired in five short axis views and one long axis view. Based on these slices, the CO was measured, where verification was performed using flow sensor measurements in the aorta. Strain imaging was performed providing radial, circumferential and longitudinal strain to assess reproducibility and inter-subject variability under steady conditions. Finally, strains in healthy hearts were compared to a heart with an implanted left ventricular assist device, simulating a failing, supported heart. Good agreement between ultrasound and flow sensor based CO measurements was found. Strains were highly reproducible (intraclass correlation coefficients  >0.8). Differences were found due to biological variation and condition of the hearts. Strain magnitude and patterns in the assisted heart were available for different pump action, revealing

  18. [Coronary artery bypass grafting on the beating heart in high-risk patients].

    Science.gov (United States)

    Rastan, Ardawan Julian; Walther, Thomas; Falk, Volkmar; Lehmann, Sven; Kempfert, Jörg; Mohr, Friedrich Wilhelm

    2007-09-01

    Since the introduction of off-pump coronary artery bypass grafting (OPCAB) for coronary multivessel disease there was growing interest to evaluate the impact of OPCAB surgery compared to conventional coronary artery bypass grafting (CCAB) with cardiopulmonary bypass and cardioplegic arrest. However, subsequent prospective randomized studies and meta-analyses comparing OPCAB and CCAB surgery were performed on low-risk patients or mixed-risk populations. They usually failed to demonstrate a significant benefit of OPCAB surgery on early mortality or perioperative major cardiac and cerebrovascular events. In recent years, efforts were made to analyze the meaning of beating-heart concepts for patients with specific cardiac and extracardiac risks like ischemic cardiomyopathy, older age, renal failure, acute coronary syndrome, left main stenosis and others. For these subsets of patients several mono- and multicenter studies are available today. Even if most of them were nonrandomized and thus failed to reach evidence level A according to the AHA/ACC (American Heart Association/American College of Cardiology) definition, they still allow analyzing interim results for each specific perioperative risk factor. Particularly multi-risk patients and patients with severely reduced left ventricular function seem to benefit in terms of perioperative mortality and major morbidity by avoiding cardiopulmonary bypass and cardioplegic arrest. Analyzing early results and long-term follow-up of 364 patients with severely reduced ejection fractioncardiac ischemia and maintaining native coronary blood flow. Follow-up results were comparable for these patients. In conclusion, beating-heart coronary artery bypass grafting seems to be advantageous in various risk populations and should be considered for patients with more than average risks for cardiopulmonary bypass and cardioplegic arrest.

  19. Effects of Interval Training Programme on Resting Heart Rate in ...

    African Journals Online (AJOL)

    Conclusion: It was concluded that moderate intensity interval training programs is effective in the non-pharmacological adjunct management of hypertension and may prevent cardiovascular event through the down regulation of HR in hypertension. Keywords: Hypertension; Interval exercise; cardiovascular risk factor; Heart ...

  20. Endovascular aortic aneurysm repair via the left ventricular apex of a beating heart.

    Science.gov (United States)

    MacDonald, Shaun; Cheung, Anson; Sidhu, Ravindar; Rheaume, Pascal; Grenon, S Marlene; Clement, Jason

    2009-03-01

    An elderly man presented with a ruptured aortic arch, left lung compression, and hemoptysis. Multiple comorbidities and inadequate aortoiliac access disqualified him from conventional open repair or hybrid retrograde transarterial thoracic endovascular aortic repair (TEVAR). Because our center has recently reported that a thoracic aortic endograft can be successfully placed through the apex of the LV of a beating heart in a pig model, we received approval for the compassionate use of antegrade transapical TEVAR (TaTEVAR) with bilateral femoral-carotid revascularization to repair the aortic arch. As in our animal model, TaTEVAR was performed with accuracy and minimal hemodynamic compromise. The patient was quickly weaned from inotropic and respiratory support postoperatively and was neurologically intact, but died on the tenth postoperative day from respiratory failure.

  1. Tracking and characterization of fragments in a beating heart using 3D ultrasound for interventional guidance.

    Science.gov (United States)

    Thienphrapa, Paul; Elhawary, Haytham; Ramachandran, Bharat; Stanton, Douglas; Popovic, Aleksandra

    2011-01-01

    Fragments generated by explosions and similar incidents can become trapped in a patient's heart chambers, potentially causing disruption of cardiac function. The conventional approach to removing such foreign bodies is through open heart surgery, which comes with high perioperative risk and long recovery times. We thus advocate a minimally invasive surgical approach through the use of 3D transesophageal echocardiography (TEE) and a flexible robotic end effector. In a phantom study, we use 3D TEE to track a foreign body in a beating heart, and propose a modified normalized cross-correlation method for improved accuracy and robustness of the tracking, with mean RMS errors of 2.3 mm. Motion analysis of the foreign body trajectory indicates very high speeds and accelerations, which render unfeasible a robotic retrieval method based on following the tracked trajectory. Instead, a probability map of the locus of the foreign body shows that the fragment tends to occupy only a small sub-volume of the ventricle, suggesting a retrieval strategy based on moving the robot end effector to the position with the highest spatial probability in order to maximize the possibility of capture.

  2. RF communication with implantable wireless device: effects of beating heart on performance of miniature antenna.

    Science.gov (United States)

    Murphy, Olive H; Borghi, Alessandro; Bahmanyar, Mohammad Reza; McLeod, Christopher N; Navaratnarajah, Manoraj; Yacoub, Magdi; Toumazou, Christofer

    2014-06-01

    The frequency response of an implantable antenna is key to the performance of a wireless implantable sensor. If the antenna detunes significantly, there are substantial power losses resulting in loss of accuracy. One reason for detuning is because of a change in the surrounding environment of an antenna. The pulsating anatomy of the human heart constitutes such a changing environment, so detuning is expected but this has not been quantified dynamically before. Four miniature implantable antennas are presented (two different geometries) along with which are placed within the heart of living swine the dynamic reflection coefficients. These antennas are designed to operate in the short range devices frequency band (863-870 MHz) and are compatible with a deeply implanted cardiovascular pressure sensor. The measurements recorded over 27 seconds capture the effects of the beating heart on the frequency tuning of the implantable antennas. When looked at in the time domain, these effects are clearly physiological and a combination of numerical study and posthumous autopsy proves this to be the case, while retrospective simulation confirms this hypothesis. The impact of pulsating anatomy on antenna design and the need for wideband implantable antennas is highlighted.

  3. Wash-out of the non-heart-beating donor liver: A comparison between ringer lactate, HTK, and polysol

    NARCIS (Netherlands)

    Bessems, M.; Doorschodt, B. M.; Albers, P. S.; van Vliet, A. K.; van Gulik, T. M.

    2005-01-01

    The solution of choice for wash-out of non-heart-beating donor (NHBD) livers is histidine tryptophan ketoglutarate (HTK). This solution has a lower viscosity, due to absence of a colloid, and is less expensive as compared to the University of Wisconsin (UW) solution. A new preservation solution for

  4. Operative correction of judoists’ training loads on the base of on-line monitoring of heart beats rate

    Directory of Open Access Journals (Sweden)

    Liu Yong Qiang

    2015-02-01

    Full Text Available Purpose: ensure increase of effectiveness of training process’s control by means of operative correction of training loads of different qualification judo wrestlers’ heart beats rate indicators. Material: the research was conducted on the base of Brest SCJSOR № 1. Judo wrestlers of different sport qualification (age 17-19 years old, n=15 participated in the research. Monitoring of judo wrestlers’ heart beats rate was carried out with the help of system “Polar”. Results: we have found factorial structure of functional fitness in every profile of sportsmen. Model characteristics of judo wrestlers were supplemented with the most important sides of functional fitness. Analysis of indicators of restoration effectiveness indicators (REI in both groups of judo wrestlers showed high level of organism’s responsiveness to training load of special and power orientation in comparison with speed power load. We have worked out algorithm of operative correction of training loads by indicators of heart beats rate in training process, depending on orientation and intensity of loads’ physiological influence on judo wrestler. Conclusions: Telemetric on-line monitoring of sportsman’s heart beats rate and calculation of REI permit to objectively assess effectiveness of training’s construction and of micro-cycle in total and detect in due time the trend to development of over-loading and failure of adaptation.

  5. Quality metrics for high order meshes: analysis of the mechanical simulation of the heart beat.

    Science.gov (United States)

    Lamata, Pablo; Roy, Ishani; Blazevic, Bojan; Crozier, Andrew; Land, Sander; Niederer, Steven A; Hose, D Rod; Smith, Nicolas P

    2013-01-01

    The quality of a computational mesh is an important characteristic for stable and accurate simulations. Quality depends on the regularity of the initial mesh, and in mechanical simulations it evolves in time, with deformations causing changes in volume and distortion of mesh elements. Mesh quality metrics are therefore relevant for both mesh personalization and the monitoring of the simulation process. This work evaluates the significance, in meshes with high order interpolation, of four quality metrics described in the literature, applying them to analyse the stability of the simulation of the heart beat. It also investigates how image registration and mesh warping parameters affect the quality and stability of meshes. Jacobian-based metrics outperformed or matched the results of coarse geometrical metrics of aspect ratio or orthogonality, although they are more expensive computationally. The stability of simulations of a complete heart cycle was best predicted with a specificity of 61%, sensitivity of 85%, and only nominal differences were found changing the intra-element and per-element combination of quality values. A compromise between fitting accuracy and mesh stability and quality was found. Generic geometrical quality metrics have a limited success predicting stability, and an analysis of the simulation problem may be required for an optimal definition of quality.

  6. Maintenance of cAMP in non-heart-beating donor lungs reduces ischemia-reperfusion injury.

    Science.gov (United States)

    Hoffmann, S C; Bleiweis, M S; Jones, D R; Paik, H C; Ciriaco, P; Egan, T M

    2001-06-01

    Studies suggest that pulmonary vascular ischemia-reperfusion injury (IRI) can be attenuated by increasing intracellular cAMP concentrations. The purpose of this study was to determine the effect of IRI on capillary permeability, assessed by capillary filtration coeficient (Kfc), in lungs retrieved from non-heart-beating donors (NHBDs) and reperfused with the addition of the beta(2)-adrenergic receptor agonist isoproterenol (iso), and rolipram (roli), a phosphodiesterase (type IV) inhibitor. Using an in situ isolated perfused lung model, lungs were retrieved from NHBD rats at varying intervals after death and either ventilated with O(2) or not ventilated. The lungs were reperfused with Earle's solution with or without a combination of iso (10 microM) and roli (2 microM). Kfc, lung viability, and pulmonary hemodynamics were measured. Lung tissue levels of adenine nucleotides and cAMP were measured by HPLC. Combined iso and roli (iso/roli) reperfusion decreased Kfc significantly (p Kfc in non-iso/roli-reperfused (r = 0.89) and iso/roli-reperfused (r = 0.97) lungs. cAMP levels correlated with Kfc (r = 0.93) in iso/roli-reperfused lungs. Pharmacologic augmentation of tissue TAN and cAMP levels might ameliorate the increased capillary permeability observed in lungs retrieved from NHBDs.

  7. A novel one-shot circular stapler closure for atrial septal defect in a beating-heart porcine model.

    Science.gov (United States)

    Tarui, Tatsuya; Tomita, Shigeyuki; Ishikawa, Norihiko; Ohtake, Hiroshi; Watanabe, Go

    2015-02-01

    In surgical atrial septal defect (ASD) closure, there are no techniques or devices that can close the ASD accurately in a short time under a beating heart. We have developed a simple and automatic ASD closure technique using a circular stapler. This study assessed the feasibility and efficacy of a new circular stapler closure for ASD. Under a continuous beating heart, hand-sewn patch plasty ASD closure was performed in 6 pigs (group A) and circular stapler ASD closure was performed in 6 pigs (group B). The time to close the ASD and the effectiveness of the closure were compared. Closure was significantly faster in group B (10.5 ± 1.0 seconds) than in group A (664 ± 10 seconds; p heart porcine model. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Arrhythmia risk assessment using heart rate variability parameters in patients with frequent ventricular ectopic beats without structural heart disease.

    Science.gov (United States)

    Barutçu, Ahmet; Temiz, Ahmet; Bekler, Adem; Altun, Burak; Kirilmaz, Bahadir; Aksu, Feyza Ulusoy; Küçük, Uğur; Gazi, Emine

    2014-11-01

    Ventricular ectopic beats (VEBs) are usually considered a benign condition that can be managed with conservative measures. Heart rate variability (HRV), which is one of the most important methods for assessing autonomic activity, is a noninvasive, quantitative method of analyzing autonomic effects on the heart. We aimed to investigate the risk of arrhythmia in patients with VEBs and without cardiovascular disease by using HRV parameters. Patients with frequent VEBs (more than 30 times in 1 hour, according to the Lown classification) were identified. Identified patients were evaluated by 24-hour ECG recording. Our study included 43 patients with frequent VEBs and 43 controls. General characteristics of the study population were similar. The LF (low frequency)/HF (high frequency) ratio was significantly higher in the frequent VEBs group than in the control group (P < 0.001). The rate of paroxysmal atrial fibrillation (PAF) was higher in the frequent VEB group than in the control group (P = 0.003). The number of VEBs was correlated with LF/HF ratio and PAF (r = 0.339, P = 0.001 and r = 0.294, P = 0.006, respectively). Our study showed that the sympathetic nervous system is dominant in young patients with VEBs and without significant comorbidities. There is a higher risk of atrial fibrillation in patients with VEBs and they should be monitored closely for atrial fibrillation. ©2014 Wiley Periodicals, Inc.

  9. Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery

    National Research Council Canada - National Science Library

    Clotario Neptali Carrasco Cueva; Maiara dosSantos Rocha; Carlos Mauricio Cardeal Mendes; Luiz Antonio Rodrigues deFreitas; Jose Augusto Baucia; Roberto Badaro

    2013-01-01

    ...: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested...

  10. A new physiological method for heart rate correction of the QT interval

    OpenAIRE

    Davey, P.

    1999-01-01

    AIM—To reassess QT interval rate correction.
BACKGROUND—The QT interval is strongly and inversely related to heart rate. To compare QT intervals between different subjects with different heart rates requires the application of a QT interval rate correction formula. To date these formulae have inappropriately assumed a fixed relation between QT interval and heart rate. An alternative method of QT interval rate correction that makes no assumptions about the QT interval-heart rate relation is ne...

  11. Ultrasound based mitral valve annulus tracking for off-pump beating heart mitral valve repair

    Science.gov (United States)

    Li, Feng P.; Rajchl, Martin; Moore, John; Peters, Terry M.

    2014-03-01

    Mitral regurgitation (MR) occurs when the mitral valve cannot close properly during systole. The NeoChordtool aims to repair MR by implanting artificial chordae tendineae on flail leaflets inside the beating heart, without a cardiopulmonary bypass. Image guidance is crucial for such a procedure due to the lack of direct vision of the targets or instruments. While this procedure is currently guided solely by transesophageal echocardiography (TEE), our previous work has demonstrated that guidance safety and efficiency can be significantly improved by employing augmented virtuality to provide virtual presentation of mitral valve annulus (MVA) and tools integrated with real time ultrasound image data. However, real-time mitral annulus tracking remains a challenge. In this paper, we describe an image-based approach to rapidly track MVA points on 2D/biplane TEE images. This approach is composed of two components: an image-based phasing component identifying images at optimal cardiac phases for tracking, and a registration component updating the coordinates of MVA points. Preliminary validation has been performed on porcine data with an average difference between manually and automatically identified MVA points of 2.5mm. Using a parallelized implementation, this approach is able to track the mitral valve at up to 10 images per second.

  12. Theory of the development of alternans in the heart during controlled diastolic interval pacing

    Science.gov (United States)

    Otani, Niels F.

    2017-09-01

    The beat-to-beat alternation in action potential durations (APDs) in the heart, called APD alternans, has been linked to the development of serious cardiac rhythm disorders, including ventricular tachycardia and fibrillation. The length of the period between action potentials, called the diastolic interval (DI), is a key dynamical variable in the standard theory of alternans development. Thus, methods that control the DI may be useful in preventing dangerous cardiac rhythms. In this study, we examine the dynamics of alternans during controlled-DI pacing using a series of single-cell and one-dimensional (1D) fiber models of alternans dynamics. We find that a model that combines a so-called memory model with a calcium cycling model can reasonably explain two key experimental results: the possibility of alternans during constant-DI pacing and the phase lag of APDs behind DIs during sinusoidal-DI pacing. We also find that these results can be replicated by incorporating the memory model into an amplitude equation description of a 1D fiber. The 1D fiber result is potentially concerning because it seems to suggest that constant-DI control of alternans can only be effective over only a limited region in space.

  13. [Flowmetric assessment of coronary bypass grafts in the conditions of artificial circulation and on the beating heart].

    Science.gov (United States)

    Bazylev, V V; Nemchenko, E V; Karnakhin, V A; Pavlov, A A; Mikulyak, A I

    2016-01-01

    Advantages and shortcomings of aortocoronary bypass grafting on the beating heart and in the conditions of artificial circulation (AC) have long been discussed. The data on patency of bypass grafts in the remote period are indicative of comparable results of operations with and without AC or advantages of using AC. In order to determine benefits of each method it is necessary to reveal intraoperative predictors of bypass grafts occlusion in the remote period. We analyzed the results of ultrasound flowmetry of the blood flow through the left internal thoracic artery during bypass grafting of the anterior descending artery with the use of AC and on the beating heart. A retrospective study included a total of 352 patients subdivided into 2 groups: Group One was composed of 120 patients undergoing surgery in the conditions of AC and Group Two comprised 232 patients subjected to similar operations on the beating heart. Blood flow was measured with the help of flowmeter VeryQ MediStim® after termination of AC and inactivation of heparin by protamine, with systolic pressure of 100-110 mm Hg. There were no statistically significant differences between the groups by the diameter and degree of stenosis of the anterior descending artery, diameter of the left internal thoracic artery. The mean volumetric blood flow velocity (Qmean) along the shunts in Group One was higher (p=0.01). No statistically significant differences by the pulsatility index (PI) between the groups were revealed (p=0.2). A conclusion was drawn that coronary bypass grafting of the anterior descending artery by the left internal thoracic artery in the conditions of artificial circulation made it possible to achieve higher volumetric velocity of blood flow through the conduit as compared with operations on the beating heart, with similar resistance index. The immediate results of the operations with the use of the both techniques did not differ.

  14. Heart beats rate indicators and structure of elite football referees’ and their assistants’ motor functioning in competition period

    Directory of Open Access Journals (Sweden)

    Chopilko T. G.

    2015-11-01

    Full Text Available Purpose: to analyze structure of motor functioning and heart beats rate indicators in elite football referees’ and their assistants’ competition activity. Material: in the research 15 referees and referees’ assistants of Ukrainian Prime League, 30 referees and referees’ assistants of first and second professional leagues of Ukraine participated. Observations over referees’ movements in 21 professional matches of Ukrainian professional leagues were fulfilled. Distance, passed by a referee in one match was determined. Results: It was found that during one match referee (depending on his functions - referee or referee’s assistant passes distance from 6000 to 12 000 meters. This scope of motor functioning depends also on motor activity of players and qualification level of teams-participants in the match. Motor actions of referees’ assistants change every 5 seconds during a match. During one match referee’s assistants fulfill about 20 sprints and 74 accelerations. A high temp of match total distance makes 1.2 km. Conclusions: Referees’ and referee assistants’ motor functioning and heart beats rate indicators can vary from aerobic-restoration to anaerobic-glycolytic zone. This fact shall be considered when planning program on special physical training. It should be noted that with heart beats rate of more than 180 bpm concentration of attention significantly weakens as well as ability to take prompt and correct decisions. In such cases probability of mistakes significantly increases.

  15. A mitral annulus tracking approach for navigation of off-pump beating heart mitral valve repair.

    Science.gov (United States)

    Li, Feng P; Rajchl, Martin; Moore, John; Peters, Terry M

    2015-01-01

    To develop and validate a real-time mitral valve annulus (MVA) tracking approach based on biplane transesophageal echocardiogram (TEE) data and magnetic tracking systems (MTS) to be used in minimally invasive off-pump beating heart mitral valve repair (MVR). The authors' guidance system consists of three major components: TEE, magnetic tracking system, and an image guidance software platform. TEE provides real-time intraoperative images to show the cardiac motion and intracardiac surgical tools. The magnetic tracking system tracks the TEE probe and the surgical tools. The software platform integrates the TEE image planes and the virtual model of the tools and the MVA model on the screen. The authors' MVA tracking approach, which aims to update the MVA model in near real-time, comprises of three steps: image based gating, predictive reinitialization, and registration based MVA tracking. The image based gating step uses a small patch centered at each MVA point in the TEE images to identify images at optimal cardiac phases for updating the position of the MVA. The predictive reinitialization step uses the position and orientation of the TEE probe provided by the magnetic tracking system to predict the position of the MVA points in the TEE images and uses them for the initialization of the registration component. The registration based MVA tracking step aims to locate the MVA points in the images selected by the image based gating component by performing image based registration. The validation of the MVA tracking approach was performed in a phantom study and a retrospective study on porcine data. In the phantom study, controlled translations were applied to the phantom and the tracked MVA was compared to its "true" position estimated based on a magnetic sensor attached to the phantom. The MVA tracking accuracy was 1.29 ± 0.58 mm when the translation distance is about 1 cm, and increased to 2.85 ± 1.19 mm when the translation distance is about 3 cm. In the study on

  16. Beating heart axillocoronary bypass for management of the untouchable ascending aorta in coronary artery bypass grafting.

    Science.gov (United States)

    Bonatti, J; Hangler, H; Oturanlar, D; Posch, L; Müller, L C; Voelckel, W; Schwarz, B; Bodner, G

    1999-11-01

    Cannulation and clamping of a severely atherosclerotic ascending aorta during coronary artery bypass grafting (CABG) can lead to cerebral embolization of atheromatous debris and should therefore be avoided whenever possible. A variety of surgical techniques including performance of extraanatomical coronary bypass conduits has been described to solve this problem. We report on a preliminary series of four patients in whom the axillary artery was used as an inflow vessel for venous coronary artery bypass grafts which were performed on the beating heart in order to achieve an aortic no touch concept. The axillary artery was exposed between the pectoralis major muscle and the deltoid muscle via an infraclavicular incision. A saphenous vein graft of at least 40 cm in length was sutured to the axillary artery and then brought into the pericardial cavity following an intercostal and transpleural route. The graft was anastomosed to the target vessel using local coronary occlusion. The procedure was carried out via sternotomy in three patients who also received additional internal mammary artery in situ grafts for adequate coronary revascularization. In one high risk patient an isolated axillocoronary bypass was performed in a minimally invasive fashion via anterolateral minithoracotomy. The procedure was completed without major technical difficulties in all four patients. The mean graft length required was 33.2 +/- 1.6 cm, postoperative ultrasonic duplex scans of the axillocoronary grafts revealed a mean flow of 62.5 +/- 23.6 ml/min. No stroke or brachial plexus injury occurred. Three patients are in angina class I (Canadian Cardiovascular Society Classification), one patient is in class II postoperatively. After a mean follow-up of 11.5 +/- 6.6 months postoperatively all grafts remain patent. Axillocoronary bypass grafting can be easily performed for management of the untouchable ascending aorta. Straightforward surgical technique and the accessibility to noninvasive

  17. Development of a non-heart-beating donor program and results after the first year.

    Science.gov (United States)

    Meneses, J C; Gámez, P; Mariscal, A; Marrón, C; Díaz-Hellín, V; Cortes, M; de Pablo, A; Lopez, E; Perez, V; Gonzalez, O; Juarros, L; Martinez, I; Hermoso, F; Avila, R; Zuluaga, M; de Nicolás, J L M

    2012-09-01

    Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Augmented reality image guidance improves navigation for beating heart mitral valve repair.

    Science.gov (United States)

    Chu, Michael W A; Moore, John; Peters, Terry; Bainbridge, Daniel; McCarty, David; Guiraudon, Gerard M; Wedlake, Chris; Lang, Pencilla; Rajchl, Martin; Currie, Maria E; Daly, Richard C; Kiaii, Bob

    2012-01-01

    Emerging off-pump beating heart valve repair techniques offer patients less invasive alternatives for mitral valve (MV) repair. However, most of these techniques rely on the limited spatial and temporal resolution of transesophageal echocardiography (TEE) alone, which can make tool visualization and guidance challenging. Using a magnetic tracking system and integrated sensors, we created an augmented reality (AR) environment displaying virtual representations of important intracardiac landmarks registered to biplane TEE imaging. In a porcine model, we evaluated the AR guidance system versus TEE alone using the transapically delivered NeoChord DS1000 system to perform MV repair with chordal reconstruction. Successful tool navigation from left ventricular apex to MV leaflet was achieved in 12 of 12 and 9 of 12 (P = 0.2) attempts with AR imaging and TEE alone, respectively. The distance errors of the tracked tool tip from the intended midline trajectory (5.2 ± 2.4 mm vs 16.8 ± 10.9 mm, P = 0.003), navigation times (16.7 ± 8.0 seconds vs 92.0 ± 84.5 seconds, P = 0.004), and total path lengths (225.2 ± 120.3 mm vs 1128.9 ± 931.1 mm, P = 0.003) were significantly shorter in the AR-guided trials compared with navigation with TEE alone. Furthermore, the potential for injury to other intracardiac structures was nearly 40-fold lower when using the AR imaging for tool navigation. The AR guidance also seemed to shorten the learning curve for novice surgeons. Augmented reality-enhanced TEE facilitates more direct and safe intracardiac navigation of the NeoChord DS tool from left ventricular apex to MV leaflet. Tracked tool path results demonstrate fourfold improved accuracy, fivefold shorter navigation times, and overall improved safety with AR imaging guidance.

  19. Extracorporeal membrane oxygenation support of donor abdominal organs in non-heart-beating donors.

    Science.gov (United States)

    Ko, W J; Chen, Y S; Tsai, P R; Lee, P H

    2000-04-01

    Both family consent and legal consent were required for organ/tissue donation from non-heart-beating donors (NHBD) in Taiwan. A district attorney had to come to the bedside to confirm the donor's asystole, confirm the family consent, and complete some legal documents before a legal consent was issued for organ donation. The resultant warm ischemic time would be unpredictably long and in fact precluded the organ donation from NHBD in Taiwan. We developed a method of using extracorporeal membrane oxygenation (ECMO) to maintain NHBD for a longer time and prevent warm ischemic injury of the donor abdominal organs. After ventilator disconnection in NHBD, phentolamine and heparin were injected and mannitol infusion was given. After the donor's asystole was confirmed by the electrocardiogram (EKG) strip recording, the ECMO support was set up through the right femoral veno-arterial route, an occlusion balloon catheter was inserted through the left femoral artery to occlude the thoracic aorta, and bilateral femoral arteries were ligated. Usually, the ECMO could begin within 10 min after the donor's asystole. The ECMO, combined with a cooler, provided cold oxygenated blood to the abdominal visceral organs, and prevented their warm ischemic injuries. Under the ECMO support (range: 45-70 min), eight renal grafts were procured from 4 NHBD. With the exception of the first two renal grafts with delayed function, all others had immediate function postoperatively and dialysis was no longer needed. In conclusion, by our ECMO technique, NHBD could be maintained for a longer time and the renal grafts had better immediate postoperative function than those reported by other methods.

  20. Quantitative evaluation of heartbeat interval time series using Poincaré analysis reveals distinct patterns of heart rate dynamics during cycles of vagus nerve stimulation in patients with heart failure.

    Science.gov (United States)

    Libbus, Imad; Nearing, Bruce D; Amurthur, Badri; KenKnight, Bruce H; Verrier, Richard L

    Optimization of stimulation parameters is essential to maximizing therapeutic efficacy and minimizing side effects. The ANTHEM-HF study enrolled patients with heart failure who received chronic autonomic regulation therapy (ART) with an implantable vagus nerve stimulation (VNS) system on either the right (n=30) or left side (n=29). Acute effects of continuously cycling VNS on R-R interval dynamics were evaluated using post hoc Poincaré analysis of ECG recordings collected during multiple titration sessions over an 8-12week period. During each titration session, VNS intensity associated with maximum tolerable dose was determined. Poincaré plots of R-R interval time series were created for epochs when VNS cycled from OFF to ON at varying intensity levels. VNS produced an immediate, relatively small change in beat-to-beat distribution of R-R intervals during the 14-sec ON time, which was correlated with stimulation current amplitude (r=0.85, p=0.05). During titration of right-sided stimulation, there was a strong correlation (r=0.91, p=0.01) between stimulus intensity and the Poincaré parameter of standard deviation, SD1, which is associated with high-frequency heart rate variability. The effect of VNS on instantaneous heart rate was indicated by a shift in the centroid of the beat-to-beat cloud distribution demarcated by the encircling ellipse. As anticipated, left-sided stimulation did not alter any Poincaré parameter except at high stimulation intensities (≥2mA). Quantitative Poincaré analysis reveals a tight coupling in beat-to-beat dynamics during VNS ON cycles that is directly related to stimulation intensity, providing a useful measurement for confirming autonomic engagement. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. On-pump beating heart coronary surgery for high risk patients requiring emergency multiple coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    von Segesser Ludwig K

    2008-07-01

    Full Text Available Abstract Background Cardiopulmonary bypass (CPB with aortic cross-clamping and cardioplegic arrest remains the method of choice for patients requiring standard myocardial revascularization. Therefore, very high-risk patients presenting with acute coronary syndrome, unstable angina, onset of cardiac decompensation and requiring emergency multiple myocardial revascularization, can have a poor outcome. The on-pump beating heart technique can reduce the mortality and the morbidity in such a selected group of patients and this report describes our clinical experience. Methods Out of 290 patients operated for CABG from January 2005 to January 2006, 25 (8.6% selected high-risk patients suffering from life threatening coronary syndrome (mean age 69 ± 7 years and requiring emergency multiple myocardial revascularization, underwent on-pump beating heart surgery. The mean pre-operative left ventricle ejection fraction (LVEF was 27 ± 8%. The majority of them (88% suffered of tri-vessel coronary disease and 6 (24% had a left main stump disease. Nine patients (35% were on severe cardiac failure and seven among them (28% received a pre-operative intra-aortic balloon pump. The pre-operative EuroScore rate was equal or above 8 in 18 patients (73%. Results All patients underwent on-pump-beating heart coronary revascularization. The mean number of graft/patient was 2.9 ± 0.6 and the internal mammary artery was used in 23 patients (92%. The mean CPB time was 84 ± 19 minutes. Two patients died during the recovery stay in the intensive care unit, and there were no postoperative myocardial infarctions between the survivors. Eight patients suffered of transitorily renal failure and 1 patient developed a sternal wound infection. The mean hospital stay was 12 ± 7 days. The follow-up was complete for all 23 patients survived at surgery and the mean follow-up time was 14 ± 5 months. One patient died during the follow-up for cardiac arrest and 2 patients required an

  2. NIR spectroscopic imaging to map hemoglobin + myoglobin oxygenation, their concentration and optical pathlength across a beating pig heart during surgery.

    Science.gov (United States)

    Gussakovsky, Eugene; Yang, Yanmin; Rendell, John; Jilkina, Olga; Kupriyanov, Valery

    2012-02-01

    The purpose of this paper is to demonstrate that near-infrared (NIR) spectroscopic imaging can provide spatial distribution (maps) of the absolute concentration of hemoglobin + myoglobin, oxygen saturation parameter and optical pathlength, reporting on the biochemico-physiological status of a beating heart in vivo. The method is based on processing the NIR spectroscopic images employing a first-derivative approach. Blood-pressure-controlled gating compensated the effect of heart motion on the imaging. All the maps are available simultaneously and noninvasively at a spatial resolution in the submillimeter range and can be obtained in a couple of minutes. The equipment has no mechanical contact with the tissue, thereby leaving the heart unaffected during the measurement. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Abnormal Left Ventricular Mechanics of Ventricular Ectopic Beats: Insights into Origin and Coupling Interval in Premature Ventricular Contraction-Induced Cardiomyopathy

    Science.gov (United States)

    Potfay, Jonathan; Kaszala, Karoly; Tan, Alex Y.; Sima, Adam P.; Gorcsan, John; Ellenbogen, Kenneth A.; Huizar, Jose F.

    2015-01-01

    Background Left ventricular (LV) dyssynchrony caused by premature ventricular contractions (PVCs) has been proposed as a mechanism of PVC-induced cardiomyopathy (CM). We sought to understand the impact of different PVC locations and coupling intervals (prematurity) on LV regional mechanics and global function of the PVC beat itself. Methods and Results Using our premature pacing algorithm, pentageminal PVCs at coupling intervals of 200–375ms were delivered from the epicardial right ventricular (RV) apex, RV outflow tract (RVOT), and LV free wall, as well as premature atrial contractions (PACs) from the left atrial (LA) appendage at a coupling interval of 200ms in seven healthy canines. LV short axis echocardiographic images, LV stroke volume (SV) and dP/dtmax were obtained during all ectopic beats and VP. LV dyssynchrony was assessed by dispersion of QRS-to-peak strain (earliest – last QRS-to-peak strain) between 6 different LV segments during each of the aforementioned beats (GE, EchoPac). LV dyssynchrony was greater during long- rather than short-coupled PVCs and PVCs at 375ms compared with rapid VP at 400ms (P<0.0001), whereas, no difference was found between PVC locations. Longer PVC coupling intervals were associated with greater SV and dP/dtmax despite more pronounced dyssynchrony (P<0.001). Conclusions PVCs with longer coupling intervals demonstrate more pronounced LV dyssynchrony, whereas PVC location has minimal impact. LV dyssynchrony cannot be attributed to prematurity or abnormal ventricular activation alone, but rather to a combination of both. This study suggests that late-coupled PVCs may cause a more severe cardiomyopathy if dyssynchrony is the leading mechanism responsible for PVC-induced CM. PMID:26297787

  4. Heart Rate Unreliability during Interval Training Recovery in Middle Distance Runners

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    Filippo Tocco, Irene Sanna, Gabriele Mulliri, Sara Magnani, Francesco Todde, Roberto Mura, Giovanna Ghiani, Alberto Concu, Franco Melis, Antonio Crisafulli

    2015-06-01

    Full Text Available Heart rate (HR was tested as a reliable index for recovery management during interval training (IT, considering its relationship with the several factors involved in respiratory, metabolic and cardiovascular homeostasis. Thirteen runners underwent two different IT sessions: at 80% and 120% of the second ventilatory threshold (VT2. Throughout both sessions HR, oxygen uptake (VO2, carbon dioxide production (VCO2 and pulmonary ventilation (VE, were measured by means of a portable gas analyzer. Carbon dioxide production excess (CO2excess, respiratory exchange ratio (RER, oxygen pulse (OP and oxygen debt (O2debt were also estimated. A significant increase in HR values (144 versus 150 beats·min−1 between the first recovery and the last, p < 0.001 was observed at 80% of the VT2 speed. At the over-threshold intensity, HR rose from 159 to 168 beats·min−1 from the first recovery to the last (p < 0.001. OP showed a declining trend from the first to the last recovery at 80% at the VT2 speed (18.3 versus 16.4 mL·beats−1, p < 0.05 and between the first and the last recovery in tests performed at 120% of the VT2 speed (17.8 versus 16.3 mL·beats−1, p < 0.05. No change occurred in CO2excess, VO2, RER, VE and O2debt. On the basis of our research, the use of fixed HR as a reliable index of the established recovery is inaccurate and unfit for training. The phenomenon of cardiac drift to set the restart timing after the repetitions, i.e. by progressively increasing HR values, should be taken into account by coaches.

  5. Preservation of Myocardial Perfusion and Function by Keeping Hypertrophied Heart Empty and Beating for Valve Surgery: An In Vivo MR Study of Pig Hearts.

    Science.gov (United States)

    Wang, Jian; Xiang, Bo; Deng, Jixian; Lin, Hung-Yu; Freed, Darren H; Arora, Rakesh C; Tian, Ganghong

    2017-01-01

    Objectives . Normothermic hyperkalemic cardioplegia arrest (NHCA) may not effectively preserve hypertrophied myocardium during open-heart surgery. Normothermic normokalemic beating perfusion (NNBP), keeping hearts empty-beating, was utilized as an alternative to evaluate its cardioprotective role. Materials and Methods . Twelve hypertrophied pig hearts at 58.6 ± 7.2 days after ascending aorta banding underwent NNBP and NHCA, respectively. Near infrared myocardial perfusion imaging with indocyanine green (ICG) was conducted to assess myocardial perfusion. Left ventricular (LV) contractile function was assessed by cine MRI. TUNEL staining and western blotting for caspase-3 cleavage and cardiac troponin I (cTnI) degradation were conducted in LV tissue samples. Results . Ascending aortic diameter was reduced by 52.7% ± 0.4% at approximately fifty-eight days after banding. LV wall thickness was significantly higher in aorta banding than in sham operation. Myocardial blood flow reflected by maximum ICG absorbance value was markedly higher in NNBP than in NHCA. The amount of apoptotic cardiomyocyte was significantly lower in NNBP than in NHCA. NNBP alleviated caspase-3 cleavage and cTnI degradation associated with NHCA. NNBP displayed a substantially increased postoperative ejection fraction relative to NHCA. Conclusions . NNBP was better than NHCA in enhancing myocardial perfusion, inhibiting cardiomyocyte apoptosis, and preserving LV contractile function for hypertrophied hearts.

  6. Extremes of fractional noises: A model for the timings of arrhythmic heart beats in post-infarction patients

    Science.gov (United States)

    Witt, Annette; Ehlers, Frithjof; Luther, Stefan

    2017-09-01

    We have analyzed symbol sequences of heart beat annotations obtained from 24-h electrocardiogram recordings of 184 post-infarction patients (from the Cardiac Arrhythmia Suppression Trial database, CAST). In the symbol sequences, each heart beat was coded as an arrhythmic or as a normal beat. The symbol sequences were analyzed with a model-based approach which relies on two-parametric peaks over the threshold (POT) model, interpreting each premature ventricular contraction (PVC) as an extreme event. For the POT model, we explored (i) the Shannon entropy which was estimated in terms of the Lempel-Ziv complexity, (ii) the shape parameter of the Weibull distribution that best fits the PVC return times, and (iii) the strength of long-range correlations quantified by detrended fluctuation analysis (DFA) for the two-dimensional parameter space. We have found that in the frame of our model the Lempel-Ziv complexity is functionally related to the shape parameter of the Weibull distribution. Thus, two complementary measures (entropy and strength of long-range correlations) are sufficient to characterize realizations of the two-parametric model. For the CAST data, we have found evidence for an intermediate strength of long-range correlations in the PVC timings, which are correlated to the age of the patient: younger post-infarction patients have higher strength of long-range correlations than older patients. The normalized Shannon entropy has values in the range 0.5

  7. Total cavopulmonary direct anastomosis in the beating heart without prosthetic material: preliminary experience with modified extracardiac fontan procedure.

    Science.gov (United States)

    Xing, Quansheng; Shi, Lei; Han, Li; Wu, Qin

    2013-09-01

    To describe modified extracardiac Fontan procedure characterized with total cavopulmonary direct anastomosis in the beating heart without using prosthetic material in seven patients and summarize the clinical experiences and follow-up results. From April 2007 to April 2011, seven patients with complex cardiac anomalies underwent this operation. The main pulmonary artery (MPA) was transected at the base of the pulmonary valve and the pulmonary annulus was oversewn. Then the inferior vena cava (ICV) was transected at the junction with the atrium. The MPA was brought to the side of the ICV and anastomosed in an end-to-end fashion. The superior vena cava (SVC) was transected at its entrance into the right atrium and was anastomosed to the right pulmonary artery. Five patients received transcatheter device closure of the fenestration with either a small atrial septal defect or ventricular septal defect occluder. All patients were in sinus rhythm and extubated on the first postoperative day. Immediate postoperative arterial oxygen saturation was 95% (93% to 96%). During the follow-up period from 17 to 65 months (median 48 months), there were no deaths and reoperations. Arterial oxygen saturation ranged from 88% to 92% on room air. The fenestration was closed in five patients postoperatively and the arterial oxygen saturation rose to 95%. Total cavopulmonary direct anastomosis in the beating heart without the use of prosthetic material provides growth potential, and avoids the need for anticoagulation. Longer follow-up will be necessary to evaluate this modification. © 2013 Wiley Periodicals, Inc.

  8. High-intensity aerobic interval exercise in chronic heart failure.

    Science.gov (United States)

    Meyer, Philippe; Gayda, Mathieu; Juneau, Martin; Nigam, Anil

    2013-06-01

    Aerobic exercise training is strongly recommended in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF) to improve symptoms and quality of life. Moderate-intensity aerobic continuous exercise (MICE) is the best established training modality in HF patients. For about a decade, however, another training modality, high-intensity aerobic interval exercise (HIIE), has aroused considerable interest in cardiac rehabilitation. Originally used by athletes, HIIE consists of repeated bouts of high-intensity exercise interspersed with recovery periods. The rationale for its use is to increase exercise time spent in high-intensity zones, thereby increasing the training stimulus. Several studies have demonstrated that HIIE is more effective than MICE, notably for improving exercise capacity in patients with HF. The aim of the present review is to describe the general principles of HIIE prescription, the acute physiological effects, the longer-term training effects, and finally the future perspectives of HIIE in patients with HF.

  9. Real-time correction of heart interbeat intervals.

    Science.gov (United States)

    Rand, Jeromie; Hoover, Adam; Fishel, Stephanie; Moss, Jason; Pappas, Jennifer; Muth, Eric

    2007-05-01

    Heart rate variability (HRV) is traditionally analyzed while a subject is in a controlled environment, such as at rest in a clinic, where it can be used as a medical indicator. This paper concerns analyzing HRV outside of controlled environments, such as on an actively moving person. We describe automated methods for inter-heartbeat interval (IBI) error detection and correction. We collected 124,998 IBIs from 18 subjects, undergoing a variety of active motions, for use in evaluating our methods. Two human graders manually labeled each IBI, evaluating 10% of the IBIs as having an error, which is a far greater error percentage than has been examined in any previous study. Our automated method had a 96% agreement rate with the two human graders when they themselves agreed, with a 49% rate of matching specific error corrections and a 0.01% false alarm rate.

  10. Simulation of Ectopic Pacemakers in the Heart: Multiple Ectopic Beats Generated by Reentry inside Fibrotic Regions.

    Science.gov (United States)

    Gouvêa de Barros, Bruno; Weber dos Santos, Rodrigo; Lobosco, Marcelo; Alonso, Sergio

    2015-01-01

    The inclusion of nonconducting media, mimicking cardiac fibrosis, in two models of cardiac tissue produces the formation of ectopic beats. The fraction of nonconducting media in comparison with the fraction of healthy myocytes and the topological distribution of cells determines the probability of ectopic beat generation. First, a detailed subcellular microscopic model that accounts for the microstructure of the cardiac tissue is constructed and employed for the numerical simulation of action potential propagation. Next, an equivalent discrete model is implemented, which permits a faster integration of the equations. This discrete model is a simplified version of the microscopic model that maintains the distribution of connections between cells. Both models produce similar results when describing action potential propagation in homogeneous tissue; however, they slightly differ in the generation of ectopic beats in heterogeneous tissue. Nevertheless, both models present the generation of reentry inside fibrotic tissues. This kind of reentry restricted to microfibrosis regions can result in the formation of ectopic pacemakers, that is, regions that will generate a series of ectopic stimulus at a fast pacing rate. In turn, such activity has been related to trigger fibrillation in the atria and in the ventricles in clinical and animal studies.

  11. Simulation of Ectopic Pacemakers in the Heart: Multiple Ectopic Beats Generated by Reentry inside Fibrotic Regions

    Directory of Open Access Journals (Sweden)

    Bruno Gouvêa de Barros

    2015-01-01

    Full Text Available The inclusion of nonconducting media, mimicking cardiac fibrosis, in two models of cardiac tissue produces the formation of ectopic beats. The fraction of nonconducting media in comparison with the fraction of healthy myocytes and the topological distribution of cells determines the probability of ectopic beat generation. First, a detailed subcellular microscopic model that accounts for the microstructure of the cardiac tissue is constructed and employed for the numerical simulation of action potential propagation. Next, an equivalent discrete model is implemented, which permits a faster integration of the equations. This discrete model is a simplified version of the microscopic model that maintains the distribution of connections between cells. Both models produce similar results when describing action potential propagation in homogeneous tissue; however, they slightly differ in the generation of ectopic beats in heterogeneous tissue. Nevertheless, both models present the generation of reentry inside fibrotic tissues. This kind of reentry restricted to microfibrosis regions can result in the formation of ectopic pacemakers, that is, regions that will generate a series of ectopic stimulus at a fast pacing rate. In turn, such activity has been related to trigger fibrillation in the atria and in the ventricles in clinical and animal studies.

  12. Surgical on-pump beating-heart treatment of ischemic patients with low LF ejection fraction: immediate results

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2015-10-01

    Full Text Available Objectives. The study compares the early results of on-pump beating-heart (ONBEAT surgery versus conventional coronary artery bypass grafting (CABG with cardioplegic arrest (ONSTOP in patients with coronary artery disease and left ventricular dysfunction. Methods. In a single-center randomized trial, 60 patients operated for severe left ventricular dysfunction (EF<35% between January 2012 and January 2014 were randomized to ONBEAT (n=30 or ONSTOP (n=30 cohorts. All patients received preventive hemodynamic support before surgery (determined by randomization: intra-aortic balloon pump or levosimendan. Preoperative, operative and postoperative variables were evaluated in both groups. Results. Preoperative characteristics were similar between both groups. The time of stay in the ICU was 3 (2; 5 days in the first group and 3 (2; 4 days in the second one (p = 0.2. In the ONBEAT group 62 distal anastomoses (30 arterial were performed and in the ONSTOP group 70 distal anastomoses (30 arterial were done (p = 0.3. Completeness of revascularization on the beating heart corresponded to that in the group with cardioplegic arrest. The presence of complications such as stroke (p = 1.0, renal failure (p = 0.5, respiratory events (p = 0.2 and heart failure (p = 0.5 did not differ significantly between the two groups. Atrial fibrillation tended to occur more often in the postoperative period in the ONSTOP group (p = 0.03. The concentration of troponin I at all stages of the study did not differ significantly between the two groups. Both groups showed a significant increase in LV ejection fraction postoperatively: the first group 30 (26; 33 to 34 (30; 39 %, (p = 0,009; the second group - 31 (27 and 33 to 35 (30; 37 % (p = 0.01. Hospital mortality in the first group was observed in 1 case and in the second one in two cases (p = 0.5. Conclusions. The on-pump beating heart technique has no advantages comparing with conventional CABG in cases of preventive hemodynamic

  13. Effect of trimetazidine and glucose- insulin-potassium use on myocard during beating heart coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Abdulkadir Ercan

    2011-12-01

    Full Text Available Objectives: This prospective, randomised, controlled, clinical study was planned to determine the effect of trimetazidine and glucose - insulin - potassium (GIK on myocardial ischemia-reperfusion during beating heart coronary artery bypass surgery.Materials and methods: Patients (n=45 with coronary artery disease who required beating heart coronary artery bypass grafting were randomly allocated into three groups. Patients in group 1 (n=15 was recevied trimetazidine (20 mg x 3 per day 7 days before surgery. Patients in group 2 (n=15 received GIK infusion after induction of anesthesia through the first 12 hours of intensive care unit convalescence. Patients in group 3 (n=15 were control group. Measurements of blood glucose, circulating creatine kinase MB (CK-MB and Troponin I (TnI concentrations were obtained before surgery, 5 minutes after completion of operation and at 12, 24, and 48 hours postoperatively. Mean pulmonary artery pressure, cardiac index, morbidity and data associated with operation were recorded in all patients preoperatively and postoperatively.Results: Preoperative risk profiles and operative variables were statistically similar when the groups were compared. The concentration of circulating CK-MB and Tn I significantly increased over time after off - pump coronary artery surgery, with no significant intergroup differences. Cardiac index and mean pulmonary artery pressure did not differ significantly between groups.Conclusion: Pretreatment with trimetazidine and GIK infusion protocol were used as an adjunct to ischemic - reperfusion therapy in off - pump coronary artery bypass surgery. These results suggested that pretreatment with trimetazidine and GIK infusion protocol do not significantly reduce ischemic reperfusion damage.

  14. Successful performance of Cox-Maze procedure on beating heart using bipolar radiofrequency ablation: a feasibility study in animals.

    Science.gov (United States)

    Gaynor, Sydney L; Ishii, Yosuke; Diodato, Michael D; Prasad, Sunil M; Barnett, Kara M; Damiano, Nicholas R; Byrd, Gregory D; Wickline, Samuel A; Schuessler, Richard B; Damiano, Ralph J

    2004-11-01

    The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation with proven long-term efficacy. However, its application has been limited by its complexity and significant morbidity. The purpose of this study was to test the feasibility and safety of performing the Cox-Maze procedure using bipolar radiofrequency ablation on the beating heart without cardiopulmonary bypass. After median sternotomy, 6 Hanford mini-pigs underwent a modified Cox-Maze procedure using bipolar radiofrequency energy. The animals survived for 30 days. Atrial function, coronary artery, pulmonary vein anatomy, and valve function were assessed by magnetic resonance imaging. At reoperation, pacing documented electrical isolation of the pulmonary veins. Induction of atrial fibrillation was attempted by burst pacing with cholinergic stimulation. Histologic assessment was performed after sacrifice. There were no perioperative mortalities or neurologic events. At 30 days, atrial fibrillation was unable to be induced, and pulmonary vein isolation was confirmed by pacing. Magnetic resonance imaging assessment revealed no coronary artery or pulmonary vein stenoses. Although atrial ejection fraction decreased slightly from 0.344 +/- 0.0114 to 0.300 +/- 0.055 (p = 0.18), atrial contractility was preserved in every animal. Histologic assessment showed all lesions to be transmural, and there were no significant stenoses of the coronary vessels or injuries to the valves. Virtually all of the lesions of the Cox-Maze procedure can be performed without cardiopulmonary bypass using bipolar radiofrequency energy. There were no late stenoses of the pulmonary veins. Clinical trials of this new technology on the beating heart are warranted.

  15. Stereoscopic vision display technology in real-time three-dimensional echocardiography-guided intracardiac beating-heart surgery.

    Science.gov (United States)

    Vasilyev, Nikolay V; Novotny, Paul M; Martinez, Joseph F; Loyola, Hugo; Salgo, Ivan S; Howe, Robert D; del Nido, Pedro J

    2008-06-01

    Stereoscopic vision display technology has been shown to be a useful tool in image-guided surgical interventions. However, the concept has not been applied to 3-dimensional echocardiography-guided cardiac procedures. We evaluated stereoscopic vision display as an aid for intracardiac navigation during 3-dimensional echocardiography-guided beating-heart surgery in a model of atrial septal defect closure. An atrial septal defect (6 mm) was created in 6 pigs using 3-dimensional echocardiography guidance. The defect was then closed using a catheter-based patch delivery system, and the patch was attached with tissue mini-anchors. Stereoscopic vision was generated with a high-performance volume renderer with stereoscopic glasses. Three-dimensional echocardiography with stereoscopic vision display was compared with 3-dimensional echocardiography with standard display for guidance of surgical repair. Task performance measures for each anchor placement (N = 32 per group) were completion time, trajectory of the tip of the anchor deployment device, and accuracy of the anchor placement. The mean time of the anchor deployment for stereoscopic vision display group was shorter by 44% compared with the standard display group: 9.7 +/- 0.9 seconds versus 17.2 +/- 0.9 seconds (P display group versus 2.3 +/- 0.3 mm for the standard display group. Stereoscopic vision display combined with 3-dimensional echocardiography improved the visualization of 3-dimensional echocardiography ultrasound images, decreased the time required for surgical task completion, and increased the precision of instrument navigation, potentially improving the safety of beating-heart intracardiac surgical interventions.

  16. Regional differences in systolic active stress profiles in the normal beating heart. Assessment using an ultrasound based mathematical model.

    Science.gov (United States)

    McLaughlin, M; Langeland, S; Streb, W; Marciniak, M; D'Hooge, J; Bijnens, B; Claus, P

    2004-01-01

    Active stress (sigmaA) developed by cardiac muscle has been measured in isolated muscle preparations, under physiological loading conditions, by subtracting the passive stress (sigmaP) from the total stress (sigmaT). We previously developed a mechanical model based on M-mode ultrasound imaging to calculate these stresses in beating hearts. However, this model was based on one-dimensional imaging information and could not estimate regional differences in sigmaA. In the current study this model was improved by including two-dimensional B-mode echocardiographic data. In a porcine model a micro-manometer tipped catheter was used to measure left-ventricular pressure (LVP) and B-mode ultrasound images were recorded in a short-axis view. On the ultrasound image points in the mid-wall were selected and tracked to completely define the deformation of the myocardium. A kinematic model of the LV was then constructed from the displacement vectors of these points. sigmaT was calculated from the LVP. The material parameters for an exponential stress/strain relation were estimated during the diastolic E-wave when it was assumed that sigmaA = 0. These parameters were used to calculate sigmaP during systole and by subtracting this from sigmaT, sigmaA was calculated. The timing and shape of sigmaA profiles match those obtained from isolated muscle experiments. SigmaA was higher and peaked sooner in the posterior wall than in the anterior wall. Regional active stress estimation is possible in normal beating hearts.

  17. Coronary artery bypass grafting on the beating heart using the Octopus method

    NARCIS (Netherlands)

    Thijssens, K. M.; Rodrigus, I. E.; Amsel, B. J.; de Hert, S. G.; Moulijn, A. C.

    2000-01-01

    STUDY OBJECTIVE: To study the usefulness and effectiveness of off-pump coronary bypass grafting with the Octopus heart stabilizing device. METHOD: The files of thirty-one patients undergoing coronary artery bypass with the aid of the Octopus heart stabilizing device between April 1996 and October

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

    NARCIS (Netherlands)

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

    2015-01-01

    Objective. To test the feasibility of a CT-compatible, ex vivo, perfused porcine heart model for myocardial perfusion CT imaging. Methods. One porcine heart was perfused according to Langendorff. Dynamic perfusion scanning was performed with a second-generation dual source CT scanner. Circulatory

  19. "And the Beat Goes Ona... Building Artificial Hearts in the Classroom.

    Science.gov (United States)

    Brock, David L.

    2000-01-01

    Among the many ideas and theories in anatomy and physiology, one particular topic provides all the potential benefits of learning about the human body: the circulatory system, specifically the heart. Describes a distinctive way to study circulation and the heart that allows students to explore the basic principles of vertebrate anatomy and…

  20. Lack of physiological adaptation of the atrioventricular interval to heart rate in patients chronically paced in the AAIR mode.

    Science.gov (United States)

    Mabo, P; Pouillot, C; Kermarrec, A; Lelong, B; Lebreton, H; Daubert, C

    1991-12-01

    Seventeen consecutive patients, aged 56 +/- 12, were chronically paced in the AAIR mode for a symptomatic sinus node disease with atrial chronotropic incompetence defined by a peak exercise heart rate (HR) less than 75% of the maximal predicted heart rate (MPHR) mean = 65 +/- 10%). Sensors used were activity sensing (n = 7), minute ventilation (n = 6), or respiratory rate (n = 4). Basic pacing rate was programmed at 71 +/- 5 beats/min and the maximal sensor rate at approximately 85% MPHR (143 +/- 10); other sensor parameters were programmed individually. Six months after implant, two standardized and symptom limited exercise tests were performed in random order, AAI and AAIR modes, respectively. AAIR pacing significantly improved peak exercise HR (139 +/- 14 vs 112 +/- 30 beats/min; P less than 0.01), maximal sustained workload (132 +/- 42 vs 110 +/- 38 watts; P less than 0.02), and total exercise duration (724 +/- 299 vs 594 +/- 245 sec; p less than 0.02) compared to the AAI mode. In all 17 patients, HR was continuously sensor driven in the AAIR mode, making it possible to precisely study the adaptation of the stimulus-R interval and of the stimulus-R:RR ratio during exercise. Six patients normally adapted with a progressive shortening. Six others did not adapt at all without any variation of interval. Five patients paradoxically increased their stimulus-R interval (286 +/- 10 msec at peak E vs 220 +/- 19 msec at rest) and their stimulus-R:RR ratio (67 +/- 20% vs 29 +/- 4%), producing P waves occurring immediately after, or even within the R wave of the preceding cycle; two patients complained of severe exercise related symptoms corresponding to the so-called "AAIR pacemaker syndrome." The principal factors involved in the nonadaptation of AV interval to HR were related to the patient (organic heart disease, with the particular problem of the denervated heart; the bradytachy syndrome; and the use of drugs, especially beta blockers and Class I antiarrhythmic drugs

  1. Normothermic ex vivo lung perfusion of non-heart-beating donor lungs in pigs : from pretransplant function analysis towards a 6-h machine preservation

    NARCIS (Netherlands)

    Erasmus, ME; Fernhout, MH; Elstrodt, JM; Rakhorst, G

    Donor shortage urges optimal use of all lungs available. Ex vivo lung perfusion (EVLP) is a method to evaluate lung function before implantation. EVLP was performed in pigs to evaluate lung function, using two different clinical non-heart-beating (NHS) donor protocols: flush perfusion and topical

  2. Multifactorial Biological Modulation of Warm Ischemia Reperfusion Injury in Liver Transplantation From Non-Heart-Beating Donors Eliminates Primary Nonfunction and Reduces Bile Salt Toxicity

    NARCIS (Netherlands)

    Monbaliu, Diethard; Vekemans, Katrien; Hoekstra, Harm; Vaahtera, Lauri; Libbrecht, Louis; Derveaux, Katelijne; Parkkinen, Jaakko; Liu, Qiang; Heedfeld, Veerle; Wylin, Tine; Deckx, Hugo; Zeegers, Marcel; Balligand, Erika; Buurman, Wim; van Pelt, Jos; Porte, Robert J.; Pirenne, Jacques

    2009-01-01

    Objective: To design a multifactorial biological modulation approach targeting ischemia reperfusion injury to augment viability of porcine liver grafts from non-heart-beating donors (NHBD). Background Data: Liver Transplantation (LTx) from NHBD is associated with an increased risk of primary

  3. The role of bile salt toxicity in the pathogenesis of bile duct injury after non-heart-beating porcine liver transplantation

    NARCIS (Netherlands)

    Yska, Marit J.; Buis, Carlijn I.; Monbaliu, Diethard; Schuurs, Theo A.; Gouw, Annette S. H.; Kahmann, Olivier N. H.; Visser, Dorien S.; Pirenne, Jacques; Porte, Robert J.

    2008-01-01

    Background. Intrahepatic bile duct strictures are a serious complication after non-heart-beating (NHB) liver transplantation. Bile salt toxicity has been identified as an important factor in the pathogenesis of bile duct injury and cholangiopathies. The role of bile salt toxicity in the development

  4. Early Reperfusion Hemodynamics Predict Recovery in Rat Hearts: A Potential Approach towards Evaluating Cardiac Grafts from Non-Heart-Beating Donors

    Science.gov (United States)

    Dornbierer, Monika; Stadelmann, Mathieu; Sourdon, Joevin; Gahl, Brigitta; Cook, Stéphane; Carrel, Thierry P.; Tevaearai, Hendrik T.; Longnus, Sarah L.

    2012-01-01

    Aims Cardiac grafts from non-heartbeating donors (NHBDs) could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs. Methods and Results Hearts (n = 31) isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32°C) for 30, 50, 55 or 60 min. Reperfusion was unloaded for 20 min, and then loaded, in working-mode, for 40 min. Left ventricular (LV) pressure was monitored using a micro-tip pressure catheter introduced via the mitral valve. Several hemodynamic parameters measured during early, unloaded reperfusion correlated significantly with LV work after 60 min reperfusion (p<0.001). Coronary flow and the production of lactate and lactate dehydrogenase (LDH) also correlated significantly with outcomes after 60 min reperfusion (p<0.05). Based on early reperfusion hemodynamic measures, a composite, weighted predictive parameter, incorporating heart rate (HR), developed pressure (DP) and end-diastolic pressure, was generated and evaluated against the HR-DP product after 60 min of reperfusion. Effective discriminating ability for this novel parameter was observed for four HR*DP cut-off values, particularly for ≥20 *103 mmHg*beats*min−1 (p<0.01). Conclusion Upon reperfusion of a NHBD heart, early evaluation, at the time of organ procurement, of cardiac hemodynamic parameters, as well as easily accessible markers of metabolism and necrosis seem to accurately predict subsequent contractile recovery and could thus potentially be of use in guiding the decision of accepting the ischemic heart for transplantation. PMID:22928009

  5. Early reperfusion hemodynamics predict recovery in rat hearts: a potential approach towards evaluating cardiac grafts from non-heart-beating donors.

    Directory of Open Access Journals (Sweden)

    Monika Dornbierer

    Full Text Available AIMS: Cardiac grafts from non-heartbeating donors (NHBDs could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs. METHODS AND RESULTS: Hearts (n = 31 isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32°C for 30, 50, 55 or 60 min. Reperfusion was unloaded for 20 min, and then loaded, in working-mode, for 40 min. Left ventricular (LV pressure was monitored using a micro-tip pressure catheter introduced via the mitral valve. Several hemodynamic parameters measured during early, unloaded reperfusion correlated significantly with LV work after 60 min reperfusion (p<0.001. Coronary flow and the production of lactate and lactate dehydrogenase (LDH also correlated significantly with outcomes after 60 min reperfusion (p<0.05. Based on early reperfusion hemodynamic measures, a composite, weighted predictive parameter, incorporating heart rate (HR, developed pressure (DP and end-diastolic pressure, was generated and evaluated against the HR-DP product after 60 min of reperfusion. Effective discriminating ability for this novel parameter was observed for four HR*DP cut-off values, particularly for ≥20 *10(3 mmHg*beats*min(-1 (p<0.01. CONCLUSION: Upon reperfusion of a NHBD heart, early evaluation, at the time of organ procurement, of cardiac hemodynamic parameters, as well as easily accessible markers of metabolism and necrosis seem to accurately predict subsequent contractile recovery and could thus potentially be of use in guiding the decision of accepting the ischemic heart for transplantation.

  6. Hearts beating through decellularized scaffolds: whole-organ engineering for cardiac regeneration and transplantation.

    Science.gov (United States)

    Zia, Sonia; Mozafari, Masoud; Natasha, G; Tan, Aaron; Cui, Zhanfeng; Seifalian, Alexander M

    2016-08-01

    Whole-organ decellularization and tissue engineering approaches have made significant inroads during recent years. If proven to be successful and clinically viable, it is highly likely that this field would be poised to revolutionize organ transplantation surgery. In particular, whole-heart decellularization has captured the attention and imagination of the scientific community. This technique allows for the generation of a complex three-dimensional (3D) extracellular matrix scaffold, with the preservation of the intrinsic 3D basket-weave macroarchitecture of the heart itself. The decellularized scaffold can then be recellularized by seeding it with cells and incubating it in perfusion bioreactors in order to create functional organ constructs for transplantation. Indeed, research into this strategy of whole-heart tissue engineering has consequently emerged from the pages of science fiction into a proof-of-concept laboratory undertaking. This review presents current trends and advances, and critically appraises the concepts involved in various approaches to whole-heart decellularization and tissue engineering.

  7. Multiple capture locations for 3D ultrasound-guided robotic retrieval of moving bodies from a beating heart

    Science.gov (United States)

    Thienphrapa, Paul; Ramachandran, Bharat; Elhawary, Haytham; Taylor, Russell H.; Popovic, Aleksandra

    2012-02-01

    Free moving bodies in the heart pose a serious health risk as they may be released in the arteries causing blood flow disruption. These bodies may be the result of various medical conditions and trauma. The conventional approach to removing these objects involves open surgery with sternotomy, the use of cardiopulmonary bypass, and a wide resection of the heart muscle. We advocate a minimally invasive surgical approach using a flexible robotic end effector guided by 3D transesophageal echocardiography. In a phantom study, we track a moving body in a beating heart using a modified normalized cross-correlation method, with mean RMS errors of 2.3 mm. We previously found the foreign body motion to be fast and abrupt, rendering infeasible a retrieval method based on direct tracking. We proposed a strategy based on guiding a robot to the most spatially probable location of the fragment and securing it upon its reentry to said location. To improve efficacy in the context of a robotic retrieval system, we extend this approach by exploring multiple candidate capture locations. Salient locations are identified based on spatial probability, dwell time, and visit frequency; secondary locations are also examined. Aggregate results indicate that the location of highest spatial probability (50% occupancy) is distinct from the longest-dwelled location (0.84 seconds). Such metrics are vital in informing the design of a retrieval system and capture strategies, and they can be computed intraoperatively to select the best capture location based on constraints such as workspace, time, and device manipulability. Given the complex nature of fragment motion, the ability to analyze multiple capture locations is a desirable capability in an interventional system.

  8. Far beyond the Sun - I. The beating magnetic heart in Horologium

    Science.gov (United States)

    Alvarado-Gómez, Julián D.; Hussain, Gaitee A. J.; Drake, Jeremy J.; Donati, Jean-François; Sanz-Forcada, Jorge; Stelzer, Beate; Cohen, Ofer; Amazo-Gómez, Eliana M.; Grunhut, Jason H.; Garraffo, Cecilia; Moschou, Sofia P.; Silvester, James; Oksala, Mary E.

    2018-02-01

    A former member of the Hyades cluster, ι Horologii (ι Hor) is a planet-hosting Sun-like star which displays the shortest coronal activity cycle known to date (Pcyc ∼ 1.6 yr). With an age of ∼625 Myr, ι Hor is also the youngest star with a detected activity cycle. The study of its magnetic properties holds the potential to provide fundamental information to understand the origin of cyclic activity and stellar magnetism in late-type stars. In this series of papers, we present the results of a comprehensive project aimed at studying the evolving magnetic field in this star and how this evolution influences its circumstellar environment. This paper summarizes the first stage of this investigation, with results from a long-term observing campaign of ι Hor using ground-based high-resolution spectropolarimetry. The analysis includes precise measurements of the magnetic activity and radial velocity of the star, and their multiple time-scales of variability. In combination with values reported in the literature, we show that the long-term chromospheric activity evolution of ι Hor follows a beating pattern, caused by the superposition of two periodic signals of similar amplitude at P1 ≃ 1.97 ± 0.02 yr and P2 ≃ 1.41 ± 0.01 yr. Additionally, using the most recent parameters for ι Hor b in combination with our activity and radial velocity measurements, we find that stellar activity dominates the radial velocity residuals, making the detection of additional planets in this system challenging. Finally, we report here the first measurements of the surface longitudinal magnetic field strength of ι Hor, which displays varying amplitudes within ±4 G and served to estimate the rotation period of the star (P_rot = 7.70^{+0.18}_{-0.67} d).

  9. Automatic filtering of outliers in RR intervals before analysis of heart rate variability in Holter recordings: a comparison with carefully edited data

    Science.gov (United States)

    2012-01-01

    Background Undetected arrhythmic beats seriously affect the power spectrum of the heart rate variability (HRV). Therefore, the series of RR intervals are normally carefully edited before HRV is analysed, but this is a time consuming procedure when 24-hours recordings are analysed. Alternatively, different methods can be used for automatic removal of arrhythmic beats and artefacts. This study compared common frequency domain indices of HRV when determined from manually edited and automatically filtered RR intervals. Methods and Results Twenty-four hours Holter recordings were available from 140 healthy subjects of age 1-75 years. An experienced technician carefully edited all recordings. Automatic filtering was performed using a recursive procedure where RR intervals were removed if they differed from the mean of the surrounding RR intervals with more than a predetermined limit (ranging from 10% to 50%). The filtering algorithm was evaluated by replacing 1% of the beats with synthesised ectopic beats. Power spectral analysis was performed before and after filtering of both the original edited data and the noisy data set. The results from the analysis using the noisy data were used to define an age-based filtering threshold. The age-based filtration was evaluated with completely unedited data, generated by removing all annotations from the series of RR intervals, and then comparing the resulting HRV indices with those obtained using edited data. The results showed equivalent results after age-based filtration of both the edited and unedited data sets, where the differences in HRV indices obtained by different preprocessing methods were small compared to the mean values within each age group. Conclusions The study showed that it might not be necessary to perform the time-consuming careful editing of all detected heartbeats before HRV is analysed in Holter recordings. In most subjects, it is sufficient to perform the regular editing needed for valid arrhythmia analyses

  10. A computer heart model incorporating anisotropic propagation. III. Simulation of ectopic beats.

    Science.gov (United States)

    Xu, Z; Gulrajani, R M; Molin, F; Lorange, M; Dubé, B; Savard, P; Nadeau, R A

    1996-04-01

    With the advent of catheter ablation procedures, it has become an important goal to predict noninvasively the site of origin of ventricular tachycardia. Site classifications based on the observed body surface potential maps (BSPMs) during ventricular endocardial pacing, as well as on the patterns of the QRS integrals of these maps, have been suggested. The goals of this study were to verify these maps and their QRS integral patterns via simulation using a computer heart model with realistic geometry and to determine whether the model could improve clinical understanding of these ectopic patterns. Simulation was achieved by initiating excitation of the heart model at different endocardial sites and their overlying epicardial counterparts. This excitation propagated in anisotropic fashion in the myocardium. Retrograde excitation of the model's His-Purkinje conduction system was necessary to obtain realistic activation durations. Simulated BSPMs, computed by placing the heart model inside a numerical torso model, and their QRS integrals were close to those observed clinically. Small differences in QRS integral map patterns and in the positions of the QRS integral map extrema were noted for endocardial sites in the left septal and anteroseptal regions. The simulated BSPMs during early QRS for an endocardial site and its epicardial counterpart tended to be mirror images about the zero isopotential contour, exchanging positive and negative map regions. The simulation results attest to the model's ability to reproduce accurately clinically recorded body surface potential distributions obtained following endocardial stimulation. The QRS integral maps from endocardial sites in the left septal and anteroseptal regions were the most labile, owing to considerable cancellation effects. Conventional BSPMs can be useful to help distinguish between endocardial and epicardial ectopic sites.

  11. Detection of inflating balloon in optical coherence tomography images of a porcine artery in a beating heart experiment

    Science.gov (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Hewko, Mark; Boulet, Benoit; Sowa, Mike; Lamouche, Guy

    2011-03-01

    Suboptimal results of angioplasty procedures have been correlated to arterial damage during balloon inflation. We propose to monitor balloon inflation during the angioplasty procedure by detecting the balloon contours with intravascular optical coherence tomography (IVOCT). This will shed more light on the interaction between the balloon and the artery and to assess the artery's mechanical response. An automatic edge detection algorithm is applied for detection of the outer surface of an inflating balloon in a porcine artery in a beating heart experiment. A compliant balloon is inflated to deform the artery. IVOCT monitoring of balloon inflation is performed at a rate of 30 frames per second. During inflation, the balloon engages the arterial wall. Therefore, the characterization of the diameter of the inflated balloon leads to a characterization of the luminal diameter of the vessel. This provides precise information about the artery response to a simulated angioplasty procedure, information currently not provided by any other existing technique. In the current experiment, balloon inflation characterization is based on 356 IVOCT frames during which the estimated balloon diameter increases approximately from 1.8 mm to 2.9 mm.

  12. Fibrinolytic preflush upon liver retrieval from non-heart beating donors to enhance postpreservation viability and energetic recovery upon reperfusion.

    Science.gov (United States)

    Minor, T; Hachenberg, A; Tolba, R; Pauleit, D; Akbar, S

    2001-06-27

    Our objective was to evaluate graft equilibration with high viscosity (University of Wisconsin solution [UW]) or low viscosity (Bretschneider's histidine-tryptophan-ketoglutarate [HTK]) during liver procurement from non-heart beating donors (NHBD) and the potential impact of a preceding fibrinolysis with streptokinase on postpreservation viability. After 60 min of cardiac arrest, rat livers were perfused by gravity (60 cm H2O) via the portal vein with either 60 ml of HTK, 20 ml of UW, or 20 ml of Ringer's solution (22 degrees C including 7500U of streptokinase) and, subsequently, 20 ml of UW. After 24 h of storage at 4 degrees C, viability of the livers was assessed upon isolated reperfusion in vitro. Magnetic resonance imaging revealed severe perfusion deficits, which were mildly attenuated with HTK, upon flush-out with UW. After preflush with streptokinase, a mostly homogenous distribution of the preservation solution was observed throughout the liver tissue. The choice of the flush-out solution (UW or HTK) had no influence on parenchymal enzyme leakage, hepatic bile production, or tissue levels of ATP after reperfusion of the livers. Fibrinolytic preflush, however, resulted in a relevant and significant improvement of structural integrity as well as functional and metabolic recovery. Compromised vascular tissue perfusion upon organ harvest in NHBD triggers graft dysfunction after cold storage and can easily be circumvented by temporary fibrinolysis before graft retrieval.

  13. [THEORETICAL BACKGROUND OF FINDING ORGANS FOR TRANSPLANTATION AMONG NON-HEART BEATING DONORS UNDER UNSUCCESSFUL EXTRACORPOREAL RESUSCITATION (LITERATURE REVIEW)].

    Science.gov (United States)

    Khodeli, N; Chkhaidze, Z; Partsakhashvili, D; Pilishvili, O; Kordzaia, D

    2016-05-01

    The number of patients who are in the "Transplant Waiting List" is increasing each year. At the same time, as a result of the significant shortage of donor organs, part of the patients dies without waiting till surgery. According to the Maastricht classification for non-heart beating donors, the patients, who had cardiac arrest outside the hospital (in the uncontrolled by medical staff conditions) should be considered as a potential donors of category II. For these patients, the most effective resuscitation is recommended. The extracorporeal life support (ECLS) considers the connection to a special artificial perfusion system for the restoration of blood circulation out-of-hospital with further transportation to the hospital. If restoration of independent cardiac activity does not occur, in spite of the full range of resuscitative measures, these patients may be regarded as potential donors. The final decision should be received in the hospital, by the council of physicians, lawyers and patient's family members. Until the final decision, the prolongation of ECLS and maintaining adequate systemic and organic circulation is recommended.

  14. Effects of phenylephrine and noradrenaline on coronary artery motion in an open-chest porcine beating heart model.

    Science.gov (United States)

    Kurosawa, Hiroyuki; Seto, Yuki; Wakamatsu, Hiroki; Sato, Yoshiyuki; Takase, Shinya; Omata, Sadao; Yokoyama, Hitoshi

    2014-06-01

    During off-pump coronary artery bypass (OPCAB), surgeons are required to perform a precise anastomosis on the beating heart. The hypotension caused by vertical displacement of the heart during OPCAB is usually treated with vasopressors, such as noradrenaline and phenylephrine. However, the effects of these agents on coronary artery motion are unknown. The present study analyzed the motion of the target coronary arteries during noradrenaline or phenylephrine infusion using three-dimensional motion capture and reconstruction technology. The left anterior descending (LAD) artery, left circumflex (LCX) artery and right coronary artery (RCA) of 12 female landrace pigs (weight 50 ± 1 kg) were stabilized using a tissue stabilizer. The motions in the regions were captured before and during noradrenaline (n = 5) and phenylephrine (n = 7) infusion. Noradrenaline (0.15 μg/kg/min) and phenylephrine (1.1 μg/kg/min) significantly increased the blood pressure. Noradrenaline significantly increased the motion parameters, such as the distance moved, maximum velocity, acceleration and deceleration at the LAD (4.2 vs. 7.9 mm, P = 0.025; 95.7 vs. 215.5 mm/s, P = 0.0074; 35.3 vs. 83.6 m/s(2), P = 0.0096 and -35.6 vs. -83.6 m/s(2), P = 0.005, respectively). The values during phenylephrine infusion did not change except for the distance moved at the LAD (3.8 vs. 7.7 mm, P = 0.042). The motion parameters at the LCX and RCA during noradrenaline and phenylephrine infusion did not change significantly. The effect of phenylephrine on the coronary artery motion was less dramatic than that of noradrenaline.

  15. Using an elastic magnifier to increase power output and performance of heart-beat harvesters

    Science.gov (United States)

    Galbier, Antonio C.; Karami, M. Amin

    2017-09-01

    Embedded piezoelectric energy harvesting (PEH) systems in medical pacemakers have been a growing and innovative research area. The goal of these systems, at present, is to remove the pacemaker battery, which makes up 60%-80% of the unit, and replace it with a sustainable power source. This requires that energy harvesting systems provide sufficient power, 1-3 μW, for operating a pacemaker. The goal of this work is to develop, test, and simulate cantilevered energy harvesters with a linear elastic magnifier (LEM). This research hopes to provide insight into the interaction between pacemaker energy harvesters and the heart. By introducing the elastic magnifier into linear and nonlinear systems oscillations of the tip are encouraged into high energy orbits and large tip deflections. A continuous nonlinear model is presented for the bistable piezoelectric energy harvesting (BPEH) system and a one-degree-of-freedom linear mass-spring-damper model is presented for the elastic magnifier. The elastic magnifier will not consider the damping negligible, unlike most models. A physical model was created for the bistable structure and formed to an elastic magnifier. A hydrogel was designed for the experimental model for the LEM. Experimental results show that the BPEH coupled with a LEM (BPEH + LEM) produces more power at certain input frequencies and operates a larger bandwidth than a PEH, BPEH, and a standard piezoelectric energy harvester with the elastic magnifier (PEH + LEM). Numerical simulations are consistent with these results. It was observed that the system enters high-energy and high orbit oscillations and that, ultimately, BPEH systems implemented in medical pacemakers can, if designed properly, have enhanced performance if positioned over the heart.

  16. QT interval prolongation in patients with hypertensive heart disease ...

    African Journals Online (AJOL)

    Conclusion: This study demonstrated high prevalence of prolonged QTc in patients with hypertensive heart disease. Affected patients had significantly higher prevalence of several factors associated with increased morbidity and mortality. Assessment of QTc is recommended for risk stratification in patients with HHD.

  17. Effects of Interval Training Programme on Resting Heart Rate in ...

    African Journals Online (AJOL)

    DATONYE ALASIA

    Student's t and Pearson correlation tests were used in data analysis. Results: Findings of the study revealed significant effect of exercise training program on HR ... presentwith a series of functional and anatomic deficits, such as increasedvascular resistance, vessel rarefaction, increased heart energy expenditure, increased.

  18. How sea ice could be the cold beating heart of European weather

    Science.gov (United States)

    Margrethe Ringgaard, Ida; Yang, Shuting; Hesselbjerg Christensen, Jens; Kaas, Eigil

    2017-04-01

    The possibility that the ongoing rapid demise of Arctic sea ice may instigate abrupt changes is, however, not tackled by current research in general. Ice cores from the Greenland Ice Sheet (GIS) show clear evidence of past abrupt warm events with up to 15 degrees warming in less than a decade, most likely triggered by rapid disappearance of Nordic Seas sea ice. At present, both Arctic Sea ice and the GIS are in strong transformation: Arctic sea-ice cover has been retreating during most of the satellite era and in recent years, Arctic sea ice experienced a dramatic reduction and the summer extent was in 2012 and 2016 only half of the 1979-2000 average. With such dramatic change in the current sea ice coverage as a point of departure, several studies have linked reduction in wintertime sea ice in the Barents-Kara seas to cold weather anomalies over Europe and through large scale tele-connections to regional warming elsewhere. Here we aim to investigate if, and how, Arctic sea ice impacts European weather, i.e. if the Arctic sea ice works as the 'cold heart' of European weather. To understand the effects of the sea ice reduction on the full climate system, a fully-coupled global climate model, EC-Earth, is used. A new energy-conserving method for assimilating sea ice using the sensible heat flux is implemented in the coupled climate model and compared to the traditional, non-conserving, method of assimilating sea ice. Using this new method, experiments are performed with reduced sea ice cover in the Barents-Kara seas under both warm and cold conditions in Europe. These experiments are used to evaluate how the Arctic sea ice modulates European winter weather under present climate conditions with a view towards favouring both relatively cold and warm conditions.

  19. QT interval variability in body surface ECG: measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology

    Science.gov (United States)

    Baumert, Mathias; Porta, Alberto; Vos, Marc A.; Malik, Marek; Couderc, Jean-Philippe; Laguna, Pablo; Piccirillo, Gianfranco; Smith, Godfrey L.; Tereshchenko, Larisa G.; Volders, Paul G.A.

    2016-01-01

    This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the relation between QTV and heart rate variability. Research frontiers of QTV include understanding of QTV physiology, systematic evaluation of the link between QTV and direct measures of neural activity, modelling of the QTV dependence on the variability of other physiological variables, distinction between QTV and general T wave shape variability, and assessing of the QTV utility for guiding therapy. Increased QTV appears to be a risk marker of arrhythmic and cardiovascular death. It remains to be established whether it can guide therapy alone or in combination with other risk factors. QT interval variability has a possible role in non-invasive assessment of tonic sympathetic activity. PMID:26823389

  20. Distinguishing between overdrive excited and suppressed ventricular beats in guinea pig ventricular myocardium

    Directory of Open Access Journals (Sweden)

    Amara eGreer-Short

    2015-02-01

    Full Text Available Rapid ventricular pacing rates induces two types of beats following pacing cessation: recovery cycle length (RCL prolongation (overdrive suppression and RCL shortening (overdrive excitation. The goals of this study were to compare common experimental protocols for studying triggered activity in whole-heart preparations and differentiate between recovery beats using a new methodology. Post-pacing recovery beat cycle length (RCL and QRS were normalized to pre-paced R-R and QRS intervals and analyzed using a K-means clustering algorithm. Control hearts only produced suppressed beats: RCL ratio increased with rapid pacing (25±4.0%, n=10 without changing QRS duration. Rapid pacing during hypercalcemia + hypothermia (5.5 mM and 34°C produced significantly earlier excited beats (53±14%, n=5 with wider QRS durations (58±6.3%, n=5 than suppressed beats. Digoxin + hypothermia (0.75 M produced the most excited beats with significantly earlier RCL (44±3.2%, n=6 and wider QRS (60±3.1%, n=6 ratios relative to suppressed beats. Increasing pacing further shortened RCL (30±7.8%, n=6. In a prospective study, TTX (100 nM increased RCL ratio (15±6.0%, n=10 without changing the QRS duration of excited beats. The algorithm was compared to a cross-correlation analysis with 93% sensitivity and 94% specificity. This ECG based algorithm distinguishes between triggered and automatic activity.

  1. Nomenclature, categorization and usage of formulae to adjust QT interval for heart rate

    Science.gov (United States)

    Rabkin, Simon W; Cheng, Xin Bo

    2015-01-01

    Assessment of the QT interval on a standard 12 lead electrocardiogram is of value in the recognition of a number of conditions. A critical part of its use is the adjustment for the effect of heart rate on QT interval. A systematic search was conducted to identify studies that proposed formulae to standardize the QT interval by heart rate. A nomenclature was developed for current and subsequent equations based on whether they are corrective (QTc) or predictive (QTp). QTc formulae attempt to separate the dependence of the length of the QT interval from the length of the RR interval. QTp formulae utilize heart rate and the output QTp is compared to the uncorrected QT interval. The nomenclature consists of the first letter of the first author’s name followed by the next two consonance (whenever possible) in capital letters; with subscripts in lower case alphabetical letter if the first author develops more than one equation. The single exception was the Framingham equation, because this cohort has developed its own “name” amongst cardiovascular studies. Equations were further categorized according to whether they were linear, rational, exponential, logarithmic, or power based. Data show that a person’s QT interval adjusted for heart rate can vary dramatically with the different QTc and QTp formulae depending on the person’s heart rate and QT interval. The differences in the QT interval adjustment equations encompasses values that are considered normal or significant prolonged. To further compare the equations, we considered that the slope of QTc versus heart rate should be zero if there was no correlation between QT and heart rate. Reviewing a sample of 107 patient ECGs from a hospital setting, the rank order of the slope - from best (closest to zero) to worst was QTcDMT, QTcRTHa, QTcHDG, QTcGOT, QTcFRM, QTcFRD, QTcBZT and QTcMYD. For two recent formulae based on large data sets specifically QTcDMT and QTcRTHa, there was no significant deviation of the slope

  2. Prevalence, predictors, and prognostic implications of PR interval prolongation in patients with heart failure.

    Science.gov (United States)

    Nikolaidou, Theodora; Pellicori, Pierpaolo; Zhang, Jufen; Kazmi, Syed; Goode, Kevin M; Cleland, John G; Clark, Andrew L

    2017-09-15

    To determine the prevalence, incidence, predictors, and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included. The prevalence of first-degree heart block [heart rate corrected PR interval (PRc) > 200 ms] was higher in patients with heart failure (21% HeFREF, 20% HeFNEF, 9% without heart failure). In patients with HeFREF or HeFNEF, longer baseline PRc was associated with greater age, male sex, and longer QRS duration, and, in those with HeFREF, treatment with amiodarone or digoxin. Patients with heart failure in the longest PRc quartile had worse survival compared to shorter PRc quartiles, but PRc was not independently associated with survival in multivariable analysis. For patients without heart failure, shorter baseline PRc was independently associated with worse survival. PRc prolongation is common in patients with HeFREF or HeFNEF and associated with worse survival, although not an independent predictor of outcome. The results of clinical trials investigating the therapeutic potential of shortening the PR interval by pacing are awaited.

  3. Performance of Fixed Heart Rate Increment Targets of 20 vs 30 Beats per Minute for Exercise Rehabilitation Prescription in Outpatients With Heart Failure.

    Science.gov (United States)

    Reed, Jennifer L; Blais, Angelica Z; Keast, Marja-Leena; Pipe, Andrew L; Reid, Robert D

    2017-06-01

    Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated. We examined the appropriateness of RHR + 20/30 for prescribing exercise intensity and improving functional capacity for 55 patients with HF in an outpatient CR program. RHR + 20/30 values were compared to % HRR derived from peak exercise testing in patients with HF. Changes in functional capacity as measured by 6-minute walk test (6MWT) distance, and differences in ratings of perceived exertion (RPE), were examined between patients exercising at RHR + 20-29 and those exercising at RHR + ≥ 30. During weeks 1-3 and exercise at RHR + 20, 26% of participants would exercise at 40%-60% HRR. At RHR + 30, 38% would exercise at 40%-60% HRR. During weeks 4-12 and exercise at RHR + 20, 20% of participants would exercise at 50%-80% HRR. At RHR + 30, 41% would exercise at 50%-80% HRR. A smaller change in 6MWT distance was observed in participants exercising at RHR + 20-29 than in those exercising at RHR + ≥ 30 (Δ86.6 ± 70.3 vs Δ135.8 ± 73.7 m; P = 0.005). No differences in RPE were observed between participants exercising at RHR + 20-29 and those exercising at RHR + ≥ 30 (P > 0.05). RHR + 30 was more effective than RHR + 20 in assisting outpatients with HF achieve recommended exercise intensities and improve functional capacity. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  4. Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition–Heart Failure (BEAT-HF) Randomized Clinical Trial

    Science.gov (United States)

    Ong, Michael K.; Romano, Patrick S.; Edgington, Sarah; Aronow, Harriet U.; Auerbach, Andrew D.; Black, Jeanne T.; De Marco, Teresa; Escarce, Jose J.; Evangelista, Lorraine S.; Hanna, Barbara; Ganiats, Theodore G.; Greenberg, Barry H.; Greenfield, Sheldon; Kaplan, Sherrie H.; Kimchi, Asher; Liu, Honghu; Lombardo, Dawn; Mangione, Carol M.; Sadeghi, Bahman; Sadeghi, Banafsheh; Sarrafzadeh, Majid; Tong, Kathleen; Fonarow, Gregg C.

    2016-01-01

    Importance It remains unclear whether telemonitoring approaches provide benefits for patients with heart failure (HF) after hospitalization. Objective To evaluate the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF. Design, Setting, and Participants We randomized 1437 patients hospitalized for HF between October 12, 2011, and September 30, 2013, to the intervention arm (715 patients) or to the usual care arm (722 patients) of the Better Effectiveness After Transition–Heart Failure (BEAT-HF) study and observed them for 180 days. The dates of our study analysis were March 30, 2014, to October 1, 2015. The setting was 6 academic medical centers in California. Participants were hospitalized individuals 50 years or older who received active treatment for decompensated HF. Interventions The intervention combined health coaching telephone calls and telemonitoring. Telemonitoring used electronic equipment that collected daily information about blood pressure, heart rate, symptoms, and weight. Centralized registered nurses conducted telemonitoring reviews, protocolized actions, and telephone calls. Main outcomes and measures The primary outcome was readmission for any cause within 180 days after discharge. Secondary outcomes were all-cause readmission within 30 days, all-cause mortality at 30 and 180 days, and quality of life at 30 and 180 days. Results Among 1437 participants, the median age was 73 years. Overall, 46.2% (664 of 1437) were female, and 22.0% (316 of 1437) were African American. The intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge, which occurred in 50.8% (363 of 715) and 49.2% (355 of 722) of patients, respectively (adjusted hazard ratio, 1.03; 95% CI, 0.88-1.20; P = .74). In secondary analyses, there were no significant differences in 30-day

  5. Auxotonic to isometric contraction transitioning in a beating heart causes myosin step-size to down shift.

    Directory of Open Access Journals (Sweden)

    Thomas P Burghardt

    Full Text Available Myosin motors in cardiac ventriculum convert ATP free energy to the work of moving blood volume under pressure. The actin bound motor cyclically rotates its lever-arm/light-chain complex linking motor generated torque to the myosin filament backbone and translating actin against resisting force. Previous research showed that the unloaded in vitro motor is described with high precision by single molecule mechanical characteristics including unitary step-sizes of approximately 3, 5, and 8 nm and their relative step-frequencies of approximately 13, 50, and 37%. The 3 and 8 nm unitary step-sizes are dependent on myosin essential light chain (ELC N-terminus actin binding. Step-size and step-frequency quantitation specifies in vitro motor function including duty-ratio, power, and strain sensitivity metrics. In vivo, motors integrated into the muscle sarcomere form the more complex and hierarchically functioning muscle machine. The goal of the research reported here is to measure single myosin step-size and step-frequency in vivo to assess how tissue integration impacts motor function. A photoactivatable GFP tags the ventriculum myosin lever-arm/light-chain complex in the beating heart of a live zebrafish embryo. Detected single GFP emission reports time-resolved myosin lever-arm orientation interpreted as step-size and step-frequency providing single myosin mechanical characteristics over the active cycle. Following step-frequency of cardiac ventriculum myosin transitioning from low to high force in relaxed to auxotonic to isometric contraction phases indicates that the imposition of resisting force during contraction causes the motor to down-shift to the 3 nm step-size accounting for >80% of all the steps in the near-isometric phase. At peak force, the ATP initiated actomyosin dissociation is the predominant strain inhibited transition in the native myosin contraction cycle. The proposed model for motor down-shifting and strain sensing involves ELC N

  6. Is High Temporal Resolution Achievable for Paediatric Cardiac Acquisitions during Several Heart Beats? Illustration with Cardiac Phase Contrast Cine-MRI.

    Directory of Open Access Journals (Sweden)

    Laurent Bonnemains

    Full Text Available During paediatric cardiac Cine-MRI, data acquired during cycles of different lengths must be combined. Most of the time, Feinstein's model is used to project multiple cardiac cycles of variable lengths into a mean cycle.To assess the effect of Feinstein projection on temporal resolution of Cine-MRI.1/The temporal errors during Feinstein's projection were computed in 306 cardiac cycles fully characterized by tissue Doppler imaging with 6-phase analysis (from a population of 7 children and young adults. 2/The effects of these temporal errors on tissue velocities were assessed by simulating typical tissue phase mapping acquisitions and reconstructions. 3/Myocardial velocities curves, extracted from high-resolution phase-contrast cine images, were compared for the 6 volunteers with lowest and highest heart rate variability, within a population of 36 young adults.1/The mean of temporal misalignments was 30 ms over the cardiac cycle but reached 60 ms during early diastole. 2/During phase contrast MRI simulation, early diastole velocity peaks were diminished by 6.1 cm/s leading to virtual disappearance of isovolumic relaxation peaks. 3/The smoothing and erasing of isovolumic relaxation peaks was confirmed on tissue phase mapping velocity curves, between subjects with low and high heart rate variability (p = 0.05.Feinstein cardiac model creates temporal misalignments that impair high temporal resolution phase contrast cine imaging when beat-to-beat heart rate is changing.

  7. ProSeal laryngeal mask airway as an alternative to standard endotracheal tube in securing upper airway in the patients undergoing beating-heart coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Kalpana Shah

    2017-01-01

    Full Text Available Background: ProSeal laryngeal mask airways (PLMAs are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery. This prospective study was conducted with the objective of demonstrating the advantages of PLMA over ETT in the patients undergoing beating-heart coronary artery bypass graft (CABG. Methodology: This prospective, interventional study was carried out in 200 patients who underwent beating-heart CABG. Patients were randomized in equal numbers to either ETT group or PLMA group, and various hemodynamic and respiratory parameters were observed at different time points. Results: Patients in PLMA group had mean systolic blood pressure 126.10 ± 5.31 mmHg compared to the patients of ETT group 143.75 ± 6.02 mmHg. Pulse rate in the PLMA group was less (74.52 ± 10.79 per min (P < 0.05 compared to ETT group (81.72 ± 9.8. Thus, hemodynamic changes were significantly lower (P < 0.05 in PLMA than in ETT group. Respiratory parameters such as oxygen saturation, pressure CO 2 (pCO 2 , peak airway pressure, and lung compliance were similar to ETT group at all evaluation times. The incidence of adverse events was also lower in PLMA group. Conclusion: In experience hand, PLMA offers advantages over the ETT in airway management in the patients undergoing beating-heart CABG.

  8. Comparison of cardiac time intervals between echocardiography and impedance cardiography at various heart rates

    Directory of Open Access Journals (Sweden)

    Maureen A.J.M. van Eijnatten

    2014-04-01

    Full Text Available The non-invasively measured Initial Systolic Time Interval (ISTI reflects a time difference between the electrical and pumping activity of the heart and depends on cardiac preload, afterload, autonomic nervous control and training level. However, the duration of the ISTI has not yet been compared to other time markers of the heart cycle. The present study gauges the duration of the ISTI by comparing the end point of this interval, the C-point, with heart cycle markers obtained by echocardiography. The heart rate of 16 healthy subjects was varied by means of an exercise stimulus. It was found that the C-point, and therefore the end point of ISTI, occurred around the moment of the maximum diameter of the aortic arch in all subjects and at all heart rates. However, while the time difference between the opening of the aortic valves and the maximum diameter of the aortic arch decreased significantly with decreasing RR-interval, the time difference with respect to the moment of the C-point remained constant within the subjects. This means that the shortening of the ISTI with increasing heart rate in response to an exercise stimulus was caused by a shortening of the pre-ejection period (PEP. It is concluded that the ISTI can be used as a non-invasive parameter indicating the time difference between the electrical and mechanical pumping activity of the heart, both inside and outside the clinic.

  9. An Experimental Study in Generative Music for Exercising to Ease Perceived Exertion by use of Heart Beat Rate as a Control Parameter

    DEFF Research Database (Denmark)

    Serafin, Stefania; Erkut, Cumhur

    This paper investigates whether generative music, adapted to a user's heart beat rate, can be used to ease the perceived exertion. A generative system was implemented and tested on 13 test participants in a controlled environment on a training bike. The test participants performed a cycling workout...... of three minutes in two conditions in a self-chosen pace, with and without music. Their pulse were used as the physiological exertion. The perceived exertion was rated by the test participants according to Borg’s 6-20 exertion scale. Five out of 13 participants showed indications supporting the notion......, while 2 out of 13 indicated the opposite. 6 out of 13 participants neither showed indications supporting nor opposing the theory. The results could be useful for exercises, where the change of heart pulse is gradual, but further work is needed in cadance-based exercises....

  10. Effects of exogenous surfactant on the non-heart-beating donor lung graft in experimental lung transplantation – a stereological study

    Science.gov (United States)

    Herrmann, Gudrun; Knudsen, Lars; Madershahian, Navid; Mühlfeld, Christian; Frank, Konrad; Rahmanian, Parwis; Wahlers, Thorsten; Wittwer, Thorsten; Ochs, Matthias

    2014-01-01

    The use of non-heart-beating donor (NHBD) lungs may help to overcome the shortage of lung grafts in clinical lung transplantation, but warm ischaemia and ischaemia/reperfusion injury (I/R injury) resulting in primary graft dysfunction represent a considerable threat. Thus, better strategies for optimized preservation of lung grafts are urgently needed. Surfactant dysfunction has been shown to contribute to I/R injury, and surfactant replacement therapy is effective in enhancing lung function and structural integrity in related rat models. In the present study we hypothesize that surfactant replacement therapy reduces oedema formation in a pig model of NHBD lung transplantation. Oedema formation was quantified with (SF) and without (non-SF) surfactant replacement therapy in interstitial and alveolar compartments by means of design-based stereology in NHBD lungs 7 h after cardiac arrest, reperfusion and transplantation. A sham-operated group served as control. In both NHBD groups, nearly all animals died within the first hours after transplantation due to right heart failure. Both SF and non-SF developed an interstitial oedema of similar degree, as shown by an increase in septal wall volume and arithmetic mean thickness as well as an increase in the volume of peribron-chovascular connective tissue. Regarding intra-alveolar oedema, no statistically significant difference could be found between SF and non-SF. In conclusion, surfactant replacement therapy cannot prevent poor outcome after prolonged warm ischaemia of 7 h in this model. While the beneficial effects of surfactant replacement therapy have been observed in several experimental and clinical studies related to heart-beating donor lungs and cold ischaemia, it is unlikely that surfactant replacement therapy will overcome the shortage of organs in the context of prolonged warm ischaemia, for example, 7 h. Moreover, our data demonstrate that right heart function and dysfunctions of the pulmonary vascular bed

  11. Results of beating heart mitral valve surgery via the trans-septal approach Resultados da abordagem transeptal para a valva mitral com coração batendo

    Directory of Open Access Journals (Sweden)

    Tomas A Salerno

    2009-03-01

    Full Text Available OBJECTIVE: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls. METHODS: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm. RESULTS: Mean age was 56.03 ± 13.93 years (range: 19-86 years; median: 56 years. There were 131 (61.2% males and 83 (38.8% females. Of the prostheses used, 108 (50.5% were biological, and 39 (18.2% were mechanical. Mitral repairs were performed in 67 (31.3% patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days. Intra-aortic balloon pump (IABP utilization was required in 12 (5.6% of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7% patients. CONCLUSIONS: Beating-heart mitral valve surgery is an option for myocardial protection in patients undergoing mitral valve surgery. This technique is facilitated by the trans-septal approach due to reduced aortic insufficiency and improved visualization of the mitral apparatus.OBJETIVO: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. MÉTODOS: Entre 2000 e 2007, 214 pacientes consecutivos foram operados com o coração batendo. A

  12. Q-T interval (QTc) in patients with cirrhosis: relation to vasoactive peptides and heart rate

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Gülberg, V.; Fuglsang, Stefan

    2007-01-01

    OBJECTIVE: Prolonged Q-T interval (QT) has been reported in patients with cirrhosis who also exhibit profound abnormalities in vasoactive peptides and often present with elevated heart rate (HR). The aim of this study was to relate QT to the circulating level of endothelins (ET-1 and ET-3...

  13. Healthy Dietary Fats Help Beat High Cholesterol

    Science.gov (United States)

    ... 166625.html Healthy Dietary Fats Help Beat High Cholesterol Eating them can reduce your risk of heart ... ones found in some vegetable oils can reduce cholesterol levels and heart disease risk as much as ...

  14. Efficacy of a novel bipolar radiofrequency ablation device on the beating heart for atrial fibrillation ablation: a long-term porcine study.

    Science.gov (United States)

    Voeller, Rochus K; Zierer, Andreas; Lall, Shelly C; Sakamoto, Shun-ichiro; Schuessler, Richard B; Damiano, Ralph J

    2010-07-01

    Over recent years, a variety of energy sources have been used to replace the traditional incisions of the Cox maze procedure for the surgical treatment of atrial fibrillation. This study evaluated the safety and efficacy of a new bipolar radiofrequency ablation device for atrial ablation in a long-term porcine model. Six pigs underwent a Cox maze IV procedure on a beating heart off cardiopulmonary bypass using the AtriCure Isolator II bipolar ablation device (AtriCure, Inc, Cincinnati, Ohio). In addition, 6 pigs underwent median sternotomy and pericardiotomy alone to serve as a control group. All animals were allowed to survive for 30 days. Each pig underwent induction of atrial fibrillation and was then humanely killed to remove the heart en bloc for histologic assessment. Magnetic resonance imaging scans were also obtained preoperatively and postoperatively to assess atrial and ventricular function, pulmonary vein anatomy, valve function, and coronary artery patency. All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins was documented by pacing acutely and at 30 days in all animals. No animal that underwent the Cox maze IV procedure was able to be induced into atrial fibrillation at 30 days postoperatively, compared with all the sham animals. All 257 ablations examined were discrete, linear, and transmural, with a mean lesion width of 2.2 +/- 1.1 mm and a mean lesion depth of 5.3 +/- 3.0 mm. The AtriCure Isolator II device was able to create reliable long-term transmural lesions of the modified Cox maze procedure on a beating heart without cardiopulmonary bypass 100% of the time. There were no discernible effects on ventricular or valvular function. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  15. Efficacy and safety of right and left atrial ablations on the beating heart with irrigated bipolar radiofrequency energy: a long-term animal study.

    Science.gov (United States)

    Melby, Spencer J; Gaynor, Sydney L; Lubahn, Jordon G; Lee, Anson M; Rahgozar, Paymon; Caruthers, Shelton D; Williams, Todd A; Schuessler, Richard B; Damiano, Ralph J

    2006-10-01

    The Cox maze procedure is the most effective surgical treatment for atrial fibrillation; however, its complexity has limited its clinical utility. The purpose of this study was to simplify the procedure by using an irrigated bipolar radiofrequency ablation device on the beating heart without cardiopulmonary bypass. Six domestic pigs underwent median sternotomy. The pulmonary veins were circumferentially ablated. Electrical isolation was confirmed by pacing. Eight lesions were performed epicardially, and three lesions were performed through purse-string sutures with one of the jaws of the device introduced into the right atrium. After 30 days, magnetic resonance imaging was performed to assess atrial function, pulmonary vein anatomy, and coronary artery patency. Cholinergic stimulation and burst pacing were administered to induce atrial fibrillation. Histologic assessment of the heart was performed after the animal was killed. A modified Cox maze procedure was successfully performed with the irrigated bipolar radiofrequency device with no deaths. In every instance, the pulmonary veins were electrically isolated. Cholinergic stimulation with burst pacing failed to produce atrial fibrillation. Imaging studies revealed tricuspid regurgitation without evidence of pulmonary vein stenosis, coronary artery stenosis, or intra-atrial thrombus. Total atrial ejection fraction was 16.9% +/- 7.5%, a significant reduction. Histologically, 99% of the lesions were transmural, and there was no evidence of coronary sinus injury. Lesions on both the right and left atria can be created successfully on the beating heart with irrigated bipolar radiofrequency. The great majority of lesions with this device were transmural. This device should not be used on valvular tissue.

  16. Induction of chagasic-like arrhythmias in the isolated beating hearts of healthy rats perfused with Trypanosoma cruzi-conditioned medium

    Directory of Open Access Journals (Sweden)

    H. Rodriguez-Angulo

    2013-01-01

    Full Text Available Chagas' myocardiopathy, caused by the intracellular protozoan Trypanosoma cruzi, is characterized by microvascular alterations, heart failure and arrhythmias. Ischemia and arrythmogenesis have been attributed to proteins shed by the parasite, although this has not been fully demonstrated. The aim of the present investigation was to study the effect of substances shed by T. cruzi on ischemia/reperfusion-induced arrhythmias. We performed a triple ischemia-reperfusion (I/R protocol whereby the isolated beating rat hearts were perfused with either Vero-control or Vero T. cruzi-infected conditioned medium during the different stages of ischemia and subsequently reperfused with Tyrode's solution. ECG and heart rate were recorded during the entire experiment. We observed that triple I/R-induced bradycardia was associated with the generation of auricular-ventricular blockade during ischemia and non-sustained nodal and ventricular tachycardia during reperfusion. Interestingly, perfusion with Vero-infected medium produced a delay in the reperfusion-induced recovery of heart rate, increased the frequency of tachycardic events and induced ventricular fibrillation. These results suggest that the presence of parasite-shed substances in conditioned media enhances the arrhythmogenic effects that occur during the I/R protocol.

  17. Heart beats in the cloud: distributed analysis of electrophysiological 'Big Data' using cloud computing for epilepsy clinical research.

    Science.gov (United States)

    Sahoo, Satya S; Jayapandian, Catherine; Garg, Gaurav; Kaffashi, Farhad; Chung, Stephanie; Bozorgi, Alireza; Chen, Chien-Hun; Loparo, Kenneth; Lhatoo, Samden D; Zhang, Guo-Qiang

    2014-01-01

    The rapidly growing volume of multimodal electrophysiological signal data is playing a critical role in patient care and clinical research across multiple disease domains, such as epilepsy and sleep medicine. To facilitate secondary use of these data, there is an urgent need to develop novel algorithms and informatics approaches using new cloud computing technologies as well as ontologies for collaborative multicenter studies. We present the Cloudwave platform, which (a) defines parallelized algorithms for computing cardiac measures using the MapReduce parallel programming framework, (b) supports real-time interaction with large volumes of electrophysiological signals, and (c) features signal visualization and querying functionalities using an ontology-driven web-based interface. Cloudwave is currently used in the multicenter National Institute of Neurological Diseases and Stroke (NINDS)-funded Prevention and Risk Identification of SUDEP (sudden unexplained death in epilepsy) Mortality (PRISM) project to identify risk factors for sudden death in epilepsy. Comparative evaluations of Cloudwave with traditional desktop approaches to compute cardiac measures (eg, QRS complexes, RR intervals, and instantaneous heart rate) on epilepsy patient data show one order of magnitude improvement for single-channel ECG data and 20 times improvement for four-channel ECG data. This enables Cloudwave to support real-time user interaction with signal data, which is semantically annotated with a novel epilepsy and seizure ontology. Data privacy is a critical issue in using cloud infrastructure, and cloud platforms, such as Amazon Web Services, offer features to support Health Insurance Portability and Accountability Act standards. The Cloudwave platform is a new approach to leverage of large-scale electrophysiological data for advancing multicenter clinical research.

  18. The development and validation of an easy to use automatic QT-interval algorithm.

    Directory of Open Access Journals (Sweden)

    Ben J M Hermans

    Full Text Available To evaluate QT-interval dynamics in patients and in drug safety analysis, beat-to-beat QT-interval measurements are increasingly used. However, interobserver differences, aberrant T-wave morphologies and changes in heart axis might hamper accurate QT-interval measurements.To develop and validate a QT-interval algorithm robust to heart axis orientation and T-wave morphology that can be applied on a beat-to-beat basis.Additionally to standard ECG leads, the root mean square (ECGRMS, standard deviation and vectorcardiogram were used. QRS-onset was defined from the ECGRMS. T-wave end was defined per individual lead and scalar ECG using an automated tangent method. A median of all T-wave ends was used as the general T-wave end per beat. Supine-standing tests of 73 patients with Long-QT syndrome (LQTS and 54 controls were used because they have wide ranges of RR and QT-intervals as well as changes in T-wave morphology and heart axis orientation. For each subject, automatically estimated QT-intervals in three random complexes chosen from the low, middle and high RR range, were compared with manually measured QT-intervals by three observers.After visual inspection of the randomly selected complexes, 21 complexes were excluded because of evident noise, too flat T-waves or premature ventricular beats. Bland-Altman analyses of automatically and manually determined QT-intervals showed a bias of 0.9 between the algorithm and all observers individually as well as between the algorithm and the mean QT-interval of the observers.Our automated algorithm provides reliable beat-to-beat QT-interval assessment, robust to heart axis and T-wave morphology.

  19. The development and validation of an easy to use automatic QT-interval algorithm.

    Science.gov (United States)

    Hermans, Ben J M; Vink, Arja S; Bennis, Frank C; Filippini, Luc H; Meijborg, Veronique M F; Wilde, Arthur A M; Pison, Laurent; Postema, Pieter G; Delhaas, Tammo

    2017-01-01

    To evaluate QT-interval dynamics in patients and in drug safety analysis, beat-to-beat QT-interval measurements are increasingly used. However, interobserver differences, aberrant T-wave morphologies and changes in heart axis might hamper accurate QT-interval measurements. To develop and validate a QT-interval algorithm robust to heart axis orientation and T-wave morphology that can be applied on a beat-to-beat basis. Additionally to standard ECG leads, the root mean square (ECGRMS), standard deviation and vectorcardiogram were used. QRS-onset was defined from the ECGRMS. T-wave end was defined per individual lead and scalar ECG using an automated tangent method. A median of all T-wave ends was used as the general T-wave end per beat. Supine-standing tests of 73 patients with Long-QT syndrome (LQTS) and 54 controls were used because they have wide ranges of RR and QT-intervals as well as changes in T-wave morphology and heart axis orientation. For each subject, automatically estimated QT-intervals in three random complexes chosen from the low, middle and high RR range, were compared with manually measured QT-intervals by three observers. After visual inspection of the randomly selected complexes, 21 complexes were excluded because of evident noise, too flat T-waves or premature ventricular beats. Bland-Altman analyses of automatically and manually determined QT-intervals showed a bias of 0.9) between the algorithm and all observers individually as well as between the algorithm and the mean QT-interval of the observers. Our automated algorithm provides reliable beat-to-beat QT-interval assessment, robust to heart axis and T-wave morphology.

  20. The development and validation of an easy to use automatic QT-interval algorithm

    Science.gov (United States)

    Vink, Arja S.; Bennis, Frank C.; Filippini, Luc H.; Meijborg, Veronique M. F.; Wilde, Arthur A. M.; Pison, Laurent; Postema, Pieter G.; Delhaas, Tammo

    2017-01-01

    Background To evaluate QT-interval dynamics in patients and in drug safety analysis, beat-to-beat QT-interval measurements are increasingly used. However, interobserver differences, aberrant T-wave morphologies and changes in heart axis might hamper accurate QT-interval measurements. Objective To develop and validate a QT-interval algorithm robust to heart axis orientation and T-wave morphology that can be applied on a beat-to-beat basis. Methods Additionally to standard ECG leads, the root mean square (ECGRMS), standard deviation and vectorcardiogram were used. QRS-onset was defined from the ECGRMS. T-wave end was defined per individual lead and scalar ECG using an automated tangent method. A median of all T-wave ends was used as the general T-wave end per beat. Supine-standing tests of 73 patients with Long-QT syndrome (LQTS) and 54 controls were used because they have wide ranges of RR and QT-intervals as well as changes in T-wave morphology and heart axis orientation. For each subject, automatically estimated QT-intervals in three random complexes chosen from the low, middle and high RR range, were compared with manually measured QT-intervals by three observers. Results After visual inspection of the randomly selected complexes, 21 complexes were excluded because of evident noise, too flat T-waves or premature ventricular beats. Bland-Altman analyses of automatically and manually determined QT-intervals showed a bias of 0.9) between the algorithm and all observers individually as well as between the algorithm and the mean QT-interval of the observers. Conclusion Our automated algorithm provides reliable beat-to-beat QT-interval assessment, robust to heart axis and T-wave morphology. PMID:28863167

  1. A beating heart cell model to predict cardiotoxicity: effects of the dietary supplement ingredients higenamine, phenylethylamine, ephedrine and caffeine.

    Science.gov (United States)

    Calvert, Richard; Vohra, Sanah; Ferguson, Martine; Wiesenfeld, Paddy

    2015-04-01

    Some dietary supplements may contain cardiac stimulants and potential cardiotoxins. In vitro studies may identify ingredients of concern. A beating human cardiomyocyte cell line was used to evaluate cellular effects following phenylethylamine (PEA), higenamine, ephedrine or caffeine treatment. PEA and higenamine exposure levels simulated published blood levels in humans or animals after intravenous administration. Ephedrine and caffeine levels approximated published blood levels following human oral intake. At low or midrange levels, each chemical was examined plus or minus 50 µM caffeine, simulating human blood levels reported after consumption of caffeine-enriched dietary supplements. To measure beats per minute (BPM), peak width, etc., rhythmic rise and fall in intracellular calcium levels following 30 min of treatment was examined. Higenamine 31.3 ng/ml or 313 ng/ml significantly increased BPM in an escalating manner. PEA increased BPM at 0.8 and 8 µg/ml, while 80 µg/ml PEA reduced BPM and widened peaks. Ephedrine produced a significant BPM dose response from 0.5 to 5.0 µM. Caffeine increased BPM only at a toxic level of 250 µM. Adding caffeine to PEA or higenamine but not ephedrine further increased BPM. These in vitro results suggest that additional testing may be warranted in vivo to further evaluate these effects. Published by Elsevier Ltd.

  2. Associations of BMI and its fat-free and fat components with blood lipids in children: Project HeartBeat!

    Science.gov (United States)

    Dai, Shifan; Eissa, Mona A; Steffen, Lyn M; Fulton, Janet E; Harrist, Ronald B; Labarthe, Darwin R

    2011-04-01

    AIM: This study aimed to distinguish between the roles of the two components of BMI, the fat mass (FM) index and the fat-free mass (FFM) index, in BMI's association with blood lipids in children and adolescents. METHODS: A total of 678 children (49.1% female, 79.9% non-black), initially aged 8, 11 and 14 years, were followed at 4-month intervals for up to 4 years (1991-1995). Total cholesterol (TC), LDL-C, HDL-C and triglycerides were determined in fasting blood samples. FFM index and FM index were calculated as FFM (kg)/height (m)(2) and FM (kg)/height (m)(2), respectively. Using a multilevel linear model, repeated measurements of blood lipids were regressed on concurrent measures of BMI or its components, adjusting for age, sex and race and, in a subsample, also for physical activity, energy intake and sexual maturity. RESULTS: Estimated regression coefficients for the relations of TC with BMI, FFM index and FM index were 1.539, -0.606 (p > 0.05) and 3.649, respectively. When FFM index and FM index were entered into the TC model simultaneously, regression coefficients were -0.855 and 3.743, respectively. An increase in BMI was related to an increase in TC; however, an equivalent increase in FM index was related to a greater increase in TC and, when FFM index was tested alone or with FM index, an increase in FFM index was related to a decrease in TC. Similar results were observed for LDL-C. FFM index and FM index were both inversely related to HDL-C and directly to triglycerides. Compared with FFM index, the equivalent increase in FM index showed a greater decrease in HDL-C. CONCLUSION: Greater BMI was related to adverse levels of blood lipids in children and adolescents, which was mainly attributable to BMI's fat component. It is important to identify weight management strategies to halt the childhood obesity epidemic and subsequently prevent heart disease in adulthood.

  3. CHANGES IN HEART RATE, HEART RATE VARIABILITY AND QT INTERVAL IN WOMEN WITH RHEUMATOID ARTHRITIS DURING RITUXIMAB TREATMENT

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA is a proven high cardiovascular risk disease. High heart rate (HR, lower heart rate variabil- ity (HRV, and increased QT interval are considered as predictors of cardiovascular events in patients with coronary heart disease, chronic heart failure, and diabetes mellitus. In RA, there is a pronounced rise in HR, a reduction in HRV, and an increase in QT interval mainly due to the factors reflecting the severity of the disease. Rituximab (RTM is successfully used to treat patients with high RA activity. At the same time there are only a few pieces of evidence for the effect of the drug on the cardiovascular system. Objective: to study changes in HR, HRV, and QT interval values obtained during electrocardiography (ECG Holter monitoring (ECG HM in RTM-treated women during a 6-month follow-up. Subjects and methods: The investigation enrolled 55 women (mean age 50 years with a definite diagnosis of RA and its high activity. The patients were examined 6 months after administration of RTM. The latter was infused intra- venously twice (500 and 1000 mg in 22% and 78% of the patients, respectively during therapy with disease-modifying antirheumatic and non-steroidal anti-inflammatory drugs and glucocorticoids. The RA patients were divided into two groups: 1 a satisfactory/good effect of RTM according to the EULAR criteria (n = 41; 2 no effect (n = 14. Analysis of 24-hour ECG HM yielded the values of HR and mean duration of corrected QT interval (QTc. The tim- ing HRV values obtained at ECG HM were standardized from age and mean HR (SDNNn, RMSSDn, and pNN50n. Results. The baseline HRmin and HRmean values were higher and SDNNn was lower in the RA patients in Group 1 than those in Group 2 (p < 0.05. In Group 1, RTM therapy was accompanied by a reduction in HRmean and HRmin by 8% and by an increase in SDNNn by 3%, RMSSDn by 26%, and pNN50n by 33% whereas no significant changes in HR and HRV were found in Group 2. The RTM therapy

  4. Autonomic nerve activity and the short-term variability of the Tpeak-Tend interval in dogs with pacing-induced heart failure.

    Science.gov (United States)

    Piccirillo, Gianfranco; Magrì, Damiano; Pappadà, Maria A; Maruotti, Antonello; Ogawa, Masahiro; Han, Seongwook; Joung, Boyoung; Rossi, Pietro; Nguyen, Bich Lien; Lin, Shien-Fong; Chen, Peng-Sheng

    2012-12-01

    In congestive heart failure (CHF), autonomic nervous system (ANS) activity is known to modulate arrhythmic risk through its effects on myocardial repolarization. An increased interval between the peak and the end of the T wave (T(peak)-T(end)) has been reported to increase the incidence of sudden cardiac death. However, the ANS influence on the T(peak)-T(end) interval remains unclear. We directly measured ANS nerve activity in ambulatory dogs with pacing-induced CHF to test the hypothesis that ANS activity modulates the T(peak)-T(end) variability index (T(peak)-T(end)VI), the short-term variability of the T(peak)-T(end) interval obtained on 30 beats (T(peak)-T(end)STV(30)), and the short-term variability of the T(peak)-T(end) interval obtained on 5-minute ECG recording (T(peak)-T(end)STV(T)). By using data previously recorded in 6 ambulatory dogs before and after pacing-induced CHF, we assessed ANS activity recorded with an implanted radiotransmitter that monitored integrated left stellate ganglion nervous activity (iSGNA), integrated vagus nerve activity (iVNA), and electrocardiogram (ECG). We selected for analysis 36 segments recorded at baseline and 36 after pacing-induced CHF with similar iSGNA. During CHF, T(peak)-T(end)STV(30) (PCHF: β 1.13, PCHF: β-1.42, PCHF, iSGNA correlates positively while iVNA correlates negatively with T(peak)-T(end)STV(T). These findings suggest that SGNA increases while VNA decreases the dispersion of ventricular repolarization in ambulatory dogs with CHF. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  5. Beat Dreams?

    DEFF Research Database (Denmark)

    Sørensen, Bent

    2009-01-01

    Two of the founding members of the Beat Generation of the 1950s wrote dream books with almost identical titles: Jack Kerouac's Book of Dreams (1961) and William Burroughs' My Education: A Book of Dreams (1995). This paper queries the function of such dream books, both from a perspective of seeing...... dream writing as a confessional genre, and from the perspective of didacticism implicit in sharing one's dream life with one's readers. What role does memory, politics, fantasies and reality play in communicating with and via dreams?...

  6. Effects of the triazolopyrimidine trapidil on force of contraction, beating frequency and phosphodiesterase I--IV activity in guinea-pig hearts.

    Science.gov (United States)

    Bethke, T; Mehl, H; Meyer, W; Schmitz, W; Scholz, H; Thomas, K; Wenzlaff, H

    1991-05-01

    The effects of the triazolopyrimidine trapidil (5-methyl-7-diethylamino-s-triazolo [1,5-alpha]pyrimidine, CAS 15421-84-8) on force of contraction, beating frequency and phosphodiesterase (PDE) activity were investigated in isolated preparations from guinea-pig hearts. The effects of 3-isobutyl-1-methylxanthine (IBMX), theophylline and milrinone were studied for comparison. Trapidil exerted a concentration-dependent (1000-3000 mumol(s)/l) positive inotropic effect (EC50 562.4 mumol(s)/l) in guinea-pig papillary muscles. The positive inotropic effect was accompanied by a shortening of the duration of contraction as described for IBMX, or isoprenaline. The efficacy of trapidil was lower than that of IBMX or milrinone. Both agents maximally enhanced force of contraction to a 3fold (milrinone) or even 6fold greater amount (IBMX). The potency of trapidil was almost in the same order of magnitude as that of milrinone. The positive inotropic effect of trapidil is at least partially due to a cyclic adenosine monophosphate (cAMP)-dependent mechanism because carbachol antagonized the increase in force of contraction. Trapidil concentration-dependently but nonselectively inhibited the activities of cAMP PDE isoenzymes I-IV as did theophylline or IBMX. Based on IC50 values (275 mumol(s)/l on the average) trapidil had a potency similar to that of theophylline while IBMX was about one order of magnitude more potent. Regarding the inhibition of PDE III, IBMX was 49fold and milrinone 114fold more potent than trapidil. Trapidil revealed only a marginal positive chronotropic effect. The frequency of spontaneously beating right auricles was increased by 13% at most. Trapidil did not produce any tachyarrhythmias or contractures. It is concluded that the positive inotropic effect of trapidil is mainly due to PDE inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Relation between QT and RR intervals is highly individual among healthy subjects: implications for heart rate correction of the QT interval.

    Science.gov (United States)

    Malik, M; Färbom, P; Batchvarov, V; Hnatkova, K; Camm, A J

    2002-03-01

    To compare the QT/RR relation in healthy subjects in order to investigate the differences in optimum heart rate correction of the QT interval. 50 healthy volunteers (25 women, mean age 33.6 (9.5) years, range 19-59 years) took part. Each subject underwent serial 12 lead electrocardiographic monitoring over 24 hours with a 10 second ECG obtained every two minutes. QT intervals and heart rates were measured automatically. In each subject, the QT/RR relation was modelled using six generic regressions, including a linear model (QT = beta + alpha x RR), a hyperbolic model (QT = beta + alpha/RR), and a parabolic model (QT = beta x RR(alpha)). For each model, the parallelism and identity of the regression lines in separate subjects were statistically tested. The patterns of the QT/RR relation were very different among subjects. Regardless of the generic form of the regression model, highly significant differences were found not only between the regression lines but also between their slopes. For instance, with the linear model, the individual slope (parameter alpha) of any subject differed highly significantly (p Conversion of the QT/RR regressions to QTc heart rate correction also showed substantial intersubject differences. Optimisation of the formula QTc = QT/RR(alpha) led to individual values of alpha ranging from 0.234 to 0.486. The QT/RR relation exhibits a very substantial intersubject variability in healthy volunteers. The hypothesis underlying each prospective heart rate correction formula that a "physiological" QT/RR relation exists that can be mathematically described and applied to all people is incorrect. Any general heart rate correction formula can be used only for very approximate clinical assessment of the QTc interval over a narrow window of resting heart rates. For detailed precise studies of the QTc interval (for example, drug induced QT interval prolongation), the individual QT/RR relation has to be taken into account.

  8. A System for 3D Ultrasound-Guided Robotic Retrieval of Foreign Bodies from a Beating Heart

    NARCIS (Netherlands)

    Thienphrapa, P.; Ramachandran, B.; Taylor, R.H.T.; Popovic, A.

    2012-01-01

    By way of the venous system or direct penetration, particles such asthrombi, bullet fragments, and shrapnel can become trapped in the heart and disrupt cardiac function. The severity of disruption can range from asymptomatic to fatal. Injuries of this nature are common in both civilian and military

  9. Intra-Aortic Balloon Pump Support in the Isolated Beating Porcine Heart in Nonischemic and Ischemic Pump Failure.

    Science.gov (United States)

    Schampaert, Stéphanie; van Nunen, Lokien X; Pijls, Nico H J; Rutten, Marcel C M; van Tuijl, Sjoerd; van de Vosse, Frans N; van 't Veer, Marcel

    2015-11-01

    The blood pressure changes induced by the intra-aortic balloon pump (IABP) are expected to create clinical improvement in terms of coronary perfusion and myocardial oxygen consumption. However, the measured effects reported in literature are inconsistent. The aim of this study was to investigate the influence of ischemia on IABP efficacy in healthy hearts and in shock. Twelve slaughterhouse porcine hearts (hearts 1-12) were connected to an external circulatory system, while physiologic cardiac performance was restored. Different clinical scenarios, ranging from healthy to cardiogenic shock, were simulated by step-wise administration of negative inotropic drugs. In hearts 7-12, severe global myocardial ischemia superimposed upon the decreased contractile states was created. IABP support was applied in all hearts under all conditions. Without ischemia, the IABP induced a mild increase in coronary blood flow and cardiac output. These effects were strongly augmented in the presence of persisting ischemia, where coronary blood flow increased by 49 ± 24% (P < 0.01) and cardiac output by 17 ± 6% (P < 0.01) in case of severe pump failure. As expected, myocardial oxygen consumption increased in case of ischemia (21 ± 17%; P < 0.01), while it slightly decreased without (-3 ± 6%; P < 0.01). In case of progressive pump failure due to persistent myocardial ischemia, the IABP increased hyperemic coronary blood flow and cardiac output significantly, and reversed the progressive hemodynamic deterioration within minutes. This suggests that IABP therapy in acute myocardial infarction is most effective in patients with viable myocardium, suffering from persistent myocardial ischemia, despite adequate epicardial reperfusion. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  10. Home-based interval training increases endurance capacity in adults with complex congenital heart disease.

    Science.gov (United States)

    Sandberg, Camilla; Hedström, Magnus; Wadell, Karin; Dellborg, Mikael; Ahnfelt, Anders; Zetterström, Anna-Klara; Öhrn, Amanda; Johansson, Bengt

    2017-12-04

    The beneficial effects of exercise training in acquired heart failure and coronary artery disease are well known and have been implemented in current treatment guidelines. Knowledge on appropriate exercise training regimes for adults with congenital heart disease is limited, thus further studies are needed. The aim of this study was to examine the effect of home-based interval exercise training on maximal endurance capacity and peak exercise capacity. Randomized controlled trial. Twenty-six adults with complex congenital heart disease were recruited from specialized units for adult congenital heart disease. Patients were randomized to either an intervention group-12 weeks of home-based interval exercise training on a cycle ergometer (n = 16), or a control group (n = 10). The latter was instructed to maintain their habitual physical activities. An incremental cardiopulmonary exercise test and a constant work rate cardiopulmonary exercise test at 75% of peak workload were performed preintervention and postintervention. Twenty-three patients completed the protocol and were followed (intervention n = 13, control n = 10). Postintervention exercise time at constant work rate cardiopulmonary exercise test increased in the intervention group compared to controls (median[range] 12[-4 to 52]min vs 0[-4 to 5]min, P = .001). At incremental cardiopulmonary exercise test, peak VO2 increased 15% within the intervention group (P = .019) compared to 2% within the control group (P = .8). However, in comparison between the groups no difference was found (285[-200 to 535] ml/min vs 17[-380 to 306] ml/min, P = .10). In addition, peak workload at incremental cardiopulmonary exercise test increased in the intervention group compared to controls (20[-10 to 70]W vs 0[-20 to 15]W, P = .003). Home-based interval exercise training increased endurance capacity and peak exercise capacity in adults with complex congenital heart disease. Aerobic endurance might

  11. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane

    2017-01-01

    BACKGROUND: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial...... ventricular end-diastolic diameter from baseline to 12 weeks. RESULTS: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left...

  12. Assessment of left-atrial strain parameters in patients with frequent ventricular ectopic beats without structural heart disease.

    Science.gov (United States)

    Barutçu, Ahmet; Gazi, Emine; Temiz, Ahmet; Bekler, Adem; Altun, Burak; Kırılmaz, Bahadır; Küçük, Uğur

    2014-08-01

    Ventricular ectopic beats (VEBs) are often encountered in daily clinical practice. Clinical significance of VEBs seen in patients without structural cardiovascular diseases is controversial. We aimed to investigate the effects of VEBs on left atrium (LA) function using speckle tracking echocardiography with LA strain parameters. Patients with frequent VEBs (more than 30 times in 1 h, according to the Lown classification) were identified. Identified patients were evaluated by speckle tracking methods. There were 40 patients with frequent VEBs and 40 controls in our study. The general characteristics were similar of the study population. The LA global longitudinal strain parameters were significantly different. Global Peak atrial longitudinal strain (PALS) (38.39 ± 7.93 vs. 44.15 ± 6.71, p = 0.001) and peak atrial contraction strain (PACS) (16.37 ± 4.58 vs. 20.49 ± 3.65, p = 0.000) were revealed significantly lower in the VEBs group. Time to peak longitudinal strain (TPLS) was found significantly longer in the VEBs group [485.5 (352-641) vs. 435 (339-516.5) p = 0.000]. Number of VEBS was correlated with TPLS (r = 0.499, p = 0.000). PALS and PACS were negatively correlated with number of VEBs (r = -0.348, p = 0.002 and r = -0.444, p = 0.000, respectively). We described that in this study, The LA functions are affected by VEBs adversely. This deterioration is increasing as the number of VEBs.

  13. Determination of aortic valve opening time and left ventricular peak filling rate from the peripheral pulse amplitude in patients with ectopic beats.

    Science.gov (United States)

    Zheng, Dingchang; Allen, John; Murray, Alan

    2008-12-01

    Ectopic beats are common in patients who have heart disease and are associated with reduced peripheral pulse amplitude. This study determined the start of the peripheral pulse increase and from it the opening of the aortic valve. The left ventricular peak filling rate was also estimated from the peripheral pulse. Results were compared with published invasive and cardiac imaging data. Twenty-five subjects with ectopic beat electrocardiograms (ECGs) were studied. The ECGs and the peripheral pulses, detected optically at the right index finger by a simple photoplethysmography (PPG) technique, were recorded for subsequent analysis. Peripheral pulse amplitudes for ectopic beats, post-ectopic sinus beats and normal sinus beats were determined. Ectopic beats induced a mean 68% decrease in pulse amplitude in comparison with sinus beats (p ectopic sinus beats increased by 20% (p ectopic beats and post-ectopic sinus beats. The range of shortest coupling interval (CI) for ectopic beats with observable pulses was from 373 to 531 ms, with the mean value equivalent to 55% of the mean sinus RR interval, comparable with the opening of the aortic valve. Finally, as the CI increased, the pulse amplitude increased quickly from zero. The average rate of increase was equivalent to 4.8 times the normal sinus amplitude in 1 s, equal to 50% filling in 208 ms, showing diastolic rapid filling, comparable with published left ventricular peak filling rate data. In conclusion, the effect of ectopic beat CI on peripheral pulse amplitude has been determined, providing useful information for developing a technique to determine the opening of the aortic valve and the peak filling rate non-invasively and peripherally in patients with frequent ectopic beats.

  14. The analysis of QT interval and repolarization morphology of the heart in chronic exposure to lead.

    Science.gov (United States)

    Kiełtucki, J; Dobrakowski, M; Pawlas, N; Średniawa, B; Boroń, M; Kasperczyk, S

    2017-10-01

    There are no common recommendations regarding electrocardiographic monitoring in occupationally exposed workers. Therefore, the present study was designed to investigate whether exposure to lead results in an increase of selected electrocardiography (ECG) pathologies, such as QT interval prolongation and repolarization disorders, in occupationally exposed workers. The study group included 180 workers occupationally exposed to lead compounds. The exposed group was divided according to the median of the mean blood lead level (PbBmean) calculated based on a series of measurements performed during 5-year observation period (35 µg/dl) into two subgroups: low exposure (LE, PbBmean = 20.0-35.0 µg/dl) and high exposure (HE, PbBmean = 35.1-46.4 µg/dl). The control group consisted of 69 healthy workers without occupational exposure to lead. ECG evaluation included the analysis of heart rate (HR), QT interval and repolarization abnormalities. Mean QT interval was significantly greater in the exposed population than in the control group by 2%. In the HE group, mean QT interval was significantly greater than in the control group by 4% and significantly different from those noted in the LE group. Positive correlations between QT interval and lead exposure indices were also reported. Besides, there was a negative correlation between HR and blood lead level. Increased concentration of lead in the blood above 35 μg/dl is associated with the QT interval prolongation, which may trigger arrhythmias when combined with other abnormalities, such as long QT syndrome. Therefore, electrocardiographic evaluation should be a part of a routine monitoring of occupationally exposed populations.

  15. Ectopic beats in approximate entropy and sample entropy-based HRV assessment

    Science.gov (United States)

    Singh, Butta; Singh, Dilbag; Jaryal, A. K.; Deepak, K. K.

    2012-05-01

    Approximate entropy (ApEn) and sample entropy (SampEn) are the promising techniques for extracting complex characteristics of cardiovascular variability. Ectopic beats, originating from other than the normal site, are the artefacts contributing a serious limitation to heart rate variability (HRV) analysis. The approaches like deletion and interpolation are currently in use to eliminate the bias produced by ectopic beats. In this study, normal R-R interval time series of 10 healthy and 10 acute myocardial infarction (AMI) patients were analysed by inserting artificial ectopic beats. Then the effects of ectopic beats editing by deletion, degree-zero and degree-one interpolation on ApEn and SampEn have been assessed. Ectopic beats addition (even 2%) led to reduced complexity, resulting in decreased ApEn and SampEn of both healthy and AMI patient data. This reduction has been found to be dependent on level of ectopic beats. Editing of ectopic beats by interpolation degree-one method is found to be superior to other methods.

  16. Beating Depression …Help Is Available

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Beating Depression …Help Is Available Past Issues / Summer 2007 Table ... treatments are available from your physician. Types of Depression Just like other illnesses, such as heart disease, ...

  17. Evaluation of Prolonged QT Interval: Structural Heart Disease Mimicking Long QT Syndrome.

    Science.gov (United States)

    Weissler-Snir, Adaya; Gollob, Michael H; Chauhan, Vijay; Care, Melanie; Spears, Danna A

    2017-04-01

    In about 20-25% of patients with congenital long QT syndrome (LQTS) a causative pathogenic mutation is not found. The aim of this study was to explore the prevalence of alternative cardiac diagnoses among patients exhibiting prolongation of QT interval with negative genetic testing for LQTS genes. We conducted a retrospective analysis of 239 consecutive patients who were evaluated in the inherited arrhythmia clinic at the Toronto General Hospital between July 2013 and December 2015 for possible LQTS. A detailed review of the patients' charts, electrocardiograms, and imaging was carried out. The analysis included 56 gene-negative patients and 61 gene-positive patients. Of the gene-negative group, 25% had structural heart disease compared to only 1.6% of gene-positive patients (P < 0.001). Structural heart disease was more likely if only one abnormal QTc parameter was found in the course of the evaluation (35.2% vs 9.1%, P = 0.01). The most common structural cardiac pathology was bileaflet mitral valve prolapse (8.9%). No gene-positive patient had episodes of nonsustained ventricular tachycardia, compared to seven of the gene-negative patients (0% vs 12.5%, P = 0.005). Structural pathology was detected in a quarter of gene-negative patients evaluated for possible LQTS. Hence, cardiac imaging and Holter monitoring should be strongly encouraged to rule out structural heart disease in this population. © 2017 Wiley Periodicals, Inc.

  18. Heart Rate Fragmentation: A New Approach to the Analysis of Cardiac Interbeat Interval Dynamics.

    Science.gov (United States)

    Costa, Madalena D; Davis, Roger B; Goldberger, Ary L

    2017-01-01

    Background: Short-term heart rate variability (HRV) is most commonly attributed to physiologic vagal tone modulation. However, with aging and cardiovascular disease, the emergence of high short-term HRV, consistent with the breakdown of the neuroautonomic-electrophysiologic control system, may confound traditional HRV analysis. An apparent dynamical signature of such anomalous short-term HRV is frequent changes in heart rate acceleration sign, defined here as heart rate fragmentation. Objective: The aims were to: (1) introduce a set of metrics designed to probe the degree of sinus rhythm fragmentation; (2) test the hypothesis that the degree of fragmentation of heartbeat time series increases with the participants' age in a group of healthy subjects; (3) test the hypothesis that the heartbeat time series from patients with advanced coronary artery disease (CAD) are more fragmented than those from healthy subjects; and (4) compare the performance of the new fragmentation metrics with standard time and frequency domain measures of short-term HRV. Methods: We analyzed annotated, open-access Holter recordings (University of Rochester Holter Warehouse) from healthy subjects and patients with CAD using these newly introduced metrics of heart rate fragmentation, as well as standard time and frequency domain indices of short-term HRV, detrended fluctuation analysis and sample entropy. Results: The degree of fragmentation of cardiac interbeat interval time series increased significantly as a function of age in the healthy population as well as in patients with CAD. Fragmentation was higher for the patients with CAD than the healthy subjects. Heart rate fragmentation metrics outperformed traditional short-term HRV indices, as well as two widely used nonlinear measures, sample entropy and detrended fluctuation analysis short-term exponent, in distinguishing healthy subjects and patients with CAD. The same level of discrimination was obtained from the analysis of normal

  19. Tp-Te interval predicts heart rate reduction after fingolimod administration in patients with multiple sclerosis.

    Science.gov (United States)

    Tocci, Giuliano; Giuliani, Manuela; Canichella, Flaminia; Timpano, Jacopo; Presta, Vivianne; Francia, Pietro; Musumeci, Maria Beatrice; Fubelli, Federica; Pozzilli, Carlo; Volpe, Massimo; Ferrucci, Andrea

    2016-10-15

    FTY720 (Fingolimod) is an immunosuppressive drug, which provides favourable effects in patients with multiple sclerosis (MS), albeit it induces heart rate (HR) and blood pressure (BP) reductions. Therefore, we tested potential factors able to predict HR response in MS patients treated with fingolimod. We analysed patients with MS followed at our Neurology Outpatient Clinic from May 2013 to June 2015. All patients underwent BP measurements and 12-lead ECG before and 6-h after drug administration. At these time intervals, conventional and new ECG indexes for cardiac damage, including Tp-Te interval, were measured. Univariate and multivariate analyses were performed to test the outcome of HR reduction more than median difference between baseline and final observations. 69 outpatients with MS (46 males, age 35.1±9.4years, BP 119.0±12.7/73.0±9.3mmHg, HR 73.5±11.4bpm) were included. No relevant adverse reactions were reported. Fingolimod induced progressive systolic (P=0.024) and diastolic (PTe (1.8±0.3 vs. 1.9±0.3mm; P=0.021), and reduced QTc (414.4±24.4 vs. 404.5±24.5ms; PTe intervals provided prognostic information at univariate analysis, although Tp-Te interval resulted the best independent predictor for HR reduction at multivariate analysis [0.057 (0.005-0.660); P=0.022]. This study firstly demonstrates that prolonged Tp-Te interval may identify those MS patients treated with fingolimod at higher risk of having significant, asymptomatic HR reduction during clinical observation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Subnormothermic machine perfusion for non-heart-beating donor liver grafts preservation in a Swine model: a new strategy to increase the donor pool?

    Science.gov (United States)

    Gringeri, E; Bonsignore, P; Bassi, D; D'Amico, F E; Mescoli, C; Polacco, M; Buggio, M; Luisetto, R; Boetto, R; Noaro, G; Ferrigno, A; Boncompagni, E; Freitas, I; Vairetti, M P; Carraro, A; Neri, D; Cillo, U

    2012-09-01

    We previously reported that subnormothermic machine perfusion (sMP; 20°C) is able to improve the preservation of livers obtained from non-heart-beating donors (NHBDs) in rats. We have compared sMP and standard cold storage (CS) to preserve pig livers after 60 minutes of cardiac arrest. In the sMP group livers were perfused for 6 hours with Celsior at 20°C. In the CS group they were stored in Celsior at 4°C for 6 hours as usual. To simulate liver transplantation, both sMP- and CS-preserved livers were reperfused using a mechanical continuous perfusion system with autologus blood for 2 hours at 37°C. At 120 min after reperfusion aspartate aminotransferase levels in sMP versus CS were 499 ± 198 versus 7648 ± 2806 U/L (P < .01); lactate dehydrogenase 1685 ± 418 versus 12998 ± 3039 U/L (P < .01); and lactic acid 4.78 ± 3.02 versus 10.46 ± 1.79 mmol/L (P < .01) respectively. The sMP group showed better histopathologic results with significantly less hepatic damage. This study confirmed that sMP was able to resuscitate liver grafts from large NHBD animals. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives.

    Science.gov (United States)

    Ribeiro, Paula A B; Boidin, Maxime; Juneau, Martin; Nigam, Anil; Gayda, Mathieu

    2017-01-01

    Recently, high-intensity interval training (HIIT) has emerged as an alternative and/or complementary exercise modality to continuous aerobic exercise training (CAET) in CHD patients. However, the literature contains descriptions of many HIIT protocols with different stage durations, nature of recovery and intensities. In this review, we discuss the most recent forms of validated HIIT protocols in patients with coronary heart disease (CHD) and how to prescribe and use them during short- and long-term (phase II and III) cardiac rehabilitation programs. We also compare the superior and/or equivalent short- and long-term effects of HIIT versus CAET on aerobic fitness, cardiovascular function, and quality of life; their efficiency, safety, and tolerance; and exercise adherence. Short interval HIIT was found beneficial for CHD patients with lower aerobic fitness and would ideally be used in initiation and improvement stages. Medium and/or long interval HIIT protocols may be beneficial for CHD patients with higher aerobic fitness, and would be ideally used in the improvement and maintenance stages because of their high physiological stimulus. Finally, we propose progressive individualized models of HIIT programs (phase II to III) for patients with CHD and how to ideally use them according to the clinical status of patients and phase of the cardiac rehabilitation program. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Heritability of QT interval : How much is explained by genes for resting heart rate? Heritability of QT interval: How much is explained by genes for resting heart rate?

    NARCIS (Netherlands)

    Dalageorgou, Chrysoula; Ge, Dongliang; Jamshidi, Yalda; Nolte, Ilja M.; Riese, Harriette; Savelieva, Irina; Carter, Nicholas D.; Spector, Tim D.; Snieder, Harold

    Heritability of QT Interval. Introduction: Objective of this study was to determine the optimal (most heritable) phenotype for gene finding studies of QT interval in the general population. We also studied the extent to which heritability of QT interval can be explained by genes that also influence

  3. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction.

    Science.gov (United States)

    Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

    2017-02-28

    Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT ( P =0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P =0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P =0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake ( P =0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P =0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. URL: http

  4. High-intensity interval exercise improves vagal tone and decreases arrhythmias in chronic heart failure.

    Science.gov (United States)

    Guiraud, Thibaut; Labrunee, Marc; Gaucher-Cazalis, Kevin; Despas, Fabien; Meyer, Philippe; Bosquet, Laurent; Gales, Celine; Vaccaro, Angelica; Bousquet, Marc; Galinier, Michel; Sénard, Jean-Michel; Pathak, Atul

    2013-10-01

    Autonomic dysfunction including sympathetic activation and vagal withdrawal has been reported in patients with chronic heart failure (CHF). We tested the hypotheses that high-intensity interval exercise (HIIE) in CHF patients would enhance vagal modulation and thus decrease arrhythmic events. Eighteen CHF patients underwent a baseline assessment (CON) and were then randomized to a single session of HIIE and to an isocaloric moderate-intensity continuous exercise (MICE). We evaluated the HR, HR variability parameters, and arrhythmic events by 24-h Holter ECG recordings after HIIE, MICE, and CON sessions. We found that HR was significantly decreased after HIIE (68 ± 3 bpm, P CHF patients, leading to significant reductions of HR and arrhythmic events in a 24-h posttraining period. Cardioprotective effects of HIIE in CHF patients need to be confirmed in a larger study population and on a long-term basis.

  5. Experience of a Maastrich type II non heart beating donor program in a small city: preliminary results.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Guerra, C; Lavid, N; Lassalle, M; González-Castro, A; Ballesteros, M A

    2015-10-01

    To study the results of a non-controlled cardiac death (Maastricht type II) donor program in a city of 200,000 inhabitants. The study was initially focused on lung donation and was extended to kidney donation after 9 months. A prospective observational study was conducted between October 2012 and December 2013. The Intensive Care Unit of Marqués de Valdecilla University Hospital in Santander (Spain), and surrounding areas. Patients (< 55 years) who died of out-of-hospital cardiac arrest. All out-of-hospital cardiac arrests were treated with mechanical cardiac compression (LUCAS II). The diagnosis of death and organ preservation were performed in the ICU. A total of 14 calls were received, of which three were discarded. Of the 11 potential donors, 7 were effective donors with a median age of 39.5 years (range: 32-48). A total of 5 single lung transplants and four kidney transplants were performed. In addition, corneas and tissues were harvested. The non-valid donors were rejected mainly due to technical problems. There were no donation refusals on the part of the patient relatives. The lung transplant patient survival rate was 100% after one month and 80% after one year. One month after transplantation, the kidney recipients had a serum creatinine concentration of<2mg/dl. The interval from cardiac arrest to renal preservation was 80minutes (range: 71-89), and the interval from cardiac arrest to lung preservation was 84minutes (range: 77-94). A Maastricht type II donation program in a small city is viable for both abdominal and thoracic organs. The program was initially very cautious, but its potential is easily improvable by increasing donor and by equipping mobile ICU ambulances with mechanical cardiac compression systems. Full management of the donor in the ICU, avoiding the emergency department or operating rooms, reduces the warm ischemia time, thereby improving transplant outcomes. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  6. Exercise training modalities in chronic heart failure: does high intensity aerobic interval training make the difference?

    Science.gov (United States)

    Giallauria, Francesco; Smart, Neil Andrew; Cittadini, Antonio; Vigorito, Carlo

    2016-10-14

    Exercise training (ET) is strongly recommended in patients with chronic heart failure (CHF). Moderate-intensity aerobic continuous ET is the best established training modality in CHF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Basically, HIIT consists of repeated bouts of high-intensity exercise alternated with recovery periods. In CHF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. These results are intriguing, mostly considering that better functional capacity translates into an improvement of symptoms and quality of life. Notably, HIIT did not reveal major safety issues; although CHF patients should be clinically stable, have had recent exposure to at least regular moderate-intensity exercise, and appropriate supervision and monitoring during and after the exercise session are mandatory. The impact of HIIT on cardiac dimensions and function and on endothelial function remains uncertain. HIIT should not replace other training modalities in heart failure but should rather complement them. Combining and tailoring different ET modalities according to each patient's baseline clinical characteristics (i.e. exercise capacity, personal needs, preferences and goals) seem the most astute approach to exercise prescription.

  7. Proarrhythmic electrical remodelling is associated with increased beat-to-beat variability of repolarisation

    DEFF Research Database (Denmark)

    Thomsen, Morten Bækgaard; Oros, Avram; Schoenmakers, Marieke

    2007-01-01

    Acquired long-QT syndrome in combination with increased beat-to-beat variability of repolarisation duration (BVR) is associated with lethal torsades de pointes arrhythmias (TdP) in dogs with remodelled heart after atrioventricular block (AVB). We evaluated the relative contributions of bradycardi...

  8. Current assessment of heart rate variability and QTc interval length in HIV/AIDS.

    Science.gov (United States)

    McIntosh, Roger C; Lobo, Judith D; Hurwitz, Barry E

    2017-11-01

    The increasing prevalence of cardiovascular disease comorbidity in persons infected with the HIV has become a global concern. The electrocardiogram (ECG) is increasingly being utilized to provide clinically relevant information regarding cardiac arrhythmias and cardio-autonomic dysfunction. The purpose of this review is to summarize the latest research comparing QT and R-to-R interval length as a function of HIV+ status or antiretroviral therapy (ART) regimen. Prolongation of the corrected QTc interval may be acquired in HIV+ ART-naive individuals, exacerbated by various classes of ART drugs, and is generally predictive of lethal cardiac arrhythmias, with effects observed from childhood to adulthood. Recent literature also suggests the trend of lower heart rate variability in HIV is indicative of cardiorespiratory and inflammatory-immune dysfunction. These emergent studies support the clinical relevance of the ECG across the age and HIV disease spectrum. Furthermore, the reported findings have implications for the management of cardiovascular and chronic inflammatory disease comorbidity in persons living with HIV.

  9. Effect of remifentanil with and without atropine on heart rate variability and RR interval in children.

    Science.gov (United States)

    Tirel, O; Chanavaz, C; Bansard, J Y; Carré, F; Ecoffey, C; Senhadji, L; Wodey, E

    2005-10-01

    Remifentanil can cause bradycardia either by parasympathetic activation or by other negative chronotropic effects. The high frequency (HF) component of heart rate variability (HRV) is a marker of parasympathetic activity. This study aimed to evaluate the effect of remifentanil on RR interval and on HRV in children. Forty children ASA I or II were studied after approval by the human studies committee and informed parental consent was obtained. After stabilisation at sevoflurane 1 MAC, they were randomly divided into two groups: one received a 20 microg.kg(-1) atropine injection (AT + REMI) and the other ringer lactate solution (REMI). Three minutes later, a 1 microg.kg(-1) bolus of remifentanil was administered over 1 min, followed by a continual infusion at 0.25 microg.kg(-1).min(-1) for 10 min increased to 0.5 microg.kg(-1).min(-1) for a further 10 min. A time varying, autoregressive analysis of RR sequences was used to estimate classical spectral parameters: low (0.04-0.15 Hz; LF) and high (0.15-0.45 Hz; HF) frequency, whereas the root mean square of successive differences of RR intervals (rmssd) was derived directly from the temporal sequence. Statistical analyses were conducted by means of the multiple correspondence analysis and with non parametrical tests. Remifentanil induced an RR interval lengthening, i.e. bradycardia, in both groups compared to pretreatment values and was associated with an increase of HF and rmssd only for the REMI group. The parasympathetic inhibition by atropine did not totally prevent remifentanil's negative chronotropic effect. A direct negative chronotropic effect of remifentanil is proposed.

  10. The effect of perfusion prior to cold preservation and addition of biliverdin on the liver graft from non-heart-beating donors.

    Science.gov (United States)

    Iwane, T; Akamatsu, Y; Narita, T; Nakamura, A; Satomi, S

    2006-12-01

    Our aim was to improve the energy status and viability of a liver graft from a non-heart-beating donor (NHBD), we investigated the effects of perfusion prior to cold preservation and the addition of an antioxidant, biliverdin. Rats were divided into five groups: group 1: without 30 minutes warm ischemia (WI) and cold preservation (control group); group 2 without WI and with 6 hours of cold preservation in UW solution (HBD group); group 3 with WI and cold preservation (NHBD group); group 4 with 30 minutes perfusion prior to cold preservation (PRE group); and group 5 with addition of biliverdin to precold preservation perfusion (BV group). Oxygenated Klebs-Henseleit solution was used as the perfusate prior to and after preservation. Portal flow and bile production during reperfusion, energy charge (EC), ATP level, GOT, and TNF-alpha were measured as well as a histological evaluation. Portal flow of the PRE and BV groups during 1 hour of reperfusion was higher than of that the NHBD group. Bile production of the PRE group was also higher than that of the NHBD group, but bile production in the BV group was comparable to the NHBD group. EC of the PRE group was higher than that of the NHBD group prior to and after reperfusion. The EC and ATP levels of the BV group after reperfusion were higher than those of the NHBD and PRE groups. The GOT and TNF-alpha were reduced in the BV group. Precold preservation perfusion improves the viability of grafts from NHBDs. Furthermore, biliverdin exerted an additive effect to ameliorate energy status.

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

    Science.gov (United States)

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

    2013-01-01

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

  12. Do nonlinearities play a significant role in short term, beat-to-beat variability?

    Science.gov (United States)

    Choi, H. G.; Mukkamala, R.; Moody, G. B.; Mark, R. G.

    2001-01-01

    Numerous studies of short-term beat-to-beat variability in cardiovascular signals have not resolved the debate about the completeness of linear analysis techniques. This aim of this paper is to evaluate further the role of nonlinearities in short-term, beat-to-beat variability. We compared linear autoregressive moving average (ARMA) and nonlinear neural network (NN) models for predicting instantaneous heart rate (HR) and mean arterial blood pressure (BP) from past HR and BP. To evaluate these models, we used HR and BP time series from the MIMIC database. Experimental results indicate that NN-based nonlinearities do not play a significant role and suggest that ARMA linear analysis techniques provide adequate characterization of the system dynamics responsible for generating short-term, beat-to-beat variability.

  13. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training

    OpenAIRE

    Freyssin, Céline; Prieur, Fabrice; Verkindt, Chantal; Benaich, Philippe; Maunier, Sébastien; Blanc, Philippe

    2012-01-01

    International audience; OBJECTIVE: To compare the effects of an 8-week, high-intensity interval training protocol versus continuous training. DESIGN: Randomized controlled trial. SETTING: Cardiac rehabilitation center. PARTICIPANTS: Patients (N=26; mean age ± SD, 54±12y) with chronic heart failure were enrolled in a cardiac rehabilitation program for 8 weeks. INTERVENTIONS: Patients were randomly assigned into 2 groups that performed either interval training (IT) or continuous training (CT). ...

  14. Interval training does not modulate diastolic function in heart transplant recipients

    DEFF Research Database (Denmark)

    Monk-Hansen, Tea; Dall, Christian; Christensen, Stefan B.

    2014-01-01

    Objectives: This study investigates the effect of aerobic interval training on diastolic function at rest and during exercise in stable heart transplant (HTx) recipients. Design: 23 stable HTx recipients (74% males, mean age 50 ±14.9 years) were recruited to a training programme. Intervention was 8...... time decreased by over 50ms, all markers of increased filling pressure. There were no correlations between diastolic function and VO2peak at baseline. After intervention VO2peak increased from 23.9 (±4.5) to 28.3(±6) ml/kg/min in the training group (difference between groups p=0.0018). No consistent...... weeks intensive training or control in a randomized controlled design. Results: At baseline participants had normal or mild diastolic dysfunction at rest. During exercise, mean E/e´ increased from 9.0 (±2.8) to 12.8 (±7.7) (p= 0.09), E/A increased from 2.1 (±0.6) to 2.6 (±0.7) (p=0.02), and deceleration...

  15. Should high-intensity-aerobic interval training become the clinical standard in heart failure?

    Science.gov (United States)

    Arena, Ross; Myers, Jonathan; Forman, Daniel E; Lavie, Carl J; Guazzi, Marco

    2013-01-01

    Aerobic exercise training in the heart failure (HF) population is supported by an extensive body of literature. The clinically accepted model for exercise prescription is currently moderate-intensity-aerobic continuous training (MI-ACT). Documented benefits from the literature include improvements in various aspects of physiologic function, aerobic exercise capacity and quality of life while the impact on morbidity and mortality is promising but requires further investigation. Recently, however, a body of evidence has begun to emerge demonstrating high-intensity-aerobic interval training (HI-AIT) can be performed safely with impressive improvements in physiology, functional capacity and quality of life. These initial findings have led some to question the long-standing clinical approach to aerobic exercise training in patients with HF (i.e., MI-ACT), implying it should perhaps be replaced with a HI-AIT model. This is a potentially controversial paradigm shift given the potential increase in adverse event risk associated with exercising at higher intensities, particularly in the HF population where the likelihood of an untoward episode is already at a heightened state relative to the apparently healthy population. The present review therefore addresses key issues related to HI-AIT in the HF population and makes recommendations for future research and current clinical practice.

  16. Refined multiscale entropy analysis of heart period and QT interval variabilities in long QT syndrome type-1 patients

    OpenAIRE

    Bari, V.; Valencia, Jose Fernando; Vallverdú Ferrer, Montserrat; Girardengo, G.; Bassani, T.; Marchi, A.; Calvillo, L.; Caminal Magrans, Pere; Cerutti, Sergio; Brink, P.A.; Crotti, L.; Schwartz, P.J.; Porta, A.

    2013-01-01

    This study assesses complexity of cardiovascular control in patients affected by type-1 variant of long QT(LQT1) syndrome. Complexity was assessed by refined multiscale entropy of heart period (HP) and QT interval variabilities. HP was taken as the time distance between two consecutive R peaks (RR) and QT interval was approximated as the time distance between the R-peak and T-wave apex (RTa) and between R-peak and T-wave end (RTe). RR, RTa and RTe intervals were automatically extracted from 2...

  17. Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS).

    Science.gov (United States)

    Umeki, Akihide; Nishimura, Takashi; Ando, Masahiko; Takewa, Yoshiaki; Yamazaki, Kenji; Kyo, Shunei; Ono, Minoru; Tsukiya, Tomonori; Mizuno, Toshihide; Taenaka, Yoshiyuki; Tatsumi, Eisuke

    2012-06-01

    There are many reports comparing pulsatile and continuous-flow left ventricular assist devices (LVAD). But continuous-flow LVAD with the pulsatile driving technique had not been tried or discussed before our group's report. We have previously developed and introduced a power-control unit for a centrifugal LVAD (EVAHEART®; Sun Medical), which can change the speed of rotation so it is synchronized with the heart beat. By use of this unit we analyzed the end-diastolic volume (EDV) to determine whether it is possible to change the native heart load. We studied 5 goats with normal hearts and 5 goats with acute LV dysfunction because of micro-embolization of the coronary artery. We used 4 modes, "circuit-clamp", "continuous", "counter-pulse", and "co-pulse", with the bypass rate (BR) 100%. We raised the speed of rotation of the LVAD in the diastolic phase with the counter-pulse mode, and raised it in the systolic phase with the co-pulse mode. As a result, the EDV decreased in the counter-pulse mode and increased in the co-pulse mode, compared with the continuous mode (p < 0.05), in both the normal and acute-heart-failure models. This result means it may be possible to achieve favorable EDV and native heart load by controlling the rotation of continuous-flow LVAD, so it is synchronized with the cardiac beat. This novel driving system may be of great benefit to patients with end-stage heart failure, especially those with ischemic etiology.

  18. Xenon does not increase heart rate-corrected cardiac QT interval in volunteers and in patients free of cardiovascular disease.

    Science.gov (United States)

    Neukirchen, Martin; Schaefer, Maximilian S; Kern, Carolin; Brett, Sarah; Werdehausen, Robert; Rellecke, Philipp; Reyle-Hahn, Matthias; Kienbaum, Peter

    2015-09-01

    Impaired cardiac repolarization, indicated by prolonged QT interval, may cause critical ventricular arrhythmias. Many anesthetics increase the QT interval by blockade of rapidly acting potassium rectifier channels. Although xenon does not affect these channels in isolated cardiomyocytes, the authors hypothesized that xenon increases the QT interval by direct and/or indirect sympathomimetic effects. Thus, the authors tested the hypothesis that xenon alters the heart rate-corrected cardiac QT (QTc) interval in anesthetic concentrations. The effect of xenon on the QTc interval was evaluated in eight healthy volunteers and in 35 patients undergoing abdominal or trauma surgery. The QTc interval was recorded on subjects in awake state, after their denitrogenation, and during xenon monoanesthesia (FetXe > 0.65). In patients, the QTc interval was recorded while awake, after anesthesia induction with propofol and remifentanil, and during steady state of xenon/remifentanil anesthesia (FetXe > 0.65). The QTc interval was determined from three consecutive cardiac intervals on electrocardiogram printouts in a blinded manner and corrected with Bazett formula. In healthy volunteers, xenon did not alter the QTc interval (mean difference: +0.11 ms [95% CI, -22.4 to 22.7]). In patients, after anesthesia induction with propofol/remifentanil, no alteration of QTc interval was noted. After propofol was replaced with xenon, the QTc interval remained unaffected (417 ± 32 ms vs. awake: 414 ± 25 ms) with a mean difference of 4.4 ms (95% CI, -4.6 to 13.5). Xenon monoanesthesia in healthy volunteers and xenon/remifentanil anesthesia in patients without clinically relevant cardiovascular disease do not increase QTc interval.

  19. Beat-to-Beat Blood Pressure Monitor

    Science.gov (United States)

    Lee, Yong Jin

    2012-01-01

    This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes.

  20. Interval training early after heart failure decompensation is safe and improves exercise tolerance and quality of life in selected patients.

    Science.gov (United States)

    Doletsky, Artem; Andreev, Denis; Giverts, Ilya; Svet, Alexey; Brand, Anna; Kuklina, Maria; Sedov, Vsevolod; Dikur, Oxana; Syrkin, Abram; Saner, Hugo

    2017-01-01

    Aims To evaluate safety and efficacy of moderate intensity interval exercise training early after heart failure decompensation on exercise tolerance and health-related quality of life (HRQoL). Methods and results This is a prospective randomized controlled study. We screened 234 consecutive patients admitted with decompensated heart failure; 46 patients (42 men/4 women; 61 ± 12 years of age) were randomized to a moderate intensity aerobic interval training ( n = 24) or to a control group ( n = 22). Patients underwent cardiopulmonary exercise testing, echocardiography and Minnesota Living with Heart Failure questionnaire (MLHFQ) at baseline, after three weeks and after three months. After three weeks, peak-VO2 increased by 17% in the training group ( p = 0.003) with further increase by 10% after three months ( p training group (from 64.6 ± 15.6 to 30.8 ± 12.9, p training group, but not in controls. Left ventricular ejection fraction was not significantly different between the two groups at baseline and after three months. No serious adverse events related to exercise testing or training were observed. Conclusions Interval exercise training early after an episode of heart failure decompensation is safe and effective in improving exercise tolerance and health-related quality of life in selected patients after achievement of clinical stability. Positive effects remained sustained after three months. Further studies are needed to define role and indications for interval exercise training early after heart failure decompensation.

  1. Effects of anti-malarial drugs on the electrocardiographic QT interval modelled in the isolated perfused guinea pig heart system

    Directory of Open Access Journals (Sweden)

    Kotaki Hajime

    2010-11-01

    Full Text Available Abstract Background Concern over the potential cardiotoxicity of anti-malarial drugs inducing a prolonged electrocardiographic QT interval has resulted in the almost complete withdrawal from the market of one anti-malarial drug - halofantrine. The effects on the QT interval of four anti-malarial drugs were examined, using the guinea pig heart. Methods The guinea pig heart was isolated, mounted on a Langendorff apparatus, and was then perfused with pyruvate-added Klebs-Henseleit solutions containing graded concentrations of the four agents such as quinidine (0.15 - 1.2 μM, quinine (0.3 - 2.4 μM, halofantrine (0.1 - 2.0 μM and mefloquine (0.1 - 2.0 μM. The heart rate-corrected QaTc intervals were measured to evaluate drug-induced QT prolongation effects. Results Quinidine, quinine, and halofantrine prolonged the QaTc interval in a dose-dependent manner, whereas no such effect was found with mefloquine. The EC50 values for the QaTc prolongation effects, the concentration that gives a half-maximum effect, were quinidine Conclusions In this study, an isolated, perfused guinea pig heart system was constructed to assess the cardiotoxic potential of anti-malarial drugs. This isolated perfused guinea pig heart system could be used to test newly developed anti-malarial drugs for their inherent QT lengthening potential. More information is required on the potential variation in unbound drug concentrations in humans, and their role in cardiotoxicity.

  2. Heart bypass surgery - discharge

    Science.gov (United States)

    Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery ...

  3. What makes a rhythm complex? The influence of musical training and accent type on beat perception

    Science.gov (United States)

    Burgoyne, J. Ashley; Odijk, Daan; Honing, Henkjan; Grahn, Jessica A.

    2018-01-01

    Perception of a regular beat in music is inferred from different types of accents. For example, increases in loudness cause intensity accents, and the grouping of time intervals in a rhythm creates temporal accents. Accents are expected to occur on the beat: when accents are “missing” on the beat, the beat is more difficult to find. However, it is unclear whether accents occurring off the beat alter beat perception similarly to missing accents on the beat. Moreover, no one has examined whether intensity accents influence beat perception more or less strongly than temporal accents, nor how musical expertise affects sensitivity to each type of accent. In two experiments, we obtained ratings of difficulty in finding the beat in rhythms with either temporal or intensity accents, and which varied in the number of accents on the beat as well as the number of accents off the beat. In both experiments, the occurrence of accents on the beat facilitated beat detection more in musical experts than in musical novices. In addition, the number of accents on the beat affected beat finding more in rhythms with temporal accents than in rhythms with intensity accents. The effect of accents off the beat was much weaker than the effect of accents on the beat and appeared to depend on musical expertise, as well as on the number of accents on the beat: when many accents on the beat are missing, beat perception is quite difficult, and adding accents off the beat may not reduce beat perception further. Overall, the different types of accents were processed qualitatively differently, depending on musical expertise. Therefore, these findings indicate the importance of designing ecologically valid stimuli when testing beat perception in musical novices, who may need different types of accent information than musical experts to be able to find a beat. Furthermore, our findings stress the importance of carefully designing rhythms for social and clinical applications of beat perception, as

  4. Entropy Analysis of RR and QT Interval Variability during Orthostatic and Mental Stress in Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Mathias Baumert

    2014-12-01

    Full Text Available Autonomic activity affects beat-to-beat variability of heart rate and QT interval. The aim of this study was to explore whether entropy measures are suitable to detect changes in neural outflow to the heart elicited by two different stress paradigms. We recorded short-term ECG in 11 normal subjects during an experimental protocol that involved head-up tilt and mental arithmetic stress and computed sample entropy, cross-sample entropy and causal interactions based on conditional entropy from RR and QT interval time series. Head-up tilt resulted in a significant reduction in sample entropy of RR intervals and cross-sample entropy, while mental arithmetic stress resulted in a significant reduction in coupling directed from RR to QT. In conclusion, measures of entropy are suitable to detect changes in neural outflow to the heart and decoupling of repolarisation variability from heart rate variability elicited by orthostatic or mental arithmetic stress.

  5. The effects of inhaled nitric oxide, gabexate mesilate, and retrograde flush in the lung graft from non-heart beating minipig donors.

    Science.gov (United States)

    Luh, S P; Tsai, C C; Shau, W Y; Chen, J S; Kuo, S H; Lin-Shiau, S Y; Lee, Y C

    2000-05-27

    The use of lung grafts from non-heart-beating donors (NHBD) is one way of solving the donor organ shortage problem. In this experiment, we studied the effect of retrograde flush (RF) from the left atrium before harvest, inhaled nitric oxide (NO), and gabexate mesilate (FOY), a protease inhibitor, in the lung grafts from NHBD. Forty-eight Lee-Sung, small-ear, miniature pigs (15-20 kg) were divided into 24 pairs (donor and recipient) and four groups. The donor lungs were flushed and harvested 90 min after cardiac arrest. No i.v. heparin was administered until the time before flush and harvest. Left single lung transplantation was undertaken, and the recipients were observed for 18 hr. The grafts warm and cold ischemia times were 90 (controlled) and 183+/-23.4 min. Group 1 (untreated control, UC, n=6) had core perfusion through a Swan-Ganz catheter followed by a single, antegrade flush with modified Euro-Collin's solution containing heparin, urokinase, and PGE1. Group 2 (RF group, n=6) had the same as group 1, except that one additive retrograde flush through the left atrium was administered. Group 3 (NO group, n=6) had the same as group 1, except that 20 parts per million (ppm) inhaled NO was administered for the cadaver donors before the graft harvest, and for the recipients after the grafts reperfusion. Group 4 (FOY group, n=6) had the same as group 1, except that the recipients received FOY i.v. infusion from the beginning of the recipient's operation and continuously throughout the experiments. Compared with the group 1 (control), group 2 (RF) had significantly (Pinjury score, and higher PaO2/FiO2 and pulmonary dynamic compliance. Group 3 (NO) had significantly lower mean pulmonary arterial pressure, PVR, lung injury score, degree of tissue neutrophils infiltration (histological and myeloperoxidase assay), bronchoalveolar lavage fluid protein content and neutrophils (PMNs) percentage, and higher PaO2/FiO2 and pulmonary dynamic compliance. Group 4 (FOY) had

  6. QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium.

    Science.gov (United States)

    Genovesi, Simonetta; Prata Pizzala, Daniela M; Pozzi, Massimo; Ratti, Laura; Milanese, Maria; Pieruzzi, Federico; Vincenti, Antonio; Stella, Andrea; Mancia, Giuseppe; Stramba-Badiale, Marco

    2009-05-14

    A prolongation of QT interval has been shown in patients with cirrhosis and it is considered as part of the definition of the so-called 'cirrhotic cardiomyopathy'. The aim of the present study was to assess the determinants of QT interval prolongation in cirrhotic patients. Forty-eight male patients with different stages of liver disease were divided into three subgroups according to the Child-Pugh classification. All patients underwent a 24-h ECG Holter recording. The 24-h mean of QT intervals corrected for heart rate (termed QTc) and the slope of the regression line QT/RR were calculated. HRV (heart rate variability), plasma calcium and potassium concentration and HVPG (hepatic venous pressure gradient) were measured. QTc was progressively prolonged from Child A to Child C patients (P=0.001). A significant correlation between QTc and HVPG was found (P=0.003). Patients with alcohol-related cirrhosis presented QTc prolongation more frequently than patients with post-viral cirrhosis (Pheart rate decreases. The plasma calcium concentration was inversely correlated with QTc (Pdisease, especially of alcoholic aetiology, who have greater HVPG and lower calcium plasma levels, have an altered ventricular repolarization and a reduced vagal activity to the heart, which may predispose to life-threatening arrhythmias.

  7. Effects of high-intensity interval versus continuous exercise training on post-exercise heart rate recovery in coronary heart-disease patients.

    Science.gov (United States)

    Villelabeitia-Jaureguizar, Koldobika; Vicente-Campos, Davinia; Senen, Alejandro Berenguel; Jiménez, Verónica Hernández; Garrido-Lestache, María Elvira Barrios; Chicharro, Jose López

    2017-10-01

    Heart rate recovery (HRR) has been considered a prognostic and mortality indicator in both healthy and coronary patients. Physical exercise prescription has shown improvements in VO2peak and HRR, but most of the studies have been carried out applying continuous training at a moderate intensity, being very limited the use of protocols of high intensity interval training in coronary patients. We aimed to compare the effects of a moderate continuous training (MCT) versus a high intensity interval training (HIIT) programme on VO2peak and HRR. Seventy three coronary patients were assigned to either HIIT or MCT groups for 8weeks. Incremental exercise tests in a cycloergometer were performed to obtain VO2peak data and heart rate was monitored during and after the exercise test to obtain heart rate recovery data. Both exercise programmes significantly increase VO2peak with a higher increase in the HIIT group (HIIT: 4.5±4.46ml/kg/min vs MCT: 2.46±3.57ml/kg/min; p=0.039). High intensity interval training resulted in a significantly increase in HRR at the first and second minute of the recovery phase (15,44±7,04 vs 21,22±6,62, ptraining. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Appropriate threshold levels of cardiac beat-to-beat variation in semi-automatic analysis of equine ECG recordings

    DEFF Research Database (Denmark)

    Madsen, Mette Flethøj; Kanters, Jørgen K.; Pedersen, Philip Juul

    2016-01-01

    Background: Although premature beats are a matter of concern in horses, the interpretation of equine ECG recordings is complicated by a lack of standardized analysis criteria and a limited knowledge of the normal beat-to-beat variation of equine cardiac rhythm. The purpose of this study...... was to determine the appropriate threshold levels of maximum acceptable deviation of RR intervals in equine ECG analysis, and to evaluate a novel two-step timing algorithm by quantifying the frequency of arrhythmias in a cohort of healthy adult endurance horses. Results: Beat-to-beat variation differed......, range 1–24). Conclusions: Beat-to-beat variation of equine cardiac rhythm varies according to HR, and threshold levels in equine ECG analysis should be adjusted accordingly. Standardization of the analysis criteria will enable comparisons of studies and follow-up examinations of patients. A small number...

  9. Reference intervals for the echocardiographic measurements of the right heart in children and adolescents: a systematic review.

    Science.gov (United States)

    Lemmer Hunsinger, Carolina E; Engel, Mark E; Stanfliet, John C; Mayosi, Bongani M

    2014-01-29

    Transthoracic echocardiography is the primary imaging modality for the diagnosis of right ventricular (RV) involvement in congenital and acquired heart diseases. There is increasing recognition of the contribution of RV dysfunction in heart diseases affecting children and adolescents, but there is insufficient information on reference intervals for the echocardiographic measurements of the right heart in children and adolescents that represent all the continental populations of the world. The aim of this systematic review was to collate, from published studies, normative data for echocardiographic evaluation of the right heart in children and adolescents, and to identify gaps in knowledge in this field especially with respect to sub-Saharan Africans. We performed a systematic literature search to identify studies of reference intervals for right heart measurements as determined by transthoracic echocardiography in healthy children and adolescents of school-going age. Articles were retrieved from electronic databases with a combination of search terms from the earliest date available until May 2013. Reference data were available for a broad range of variables. Fifty one studies out of 3096 publications were included. The sample sizes of the reference populations ranged from 13 to 2036 with ages varying from 5 to 21 years. We identified areas lacking sufficient reference data. These included reference data for determining right atrial size, tricuspid valve area, RV dimensions and areas, the RV % fractional area change, pulmonary artery pressure gradients and the right-sided haemodynamics, including the inferior vena cava dimensions and collapsibility. There were no data for sub-Saharan African children and adolescents. Reliable reference data are lacking for important echocardiographic measurements of the RV in children and adolescents, especially for sub-Saharan Africans.

  10. Changes in Blood Pressure and Heart Rate during Fixed-Interval Responding in Squirrel Monkeys

    Science.gov (United States)

    DeWeese, Jo

    2009-01-01

    Episodic and sustained increases in heart rate and mean arterial blood pressure can occur with recurring patterns of schedule-controlled behavior. Most previous studies were conducted under fixed-ratio schedules, which maintained a consistent high rate of responding that alternated with periods of no responding during times when the schedule was…

  11. Discrete Scale Invariance in the Cascade Heart Rate Variability Of Healthy Humans

    OpenAIRE

    Lin, Der Chyan

    2004-01-01

    Evidence of discrete scale invariance (DSI) in daytime healthy heart rate variability (HRV) is presented based on the log-periodic power law scaling of the heart beat interval increment. Our analysis suggests multiple DSI groups and a dynamic cascading process. A cascade model is presented to simulate such a property.

  12. The Health Benefits of a 12-Week Home-Based Interval Training Cardiac Rehabilitation Program in Patients With Heart Failure.

    Science.gov (United States)

    Safiyari-Hafizi, Hedieh; Taunton, Jack; Ignaszewski, Andrew; Warburton, Darren E R

    2016-04-01

    Recently, high-intensity interval training has been advocated for the rehabilitation of persons living with heart failure (HF). Home-based training is more convenient for many patients and could augment compliance. However, the safety and efficacy of home-based interval training remains unclear. We evaluated the safety and efficacy of a supervised home-based exercise program involving a combination of interval and resistance training. Measures of aerobic power, endurance capacity, ventilatory threshold, and quality of life in 40 patients with HF, were taken at baseline and after 12 weeks. Patients were matched and randomized to either control (CTL; n = 20) or experimental (EXP; n = 20) conditions. The EXP group underwent a 12-week high-intensity interval and resistance training program while the CTL group maintained their usual activities of daily living. In the EXP group, we found a significant improvement in aerobic power, endurance capacity, ventilatory threshold, and quality of life. There were no significant changes in the CTL group. We have shown that a home-based cardiac rehabilitation program involving interval and resistance training is associated with improved aerobic capacity and quality of life in patients with HF. This research has important implications for the treatment of HF. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  13. Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses.

    Directory of Open Access Journals (Sweden)

    Nils Thomas Songstad

    Full Text Available To investigate the effects of high intensity interval training (HIIT on the maternal heart, fetuses and placentas of pregnant rats.Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85-90% of maximal oxygen consumption for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats, echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples.Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03, hypoxia-inducible factor 1α (p = 0.04 and glutathione peroxidase 4.2 (p = 0.02 in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014, superoxide dismutase 1 (p = 0.001 and tissue inhibitor of metallopeptidase 3 (p = 0.049 in the fetal heart.Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated.

  14. Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses.

    Science.gov (United States)

    Songstad, Nils Thomas; Kaspersen, Knut-Helge Frostmo; Hafstad, Anne Dragøy; Basnet, Purusotam; Ytrehus, Kirsti; Acharya, Ganesh

    2015-01-01

    To investigate the effects of high intensity interval training (HIIT) on the maternal heart, fetuses and placentas of pregnant rats. Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85-90% of maximal oxygen consumption) for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats), echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples. Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03), hypoxia-inducible factor 1α (p = 0.04) and glutathione peroxidase 4.2 (p = 0.02) in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014), superoxide dismutase 1 (p = 0.001) and tissue inhibitor of metallopeptidase 3 (p = 0.049) in the fetal heart. Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated.

  15. The Harvard Beat Assessment Test (H-BAT): a battery for assessing beat perception and production and their dissociation.

    Science.gov (United States)

    Fujii, Shinya; Schlaug, Gottfried

    2013-01-01

    Humans have the abilities to perceive, produce, and synchronize with a musical beat, yet there are widespread individual differences. To investigate these abilities and to determine if a dissociation between beat perception and production exists, we developed the Harvard Beat Assessment Test (H-BAT), a new battery that assesses beat perception and production abilities. H-BAT consists of four subtests: (1) music tapping test (MTT), (2) beat saliency test (BST), (3) beat interval test (BIT), and (4) beat finding and interval test (BFIT). MTT measures the degree of tapping synchronization with the beat of music, whereas BST, BIT, and BFIT measure perception and production thresholds via psychophysical adaptive stair-case methods. We administered the H-BAT on thirty individuals and investigated the performance distribution across these individuals in each subtest. There was a wide distribution in individual abilities to tap in synchrony with the beat of music during the MTT. The degree of synchronization consistency was negatively correlated with thresholds in the BST, BIT, and BFIT: a lower degree of synchronization was associated with higher perception and production thresholds. H-BAT can be a useful tool in determining an individual's ability to perceive and produce a beat within a single session.

  16. The Harvard Beat Assessment Test (H-BAT: A Battery for Assessing Beat Perception and Production and their Dissociation

    Directory of Open Access Journals (Sweden)

    Shinya eFujii

    2013-11-01

    Full Text Available Humans have the abilities to perceive, produce, and synchronize with a musical beat, yet there are widespread individual differences. To investigate these abilities and to determine if a dissociation between beat perception and production exists, we developed the Harvard Beat Assessment Test (H-BAT, a new battery that assesses beat perception and production abilities. H-BAT consists of four subtests: 1 music tapping test (MTT, 2 beat saliency test (BST, 3 beat interval test (BIT, and 4 beat finding and interval test (BFIT. MTT measures the degree of tapping synchronization with the beat of music, whereas BST, BIT, and BFIT measure perception and production thresholds via psychophysical adaptive stair-case methods. We administered the H-BAT on thirty individuals and investigated the performance distribution across these individuals in each subtest. There was a wide distribution in individual abilities to tap in synchrony with the beat of music during the MTT. The degree of synchronization consistency was negatively correlated with thresholds in the BST, BIT, and BFIT: a lower degree of synchronization was associated with higher perception and production thresholds. H-BAT can be a useful tool in determining an individual’s ability to perceive and produce a beat within a single session.

  17. Binaural beat salience

    Science.gov (United States)

    Grose, John H.; Buss, Emily; Hall, Joseph W.

    2012-01-01

    Previous studies of binaural beats have noted individual variability and response lability, but little attention has been paid to the salience of the binaural beat percept. The purpose of this study was to gauge the strength of the binaural beat percept by matching its salience to that of sinusoidal amplitude modulation (SAM), and to then compare rate discrimination for the two types of fluctuation. Rate discrimination was measured for standard rates of 4, 8, 16, and 32 Hz – all in the 500-Hz carrier region. Twelve normal-hearing adults participated in this study. The results indicated that discrimination acuity for binaural beats is similar to that for SAM tones whose depths of modulation have been adjusted to provide equivalent modulation salience. The matched-salience SAM tones had relatively shallow depths of modulation, suggesting that the perceptual strength of binaural beats is relatively weak, although all listeners perceived them. The Weber fraction for detection of an increase in binaural beat rate is roughly constant across beat rates, at least for rates above 4 Hz, as is rate discrimination for SAM tones. PMID:22326292

  18. Is the stroke volume during post-ectopic beat associated with ventricular premature complex-related symptoms?

    Science.gov (United States)

    Gwag, Hye Bin; Kim, Eun Kyoung; Hwang, Jin Kyung; Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Kyoung-Min

    2017-07-03

    This study aimed to investigate if increased stroke volume (SV) after a ventricular premature complex (VPC) was related to VPC-related symptoms. We selected patients having an isolated VPC during echocardiography from a prospective registry that included patients with a structurally normal heart and 24-h VPC >1%. Patients were divided into two groups according to the presence or absence of VPC-related symptoms (skipped beat or palpitation) when VPC occurred. Left ventricular (LV) volumes and time-velocity integral (TVI) at the LV outflow tract were measured during the preceding sinus beat, VPC, and post-ectopic sinus beat. Percent LV SV of the VPC and post-ectopic sinus beat were calculated by dividing each SV by the SV of the preceding sinus beat. A total of 47 patients were eligible. Most patients had VPC with left bundle branch block morphology and inferior axis. Patients in the symptom (+) group had a significantly lower SV, %LV SV, and TVI during post-ectopic sinus beat than those in the symptom (-) group. The sum of SVs during VPC and post-ectopic beat was significantly lower in symptomatic patients than non-symptomatic patients (103.4 mL vs. 125.1 mL, P = 0.02), while the sum of %LV SVs during VPC and post-ectopic beat tended to be lower in patients with symptoms than those without symptoms (P = 0.08). The sum of %LV SVs during VPC and post-VPC was positively correlated with coupling interval (CI) and CI ratio. Ventricular premature complex-related symptoms may not be associated with the amount of post-VPC SV.

  19. Q-T interval (QT(C)) in patients with cirrhosis: relation to vasoactive peptides and heart rate

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Gülberg, V; Fuglsang, S

    2007-01-01

    OBJECTIVE: Prolonged Q-T interval (QT) has been reported in patients with cirrhosis who also exhibit profound abnormalities in vasoactive peptides and often present with elevated heart rate (HR). The aim of this study was to relate QT to the circulating level of endothelins (ET-1 and ET-3......) and calcitonin gene-related peptide (CGRP) in patients with cirrhosis. In addition, we studied problems with HR correction of QT. MATERIAL AND METHODS: Forty-eight patients with cirrhosis and portal hypertension were studied during a haemodynamic investigation. Circulating levels of ETs and CGRP were determined...

  20. Controlled study of myocardial recovery after interval training in heart failure: SMARTEX-HF - rationale and design

    DEFF Research Database (Denmark)

    Støylen, Asbjørn; Conraads, Viviane; Halle, Martin

    2011-01-01

    interval training at high relative intensity would yield significantly larger effects in terms of left ventricular remodelling compared to moderate continuous exercise training. Study design: In a three-armed randomized multicentre study of stable heart failure patients with left ventricular ejection...... fraction =35%, the effects of a 12-week programme of high-intensity interval training (HIT; 85-90% of peak oxygen uptake, VO(2peak)) will be compared to actual practice in Europe, represented by either an isocaloric programme of moderate continuous training (MCT; 50-60% of VO(2peak)) and a recommendation......Background: The large randomized controlled multicentre clinical trial, HF-ACTION, recently demonstrated that a programme of recommendation of regular exercise training at moderate intensity is safe, improves quality of life, and reduces the combined endpoint of all-cause death and hospitalization...

  1. Association between frequency of atrial and ventricular ectopic beats and biventricular pacing percentage and outcomes in patients with cardiac resynchronization therapy.

    Science.gov (United States)

    Ruwald, Martin H; Mittal, Suneet; Ruwald, Anne-Christine; Aktas, Mehmet K; Daubert, James P; McNitt, Scott; Al-Ahmad, Amin; Jons, Christian; Kutyifa, Valentina; Steinberg, Jonathan S; Wang, Paul; Moss, Arthur J; Zareba, Wojciech

    2014-09-09

    A high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been well established. This study sought to determine if increased ectopic beats reduce the chance of high biventricular pacing percentage and are associated with subsequent adverse outcomes. From the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy), 801 patients with an implanted CRT-defibrillator device with data available on biventricular pacing percentage and pre-implantation 24-h Holter recordings were included. Using logistic regression, we estimated the influence of ectopic beats on the percentage of biventricular pacing. Reverse remodeling was measured as reductions in atrial and left ventricular end-systolic volumes (LVESV) at 1 year. Cox models were used to assess the influence of ectopic beats on the outcomes of heart failure (HF) or death, ventricular tachyarrhythmias (VTAs), and death. In the pre-implantation Holter recording, ectopic beats accounted for a mean 3.2 ± 5.5% of all beats. The probability of subsequent low biventricular pacing percentage (ectopic beats and 13-fold (odds ratio: 13.42; 95% confidence interval: 7.02 to 25.66; p 1.5% ectopic beats compared with those with ectopic beats. Patients with ≥0.1% ectopic beats had significantly less reverse remodeling (percent reduction in LVESV 31 ± 15%) than patients with ectopic beats (percent reduction in LVESV 39 ± 14%; p ectopic beats (hazard ratio: 3.13 and 1.84, respectively) and for >1.5% ectopic beats (hazard ratio: 2.38 and 2.74, respectively). Relatively low frequencies of ectopic beats (≥0.1%) dramatically increase the probability of low biventricular pacing (<97%), with reduced CRT efficacy by less reverse remodeling and higher risk of HF/death and VTA. This supports pre-implantation Holter monitoring of

  2. Up-Beat UK: A programme of research into the relationship between coronary heart disease and depression in primary care patients

    Directory of Open Access Journals (Sweden)

    Pariante Carmine M

    2011-05-01

    Full Text Available Abstract Background Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression. Methods/design This programme of research will consist of 4 inter-related studies. A 4 year prospective cohort study of primary care patients with coronary heart disease will be conducted to explore the relationship between coronary heart disease and depression. Within this, a nested case-control biological study will investigate genetic and blood-biomarkers as predictors of depression in this sample. Two qualitative studies, one of patients' perspectives of treatments for coronary heart disease and co-morbid depression and one of primary care professionals' views on the management of patients with coronary heart disease and depression will inform the development of an intervention for this patient group. A feasibility study for a randomised controlled trial will then be conducted. Discussion This study will provide information on the relationship between coronary heart disease and depression that will allow health services to determine the efficiency of case-finding for depression in this patient group. The results of the cohort study will also provide information on risk factors for depression. The study will provide evidence on the efficacy and feasibility of a joint patient and professional led intervention and data necessary to plan a

  3. Up-beat UK: a programme of research into the relationship between coronary heart disease and depression in primary care patients.

    Science.gov (United States)

    Tylee, André; Ashworth, Mark; Barley, Elizabeth; Brown, June; Chambers, John; Farmer, Anne; Fortune, Zoe; Haddad, Mark; Lawton, Rebecca; Mann, Anthony; Mehay, Anita; McCrone, Paul; Murray, Joanna; Leese, Morven; Pariante, Carmine M; Rose, Diana; Rowlands, Gill; Smith, Alison; Walters, Paul

    2011-05-23

    Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression. This programme of research will consist of 4 inter-related studies. A 4 year prospective cohort study of primary care patients with coronary heart disease will be conducted to explore the relationship between coronary heart disease and depression. Within this, a nested case-control biological study will investigate genetic and blood-biomarkers as predictors of depression in this sample. Two qualitative studies, one of patients' perspectives of treatments for coronary heart disease and co-morbid depression and one of primary care professionals' views on the management of patients with coronary heart disease and depression will inform the development of an intervention for this patient group. A feasibility study for a randomised controlled trial will then be conducted. This study will provide information on the relationship between coronary heart disease and depression that will allow health services to determine the efficiency of case-finding for depression in this patient group. The results of the cohort study will also provide information on risk factors for depression. The study will provide evidence on the efficacy and feasibility of a joint patient and professional led intervention and data necessary to plan a definitive randomised controlled trial of the intervention.

  4. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training.

    Science.gov (United States)

    Freyssin, Céline; Verkindt, Chantal; Prieur, Fabrice; Benaich, Philippe; Maunier, Sébastien; Blanc, Philippe

    2012-08-01

    To compare the effects of an 8-week, high-intensity interval training protocol versus continuous training. Randomized controlled trial. Cardiac rehabilitation center. Patients (N=26; mean age ± SD, 54±12y) with chronic heart failure were enrolled in a cardiac rehabilitation program for 8 weeks. Patients were randomly assigned into 2 groups that performed either interval training (IT) or continuous training (CT). IT consisted of 3 sessions of 12 repetitions of 30 seconds of exercise at very high intensity, followed by 60 seconds of complete rest. The CT group performed CT exercises, which consisted of 45 minutes of aerobic exercise. Parameters of gas exchanges: peak oxygen consumption (Vo(2)peak), first ventilator threshold (VT1), distance at six-minute walk test (6MWT), and level of anxiety and depression were measured. The IT group increased significantly their Vo(2)peak, the duration of the exercise test, the oxygen pulse, oxygen consumption at the VT1, and the distance walked during the 6MWT. The CT group only increased the time at the VT1 and the distance performed at the 6MWT. The improvement in the time at the VT1 was significantly higher for the IT group than for the CT group. This study shows that IT at very high intensity for patients with heart failure appears to be more effective than CT in improving indices of submaximal exercise capacity. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. [QT interval dispersion in hypertensive diabetics and in patients with hypertension with chronic heart failure without diabetes].

    Science.gov (United States)

    Radman, A; Murín, J; Bulas, J; Reptová, A; Ravingerová, T; Mikes, P; Kozliková, K; Ghanem, W; Jaber, J; Baqi, L

    2003-10-01

    Our aim was to: 1. compare QT dispersion from routine ECG in diabetic and no-diabetic patients with congestive heart failure, 2. describe associations between QT dispersion and circadian blood (BP) pressure variation in type 2 diabetic patients with congestive heart failure (CHF). 122 patients admitted to hospital due to CHF in the period between years 2000-2001 have been divided into 2 groups: group 1:70 patients (m: 40, f: 30, mean age 64.7 +/- 9 years) with type II diabetes mellitus (DM), group 2:52 patients (m: 28, f:24, mean age 62.5 +/- 10.9 years) without DM. Diagnosis of CHF was made clinically and proved by ECG and ECHO (EF 11.1 mmol/l). The QT interval was measured from the beginning of the QRS complex to the end of the T wave from routine 12-lead ECG. QT intervals were corrected for heart rate using Bazett's formula. QT dispersion (QTd) and rate corrected QT dispersion (QTc) were defined as the difference between the maximum and minimum QT and QTc intervals, respectively. Ambulatory blood pressure (AMBP) was measured by an oscillometic technique. Diabetic patients with CHF were divided both according to below and above the median QTc dispersion (65 ms). Chi-square and Student's t-test. Significant differences were assumed of p CHF had significantly longer QTc interval (maximum and minimum), QT dispersion and QTc dispersion compared with non-diabetic patients with CHF. Diabetic patients with CHF with QTc dispersion > 65 ms had significantly higher night systolic (133 +/- 14 vs. 112 +/- 14) and diastolic (80 +/- 11 vs. 65 +/- 6) BP and significantly higher night/day ratio for both systolic (0.94 +/- 0.05 vs. 0.86 +/- 0.06) and diastolic (0.89 +/- 0.07 vs. 0.80 +/- 0.05) compared with diabetic patients with CHF with QTc dispersion CHF are higher risk than non-diabetic. Our data describe both factors related to cardiovascular risk in diabetic patients with CHF-prolongation of the QT and QTc dispersion and reduced nocturnal blood pressure.

  6. Heritability of Tpeak-Tend Interval and T-wave Amplitude: A Twin Study

    DEFF Research Database (Denmark)

    Haarmark, Christian; Kyvik, Kirsten O; Vedel-Larsen, Esben

    2011-01-01

    BACKGROUND: -Tpeak-Tend interval (TpTe) and T-wave amplitude (Tamp) carry diagnostic and prognostic information regarding cardiac morbidity and mortality. Heart rate and QT interval are known to be heritable traits. The heritability of T-wave morphology parameters such as TpTe and Tamp is unknown...... interval, QTpeak and QTend interval) were measured and averaged over three consecutive beats in lead V5. TpTe was calculated as the QTend and QTpeak interval difference. Heritability was assessed using structural equation models adjusting for age, gender and BMI. All models were reducible to a model...... are heritable ECG parameters....

  7. Effect of missing RR-interval data on heart rate variability analysis in the time domain.

    Science.gov (United States)

    Kim, Ko Keun; Lim, Yong Gyu; Kim, Jung Soo; Park, Kwang Suk

    2007-12-01

    In this study, the effects of missing RR-interval data on time-domain analysis were investigated using simulated missing data in real RR-interval tachograms and actual missing RR data in an ECG obtained by an unconstrained measurement. For the simulation, randomly selected data (0-100 s) were removed from real RR data obtained from the MIT-BIH normal sinus rhythm database. In all, 2615 tachograms of 5 min durations were used for this analysis. For certain durations of missing data, the analysis was performed by 1000 Monte Carlo runs. MeanNN, SDNN, SDSD, RMSSD and pNN50 were calculated as the time-domain parameters in each run, and the relative errors between the original and the incomplete tachograms for these parameters were computed. The results of the simulation revealed that MeanNN is the parameter most robust to missing data; this feature can be explained by the theory of finite population correction (FPC). pNN50 is the parameter most sensitive to missing data. MeanNN was also found to be the most robust to real missing RR data derived from a capacitive-coupled ECG recorded during sleep; furthermore, the parameter patterns for the missing data were considerably similar to those for the original RR data, although the relative errors may exceed those of the simulation results.

  8. Refined multiscale entropy analysis of heart period and QT interval variabilities in long QT syndrome type-1 patients.

    Science.gov (United States)

    Bari, Vlasta; Valencia, Jose F; Vallverdu, Montserrat; Girardengo, Giulia; Bassani, Tito; Marchi, Andrea; Calvillo, Laura; Caminal, Pere; Cerutti, Sergio; Brink, Paul A; Crotti, Lia; Schwartz, Peter J; Porta, Alberto

    2013-01-01

    This study assesses complexity of cardiovascular control in patients affected by type-1 variant of long QT (LQT1) syndrome. Complexity was assessed by refined multiscale entropy of heart period (HP) and QT interval variabilities. HP was taken as the time distance between two consecutive R peaks (RR) and QT interval was approximated as the time distance between the R-peak and T-wave apex (RTa) and between R-peak and T-wave end (RTe). RR, RTa and RTe intervals were automatically extracted from 24h Holter recordings and the daytime period was analyzed (from 02:00 to 06:00 PM). Non mutation carrier (NMC) individuals (n=11), utilized as a control group, were taken from the same family line of the mutation carrier (MC) subjects (n=26). We found that, while NMC and MC groups were indistinguishable based on time domain and complexity analyses of RR dynamics, complexity analysis of RTa and RTe variabilities clearly separates the two populations and suggests an impairment in the cardiac control mechanisms acting on the ventricles.

  9. Beat-to-beat T-wave alternans detection using the Ensemble Empirical Mode Decomposition method.

    Science.gov (United States)

    Hasan, Muhammad A; Chauhan, Vijay S; Krishnan, Sridhar

    2016-10-01

    T-wave alternans (TWA) is defined as a consistent variation in the repolarization morphology that repeats on every other beat. This study aimed to evaluate beat-to-beat TWA detection using the Ensemble EMD (EEMD) method. A total of 108 recordings of standard 12-lead ECGs of 69 healthy subjects (17 females, 42±18 years; 52 males, 40±13 years) and 39 cardiac-condition patients (ischemic cardiomyopathy; ICM and dilated cardiomyopathy; DCM) with left ventricular ejection fractions (LVEF) ≤40% were studied. We first determined the QT interval of ECG via a template matching algorithm. Then, beat-to-beat T-waves were extracted to quantify beat-to-beat TWA. The EEMD method was applied to the T-wave time series to decompose them into a set of intrinsic mode functions (IMFs). The instantaneous frequency was measured by performing the Hilbert transform on the selected IMF for extracting the features. Four different classifiers were applied to the extracted features to assess and classify the existence of TWA in the ECG signal. In the simulation study, the global classifier worked better than the subject-based classifier for detecting alternans in the T-waves. In addition, the average accuracy and sensitivity for detecting TWA were greater than 80%. In the real Holter ECG data obtained from Toronto General Hospital, the Ensemble classifier had higher classification accuracy, 74%, than other classifiers and a positive predictive value of 100%. In conclusion, the proposed Ensemble EMD method with Ensemble classifier can be utilized for detecting beat-to-beat TWA in the ECG signal. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Data and Statistics: Heart Failure

    Science.gov (United States)

    ... High Blood Pressure Salt Cholesterol Million Hearts® WISEWOMAN Heart Failure Fact Sheet Recommend on Facebook Tweet Share Compartir ... not mean that the heart has stopped beating. Heart Failure in the United States About 5.7 million ...

  11. Binaural Beat: A Failure to Enhance EEG Power and Emotional Arousal

    Directory of Open Access Journals (Sweden)

    Fran López-Caballero

    2017-11-01

    Full Text Available When two pure tones of slightly different frequencies are delivered simultaneously to the two ears, is generated a beat whose frequency corresponds to the frequency difference between them. That beat is known as acoustic beat. If these two tones are presented one to each ear, they still produce the sensation of the same beat, although no physical combination of the tones occurs outside the auditory system. This phenomenon is called binaural beat. In the present study, we explored the potential contribution of binaural beats to the enhancement of specific electroencephalographic (EEG bands, as previous studies suggest the potential usefulness of binaural beats as a brainwave entrainment tool. Additionally, we analyzed the effects of binaural-beat stimulation on two psychophysiological measures related to emotional arousal: heart rate and skin conductance. Beats of five different frequencies (4.53 Hz -theta-, 8.97 Hz -alpha-, 17.93 Hz -beta-, 34.49 Hz -gamma- or 57.3 Hz -upper-gamma were presented binaurally and acoustically for epochs of 3 min (Beat epochs, preceded and followed by pink noise epochs of 90 s (Baseline and Post epochs, respectively. In each of these epochs, we analyzed the EEG spectral power, as well as calculated the heart rate and skin conductance response (SCR. For all the beat frequencies used for stimulation, no significant changes between Baseline and Beat epochs were observed within the corresponding EEG bands, neither with binaural or with acoustic beats. Additional analysis of spectral EEG topographies yielded negative results for the effect of binaural beats in the scalp distribution of EEG spectral power. In the psychophysiological measures, no changes in heart rate and skin conductance were observed for any of the beat frequencies presented. Our results do not support binaural-beat stimulation as a potential tool for the enhancement of EEG oscillatory activity, nor to induce changes in emotional arousal.

  12. High intensity interval and endurance training have opposing effects on markers of heart failure and cardiac remodeling in hypertensive rats.

    Science.gov (United States)

    Holloway, Tanya M; Bloemberg, Darin; da Silva, Mayne L; Simpson, Jeremy A; Quadrilatero, Joe; Spriet, Lawrence L

    2015-01-01

    There has been re-emerging interest and significant work dedicated to investigating the metabolic effects of high intensity interval training (HIIT) in recent years. HIIT is considered to be a time efficient alternative to classic endurance training (ET) that elicits similar metabolic responses in skeletal muscle. However, there is a lack of information on the impact of HIIT on cardiac muscle in disease. Therefore, we determined the efficacy of ET and HIIT to alter cardiac muscle characteristics involved in the development of diastolic dysfunction, such as ventricular hypertrophy, fibrosis and angiogenesis, in a well-established rodent model of hypertension-induced heart failure before the development of overt heart failure. ET decreased left ventricle fibrosis by ~40% (P HIIT did not decrease existing fibrosis, and HIIT animals displayed a 20% increase in left ventricular mass (PHIIT also increased brain natriuretic peptide by 50% (PHIIT promoted a pathological adaptation in the left ventricle in the presence of hypertension, highlighting the need for further research on the widespread effects of HIIT in the presence of disease.

  13. Wearable Beat to Beat Blood Pressure Monitor Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A key component of NASA's human exploration programs is a system that monitors the health of the crew during space missions. The wearable beat-to-beat blood pressure...

  14. On-chip constructive cell-network study (I): contribution of cardiac fibroblasts to cardiomyocyte beating synchronization and community effect.

    Science.gov (United States)

    Kaneko, Tomoyuki; Nomura, Fumimasa; Yasuda, Kenji

    2011-05-23

    To clarify the role of cardiac fibroblasts in beating synchronization, we have made simple lined-up cardiomyocyte-fibroblast network model in an on-chip single-cell-based cultivation system. The synchronization phenomenon of two cardiomyocyte networks connected by fibroblasts showed (1) propagation velocity of electrophysiological signals decreased a magnitude depending on the increasing number of fibroblasts, not the lengths of fibroblasts; (2) fluctuation of interbeat intervals of the synchronized two cardiomyocyte network connected by fibroblasts did not always decreased, and was opposite from homogeneous cardiomyocyte networks; and (3) the synchronized cardiomyocytes connected by fibroblasts sometimes loses their synchronized condition and recovered to synchronized condition, in which the length of asynchronized period was shorter less than 30 beats and was independent to their cultivation time, whereas the length of synchronized period increased according to cultivation time. The results indicated that fibroblasts can connect cardiomyocytes electrically but do not significantly enhance and contribute to beating interval stability and synchronization. This might also mean that an increase in the number of fibroblasts in heart tissue reduces the cardiomyocyte 'community effect', which enhances synchronization and stability of their beating rhythms.

  15. RECOVERY OF POWER OUTPUT AND HEART RATE KINETICS DURING REPEATED BOUTS OF ROWING EXERCISE WITH DIFFERENT REST INTERVALS

    Directory of Open Access Journals (Sweden)

    Evangelia Mavrommataki

    2006-03-01

    Full Text Available This study examined the effect of recovery time on the maintenance of power output and the heart rate response during repeated maximal rowing exercise. Nine male, junior rowers (age: 16 ± 1 years; body mass: 74.0 ± 9.1 kg; height: 1.78 ± 0.03 m performed two consecutive all-out 1000 m bouts on a rowing ergometer on three separate occasions. The rest interval between the two bouts was 1.5 (INT1.5, 3 (INT3 and 6 min (INT6, allocated in random order. Power output was averaged for each 1000 m bout and for the first and last 500 m of each bout. Heart rate kinetics were determined using a two-component exponential model. Performance time and mean power output for the first bout was 209 ± 3 s and 313 ± 10 W respectively. Recovery of mean power output was incomplete even after 6 min (78 ± 2, 81 ± 2 and 84 ± 2 % for INT1.5, INT3 and INT6 respectively. Mean power output after INT6 was higher (p < 0.01 only compared with INT1.5. Power output during the first 500 m of bout 2 after INT6 was 10% higher compared with the second 500 m. During INT1.5 and INT3 power output during the first and the second 500 m of bout 2 was similar. Peak heart rate (~197 b·min-1 and the HR time constant (~13 s were unaffected by prior exercise and recovery time. However, when the recovery was short (INT1.5, HR during the first 50 s of bout 2 was significantly higher compared with corresponding values during bout 1. The present study has shown that in order to maintain similar power outputs during repeated maximal rowing exercise, the recovery interval must be greater than 6 min. The influence of a longer recovery time (INT6 on maintenance of power output was only evident during the first half of the second 1000 m bout.

  16. Resting heart rate, heart rate variability and functional decline in old age

    DEFF Research Database (Denmark)

    Ogliari, Giulia; Mahinrad, Simin; Stott, David J

    2015-01-01

    BACKGROUND: Heart rate and heart rate variability, markers of cardiac autonomic function, have been linked with cardiovascular disease. We investigated whether heart rate and heart rate variability are associated with functional status in older adults, independent of cardiovascular disease. METHODS......: We obtained data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). A total of 5042 participants were included in the present study, and mean followup was 3.2 years. Heart rate and heart rate variability were derived from baseline 10-second electrocardiograms. Heart rate.......3 years. At baseline, higher heart rate was associated with worse ADL and IADL, and lower SDNN was related to worse IADL (all p values heart rate (range 71-117 beats/min) had a 1.79-fold (95% confidence interval [CI] 1.45-2.22) and 1.35-fold (95% CI 1...

  17. Prognostic ability of VE/VCO2 slope calculations using different exercise test time intervals in subjects with heart failure.

    Science.gov (United States)

    Arena, Ross; Humphrey, Reed; Peberdy, Mary Ann

    2003-12-01

    The minute ventilation-carbon dioxide production (VE/VCO2) slope, obtained during exercise testing, possesses prognostic value in heart failure (HF). The VE-VCO2 relationship is generally linear thereby hypothetically producing similar slope values regardless of the exercise-test time interval used for calculation. This study assesses the ability of the VE/VCO2 slope, calculated at different time intervals throughout a progressive exercise test, to predict 1-year cardiac-related hospitalization and mortality in subjects with HF. Seventy-two subjects underwent symptom-limited exercise testing with ventilatory expired gas analysis. Mean age and left ventricular ejection fraction for 44 male and 28 female subjects were 51.2 years (+/-13.0) and 27.0% (+/-12.3) respectively. The VE/VCO2 slope was calculated from time 0 to 25, 50, 75 and 100% of exercise time and subsequently used to create five randomly selected VE/VCO2 slope categories. (The intraclass correlation coefficient found calculation of the VE/VCO2 slope, when divided into quartiles, to be a reliable measure (alpha=0.94, Pslope categories (25-100% and random selections) were significant predictors of cardiac-related hospitalization and mortality over a 1-year period. Multivariate Cox regression analysis revealed all VE/VCO2 slope categories outperformed peak oxygen consumption (VO2) in predicting hospitalization and mortality at 1 year. Although the different classification schemes were not identical, these results suggest VE/VCO2 slope maintains prognostic significance regardless of exercise-test time interval. Calculation of VE/VCO2 slope may therefore still be valuable in subjects putting forth a sub-maximal effort while effort-dependent measures, such as peak VO2, are not.

  18. Beating Breast Cancer

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Breast Cancer Beating Breast Cancer Past Issues / Winter 2017 Table of Contents Melanie ... Her mother had died at age 49 of breast cancer after three battles with the disease. Ovarian cancer ...

  19. Beat in der Kleinstadt

    OpenAIRE

    Spengler, Peter

    1994-01-01

    Beat in der Kleinstadt : "langhaarige Affen" oder Jugendkultur in d. 60er Jahren. - In: "Schön ist die Jugendzeit ...?" / hrsg. von Harald Parigger ... - Augsburg : Haus d. Bayer. Geschichte, 1994. - S. 81-85. - (Veröffentlichungen zur bayerischen Geschichte und Kultur ; 27)

  20. Europe’s Wild Heart – still beating? Experiences from a new transboundary wilderness area in the middle of the Old Continent

    Directory of Open Access Journals (Sweden)

    Zdenka Křenová

    2013-03-01

    Full Text Available The face of Europe has been shaped by human civilization for centuries and wilderness did not only vanish from the continent’s surface but also from humans’ minds and experiences. However, there are still a few places left, which have remained more or less unmodified and have at least the potential for rewilding. Among them are the Šumava National Park and the neighbouring Bavarian Forest NP, which together create a unique forest zone in the middle of Europe susceptible to host and demonstrate natural forest dynamics and ecosystem processes. This is also a large and very important Natura 2000 area. Transboundary cooperation between both National parks has improved since 1990, when the former Iron Curtain Corridor was opened, and culminated by the project Europe’s Wild Heart. The main goal of the project Europe’s Wild Heart, which started in 2008, was to develop a transboundary wilderness area in the core zones of the two national parks – BFNP and ŠNP. The project area was 13,060 ha and a “life story” of this project is described in this paper. A common “vision 2020” was signed where both parks committed among other things “to achieve a joint core area of about 15,000 ha with harmonized management principles, information services and monitoring networks to officially become the first and largest transboundary wilderness area in Central Europe”. Unfortunately, the bark beetle outbreak which followed the Kyrill hurricane in 2008 and 2009 escalated the discussion about appropriate forest management in the ŠNP. Opponents of the national park principles, non-intervention and wilderness concept became more and more vocal. The situation escalated after the election in 2010 when the Green Party was replaced by conservatives (ODS – Civic Democratic Party at the Czech Ministry of Environment. Clear cuttings were started in some former non-intervention parts of the ŠNP and hunting was again allowed in the core zone. Since then

  1. Prevalence and correlates of ventricular premature beats detected by ambulatory electrocardiography in working populations.

    Science.gov (United States)

    Green, M S; Jucha, E; Luz, J; Cocos, M; Nurynberg, M; Rosenberg, N

    1988-05-01

    The associations of ventricular premature beats detected on a one-hour ambulatory electrocardiogram with demographic, behavioral, physiologic, and anthropometric variables were examined in 2,331 factory workers aged 20-69 years. Ventricular premature beats were more prevalent with increasing age and with abnormal resting electrocardiograms. From the age of 40, they were more common among males than among females. An association with ethnicity was observed, ventricular premature beats being most common among Israelis of European origin. In univariate analysis, resting heart rate was inversely associated with the presence of ventricular premature beats for females only. Ambulatory heart rate was positively associated with ventricular premature beats only among males. No associations with smoking habits or relative weight were found. Among males and females with normal electrocardiograms, systolic and diastolic blood pressures were significant correlates of ventricular premature beats in univariate analysis and after controlling for age, resting and ambulatory heart rates, and ethnic origin.

  2. Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: A pragmatic randomised clinical trial of feasibility and effectiveness

    OpenAIRE

    Koufaki, Pelagia; Mercer, Tom; George, K.; Nolan, J.

    2014-01-01

    Objectives: The health benefits of high-intensity interval\\ud training in cardiac rehabilitation warrant further research.\\ud We compared the effectiveness of low-volume high-intensity\\ud interval training vs continuous aerobic exercise training in\\ud chronic heart failure.\\ud Design/Settings: Unblinded, two arm parallel design with\\ud random assignment to exercise interventions in out-patient\\ud hospital rehabilitation gym.\\ud Methods: Patients with signs of chronic heart failure and\\ud ejec...

  3. Does rating of perceived exertion result in target exercise intensity during interval training in cardiac rehabilitation? A study of the Borg scale versus a heart rate monitor.

    Science.gov (United States)

    Aamot, Inger-Lise; Forbord, Siv Hege; Karlsen, Trine; Støylen, Asbjørn

    2014-09-01

    To assess whether rating of perceived exertion using the Borg 6-20 scale is a valid method for achieving target exercise intensity during high-intensity interval training in cardiac rehabilitation. A single-group cross-over design. Ten participants (56 (6.5) years) who were enrolled in a high-intensity interval training cardiac rehabilitation program were recruited. A target exercise intensity of Borg 17 (very hard) was used for exercise intensity guidance in the initial four exercise sessions that took place before a cardiopulmonary exercise test, as in usual care rehabilitation. The heart rate was recorded and blinded to the participants. After performing the test, the participants were then instructed using heart rate monitors openly for exercise guidance in four subsequent exercise sessions, at an intensity corresponding to 85-95% of peak heart rate. The mean exercise intensity during high-intensity bouts was 82% (6%) of peak heart rate for the rating of perceived exertion and 85% (6%) using heart rate monitors (p=0.005). Bland-Altman limits of agreement analysis with a mean bias showed a bias of 2.97 (-2.08, 8.02) percentage points for the two methods. Exercise intensity was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86-0.99, phigh-intensity interval training bouts in cardiac rehabilitation. Heart rate monitoring should be used for accurate intensity guidance. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  4. Ultrasound-Guided Transesophageal High-Intensity Focused Ultrasound Cardiac Ablation in a Beating Heart: A Pilot Feasibility Study in Pigs.

    Science.gov (United States)

    Bessiere, Francis; N'djin, W Apoutou; Colas, Elodie Constanciel; Chavrier, Françoise; Greillier, Paul; Chapelon, Jean Yves; Chevalier, Philippe; Lafon, Cyril

    2016-08-01

    Catheter ablation for the treatment of arrhythmia is associated with significant complications and often-repeated procedures. Consequently, a less invasive and more efficient technique is required. Because high-intensity focused ultrasound (HIFU) enables the generation of precise thermal ablations in deep-seated tissues without harming the tissues in the propagation path, it has the potential to be used as a new ablation technique. A system capable of delivering HIFU into the heart by a transesophageal route using ultrasound (US) imaging guidance was developed and tested in vivo in six male pigs. HIFU exposures were performed on atria and ventricles. At the time of autopsy, visual inspection identified thermal lesions in the targeted areas in three of the animals. These lesions were confirmed by histologic analysis (mean size: 5.5 mm(2) × 11 mm(2)). No esophageal thermal injury was observed. One animal presented with bradycardia due to an atrio-ventricular block, which provides real-time confirmation of an interaction between HIFU and the electrical circuits of the heart. Thus, US-guided HIFU has the potential to minimally invasively create myocardial lesions without an intra-cardiac device. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  5. High intensity interval and endurance training have opposing effects on markers of heart failure and cardiac remodeling in hypertensive rats.

    Directory of Open Access Journals (Sweden)

    Tanya M Holloway

    Full Text Available There has been re-emerging interest and significant work dedicated to investigating the metabolic effects of high intensity interval training (HIIT in recent years. HIIT is considered to be a time efficient alternative to classic endurance training (ET that elicits similar metabolic responses in skeletal muscle. However, there is a lack of information on the impact of HIIT on cardiac muscle in disease. Therefore, we determined the efficacy of ET and HIIT to alter cardiac muscle characteristics involved in the development of diastolic dysfunction, such as ventricular hypertrophy, fibrosis and angiogenesis, in a well-established rodent model of hypertension-induced heart failure before the development of overt heart failure. ET decreased left ventricle fibrosis by ~40% (P < 0.05, and promoted a 20% (P<0.05 increase in the left ventricular capillary/fibre ratio, an increase in endothelial nitric oxide synthase protein (P<0.05, and a decrease in hypoxia inducible factor 1 alpha protein content (P<0.05. In contrast, HIIT did not decrease existing fibrosis, and HIIT animals displayed a 20% increase in left ventricular mass (P<0.05 and a 20% decrease in cross sectional area (P<0.05. HIIT also increased brain natriuretic peptide by 50% (P<0.05, in the absence of concomitant angiogenesis, strongly suggesting pathological cardiac remodeling. The current data support the longstanding belief in the effectiveness of ET in hypertension. However, HIIT promoted a pathological adaptation in the left ventricle in the presence of hypertension, highlighting the need for further research on the widespread effects of HIIT in the presence of disease.

  6. The Effects of Heart Rate Versus Speed-Based High-Intensity Interval Training on Heart Rate Variability in Young Females

    Directory of Open Access Journals (Sweden)

    Maryam Rabbani

    2017-06-01

    Full Text Available Introduction: The aim of this study was to compare the effects of high-intensity interval training (HIT prescription by heart rate (HR-based and running speed (speed-based methods on natural logarithm of the square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals (Ln rMSSD as a measure of heart rate variability (HRV in young female student athletes. Methods: Seventeen female student athletes participated in this study and were divided into HR-based (n=9, age: 16.7 years and speed-based (n=8, age: 16.9 years HIT groups. 30-15 Intermittent Fitness Test was used for the speed-based group to detect the reference maximum speed (VIFT for prescribing the HIT intensity accordingly. Age predicted maximal HR was used for the HR-based group as the reference value. All subjects performed similar training protocol for 5 weeks, except the method of individualizing HIT sessions (2 weekly sessions of HIT=3 sets of 3 minutes work interspersed with 3 minutes passive recovery with the 15-15 seconds format during each working set; either according to 90%-95% of maximal HR or VIFT. Results: HR- and speed-based HIT groups showed the most likely large improvements in Ln rMSSD of +7.9%, 90% confidence limits [CL] (5.9; 10.0; standardized change: +1.75 (1.32; 2.19 and +5.5%, (2.8; 8.3; +1.41 (0.72; 2.09, respectively. In between group analyses, HR-based HIT produced likely a small greater improvement in Ln rMSSD than speed-based HIT (+1.9%, [-5.0; 4.4]; +0.50 [-0.14; 1.14], chances for greater/similar/lower values of 79/17/4. Conclusion: It is concluded that both HIT prescription strategies were effective in Ln rMSSD elevation, but using maximal HR as a reference may elicit higher parasympathetic dominance with small effect in young female student athletes.

  7. Prolongation of heart rate-corrected QT interval is a predictor of cardiac autonomic dysfunction in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Nomura, Atsushi; Kishimoto, Mitsumasa; Takahashi, Osamu; Deshpande, Gautam A; Yamaguchi, Kenichi; Okada, Masato

    2014-05-01

    Heart rate-corrected QT interval duration (QTc) has been shown to be related to cardiac autonomic dysfunction in patients with diabetes mellitus, although this association has not been previously described in patients with systemic lupus erythematosus (SLE). We retrospectively reviewed the medical records of 91 SLE patients and 144 non-SLE connective tissue disease patients visiting our clinic from November 2010 to April 2011. We compared ambulatory heart rate identified by pulse measured by automated machine in an outpatient waiting area versus resting heart rate identified on prior screening electrocardiogram. Heart rate differences were analyzed in relation to QTc interval and other characteristics. Ambulatory and resting heart rate differences were larger among SLE patients with QTc prolongation (QTc > 430 ms) than those without QTc prolongation (mean difference, 15.9 vs. 9.6, p = 0.001). In multivariate analysis, differences in heart rate were associated with QTc prolongation (OR 1.10, 95 % CI 1.01-1.21; p = 0.038), independent of age, duration of disease, immunosuppressant use, hydroxychloroquine use, diabetes mellitus, cardiac abnormality, anti-Ro/SS-A antibody positivity, or resting heart rate. Cardiac autonomic dysfunction is a common manifestation of SLE and may be related to QTc prolongation.

  8. BIOPHYSICAL CHARACTERISATION OF THE UNDER-APPRECIATED AND IMPORTANT RELATIONSHIP BETWEEN HEART RATE VARIABILITY AND HEART RATE

    Science.gov (United States)

    Monfredi, Oliver; Lyashkov, Alexey E; Johnsen, Anne-Berit; Inada, Shin; Schneider, Heiko; Wang, Ruoxi; Nirmalan, Mahesh; Wisloff, Ulrik; Maltsev, Victor A; Lakatta, Edward G; Zhang, Henggui; Boyett, Mark R

    2014-01-01

    Heart rate variability (beat-to-beat changes in the RR interval) has attracted considerable attention over the last 30+ years (PubMed currently lists >17,000 publications). Clinically, a decrease in heart rate variability is correlated to higher morbidity and mortality in diverse conditions, from heart disease to foetal distress. It is usually attributed to fluctuation in cardiac autonomic nerve activity. We calculated heart rate variability parameters from a variety of cardiac preparations (including humans, living animals, Langendorff-perfused heart and single sinoatrial nodal cell) in diverse species, combining this with data from previously published papers. We show that regardless of conditions, there is a universal exponential decay-like relationship between heart rate variability and heart rate. Using two biophysical models, we develop a theory for this, and confirm that heart rate variability is primarily dependent on heart rate and cannot be used in any simple way to assess autonomic nerve activity to the heart. We suggest that the correlation between a change in heart rate variability and altered morbidity and mortality is substantially attributable to the concurrent change in heart rate. This calls for re-evaluation of the findings from many papers that have not adjusted properly or at all for heart rate differences when comparing heart rate variability in multiple circumstances. PMID:25225208

  9. smRithm: Graphical user interface for heart rate variability analysis.

    Science.gov (United States)

    Nara, Sanjeev; Kaur, Manvinder; Datta, Saurav

    2015-01-01

    Over the past 25 years, Heart rate variability (HRV) has become a non-invasive research and clinical tool for indirectly carrying out investigation of both cardiac and autonomic system function in both healthy and diseased. It provides valuable information about a wide range of cardiovascular disorders, pulmonary diseases, neurological diseases, etc. Its primary purpose is to access the functioning of the nervous system. The source of information for HRV analysis is the continuous beat to beat measurement of inter-beat intervals. The electrocardiography (ECG or EKG) is considered as the best way to measure inter-beat intervals. This paper proposes an open source Graphical User Interface (GUI): smRithm developed in MATLAB for HRV analysis that will apply effective techniques on the raw ECG signals to process and decompose it in a simpler manner to obtain more useful information out of signals that can be utilized for more powerful and efficient applications in the near future related to HRV.

  10. Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

    NARCIS (Netherlands)

    Benda, N.M.M.; Seeger, J.P.; Stevens, G.G.; Hijmans-Kersten, B.T.P.; Dijk, A.P.J. van; Bellersen, L.; Lamfers, E.J.; Hopman, M.T.E.; Thijssen, D.H.J.

    2015-01-01

    INTRODUCTION: Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF

  11. Effects of high-intensity interval training on central haemodynamics and skeletal muscle oxygenation during exercise in patients with chronic heart failure

    NARCIS (Netherlands)

    Spee, Ruud F.; Niemeijer, Victor M.; Wijn, Pieter F. F.; Doevendans, Pieter A.|info:eu-repo/dai/nl/164248366; Kemps, Hareld M. C.

    2016-01-01

    Background High-intensity interval training (HIT) improves exercise capacity in patients with chronic heart failure (CHF). Moreover, HIT was associated with improved resting cardiac function. However, the extent to which these improvements actually contribute to training-induced changes in exercise

  12. Usefulness of short-term variability of QT intervals as a predictor for electrical remodeling and proarrhythmia in patients with nonischemic heart failure

    DEFF Research Database (Denmark)

    Hinterseer, Martin; Beckmann, Britt-Maria; Thomsen, Morten Bækgaard

    2010-01-01

    The high incidence of sudden cardiac death in heart failure (HF) reflects electrophysiologic changes in response to myocardial failure. We previously showed that short-term variability of QT intervals (STV(QT)) identifies latent repolarization disorders in patients with drug-induced or congenital...

  13. Quantification of fetal heart rate regularity using symbolic dynamics

    Science.gov (United States)

    van Leeuwen, P.; Cysarz, D.; Lange, S.; Geue, D.; Groenemeyer, D.

    2007-03-01

    Fetal heart rate complexity was examined on the basis of RR interval time series obtained in the second and third trimester of pregnancy. In each fetal RR interval time series, short term beat-to-beat heart rate changes were coded in 8bit binary sequences. Redundancies of the 28 different binary patterns were reduced by two different procedures. The complexity of these sequences was quantified using the approximate entropy (ApEn), resulting in discrete ApEn values which were used for classifying the sequences into 17 pattern sets. Also, the sequences were grouped into 20 pattern classes with respect to identity after rotation or inversion of the binary value. There was a specific, nonuniform distribution of the sequences in the pattern sets and this differed from the distribution found in surrogate data. In the course of gestation, the number of sequences increased in seven pattern sets, decreased in four and remained unchanged in six. Sequences that occurred less often over time, both regular and irregular, were characterized by patterns reflecting frequent beat-to-beat reversals in heart rate. They were also predominant in the surrogate data, suggesting that these patterns are associated with stochastic heart beat trains. Sequences that occurred more frequently over time were relatively rare in the surrogate data. Some of these sequences had a high degree of regularity and corresponded to prolonged heart rate accelerations or decelerations which may be associated with directed fetal activity or movement or baroreflex activity. Application of the pattern classes revealed that those sequences with a high degree of irregularity correspond to heart rate patterns resulting from complex physiological activity such as fetal breathing movements. The results suggest that the development of the autonomic nervous system and the emergence of fetal behavioral states lead to increases in not only irregular but also regular heart rate patterns. Using symbolic dynamics to

  14. Endoscopic exposure and stabilization of posterior and inferior branches using the endo-starfish cardiac positioner and the endo-octopus stabilizer for closed-chest beating heart multivessel CABG: hemodynamic changes in the pig.

    Science.gov (United States)

    Gründeman, Paul F; Budde, Ricardo; Beck, Hendricus Mansvelt; van Boven, Wim-Jan; Borst, Cornelius

    2003-09-09

    RDP, and composite graft from left IMA jump to diagonal branch). In 10 animals, 16 successfully completed anastomoses to RPD and OM branches of Ø1.75 to 2.5 mm required 25 to 60 minutes each to construct. At sacrifice, all anastomoses were patent. In the closed-chest pig in Trendelenburg position and during lifting of the sternum, the EndoStarfish and EndoOctopus enabled IMA grafting of posterior and inferior branches on the beating heart without mean arterial pressure dropping below 70 mm Hg.

  15. Congestive Heart Failure Leads to Prolongation of the PR Interval and Atrioventricular Junction Enlargement and Ion Channel Remodelling in the Rabbit

    Science.gov (United States)

    Nikolaidou, Theodora; Cai, Xue J.; Stephenson, Robert S.; Yanni, Joseph; Lowe, Tristan; Atkinson, Andrew J.; Jones, Caroline B.; Sardar, Rida; Corno, Antonio F.; Dobrzynski, Halina; Withers, Philip J.; Jarvis, Jonathan C.; Hart, George; Boyett, Mark R.

    2015-01-01

    Heart failure is a major killer worldwide. Atrioventricular conduction block is common in heart failure; it is associated with worse outcomes and can lead to syncope and bradycardic death. We examine the effect of heart failure on anatomical and ion channel remodelling in the rabbit atrioventricular junction (AVJ). Heart failure was induced in New Zealand rabbits by disruption of the aortic valve and banding of the abdominal aorta resulting in volume and pressure overload. Laser micro-dissection and real-time polymerase chain reaction (RT-PCR) were employed to investigate the effects of heart failure on ion channel remodelling in four regions of the rabbit AVJ and in septal tissues. Investigation of the AVJ anatomy was performed using micro-computed tomography (micro-CT). Heart failure animals developed first degree heart block. Heart failure caused ventricular myocardial volume increase with a 35% elongation of the AVJ. There was downregulation of HCN1 and Cx43 mRNA transcripts across all regions and downregulation of Cav1.3 in the transitional tissue. Cx40 mRNA was significantly downregulated in the atrial septum and AVJ tissues but not in the ventricular septum. mRNA abundance for ANP, CLCN2 and Navβ1 was increased with heart failure; Nav1.1 was increased in the inferior nodal extension/compact node area. Heart failure in the rabbit leads to prolongation of the PR interval and this is accompanied by downregulation of HCN1, Cav1.3, Cx40 and Cx43 mRNAs and anatomical enlargement of the entire heart and AVJ. PMID:26509807

  16. Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness.

    Science.gov (United States)

    Koufaki, Pelagia; Mercer, Thomas H; George, Keith P; Nolan, James

    2014-04-01

    The health benefits of high-intensity interval training in cardiac rehabilitation warrant further research. We compared the effectiveness of low-volume high-intensity interval training vs continuous aerobic exercise training in chronic heart failure. Unblinded, two arm parallel design with random assignment to exercise interventions in out-patient hospital rehabilitation gym. Patients with signs of chronic heart failure and ejection fraction training (n = 9) or high-intensity interval training (n = 8). Cardiorespiratory fitness was determined during cycle ergometry using respiratory gas exchange analysis. Functional capacity was assessed via sit-to-stand and gait speed. Quality of life was assessed using the MOS Short-Form 36 and Minnesota living with heart failure questionnaires. Cardiac autonomic regulation was assessed using Heart Rate Variability. Analysis of Covariance revealed significant time effects but no group × time interactions for exercise and functional capacity outcomes. Peak oxygen uptake (VO2peak) improved by a mean of 14.9% (SD 16.3%) from baseline and by 22% (SD 28.3) at ventilatory threshold in both groups. Sit-to-stand (11.9 (SD 11%)) and gait speed (16.0 (SD 19%)) improved similarly in both groups. No changes in quality of life or heart rate variability were noted. Training adaptations in high-intensity interval training were achieved despite a significantly reduced time commitment and total work volume compared to continuous aerobic exercise training. Low-volume high-intensity interval training is a feasible and well tolerated training modality in cardiac rehabilitation settings, but is not more effective than continuous aerobic exercise training.

  17. Electrocardiogram: his bundle potentials can be recorded noninvasively beat by beat on surface electrocardiogram.

    Science.gov (United States)

    Wang, Gaopin; Liu, Renguang; Chang, Qinghua; Xu, Zhaolong; Zhang, Yingjie; Pan, Dianzhu

    2017-03-15

    The micro waveform of His bundle potential can't be recorded beat-to-beat on surface electrocardiogram yet. We have found that the micro-wavelets before QRS complex may be related to atrioventricular conduction system potentials. This study is to explore the possibility of His bundle potential can be noninvasively recorded on surface electrocardiogram. We randomized 65 patients undergoing radiofrequency catheter ablation of paroxysmal superventricular tachycardia (exclude overt Wolff-Parkinson-White syndrome) to receive "conventional electrocardiogram" and "new electrocardiogram" before the procedure. His bundle electrogram was collected during the procedure. Comparative analysis of PA s (PA interval recorded on surface electrocardiogram), AH s (AH interval recorded on surface electrocardiogram) and HV s (HV interval recorded on surface electrocardiogram) interval recorded on surface "new electrocardiogram" and PA, AH, HV interval recorded on His bundle electrogram was investigated. There was no difference (P > 0.05) between groups in HV s interval (49.63 ± 6.19 ms) and HV interval (49.35 ± 6.49 ms). Results of correlational analysis found that HV S interval was significantly positively associated with HV interval (r = 0.929; P electrocardiogram. Noninvasive His bundle potential tracing might represent a new method for locating the site of atrioventricular block and identifying the origin of a wide QRS complex.

  18. Blood Pressure vs. Heart Rate

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Sep 15,2017 Understanding the difference ... your blood moving through your blood vessels, your heart rate is the number of times your heart beats ...

  19. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  20. The effects of auditory stimulation with music on heart rate variability in healthy women

    Directory of Open Access Journals (Sweden)

    Adriano L. Roque

    2013-07-01

    Full Text Available OBJECTIVES: There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. METHODS: We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21, who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19, who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB. A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB. The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio, low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. RESULTS: The triangular index and the standard deviation of

  1. The effects of auditory stimulation with music on heart rate variability in healthy women.

    Science.gov (United States)

    Roque, Adriano L; Valenti, Vitor E; Guida, Heraldo L; Campos, Mônica F; Knap, André; Vanderlei, Luiz Carlos M; Ferreira, Lucas L; Ferreira, Celso; Abreu, Luiz Carlos de

    2013-07-01

    There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. The triangular index and the standard deviation of the long-term RR interval indices were reduced

  2. Regularity of beating of small clusters of embryonic chick ventricular heart-cells: experiment vs. stochastic single-channel population model

    Science.gov (United States)

    Krogh-Madsen, Trine; Kold Taylor, Louise; Skriver, Anne D.; Schaffer, Peter; Guevara, Michael R.

    2017-09-01

    The transmembrane potential is recorded from small isopotential clusters of 2-4 embryonic chick ventricular cells spontaneously generating action potentials. We analyze the cycle-to-cycle fluctuations in the time between successive action potentials (the interbeat interval or IBI). We also convert an existing model of electrical activity in the cluster, which is formulated as a Hodgkin-Huxley-like deterministic system of nonlinear ordinary differential equations describing five individual ionic currents, into a stochastic model consisting of a population of ˜20 000 independently and randomly gating ionic channels, with the randomness being set by a real physical stochastic process (radio static). This stochastic model, implemented using the Clay-DeFelice algorithm, reproduces the fluctuations seen experimentally: e.g., the coefficient of variation (standard deviation/mean) of IBI is 4.3% in the model vs. the 3.9% average value of the 17 clusters studied. The model also replicates all but one of several other quantitative measures of the experimental results, including the power spectrum and correlation integral of the voltage, as well as the histogram, Poincaré plot, serial correlation coefficients, power spectrum, detrended fluctuation analysis, approximate entropy, and sample entropy of IBI. The channel noise from one particular ionic current (IKs), which has channel kinetics that are relatively slow compared to that of the other currents, makes the major contribution to the fluctuations in IBI. Reproduction of the experimental coefficient of variation of IBI by adding a Gaussian white noise-current into the deterministic model necessitates using an unrealistically high noise-current amplitude. Indeed, a major implication of the modelling results is that, given the wide range of time-scales over which the various species of channels open and close, only a cell-specific stochastic model that is formulated taking into consideration the widely different ranges in

  3. Mesenchymal stem cells improve mouse non-heart-beating liver graft survival by inhibiting Kupffer cell apoptosis via TLR4-ERK1/2-Fas/FasL-caspase3 pathway regulation

    Directory of Open Access Journals (Sweden)

    Yang Tian

    2016-10-01

    Full Text Available Abstract Background Liver transplantation is the optimal treatment option for end-stage liver disease, but organ shortages dramatically restrict its application. Donation after cardiac death (DCD is an alternative approach that may expand the donor pool, but it faces challenges such as graft dysfunction, early graft loss, and cholangiopathy. Moreover, DCD liver grafts are no longer eligible for transplantation after their warm ischaemic time exceeds 30 min. Mesenchymal stem cells (MSCs have been proposed as a promising therapy for treatment of certain liver diseases, but the role of MSCs in DCD liver graft function remains elusive. Methods In this study, we established an arterialized mouse non-heart-beating (NHB liver transplantation model, and compared survival rates, cytokine and chemokine expression, histology, and the results of in vitro co-culture experiments in animals with or without MSC infusion. Results MSCs markedly ameliorated NHB liver graft injury and improved survival post-transplantation. Additionally, MSCs suppressed Kupffer cell apoptosis, Th1/Th17 immune responses, chemokine expression, and inflammatory cell infiltration. In vitro, PGE2 secreted by MSCs inhibited Kupffer cell apoptosis via TLR4-ERK1/2-caspase3 pathway regulation. Conclusion Our study uncovers a protective role for MSCs and elucidates the underlying immunomodulatory mechanism in an NHB liver transplantation model. Our results suggest that MSCs are uniquely positioned for use in future clinical studies owing to their ability to protect DCD liver grafts, particularly in patients for whom DCD organs are not an option according to current criteria.

  4. A quantitative high resolution voxel-wise assessment of myocardial blood flow from contrast-enhanced first-pass magnetic resonance perfusion imaging: microsphere validation in a magnetic resonance compatible free beating explanted pig heart model.

    Science.gov (United States)

    Schuster, Andreas; Sinclair, Matthew; Zarinabad, Niloufar; Ishida, Masaki; van den Wijngaard, Jeroen P H M; Paul, Matthias; van Horssen, Pepijn; Hussain, Shazia T; Perera, Divaka; Schaeffter, Tobias; Spaan, Jos A E; Siebes, Maria; Nagel, Eike; Chiribiri, Amedeo

    2015-10-01

    To assess the feasibility of high-resolution quantitative cardiovascular magnetic resonance (CMR) voxel-wise perfusion imaging using clinical 1.5 and 3 T sequences and to validate it using fluorescently labelled microspheres in combination with a state of the art imaging cryomicrotome in a novel, isolated blood-perfused MR-compatible free beating pig heart model without respiratory motion. MR perfusion imaging was performed in pig hearts at 1.5 (n = 4) and 3 T (n = 4). Images were acquired at physiological flow ('rest'), reduced flow ('ischaemia'), and during adenosine-induced hyperaemia ('stress') in control and coronary occlusion conditions. Fluorescently labelled microspheres and known coronary myocardial blood flow represented the reference standards for quantitative perfusion validation. For the comparison with microspheres, the LV was divided into 48 segments based on a subdivision of the 16 AHA segments into subendocardial, midmyocardial, and subepicardial subsegments. Perfusion quantification of the time-signal intensity curves was performed using a Fermi function deconvolution. High-resolution quantitative voxel-wise perfusion assessment was able to distinguish between occluded and remote myocardium (P < 0.001) and between rest, ischaemia, and stress perfusion conditions at 1.5 T (P < 0.001) and at 3 T (P < 0.001). CMR-MBF estimates correlated well with the microspheres at the AHA segmental level at 1.5 T (r = 0.94, P < 0.001) and at 3 T (r = 0.96, P < 0.001) and at the subendocardial, midmyocardial, and subepicardial level at 1.5 T (r = 0.93, r = 0.9, r = 0.88, P < 0.001, respectively) and at 3 T (r = 0.91, r = 0.95, r = 0.84, P < 0.001, respectively). CMR-derived voxel-wise quantitative blood flow assessment is feasible and very accurate compared with microspheres. This technique is suitable for both clinically used field strengths and may provide the tools to assess extent and severity of myocardial ischaemia. Published on behalf of the European Society

  5. An efficient method for ectopic beats cancellation based on radial basis function.

    Science.gov (United States)

    Mateo, Jorge; Torres, Ana; Rieta, José J

    2011-01-01

    The analysis of the surface Electrocardiogram (ECG) is the most extended noninvasive technique in cardiological diagnosis. In order to properly use the ECG, we need to cancel out ectopic beats. These beats may occur in both normal subjects and patients with heart disease, and their presence represents an important source of error which must be handled before any other analysis. This paper presents a method for electrocardiogram ectopic beat cancellation based on Radial Basis Function Neural Network (RBFNN). A train-able neural network ensemble approach to develop customized electrocardiogram beat classifier in an effort to further improve the performance of ECG processing and to offer individualized health care is presented. Six types of beats including: Normal Beats (NB); Premature Ventricular Contractions (PVC); Left Bundle Branch Blocks (LBBB); Right Bundle Branch Blocks (RBBB); Paced Beats (PB) and Ectopic Beats (EB) are obtained from the MIT-BIH arrhythmia database. Four morphological features are extracted from each beat after the preprocessing of the selected records. Average Results for the RBFNN based method provided an ectopic beat reduction (EBR) of (mean ± std) EBR = 7, 23 ± 2.18 in contrast to traditional compared methods that, for the best case, yielded EBR = 4.05 ± 2.13. The results prove that RBFNN based methods are able to obtain a very accurate reduction of ectopic beats together with low distortion of the QRST complex.

  6. Survival after withdrawal of dofetilide in patients with congestive heart failure and a short baseline QTc interval; a follow-up on the Diamond-CHF QT substudy

    DEFF Research Database (Denmark)

    Brendorp, B; Torp-Pedersen, C; Elming, H

    2003-01-01

    withdrawal of dofetilide. METHODS: Patients with congestive heart failure (CHF) and reduced left ventricular function enrolled in the Diamond-CHF (Danish Investigations of Arrhythmia and Mortality on Dofetilide-CHF) study were eligible for our QT substudy provided they were in sinus rhythm and had......% confidence interval 1.1-2.8)[corrected]. CONCLUSIONS: This follow-up study shows significant loss of survival benefit upon withdrawal of dofetilide in patients with CHF and a pre-treatment QTc interval below 429 ms. An independent randomized trial is warranted to validate these results....

  7. The effect of low-dose β-blocker on heart rate and heart rate variability in health subjects wth a resting heart rate of less than 65 beats per minute: Effect on the quality of prospective electrocardiography-gated coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chul Hwan; Kim, Tae Hoon [Dept. of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Sang Min [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-02-15

    We assessed the effect of a low-dose β-blocker on heart rate (HR), HR variability (HRV) and image quality of prospective electrocardiography-gated coronary CT angiography (CCTA) in healthy subjects with low HR. CCTA was performed with a 64-slice CT in 75 subjects with a HR of less than 65 beats per minute (bpm). Subjects were divided into 2 groups: Group 1 (G1), 35 with a low dose β-blocker; and Group 2 (G2), 40 without pre-medication. The image quality (IQ) of the CCTA was assessed on a 4-point grading scale (1, poor; 4, excellent). Initial HR (bpm) was not different between the 2 groups. HR during CCTA was lower in G1 than G2 (50.3 ± 5.6 vs. 53.3 ± 4.8, p = 0.016). HRV was not different between the 2 groups. Per-segment analysis showed better IQ at the mid-segment of the right coronary artery (3.0 ± 0.9 vs. 2.5 ± 1.1, p = 0.039) and the first diagonal branch (3.4 ± 0.6 vs. 3.1 ± 0.7, p = 0.024), in the G1 than the G2 group, respectively. The IQ was negatively correlated with HR, but no correlation was found between HRV and IQ. The IQs in the per-vessel analysis were not different between the 2 groups. Low-dose β-blocker reduced HR and improved the IQ of CCTA in a few segments, even at a HR of less than 65 bpm. However the effect was limited.

  8. One year of high-intensity interval training improves exercise capacity, but not left ventricular function in stable heart transplant recipients: a randomised controlled trial.

    Science.gov (United States)

    Rustad, Lene A; Nytrøen, Kari; Amundsen, Brage H; Gullestad, Lars; Aakhus, Svend

    2014-02-01

    Heart transplant recipients have lower exercise capacity and impaired cardiac function compared with the normal population. High-intensity interval training (HIIT) improves exercise capacity and cardiac function in patients with heart failure and hypertension, but the effect on cardiac function in stable heart transplant recipients is not known. Thus, we investigated whether HIIT improved cardiac function and exercise capacity in stable heart transplant recipients by use of comprehensive rest- and exercise-echocardiography and cardiopulmonary exercise testing. Fifty-two clinically stable heart transplant recipients were randomised either to HIIT (4 × 4 minutes at 85-95% of peak heart rate three times per week for eight weeks) or to control. Three such eight-week periods were distributed throughout one year. Echocardiography (rest and submaximal exercise) and cardiopulmonary exercise testing were performed at baseline and follow-up. One year of HIIT increased VO 2peak from 27.7 ± 5.5 at baseline to 30.9 ± 5.0 ml/kg/min at follow-up, while the control group remained unchanged (28.5 ± 7.0 vs. 28.0 ± 6.7 ml/kg per min, p cardiac systolic and diastolic function significantly. Thus, the observed augmentation in exercise capacity is best explained by extra-cardiac adaptive mechanisms.

  9. Efectos del entrenamiento continuo e interválico de carga externa similar sobre la frecuencia cardiaca Effects of continuous and interval training similar external load on heart rate

    Directory of Open Access Journals (Sweden)

    J. L. Tuimil

    2010-09-01

    Full Text Available

     

    Los objetivos de este estudio fueron comparar la frecuencia cardíaca (FC media entre dos tipos de entrenamiento de carga externa equiparada basados en la carrera, la relación de la velocidad aeróbica máxima (VAM con la F.C. de reserva (FCR y los efectos de estos dos tipos de entrenamiento sobre la F.C. basal (FCB. El estudio se llevó a cabo con ocho estudiantes de educación física (23,25 años; VAM: 17,93 Km.h-1 que realizaron dos tipos de entrenamiento: CC =8 km al 70%VAM y CI= 4x(1000m al 90%VAM+1000m al 50% VAM. Se registró la FC durante el entrenamiento y la FCB antes y después del mismo. La diferencia de la FC media entre ambos métodos no fue estadísticamente significativa, sin embargo las medias del CC (FCCC (Z=2,240; p<0,05 y CI (FCCI (Z=2,380; p<0,05 fueron significativamente más elevadas que la calculada al 70% de FCR. La FCB se elevó de forma significativa (Z=2,319; p=0.020 solamente después del entrenamiento CI. En conclusión, dos métodos de entrenamiento distintos, pero de intensidad media similar, pueden dar lugar a una FC media también similar. La intensidad de carrera programada en función de la VAM es significativamente superior a la programada en función de la FCR. El entrenamiento interválico puede tener un mayor efecto sobre el incremento de la FCB.
    PALABRAS CLAVE: Frecuencia cardíaca media, frecuencia cardíaca de reserva, frecuencia cardíaca basal, VAM, carrera continua, carrera interválica.

    The aims of this study were to compare the mean heart rate response in two training methods of equal average intensity based on running, the relationship of the maximal aerobic speed (VAM with the reserve heart rate (FCR and the effects of these modes of training on the basal heart rate (FCB. The study was carried out with eight physical activity students (23,25 years old; VAM: 17,93 Km.h-1

  10. Design and evaluation of a handheld impedance plethysmograph for measuring heart rate variability

    DEFF Research Database (Denmark)

    Kristiansen, N. K.; Fleischer, J.; Jensen, M. S.

    2005-01-01

    Heart rate variability (HRV) analysis from 10s ECGs has been shown to be reliable. However, the short examination time warrants a user-friendly system that can be used for ad-hoc examinations without normal preparation, unlike ECG. A handheld device has been developed that can measure ultra...... was performed by a digital signal processor, where the discrete heart beats were detected using a correlation algorithm that could adapt to individual pulse wave shapes to account for biological variation. The novel device was evaluated in 20 mainly young volunteers, using 10 s time-correlated ECG recordings...... as the reference method. Agreement between the two methods in measuring heart rate and root mean square of successive differences in the heart beat interval (RMSSD) was analysed using correlation coefficients (Pearson's R-2), mean differences with 95% confidence intervals and 95% limits of agreement, and Bland...

  11. [Physical training as interval or continuous training in chronic heart failure for improving functional capacity, hemodynamics and quality of life--a controlled study].

    Science.gov (United States)

    Nechwatal, R M; Duck, C; Gruber, G

    2002-04-01

    We conducted a three-week randomized trial comparing the improvement of functional capacity by exercise training in chronic heart failure by the steady-state (EF 27.3%, n = 20) and the interval modus (EF 29.3%, n = 20) with a control group (EF = 26.6%, n = 10). Minimal EF was 10%, the lowest maximal oxygen consumption was 9.3 ml/kg/min and the lowest cardiac output was 1.9 l/min; 9 patients had been evaluated for HTX. VO2 at the anaerobic threshold and at maximal exercise increased in the continuous exercise group by 1.4 or 1.6 ml/kg/min, respectively, corresponding to an increase of 13.7% (p clinically stable patients with heart failure and even those already having been evaluated for cardiac transplantation profit from short-term physical training. Both training modalities seem equally suited to improve functional capacity. However interval training leads to more pronounced improvement in hemodynamics compared to the steady-state exercise, whereas the later had a greater impact on psychological well-being and quality of life. Patients with heart failure and severe peripheral deconditioning tolerate higher workloads with more peripheral stress by an interval training modus. Long-term training modalities need to be established to further improve and stabilize functional status.

  12. High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure.

    Science.gov (United States)

    Taya, Masanobu; Amiya, Eisuke; Hatano, Masaru; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Tsuji, Masaki; Hosoya, Yumiko; Minatsuki, Shun; Nakayama, Astuko; Fujiwara, Takayuki; Konishi, Yuto; Yokota, Kazuhiko; Watanabe, Masafumi; Morita, Hiroyuki; Haga, Nobuhiko; Komuro, Issei

    2018-01-15

    This study investigated the effectiveness and safety of interval training during in-hospital treatment of patients with advanced heart failure. Twenty-four consecutive patients with advanced symptomatic heart failure who were referred for cardiac transplant evaluation were recruited. After performing aerobic exercise for approximate intensity, high-intensity interval training (HIIT) was performed. The protocol consisted of 3 or 4 sessions of 1-min high-intensity exercise aimed at 80% of peak VO2 or 80% heart rate reserve, followed by 4-min recovery periods of low intensity. In addition to the necessary laboratory data, hand grip strength and knee extensor strength were evaluated at the start of exercise training and both at the start and the end of HIIT. Knee extensor strength was standardized by body weight. The BNP level at the start of exercise training was 432 (812) pg/mL and it significantly decreased to 254 (400) pg/mL (p training to the start of HIIT. In addition, the change in knee extensor strength during HIIT was significantly associated with the hemoglobin A1c level at the start of exercise (R = - 0.55; p = 0.015). HIIT has a positive impact on skeletal muscle strength among in-hospital patients with advanced heart failure.

  13. Patient-specific ECG beat classification technique.

    Science.gov (United States)

    Das, Manab K; Ari, Samit

    2014-09-01

    Electrocardiogram (ECG) beat classification plays an important role in the timely diagnosis of the critical heart condition. An automated diagnostic system is proposed to classify five types of ECG classes, namely normal (N), ventricular ectopic beat (V), supra ventricular ectopic beat (S), fusion (F) and unknown (Q) as recommended by the Association for the Advancement of Medical Instrumentation (AAMI). The proposed method integrates the Stockwell transform (ST), a bacteria foraging optimisation (BFO) algorithm and a least mean square (LMS)-based multiclass support vector machine (SVM) classifier. The ST is utilised to extract the important morphological features which are concatenated with four timing features. The resultant combined feature vector is optimised by removing the redundant and irrelevant features using the BFO algorithm. The optimised feature vector is applied to the LMS-based multiclass SVM classifier for automated diagnosis. In the proposed technique, the LMS algorithm is used to modify the Lagrange multiplier, which in turn modifies the weight vector to minimise the classification error. The updated weights are used during the testing phase to classify ECG beats. The classification performances are evaluated using the MIT-BIH arrhythmia database. Average accuracy and sensitivity performances of the proposed system for V detection are 98.6% and 91.7%, respectively, and for S detections, 98.2% and 74.7%, respectively over the entire database. To generalise the capability, the classification performance is also evaluated using the St. Petersburg Institute of Cardiological Technics (INCART) database. The proposed technique performs better than other reported heartbeat techniques, with results suggesting better generalisation capability.

  14. The time interval between the onset of tricuspid E wave and annular Ea wave (TE-Ea) can predict right atrial pressure in patients with heart failure.

    Science.gov (United States)

    Naderi, Nasim; Amin, Ahmad; Haghighi, Zahra Ojaghi; Esmaeilzadeh, Maryam; Bakhshandeh, Hooman; Taghavi, Sepideh; Maleki, Majid

    2014-11-01

    There is conflicting data regarding the tricuspid annular velocities and their relation to right ventricular filling pressures. We aimed to assess if the time interval between the onset of tricuspid E wave and annular Ea wave has any correlation with right sided filling pressure in patients with heart failure. Thirty heart failure patients (left ventricular ejection fraction≤35%) were enrolled. Echocardiography was performed to obtain tricuspid inflow and tissue Doppler annular velocities just before a standard right heart catheterization. The right atrial pressure was obtained from right heart catheterization. The E/Ea [the ratio of peak velocity of early tricuspid inflow wave (E) to peak velocity of early diastolic wave of the lateral tricuspid annulus (Ea)] and the time intervals between the beginning of R wave of electrocardiogram and onset of E (TE) as well as between the beginning of R wave and onset of Et (TEa) were measured, TE-Ea was calculated as TE-TEa. The mean right atrial pressure (RAP) was 8.8 (SD=4.7) mm Hg. The mean TE-Ea was + 8.61 milliseconds. There was no significant correlation between RAP and E/Ea (r=0.08, p>0.05) but the correlation between TE-Ea and RAP was significant (r=0.5, p=0.01). According to our results and in contrary to some prior studies, we showed for the first time that right side TE-Ea stands as a better surrogate of right atrial pressure than E/Ea in heart failure patients. This finding needs more accurate studies and could present TE-Ea as a feasible tool to look into hemodynamics of heart failure patients.

  15. Heart beats from the dark side

    Science.gov (United States)

    Chang, Jin

    2018-01-01

    The Dark Matter Particle Explorer (DAMPE) satellite is currently in orbit measuring cosmic rays to research their origin and propagation and also to find possible hidden signatures of dark matter, emphasizes Principal Investigator Jin Chang.

  16. [The Study of the Measurement of Heart Rate Variability Using ECG and Photoplethysmographic Signal].

    Science.gov (United States)

    Wang, Buqing; Chai, Xiaoke; Zhang Zhengbo; Wang, Weidong

    2015-07-01

    In comparison with the measurement of heart rate variability from ECG and from photoplethysmographic signal from 46 healthy adults in their spontaneous breathing state. The beat-to-beat intervals in ECG and pulse-to-pulse intervals in photoplethysmographic signal are extracted, and then the parameters of heart rate variability are calculated. Three kinds of algorithms are chosen to get the pulse-to-pulse intervals, which are the intervals of maximum of second derivative, the maximum of PPG signal and the tangent intersection. The results show that the correlation coefficients of the HRV parameters in the two calculation methods are highly correlated. The Bland-Altman scattered plots show the relative bias results from the algorithm of the maximum of PPG signal are smallest and singular points that deviate from the consistent limits are the least compared with the other two algorithms.

  17. The Effects of Female Sex Hormones on Ventricular Premature Beats and Repolarization Parameters in Physiological Menstrual Cycle.

    Science.gov (United States)

    Dogan, Mehmet; Yiginer, Omer; Uz, Omer; Kucuk, Ugur; Degirmencioglu, Gokhan; Isilak, Zafer; Uzun, Mehmet; Davulcu, Ezgi

    2016-05-01

    The effects of gender difference on cardiac electrophysiology have been well studied. In this study, we aimed to evaluate the effects of estradiol and progesteron changes occuring in physiological menstrual cycle on ventricular premature beats (VPBs) and cardiac repolarization parameters. Women of reproductive age with VPBs were included into the study group and healthy women were recruited as the control group. During the menstruation period, a 12-lead electrocardiography, blood samples, and 24-hour rhythm Holter were applied to the study group. Similarly, all tests were repeated in the estimated ovulation period (12-14 days before menstruation) by all cases. The study group consisted of 20 women patients with VPB, and the control group of 18 healthy women. While the number of VPB in the menstruation period was 210 beats/day (interquartile range [IQR]: 1,144), it decreased to 86 beats/day (IQR: 251) in the ovulation period with statistical significance (P < 0.05). Average heart rate in the menstruation period was 81.4 ± 10 beats/min and it significantly increased to 84.6 ± 8 beats/min in the ovulation period (P < 0.05). There were no differences in cardiac repolarization parameters in both menstruation and ovulation periods between the study and control groups. Comparing the menstruation and the ovulation periods, J-Tpeak interval, which reflects early repolarization, was shorter in the ovulation period (193 ± 27.7 ms and 201.1 ± 28.6 ms, respectively; P < 0.05). Other repolarization parameters did not show any significant difference. VPB frequency decreases with estradiol peak in the ovulation period. This suggests that estrogen may have protective effects against ventricular arrhythmias. ©2016 Wiley Periodicals, Inc.

  18. Unexplained Graft Dysfunction after Heart Transplantation—Role of Novel Molecular Expression Test Score and QTc-Interval: A Case Report

    Directory of Open Access Journals (Sweden)

    Khurram Shahzad

    2010-01-01

    Full Text Available In the current era of immunosuppressive medications there is increased observed incidence of graft dysfunction in the absence of known histological criteria of rejection after heart transplantation. A noninvasive molecular expression diagnostic test was developed and validated to rule out histological acute cellular rejection. In this paper we present for the first time, longitudinal pattern of changes in this novel diagnostic test score along with QTc-interval in a patient who was admitted with unexplained graft dysfunction. Patient presented with graft failure with negative findings on all known criteria of rejection including acute cellular rejection, antibody mediated rejection and cardiac allograft vasculopathy. The molecular expression test score showed gradual increase and QTc-interval showed gradual prolongation with the gradual decline in graft function. This paper exemplifies that in patients presenting with unexplained graft dysfunction, GEP test score and QTc-interval correlate with the changes in the graft function.

  19. Influence of serotonin transporter gene polymorphism (5-HTTLPR polymorphism on the relation between brain 5-HT transporter binding and heart rate corrected cardiac repolarization interval.

    Directory of Open Access Journals (Sweden)

    Esa Kauppila

    Full Text Available OBJECTIVE: Serotonin transporter gene polymorphism (5-HTTLPR polymorphism predicts the degree of structural and functional connectivity in the brain, and less consistently the degree of vulnerability for anxiety and depressive disorders. It is less known how 5-HTTLPR polymorphism influences on the coupling between brain and neuronal cardiovascular control. The present study demonstrates the impact of 5-HTTLPR polymorphism on the relations between heart rate (HR corrected cardiac repolarization interval (QTc interval and the brain 5-HTT binding. MATERIAL AND METHODS: Thirty healthy young adults (fifteen monozygotic twin pairs (mean age 26±1.3 years, 16 females were imagined with single-photon emission computed tomography (SPECT using iodine-123 labeled 2β-carbomethoxy-3β-(4-iodophenyl nortropane (nor-β-CIT. Continuous ECG recording was obtained from each participant at supine rest. Signal averaged QTc interval on continuous ECG was calculated and compared with the brain imaging results. RESULTS: In the two groups [l homozygotes (n = 16, 10 females, s carriers (n = 14, 8 female] HR and the length of QTc interval were not influenced by 5-HTTLPR polymorphism. There were no significant relations between HR and 5-HTT binding in the brain. There were significant associations between QTc interval and nor-β-CIT binding in the brain in l homozygotes, but not in s carriers (correlations for QTc interval and nor-β-CIT binding of striatum, thalamus and right temporal region were -0.8--0.9, (p<0.0005, respectively. CONCLUSION: The finding of longer QTc interval with less 5-HTT binding availability in major serotonergic binding sites in l homozygotes, but not in s carriers, implicate to differentiated control of QTc interval by 5-HTTLPR polymorphism.

  20. Beat-to-beat tracking of systolic blood pressure using noninvasive pulse transit time during anesthesia induction in hypertensive patients.

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    Kim, Sung-Hoon; Song, Jun-Gol; Park, Ji-Hyun; Kim, Jung-Won; Park, Yong-Seok; Hwang, Gyu-Sam

    2013-01-01

    Pulse transit time (PTT) has been reported to show good agreement with arterial blood pressure (BP) in awake humans. We evaluated whether noninvasive beat-to-beat PTT accurately correlated with invasively measured continuous arterial BP during anesthesia induction in hypertensive patients. Twenty-three hypertensive patients who were scheduled for kidney transplant were enrolled. Radial arterial BP, electrocardiogram, and finger pulse oximetric plethysmography were simultaneously recorded. PTT was measured as the time interval from the R-wave peak on the electrocardiogram to the maximal upslope of the photoplethysmogram. Relationships between beat-to-beat PTT and BP were evaluated by correlation and receiver operating characteristic (ROC) curve analysis. During anesthesia induction, changes in PTT were directly proportional to changes in BP: when BP decreased, PTT lengthened, and vice versa. The inverse of PTT demonstrated significantly better correlation with systolic BP than with mean BP (r = 0.81 ± 0.11 vs r = 0.72 ± 0.17; P < 0.001) or diastolic BP (r = 0.81 ± 0.11 vs r = 0.52 ± 0.24; P < 0.001). The inverse of PTT was more highly correlated with decreasing than with increasing changes in systolic BP (r = 0.83 ± 0.12 vs r = 0.68 ± 0.20; P = 0.001). The ROC curve analysis revealed that a 15% increase in PTT during anesthesia induction could detect a ≥30% decrease in systolic BP, with an area under the ROC curve of 0.85. Beat-to-beat PTT was fairly well correlated with invasive systolic BP and could predict a reduction in systolic BP during anesthesia induction. Beat-to-beat PTT may show potential as a useful noninvasive index of systolic BP when invasive BP is unavailable in high-risk hypertensive patients.

  1. Effects of Heart Rate vs. Speed-Based High Intensity Interval Training on Aerobic and Anaerobic Capacity of Female Soccer Players

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    Hamid Arazi

    2017-08-01

    Full Text Available The purpose of this study was to compare the effects of two types of high-intensity interval training (HIIT programs on aerobic and anaerobic capacity of female soccer players. Regional-level female athletes were randomly divided into heart rate-based HIIT (n = 8; age 23.4 ± 1.1 year and speed-based HIIT groups (n = 8; age 23.4 ± 1.3 year. Athletes trained three days per week for six weeks. Before and after training, each athlete’s performance was assessed directly through the Hoff test, 30-15 Intermittent Fitness Test (VIFT, and repeated-sprint ability test (RAST; maximal oxygen consumption (VO2max, power and fatigue were estimated indirectly. Both experimental groups improved power, fatigue index and VO2max after training (p < 0.05. It was noteworthy that the speed-based group had greater gains in minimal power (effect size (ES: 3.99 vs. 0.75, average power (ES: 2.23 vs. 0.33, and fatigue index (ES: 2.53 vs. 0.17 compared to heart rate-based group (p < 0.05. In conclusion, both heart rate-based and speed-based HIIT induced meaningful improvements in power, VO2max, and fatigue index in female soccer players, although the speed-based HIIT group achieved greater gains in power and fatigue index compared to the heart rate-based group.

  2. Resting heart rate and the risk of hypertension and heart failure: a dose-response meta-analysis of prospective studies.

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    Shi, Yuanyuan; Zhou, Wen; Liu, Xuejiao; Ping, Zhiguang; Li, Yu-Qian; Wang, Chongjian; Lu, Jie; Mao, Zhen-Xing; Zhao, Jingzhi; Yin, Lei; Zhang, Dongdong; Li, Linlin

    2017-11-25

    Studies on the relationship of resting heart rate to the risks of hypertension and heart failure have been inconsistent, and the question as to whether there is a linear association between them is unanswered. To evaluate this possible relationship, we carried out a dose-response meta-analysis of studies that looked at risks associated with resting heart rate and hypertension or heart failure. We searched PubMed, Embase, CNKI and WanFang databases for articles published before 15 June 2017. A random-effect model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the resting heart rate-hypertension and heart failure risk association. We identified 13 and 17 cohort studies for hypertension and heart failure, respectively. The risk for each disease, respectively, increased by 11% relative risk: 1.11 (95% confidence interval: 1.07-1.15) and 19% relative risk: 1.19 (95% confidence interval: 1.13-1.25) for each 10 beats-per-minute increment in resting heart rate. The relationship between resting heart rate and hypertension or heart failure was consistent in most subgroup analyses except for gender subgroups, with no significant association observed in the women subgroup. The results provide no evidence of a nonlinear association of elevated resting heart rate with hypertension and heart failure risk. Resting heart rate shows a linear positive association with the incidence of hypertension and heart failure.

  3. The prognostic significance of heart rate in patients hospitalized for heart failure with reduced ejection fraction in sinus rhythm: insights from the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study With Tolvaptan) trial.

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    Greene, Stephen J; Vaduganathan, Muthiah; Wilcox, Jane E; Harinstein, Matthew E; Maggioni, Aldo P; Subacius, Haris; Zannad, Faiez; Konstam, Marvin A; Chioncel, Ovidiu; Yancy, Clyde W; Swedberg, Karl; Butler, Javed; Bonow, Robert O; Gheorghiade, Mihai

    2013-12-01

    The purpose of this study was to characterize the relationship between heart rate and post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction (EF) in sinus rhythm. A reduction in heart rate improves clinical outcomes in patients with chronic heart failure and in sinus rhythm, but the association between heart rate and post-discharge outcomes in patients with HHF is presently unclear. This post-hoc analysis of the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study With Tolvaptan) trial examined 1,947 patients with HHF and EF ≤40% not in atrial fibrillation/flutter or pacemaker dependent. The median follow-up period was 9.9 months. At baseline, patients with a higher heart rate tended to be younger with lower EF and were more likely to have worse New York Heart Association functional class and higher natriuretic peptide levels. After adjustment for clinical risk factors, baseline heart rate was not predictive of all-cause mortality (p ≥ 0.066). However, at ≥70 beats/min, every 5-beat increase in 1-week post-discharge heart rate was independently associated with increased all-cause mortality (hazard ratio: 1.13 [95% confidence interval: 1.05 to 1.22]; p = 0.002). Similarly, every 5-beat increase ≥70 beats/min in 4-week post-discharge heart rate was predictive of all-cause mortality (hazard ratio: 1.12 [95% confidence interval: 1.05 to 1.19]; p = 0.001). In this large cohort of patients with HHF with reduced EF and in sinus rhythm, baseline heart rate did not correlate with all-cause mortality. In contrast, at ≥70 beats/min, higher heart rate in the early post-discharge period was independently predictive of death during subsequent follow-up. Further study of post-discharge heart rate as a potential therapeutic target in this high-risk population is encouraged. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. QT Interval Variability Index and QT Interval Duration in Different Sleep Stages: Analysis of Polysomnographic Recordings in Nonapneic Male Patients

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    Moonika Viigimae

    2015-01-01

    Full Text Available The aim of the study was to determine whether different sleep stages, especially REM sleep, affect QT interval duration and variability in male patients without obstructive sleep apnea (OSA. Polysomnographic recordings of 30 patients were analyzed. Beat-to-beat QT interval variability was calculated using QTV index (QTVI formula. For QTc interval calculation, in addition to Bazett’s formula, linear and parabolic heart rate correction formulas with two separate α values were used. QTVI and QTc values were calculated as means of 2 awake, 3 NREM, and 3 REM sleep episodes; the duration of each episode was 300 sec. Mean QTVI values were not statistically different between sleep stages. Therefore, elevated QTVI values found in patients with OSA cannot be interpreted as physiological sympathetic impact during REM sleep and should be considered as a risk factor for potentially life-threatening ventricular arrhythmias. The absence of difference of the mean QTc interval values between NREM and REM stages seems to confirm our conclusion that sympathetic surges during REM stage do not induce repolarization variability. In patients without notable structural and electrical remodeling of myocardium, physiological elevation in sympathetic activity during REM sleep remains subthreshold concerning clinically significant increase of myocardial electrical instability.

  5. Use of beat-to-beat cardiovascular variability data to determine the validity of sham therapy as the placebo control in osteopathic manipulative medicine research.

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    Henley, Charles E; Wilson, Thad E

    2014-11-01

    Osteopathic manipulative medicine researchers often use sham therapy as the placebo control during clinical trials. Optimally, the sham therapy should be a hands-on procedure that is perceptually indistinguishable from osteopathic manipulative treatment, does not create an effect on its own, and is not a treatment intervention. However, the sham therapy itself may often influence the outcome. The use of cardiovascular variability (eg, beat-to-beat heart rate variability) as a surrogate for the autonomic nervous system is one objective method by which to identify such an effect. By monitoring cardiovascular variability, investigators can assess autonomic nervous system activity as a response to the sham therapy and quickly determine whether or not the selected sham therapy is a true placebo control. The authors provide evidence for assessment of beat-to-beat heart rate variability as one method for assuring objectivity of sham therapy as a placebo control in osteopathic manipulative medicine research. © 2014 The American Osteopathic Association.

  6. Comparison and Validation of Recommended QT Interval Correction Formulas for Predicting Cardiac Arrhythmias in Patients With Advanced Heart Failure and Cardiac Resynchronization Devices.

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    Iglesias-Álvarez, Diego; Rodríguez-Mañero, Moisés; García-Seara, Francisco Javier; Kreidieh, Omar; Martínez-Sande, José Luis; Álvarez-Álvarez, Belén; Fernández-López, Xesús Alberte; González-Melchor, Laila; Lage-Fernández, Ricardo; Moscoso-Galán, Isabel; González-Juanatey, José Ramón

    2017-09-15

    QT interval prolongation is an important marker for the development of cardiac arrhythmias (CAs). Optimal methods to estimate QT/QTc intervals in patients with ventricular pacing (VP) and its correlation with CA have not been widely investigated. We aimed to validate the currently available formulas for QT determination during VP and to compare their abilities in predicting the occurrence of CA (atrial fibrillation [AF] and malignant ventricular arrhythmias [VAs] in patients with advanced heart failure and cardiac resynchronization therapy). Consecutive patients with advanced heart failure who underwent cardiac resynchronization therapy implantation between August 2001 and April 2015 were included in a retrospective study. Four proposed formulas for QT correction in VP rhythms were evaluated. One hundred eighty patients were enrolled. During 44 months of follow-up, 43 patients (37.7%) developed AF and 16 patients (8.9%) developed VA. There was no correlation between corrected QT increments and AF risk with any of the formulas for paced rhythms. Regarding VA, higher corrected QT values measured with Massachusetts' formula (QTcM) were found to have a higher risk of event (p = 0.036) (Beta = 1.012 [1.001 to 1.023]). Each 1 ms increase in QTc increased the probability of experiencing VA by 12‰. QTcM >444 was found to be a strong predictor of VA. In conclusion, there are significant differences in mean QTc interval measured by the currently advised formulas. QTc interval was not associated with AF in any of the formulas. Only the QTcM formula showed a significant stepwise increase in the risk of experiencing malignant VA. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Comparison of three mobile devices for measuring R-R intervals and heart rate variability: Polar S810i, Suunto t6 and an ambulatory ECG system.

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    Weippert, Matthias; Kumar, Mohit; Kreuzfeld, Steffi; Arndt, Dagmar; Rieger, Annika; Stoll, Regina

    2010-07-01

    The first aim of this study was to compare an ambulatory five-lead ECG system with the commercially available breast belt measuring devices; Polar S810i and Suunto t6, in terms of R-R interval measures and heart rate variability (HRV) indices. The second aim was to compare different HRV spectral analysis methods. Nineteen young males (aged between 22 and 31 years, median 24 years) underwent simultaneous R-R interval recordings with the three instruments during supine and sitting rest, moderate dynamic, and moderate to vigorous static exercise of the upper and lower limb. For each subject, 17 R-R interval series of 3-min length were extracted from the whole recordings and then analyzed in frequency domain using (1) a fast Fourier transform (FFT), (2) an autoregressive model (AR), (3) a Welch periodogram (WP) and (4) a continuous wavelet transform (CWT). Intra-class correlation coefficients (ICC) and Bland-Altman limits of agreement (LoA) method served as criteria for measurement agreement. Regarding the R-R interval recordings, ICC (lower ICC 95% confidence interval >0.99) as well as LoA (maximum LoA: -15.1 to 14.3 ms for ECG vs. Polar) showed an excellent agreement between all devices. Therefore, the three instruments may be used interchangeably in recording and interpolation of R-R intervals. ICCs for HRV frequency parameters were also high, but in most cases LoA analysis revealed unacceptable discrepancies between the instruments. The agreement among the different frequency transform methods can be taken for granted when analyzing the normalized power in low and high frequency ranges; however, not when analyzing the absolute values.

  8. A novel technique for fetal heart rate estimation from Doppler ultrasound signal

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    Jezewski Janusz

    2011-10-01

    Full Text Available Abstract Background The currently used fetal monitoring instrumentation that is based on Doppler ultrasound technique provides the fetal heart rate (FHR signal with limited accuracy. It is particularly noticeable as significant decrease of clinically important feature - the variability of FHR signal. The aim of our work was to develop a novel efficient technique for processing of the ultrasound signal, which could estimate the cardiac cycle duration with accuracy comparable to a direct electrocardiography. Methods We have proposed a new technique which provides the true beat-to-beat values of the FHR signal through multiple measurement of a given cardiac cycle in the ultrasound signal. The method consists in three steps: the dynamic adjustment of autocorrelation window, the adaptive autocorrelation peak detection and determination of beat-to-beat intervals. The estimated fetal heart rate values and calculated indices describing variability of FHR, were compared to the reference data obtained from the direct fetal electrocardiogram, as well as to another method for FHR estimation. Results The results revealed that our method increases the accuracy in comparison to currently used fetal monitoring instrumentation, and thus enables to calculate reliable parameters describing the variability of FHR. Relating these results to the other method for FHR estimation we showed that in our approach a much lower number of measured cardiac cycles was rejected as being invalid. Conclusions The proposed method for fetal heart rate determination on a beat-to-beat basis offers a high accuracy of the heart interval measurement enabling reliable quantitative assessment of the FHR variability, at the same time reducing the number of invalid cardiac cycle measurements.

  9. Resting heart rate and the risk of heart failure in healthy adults: the Rotterdam Study.

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    Nanchen, David; Leening, Maarten J G; Locatelli, Isabella; Cornuz, Jacques; Kors, Jan A; Heeringa, Jan; Deckers, Jaap W; Hofman, Albert; Franco, Oscar H; Stricker, Bruno H Ch; Witteman, Jacqueline C M; Dehghan, Abbas

    2013-05-01

    An elevated resting heart rate is associated with rehospitalization for heart failure and is a modifiable risk factor in heart failure patients. We aimed to examine the association between resting heart rate and incident heart failure in a population-based cohort study of healthy adults without pre-existing overt heart disease. We studied 4768 men and women aged ≥55 years from the population-based Rotterdam Study. We excluded participants with prevalent heart failure, coronary heart disease, pacemaker, atrial fibrillation, atrioventricular block, and those using β-blockers or calcium channel blockers. We used extended Cox models allowing for time-dependent variation of resting heart rate along follow-up. During a median of 14.6 years of follow-up, 656 participants developed heart failure. The risk of heart failure was higher in men with higher resting heart rate. For each increment of 10 beats per minute, the multivariable adjusted hazard ratios in men were 1.16 (95% confidence interval, 1.05-1.28; P=0.005) in the time-fixed heart rate model and 1.13 (95% confidence interval, 1.02-1.25; P=0.017) in the time-dependent heart rate model. The association could not be demonstrated in women (P for interaction=0.004). Censoring participants for incident coronary heart disease or using time-dependent models to account for the use of β-blockers or calcium channel blockers during follow-up did not alter the results. Baseline or persistent higher resting heart rate is an independent risk factor for the development of heart failure in healthy older men in the general population.

  10. An algorithm for the beat-to-beat assessment of cardiac mechanics during sleep on Earth and in microgravity from the seismocardiogram.

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    Di Rienzo, Marco; Vaini, Emanuele; Lombardi, Prospero

    2017-11-15

    Seismocardiogram, SCG, is the measure of precordial vibrations produced by the beating heart, from which cardiac mechanics may be explored on a beat-to-beat basis. We recently collected a large amount of SCG data (>69 recording hours) from an astronaut to investigate cardiac mechanics during sleep aboard the International Space Station and on Earth. SCG sleep recordings are characterized by a prolonged duration and wide heart rate swings, thus a specific algorithm was developed for their analysis. In this article we describe the new algorithm and its performance. The algorithm is composed of three parts: 1) artifacts removal, 2) identification in each SCG waveform of four fiducial points associated with the opening and closure of the aortic and mitral valves, 3) beat-to-beat computation of indexes of cardiac mechanics from the SCG fiducial points. The algorithm was tested on two sleep recordings and yielded the identification of the fiducial points in more than 36,000 beats with a precision, quantified by the Positive Predictive Value, ≥99.2%. These positive findings provide the first evidence that cardiac mechanics may be explored by the automatic analysis of SCG long-lasting recordings, taken out of the laboratory setting, and in presence of significant heart rate modulations.

  11. Changes in the heart rate recovery to endurance effort after high intensity interval, strength, and concurrent exercise training in patients with insulin resistance.

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    Álvarez, Cristian; Ramírez-Campillo, Rodrigo; Martínez, Cristian; Castro-Sepúlveda, Mauricio; Cano-Montoya, Johnathan; Mancilla, Rodrigo; Flores-Opazo, Marcelo

    2017-11-01

    The aim of this study was to assess the effects of three exercise training programs in the adaptation of the heart rate recovery of patients with insulin resistance. We studied 43 women with insulin resistance, which were assigned to three training groups: 1) high intensity interval training (HIT, age 39.0±10 years); 2) strength training (ST, age 33.9±9.4 years); 3) HIT+ST (MIXT, age 43.3±8.1 years); and 4) control group (CG, age 40.1±11 years). Heart rate was measured at rest (HRrest), during the 2-km-walking-test (UKKT) for mean (HRDE), and maximum (HRMDE) values, and during the recovery at one, two, and three minutes after the UKKT. Additionally, anthropometric measurements (body mass and body mass index) were assessed. HIT significantly decreased HRrest and HRDE (-4.5% and -2% respectively, Ptraining also decreased HRDE in -3% whilst both average and maximal HR during UKK were significantly increased in the control group HRDE (+2% and +3% respectively). Moreover, there were significant reductions in HR recovery at 1, 2 and 3 minutes after both HIT and MIXT training, whereas these values were increased in control group. Our findings suggest that HIT induces meaningful cardiovascular adaptations in patient with insulin resistance, reducing heart rate at rest, as well as during and after exercise, and that complementary strength training increases these adaptations.

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

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    Bhaduri, Anirban; Bhaduri, Susmita; Ghosh, Dipak

    2017-09-01

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

  13. Heart Rate-Corrected QT and JT Intervals in Electrocardiograms in Physically Fit Students and Student Athletes.

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    Misigoj-Durakovic, Marjeta; Durakovic, Zijad; Prskalo, Ivan

    2016-11-01

    In literature, data on the prevalence of prolonged and shortened corrected QT (QTc) have shown considerable variability. The aim of the study was to compare QTc and JTc intervals of competitive student athletes and noncompetitive sport participants to QTc cutoff points used in athletes. A group of 485 physically fit candidates for the study of kinesiology (139 female and 346 male candidates) aged 18-20 participated in the study. Basic anthropometry, field fitness test, cardiovascular, electrocardiograms measurements, and blood sampling for lipid profile were conducted. The prolonged QTc according to European Society of Cardiology criteria was found in 2.9% of female and 4.3% of male students. When the "Seattle criteria" were used, the proportion of prolonged QTc was 1.44% in female and 0.29% in male students. The shortened QTc according to the Seattle cutoff points was presented in 0.7% of female and 2.0% of male students. The JTc over 400 ms was found in 0.72% of female and 0.29% of male students. The JTc shorter than 320 ms was presented in 0.7% of female and 1.1% of male students. No significant differences were found between students involved in competitive sport and those involved in recreational sporting activities. Female students had lower body mass index and blood pressure values, better blood lipid profile, and lower uric acid concentrations. In conclusion, the Seattle criteria markedly decreased the proportion of prolonged QTc in student athletes, particularly in male students. It seems that the JTc interval could be a better parameter than the QTc interval for the estimation of specific repolarization time in physically fit university students. © 2016 Wiley Periodicals, Inc.

  14. Arrhythmogenic drugs can amplify spatial heterogeneities in the electrical restitution in perfused guinea-pig heart: An evidence from assessments of monophasic action potential durations and JT intervals.

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    Oleg E Osadchii

    Full Text Available Non-uniform shortening of the action potential duration (APD90 in different myocardial regions upon heart rate acceleration can set abnormal repolarization gradients and promote arrhythmia. This study examined whether spatial heterogeneities in APD90 restitution can be amplified by drugs with clinically proved proarrhythmic potential (dofetilide, quinidine, procainamide, and flecainide and, if so, whether these effects can translate to the appropriate changes of the ECG metrics of ventricular repolarization, such as JT intervals. In isolated, perfused guinea-pig heart preparations, monophasic action potentials and volume-conducted ECG were recorded at progressively increased pacing rates. The APD90 measured at distinct ventricular sites, as well as the JTpeak and JTend values were plotted as a function of preceding diastolic interval, and the maximum slopes of the restitution curves were determined at baseline and upon drug administration. Dofetilide, quinidine, and procainamide reverse rate-dependently prolonged APD90 and steepened the restitution curve, with effects being greater at the endocardium than epicardium, and in the right ventricular (RV vs. the left ventricular (LV chamber. The restitution slope was increased to a greater extent for the JTend vs. the JTpeak interval. In contrast, flecainide reduced the APD90 restitution slope at LV epicardium without producing effect at LV endocardium and RV epicardium, and reduced the JTpeak restitution slope without changing the JTend restitution. Nevertheless, with all agents, these effects translated to the amplified epicardial-to-endocardial and the LV-to-RV non-uniformities in APD90 restitution, paralleled by the increased JTend vs. JTpeak difference in the restitution slope. In summary, these findings suggest that arrhythmic drug profiles are partly attributable to the accentuated regional heterogeneities in APD90 restitution, which can be indirectly determined through ECG assessments of the

  15. Beat Rate Variability in Murine Embryonic Stem Cell-Derived Cardiomyocytes: Effect of Antiarrhythmic Drugs.

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    Niehoff, Julius; Matzkies, Matthias; Nguemo, Filomain; Hescheler, Jürgen; Reppel, Michael

    2016-01-01

    Heart rate variability (HRV) refers to the fluctuation of the time interval between consecutive heartbeats in humans. It has recently been discovered that cardiomyocytes derived from human embryonic and induced pluripotent stem cells show beat rate variability (BRV) that is similar to the HRV in humans. In the present study, clinical aspects of HRV were transferred to an in vitro model. The aims of the study were to explore the BRV in murine embryonic stem cell (mESC)-derived cardiomyocytes and to demonstrate the influence of antiarrhythmic drugs on BRV as has been shown in clinical trials previously. The Microelectrode Array (MEA) technique was used to perform short-term recordings of extracellular field potentials (FPs) of spontaneously beating cardiomyocytes derived from mESCs (D3 cell line, αPig-44). Offline analysis was focused on time domain and nonlinear methods. The Poincaré-Plot analysis of measurements without pharmacological intervention revealed that three different shapes of scatter plots occurred most frequently. Comparable shapes have been described in clinical studies before. The antiarrhythmic drugs Ivabradine, Verapamil and Sotalol augmented BRV, whereas Flecainide decreased BRV parameters at low concentrations (SDSD 79.0 ± 8.7% of control at 10(-9) M, p < 0.05) and increased variability measures at higher concentrations (SDNN 258.8 ± 42.7% of control at 10(-5) M, p < 0.05). Amiodarone and Metoprolol did not alter BRV significantly. Spontaneously beating cardiomyocytes derived from mESCs showed BRV that appears to be similar to the HRV known from humans. Antiarrhythmic drugs affected BRV parameters similar to clinical observations. Therefore, our study demonstrates that this in vitro model can contribute to a better understanding of electrophysiological properties of mESC-derived cardiomyocytes and might serve as a valuable tool for drug safety screening. © 2016 The Author(s) Published by S. Karger AG, Basel.

  16. Beat Rate Variability in Murine Embryonic Stem Cell-Derived Cardiomyocytes: Effect of Antiarrhythmic Drugs

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    Julius Niehoff

    2016-02-01

    Full Text Available Background/Aims: Heart rate variability (HRV refers to the fluctuation of the time interval between consecutive heartbeats in humans. It has recently been discovered that cardiomyocytes derived from human embryonic and induced pluripotent stem cells show beat rate variability (BRV that is similar to the HRV in humans. In the present study, clinical aspects of HRV were transferred to an in vitro model. The aims of the study were to explore the BRV in murine embryonic stem cell (mESC-derived cardiomyocytes and to demonstrate the influence of antiarrhythmic drugs on BRV as has been shown in clinical trials previously. Methods: The Microelectrode Array (MEA technique was used to perform short-term recordings of extracellular field potentials (FPs of spontaneously beating cardiomyocytes derived from mESCs (D3 cell line, αPig-44. Offline analysis was focused on time domain and nonlinear methods. Results: The Poincaré-Plot analysis of measurements without pharmacological intervention revealed that three different shapes of scatter plots occurred most frequently. Comparable shapes have been described in clinical studies before. The antiarrhythmic drugs Ivabradine, Verapamil and Sotalol augmented BRV, whereas Flecainide decreased BRV parameters at low concentrations (SDSD 79.0 ± 8.7% of control at 10-9 M, p -5 M, p Conclusions: Spontaneously beating cardiomyocytes derived from mESCs showed BRV that appears to be similar to the HRV known from humans. Antiarrhythmic drugs affected BRV parameters similar to clinical observations. Therefore, our study demonstrates that this in vitro model can contribute to a better understanding of electrophysiological properties of mESC-derived cardiomyocytes and might serve as a valuable tool for drug safety screening.

  17. Enhanced Timing Abilities in Percussionists Generalize to Rhythms Without a Musical Beat

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    Daniel J Cameron

    2014-12-01

    Full Text Available The ability to entrain movements to music is arguably universal, but it is unclear how specialized training may influence this. Previous research suggests that percussionists have superior temporal precision in perception and production tasks. Such superiority may be limited to temporal sequences that resemble real music or, alternatively, may generalize to musically implausible sequences. To test this, percussionists and nonpercussionists completed two tasks that used rhythmic sequences varying in musical plausibility. In the beat tapping task, participants tapped with the beat of a rhythmic sequence over 3 stages: finding the beat (as an initial sequence played, continuation of the beat (as a second sequence was introduced and played simultaneously, and switching to a second beat (the initial sequence finished, leaving only the second. The metres of the two sequences were either congruent or incongruent, as were their tempi (minimum inter-onset intervals. In the rhythm reproduction task, participants reproduced rhythms of four types, ranging from high to low musical plausibility: Metric simple rhythms induced a strong sense of the beat, metric complex rhythms induced a weaker sense of the beat, nonmetric rhythms had no beat, and jittered nonmetric rhythms also had no beat as well as low temporal predictability. For both tasks, percussionists performed more accurately than nonpercussionists. In addition, both groups were better with musically plausible than implausible conditions. Overall, the percussionists’ superior abilities to entrain to, and reproduce, rhythms generalized to musically implausible sequences.

  18. Enhanced timing abilities in percussionists generalize to rhythms without a musical beat.

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    Cameron, Daniel J; Grahn, Jessica A

    2014-01-01

    The ability to entrain movements to music is arguably universal, but it is unclear how specialized training may influence this. Previous research suggests that percussionists have superior temporal precision in perception and production tasks. Such superiority may be limited to temporal sequences that resemble real music or, alternatively, may generalize to musically implausible sequences. To test this, percussionists and nonpercussionists completed two tasks that used rhythmic sequences varying in musical plausibility. In the beat tapping task, participants tapped with the beat of a rhythmic sequence over 3 stages: finding the beat (as an initial sequence played), continuation of the beat (as a second sequence was introduced and played simultaneously), and switching to a second beat (the initial sequence finished, leaving only the second). The meters of the two sequences were either congruent or incongruent, as were their tempi (minimum inter-onset intervals). In the rhythm reproduction task, participants reproduced rhythms of four types, ranging from high to low musical plausibility: Metric simple rhythms induced a strong sense of the beat, metric complex rhythms induced a weaker sense of the beat, nonmetric rhythms had no beat, and jittered nonmetric rhythms also had no beat as well as low temporal predictability. For both tasks, percussionists performed more accurately than nonpercussionists. In addition, both groups were better with musically plausible than implausible conditions. Overall, the percussionists' superior abilities to entrain to, and reproduce, rhythms generalized to musically implausible sequences.

  19. Automatic Arrhythmia Beat Detection: Algorithm, System, and Implementation

    Directory of Open Access Journals (Sweden)

    Wisnu Jatmiko

    2016-08-01

    Full Text Available Cardiac disease is one of the major causes of death in the world. Early diagnose of the symptoms depends on abnormality on heart beat pattern, known as Arrhythmia. A novel fuzzy neuro generalized learning vector quantization for automatic Arrhythmia heart beat classification is proposed. The algorithm is an extension from theGLVQ algorithm that employs a fuzzy logic concept as the discriminant function in order to develop a robust algorithmand improve the classification performance. The algorithm is testedagainst MIT-BIH arrhythmia database to measure theperformance. Based on the experiment result, FN-GLVQ is able to increase the accuracy of GLVQ by a soft margin. As we intend to build a device with automated Arrhythmia detection,FN-GLVQ is then implemented into Field Gate Programmable Array to prototype the system into a real device.

  20. Effectiveness of Moderate Intensity Interval Training as an Index of Autonomic Nervous Activity.

    Science.gov (United States)

    Kai, Satoru; Nagino, Koji; Ito, Takayoshi; Oi, Rie; Nishimura, Kazushi; Morita, Shuhei; Yaoi, Riyo

    2016-01-01

    The purpose of this study was to examine the effects of moderate intensity interval training from the change of the autonomic nervous activity. Ten male volunteers aged 21-22 years were studied. After 10-minute rest in a seated position, the subjects were asked to perform the strength of moderate cycling exercise in ergometer. Cycling rate was done in 50 times/min. Load resistance of the ergometer was set to 2.0 kgm. Subjects paused the exercise when the heart rate becomes 120 beats/min. Subjects have resumed the exercise when the heart rate returns to the value at rest. This trial was repeated twice. The experiment was ended when the heart rate of the subjects has returned to resting level. When the heart rate during exercise is maintained to less than 120 beats/min, sympathetic nerve activity during exercise did not work actively compared to the baseline. Vagus nerve activity after exercise cessation exceeds the baseline. It is clarified that the exercise as well as activating the vagus nerve activity stimulates the total autonomic nervous activity. It has revealed that at the time of interval training at moderate load the vagus nerve activity can be carried out.

  1. Effectiveness of Moderate Intensity Interval Training as an Index of Autonomic Nervous Activity

    Directory of Open Access Journals (Sweden)

    Satoru Kai

    2016-01-01

    Full Text Available The purpose of this study was to examine the effects of moderate intensity interval training from the change of the autonomic nervous activity. Ten male volunteers aged 21-22 years were studied. After 10-minute rest in a seated position, the subjects were asked to perform the strength of moderate cycling exercise in ergometer. Cycling rate was done in 50 times/min. Load resistance of the ergometer was set to 2.0 kgm. Subjects paused the exercise when the heart rate becomes 120 beats/min. Subjects have resumed the exercise when the heart rate returns to the value at rest. This trial was repeated twice. The experiment was ended when the heart rate of the subjects has returned to resting level. When the heart rate during exercise is maintained to less than 120 beats/min, sympathetic nerve activity during exercise did not work actively compared to the baseline. Vagus nerve activity after exercise cessation exceeds the baseline. It is clarified that the exercise as well as activating the vagus nerve activity stimulates the total autonomic nervous activity. It has revealed that at the time of interval training at moderate load the vagus nerve activity can be carried out.

  2. Disentangling beat perception from sequential learning and examining the influence of attention and musical abilities on ERP responses to rhythm.

    Science.gov (United States)

    Bouwer, Fleur L; Werner, Carola M; Knetemann, Myrthe; Honing, Henkjan

    2016-05-01

    Beat perception is the ability to perceive temporal regularity in musical rhythm. When a beat is perceived, predictions about upcoming events can be generated. These predictions can influence processing of subsequent rhythmic events. However, statistical learning of the order of sounds in a sequence can also affect processing of rhythmic events and must be differentiated from beat perception. In the current study, using EEG, we examined the effects of attention and musical abilities on beat perception. To ensure we measured beat perception and not absolute perception of temporal intervals, we used alternating loud and soft tones to create a rhythm with two hierarchical metrical levels. To control for sequential learning of the order of the different sounds, we used temporally regular (isochronous) and jittered rhythmic sequences. The order of sounds was identical in both conditions, but only the regular condition allowed for the perception of a beat. Unexpected intensity decrements were introduced on the beat and offbeat. In the regular condition, both beat perception and sequential learning were expected to enhance detection of these deviants on the beat. In the jittered condition, only sequential learning was expected to affect processing of the deviants. ERP responses to deviants were larger on the beat than offbeat in both conditions. Importantly, this difference was larger in the regular condition than in the jittered condition, suggesting that beat perception influenced responses to rhythmic events in addition to sequential learning. The influence of beat perception was present both with and without attention directed at the rhythm. Moreover, beat perception as measured with ERPs correlated with musical abilities, but only when attention was directed at the stimuli. Our study shows that beat perception is possible when attention is not directed at a rhythm. In addition, our results suggest that attention may mediate the influence of musical abilities on beat

  3. Prognostic value of the VE/VCO2 slope calculated from different time intervals in patients with suspected heart failure.

    Science.gov (United States)

    Ingle, Lee; Goode, Kevin; Carroll, Sean; Sloan, Rebecca; Boyes, Carrie; Cleland, John G F; Clark, Andrew L

    2007-06-12

    Maximal exercises testing, whether involving cycling- or walking-based protocols, are often not well tolerated in patients with chronic heart failure (CHF). The peak oxygen consumption and the slope of the relation between ventilation (V(E)) and carbon dioxide production (V(CO(2))) are independent predictors of outcome and help risk stratification. The prognostic usefulness of submaximal exercise testing is not clear. The aim of the present study was to assess the prognostic value of the V(E)/V(CO(2)) slope when derived from data acquired from submaximal exercise. 394 patients referred with breathlessness and suspected heart failure (74% male) (mean+/-S.D.) age 60+/-12 years; BMI 27+/-5 performed a CPET to determine peak V(O(2)) and the V(E)/V(CO(2)) slope. The V(E)/V(CO(2)) slope was calculated using least squares regression from data acquired from the first 25% of exercise (mean V(E)/V(CO(2)) slope+/-SD; 30.6+/-5.7), 50% (29.6+/-6.9), below the ventilatory compensation point (sub-VCP) (29.9+/-6.8), and all data points (full slope) (32.1+/-7.8). For each measure, patients were divided into quartiles and Kaplan-Meier curves were constructed to determine probability of death after 24 months. The prognostic value of the different classifications was assessed using the chi(2) statistic from the Mantel-Cox log-rank test. During a mean follow-up period of 41+/-19 months, 48 patients died. For the V(E)/V(CO(2)) slope, the log-rank statistic was greatest for the full slope (chi(2)=53.7; P=0.0001), followed by the sub-VCP (chi(2)=45.5; P=0.0001), 50% (chi(2)=41.9; P=0.0001), and 25% (chi(2)= 26.0; P=0.01). The pair-wise log-rank statistic between the fourth and third quartiles was also greatest using the full slope (chi(2)=25.4; P=0.001) followed in order by the sub-VCP (chi(2)=20.1; P=0.001), 50% (chi(2)=19.7; P=0.001), and 25% (chi(2)=14.2; P=0.05). Using the stratified slope measurements entered into a Cox regression analysis using a forward LR stepwise elimination

  4. The association of long-term glycaemic variability versus sustained chronic hyperglycaemia with heart rate-corrected QT interval in patients with type 2 diabetes.

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    Jian-Bin Su

    Full Text Available Prolonged heart rate-corrected QT(QTc interval is related to ventricular arrhythmia and cardiovascular mortality, with considerably high prevalence of type 2 diabetes. Additionally, long-term glycaemic variability could be a significant risk factor for diabetic complications in addition to chronic hyperglycaemia. We compared the associations of long-term glycaemic variability versus sustained chronic hyperglycaemia with the QTc interval among type 2 diabetes patients.In this cross-sectional study, 2904 type 2 diabetes patients were recruited who had undergone at least four fasting plasma glucose (FPG and 2-hour postprandial plasma glucose (PPG measurements (at least once for every 3 months, respectively during the preceding year. Long-term glycaemic variabilities of FPG and 2-hour PPG were assessed by their standard deviations (SD-FPG and SD-PPG, respectively, and chronic fasting and postprandial hyperglycaemia were assessed by their means (M-FPG and M-PPG, respectively. HbA1c was also determined upon enrolment to assess current overall glycaemic control. QTc interval was estimated from resting 12-lead electrocardiograms, and more than 440 ms was considered abnormally prolonged.Patients with prolonged QTc interval (≥440 ms had greater M-FPG, M-PPG, SD-PPG and HbA1c than those with normal QTc interval but comparable SD-FPG. QTc interval was correlated with M-FPG, M-PPG, SD-PPG and HbA1c (r = 0.133, 0.153, 0.245 and 0.207, respectively, p = 0.000 but not with SD-FPG (r = 0.024, p = 0.189. After adjusting for metabolic risk factors via multiple linear regression analysis, SD-PPG, M-PPG and HbA1c (t = 12.16, 2.69 and 10.16, respectively, p = 0.000 were the major independent contributors to the increased QTc interval. The proportion of prolonged QTc interval increased significantly from 10.9% to 14.2% to 26.6% for the first (T1 to second (T2 to third (T3 tertiles of SD-PPG. After adjusting via multiple logistic regression analysis, the odd ratios

  5. Effect of muscle mass and intensity of isometric contraction on heart rate.

    Science.gov (United States)

    Gálvez, J M; Alonso, J P; Sangrador, L A; Navarro, G

    2000-02-01

    The purpose of this study was to determine the effect of muscle mass and the level of force on the contraction-induced rise in heart rate. We conducted an experimental study in a sample of 28 healthy men between 20 and 30 yr of age (power: 95%, alpha: 5%). Smokers, obese subjects, and those who performed regular physical activity over a certain amount of energetic expenditure were excluded from the study. The participants exerted two types of isometric contractions: handgrip and turning a 40-cm-diameter wheel. Both were sustained to exhaustion at 20 and 50% of maximal force. Twenty-five subjects finished the experiment. Heart rate increased a mean of 15.1 beats/min [95% confidence interval (CI): 5.5-24.6] from 20 to 50% handgrip contractions, and 20.7 beats/min (95% CI: 11.9-29.5) from 20 to 50% wheel-turn contractions. Heart rate also increased a mean of 13.3 beats/min (95% CI: 10.4-16.1) from handgrip to wheel-turn contractions at 20% maximal force, and 18.9 beats/min (95% CI: 9. 8-28.0) from handgrip to wheel-turn contractions at 50% maximal force. We conclude that the magnitude of the heart rate increase during isometric exercise is related to the intensity of the contraction and the mass of the contracted muscle.

  6. To Beat or Not to Beat: Beat Gestures in Direction Giving

    NARCIS (Netherlands)

    Theune, Mariet; Brandhorst, Chris J.; Kopp, S.; Wachsmuth, I.

    2010-01-01

    Research on gesture generation for embodied conversational agents (ECA’s) mostly focuses on gesture types such as pointing and iconic gestures, while ignoring another gesture type frequently used by human speakers: beat gestures. Analysis of a corpus of route descriptions showed that although

  7. Effects of high intensity interval versus moderate continuous training on markers of ventilatory and cardiac efficiency in coronary heart disease patients.

    Science.gov (United States)

    Cardozo, Gustavo G; Oliveira, Ricardo B; Farinatti, Paulo T V

    2015-01-01

    We tested the hypothesis that high intensity interval training (HIIT) would be more effective than moderate intensity continuous training (MIT) to improve newly emerged markers of cardiorespiratory fitness in coronary heart disease (CHD) patients, as the relationship between ventilation and carbon dioxide production (VE/VCO2 slope), oxygen uptake efficiency slope (OUES), and oxygen pulse (O2P). Seventy-one patients with optimized treatment were randomly assigned into HIIT (n = 23, age = 56 ± 12 years), MIT (n = 24, age = 62 ± 12 years), or nonexercise control group (CG) (n = 24, age = 64 ± 12 years). MIT performed 30 min of continuous aerobic exercise at 70-75% of maximal heart rate (HRmax), and HIIT performed 30 min sessions split in 2 min alternate bouts at 60%/90% HRmax (3 times/week for 16 weeks). No differences among groups (before versus after) were found for VE/VCO2 slope or OUES (P > 0.05). After training the O2P slope increased in HIIT (22%, P 0.05), while decreased in CG (-20%, P < 0.05) becoming lower versus HIIT (P = 0.03). HIIT was more effective than MIT for improving O2P slope in CHD patients, while VE/VCO2 slope and OUES were similarly improved by aerobic training regimens versus controls.

  8. High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men.

    Science.gov (United States)

    Grace, Fergal; Herbert, Peter; Elliott, Adrian D; Richards, Jo; Beaumont, Alexander; Sculthorpe, Nicholas F

    2017-05-13

    This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7±5.2yrs) (LEX; n=17, aged=61.1±5.4yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each PHIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (PHIIT. A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Analysis of ependymal ciliary beat pattern and beat frequency using high speed imaging: comparison with the photomultiplier and photodiode methods.

    Science.gov (United States)

    O'Callaghan, Chris; Sikand, Kulvinder; Chilvers, Mark A

    2012-06-07

    The aim of this study was to compare beat frequency measurements of ependymal cilia made by digital high speed imaging to those obtained using the photomultiplier and modified photodiode techniques. Using high speed video analysis the relationship of the power and recover strokes was also determined. Ciliated strips of ependyma attached to slices from the brain of Wistar rats were incubated at 30°C and observed using a ×50 water immersion lens. Ciliary beat frequency was measured using each of the three techniques: the high speed video, photodiode and photomultiplier. Readings were repeated after 30 minutes incubation at 37°C. Ependymal cilia were observed in slow motion and the precise movement of cilia during the recovery stroke relative to the path travelled during the power stroke was measured. The mean (95% confidence intervals) beat frequencies determined by the high speed video, photomultiplier and photodiode at 30°C were 27.7 (26.6 to 28.8), 25.5 (24.4 to 26.6) and 20.8 (20.4 to 21.3) Hz, respectively. The mean (95% confidence intervals) beat frequencies determined by the high speed video, photomultiplier and photodiode at 37°C were 36.4 (34 to 39.5), 38.4 (36.8 to 39.9) and 18.8 (16.9 to 20.5) Hz. The inter and intra observer reliability for measurement of ciliary beat frequency was 3.8% and 1%, respectively. Ependymal cilia were observed to move in a planar fashion during the power and recovery strokes with a maximum deviation to the right of the midline of 12.1(11.8 to 13.0)° during the power stroke and 12.6(11.6 to 13.6)° to the left of the midline during the recovery stroke. The photodiode technique greatly underestimates ciliary beat frequency and should not be used to measure ependymal ciliary beat frequency at the temperatures studied. Ciliary beat frequency from the high speed video and photomultiplier techniques cannot be used interchangeably. Ependymal cilia had minimal deviation to the right side during their power stroke and to the left

  10. Effects of aerobic interval training on measures of anxiety, depression and quality of life in patients with ischaemic heart failure and an implantable cardioverter defibrillator: A prospective non-randomized trial.

    Science.gov (United States)

    Isaksen, Kjetil; Munk, Peter Scott; Giske, Rune; Larsen, Alf Inge

    2016-03-01

    To evaluate the short- and long-term effects of aerobic interval training on quality of life and on symptoms of anxiety and depression among patients with ischaemic heart failure and an implantable cardioverter defibrillator. Prospective, non-randomized controlled study. Patients with ischaemic heart failure and an implantable cardioverter defibrillator, willing to undergo an aerobic interval training programme. A total of 31 patients were enrolled (19 were assigned to the aerobic interval training group and 12 to the control group). The aerobic interval training group performed a 12-week exercise training programme. All patients were evaluated with the Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale (HADS) and the International Physical Activity Questionnaire at baseline, after 12 weeks and at 2 years. The aerobic interval training group showed significant improvements in several SF-36 subscores at 12 weeks. There was an unadjusted significant reduction in the HADS depression (HADS-D) score. At follow-up, results in the aero-bic interval training group moved towards baseline or remained stable, whereas in the control group HADS-D scores and some SF-36 subscores deteriorated. Participation in a 12-week aerobic interval training programme resulted in significant improvements in several measures of quality of life and the unadjusted HADS-D score in patients with ischaemic heart failure with an implantable cardioverter defibrillator. At follow-up there was significantly less sedentary activity in the aerobic interval training group, while psychometric measures were no longer significantly different from baseline.

  11. Serial binary interval ratios improve rhythm reproduction

    OpenAIRE

    Xiang eWu; Anders eWestanmo; Liang eZhou; Junhao ePan

    2013-01-01

    Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are bett...

  12. High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study.

    Science.gov (United States)

    Angadi, Siddhartha S; Mookadam, Farouk; Lee, Chong D; Tucker, Wesley J; Haykowsky, Mark J; Gaesser, Glenn A

    2015-09-15

    Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality. Exercise training is an established adjuvant therapy in heart failure; however, the effects of high-intensity interval training (HIIT) in HFpEF are unknown. We compared the effects of HIIT vs. moderate-intensity aerobic continuous training (MI-ACT) on peak oxygen uptake (V̇o₂peak), left ventricular diastolic dysfunction, and endothelial function in patients with HFpEF. Nineteen patients with HFpEF (age 70 ± 8.3 yr) were randomized to either HIIT (4 × 4 min at 85-90% peak heart rate, with 3 min active recovery) or MI-ACT (30 min at 70% peak heart rate). Fifteen patients completed exercise training (HIIT: n = 9; MI-ACT: n = 6). Patients trained 3 days/wk for 4 wk. Before and after training patients underwent a treadmill test for V̇o₂peak determination, 2D-echocardiography for assessment of left ventricular diastolic dysfunction, and brachial artery flow-mediated dilation (FMD) for assessment of endothelial function. HIIT improved V̇o₂peak (pre = 19.2 ± 5.2 ml·kg(-1)·min(-1); post = 21.0 ± 5.2 ml·kg(-1)·min(-1); P = 0.04) and left ventricular diastolic dysfunction grade (pre = 2.1 ± 0.3; post = 1.3 ± 0.7; P = 0.02), but FMD was unchanged (pre = 6.9 ± 3.7%; post = 7.0 ± 4.2%). No changes were observed following MI-ACT. A trend for reduced left atrial volume index was observed following HIIT compared with MI-ACT (-3.3 ± 6.6 vs. +5.8 ± 10.7 ml/m(2); P = 0.06). In HFpEF patients 4 wk of HIIT significantly improved V̇o₂peak and left ventricular diastolic dysfunction. HIIT may provide a more robust stimulus than MI-ACT for early exercise training adaptations in HFpEF. Copyright © 2015 the American Physiological Society.

  13. Reduced intrinsic heart rate is associated with reduced arrhythmic susceptibility in guinea-pig heart.

    Science.gov (United States)

    Osadchii, Oleg E

    2014-12-01

    In the clinical setting, patients with slower resting heart rate are less prone to cardiovascular death compared with those with elevated heart rate. However, electrophysiological adaptations associated with reduced cardiac rhythm have not been thoroughly explored. In this study, relationships between intrinsic heart rate and arrhythmic susceptibility were examined by assessments of action potential duration (APD) rate adaptation and inducibility of repolarization alternans in sinoatrial node (SAN)-driven and atrioventricular (AV)-blocked guinea-pig hearts perfused with Langendorff apparatus. Electrocardiograms, epicardial monophasic action potentials, and effective refractory periods (ERP) were assessed in normokalemic and hypokalemic conditions. Slower basal heart rate in AV-blocked hearts was associated with prolonged ventricular repolarization during spontaneous beating, and with attenuated APD shortening at increased cardiac activation rates during dynamic pacing, when compared with SAN-driven hearts. During hypokalemic perfusion, the inducibility of repolarization alternans and tachyarrhythmia by rapid pacing was found to be lower in AV-blocked hearts. This difference was ascribed to prolonged ERP in the setting of reduced basal heart rate, which prevented ventricular capture at critically short pacing intervals required to induce arrhythmia. Reduced basal heart rate is associated with electrophysiological changes that prevent electrical instability upon an abrupt cardiac acceleration.

  14. Biophysical characterization of the underappreciated and important relationship between heart rate variability and heart rate.

    Science.gov (United States)

    Monfredi, Oliver; Lyashkov, Alexey E; Johnsen, Anne-Berit; Inada, Shin; Schneider, Heiko; Wang, Ruoxi; Nirmalan, Mahesh; Wisloff, Ulrik; Maltsev, Victor A; Lakatta, Edward G; Zhang, Henggui; Boyett, Mark R

    2014-12-01

    Heart rate (HR) variability (HRV; beat-to-beat changes in the R-wave to R-wave interval) has attracted considerable attention during the past 30+ years (PubMed currently lists >17 000 publications). Clinically, a decrease in HRV is correlated to higher morbidity and mortality in diverse conditions, from heart disease to fetal distress. It is usually attributed to fluctuation in cardiac autonomic nerve activity. We calculated HRV parameters from a variety of cardiac preparations (including humans, living animals, Langendorff-perfused heart, and single sinoatrial nodal cell) in diverse species, combining this with data from previously published articles. We show that regardless of conditions, there is a universal exponential decay-like relationship between HRV and HR. Using 2 biophysical models, we develop a theory for this and confirm that HRV is primarily dependent on HR and cannot be used in any simple way to assess autonomic nerve activity to the heart. We suggest that the correlation between a change in HRV and altered morbidity and mortality is substantially attributable to the concurrent change in HR. This calls for re-evaluation of the findings from many articles that have not adjusted properly or at all for HR differences when comparing HRV in multiple circumstances. © 2014 American Heart Association, Inc.

  15. Beat-to-beat variability of cardiac action potential duration: underlying mechanism and clinical implications.

    Science.gov (United States)

    Nánási, Péter P; Magyar, János; Varró, András; Ördög, Balázs

    2017-10-01

    Beat-to-beat variability of cardiac action potential duration (short-term variability, SV) is a common feature of various cardiac preparations, including the human heart. Although it is believed to be one of the best arrhythmia predictors, the underlying mechanisms are not fully understood at present. The magnitude of SV is basically determined by the intensity of cell-to-cell coupling in multicellular preparations and by the duration of the action potential (APD). To compensate for the APD-dependent nature of SV, the concept of relative SV (RSV) has been introduced by normalizing the changes of SV to the concomitant changes in APD. RSV is reduced by I Ca , I Kr , and I Ks while increased by I Na , suggesting that ion currents involved in the negative feedback regulation of APD tend to keep RSV at a low level. RSV is also influenced by intracellular calcium concentration and tissue redox potential. The clinical implications of APD variability is discussed in detail.

  16. Atrial fibrillation detection by heart rate variability in Poincare plot

    Directory of Open Access Journals (Sweden)

    Jeon Moongu

    2009-12-01

    Full Text Available Abstract Background Atrial fibrillation (AFib is one of the prominent causes of stroke, and its risk increases with age. We need to detect AFib correctly as early as possible to avoid medical disaster because it is likely to proceed into a more serious form in short time. If we can make a portable AFib monitoring system, it will be helpful to many old people because we cannot predict when a patient will have a spasm of AFib. Methods We analyzed heart beat variability from inter-beat intervals obtained by a wavelet-based detector. We made a Poincare plot using the inter-beat intervals. By analyzing the plot, we extracted three feature measures characterizing AFib and non-AFib: the number of clusters, mean stepping increment of inter-beat intervals, and dispersion of the points around a diagonal line in the plot. We divided distribution of the number of clusters into two and calculated mean value of the lower part by k-means clustering method. We classified data whose number of clusters is more than one and less than this mean value as non-AFib data. In the other case, we tried to discriminate AFib from non-AFib using support vector machine with the other feature measures: the mean stepping increment and dispersion of the points in the Poincare plot. Results We found that Poincare plot from non-AFib data showed some pattern, while the plot from AFib data showed irregularly irregular shape. In case of non-AFib data, the definite pattern in the plot manifested itself with some limited number of clusters or closely packed one cluster. In case of AFib data, the number of clusters in the plot was one or too many. We evaluated the accuracy using leave-one-out cross-validation. Mean sensitivity and mean specificity were 91.4% and 92.9% respectively. Conclusions Because pulse beats of ventricles are less likely to be influenced by baseline wandering and noise, we used the inter-beat intervals to diagnose AFib. We visually displayed regularity of the inter-beat

  17. Atrial fibrillation detection by heart rate variability in Poincare plot.

    Science.gov (United States)

    Park, Jinho; Lee, Sangwook; Jeon, Moongu

    2009-12-11

    Atrial fibrillation (AFib) is one of the prominent causes of stroke, and its risk increases with age. We need to detect AFib correctly as early as possible to avoid medical disaster because it is likely to proceed into a more serious form in short time. If we can make a portable AFib monitoring system, it will be helpful to many old people because we cannot predict when a patient will have a spasm of AFib. We analyzed heart beat variability from inter-beat intervals obtained by a wavelet-based detector. We made a Poincare plot using the inter-beat intervals. By analyzing the plot, we extracted three feature measures characterizing AFib and non-AFib: the number of clusters, mean stepping increment of inter-beat intervals, and dispersion of the points around a diagonal line in the plot. We divided distribution of the number of clusters into two and calculated mean value of the lower part by k-means clustering method. We classified data whose number of clusters is more than one and less than this mean value as non-AFib data. In the other case, we tried to discriminate AFib from non-AFib using support vector machine with the other feature measures: the mean stepping increment and dispersion of the points in the Poincare plot. We found that Poincare plot from non-AFib data showed some pattern, while the plot from AFib data showed irregularly irregular shape. In case of non-AFib data, the definite pattern in the plot manifested itself with some limited number of clusters or closely packed one cluster. In case of AFib data, the number of clusters in the plot was one or too many. We evaluated the accuracy using leave-one-out cross-validation. Mean sensitivity and mean specificity were 91.4% and 92.9% respectively. Because pulse beats of ventricles are less likely to be influenced by baseline wandering and noise, we used the inter-beat intervals to diagnose AFib. We visually displayed regularity of the inter-beat intervals by way of Poincare plot. We tried to design an

  18. Real time heart rate variability assessment from Android smartphone camera photoplethysmography: Postural and device influences.

    Science.gov (United States)

    Guede-Fernandez, F; Ferrer-Mileo, V; Ramos-Castro, J; Fernandez-Chimeno, M; Garcia-Gonzalez, M A

    2015-01-01

    The aim of this paper is to present a smartphone based system for real-time pulse-to-pulse (PP) interval time series acquisition by frame-to-frame camera image processing. The developed smartphone application acquires image frames from built-in rear-camera at the maximum available rate (30 Hz) and the smartphone GPU has been used by Renderscript API for high performance frame-by-frame image acquisition and computing in order to obtain PPG signal and PP interval time series. The relative error of mean heart rate is negligible. In addition, measurement posture and the employed smartphone model influences on the beat-to-beat error measurement of heart rate and HRV indices have been analyzed. Then, the standard deviation of the beat-to-beat error (SDE) was 7.81 ± 3.81 ms in the worst case. Furthermore, in supine measurement posture, significant device influence on the SDE has been found and the SDE is lower with Samsung S5 than Motorola X. This study can be applied to analyze the reliability of different smartphone models for HRV assessment from real-time Android camera frames processing.

  19. Heart rate-corrected QT interval is a novel risk marker for the progression of albuminuria in people with Type 2 diabetes.

    Science.gov (United States)

    Hashimoto, Y; Tanaka, M; Senmaru, T; Okada, H; Hamaguchi, M; Asano, M; Yamazaki, M; Oda, Y; Hasegawa, G; Nakamura, N; Fukui, M

    2015-09-01

    A close association between heart rate-corrected QT interval (QTc) and albuminuria in people with Type 2 diabetes has been reported in cross sectional studies. The aim of this study was to evaluate the relationship between QTc and change in urine albumin excretion (UAE) or progression of albuminuria in people with Type 2 diabetes. We measured QTc in 251 consecutive people at baseline. We performed a 5-year follow-up cohort study to assess the relationship between QTc and change in UAE, defined as an increase of UAE/follow-up duration (year), or progression of albuminuria, defined as an increase in the category of diabetic nephropathy. During follow-up, 23 of 151 people with normoalbuminuria and 13 of 73 people with microalbuminuria at baseline had progression of albuminuria. Multiple regression analysis demonstrated that QTc was independently associated with change in UAE (β = 0.176, P = 0.0104). Logistic regression analyses showed that QTc was a risk marker for progression of albuminuria [odds ratio per 0.01-s increase in QTc 1.35, 95% confidence interval (CI) 1.11-1.66, P = 0.0024] after adjusting for confounders. According to the receiver operator characteristic (ROC) analysis, the optimal cut-off point of QTc for progression of albuminuria was 0.418 s [area under the ROC curve 0.75 (95% CI 0.66-0.82), sensitivity = 0.86, specificity = 0.56, P albuminuria in people with Type 2 diabetes. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  20. Design and rationale of the HITTS randomized controlled trial: Effect of High-intensity Interval Training in de novo Heart Transplant Recipients in Scandinavia.

    Science.gov (United States)

    Nytrøen, Kari; Yardley, Marianne; Rolid, Katrine; Bjørkelund, Elisabeth; Karason, Kristjan; Wigh, Julia Philip; Dall, Christian Have; Arora, Satish; Aakhus, Svend; Lunde, Ketil; Solberg, Ole Geir; Gustafsson, Finn; Prescott, Eva Irene Bossano; Gullestad, Lars

    2016-02-01

    There is no consensus on how, when, and at what intensity exercise should be performed and organized after heart transplantation (HTx). Most rehabilitation programs are conducted in HTx centers, which might be impractical and costly. We have recently shown that high-intensity interval training (HIT) is safe, well tolerated, and efficacious in maintenance HTx recipients, but there are no studies among de novo patients, and whether HIT is feasible and superior to moderate training in HTx recipients is unclear. A total of 120 clinically stable HTx recipients older than 18 years will be recruited from 3 Scandinavian HTx centers. Participants are randomized to HIT or moderate training, shortly after surgery. All exercises are supervised in the patients' local communities. Testing at baseline and follow-up includes the following: VO2peak (primary end point), muscle strength, body composition, quality of life, myocardial performance, endothelial function, biomarkers, and progression of cardiac allograft vasculopathy. A subgroup (n = 90) will also be tested at 3-year follow-up to assess long-term effects of exercise. So far, the HIT intervention is well tolerated, without any serious adverse events. We aim to test whether decentralized HIT is feasible, safe, and superior to moderate training, and whether it will lead to significant improvement in exercise capacity and less long-term complications. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

    Science.gov (United States)

    Benda, Nathalie M M; Seeger, Joost P H; Stevens, Guus G C F; Hijmans-Kersten, Bregina T P; van Dijk, Arie P J; Bellersen, Louise; Lamfers, Evert J P; Hopman, Maria T E; Thijssen, Dick H J

    2015-01-01

    Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT. Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6%) were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload) or CT (30 minutes at 60-75% of maximal workload). Before and after intervention, we examined physical fitness (incremental cycling test), cardiac function and structure (echocardiography), vascular function and structure (ultrasound) and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ)). Training improved maximal workload, peak oxygen uptake (VO2peak) related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all Ptraining (Ptraining (N.S.). Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III. Nederlands Trial Register NTR3671.

  2. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training.

    Science.gov (United States)

    Stöggl, Thomas L; Björklund, Glenn

    2017-01-01

    The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg-1·min-1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes.

  3. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

    Science.gov (United States)

    Stöggl, Thomas L.; Björklund, Glenn

    2017-01-01

    The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes. PMID:28824457

  4. The impact of binaural beats on creativity

    National Research Council Canada - National Science Library

    Reedijk, Susan A; Bolders, Anne; Hommel, Bernhard

    2013-01-01

    ... through stimulating neuronal phase locking. We aimed to investigate whether binaural beats affect creative performance at all, whether they affect divergent thinking, convergent thinking, or both, and...

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

    Directory of Open Access Journals (Sweden)

    Peter Van Leeuwen

    Full Text Available 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.

  6. Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal

    OpenAIRE

    Patrick eMcConnell; Patrick eMcConnell; Brett eFroeliger; Eric L. Garland; Jeffrey C. Ives; Gary A. Sforzo

    2014-01-01

    Binaural beats are an auditory illusion perceived when two or more pure tones of similar frequencies are presented dichotically through stereo headphones. Although this phenomenon is thought to facilitate state changes (e.g., relaxation), few empirical studies have reported on whether binaural beats produce changes in autonomic arousal. Therefore, the present study investigated the effects of binaural beating on autonomic dynamics (heart-rate variability (HRV)) during post-exercise relaxation...

  7. Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal

    OpenAIRE

    McConnell, Patrick A.; Froeliger, Brett; Garland, Eric L.; Ives, Jeffrey C.; Sforzo, Gary A.

    2014-01-01

    Binaural beats are an auditory illusion perceived when two or more pure tones of similar frequencies are presented dichotically through stereo headphones. Although this phenomenon is thought to facilitate state changes (e.g., relaxation), few empirical studies have reported on whether binaural beats produce changes in autonomic arousal. Therefore, the present study investigated the effects of binaural beating on autonomic dynamics [heart rate variability (HRV)] during post-exercise relaxation...

  8. Short-term variability in QT interval and ventricular arrhythmias induced by dofetilide are dependent on high-frequency autonomic oscillations.

    Science.gov (United States)

    Champeroux, P; Thireau, J; Judé, S; Laigot-Barbé, C; Maurin, A; Sola, M L; Fowler, J S L; Richard, S; Le Guennec, J Y

    2015-06-01

    The present study was undertaken to investigate an effect of dofetilide, a potent arrhythmic blocker of the voltage-gated K(+) channel, hERG, on cardiac autonomic control. Combined with effects on ardiomyocytes, these properties could influence its arrhythmic potency. The short-term variability of beat-to-beat QT interval (STVQT ), induced by dofetilide is a strong surrogate of Torsades de pointes liability. Involvement of autonomic modulation in STVQT was investigated in healthy cynomolgus monkeys and beagle dogs by power spectral analysis under conditions of autonomic blockade with hexamethonium. Increase in STVQT induced by dofetilide in monkeys and dogs was closely associated with an enhancement of endogenous heart rate and QT interval high-frequency (HF) oscillations. These effects were fully suppressed under conditions of autonomic blockade with hexamethonium. Ventricular arrhythmias, including Torsades de pointes in monkeys, were prevented in both species when HF oscillations were suppressed by autonomic blockade. Similar enhancements of heart rate HF oscillations were found in dogs with other hERG blockers described as causing Torsades de pointes in humans. These results demonstrate for the first time that beat-to-beat ventricular repolarization variability and ventricular arrhythmias induced by dofetilide are dependent on endogenous HF autonomic oscillations in heart rate. When combined with evidence of hERG-blocking properties, enhancement of endogenous HF oscillations in heart rate could constitute an earlier and more sensitive biomarker than STVQT for Torsades de pointes liability, applicable to preclinical regulatory studies conducted in healthy animals. © 2015 The British Pharmacological Society.

  9. Short-term variability in QT interval and ventricular arrhythmias induced by dofetilide are dependent on high-frequency autonomic oscillations

    Science.gov (United States)

    Champeroux, P; Thireau, J; Judé, S; Laigot-Barbé, C; Maurin, A; Sola, M L; Fowler, J S L; Richard, S; Le Guennec, J Y

    2015-01-01

    Background and Purpose The present study was undertaken to investigate an effect of dofetilide, a potent arrhythmic blocker of the voltage-gated K+ channel, hERG, on cardiac autonomic control. Combined with effects on ardiomyocytes, these properties could influence its arrhythmic potency. Experimental Approach The short-term variability of beat-to-beat QT interval (STVQT), induced by dofetilide is a strong surrogate of Torsades de pointes liability. Involvement of autonomic modulation in STVQT was investigated in healthy cynomolgus monkeys and beagle dogs by power spectral analysis under conditions of autonomic blockade with hexamethonium. Key Results Increase in STVQT induced by dofetilide in monkeys and dogs was closely associated with an enhancement of endogenous heart rate and QT interval high-frequency (HF) oscillations. These effects were fully suppressed under conditions of autonomic blockade with hexamethonium. Ventricular arrhythmias, including Torsades de pointes in monkeys, were prevented in both species when HF oscillations were suppressed by autonomic blockade. Similar enhancements of heart rate HF oscillations were found in dogs with other hERG blockers described as causing Torsades de pointes in humans. Conclusions and Implications These results demonstrate for the first time that beat-to-beat ventricular repolarization variability and ventricular arrhythmias induced by dofetilide are dependent on endogenous HF autonomic oscillations in heart rate. When combined with evidence of hERG-blocking properties, enhancement of endogenous HF oscillations in heart rate could constitute an earlier and more sensitive biomarker than STVQT for Torsades de pointes liability, applicable to preclinical regulatory studies conducted in healthy animals. PMID:25625756

  10. HEART RATE VARIABILITY CLASSIFICATION USING SADE-ELM CLASSIFIER WITH BAT FEATURE SELECTION

    Directory of Open Access Journals (Sweden)

    R Kavitha

    2017-07-01

    Full Text Available The electrical activity of the human heart is measured by the vital bio medical signal called ECG. This electrocardiogram is employed as a crucial source to gather the diagnostic information of a patient’s cardiopathy. The monitoring function of cardiac disease is diagnosed by documenting and handling the electrocardiogram (ECG impulses. In the recent years many research has been done and developing an enhanced method to identify the risk in the patient’s body condition by processing and analysing the ECG signal. This analysis of the signal helps to find the cardiac abnormalities, arrhythmias, and many other heart problems. ECG signal is processed to detect the variability in heart rhythm; heart rate variability is calculated based on the time interval between heart beats. Heart Rate Variability HRV is measured by the variation in the beat to beat interval. The Heart rate Variability (HRV is an essential aspect to diagnose the properties of the heart. Recent development enhances the potential with the aid of non-linear metrics in reference point with feature selection. In this paper, the fundamental elements are taken from the ECG signal for feature selection process where Bat algorithm is employed for feature selection to predict the best feature and presented to the classifier for accurate classification. The popular machine learning algorithm ELM is taken for classification, integrated with evolutionary algorithm named Self- Adaptive Differential Evolution Extreme Learning Machine SADEELM to improve the reliability of classification. It combines Effective Fuzzy Kohonen clustering network (EFKCN to be able to increase the accuracy of the effect for HRV transmission classification. Hence, it is observed that the experiment carried out unveils that the precision is improved by the SADE-ELM method and concurrently optimizes the computation time.

  11. Effects of single cycle binaural beat duration on auditory evoked potentials.

    Science.gov (United States)

    Mihajloski, Todor; Bohorquez, Jorge; Özdamar, Özcan

    2014-01-01

    Binaural beat (BB) illusions are experienced as continuous central pulsations when two sounds with slightly different frequencies are delivered to each ear. It has been shown that steady-state auditory evoked potentials (AEPs) to BBs can be captured and investigated. The authors recently developed a new method of evoking transient AEPs to binaural beats using frequency modulated stimuli. This methodology was able to create single BBs in predetermined intervals with varying carrier frequencies. This study examines the effects of the BB duration and the frequency modulating component of the stimulus on the binaural beats and their evoked potentials. Normal hearing subjects were tested with a set of four durations (25, 50, 100, and 200 ms) with two stimulation configurations, binaural dichotic (binaural beats) and diotic (frequency modulation). The results obtained from the study showed that out of the given durations, the 100 ms beat, was capable of evoking the largest amplitude responses. The frequency modulation effect showed a decrease in peak amplitudes with increasing beat duration until their complete disappearance at 200 ms. Even though, at 200 ms, the frequency modulation effects were not present, the binaural beats were still perceived and captured as evoked potentials.

  12. Ginsenoside Re prevents angiotensin II-induced gap-junction remodeling by activation of PPARγ in isolated beating rat atria.

    Science.gov (United States)

    Zhang, Bo; Cui, Xun; Jin, Hong-Hua; Hong, Lan; Liu, Xia; Li, Xiang; Zhang, Qing-Gao; Liu, Li-Ping

    2017-12-01

    Ginsenoside Re (G-Re), a major ginsenoside in ginseng, has many beneficial pharmacological effects on negative cardiac contractility, electromechanical alternans, antiarrhythmia, angiogenic regeneration and cardiac electrophysiological function. However, effects of G-Re on gap-junction remodeling are unclear. Therefore, this study aimed to investigate the effect of G-Re on angiotensin II (Ang II)-induced downregulation of connexin-40 (CX40) and -43 (CX43) in beating rat left atria. In this study, the isolated perfused beating rat atrial model was used and atrial gap-junction remodeling was induced by Ang II. In vivo hemodynamic experiments were analyzed with a biological recorder. Changes in protein expression were analyzed by western blot. G-Re attenuated Ang II-induced abnormal changes in heart rate, MAP, LVESP, LVEDP, +dp/dt max, -dp/dt min, P wave amplitude, P-R interval and P wave length. This indicated a dose-dependent preventive role against Ang II-induced hyper hemodynamics in rats. Atrial activities of p38 mitogen-activated protein kinase (MAPK), nuclear factor kappa-B (NF-κB) and activator protein 1 (AP-1) were significantly increased by Ang II, as was expression of atrial collagen I and matrix metalloproteinase 2 (MMP2). Atrial CX40 and CX43 expression was downregulated by Ang II. These Ang II-induced atrial effects were blocked by G-Re, as well as rosiglitazone, an agonist of peroxisome proliferator-activated receptor γ (PPARγ), in a dose-dependent manner. However, this inhibition was abolished by the PPARγ inhibitor GW9662. G-Re may suppress Ang II-induced downregulation of CX40 and CX43, by activating PPARγ signaling, in isolated perfused beating rat atria. Copyright © 2017. Published by Elsevier Inc.

  13. A heart that beats for 500 years: age-related changes in cardiac proteasome activity, oxidative protein damage and expression of heat shock proteins, inflammatory factors, and mitochondrial complexes in Arctica islandica, the longest-living noncolonial animal.

    Science.gov (United States)

    Sosnowska, Danuta; Richardson, Chris; Sonntag, William E; Csiszar, Anna; Ungvari, Zoltan; Ridgway, Iain

    2014-12-01

    Study of negligibly senescent animals may provide clues that lead to better understanding of the cardiac aging process. To elucidate mechanisms of successful cardiac aging, we investigated age-related changes in proteasome activity, oxidative protein damage and expression of heat shock proteins, inflammatory factors, and mitochondrial complexes in the heart of the ocean quahog Arctica islandica, the longest-lived noncolonial animal (maximum life span potential: 508 years). We found that in the heart of A. islandica the level of oxidatively damaged proteins did not change significantly up to 120 years of age. No significant aging-induced changes were observed in caspase-like and trypsin-like proteasome activity. Chymotrypsin-like proteasome activity showed a significant early-life decline, then it remained stable for up to 182 years. No significant relationship was observed between the extent of protein ubiquitination and age. In the heart of A. islandica, an early-life decline in expression of HSP90 and five mitochondrial electron transport chain complexes was observed. We found significant age-related increases in the expression of three cytokine-like mediators (interleukin-6, interleukin-1β, and tumor necrosis factor-α) in the heart of A. islandica. Collectively, in extremely long-lived molluscs, maintenance of protein homeostasis likely contributes to the preservation of cardiac function. Our data also support the concept that low-grade chronic inflammation in the cardiovascular system is a universal feature of the aging process, which is also manifest in invertebrates. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

    Directory of Open Access Journals (Sweden)

    Thomas L. Stöggl

    2017-08-01

    Full Text Available The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR in well-trained endurance athletes.Methods: Thirty-six male (n = 33 and female (n = 3 runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak: 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT. A maximal anaerobic running/cycling test (MART/MACT was performed prior to and following a 9-week training period.Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001 and peak lactate (P = 0.001 during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1 was changed (P > 0.05. Acute HRR was improved in HIIT (11.2%, P = 0.002 and POL (7.9%, P = 0.023 with no change in the HVLIT oriented control group.Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT had no effect on any performance or HRR outcomes.

  15. The impact of high intensity aerobic interval training (HIIT and flaxseed oil on ICAM-1 gene expression in heart tissue in male Wistar rats

    Directory of Open Access Journals (Sweden)

    Y Khademi

    2016-12-01

    Full Text Available Abstract Background: The prevalence of cardiovascular disease may be due to inflammation and systemic inflammation plays an important role in the development and progression of atherosclerosis. ICAM-1 is one of the important factors in the pathogenesis of atherosclerosis is an inflammatory effect of physical activity and plant protection products on the response it is not well known. Methods  Thirty Wistar rats were selected as sample. Rats were randomly divided into six groups of five, including control, exercise, extracts dose of 10 mg / kg, extract dose 30 mg / kg, a dose of extract practice mg / kg 10, and extracts Practice dose of 30 mg / kg, respectively. Training groups, five sessions per week for 10 weeks, intense interval training involves running on a treadmill with an intensity of 90 to 95 percent of VO2max for rodents, at specified hours during the day. After the rats were sacrificed and the heart tissue, and to measure gene expression of ICAM-1 and LFA-1 were used. Result Data analysis showed that the expression of ICAM-1 has been reduced in training supplement groups The expression of intercellular adhesion molecule receptor (ITG has decreased in the exercise and supplement group. Conclusion: The results of this study show that both exercise and extract significant effect on gene expression of ICAM-1. And decreased expression of ICAM-1 was also flax oil ICAM-1 gene expression was also reduced. The findings of this study showed that the combination of training and flax oil reduces the expression of ICAM-1 compared to the control group. So it is likely that this method can be used as a way to prevent cardiovascular disease.

  16. Long-term effects of high-intensity interval training in heart transplant recipients: A 5-year follow-up study of a randomized controlled trial.

    Science.gov (United States)

    Yardley, Marianne; Gullestad, Lars; Bendz, Bjørn; Bjørkelund, Elisabeth; Rolid, Katrine; Arora, Satish; Nytrøen, Kari

    2017-01-01

    Previous studies have demonstrated that high-intensity interval training (HIT) is superior to moderate-continuous exercise in general and in cardiovascular diseases. Recently, we also found HIT safe and efficient after heart transplantation (HTx). This study reports the 5-year long-term effects. Forty-one HTx patients who had completed the previous 12-month randomized controlled trial, comparing HIT intervention with usual care, were eligible. In particular, we measured VO2peak , muscular capacity, intravascular ultrasound, and questionnaires measuring physical and mental health. The baseline mean±SD values were as follows: age; 49.1±16.5 years, men; 68%, time since HTx: 4.1±2.2 years. Within the HIT group, initial VO2peak increased significantly from 27.7±5.7 to 31.2±5.3 mL/kg/min. However, during the next 4 years, VO2peak decreased to 26.0±6.2 mL/kg/min. The control group showed slightly decreasing VO2peak values during the entire 5-year period. The HIT group reported significantly less anxiety symptoms, but there were no long-term differences in VO2peak , muscular capacity, or cardiac allograft vasculopathy between the groups. The similar VO2peak values correspond to our findings of similar everyday activity. Our findings suggest that intermittent periods of HIT may be necessary to maintain the initial benefits gained from the intervention. However, HIT probably reduces the burden of anxiety, which is a frequent health issue following HTx. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

    Directory of Open Access Journals (Sweden)

    Nathalie M M Benda

    Full Text Available Physical fitness is an important prognostic factor in heart failure (HF. To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT. We comprehensively compared effects of HIT versus continuous training (CT in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT.Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6% were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload or CT (30 minutes at 60-75% of maximal workload. Before and after intervention, we examined physical fitness (incremental cycling test, cardiac function and structure (echocardiography, vascular function and structure (ultrasound and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ.Training improved maximal workload, peak oxygen uptake (VO2peak related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05, whilst no differences were present between HIT and CT (N.S.. We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05, whilst SF-36 total score and MLHFQ did not change after training (N.S..Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III.Nederlands Trial Register NTR3671.

  18. Time Interval from Symptom Onset to Hospital Care in Patients with Acute Heart Failure: A Report from the Tokyo Cardiac Care Unit Network Emergency Medical Service Database.

    Science.gov (United States)

    Shiraishi, Yasuyuki; Kohsaka, Shun; Harada, Kazumasa; Sakai, Tetsuro; Takagi, Atsutoshi; Miyamoto, Takamichi; Iida, Kiyoshi; Tanimoto, Shuzou; Fukuda, Keiichi; Nagao, Ken; Sato, Naoki; Takayama, Morimasa

    2015-01-01

    There seems to be two distinct patterns in the presentation of acute heart failure (AHF) patients; early- vs. gradual-onset. However, whether time-dependent relationship exists in outcomes of patients with AHF remains unclear. The Tokyo Cardiac Care Unit Network Database prospectively collects information of emergency admissions via EMS service to acute cardiac care facilities from 67 participating hospitals in the Tokyo metropolitan area. Between 2009 and 2011, a total of 3811 AHF patients were registered. The documentation of symptom onset time was mandated by the on-site ambulance team. We divided the patients into two groups according to the median onset-to-hospitalization (OH) time for those patients (2h); early- (presenting ≤2h after symptom onset) vs. gradual-onset (late) group (>2h). The primary outcome was in-hospital mortality. The early OH group had more urgent presentation, as demonstrated by a higher systolic blood pressure (SBP), respiratory rate, and higher incidence of pulmonary congestion (48.6% vs. 41.6%; P<0.001); whereas medical comorbidities such as stroke (10.8% vs. 7.9%; P<0.001) and atrial fibrillation (30.0% vs. 26.0%; P<0.001) were more frequently seen in the late OH group. Overall, 242 (6.5%) patients died during hospitalization. Notably, a shorter OH time was associated with a better in-hospital mortality rate (odds ratio, 0.71; 95% confidence interval, 0.51-0.99; P = 0.043). Early-onset patients had rather typical AHF presentations (e.g., higher SBP or pulmonary congestion) but had a better in-hospital outcome compared to gradual-onset patients.

  19. QT Interval in Pregnant and Non-pregnant Women

    Directory of Open Access Journals (Sweden)

    Majid Zamani

    2014-03-01

    Full Text Available Introduction: Prolongation of QT interval might result in dangerous cardiac arrhythmias, including Torsades de Pointes (TdP, consequently leading to syncope or death. A limited number of studies carried out in this respect to date have shown that QT interval might increase during pregnancy. On the other hand, it has been shown that each pregnancy might result in an increase in the risk of cardiac accidents in patients with long QT interval. Therefore, the present study was undertaken to compare QT intervals in pregnant and non-pregnant women. Methods: Pregnant women group consisted of 40 women in the second and third trimesters of pregnancy and the non-pregnant control group consisted of healthy women 18-35 years of age. All the patients underwent standard 12-lead electrocardiogram (ECG. The QT interval was measured for each patient at lead II. The mean corrected QT interval (QTc and QT dispersions (QTd were compared between the two groups. Results: Mean heart rates in the pregnant and non-pregnant groups were 98.55±14.09 and 72.53±13.17 beats/minutes (P<0.001. QTd and QTc means were in the normal range in both groups; however, these variables were 49.50±12.80 and 43.03±18.47 milliseconds in the pregnant group and 39.5±9.59 and 40.38±17.20 milliseconds in the control group, respectively (P<0.001. Conclusion: The QT interval was longer in pregnant women compared to non-pregnant women; however, it was in the normal range in both groups. Therefore, it is important to monitor and manage risk factors involved in prolongation of QT interval and prevent concurrence of these factors with pregnancy.

  20. Atropine unmasks bed-rest effect - A spectral analysis of cardiac interbeat intervals

    Science.gov (United States)

    Goldberger, Ary L.; Goldwater, Danielle; Bhargava, Valmik

    1986-01-01

    Heart rate spectral data obtained for 10 male subjects between 35-49 years following orthostatic tolerance testing with lower body negative pressure prebed rest and after 7-10 days of bed rest, while on placebo and after intravenous atropine are analyzed. Comparison of the spectral atropine rms for subjects prebed rest and after bed rest reveal a decrease from 63 + or - 24 ms to 40 + or - 23 ms. It is observed that heart rate interval variability for subjects after bed rest and with atropine is reduced; the heart rate at bed rest with atropine is increased from 70.4 + or - 12.4 beats/min prebed rest to 83.7 + or - 18.9 beats/min; and the exercise tolerance time for subjects in the atropine prebed-rest phase (658 + or - 352 s) is higher than the bed-rest phase (505 + or - 252 s). It is noted that bed rest impairs the cardiovascular capacity to adaptively modulate physiological responses, atropine exposes bed-rest deconditioning effects, and spectral analysis is useful for studying the effects of bed-rest deconditioning on cardiac dynamics.

  1. Decreased heart rate variability responses during early postoperative mobilization

    DEFF Research Database (Denmark)

    Jans, Øivind; Brinth, Louise; Kehlet, Henrik

    2015-01-01

    BACKGROUND: Intact orthostatic blood pressure regulation is essential for early mobilization after surgery. However, postoperative orthostatic hypotension and intolerance (OI) may delay early ambulation. The mechanisms of postoperative OI include impaired vasopressor responses relating to postope......BACKGROUND: Intact orthostatic blood pressure regulation is essential for early mobilization after surgery. However, postoperative orthostatic hypotension and intolerance (OI) may delay early ambulation. The mechanisms of postoperative OI include impaired vasopressor responses relating...... to postoperative autonomic dysfunction. Thus, based on a previous study on haemodynamic responses during mobilization before and after elective total hip arthroplasty (THA), we performed secondary analyses of heart rate variability (HRV) and aimed to identify possible abnormal postoperative autonomic responses...... in relation to postural change. METHODS: A standardized mobilization protocol before, 6 and 24 h after surgery was performed in 23 patients scheduled for elective THA. Beat-to-beat arterial blood pressure was measured by photoplethysmography and HRV was derived from pulse wave interbeat intervals and analysed...

  2. Applicability of a Novel Formula (Bogossian formula) for Evaluation of the QT-Interval in Heart Failure and Left Bundle Branch Block Due to Right Ventricular Pacing.

    Science.gov (United States)

    Frommeyer, Gerrit; Bogossian, Harilaos; Pechlivanidou, Eleni; Conzen, Philipp; Gemein, Christopher; Weipert, Kay; Helmig, Inga; Chasan, Ritvan; Johnson, Victoria; Eckardt, Lars; Hamm, Christian W; Seyfarth, Melchior; Lemke, Bernd; Zarse, Markus; Schmitt, Jörn; Erkapic, Damir

    2017-04-01

    The presence of left bundle branch block (LBBB) due to right ventricular pacing represents a particular challenge in properly measuring the QTc interval. In 2014, a new formula for the evaluation of QT interval in patients with LBBB was reported. 145 patients with implantable cardioverter defibrillator were included in this prospective multicenter observational study. Inclusion criteria were: no permanent right ventricular stimulation, an intrinsic QRS interval of QT-interval must be respected. © 2017 Wiley Periodicals, Inc.

  3. Detection and removal of ventricular ectopic beats in atrial fibrillation recordings via principal component analysis.

    Science.gov (United States)

    Martínez, Arturo; Alcaraz, Raúl; Rieta, José J

    2011-01-01

    Ectopic beats are early heart beats with remarkable large amplitude that provoke serious disturbances in the analysis of electrocardiograms (ECG). These beats are very common in atrial fibrillation (AF) and are the source of important residua when the QRST is intended to be removed. Given that QRST cancellation is a binding step in the appropriate analysis of atrial activity (AA) in AF, a method for ventricular ectopic beats cancellation is proposed as a previous step to the application of any QRST removal technique. First, the method discriminates between normal and ectopic beats with an accuracy higher than 99% through QRS morphological characterization. Next, the most similar ectopic beats to the one under cancellation are clustered and serve to get their eigenvector matrix by principal component analysis. Finally, the highest variance eigenvector is used as cancellation template. The reduction ectopic rate (RER) has been defined to evaluate the method's performance by using templates generated with 5, 10, 20, 40 or 80 ectopics. Optimal results were reached with the 5 most similar complexes, yielding a RER higher than 5.5. In addition, a decreasing RER trend was noticed as the number of considered ectopics for cancellation increased. As conclusion, given that ectopics presented a remarkable variability in their morphology, the proposed cancellation approach is a robust ectopic remover and can notably facilitate the later application of any QRST cancellation technique to extract the AA in the best conditions.

  4. Effect of changing heart rate during treatment of hypertension on incidence of heart failure.

    Science.gov (United States)

    Okin, Peter M; Kjeldsen, Sverre E; Julius, Stevo; Hille, Darcy A; Dahlöf, Björn; Devereux, Richard B

    2012-03-01

    An elevated heart rate (HR) at rest at baseline is associated with an increased risk of incident heart failure (HF) and with greater cardiovascular event rates in patients with chronic HF. However, despite the high attributable risk of hypertension for HF, whether the in-treatment HR predicts incident HF in patients with treated hypertension has not been evaluated. The HR was evaluated on annual electrocardiograms from 9,024 patients with hypertension without HF who were treated with losartan- or atenolol-based regimens. During a mean follow-up of 4.7 ± 1.1 years, HF developed in 285 patients (3.2%). On multivariate Cox analyses adjusted for randomized treatment, the baseline risk factors for HF, baseline and in-treatment blood pressure, QRS duration, and electrocardiographic left ventricular hypertrophy, a greater in-treatment HR predicted a 45% greater adjusted risk of new HF for every 10-beats/min increase in the HR (95% confidence interval [CI] 34% to 57%) or a 159% greater risk of HF in patients with the persistence or development of a HR of ≥84 beats/min (95% CI 88% to 257%). In contrast, with adjustment for the same covariates, the baseline HR as a continuous variable was a significantly less powerful predictor of new HF (hazard ratio 1.15 per 10 beats/min, 95% CI 1.03 to 1.28) and a baseline HR of ≥84 beats/min did not predict new HF (hazard ratio 1.00, 95% CI 0.63 to 1.58). In conclusion, a greater in-treatment HR on the serial electrocardiograms predicts a greater risk of incident HF during antihypertensive treatment, independent of the covariates, in patients with hypertension with electrocardiographic left ventricular hypertrophy. These findings support serial HR assessment to improve the risk stratification of patients with hypertension. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Heart Rate Variability - A Historical Perspective

    Directory of Open Access Journals (Sweden)

    George E Billman

    2011-11-01

    Full Text Available Heart rate variability (HRV, the beat-to-beat variation in either heart rate or the duration of the R-R interval – the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration – the so called respiratory sinus arrhythmia, RSA and are widely believed to reflect changes in cardiac autonomic regulation. Although the exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate, a number of time and frequency domain techniques have been developed to provide insight into cardiac autonomic regulation in both health and disease. It is the purpose of this essay to provide an historical overview of the evolution in the concept of heart rate variability. Briefly, pulse rate was first measured by ancient Greek physicians and scientists. However, it was not until the invention of the Physician’s Pulse Watch (a watch with a second hand that could be stopped in 1707 that changes in pulse rate could be accurately assessed. The Rev. Stephen Hales (1733 was the first to note that pulse varied with respiration and in 1847 Carl Ludwig was the first to record RSA. With the measurement of the ECG (1895 and advent of digital signal processing techniques in the 1960’s, investigation of HRV and its relationship to health and disease has exploded. This essay will conclude with a brief description of time domain, frequency domain, and non-linear dynamic analysis techniques (and their limitations that are commonly used to measure heart rate variability.

  6. Heart rate is a marker of amiodarone mortality reduction in severe heart failure. The GESICA-GEMA Investigators. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina-Grupo de Estudios Multicéntricos en Argentina.

    Science.gov (United States)

    Nul, D R; Doval, H C; Grancelli, H O; Varini, S D; Soifer, S; Perrone, S V; Prieto, N; Scapin, O

    1997-05-01

    The impact of amiodarone on mortality in patients with severe congestive heart failure (CHF) (New York Heart Association functional classes II [advanced], III and IV; left ventricular ejection fraction Cardiaca en Argentina (GESICA) trial was analyzed in relation to initial mean baseline heart rate (BHR) and its change after 6 months of follow-up. Trials of amiodarone therapy in CHF have produced discordant results, suggesting that the effect is not uniform in all patient subgroups with regard to survival. The present analysis was carried out in 516 patients randomized to receive amiodarone, 300 mg/day (n = 260), or nonantiarrhythmic therapy (n = 256, control group) and followed up for 2 years. Survival was evaluated for patients with a BHR > or = 90 beats/min (control: n = 132; amiodarone: n = 122) and or = 90 beats/min, amiodarone therapy reduced mortality to 38.4% compared with 62.4% in control patients (relative risk [RR] 0.55, 95% confidence interval [CI] 0.35 to 0.95, p or = 90 beats/min, which was reduced at 6 months. Elevated rest heart rates in severe CHF identify a subgroup of patients who benefit from treatment with amiodarone. Amiodarone-induced heart rate slowing may be an important benefit for patients.

  7. Visualizing acoustical beats with a smartphones

    CERN Document Server

    Giménez, Marcos H; Castro-Palacio, Juan C; Gómez-Tejedor, José A; Monsoriu, Juan A

    2016-01-01

    In this work, a new Physics laboratory experiment on Acoustics beats is presented. We have designed a simple experimental setup to study superposition of sound waves of slightly different frequencies (acoustic beat). The microphone of a smartphone is used to capture the sound waves emitted by two equidistant speakers from the mobile which are at the same time connected to two AC generators. The smartphone is used as a measuring instrument. By means of a simple and free AndroidTM application, the sound level (in dB) as a function of time is measured and exported to a .csv format file. Applying common graphing analysis and a fitting procedure, the frequency of the beat is obtained. The beat frequencies as obtained from the smartphone data are compared with the difference of the frequencies set at the AC generator. A very good agreement is obtained being the percentage discrepancies within 1 %.

  8. Wearable Beat-to-Beat Blood Pressure Monitor

    Science.gov (United States)

    Lee, Yong Jin

    2015-01-01

    Linea Research Corporation has developed a wearable noninvasive monitor that provides continuous blood pressure and heart rate measurements in extreme environments. Designed to monitor the physiological effects of astronauts' prolonged exposure to reduced-gravity environments as well as the effectiveness of various countermeasures, the device offers wireless connectivity to allow transfer of both real-time and historical data. It can be modified to monitor the health status of astronaut crew members during extravehicular missions.

  9. The Effect of Dopaminergic Medication on Beat-Based Auditory Timing in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Daniel J Cameron

    2016-02-01

    Full Text Available Parkinson’s disease (PD adversely affects timing abilities. Beat-based timing is a mechanism that times events relative to a regular interval, such as the ‘beat’ in musical rhythm, and is impaired in PD. It is unknown if dopaminergic medication influences beat-based timing in PD. Here we tested beat-based timing over two sessions in participants with PD (OFF then ON dopaminergic medication, and unmedicated control participants. People with PD and control participants completed two tasks. The first was a discrimination task in which participants compared two rhythms and determined whether they were the same or different. Rhythms either had a beat structure (metric simple rhythms, or did not (metric complex rhythms, as in previous studies. Discrimination accuracy was analyzed to test for the effects of beat structure, as well as differences between participants with PD and controls, and effects of medication (PD group only. The second task was the Beat Alignment Test (BAT, in which participants listened to music with regular tones superimposed, and responded as to whether the tones were ‘on’ or ‘off’ the beat of the music. Accuracy was analyzed to test for differences between participants with PD and controls, and for an effect of medication in patients.Both patients and controls discriminated metric simple rhythms better than metric complex rhythms. Controls also improved at the discrimination task in the second vs. first session, whereas people with PD did not. For participants with PD, the difference in performance between metric simple and metric complex rhythms was greater (sensitivity to changes in simple rhythms increased and sensitivity to changes in complex rhythms decreased when ON vs. OFF medication. Performance also worsened with disease severity. For the Beat Alignment Test, no group differences or effects of medication were found. Overall, these findings suggest that timing is impaired in PD, and that dopaminergic

  10. General anesthesia suppresses normal heart rate variability in humans

    Science.gov (United States)

    Matchett, Gerald; Wood, Philip

    2014-06-01

    The human heart normally exhibits robust beat-to-beat heart rate variability (HRV). The loss of this variability is associated with pathology, including disease states such as congestive heart failure (CHF). The effect of general anesthesia on intrinsic HRV is unknown. In this prospective, observational study we enrolled 100 human subjects having elective major surgical procedures under general anesthesia. We recorded continuous heart rate data via continuous electrocardiogram before, during, and after anesthesia, and we assessed HRV of the R-R intervals. We assessed HRV using several common metrics including Detrended Fluctuation Analysis (DFA), Multifractal Analysis, and Multiscale Entropy Analysis. Each of these analyses was done in each of the four clinical phases for each study subject over the course of 24 h: Before anesthesia, during anesthesia, early recovery, and late recovery. On average, we observed a loss of variability on the aforementioned metrics that appeared to correspond to the state of general anesthesia. Following the conclusion of anesthesia, most study subjects appeared to regain their normal HRV, although this did not occur immediately. The resumption of normal HRV was especially delayed on DFA. Qualitatively, the reduction in HRV under anesthesia appears similar to the reduction in HRV observed in CHF. These observations will need to be validated in future studies, and the broader clinical implications of these observations, if any, are unknown.

  11. Interval Training

    Science.gov (United States)

    ... Weston M, et al. Effects of low-volume high-intensity interval training (HIT) on fitness in adults: A meta-analysis ... 2014;44:1005. Gillen JB, et al. Is high-intensity interval training a time-efficient exercise strategy to improve health ...

  12. A comparison of robust Kalman filtering methods for artifact correction in heart rate variability analysis.

    Directory of Open Access Journals (Sweden)

    Carlos D. Zuluaga-Ríos

    2015-01-01

    Full Text Available Heart rate variability (HRV has received considerable attention for many years, since it provides a quantitative marker for examining the sinus rhythm modulated by the autonomic nervous system (ANS. The ANS plays an important role in clinical and physiological fields. HRV analysis can be performed by computing several time and frequency domain measurements. However, the computation of such measurements can be affected by the presence of artifacts or ectopic beats in the electrocardiogram (ECG recording. This is particularly true for ECG recordings from Holter monitors. The aim of this work was to study the performance of several robust Kalman filters for artifact correction in Inter-beat (RR interval time series. For our experiments, two data sets were used: the first data set included 10 RR interval time series from a realistic RR interval time series generator. The second database contains 10 sets of RR interval series from five healthy patients and five patients suffering from congestive heart failure. The standard deviation of the RR interval was computed over the filtered signals. Results were compared with a state of the art processing software, showing similar values and behavior. In addition, the proposed methods offer satisfactory results in contrast to standard Kalman filtering.

  13. Substrate stiffness-modulated registry phase correlations in cardiomyocytes map structural order to coherent beating

    Science.gov (United States)

    Dasbiswas, K.; Majkut, S.; Discher, D. E.; Safran, Samuel A.

    2015-01-01

    Recent experiments show that both striation, an indication of the structural registry in muscle fibres, as well as the contractile strains produced by beating cardiac muscle cells can be optimized by substrate stiffness. Here we show theoretically how the substrate rigidity dependence of the registry data can be mapped onto that of the strain measurements. We express the elasticity-mediated structural registry as a phase-order parameter using a statistical physics approach that takes the noise and disorder inherent in biological systems into account. By assuming that structurally registered myofibrils also tend to beat in phase, we explain the observed dependence of both striation and strain measurements of cardiomyocytes on substrate stiffness in a unified manner. The agreement of our ideas with experiment suggests that the correlated beating of heart cells may be limited by the structural order of the myofibrils, which in turn is regulated by their elastic environment.

  14. Alterações hemodinâmicas devido ao uso de estabilizadores em revascularização do miocárdio: estudo experimental Hemodynamic disorders related to beating heart surgery using cardiac stabilizers: experimental study

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Martins de Oliveira

    2007-12-01

    -pump coronary artery bypass graft surgeries by means of both a suction device "Octopus" and a compression device (Speroni. METHODS: Ten swine underwent median sternotomy. Monitoring of ECG, continuous cardiac output, mean arterial pressure, mean pulmonary artery pressure, mean right and left atrial pressures, and right and left ventricular diastolic pressure were performed. Stroke volume and systemic vascular resistance were calculated. Both stabilizers were studied placed on three vessels: anterior interventricular branch, posterior interventricular branch, and marginal branch of the circumflex branch. Each animal was randomly designed to application regarding the type of stabilizer and the target artery. The measurements were carried out 5 minutes before and after the stabilizer application. RESULTS: In the anterior interventricular branch changes have occurred only with the compression device, thus reducing cardiac output, stroke volume, and mean arterial pressure, but increasing the systemic vascular resistance. In the posterior interventricular branch changes have occurred with the compression device (Speroni, reducing cardiac output and stroke volume, but increasing the heart rate. With the suction device (octopus there was an increase of both heart rate and systemic vascular resistance, but a decrease in stroke volume. In the marginal branch of the circumflex branch there was a decrease of cardiac output, stroke volume, and mean arterial pressure with both stabilizers. Also, there was a decrease in the mean pulmonary artery pressure and an increase in the mean right atrial pressure with the compression device (Speroni. CONCLUSION: Both stabilizers have caused hemodynamic changes. The compression device (Speroni is more associated with changes than the suction device (Octopus.

  15. Qtc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide

    DEFF Research Database (Denmark)

    Brendorp, B; Elming, H; Jun, L

    2001-01-01

    BACKGROUND: A prolonged QTc interval is considered a contraindication for class III antiarrhythmic drugs, but the influence of a normal or a slightly increased baseline QTc interval on the risk or benefit of treatment with a class III antiarrhythmic drug is not sufficiently clarified. METHODS...... interval was measured before randomization to either dofetilide, a new class III antiarrhythmic drug, or placebo. During a median follow-up of 18 months (minimum 1 year), 285 patients (41%) died. Baseline QTc interval had no prognostic value on survival in placebo-treated patients. In dofetilide...... limits is associated with a marked reduction of mortality in patients with CHF and left ventricular systolic dysfunction treated with dofetilide. This is a potentially important indication of which patients with CHF might benefit from prophylactic treatment with an antiarrhythmic drug....

  16. The impact of binaural beats on creativity.

    Science.gov (United States)

    Reedijk, Susan A; Bolders, Anne; Hommel, Bernhard

    2013-01-01

    Human creativity relies on a multitude of cognitive processes, some of which are influenced by the neurotransmitter dopamine. This suggests that creativity could be enhanced by interventions that either modulate the production or transmission of dopamine directly, or affect dopamine-driven processes. In the current study we hypothesized that creativity can be influenced by means of binaural beats, an auditory illusion that is considered a form of cognitive entrainment that operates through stimulating neuronal phase locking. We aimed to investigate whether binaural beats affect creative performance at all, whether they affect divergent thinking, convergent thinking, or both, and whether possible effects may be mediated by the individual striatal dopamine level. Binaural beats were presented at alpha and gamma frequency. Participants completed a divergent and a convergent thinking task to assess two important functions of creativity, and filled out the Positive And Negative Affect Scale-mood State questionnaire (PANAS-S) and an affect grid to measure current mood. Dopamine levels in the striatum were estimated using spontaneous eye blink rates (EBRs). Results showed that binaural beats, regardless of the presented frequency, can affect divergent but not convergent thinking. Individuals with low EBRs mostly benefitted from alpha binaural beat stimulation, while individuals with high EBRs were unaffected or even impaired by both alpha and gamma binaural beats. This suggests that binaural beats, and possibly other forms of cognitive entrainment, are not suited for a one-size-fits-all approach, and that individual cognitive-control systems need to be taken into account when studying cognitive enhancement methods.

  17. The impact of binaural beats on creativity

    Directory of Open Access Journals (Sweden)

    Susan A. Reedijk

    2013-11-01

    Full Text Available Human creativity relies on a multitude of cognitive processes, some of which are influenced by the neurotransmitter dopamine. This suggests that creativity could be enhanced by interventions that either modulate the production or transmission of dopamine directly, or affect dopamine-driven processes. In the current study we hypothesized that creativity can be influenced by means of binaural beats, an auditory illusion that is considered a form of cognitive entrainment that operates through stimulating neuronal phase locking. We aimed to investigate whether binaural beats affect creative performance at all, whether they affect divergent thinking, convergent thinking, or both, and whether possible effects may be mediated by the individual striatal dopamine level. Binaural beats were presented at alpha and gamma frequency. Participants completed a divergent and a convergent thinking task to assess two important functions of creativity, and filled out the Positive And Negative Affect Scale – mood State questionnaire (PANAS-S and affect grid to measure current mood. Dopamine levels in the striatum were estimated using spontaneous eye blink rates (EBRs. Results showed that binaural beats, regardless of the presented frequency, can affect divergent but not convergent thinking. Individuals with low EBRs mostly benefitted from alpha binaural beat stimulation, while individuals with high EBR were unaffected or even impaired by both alpha and gamma binaural beats. This suggests that binaural beats, and possibly other forms of cognitive entrainment, are not suited for a one-size-fits-all approach, and that individual cognitive-control systems need to be taken into account when studying cognitive enhancement methods.

  18. The effect of heart rate on the heart rate variability response to autonomic interventions.

    Science.gov (United States)

    Billman, George E

    2013-01-01

    Heart rate variability (HRV), the beat-to-beat variation in either heart rate (HR) or heart period (R-R interval), has become a popular clinical and investigational tool to quantify cardiac autonomic regulation. However, it is not widely appreciated that, due to the inverse curvilinear relationship between HR and R-R interval, HR per se can profoundly influence HRV. It is, therefore, critical to correct HRV for the prevailing HR particularly, as HR changes in response to autonomic neural activation or inhibition. The present study evaluated the effects of HR on the HRV response to autonomic interventions that either increased (submaximal exercise, n = 25 or baroreceptor reflex activation, n = 20) or reduced (pharmacological blockade: β-adrenergic receptor, muscarinic receptor antagonists alone and in combination, n = 25, or bilateral cervical vagotomy, n = 9) autonomic neural activity in a canine model. Both total (RR interval standard deviation, RRSD) and the high frequency (HF) variability (HF, 0.24-1.04 Hz) were determined before and in response to an autonomic intervention. All interventions that reduced or abolished cardiac parasympathetic regulation provoked large reductions in HRV even after HR correction [division by mean RRsec or (mean RRsec)(2) for RRSD and HF, respectively] while interventions that reduced HR yielded mixed results. β-adrenergic receptor blockade reduced HRV (RRSD but not HF) while both RRSD and HF increased in response to increases in arterial blood (baroreceptor reflex activation) even after HR correction. These data suggest that the physiological basis for HRV is revealed after correction for prevailing HR and, further, that cardiac parasympathetic activity is responsible for a major portion of the HRV in the dog.

  19. The Effect of Heart Rate on the Heart Rate Variability Response to Autonomic Interventions

    Directory of Open Access Journals (Sweden)

    George E Billman

    2013-08-01

    Full Text Available Heart rate variability (HRV, the beat-to-beat variation in either heart rate (HR or heart period (R-R interval, has become a popular clinical and investigational tool to quantify cardiac autonomic regulation. However, it is not widely appreciated that, due to the inverse curvilinear relationship between HR and R-R interval, HR per se can profoundly influence HRV. It is, therefore, critical to correct HRV for the prevailing HR particularly, as HR changes in response to autonomic neural activation or inhibition. The present study evaluated the effects of HR on the HRV response to autonomic interventions that either increased (submaximal exercise, n = 25 or baroreceptor reflex activation, n = 20 or reduced (pharmacological blockade: β-adrenergic receptor, muscarinic receptor antagonists alone and in combination, n = 25, or bilateral cervical vagotomy, n = 9 autonomic neural activity in a canine model. Both total (RR interval standard deviation, RRSD and the high frequency variability (HF, 0.2 to 1.04 Hz were determined before and in response to an autonomic intervention. All interventions that reduced or abolished cardiac parasympathetic regulation provoked large reductions in HRV even after HR correction [division by mean RRsec or (mean RRsec2 for RRSD and HF, respectively] while interventions that reduced HR yielded mixed results. β-adrenergic receptor blockade reduced HRV (RRSD but not HF while both RRSD and HF increased in response to increases in arterial blood (baroreceptor reflex activation even after HR correction. These data suggest that the physiological basis for HRV is revealed after correction for prevailing HR and, further, that cardiac parasympathetic activity is responsible for a major portion of the HRV in the dog.

  20. Effects of daily hemodialysis on heart rate variability: results from the Frequent Hemodialysis Network (FHN) Daily Trial.

    Science.gov (United States)

    Chan, Christopher T; Chertow, Glenn M; Daugirdas, John T; Greene, Tom H; Kotanko, Peter; Larive, Brett; Pierratos, Andreas; Stokes, John B

    2014-01-01

    End-stage renal disease is associated with reduced heart rate variability (HRV), components of which generally are associated with advanced age, diabetes mellitus and left ventricular hypertrophy. We hypothesized that daily in-center hemodialysis (HD) would increase HRV. The Frequent Hemodialysis Network (FHN) Daily Trial randomized 245 patients to receive 12 months of six versus three times per week in-center HD. Two hundred and seven patients had baseline Holter recordings. HRV measures were calculated from 24-h Holter electrocardiograms at both baseline and 12 months in 131 patients and included low-frequency power (LF, a measure of sympathetic modulation), high-frequency power (HF, a measure of parasympathetic modulation) and standard deviation (SD) of the R-R interval (SDNN, a measure of beat-to-beat variation). Baseline to Month 12 change in LF was augmented by 50% [95% confidence interval (95% CI) 6.1-112%, P =0.022] and LF + HF was augmented by 40% (95% CI 3.3-88.4%, P = 0.03) in patients assigned to daily hemodialysis (DHD) compared with conventional HD. Changes in HF and SDNN were similar between the randomized groups. The effects of DHD on LF were attenuated by advanced age and diabetes mellitus (predefined subgroups). Changes in HF (r = -0.20, P = 0.02) and SDNN (r = -0.18, P = 0.04) were inversely associated with changes in left ventricular mass (LVM). DHD increased the LF component of HRV. Reduction of LVM by DHD was associated with increased vagal modulation of heart rate (HF) and with increased beat-to-beat heart rate variation (SDNN), suggesting an important functional correlate to the structural effects of DHD on the heart in uremia.

  1. Nonlinear evolution of the plasma beat wave: Compressing the laser beat notes via electromagnetic cascading.

    Science.gov (United States)

    Kalmykov, Serguei; Shvets, Gennady

    2006-04-01

    The near-resonant beat wave excitation of an electron plasma wave (EPW) can be employed for generating the trains of few-femtosecond electromagnetic (EM) pulses in rarefied plasmas. The EPW produces a comoving index grating that induces a laser phase modulation at the difference frequency. As a result, the cascade of sidebands red and blue shifted by integer multiples of the beat frequency is generated in the laser spectrum. The bandwidth of the phase-modulated laser is proportional to the product of the plasma length, laser wavelength, and amplitude of the electron density perturbation. When the beat frequency is lower than the electron plasma frequency, the redshifted spectral components are advanced in time with respect to the blueshifted ones near the center of each laser beat note. The group velocity dispersion of plasma compresses so chirped beat notes to a few-laser-cycle duration thus creating a train of sharp EM spikes with the beat periodicity. Depending on the plasma and laser parameters, chirping and compression can be implemented either concurrently in the same, or sequentially in different plasmas. Evolution of the laser beat wave and electron density perturbations is described in time and one spatial dimension in a weakly relativistic approximation. Using the compression effect, we demonstrate that the relativistic bistability regime of the EPW excitation [G. Shvets, Phys. Rev. Lett. 93, 195004 (2004)] can be achieved with the initially subthreshold beat wave pulse.

  2. BeatBox-HPC simulation environment for biophysically and anatomically realistic cardiac electrophysiology.

    Science.gov (United States)

    Antonioletti, Mario; Biktashev, Vadim N; Jackson, Adrian; Kharche, Sanjay R; Stary, Tomas; Biktasheva, Irina V

    2017-01-01

    The BeatBox simulation environment combines flexible script language user interface with the robust computational tools, in order to setup cardiac electrophysiology in-silico experiments without re-coding at low-level, so that cell excitation, tissue/anatomy models, stimulation protocols may be included into a BeatBox script, and simulation run either sequentially or in parallel (MPI) without re-compilation. BeatBox is a free software written in C language to be run on a Unix-based platform. It provides the whole spectrum of multi scale tissue modelling from 0-dimensional individual cell simulation, 1-dimensional fibre, 2-dimensional sheet and 3-dimensional slab of tissue, up to anatomically realistic whole heart simulations, with run time measurements including cardiac re-entry tip/filament tracing, ECG, local/global samples of any variables, etc. BeatBox solvers, cell, and tissue/anatomy models repositories are extended via robust and flexible interfaces, thus providing an open framework for new developments in the field. In this paper we give an overview of the BeatBox current state, together with a description of the main computational methods and MPI parallelisation approaches.

  3. Strong modulation of ectopic focus as a mechanism of repetitive interpolated ventricular bigeminy with heart rate doubling.

    Science.gov (United States)

    Takayanagi, Kan; Nakahara, Shiro; Toratani, Noritaka; Chida, Ryuji; Kobayashi, Sayuki; Sakai, Yoshihiko; Takeuchi, Akihiro; Ikeda, Noriaki

    2013-10-01

    Repetitive interpolated ventricular bigeminy (RIVB) can introduce a doubling of the ventricular rate. To clarify the mechanism of RIVB, we hypothesized that it was introduced by a strong modulation of the ventricular automatic focus. RIVB, defined as more than 7 bigeminy events, was detected by instantaneous heart rate and bigeminy interval (BI) tachograms in 1450 successive patients with frequent ventricular premature contractions (≥3000 per day). Postextrasystolic interval bigeminy interval curves were plotted to determine the degree of modulation. Mean sinus cycle length bigeminy interval curves were plotted for selection. RIVB was simulated by using a computer-based parasystole model. RIVB was observed in 7 patients (age 60 ± 16 years; 2 men and 5 women) with a heart rate of 58.2 ± 6.5 beats/min during a rest period both during the day and at night. The tachograms disclosed the onset of the RIVB with a doubled ventricular rate to 112.3 ± 8.5 beats/min. On the postextrasystolic interval bigeminy interval curves, compensatory bigeminy and interpolated bigeminy constituted overlapping regression lines with slopes close to 1.00 and RIVB was located in the lower left portion. RIVB lasting for up to 3 hours was quickly detected by mean sinus cycle length bigeminy interval curve. The PQ interval immediately after RIVB was prolonged in comparison with baseline (0.18 ± 0.02 to 0.21 ± 0.02 seconds; P heart rate. Our findings support the hypothesis that RIVB was introduced by strongly modulated ventricular pacemaker accelerated by an intervening normal QRS. © 2013 Heart Rhythm Society. All rights reserved.

  4. Circadian profile of QT interval and QT interval variability in 172 healthy volunteers

    DEFF Research Database (Denmark)

    Bonnemeier, Hendrik; Wiegand, Uwe K H; Braasch, Wiebke

    2003-01-01

    The limited prognostic value of QT dispersion has been demonstrated in recent studies. However, longitudinal data on physiological variations of QT interval and the influence of aging and sex are few. This analysis included 172 healthy subjects (89 women, 83 men; mean age 38.7 +/- 15 years). Beat...

  5. High beat-to-beat blood pressure variability in atrial fibrillation compared to sinus rhythm.

    Science.gov (United States)

    Olbers, Joakim; Gille, Adam; Ljungman, Petter; Rosenqvist, Mårten; Östergren, Jan; Witt, Nils

    2018-02-07

    Atrial fibrillation (AF) is associated with an increased risk for cardiovascular morbidity and mortality, not entirely explained by thromboembolism. The underlying mechanisms for this association are largely unknown. Similarly, high blood pressure (BP) increases the risk for cardiovascular events. Despite this the interplay between AF and BP is insufficiently studied. The purpose of this study was to examine and quantify the beat-to-beat blood pressure variability in patients with AF in comparison to a control group of patients with sinus rhythm. We studied 33 patients - 21 in atrial fibrillation and 12 in sinus rhythm - undergoing routine coronary angiography. Invasive blood pressure was recorded at three locations: radial artery, brachial artery and ascending aorta. Blood pressure variability, defined as average beat-to-beat blood pressure difference, was calculated for systolic and diastolic blood pressure at each site. We observed a significant difference (p blood pressure variability between the atrial fibrillation and sinus rhythm groups at all locations. Systolic blood pressure variability roughly doubled in the atrial fibrillation group compared to the sinus rhythm group (4.9 and 2.4 mmHg respectively). Diastolic beat-to-beat blood pressure variability was approximately 6 times as high in the atrial fibrillation group compared to the sinus rhythm group (7.5 and 1.2 mmHg respectively). No significant difference in blood pressure variability was seen between measurement locations. Beat-to-beat blood pressure variability in patients with atrial fibrillation was substantially higher than in patients with sinus rhythm. Hemodynamic effects of this beat-to-beat variation in blood pressure may negatively affect vascular structure and function, which may contribute to the increased cardiovascular morbidity and mortality seen in patients with atrial fibrillation.

  6. Clustering of RR intervals predicts effective electrical cardioversion for atrial fibrillation

    NARCIS (Netherlands)

    Van den Berg, MP; Van Noord, T; Brouwer, J; Haaksma, J; Van Veldhuisen, DJ; Crijns, HJGM; Van Gelder, IC

    Electrical Cardioversion for Atrial Fibrillation. Introduction: Atrial fibrillation (AF) is characterized by an irregularly irregular ("random") heart beat. However, controversy exists whether the ventricular rhythm in AF is truly random. We investigated randomness by constructing three-dimensional

  7. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

    Directory of Open Access Journals (Sweden)

    Cao R

    2014-12-01

    Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

  8. Acoustical sensing of cardiomyocyte cluster beating

    Energy Technology Data Exchange (ETDEWEB)

    Tymchenko, Nina; Kunze, Angelika [Dept. of Applied Physics, Chalmers University of Technology, 412 96 Göteborg (Sweden); Dahlenborg, Kerstin [Cellectis, 413 46 Göteborg (Sweden); Svedhem, Sofia, E-mail: sofia.svedhem@chalmers.se [Dept. of Applied Physics, Chalmers University of Technology, 412 96 Göteborg (Sweden); Steel, Daniella [Cellectis, 413 46 Göteborg (Sweden)

    2013-06-14

    Highlights: •An example of the application of QCM-D to live cell studies. •Detection of human pluripotent stem cell-derived cardiomyocyte cluster beating. •Clusters were studied in a thin liquid film and in a large liquid volume. •The QCM-D beating profile provides an individual fingerprint of the hPS-CMCs. -- Abstract: Spontaneously beating human pluripotent stem cell-derived cardiomyocytes clusters (CMCs) represent an excellent in vitro tool for studies of human cardiomyocyte function and for pharmacological cardiac safety assessment. Such testing typically requires highly trained operators, precision plating, or large cell quantities, and there is a demand for real-time, label-free monitoring of small cell quantities, especially rare cells and tissue-like structures. Array formats based on sensing of electrical or optical properties of cells are being developed and in use by the pharmaceutical industry. A potential alternative to these techniques is represented by the quartz crystal microbalance with dissipation monitoring (QCM-D) technique, which is an acoustic surface sensitive technique that measures changes in mass and viscoelastic properties close to the sensor surface (from nm to μm). There is an increasing number of studies where QCM-D has successfully been applied to monitor properties of cells and cellular processes. In the present study, we show that spontaneous beating of CMCs on QCM-D sensors can be clearly detected, both in the frequency and the dissipation signals. Beating rates in the range of 66–168 bpm for CMCs were detected and confirmed by simultaneous light microscopy. The QCM-D beating profile was found to provide individual fingerprints of the hPS-CMCs. The presented results point towards acoustical assays for evaluation cardiotoxicity.

  9. A combined abnormality in heart rate variation and QT corrected interval is a strong predictor of cardiovascular death in type 1 diabetes

    DEFF Research Database (Denmark)

    Lykke, J A; Tarnow, Lise; Parving, H H

    2008-01-01

    Long-term diabetes is associated with excess morbidity and mortality, and cardiovascular autonomic neuropathy and QTc interval abnormalities are both predictive of early cardiovascular death in diabetes. We aimed to investigate the effect of these risk factors in a large cohort of type 1 diabetic...

  10. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing.

    Science.gov (United States)

    Cao, Ruihua; Bai, Yongyi; Xu, Ruyi; Ye, Ping

    2015-01-01

    N-terminal pro-brain natriuretic peptide (NT-proBNP) is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear. This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population. We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21-96 years) from a community-based population in Beijing, People's Republic of China. In patients with high resting heart rate (≥75 beats/min), NT-proBNP was higher than in those having low resting heart rate (heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18-1.51; P=0.011). A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49-2.36; P=0.031); while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage.

  11. Heart rate variability during cycloergometric exercise or judo wrestling eliciting the same heart rate level.

    Science.gov (United States)

    Cottin, François; Durbin, François; Papelier, Yves

    2004-03-01

    This study compared heart rate variability (HRV) in ten male judokas between two types of exercise eliciting the same near-maximal average heart rate (HR): judo wrestling vs. cycloergometric bout. Beat-to-beat RR intervals were recorded during (1) a 4-min judo randori (wrestling); (2) a 4-min cycloergometric exercise eliciting maximal oxygen consumption (VO(2MAX)). Time series were analyzed both by short term Fourier transform (STFT) and Poincaré plot (PP). The main results are as follows. First, despite the fact that the same maximal HR was reached during the two exercises, the spectral energy computed from the judo recordings was significantly higher than that recorded from the cycloergometric exercise. Second, according to the PP index of rapid HRV (SD1), the high-frequency spectral energy (HF) was significantly higher during judo than cycloergometric exercise as well. Third, judo spectra show chaotic harmonics in place of the precise HF peak observed during cycloergometric exercise. Fourth, the respective parts of normalized LFn and HFn are not different between the two exercise modes, suggesting that autonomic control during severe exercise cannot depend on the type of exercise. In conclusion, this study shows that it is possible, according to the observed kind of variability from RR time series, to differentiate between two types of effort: steady-state dynamic exercise or conversely exercise made of both isometric and irregular dynamic efforts (wrestling, collective sports, and others).

  12. Normative references of heart rate variability and salivary alpha-amylase in a healthy young male population.

    Science.gov (United States)

    Kobayashi, Hiromitsu; Park, Bum-Jin; Miyazaki, Yoshifumi

    2012-04-20

    This study aimed to present normative reference values of heart rate variability and salivary alpha-amylase in a healthy young male population with a particular focus on their distribution and reproducibility. The short-term heart rate variability of 417 young healthy Japanese men was studied. Furthermore, salivary alpha-amylase was measured in 430 men. The average age of the subjects were 21.9 years with standard deviation of 1.6 years. Interindividual variations in heart rate variability indices and salivary alpha-amylase levels were plotted as histograms. Data are presented as the mean, median, standard deviation, coefficient of variation, skewness, kurtosis, and fifth and 95th percentiles of each physiological index. Mean recorded values were heart period 945.85 ms, log-transformed high frequency component 9.84 ln-ms2, log-transformed low frequency component 10.42 ln-ms2, log-transformed low frequency to high frequency ratio 0.58 ln-ratio, standard deviation of beat-to-beat interval 27.17 ms and root mean square of successive difference 37.49 ms. The mean value of raw salivary alpha-amylase was 17.48 U/mL, square root salivary alpha-amylase 3.96 sqrt[U/mL] and log-transformed salivary alpha-amylase 2.65 ln[U/mL]. Log-transformed heart rate variability indices exhibited almost symmetrical distributions; however, time-domain indices of heart rate variability (standard deviation of beat-to-beat interval and root mean square of successive difference) exhibited right-skewed (positive skewness) distributions. A considerable right-skewed distribution was observed for raw salivary alpha-amylase. Logarithmic transformation improved the distribution of salivary alpha-amylase, although square root transformation was insufficient. The day-to-day reproducibility of these indices was assessed using intraclass correlation coefficients. Intraclass correlation coefficients of most heart rate variability and salivary indices were approximately 0.5 to 0.6. Intraclass correlation

  13. Behind the scenes of GS: CERN’s beating heart

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    Founded at the same time as CERN, the library has followed, and sometimes even moved ahead of, the changes in the Organization. Today, far from being a simple book depository, the Scientific Information Service (SIS) that manages CERN's library is increasingly digitising its material and investing in innovative projects, such as Open Access.   Ever since it was set up in Building 52 on 1 September 1957, the library has played a vital role in the Organization.  “Our only official task is to provide a complete list of the publications by CERN researchers, but, in fact, this place is the memory bank of the whole Laboratory,” emphasises Tullio Basaglia, head of the Library Section within SIS.  “The role of the library and archives is to preserve, document and disseminate the knowledge produced at CERN.” Sixty years after its creation, the library today contains 90,000 books, two thirds of which are available in a digital ...

  14. The new heart of the PS is beating strongly

    CERN Document Server

    Corinne Pralavorio

    2011-01-01

    The PS has resumed operation with a brand new electrical power system called POPS; this enormous system comprising power electronics and capacitors is crucial because if it broke down practically no particles would be able to circulate at CERN. As soon as it started, POPS passed all the tests with flying colours and is now pulsing at full power.   The new PS power system is made up of 6 containers, each with 60 tonnes of capacitors and 8 power converters. The date 11/02/11 will always be remembered with affection by the engineers in the Electrical Power Converters Group. At 11:11 in the morning (no joke), the first beams powered by the new system began to circulate in the PS. The cutely-named POPS (POwer for PS) took over from the old rotating machine that had been working since 1968. From now on it will be POPS that supplies the PS main magnets with the electrical pulses needed to accelerate the beams for the LHC and all CERN's other facilities. The system is crucial as the PS is one of the lyn...

  15. Truthfulness in transplantation: non-heart-beating organ donation

    Directory of Open Access Journals (Sweden)

    Potts Michael

    2007-08-01

    Full Text Available Abstract The current practice of organ transplantation has been criticized on several fronts. The philosophical and scientific foundations for brain death criteria have been crumbling. In addition, donation after cardiac death, or non-heartbeating-organ donation (NHBD has been attacked on grounds that it mistreats the dying patient and uses that patient only as a means to an end for someone else's benefit. Verheijde, Rady, and McGregor attack the deception involved in NHBD, arguing that the donors are not dead and that potential donors and their families should be told that is the case. Thus, they propose abandoning the dead donor rule and allowing NHBD with strict rules concerning adequate informed consent. Such honesty about NHBD should be welcomed. However, NHBD violates a fundamental end of medicine, nonmaleficience, "do no harm." Physicians should not be harming or killing patients, even if it is for the benefit of others. Thus, although Verheijde and his colleages should be congratulated for calling for truthfulness about NHBD, they do not go far enough and call for an elimination of such an unethical procedure from the practice of medicine.

  16. [A case of left ventricular pseudoaneurysm with severe cardiac failure and premature ventricular beats].

    Science.gov (United States)

    Nakmura, M; Kazui, T; Takagi, N; Harada, H; Yokoyama, H; Okamoto, F; Komatsu, S

    1989-10-01

    A surgically successful case of left ventricular pseudoaneurysm 10 years after an acute myocardial infarction was reported. A 63-year-old man had an acute inferior myocardial infarction 10 years ago. Recently congestive heart failure and premature ventricular beats developed. He was diagnosed as a left ventricular pseudoaneurysm by echocardiogram, CT scan, and left ventriculogram. After the operation, the symptoms diminished and improvement of left ventricular function was observed. A brief review of the literature is given.

  17. Newborn infants detect the beat in music

    NARCIS (Netherlands)

    Winkler, I.; Háden, G.P.; Ladinig, O.; Sziller, I.; Honing, H.

    2009-01-01

    To shed light on how humans can learn to understand music, we need to discover what the perceptual capabilities with which infants are born. Beat induction, the detection of a regular pulse in an auditory signal, is considered a fundamental human trait that, arguably, played a decisive role in the

  18. Short-term Effects of High-Dose Caffeine on Cardiac Arrhythmias in Patients With Heart Failure: A Randomized Clinical Trial.

    Science.gov (United States)

    Zuchinali, Priccila; Souza, Gabriela C; Pimentel, Maurício; Chemello, Diego; Zimerman, André; Giaretta, Vanessa; Salamoni, Joyce; Fracasso, Bianca; Zimerman, Leandro I; Rohde, Luis E

    2016-12-01

    The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital. The trial included patients with chronic heart failure with moderate-to-severe systolic dysfunction (left ventricular ejection fraction Caffeine (100 mg) or lactose capsules, in addition to 5 doses of 100 mL decaffeinated coffee at 1-hour intervals, for a total of 500 mg of caffeine or placebo during a 5-hour protocol. After a 1-week washout period, the protocol was repeated. Number and percentage of ventricular and supraventricular premature beats assessed by continuous electrocardiographic monitoring. We enrolled 51 patients (37 [74%] male; mean [SD] age, 60.6 [10.9] years) with predominantly moderate-to-severe left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 29% [7%]); 31 [61%] had an implantable cardioverter-defibrillator device. No significant differences between the caffeine and placebo groups were observed in the number of ventricular (185 vs 239 beats, respectively; P = .47) and supraventricular premature beats (6 vs 6 beats, respectively; P = .44), as well as in couplets, bigeminal cycles, or nonsustained tachycardia during continuous electrocardiographic monitoring. Exercise test-derived variables, such as ventricular and supraventricular premature beats, duration of exercise, estimated peak oxygen consumption, and heart rate, were not influenced by caffeine ingestion. We observed no increases in ventricular premature beats (91 vs 223

  19. Predictive value of beat-to-beat QT variability index across the continuum of left ventricular dysfunction: competing risks of noncardiac or cardiovascular death and sudden or nonsudden cardiac death.

    Science.gov (United States)

    Tereshchenko, Larisa G; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-08-01

    The goal of the present study was to determine the predictive value of beat-to-beat QT variability in heart failure patients across the continuum of left ventricular dysfunction. Beat-to-beat QT variability index (QTVI), log-transformed heart rate variance, normalized QT variance, and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca heart failure study (mean age, 63.1±11.7; men, 70.6%; left ventricular ejection fraction >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death (subhazard ratio, 1.67 [95% CI, 1.14-2.47]; P=0.009) and, in particular, with non-SCD (subhazard ratio, 2.91 [1.69-5.01]; P<0.001). Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular (subhazard ratio, 1.57 [1.04-2.35]; P=0.031) and non-SCD in multivariate competing risk model (subhazard ratio, 2.58 [1.13-3.78]; P=0.001). No interaction between QTVI and left ventricular ejection fraction was found. QTVI predicted neither noncardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability rather than increased QT variability was the reason for increased QTVI in the present study. Increased QTVI because of depressed heart rate variability predicts cardiovascular mortality and non-SCD but neither SCD nor extracardiac mortality in heart failure across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from heart failure patients at risk.

  20. Habituation of parasympathetic-mediated heart rate responses to recurring acoustic startle.

    Science.gov (United States)

    Chen, Kuan-Hua; Aksan, Nazan; Anderson, Steven W; Grafft, Amanda; Chapleau, Mark W

    2014-01-01

    Startle habituation is a type of implicit and automatic emotion regulation. Diminished startle habituation is linked to several psychiatric or neurological disorders. Most previous studies quantified startle habituation by assessing skin conductance response (SCR; reflecting sympathetic-mediated sweating), eye-blink reflex, or motor response. The habituation of parasympathetic-mediated heart rate responses to recurrent startle stimuli is not well understood. A variety of methods and metrics have been used to quantify parasympathetic activity and its effects on the heart. We hypothesized that these different measures reflect unique psychological and physiological processes that may habituate differently during repeated startle stimuli. We measured cardiac inter-beat intervals (IBIs) to recurring acoustic startle probes in 75 eight year old children. Eight acoustic stimuli of 500 ms duration were introduced at intervals of 15-25 s. Indices of parasympathetic effect included: (1) the initial rapid decrease in IBI post-startle mediated by parasympathetic inhibition (PI); (2) the subsequent IBI recovery mediated by parasympathetic reactivation (PR); (3) rapid, beat-to-beat heart rate variability (HRV) measured from the first seven IBIs following each startle probe. SCR and motor responses to startle were also measured. Results showed that habituation of PR (IBI recovery and overshoot) and SCRs were rapid and robust. In addition, changes in PR and SCR were significantly correlated. In contrast, habituation of PI (the initial decrease in IBI) was slower and relatively modest. Measurement of rapid HRV provided an index reflecting the combination of PI and PR. We conclude that different measures of parasympathetic-mediated heart rate responses to repeated startle probes habituate in a differential manner.

  1. Do Preferred Beat Rate and Entrainment to the Beat Have a Common Origin in Movement?

    Directory of Open Access Journals (Sweden)

    Laurel J. Trainor

    2007-01-01

    Full Text Available The idea that beat induction derives from body movement is attractive, but until recently unequivocal empirical evidence of such a linkage has been elusive. Todd et al. (2007 provide evidence that individual differences in locomotion affect preferred beat rate, and Phillips-Silver & Trainor (2005, 2007, under review show that metrical interpretation is affected by movement. These studies examine different aspects of rhythm processing, but together provide converging evidence for pervasive movement/auditory interactions.

  2. QT intervals and QT dispersion determined from a 12-lead 24-hour Holter recording in patients with coronary artery disease and patients with heart failure

    DEFF Research Database (Denmark)

    Hansen, S.; Rasmussen, V.; Torp-Pedersen, C.

    2008-01-01

    BACKGROUND: QT dispersion is considered an index of spatial inhomogeneity of repolarization duration and increased dispersion of ventricular repolarization is supposed to increase the risk of ventricular arrhythmia. Circadian variation in QT dispersion was investigated. METHODS: Three different...... in QTdisp 12 (Mean +/- SD 33.13 +/- 14.86 ms; P QT dispersion was detected in healthy subjects and in patients with uncomplicated CAD, but not in those who...... had suffered a previous MI and in patients with HF. The number of leads among which selection of the longest and shortest QT intervals took place was critical for the disclosure of circadian variation of QT dispersion....

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

    Science.gov (United States)

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

    2014-07-16

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

  4. From music-beat to heart-beat: a journey in the complex interactions between music, brain and heart.

    Science.gov (United States)

    Cervellin, Gianfranco; Lippi, Giuseppe

    2011-08-01

    Although the potential influence of music in eliciting organic reactions has been appreciated since the ancient Assyrian and Greek cultures, its relationship with body responses has been believed for long to belong to the field of magic. Growing experimental evidence now attests that some kind of music might indeed modulate several cardiac and neurological functions, as well as trigger biochemical measurable stress-reducing effects in certain individuals, mostly depending on their subjective musical education. On this basis, music has been increasingly used as a therapeutic tool in the treatment of different diseases in healthy and ill subjects over recent years (e.g., the so called "Mozart effect"), although the underlying scientific background is still poorly understood. The aim of this article is to review the current scientific evidences about the complex and multifaceted interactions between music and human biology. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  5. Prolonged QT interval: A tricky diagnosis?

    NARCIS (Netherlands)

    M.C. de Bruyne (Martine); A.W. Hoes (Arno); J.A. Kors (Jan); J.M. Dekker (Jacqueline); A. Hofman (Albert); J.H. van Bemmel (Jan); D.E. Grobbee (Diederick)

    1997-01-01

    textabstractProlonged heart-rate adjusted QT intervals on the electrocardiogram (ECG) are associated with an increased risk far coronary heart disease and sudden death. However, the diagnosis of the prolonged QT interval is hampered by lack of standards. We studied variations in the prevalence of

  6. Effects of atomoxetine on heart rhythm in children and adolescents.

    Science.gov (United States)

    Tanidir, Ibrahim Cansaran; Tanidir, Canan; Ozturk, Erkut; Bahali, Kayhan; Gunes, Hatice; Ergul, Yakup; Uneri, Ozden Sukran; Akdeniz, Celal; Tuzcu, Volkan

    2015-12-01

    The aim of this study was to examine the effects of atomoxetine on heart rhythm using 12-lead electrocardiography (ECG) and 24 h Holter monitoring. Children and adolescents who were diagnosed with attention deficit-hyperactivity disorder according to DSM-IV-TR were referred to a pediatric cardiology clinic for cardiologic examination before and after 4 or 5 weeks of atomoxetine treatment. Cardiac examination, complete blood count, biochemistry, thyroid function tests, 12-lead ECG and 24 h Holter monitoring were performed routinely in all patients. Each subject underwent 24 h Holter ECG monitoring before atomoxetine was started and after 4 or 5 weeks of effective dose atomoxetine treatment. Forty-one patients were included in this prospective study. No statistically significant change was found in QT, QTc or QT interval dispersion or blood pressure before and after 4 or 5 weeks of atomoxetine treatment. There was a statistically significant increase in heart rate (both during the day and at night) and QRS duration, and a statistically significant decrease in P wave dispersion. Three patients had rhythm disturbances. All of these three patients were asymptomatic and none of these arrhythmias reached clinical significance. Atomoxetine did not cause significant changes in ECG or Holter variables. In two patients, who had undiagnosed subclinical extrasystoles, extra beats were increased after 4th week of treatment, but still remained clinically insignificant. Before and after atomoxetine treatment, listening to the heart sounds for a longer time, may help clinicians to notice an extra beat. If an extra beat is identified then 24 Holter monitoring is recommended. © 2015 Japan Pediatric Society.

  7. Relationship between age and location of the apex beat among ...

    African Journals Online (AJOL)

    Apex beat location in the intercostal space was determined and distance of apex beat from the midline, midclavicular line and nipple lines were measured. The measured distances were related to age using linear regression and Pearson correlation. Results: The mean distance of apex beat from the midline from birth to 10 ...

  8. Beat Gestures Modulate Auditory Integration in Speech Perception

    Science.gov (United States)

    Biau, Emmanuel; Soto-Faraco, Salvador

    2013-01-01

    Spontaneous beat gestures are an integral part of the paralinguistic context during face-to-face conversations. Here we investigated the time course of beat-speech integration in speech perception by measuring ERPs evoked by words pronounced with or without an accompanying beat gesture, while participants watched a spoken discourse. Words…

  9. Peak heart rates at extreme altitudes

    DEFF Research Database (Denmark)

    Lundby, C; Van Hall, Gerrit

    2001-01-01

    We have measured maximal heart rate during a graded maximal bicycle exercise test to exhaustion in five healthy climbers before and during an expedition to Mt. Everest. Maximal heart rates at sea level were 186 (177-204) beats/min(-1) at sea level and 170 (169-182) beats/min(-1) with acute hypoxia....... After 1, 4 and 6 weeks of acclimatization to 5400 m, maximal heart rates were 155 (135-182), 158 (144-182), and 155 (140-183) beats/min(-1), respectively. Heart rates of two of the climbers were measured during their attempt to reach the summit of Mt. Everest without the use of supplemental oxygen....... The peak heart rates at 8,750 m for the two climbers were 142 and 144 beats/min(-1), which were similar to their maximal heart rates during exhaustive bicycle exercise at 5,400 m, the values being 144 and 148 beats/min(-1), respectively. The peak heart rates at 8,750 m are in agreement with other field...

  10. Activating and Relaxing Music Entrains the Speed of Beat Synchronized Walking

    Science.gov (United States)

    Leman, Marc; Moelants, Dirk; Varewyck, Matthias; Styns, Frederik; van Noorden, Leon; Martens, Jean-Pierre

    2013-01-01

    Inspired by a theory of embodied music cognition, we investigate whether music can entrain the speed of beat synchronized walking. If human walking is in synchrony with the beat and all musical stimuli have the same duration and the same tempo, then differences in walking speed can only be the result of music-induced differences in stride length, thus reflecting the vigor or physical strength of the movement. Participants walked in an open field in synchrony with the beat of 52 different musical stimuli all having a tempo of 130 beats per minute and a meter of 4 beats. The walking speed was measured as the walked distance during a time interval of 30 seconds. The results reveal that some music is ‘activating’ in the sense that it increases the speed, and some music is ‘relaxing’ in the sense that it decreases the speed, compared to the spontaneous walked speed in response to metronome stimuli. Participants are consistent in their observation of qualitative differences between the relaxing and activating musical stimuli. Using regression analysis, it was possible to set up a predictive model using only four sonic features that explain 60% of the variance. The sonic features capture variation in loudness and pitch patterns at periods of three, four and six beats, suggesting that expressive patterns in music are responsible for the effect. The mechanism may be attributed to an attentional shift, a subliminal audio-motor entrainment mechanism, or an arousal effect, but further study is needed to figure this out. Overall, the study supports the hypothesis that recurrent patterns of fluctuation affecting the binary meter strength of the music may entrain the vigor of the movement. The study opens up new perspectives for understanding the relationship between entrainment and expressiveness, with the possibility to develop applications that can be used in domains such as sports and physical rehabilitation. PMID:23874469

  11. Activating and relaxing music entrains the speed of beat synchronized walking.

    Directory of Open Access Journals (Sweden)

    Marc Leman

    Full Text Available Inspired by a theory of embodied music cognition, we investigate whether music can entrain the speed of beat synchronized walking. If human walking is in synchrony with the beat and all musical stimuli have the same duration and the same tempo, then differences in walking speed can only be the result of music-induced differences in stride length, thus reflecting the vigor or physical strength of the movement. Participants walked in an open field in synchrony with the beat of 52 different musical stimuli all having a tempo of 130 beats per minute and a meter of 4 beats. The walking speed was measured as the walked distance during a time interval of 30 seconds. The results reveal that some music is 'activating' in the sense that it increases the speed, and some music is 'relaxing' in the sense that it decreases the speed, compared to the spontaneous walked speed in response to metronome stimuli. Participants are consistent in their observation of qualitative differences between the relaxing and activating musical stimuli. Using regression analysis, it was possible to set up a predictive model using only four sonic features that explain 60% of the variance. The sonic features capture variation in loudness and pitch patterns at periods of three, four and six beats, suggesting that expressive patterns in music are responsible for the effect. The mechanism may be attributed to an attentional shift, a subliminal audio-motor entrainment mechanism, or an arousal effect, but further study is needed to figure this out. Overall, the study supports the hypothesis that recurrent patterns of fluctuation affecting the binary meter strength of the music may entrain the vigor of the movement. The study opens up new perspectives for understanding the relationship between entrainment and expressiveness, with the possibility to develop applications that can be used in domains such as sports and physical rehabilitation.

  12. Activating and relaxing music entrains the speed of beat synchronized walking.

    Science.gov (United States)

    Leman, Marc; Moelants, Dirk; Varewyck, Matthias; Styns, Frederik; van Noorden, Leon; Martens, Jean-Pierre

    2013-01-01

    Inspired by a theory of embodied music cognition, we investigate whether music can entrain the speed of beat synchronized walking. If human walking is in synchrony with the beat and all musical stimuli have the same duration and the same tempo, then differences in walking speed can only be the result of music-induced differences in stride length, thus reflecting the vigor or physical strength of the movement. Participants walked in an open field in synchrony with the beat of 52 different musical stimuli all having a tempo of 130 beats per minute and a meter of 4 beats. The walking speed was measured as the walked distance during a time interval of 30 seconds. The results reveal that some music is 'activating' in the sense that it increases the speed, and some music is 'relaxing' in the sense that it decreases the speed, compared to the spontaneous walked speed in response to metronome stimuli. Participants are consistent in their observation of qualitative differences between the relaxing and activating musical stimuli. Using regression analysis, it was possible to set up a predictive model using only four sonic features that explain 60% of the variance. The sonic features capture variation in loudness and pitch patterns at periods of three, four and six beats, suggesting that expressive patterns in music are responsible for the effect. The mechanism may be attributed to an attentional shift, a subliminal audio-motor entrainment mechanism, or an arousal effect, but further study is needed to figure this out. Overall, the study supports the hypothesis that recurrent patterns of fluctuation affecting the binary meter strength of the music may entrain the vigor of the movement. The study opens up new perspectives for understanding the relationship between entrainment and expressiveness, with the possibility to develop applications that can be used in domains such as sports and physical rehabilitation.

  13. Modulation of heart activity during withdrawal reflexes in the snail Helix aspersa.

    Science.gov (United States)

    Weatherill, Daniel; Chase, Ronald

    2005-04-01

    The beating activity of the molluscan heart is myogenic, but it is influenced by nervous signals of central origin. Previous studies have demonstrated changes in cardiac output during feeding and other behaviors. Here, we describe a short latency, transient cardiac response that accompanies withdrawal reflexes. When evoked by electrical stimulation of peripheral nerves, the response was detected within one or two heartbeats. Beat amplitudes increased on average 11.6%, and inter-beat intervals decreased on average 2.1%. The mean duration of the response was 28.1 s. A transient inhibitory phase often preceded the excitatory response. Results from testing various nerves and tissues show that the cardiac responses invariably occur whenever contractions of the tentacle retractor muscle are elicited. Even stimulation of the ovotestis and the kidney elicit responses despite their protected locations within the mantle cavity. Three excitatory cardioactive neurons are identified in the central nervous system of Helix aspersa, and their involvement in the reflex response is documented. The results suggest that the heart output is initially inhibited to relax the hydroskeleton and thereby aid withdrawal movements. A delayed increase in cardiac output then facilitates the re-inflation, hence eversion, of the withdrawn body parts.

  14. [Improving of muscle mass and force in rehabilitation of heart-lung patients. Aerobic interval training, resistance-exercises, excentric exercises, vibration].

    Science.gov (United States)

    Apor, Péter; Tihanyi, József; Borka, Péter

    2005-09-18

    Improvement of muscle mass and force which got depleted by inactivity or pathological processes is one of the aims and also a prerequisite of a rehabilitative intervention. Metabolically active larger and stronger muscles diminish the cardiovascular risk, permit the aerobic preventive and rehabilitative activities and enables a higher quality of life. Interval forms of aerobic exercise improves also the muscles. The resistance training plays an important part in rehabilitation. Beside the traditional dynamic strength training with weights, gym machines, body weight etc. the excentric type of muscle activity potentiates higher muscle load with lesser energy consumption, therefore it is suitable in the case of smaller performance ability. Vibration of the whole body or parts of it by machines improves the co-activity of the motor units and results in force development with small metabolic involvement.

  15. Effect of magnesium sulfate on fetal heart rate patterns in the second stage of labor.

    Science.gov (United States)

    Duffy, Cassandra R; Odibo, Anthony O; Roehl, Kimberly A; Macones, George A; Cahill, Alison G

    2012-06-01

    To estimate the effect of maternal exposure to magnesium sulfate on fetal heart rate characteristics during active labor. Within a 4-year retrospective cohort study of consecutive term deliveries reaching the second stage of labor, we compared women exposed to magnesium for severe preeclampsia to all women not exposed. Primary outcome was the electronic fetal monitoring tracing in the 30 minutes preceding delivery. Secondary outcomes were fetal acidemia and nursery disposition. Attributable risk estimates and multivariable logistic regression were used to estimate the association between magnesium exposure and fetal heart rate characteristics. Unadjusted risk estimates for the association between fetal heart rate characteristics and neonatal outcomes were generated stratified by group. Of 5,387 women, 248 (4.6%) were exposed to magnesium. Magnesium exposure was associated with lower fetal heart rate baseline (136.9 ± 12.3 beats per minute compared with 139.0 ± 13.5 beats per minute; P=.02), increased risk of baseline less than 120 beats per minute (adjusted odds ratio [OR] 1.76, 95% confidence interval [CI] 1.21-2.56), and increased risk of absent or minimal variability (adjusted OR 2.41, 95% CI 1.78-3.27). More than 20% increased frequency of ever absent or minimal variability was attributable to magnesium (attributable risk 0.21, 95% CI 0.15-0.27). There were no significant differences in presence or number of accelerations or decelerations; however, magnesium was associated with fewer prolonged decelerations (adjusted OR 0.64, 95% CI 0.49-0.84). After excluding women with adverse neonatal outcomes, these associations remained. Maternal exposure to magnesium is associated with lower fetal heart rate baseline within the accepted normal range, decreased variability, and fewer prolonged decelerations without evidence of adverse effect on neonatal outcome. II.

  16. Mechanisms of Intrinsic Beating Variability in Cardiac Cell Cultures and Model Pacemaker Networks

    Science.gov (United States)

    Ponard, Julien G. C.; Kondratyev, Aleksandar A.; Kucera, Jan P.

    2007-01-01

    Heart rate variability (HRV) exhibits fluctuations characterized by a power law behavior of its power spectrum. The interpretation of this nonlinear HRV behavior, resulting from interactions between extracardiac regulatory mechanisms, could be clinically useful. However, the involvement of intrinsic variations of pacemaker rate in HRV has scarcely been investigated. We examined beating variability in spontaneously active incubating cultures of neonatal rat ventricular myocytes using microelectrode arrays. In networks of mathematical model pacemaker cells, we evaluated the variability induced by the stochastic gating of transmembrane currents and of calcium release channels and by the dynamic turnover of ion channels. In the cultures, spontaneous activity originated from a mobile focus. Both the beat-to-beat movement of the focus and beat rate variability exhibited a power law behavior. In the model networks, stochastic fluctuations in transmembrane currents and stochastic gating of calcium release channels did not reproduce the spatiotemporal patterns observed in vitro. In contrast, long-term correlations produced by the turnover of ion channels induced variability patterns with a power law behavior similar to those observed experimentally. Therefore, phenomena leading to long-term correlated variations in pacemaker cellular function may, in conjunction with extracardiac regulatory mechanisms, contribute to the nonlinear characteristics of HRV. PMID:17325022

  17. Autonomic heart-rate control in response to standing in toxemic and normotensive primigravid pregnancies

    NARCIS (Netherlands)

    WJ Jaspers; PA de Jong; PJ Kurver; MD E.J.M. Wouters

    1984-01-01

    Heart-rate changes after transition from a supine to a standing posture were measured in 12 hypertensive and 12 normotensive primigravid women, in their last trimester of gestation. The subjects beat-to-beat heart-rate (HR) changes were recorded on both an ordinary cardiotocograph and on magnetic

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

    Science.gov (United States)

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

    2014-06-01

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

  19. Acute and delayed effects of high intensity interval resistance training organization on cortisol and testosterone production.

    Science.gov (United States)

    Di Blasio, Andrea; Izzicupo, Pascal; Tacconi, Laura; Di Santo, Serena; Leogrande, Marina; Bucci, Ines; Ripari, Patrizio; Di Baldassarre, Angela; Napolitano, Giorgio

    2016-03-01

    The use of high-intensity interval training (HIIT) is widely diffused as strategy to enhance aerobic fitness and body composition. In order to offer a more complete training, resistance exercises have been added to HIIT (HIIRT). Aims of our study were to characterize both heart rate and hormonal responses elicited by three different protocols of HIIRT having the same exercises, the same load and number of repetitions for each exercise. Eight healthy trained men (28.61±3.51 years) performed three different workouts: exercise order, recovery and speed of execution were differently organized according to workout. Salivary samples were collected before and after each workout, at 11:00 p.m. and at 7:00 a.m. of the following day. Salive was also collected during a non-training day. Before and after the workout, plasma lactate was measured while a beat-to-beat heart rate recording was executed during each workout. Cortisol (C) and testosterone (T) were measured in salivary samples. Workouts elicited the same heart rate response while random organization seems to elicit the highest lactate, C and T increases. Also when we studied the effects of workouts on prolonged hormones production we observed that workout organization influenced post-exercise hormonal production until the following morning modifying their physiological trend. Even if exercises, load and number of repetitions were maintained fixed, exercise order, structured recovery and speed of execution determined different acute and prolonged effects. The knowledge of these responses is very important because may positively or negatively influence performance and health.

  20. The Impact of Monaural Beat Stimulation on Anxiety and Cognition

    Directory of Open Access Journals (Sweden)

    Leila Chaieb

    2017-05-01

    Full Text Available Application of auditory beat stimulation has been speculated to provide a promising new tool with which to alleviate symptoms of anxiety and to enhance cognition. In spite of reportedly similar EEG effects of binaural and monaural beats, data on behavioral effects of monaural beats are still lacking. Therefore, we examined the impact of monaural beat stimulation on anxiety, mood and memory performance. We aimed to target states related to anxiety levels and general well-being, in addition to long-term and working memory processes, using monaural beats within the range of main cortical rhythms. Theta (6 Hz, alpha (10 Hz and gamma (40 Hz beat frequencies, as well as a control stimulus were applied to healthy participants for 5 min. After each stimulation period, participants were asked to evaluate their current mood state and to perform cognitive tasks examining long-term and working memory processes, in addition to a vigilance task. Monaural beat stimulation was found to reduce state anxiety. When evaluating responses for the individual beat frequencies, positive effects on state anxiety were observed for all monaural beat conditions compared to control stimulation. Our results indicate a role for monaural beat stimulation in modulating state anxiety and are in line with previous studies reporting anxiety-reducing effects of auditory beat stimulation.

  1. Applicability and performance of heart rate variability methods

    NARCIS (Netherlands)

    Haaksma, J; Brouwer, J; Dijk, WA; van den Berg, M; Takens, F; Dassen, WRM; Murray, A

    2003-01-01

    Heart Rate Variability (HRV) may be measured using different measurement techniques. Almost all of these techniques deal with ectopic beats. Either these beats are excluded from the analysis or they are required. To access the functional character and easiness of use of several HRV techniques we

  2. Effects of GABA, Neural Regulation, and Intrinsic Cardiac Factors on Heart Rate Variability in Zebrafish Larvae.

    Science.gov (United States)

    Vargas, Rafael Antonio

    2017-04-01

    Heart rate (HR) is a periodic activity that is variable over time due to intrinsic cardiac factors and extrinsic neural control, largely by the autonomic nervous system. Heart rate variability (HRV) is analyzed by measuring consecutive beat-to-beat intervals. This variability can contain information about the factors regulating cardiac activity under normal and pathological conditions, but the information obtained from such analyses is not yet fully understood. In this article, HRV in zebrafish larvae was evaluated under normal conditions and under the effect of substances that modify intrinsic cardiac activity and cardiac activity modulated by the nervous system. We found that the factors affecting intrinsic activity have negative chronotropic and arrhythmogenic effects at this stage of development, whereas neural modulatory factors have a lesser impact. The results suggest that cardiac activity largely depends on the intrinsic properties of the heart tissue in the early stages of development and, to a lesser extent, in the maturing nervous system. We also report, for the first time, the influence of the neurotransmitter gamma amino butyric acid on HRV. The results demonstrate the larval zebrafish model as a useful tool in the study of intrinsic cardiac activity and its role in heart diseases.

  3. Heart rate variability analysis using robust period detection.

    Science.gov (United States)

    Skotte, Jørgen H; Kristiansen, Jesper

    2014-09-23

    Heart rate variability (HRV) analysis, which is an important tool for activity assessment of the cardiac autonomic nervous system, very often includes the estimation of power spectra for series of interbeat intervals (IBI). Ectopic beats and artifacts have a destructive effect on the standard methods (Fourier transform, FFT) for frequency analysis. This study investigates an alternative method for calculation of the periodogram using a robust period detection (RPD). Error free IBI series of 5 minutes for 221 subjects during one day were artificially distorted by randomly changing IBI values by ±15-40%. The low to high frequency rate (LF/HF) were calculated from periodograms estimated by the FFT, RPD and Lomb (LSP) methods for both error free and distorted series and for series with removed beats. Log transformed LF/HF values for series with distorted/removed beats were compared to undistorted values by linear regression. For series with 10% of distorted IBI values the regression analysis between distorted and undistorted series showed a goodness of fit, coefficient and intercept of 0.98, 0.94 and 0.02, respectively. In comparison, the values of these parameters were (0.34, 0.46, -1.61) and (0.28, 0.42,-1.32) for the FFT and LSP methods, respectively. Similarly, the comparison between series with removed and undistorted beats yielded goodness of fit, coefficient and intercept of (0.98, 0.96, -0.01), (0.93, 0.78, -0.02) and (0.98, 0.95, 0.19) for RPD, FFT and LSP, respectively. The RPD method demonstrated superior performance compared to the FFT and LSP method by estimation of power spectral characteristics for HRV analysis.

  4. Heart rate turbulence.

    Science.gov (United States)

    Cygankiewicz, Iwona

    2013-01-01

    Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death. © 2013.

  5. Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal.

    Science.gov (United States)

    McConnell, Patrick A; Froeliger, Brett; Garland, Eric L; Ives, Jeffrey C; Sforzo, Gary A

    2014-01-01

    Binaural beats are an auditory illusion perceived when two or more pure tones of similar frequencies are presented dichotically through stereo headphones. Although this phenomenon is thought to facilitate state changes (e.g., relaxation), few empirical studies have reported on whether binaural beats produce changes in autonomic arousal. Therefore, the present study investigated the effects of binaural beating on autonomic dynamics [heart rate variability (HRV)] during post-exercise relaxation. Subjects (n = 21; 18-29 years old) participated in a double-blind, placebo-controlled study during which binaural beats and placebo were administered over two randomized and counterbalanced sessions (within-subjects repeated-measures design). At the onset of each visit, subjects exercised for 20-min; post-exercise, subjects listened to either binaural beats ('wide-band' theta-frequency binaural beats) or placebo (carrier tones) for 20-min while relaxing alone in a quiet, low-light environment. Dependent variables consisted of high-frequency (HF, reflecting parasympathetic activity), low-frequency (LF, reflecting sympathetic and parasympathetic activity), and LF/HF normalized powers, as well as self-reported relaxation. As compared to the placebo visit, the binaural-beat visit resulted in greater self-reported relaxation, increased parasympathetic activation and increased sympathetic withdrawal. By the end of the 20-min relaxation period there were no observable differences in HRV between binaural-beat and placebo visits, although binaural-beat associated HRV significantly predicted subsequent reported relaxation. Findings suggest that listening to binaural beats may exert an acute influence on both LF and HF components of HRV and may increase subjective feelings of relaxation.

  6. Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal

    Directory of Open Access Journals (Sweden)

    Patrick eMcConnell

    2014-11-01

    Full Text Available Binaural beats are an auditory illusion perceived when two or more pure tones of similar frequencies are presented dichotically through stereo headphones. Although this phenomenon is thought to facilitate state changes (e.g., relaxation, few empirical studies have reported on whether binaural beats produce changes in autonomic arousal. Therefore, the present study investigated the effects of binaural beating on autonomic dynamics (heart-rate variability (HRV during post-exercise relaxation. Subjects (n = 21; 18-29 years old participated in a double-blind, placebo-controlled study during which binaural beats and placebo were administered over two randomized and counterbalanced sessions (within-subjects repeated-measures design. At the onset of each visit, subjects exercised for 20-min; post-exercise, subjects listened to either binaural beats (‘wide-band’ theta-frequency binaural beats or placebo (carrier tone for 20-min while relaxing alone in a quiet, low-light environment. Dependent variables consisted of high frequency (HF, reflecting parasympathetic activity, low frequency (LF, reflecting sympathetic and parasympathetic activity and LF/HF normalized powers, as well as self-reported relaxation. As compared to the placebo visit, the binaural beat visit resulted in greater self-reported relaxation, as well as increased parasympathetic activation and sympathetic withdrawal. By the end of the 20-min relaxation period there were no observable differences in HRV between binaural beat and placebo visits, although binaural-beat associated HRV significantly predicted subsequent reported relaxation. Findings suggest that listening to binaural beats may exert an acute influence on both LF and HF components of HRV and may increase subjective feelings of relaxation.

  7. Noisy fluctuation of heart rate indicates cardiovascular system instability.

    Science.gov (United States)

    Fortrat, Jacques-Olivier; Baum, Charlotte; Jeanguillaume, Christian; Custaud, Marc-Antoine

    2013-09-01

    Heart rate spontaneously fluctuates despite homeostatic regulatory mechanisms to stabilize it. Harmonic and fractal fluctuations have been described. Non-harmonic non-fractal fluctuation has not been studied because it is usually thought that it is caused by apparatus noise. We hypothesized that this fluctuation looking like apparatus noise (that we call "noisy fluctuation") is linked to challenged blood pressure stabilization and not to apparatus noise. We assessed noisy fluctuation by quantifying the small and fastest beat-to-beat fluctuation of RR-interval by means of spectral analysis (Nyquist power of heart rate variability: nyHRV) after filtering out its fractal component. We observed nyHRV in healthy supine subjects and in patients with vasovagal symptoms. We challenged stabilization of blood pressure by upright posture (by means of a head-up tilt table test). Head-up position on the tilt table dramatically decreased nyHRV (0.128 ± 0.063 vs. 0.004 ± 0.002, p cardiovascular system is challenged (upright posture). It also indicates cardiovascular instability because it does not disappear in upright patients before vasovagal syncope, a transient failure of cardiovascular regulation.

  8. Adult murine skeletal muscle contains cells that can differentiate into beating cardiomyocytes in vitro.

    Directory of Open Access Journals (Sweden)

    Steve O Winitsky

    2005-04-01

    Full Text Available It has long been held as scientific fact that soon after birth, cardiomyocytes cease dividing, thus explaining the limited restoration of cardiac function after a heart attack. Recent demonstrations of cardiac myocyte differentiation observed in vitro or after in vivo transplantation of adult stem cells from blood, fat, skeletal muscle, or heart have challenged this view. Analysis of these studies has been complicated by the large disparity in the magnitude of effects seen by different groups and obscured by the recently appreciated process of in vivo stem-cell fusion. We now show a novel population of nonsatellite cells in adult murine skeletal muscle that progress under standard primary cell-culture conditions to autonomously beating cardiomyocytes. Their differentiation into beating cardiomyocytes is characterized here by video microscopy, confocal-detected calcium transients, electron microscopy, immunofluorescent cardiac-specific markers, and single-cell patch recordings of cardiac action potentials. Within 2 d after tail-vein injection of these marked cells into a mouse model of acute infarction, the marked cells are visible in the heart. By 6 d they begin to differentiate without fusing to recipient cardiac cells. Three months later, the tagged cells are visible as striated heart muscle restricted to the region of the cardiac infarct.

  9. Adult Murine Skeletal Muscle Contains Cells That Can Differentiate into Beating Cardiomyocytes In Vitro

    Directory of Open Access Journals (Sweden)

    Winitsky Steve O

    2005-01-01

    Full Text Available It has long been held as scientific fact that soon after birth, cardiomyocytes cease dividing, thus explaining the limited restoration of cardiac function after a heart attack. Recent demonstrations of cardiac myocyte differentiation observed in vitro or after in vivo transplantation of adult stem cells from blood, fat, skeletal muscle, or heart have challenged this view. Analysis of these studies has been complicated by the large disparity in the magnitude of effects seen by different groups and obscured by the recently appreciated process of in vivo stem-cell fusion. We now show a novel population of nonsatellite cells in adult murine skeletal muscle that progress under standard primary cell-culture conditions to autonomously beating cardiomyocytes. Their differentiation into beating cardiomyocytes is characterized here by video microscopy, confocal-detected calcium transients, electron microscopy, immunofluorescent cardiac-specific markers, and single-cell patch recordings of cardiac action potentials. Within 2 d after tail-vein injection of these marked cells into a mouse model of acute infarction, the marked cells are visible in the heart. By 6 d they begin to differentiate without fusing to recipient cardiac cells. Three months later, the tagged cells are visible as striated heart muscle restricted to the region of the cardiac infarct.

  10. Automatic Identification of Systolic Time Intervals in Seismocardiogram

    Science.gov (United States)

    Shafiq, Ghufran; Tatinati, Sivanagaraja; Ang, Wei Tech; Veluvolu, Kalyana C.

    2016-11-01

    Continuous and non-invasive monitoring of hemodynamic parameters through unobtrusive wearable sensors can potentially aid in early detection of cardiac abnormalities, and provides a viable solution for long-term follow-up of patients with chronic cardiovascular diseases without disrupting the daily life activities. Electrocardiogram (ECG) and siesmocardiogram (SCG) signals can be readily acquired from light-weight electrodes and accelerometers respectively, which can be employed to derive systolic time intervals (STI). For this purpose, automated and accurate annotation of the relevant peaks in these signals is required, which is challenging due to the inter-subject morphological variability and noise prone nature of SCG signal. In this paper, an approach is proposed to automatically annotate the desired peaks in SCG signal that are related to STI by utilizing the information of peak detected in the sliding template to narrow-down the search for the desired peak in actual SCG signal. Experimental validation of this approach performed in conventional/controlled supine and realistic/challenging seated conditions, containing over 5600 heart beat cycles shows good performance and robustness of the proposed approach in noisy conditions. Automated measurement of STI in wearable configuration can provide a quantified cardiac health index for long-term monitoring of patients, elderly people at risk and health-enthusiasts.

  11. QT interval changes in term pregnant women living at moderately ...

    African Journals Online (AJOL)

    2015-12-20

    Dec 20, 2015 ... the QRS interval of body surface electrocardiography (ECG), has been shown to alter during pregnancy.[4,5] Early atrial and ventricular beats can be seen during pregnancy.[6] In addition to these changes, pregnant women living at high altitude also experience an increase in erythropoietin and hematocrit.

  12. A new Bayesian Earthquake Analysis Tool (BEAT)

    Science.gov (United States)

    Vasyura-Bathke, Hannes; Dutta, Rishabh; Jónsson, Sigurjón; Mai, Martin

    2017-04-01

    Modern earthquake source estimation studies increasingly use non-linear optimization strategies to estimate kinematic rupture parameters, often considering geodetic and seismic data jointly. However, the optimization process is complex and consists of several steps that need to be followed in the earthquake parameter estimation procedure. These include pre-describing or modeling the fault geometry, calculating the Green's Functions (often assuming a layered elastic half-space), and estimating the distributed final slip and possibly other kinematic source parameters. Recently, Bayesian inference has become popular for estimating posterior distributions of earthquake source model parameters given measured/estimated/assumed data and model uncertainties. For instance, some research groups consider uncertainties of the layered medium and propagate these to the source parameter uncertainties. Other groups make use of informative priors to reduce the model parameter space. In addition, innovative sampling algorithms have been developed that efficiently explore the often high-dimensional parameter spaces. Compared to earlier studies, these improvements have resulted in overall more robust source model parameter estimates that include uncertainties. However, the computational demands of these methods are high and estimation codes are rarely distributed along with the published results. Even if codes are made available, it is often difficult to assemble them into a single optimization framework as they are typically coded in different programing languages. Therefore, further progress and future applications of these methods/codes are hampered, while reproducibility and validation of results has become essentially impossible. In the spirit of providing open-access and modular codes to facilitate progress and reproducible research in earthquake source estimations, we undertook the effort of producing BEAT, a python package that comprises all the above-mentioned features in one

  13. Review: Beate Krais & Gunter Gebauer (2002). Habitus

    OpenAIRE

    Spetsmann-Kunkel, Martin

    2003-01-01

    Beate KRAIS' und Gunter GEBAUERs Buch führt auf eine sehr verständliche Weise in das von Pierre BOURDIEU entwickelte Konzept des Habitus ein. Habitus ist der zentrale Begriff im gesamten Werk BOURDIEUs, welcher bemüht ist, den Menschen als vergesellschaftetes Subjekt zu beschreiben. Anders als der ältere Begriff der sozialen Rolle ist der Habitus als ein generatives Prinzip zu denken, das sowohl an der (Re-) Produktion sozialer Strukturen beteiligt ist als auch diese Strukturen verinnerlicht ...

  14. Record low β beating in the LHC

    Directory of Open Access Journals (Sweden)

    R. Tomás

    2012-09-01

    Full Text Available The LHC is currently operating with a proton energy of 4 TeV and β^{*} functions at the ATLAS and CMS interaction points of 0.6 m. This is close to the design value at 7 TeV (β^{*}=0.55  m and represented a challenge for various aspects of the machine operation. In particular, a huge effort was put into the optics commissioning and an unprecedented peak β beating of around 7% was achieved in a high energy hadron collider.

  15. Beats on the Table: Beat Writing in the Chicago Review and Big Table

    Directory of Open Access Journals (Sweden)

    Jaap van der Bent

    2012-07-01

    Full Text Available Normal 0 21 false false false NL X-NONE X-NONE MicrosoftInternetExplorer4 Kleine literaire tijdschriften, zogenaamde little magazines, hebben een belangrijke rol gespeeld bij de doorbraak, in de loop van de jaren vijftig, van de Amerikaanse Beat Generation. Aangezien grotere uitgeverijen en de gevestigde tijdschriften lange tijd terugschrokken voor de zowel inhoudelijk als formeel van de norm afwijkende uitingen van de Beats, verscheen hun werk aanvankelijk vooral in kleinere tijdschriften als de twee waaraan in dit artikel aandacht wordt besteed: de Chicago Review en Big Table. Aan de hand van een beschrijving van de inhoud van deze twee tijdschriften wordt geprobeerd duidelijk te maken hoe het werk van de Beat Generation zich in deze tijdschriften gaandeweg een eigen plaats verwierf. Speciale aandacht wordt besteed aan de rol van de redacteuren Irving Rosenthal en Paul Carroll; door zijn uitgekiende strategie om voor het omstreden werk van Beat-auteur William S. Burroughs geleidelijk een steeds grotere plaats in te ruimen, bepaalde vooral Rosenthal het veranderende karakter van de Chicago Review. De veranderingen bij dat tijdschrift verliepen niet zonder slag of stoot en waren voor de eigenaar ervan, de University of Chicago, op een gegeven moment aanleiding om de Chicago Review aan censuur te onderwerpen. Ook deze censuur en de reactie erop, de oprichting van Big Table, worden in het artikel belicht.

  16. Spoken Word Recognition Enhancement Due to Preceding Synchronized Beats Compared to Unsynchronized or Unrhythmic Beats

    Directory of Open Access Journals (Sweden)

    Christos Sidiras

    2017-07-01

    Full Text Available The relation between rhythm and language has been investigated over the last decades, with evidence that these share overlapping perceptual mechanisms emerging from several different strands of research. The dynamic Attention Theory posits that neural entrainment to musical rhythm results in synchronized oscillations in attention, enhancing perception of other events occurring at the same rate. In this study, this prediction was tested in 10 year-old children by means of a psychoacoustic speech recognition in babble paradigm. It was hypothesized that rhythm effects evoked via a short isochronous sequence of beats would provide optimal word recognition in babble when beats and word are in sync. We compared speech recognition in babble performance in the presence of isochronous and in sync vs. non-isochronous or out of sync sequence of beats. Results showed that (a word recognition was the best when rhythm and word were in sync, and (b the effect was not uniform across syllables and gender of subjects. Our results suggest that pure tone beats affect speech recognition at early levels of sensory or phonemic processing.

  17. Motor responses to a steady beat.

    Science.gov (United States)

    Schaefer, Rebecca S; Overy, Katie

    2015-03-01

    It is increasingly well established that music containing an isochronous pulse elicits motor responses at the levels of both brain and behavior. Such motor responses are often used in pedagogical and clinical practice to induce movement, particularly where motor functions are impaired. However, the complex nature of such apparently universal human responses has, arguably, not received adequate research attention to date. In particular, it should be noted that many adults, including those with disabilities, find it somewhat difficult to synchronize their movements with a beat with perfect accuracy; indeed, perfecting the skill of being musically "in time" can take years of training during childhood. Further research is needed on the nature of both the specificity and range of motor responses that can arise from the perception of a steady auditory pulse, with different populations, musical stimuli, conditions, and required levels of accuracy in order to better understand and capture the potential value of the musical beat as a pedagogical and therapeutic tool. © 2015 New York Academy of Sciences.

  18. Nonlinear amplitude dynamics in flagellar beating

    Science.gov (United States)

    Oriola, David; Gadêlha, Hermes; Casademunt, Jaume

    2017-03-01

    The physical basis of flagellar and ciliary beating is a major problem in biology which is still far from completely understood. The fundamental cytoskeleton structure of cilia and flagella is the axoneme, a cylindrical array of microtubule doublets connected by passive cross-linkers and dynein motor proteins. The complex interplay of these elements leads to the generation of self-organized bending waves. Although many mathematical models have been proposed to understand this process, few attempts have been made to assess the role of dyneins on the nonlinear nature of the axoneme. Here, we investigate the nonlinear dynamics of flagella by considering an axonemal sliding control mechanism for dynein activity. This approach unveils the nonlinear selection of the oscillation amplitudes, which are typically either missed or prescribed in mathematical models. The explicit set of nonlinear equations are derived and solved numerically. Our analysis reveals the spatio-temporal dynamics of dynein populations and flagellum shape for different regimes of motor activity, medium viscosity and flagellum elasticity. Unstable modes saturate via the coupling of dynein kinetics and flagellum shape without the need of invoking a nonlinear axonemal response. Hence, our work reveals a novel mechanism for the saturation of unstable modes in axonemal beating.

  19. Serial binary interval ratios improve rhythm reproduction

    Directory of Open Access Journals (Sweden)

    Xiang eWu

    2013-08-01

    Full Text Available Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8, non-binary integer (1:3:5:6, and non-integer (1:2.3:5.3:6.4 ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  20. Serial binary interval ratios improve rhythm reproduction.

    Science.gov (United States)

    Wu, Xiang; Westanmo, Anders; Zhou, Liang; Pan, Junhao

    2013-01-01

    Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8), non-binary integer (1:3:5:6), and non-integer (1:2.3:5.3:6.4) ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  1. Ischemia and ischemic preconditioning in the buffer-perfused pigeon heart.

    Science.gov (United States)

    Rischard, F; McKean, T

    1998-01-01

    Isolated pigeon hearts were perfused with Krebs-Henseleit bicarbonate buffer with 1.25 mM Ca++ at a pressure of 60 cm H2O and paced at 210 beats per min. After an equilibration perfusion of 30 min, hearts were subjected to 10 min global ischemia and then reperfused for 30 min. Left ventricular +dP/dtmax, systolic, and end diastolic pressures differed significantly from baseline values during reperfusion as did the release of lactate dehydrogenase (LDH). When the hearts were preconditioned by interruption of flow for two 2.5-min intervals, followed by 10 min of ischemia and then reperfusion, the short periods of ischemia, followed by reperfusion, protected the hearts against the longer bout of ischemia as evidenced by significant differences between the left ventricular (LV) pressure, +dP/dtmax, LV end diastolic pressure and LDH values obtained from the hearts of control vs. preconditioned hearts. Substitution of 1 microM adenosine for the preconditioning ischemia also resulted in the preconditioning response. Ischemic preconditioning (IP) was not blocked by addition of 100 microM 8-(-p-sulfophenyl) theophylline, an adenosine receptor antagonist. Therefore, isolated, perfused bird hearts can be preconditioned, and the mechanism may involve adenosine receptors, although their activation is not necessary for i.p. to occur. Factors in addition to adenosine are likely involved.

  2. Marked First Degree Atrioventricular Block: an extremely prolonged PR interval associated with Atrioventricular Dissociation in a young Nigerian man with Pseudo-Pacemaker Syndrome: a case report.

    Science.gov (United States)

    Ogunlade, Oluwadare; Akintomide, Anthony O; Ajayi, Olufemi E; Eluwole, Omotayo A

    2014-11-04

    The diagnosis of Marked First Degree Atrioventricular Block is made with electrocardiogram when PR interval ≥0.30 s. A PR interval of up to 0.48 s had been reported in literature. Data is sparse on an extremely prolonged PR interval associated with Atrioventricular Dissociation and Pseudo-Pacemaker Syndrome. Electrocardiogram with this type of uncommon features poses diagnostic and management challenges in clinical practice. We report a case of a 22 year old Nigerian male from Igbo ethnic group who presented himself for medical screening with a history of exercise intolerance, occasional palpitation and fainting spells. He has no history of cough, orthopnoea, paroxysmal nocturnal dyspnoea nor body swelling. A physical examination revealed that the patient has a pulse rate of 64 beats per minute, blood pressure of 110/70 mmHg and soft heart sounds. Standard 12-lead electrocardiogram showed an uncommon Marked First Degree Atrioventricular Block with an extremely prolonged PR interval of 0.56 s. Long rhythm strips of the electrocardiogram showed extremely prolonged PR interval associated with Atrioventricular Dissociation and variable degrees of Atrioventricular Block (Mobitz type I and II). An extremely prolonged PR interval may occur in First Degree Atrioventricular Block and it may be associated with Atrioventricular Dissociation and Pseudo-Pacemaker Syndrome which may pose diagnostic and management challenges. This suggests that not all cases of First Degree Atrioventricular Block are benign and so should be sub-classified based on degree of PR interval prolongation and associated electrical abnormalities.

  3. Healing study of porcine heart transapical wounds closed using a remote automated suturing technology.

    Science.gov (United States)

    Wilshire, Candice L; Kaufer, James W; Gorea, Heather R; Sauer, Jude S; Knight, Peter A

    2013-01-01

    A safe and reliable direct percutaneous approach for transapical access to the left ventricle would be a significant advance toward decreasing the invasiveness of intracardiac interventions. This report presents results from a surviving porcine beating heart model in which transapical access sites were closed using an automated suturing technique ultimately intended for percutaneous use. Through an approved protocol including general anesthesia, the cardiac apex in 10 beating pig hearts was surgically exposed, permitting transapical passage of a 0.035-in guidewire and a 5.5F, 0.9-mL Fogarty balloon catheter. An automated suturing device was passed over the guidewire and the Fogarty onto the transapical access site. Two pledgeted horizontal mattress sutures were simultaneously placed concentrically around the apical access site with a single squeeze of the device's lever. A 25F dilator was passed into the left ventricle over the guidewire and subsequently removed. The sutures were then secured using pledgeted titanium knots. Chest wall and skin incisions were closed. The animals were recovered from anesthesia and resumed a normal diet. Under general anesthesia, the transapical access site of each animal was re-exposed, five at 1-week and five at 2-week intervals. Hemostasis was complete, and all wounds healed well. The evaluation of transapical wound closures in this surviving porcine heart model demonstrates complete hemostasis and excellent healing through the use of this automated remote suturing technology.

  4. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  5. When heart goes "BOOM" to fast. Heart rate greater than 80 as mortality predictor in acute myocardial infarction.

    Science.gov (United States)

    Davidovic, Goran; Iric-Cupic, Violeta; Milanov, Srdjan; Dimitijevic, Aleksandra; Petrovic-Janicijevic, Mirjana

    2013-01-01

    Many prospective studies established association between high heart rate and increased cardiovascular morbidity and mortality, independently of other risk factors. Heart rate over 80 beats per minute more often leads to atherosclerotic plaque disruption, the main step in developing acute coronary syndrome. Purpose was to investigate the incidence of higher heart rate levels in patients with anterior wall acute myocardial infarction with ST-segment elevation and the influence of heart rate on mortality. Research included 140 patients with anterior wall acute myocardial infarction with ST-segment elevation treated in Coronary Unit, Clinical Center Kragujevac in the period from January 2001-June 2006. Heart rate was calculated as the mean value of baseline and heart rate in the first 30 minutes after admission. Other risk factors were also followed to determine their connection with elevated heart rate. Results showed that the majority of patients survived (over 70%). In a total number of patients, more than 75% had a heart rate levels greater than 80 beats per minute. There was a significant difference in heart rate on addmision between survivors and patients who died, with a greater levels in patients with fatal outcome. Both, univariate and multivariate regression analysis singled out heart rate greater than 80 beats per minute as independent mortality predictor in these patients. Heart rate greater than 80 beats per minute is a major, independent risk factor for morbidity and important predictor of mortality in patients with acute myocardial infarction.

  6. Nonlinear amplitude dynamics in flagellar beating

    CERN Document Server

    Oriola, David; Casademunt, Jaume

    2016-01-01

    The physical basis of flagellar and ciliary beating is a major problem in biology which is still far from completely understood. The fundamental cytoskeleton structure of cilia and flagella is the axoneme, a cylindrical array of microtubule doublets connected by passive crosslinkers and dynein motor proteins. The complex interplay of these elements leads to the generation of self-organized bending waves. Although many mathematical models have been proposed to understand this process, few attempts have been made to assess the role of dyneins on the nonlinear nature of the axoneme. Here, we investigate the nonlinear dynamics of flagella by considering an axonemal sliding control mechanism for dynein activity. This approach unveils the nonlinear selection of the oscillation amplitudes, which are typically either missed or prescribed in mathematical models. The explicit set of nonlinear equations are derived and solved numerically. Our analysis reveals the spatiotemporal dynamics of dynein populations and flagell...

  7. Beating Social Democracy on Its Own Turf

    DEFF Research Database (Denmark)

    Arndt, Christoph

    2014-01-01

    Recent elections yielded sweeping majorities for the centre-right in Scandinavia with a decade of pure centre-right majorities in Denmark and the longest sitting centre-right coalition in Sweden for decades. This is a blind spot in the issue voting literature, which would not expect centre......-right parties to flourish in contexts where welfare issues have a natural salience as in the case of universal welfare states. In contrast, Scandinavian universal welfare states ought to benefit social democracy when it comes to issue voting on welfare issues. It is argued in this article that centre......-right parties can beat social democrats by credibly converging to its social democratic opponent on issues of universal welfare. Issue ownership voting to the benefit of centre-right parties will then be strongest among voters perceiving the centre-right to have converged to social democracy and perceiving...

  8. Gimme the beat: assessment of low frequency beat noise for drilling rig

    Energy Technology Data Exchange (ETDEWEB)

    Bilawchuk, Steven; Froment, Patrick [aci Acoustical Consultants Inc. (Canada)], email: stevenb@aciacoustical.com, email: patrickf@aciacoustical.com

    2011-07-01

    The concern of an Alberta resident over the noise level from a drilling rig led to a low frequency noise impact assessment being done by an acoustic consulting firm. This paper describes the investigation that was conducted to determine the low frequency noise source, evaluate its sound emission levels and spectra, and propose mitigation options. Noise measurements were made over several days, with a sound level meter and additionally, a weather monitoring station was also used. Analysis showed low frequency tonal noise at the residential location, resulting in an overall sound level exceeding the permissible sound level imposed by the Alberta noise regulating bodies. Moreover, a beat phenomenon was observed, and after detailed investigation of possible sources, it was established that shale shakers were responsible for the low frequency noise and the beat phenomenon, a fact verified by beat theory. Due to the temporary nature of the drilling rig's operation, no thorough mitigation options could be proposed but a simple stop gap solution for the shale shakers allowed the reduction of low frequency tonal noise.

  9. HEART RATE DURING SLEEP: IMPLICATIONS FOR MONITORING TRAINING STATUS

    Directory of Open Access Journals (Sweden)

    Miriam R. Waldeck

    2003-12-01

    Full Text Available Resting heart rate has sometimes been used as a marker of training status. It is reasonable to assume that the relationship between heart rate and training status should be more evident during sleep when extraneous factors that may influence heart rate are reduced. Therefore the aim of the study was to assess the repeatability of monitoring heart rate during sleep when training status remained unchanged, to determine if this measurement had sufficient precision to be used as a marker of training status. The heart rate of ten female subjects was monitored for 24 hours on three occasions over three weeks whilst training status remained unchanged. Average, minimum and maximum heart rate during sleep was calculated. The average heart rate of the group during sleep was similar on each of the three tests (65 ± 9, 63 ± 6 and 67 ± 7 beats·min-1 respectively. The range in minimum heart rate variation during sleep for all subjects over the three testing sessions was from 0 to 10 beats·min-1 (mean = 5 ± 3 beats·min-1 and for maximum heart rate variation was 2 to 31 beats·min-1 (mean = 13 ± 9 beats·min-1. In summary it was found that on an individual basis the minimum heart rate during sleep varied by about 8 beats·min-1. This amount of intrinsic day-to-day variation needs to be considered when changes in heart rate that may occur with changes in training status are interpreted

  10. Heart rate during sleep: implications for monitoring training status.

    Science.gov (United States)

    Waldeck, Miriam R; Lambert, Michael I

    2003-12-01

    Resting heart rate has sometimes been used as a marker of training status. It is reasonable to assume that the relationship between heart rate and training status should be more evident during sleep when extraneous factors that may influence heart rate are reduced. Therefore the aim of the study was to assess the repeatability of monitoring heart rate during sleep when training status remained unchanged, to determine if this measurement had sufficient precision to be used as a marker of training status. The heart rate of ten female subjects was monitored for 24 hours on three occasions over three weeks whilst training status remained unchanged. Average, minimum and maximum heart rate during sleep was calculated. The average heart rate of the group during sleep was similar on each of the three tests (65 ± 9, 63 ± 6 and 67 ± 7 beats·min(-1) respectively). The range in minimum heart rate variation during sleep for all subjects over the three testing sessions was from 0 to 10 beats·min(-1) (mean = 5 ± 3 beats·min(-1)) and for maximum heart rate variation was 2 to 31 beats·min(-1) (mean = 13 ± 9 beats·min(-1)). In summary it was found that on an individual basis the minimum heart rate during sleep varied by about 8 beats·min(-1). This amount of intrinsic day-to-day variation needs to be considered when changes in heart rate that may occur with changes in training status are interpreted.

  11. Origin of heart rate variability and turbulence: an appraisal of autonomic modulation of cardiovascular function.

    Directory of Open Access Journals (Sweden)

    Federico eLombardi

    2011-12-01

    Full Text Available Assessment of autonomic modulation of sinus node by non-invasive techniques has provided relevant clinical information in patients with several cardiac and non-cardiac diseases and has facilitated the appraisal of neural regulatory mechanisms in normal and diseased subjects. The finding that even during resting conditions the heart period changes on a beat to beat basis and that after a premature ventricular beat there are small variations in RR interval whose measurements may be utilised to evaluate the autonomic modulation of sinus node, has provided unprecedented clinical and pathophysiological information. Heart rate variability (HRV and Heart Rate Turbulence (HRT have been extensively utilised in the clinical setting. To explain the negative predictive value of a reduced HRV it was determined that overall HRV was largely dependent on vagal mechanisms and that a reduction in HRV could reflect an increased sympathetic and a reduced vagal modulation of sinus node; i.e. an autonomic alteration favouring cardiac electrical instability. This initial interpretation was challenged by several findings indicating a greater complexity of the relationship between neural input and sinus node responsiveness as well as the possible interference with non-neural mechanisms.Under controlled conditions, however, the computation of low and high frequency components and of their ratio seems capable of providing adequate information on sympatho-vagal balance in normal subjects as well as in most patients with a preserved left ventricular function, thus providing a unique tool to investigate neural control mechanisms. Analysis on non-linear dynamics of HRV has also been utilised to describe the fractal like characteristic of the variability signal and proven effective to identify patients at risk for sudden cardiac death. A reduction on HRT parameters reflecting reduced baroreflex sensitivity as a likely result of a reduced vagal and of an increased sympathetic

  12. Heart rate variability analysis with the R package RHRV

    CERN Document Server

    García Martínez, Constantino Antonio; Vila, Xosé A; Lado Touriño, María José; Rodríguez-Liñares, Leandro; Rodríguez Presedo, Jesús María; Méndez Penín, Arturo José

    2017-01-01

    This book introduces readers to the basic concepts of Heart Rate Variability (HRV) and its most important analysis algorithms using a hands-on approach based on the open-source RHRV software. HRV refers to the variation over time of the intervals between consecutive heartbeats. Despite its apparent simplicity, HRV is one of the most important markers of the autonomic nervous system activity and it has been recognized as a useful predictor of several pathologies. The book discusses all the basic HRV topics, including the physiological contributions to HRV, clinical applications, HRV data acquisition, HRV data manipulation and HRV analysis using time-domain, frequency-domain, time-frequency, nonlinear and fractal techniques. Detailed examples based on real data sets are provided throughout the book to illustrate the algorithms and discuss the physiological implications of the results. Offering a comprehensive guide to analyzing beat information with RHRV, the book is intended for masters and Ph.D. students in v...

  13. Persistent fluctuations in stride intervals under fractal auditory stimulation.

    Science.gov (United States)

    Marmelat, Vivien; Torre, Kjerstin; Beek, Peter J; Daffertshofer, Andreas

    2014-01-01

    Stride sequences of healthy gait are characterized by persistent long-range correlations, which become anti-persistent in the presence of an isochronous metronome. The latter phenomenon is of particular interest because auditory cueing is generally considered to reduce stride variability and may hence be beneficial for stabilizing gait. Complex systems tend to match their correlation structure when synchronizing. In gait training, can one capitalize on this tendency by using a fractal metronome rather than an isochronous one? We examined whether auditory cues with fractal variations in inter-beat intervals yield similar fractal inter-stride interval variability as isochronous auditory cueing in two complementary experiments. In Experiment 1, participants walked on a treadmill while being paced by either an isochronous or a fractal metronome with different variation strengths between beats in order to test whether participants managed to synchronize with a fractal metronome and to determine the necessary amount of variability for participants to switch from anti-persistent to persistent inter-stride intervals. Participants did synchronize with the metronome despite its fractal randomness. The corresponding coefficient of variation of inter-beat intervals was fixed in Experiment 2, in which participants walked on a treadmill while being paced by non-isochronous metronomes with different scaling exponents. As expected, inter-stride intervals showed persistent correlations similar to self-paced walking only when cueing contained persistent correlations. Our results open up a new window to optimize rhythmic auditory cueing for gait stabilization by integrating fractal fluctuations in the inter-beat intervals.

  14. Multifractal multiscale dfa of cardiovascular time series: Differences in complex dynamics of systolic blood pressure, diastolic blood pressure and heart rate.

    Science.gov (United States)

    Castiglioni, Paolo; Lazzeroni, Davide; Brambilla, Valerio; Coruzzi, Paolo; Faini, Andrea

    2017-07-01

    The heart-rate fractal dynamics can be assessed by Detrended Fluctuation Analysis (DFA), originally proposed for estimating a short-term coefficient, α1 (for scales n≤12 beats), and a long-term coefficient α2 (for longer scales). Successively, DFA was extended to provide a multiscale α, i.e. a continuous function of n, α(n); or a multifractal α, i.e. a function of the order q of the fluctuations moment, α(q). Very recently, a multifractal-multiscale DFA was proposed for evaluating multifractality at different scales separately. Aim of this work is to describe the multifractal multiscale dynamics of three cardiovascular signals often recorded beat by beat in physiological and clinical settings: systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse interval (PI, inverse of the heart rate). We recorded SBP, DBP and PI for at least 90' in 65 healthy volunteers at rest, and adapted the previously proposed multifractal multiscale DFA to estimate α as function of the temporal scale, τ, between 15 and 450 s, and of the order q, between -5 and 5. We report, for the first time: 1) substantial differences among α(q,τ) surfaces of PI, SBP and DBP; 2) a strong dependency of the degree of multifractality on the temporal scale.

  15. ZumBeat: Evaluation of a Zumba Dance Intervention in Postmenopausal Overweight Women

    Directory of Open Access Journals (Sweden)

    Anja Rossmeissl

    2016-01-01

    Full Text Available Physical inactivity is a major public health concern since it increases individuals’ risk of morbidity and mortality. A subgroup at particular risk is postmenopausal overweight women. The aim of this study was to assess the feasibility and effect of a 12-week ZumBeat dance intervention on cardiorespiratory fitness and psychosocial health. Postmenopausal women with a body mass index (BMI >30 kg/m2 or a waist circumference >94 cm who were not regularly physically active were asked to complete a 12-week ZumBeat dance intervention with instructed and home-based self-training sessions. Before and after the intervention, peak oxygen consumption (VO2peak was assessed on a treadmill; and body composition and several psychometric parameters (including quality of life, sports-related barriers and menopausal symptoms were investigated. Of 17 women (median age: 54 years; median BMI: 30 kg/m2 enrolled in the study, 14 completed the study. There was no apparent change in VO2peak after the 12-week intervention period (average change score: −0.5 mL/kg/min; 95% confidence interval: −1.0, 0.1; but, quality of life had increased, and sports-related barriers and menopausal symptoms had decreased. A 12-week ZumBeat dance intervention may not suffice to increase cardiorespiratory fitness in postmenopausal overweight women, but it increases women’s quality of life.

  16. The Measurement of the QT Interval

    Science.gov (United States)

    Postema, Pieter G; Wilde, Arthur A.M

    2014-01-01

    The evaluation of every electrocardiogram should also include an effort to interpret the QT interval to assess the risk of malignant arrhythmias and sudden death associated with an aberrant QT interval. The QT interval is measured from the beginning of the QRS complex to the end of the T-wave, and should be corrected for heart rate to enable comparison with reference values. However, the correct determination of the QT interval, and its value, appears to be a daunting task. Although computerized analysis and interpretation of the QT interval are widely available, these might well over- or underestimate the QT interval and may thus either result in unnecessary treatment or preclude appropriate measures to be taken. This is particularly evident with difficult T-wave morphologies and technically suboptimal ECGs. Similarly, also accurate manual assessment of the QT interval appears to be difficult for many physicians worldwide. In this review we delineate the history of the measurement of the QT interval, its underlying pathophysiological mechanisms and the current standards of the measurement of the QT interval, we provide a glimpse into the future and we discuss several issues troubling accurate measurement of the QT interval. These issues include the lead choice, U-waves, determination of the end of the T-wave, different heart rate correction formulas, arrhythmias and the definition of normal and aberrant QT intervals. Furthermore, we provide recommendations that may serve as guidance to address these complexities and which support accurate assessment of the QT interval and its interpretation. PMID:24827793

  17. The effect of music with and without binaural beat audio on operative anxiety in patients undergoing cataract surgery: a randomized controlled trial.

    Science.gov (United States)

    Wiwatwongwana, D; Vichitvejpaisal, P; Thaikruea, L; Klaphajone, J; Tantong, A; Wiwatwongwana, A

    2016-11-01

    PurposeTo investigate the anxiolytic effects of binaural beat embedded audio in patients undergoing cataract surgery under local anesthesia.MethodsThis prospective RCT included 141 patients undergoing cataract surgery under local anesthesia. The patients were randomized into three groups; the Binaural beat music group (BB), the plain music intervention group (MI), and a control group (ear phones with no music). Blood pressure (BP) and heart rate were measured on admission, at the beginning of and 20 min after the start of the operation. Peri-operative anxiety level was assessed using the State-Trait Anxiety Inventory questionnaire (STAI).ResultsThe BB and MI groups comprised 44 patients each and the control group 47. Patients in the MI group and BB group showed significant reduction of STAI state scores after music intervention compared with the control group (Pbinaural beat, was proven to decrease anxiety level and lower systolic BP. Patients who received binaural beat audio showed additional decrease in heart rate. Binaural beat embedded musical intervention may have benefit over musical intervention alone in decreasing operative anxiety.

  18. Hierarchical Structure of Heart Rate Variability in Humans

    Science.gov (United States)

    Gao, X. Z.; Ching, E. S. C.; Lin, D. C.

    2004-03-01

    We show a hierarchical structure (HS) of the She-Leveque form in the beat-to-beat RR intervals of heart rate variability (HRV) in humans. This structure, first found as an empirical law in turbulent fluid flows, implies further details in the HRV multifractal scaling. We tested HS using daytime RRi data from healthy subjects and heart diseased patients with congestive heart failure and found a universal law C(b) where b characterizes the multifractality of HRV and C is related to a co-dimension parameter of the most violent events in the fluctuation. The potential of diagnosis is discussed based on the characteristics of this finding. To model the HRV phenomenology, we propose a local-feedback-global-cascade (LFGC) model based on the She-Waymire (SW) cascade solution to the HS in fluid turbulence. This model extends from the previous work in that it integrates additive law multiplicatively into the cascade structure. It is an attempt to relate to the cardiovascular physiology which consists of numerous feedback controls that function primarily on the principle of additive law. In particular, the model is based on the same philosophy as the SW cascade that its multifractal dynamics consists of a singular and a modulating component. In the LFGC model, we introduce local feedback to model the dynamics of the modulating effect. The novelty of our model is to incorporate the cascade structure in the scheduling for the feedback control. This model also represents an alternative solution to the HS. We will present the simulation results by the LFGC model and discuss its implication in physiology terms.

  19. Resultados de la intervención de Norwood en pacientes con síndrome de ventrículo izquierdo hipoplásico Results of Norwood's operation in patients with hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Miguel Ruz

    2009-04-01

    Full Text Available Introducción: el síndrome de ventrículo izquierdo hipoplásico, es una cardiopatía congénita compleja que requiere corrección quirúrgica en los primeros días de vida. El tratamiento es paliativo y el procedimiento de Norwood es la primera cirugía que se realiza. En esta intervención el ventrículo derecho es sistémico y la circulación pulmonar ocurre a través de una fístula sistémica-pulmonar o ventrículo-pulmonar. Objetivo: comunicar nuestra experiencia con la cirugía de Norwood en el tratamiento de los pacientes con diagnóstico de síndrome de ventrículo izquierdo hipoplásico. Métodos: estudio retrospectivo, observacional y descriptivo, en el cual se incluyen pacientes que ingresaron con diagnóstico de síndrome de ventrículo izquierdo hipoplásico y se llevaron a cirugía tipo Norwood entre diciembre de 2001 y octubre de 2007. Se clasificaron en dos grupos de acuerdo con el tipo de técnica utilizada; grupo I: fístula Blalock-Taussig, grupo II: conducto entre el ventrículo derecho y la arteria pulmonar. Resultados: se incluyeron 32 pacientes; 12 (37,5% pertenecieron al grupo I y 20 (62,5% al II. La distribución por géneros fue de 19 hombres (59,4% y 13 mujeres (40,6%. El promedio de días de vida al momento de la cirugía, fue de 14,7. Se detectaron 14 (43,7% pacientes con atresia aórtica y mitral. El promedio de tiempo en circulación extracorpórea fue de 192 minutos, con un rango de 95 a 310 minutos y la media de paro circulatorio fue de 60 minutos. El promedio de horas de ventilación mecánica fue de 153 y el cierre esternal se realizó en promedio a las 56 horas. La mortalidad en el grupo I fue de 83% y en el II de 50%, para una mortalidad global de 62% hasta 2006; para 2007 la mortalidad fue de 0%. Conclusiones: los avances actuales en técnicas de diagnóstico prenatal, tratamiento médico, intervención hemodinámica y técnicas quirúrgicas son prometedoras para mejorar la sobrevida de estos pacientes. En

  20. Tempo and beat analysis of acoustic musical signals.

    Science.gov (United States)

    Scheirer, E D

    1998-01-01

    A method is presented for using a small number of bandpass filters and banks of parallel comb filters to analyze the tempo of, and extract the beat from, musical signals of arbitrary polyphonic complexity and containing arbitrary timbres. This analysis is performed causally, and can be used predictively to guess when beats will occur in the future. Results in a short validation experiment demonstrate that the performance of the algorithm is similar to the performance of human listeners in a variety of musical situations. Aspects of the algorithm are discussed in relation to previous high-level cognitive models of beat tracking.

  1. Beliefs about wife beating: an exploratory study with Lebanese students.

    Science.gov (United States)

    Obeid, Nadine; Chang, Doris F; Ginges, Jeremy

    2010-06-01

    In recent years, there has been a growing interest in understanding the sociocultural contexts and risk factors for domestic violence in the Arab world. This study provides an analysis of the religious, legal, and familial contexts of domestic violence in Lebanon and assesses contemporary attitudes toward women and wife beating in a sample of 206 Lebanese university students. Gender, patriarchal attitudes, religion, childhood experiences with family violence, and mother's employment status were investigated as predictors of attitudes toward wife beating. Consistent with feminist theories of wife abuse, gender and attitudes toward women's roles emerged as the strongest predictors of beliefs about wife beating.

  2. Generic flow profiles induced by a beating cilium.

    Science.gov (United States)

    Vilfan, A

    2012-08-01

    We describe a multipole expansion for the low-Reynolds-number fluid flows generated by a localized source embedded in a plane with a no-slip boundary condition. It contains 3 independent terms that fall quadratically with the distance and 6 terms that fall with the third power. Within this framework we discuss the flows induced by a beating cilium described in different ways: a small particle circling on an elliptical trajectory, a thin rod and a general ciliary beating pattern. We identify the flow modes present based on the symmetry properties of the ciliary beat.

  3. Association of impaired heart rate recovery with cardiopulmonary complications after lung cancer resection surgery.

    Science.gov (United States)

    Ha, Duc; Choi, Humberto; Zell, Katrina; Raymond, Daniel P; Stephans, Kevin; Wang, Xiao-Feng; Videtic, Gregory; McCarthy, Kevin; Minai, Omar A; Mazzone, Peter J

    2015-04-01

    Patients who undergo lung resection surgery are at risk for postoperative morbidity and mortality. Appropriate selection of the surgical candidate is crucial in the treatment of lung cancer. Heart rate recovery is a measure of physical fitness. We aimed to investigate the association of impaired heart rate recovery with cardiopulmonary complications after lung resection surgery for treatment of lung cancer. Data from consecutive patients who, between 2009 and 2013, underwent heart rate recovery evaluation after 6-minute walk tests before lung resection surgery were retrospectively reviewed. Impaired heart rate recovery was defined as a 12-beat or less decrease in peak heart rate at 1 minute after the 6-minute walk test. Postoperative cardiopulmonary complications were as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. Logistic regression was performed, including previously known risk factors for postoperative complications after lung resection surgery. A total of 96 patients had heart rate recovery evaluated within 6 months of lung resection surgery for treatment of lung cancer. Thirty-one patients had impaired heart rate recovery, 17 of whom (55%) had cardiopulmonary complications. A total of 65 patients had normal heart rate recovery, 17 of whom (26%) had cardiopulmonary complications. In multivariable logistic regression analysis, impaired heart rate recovery was significantly associated with postoperative cardiopulmonary complications (odds ratio, 4.97; confidence interval, 1.79-13.8; P = .002). No patient died within 30 days after surgery. Impaired heart rate recovery after the 6-minute walk test is associated with postoperative cardiopulmonary complications in patients who underwent lung resection surgery for treatment of lung cancer. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  4. "'Jackin’ for Beats'": DJing for Citation Critique

    Directory of Open Access Journals (Sweden)

    Todd Craig

    2013-10-01

    Full Text Available A challenge in teaching English composition is helping students envision plagiarism as “borrowing” – showing love to author(s and/or text(s that further their argument(s, versus “stealing” – biting someone’s style and words. Alastair Pennycook (1996 and Sarah Wakefield (2006 have contributed pieces to the elaborate plagiarism/citation puzzle, while Houston Baker situated the hip-hop DJ in seminal text Black Studies, Rap and the Academy (1993. Merging these moments introduces critical questions: Did Diddy invent “the remix” or become the illest beat-biter ever? How did DJ/Producers Pete Rock and Large Professor pay homage to previous musical genres to further hip-hop remix production without just taking 4-8 bar samples, copying sources and claiming unethical ownership? And how can this discussion provide students a window into citation conversations? This article will remix these “texts” to introduce the idea of DJ Rhetoric to discuss plagiarism. Through the lens of the hip-hop DJ in writing classrooms, one can foster an appreciation of the difference between “love and theft” in student citation. This article will couple examples from hip-hop music/culture while simultaneously remixing interviews from various hip-hop DJ/producers to help answer these difficult questions.

  5. Selective particle capture by asynchronously beating cilia

    Science.gov (United States)

    Ding, Yang; Kanso, Eva

    2015-12-01

    Selective particle filtration is fundamental in many engineering and biological systems. For example, many aquatic microorganisms use filter feeding to capture food particles from the surrounding fluid, using motile cilia. One of the capture strategies is to use the same cilia to generate feeding currents and to intercept particles when the particles are on the downstream side of the cilia. Here, we develop a 3D computational model of ciliary bands interacting with flow suspended particles and calculate particle trajectories for a range of particle sizes. Consistent with experimental observations, we find optimal particle sizes that maximize capture rate. The optimal size depends nonlinearly on cilia spacing and cilia coordination, synchronous vs. asynchronous. These parameters affect the cilia-generated flow field, which in turn affects particle trajectories. The low capture rate of smaller particles is due to the particles' inability to cross the flow streamlines of neighboring cilia. Meanwhile, large particles have difficulty entering the sub-ciliary region once advected downstream, also resulting in low capture rates. The optimal range of particle sizes is enhanced when cilia beat asynchronously. These findings have potentially important implications on the design and use of biomimetic cilia in processes such as particle sorting in microfluidic devices.

  6. The heartbrake of social rejection: heart rate deceleration in response to unexpected peer rejection

    NARCIS (Netherlands)

    Gunther Moor, B.; Crone, E.A.; van der Molen, M.W.

    2010-01-01

    Social relationships are vitally important in human life. Social rejection in particular has been conceptualized as a potent social cue resulting in feelings of hurt. Our study investigated the psychophysiological manifestation of hurt feelings by examining the beat-by-beat heart rate response

  7. Cardiac Autonomic Modulation and the Kinetics of Heart Rate Responses in the On- and Off-Transient during Exercise in Women with Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Lucas R. B. E. Silva

    2017-07-01

    Full Text Available Objective: To test whether women with metabolic syndrome (MS have impairments in the on- and off-transients during an incremental test and to study whether any of the MS components are independently associated with the observed responses.Research Design and Methods: Thirty-six women aged 35–55 years were divided into a group with MS (MSG, n = 19 and a control group (CG, n = 17. R-R intervals (RRi and heart rate variability (HRV were calculated on a beat-to-beat basis and the heart rate (HR at the on- and off-transient were analyzed during an incremental cardiopulmonary exercise test (CPET.Results: MSG showed lower aerobic capacity and lower parasympathetic cardiac modulation at rest compared with CG. HR values in on-transient phase were significantly lower in MSG compared with CG. The exponential amplitudes “amp” and the parameters “τ” [speed of heart rate recovery (HRR] were lower in MSG. MSG exhibited higher HR values in comparison to CG during the off-transient indicating a slower HRR. In MSG, there was an inverse and significant correlation between fasting plasma vs. ΔF and glucose vs. exponential “τ” of HRR dynamics.Conclusion: MS is associated with poor heart rate kinetics. The altered HR kinetics seems to be related to alterations in cardiac parasympathetic modulation, and glucose metabolism seems to be the major determinant.

  8. Cardiac Autonomic Modulation and the Kinetics of Heart Rate Responses in the On- and Off-Transient during Exercise in Women with Metabolic Syndrome

    Science.gov (United States)

    Silva, Lucas R. B. E.; Zamunér, Antonio R.; Gentil, Paulo; Alves, Fagner M.; Leal, Acácia G. F.; Soares, Viviane; Silva, Maria S.; Vieira, Marcus F.; Simões, Karina; Pedrino, Gustavo R.; Rebelo, Ana C. S.

    2017-01-01

    Objective: To test whether women with metabolic syndrome (MS) have impairments in the on- and off-transients during an incremental test and to study whether any of the MS components are independently associated with the observed responses. Research Design and Methods: Thirty-six women aged 35–55 years were divided into a group with MS (MSG, n = 19) and a control group (CG, n = 17). R-R intervals (RRi) and heart rate variability (HRV) were calculated on a beat-to-beat basis and the heart rate (HR) at the on- and off-transient were analyzed during an incremental cardiopulmonary exercise test (CPET). Results: MSG showed lower aerobic capacity and lower parasympathetic cardiac modulation at rest compared with CG. HR values in on-transient phase were significantly lower in MSG compared with CG. The exponential amplitudes “amp” and the parameters “τ” [speed of heart rate recovery (HRR)] were lower in MSG. MSG exhibited higher HR values in comparison to CG during the off-transient indicating a slower HRR. In MSG, there was an inverse and significant correlation between fasting plasma vs. ΔF and glucose vs. exponential “τ” of HRR dynamics. Conclusion: MS is associated with poor heart rate kinetics. The altered HR kinetics seems to be related to alterations in cardiac parasympathetic modulation, and glucose metabolism seems to be the major determinant. PMID:28798697

  9. Xenoreactive natural antibodies and induced antibodies--their effects of beating cardiomyocytes as a model of a xenograft.

    Science.gov (United States)

    Müller-Werdan, U; Koidl, B; Autenrieth, A; Klein, D; Werdan, K; Hammer, C

    1996-01-01

    Xenotransplantation has been complicated by hyperacute rejection reactions, which are supposedly triggered by preformed natural antibodies (PNAb) of the recipient organism, whereas the role of antibodies specifically induced by previous antigen contact (IAb) is less clear. Primary cultures of spontaneously beating neonatal rat cardiomyocytes were used as a model of the heart to elaborate the effects of both PNAb and IAb from xenogeneic species and to investigate into their mechanisms of action. An experimental setup allowing for rapid medium exchange under continuous observation was employed. Sera containing PNAb reproducibly bring about a stereotype pattern of altered contractility including an initial increase in beating frequency followed by a temporary cessation of beating within the first minutes after administration. After recovery of spontaneous contractions, the cells within the monolayer exhibited a dissociation of the synchronicity of the beating persisting for several hours. The temporary pause in beating was prevented by a very high extracellular calcium concentration, but not by extracellular electrical stimulation sufficient to trigger contractions in control cells. Electrophysiological measurements carried out in adult ventricular guinea pig heart muscle cells under the same experimental conditions revealed an increase of the excitation threshold of the cells after application of sera containing PNAb due to an enhanced input resistance. These results indicate that the effect of PNAb is the consequence rather of a generally reduced excitability of the cell than of the inhibition of a singular ionic conductance. After specific absorption of PNAb directed against rat antigens beating of neonatal rate cardiomyocytes ensued without interruption. Sera specimens devoid of complement produced similar effects on contractility, although the duration of the standstill period was significantly shorter. The increase in input resistance visualized in guinea pig

  10. Beat-to-beat P-wave morphology as a predictor of paroxysmal atrial fibrillation.

    Science.gov (United States)

    Filos, Dimitrios; Chouvarda, Ioanna; Tachmatzidis, Dimitris; Vassilikos, Vassilios; Maglaveras, Nicos

    2017-11-01

    Atrial Fibrillation (AF) is the most common cardiac arrhythmia. The initiation and the perpetuation of AF is linked with phenomena of atrial remodeling, referring to the modification of the electrical and structural characteristics of the atrium. P-wave morphology analysis can reveal information regarding the propagation of the electrical activity on the atrial substrate. The purpose of this study is to investigate patterns on the P-wave morphology that may occur in patients with Paroxysmal AF (PAF) and which can be the basis for distinguishing between PAF and healthy subjects. Vectorcardiographic signals in the three orthogonal axes (X, Y and Z), of 3-5 min duration, were analyzed during SR. In total 29 PAF patients and 34 healthy volunteers were included in the analysis. These data were divided into two distinct datasets, one for the training and one for the testing of the proposed approach. The method is based on the identification of the dominant and the secondary P-wave morphology by combining adaptive k-means clustering of morphologies and a beat-to-beat cross correlation technique. The P-waves of the dominant morphology were further analyzed using wavelet transform whereas time domain characteristics were also extracted. Following a feature selection step, a SVM classifier was trained, for the discrimination of the PAF patients from the healthy subjects, while its accuracy was tested using the independent testing dataset. In the cohort study, in both groups, the majority of the P-waves matched a main and a secondary morphology, while other morphologies were also present. The percentage of P-waves which simultaneously matched the main morphology in all three leads was lower in PAF patients (90.4 ± 7.8%) than in healthy subjects (95.5 ± 3.4%, p= 0.019). Three optimal scale bands were found and wavelet parameters were extracted which presented statistically significant differences between the two groups. Classification between the two groups was

  11. Drug Beats Steroids for Controlling Blood Vessel Inflammation in Study

    Science.gov (United States)

    ... html Drug Beats Steroids for Controlling Blood Vessel Inflammation in Study With tocilizumab's approval, there's an alternative ... treating the most common form of blood vessel inflammation known as giant cell arteritis, a new study ...

  12. Modulation of attosecond beating in resonant two-photon ionization

    CERN Document Server

    Galán, Álvaro J; Martín, Fernando

    2014-01-01

    We present a theoretical study of the photoelectron attosecond beating at the basis of RABBIT (Reconstruction of Attosecond Beating By Interference of Two-photon transitions) in the presence of autoionizing states. We show that, as a harmonic traverses a resonance, its sidebands exhibit a peaked phase shift as well as a modulation of the beating frequency itself. Furthermore, the beating between two resonant paths persists even when the pump and the probe pulses do not overlap, thus providing a sensitive non-holographic interferometric means to reconstruct coherent metastable wave packets. We characterize these phenomena quantitatively with a general finite-pulse analytical model that accounts for the effect of both intermediate and final resonances on two-photon processes, at a negligible computational cost. The model predictions are in excellent agreement with those of accurate ab initio calculations for the helium atom in the region of the N=2 doubly excited states.

  13. Heritability of wing-beat frequency in Anopheles quadrimaculatus.

    Science.gov (United States)

    Robertson, Shawn P; Caprio, Michael A; Faver, Marla K

    2002-12-01

    The repeatability of male wing-beat frequency measurements of Anopheles quadrimaculatus was determined by using mosquitoes allowed free flight in a confined space. Heritability of the wing-beat frequency trait was estimated for a laboratory and a wild-strain population of An. quadrimaculatus by using free-flight measurement with a parent-offspring regression of offspring on dams. Repeatability was 0.75 for free flight. Wing-beat frequency rose for the 1st day after adult emergence and then became steady. Female heritability of wing-beat frequency was 21.6% for colony and 24.0% for wild-strain mosquitoes. Male heritability was 57.2% for colony and 53.7% for wild-strain mosquitoes. Male heritability was significantly different from 0 when probabilities were combined across both populations.

  14. Heart rate response to breathing

    DEFF Research Database (Denmark)

    Mehlsen, J; Pagh, K; Nielsen, J S

    1987-01-01

    Heart rate responses to stepwise and periodic changes in lung volume were studied in seven young healthy males. Stepwise inspiration and expiration both resulted in an increase in heart rate followed by a rapid decrease in heart rate. The fastest heart rate was reached in 1.6 +/- 0.5 s and in 3.......6 +/- 1.4 s in response to inspiration and expiration, respectively (P less than 0.01). The slowest heart rate was reached in 4.8 +/- 1.0 s and in 7.6 +/- 1.9 s in response to inspiration and expiration, respectively (P less than 0.01). Following this biphasic change the heart rate returned to a steady...... level. The difference between the fastest and the slowest heart rates was significantly larger in response to inspiration (21.7 +/- 7.3 beats per minute) than in response to expiration (12.0 +/- 7.3 beats per minute; P less than 0.01). Periodic changes in lung volume were performed with frequencies from...

  15. When heart goes “BOOM” to fast. Heart rate greater than 80 as mortality predictor in acute myocardial infarction

    OpenAIRE

    Davidovic, Goran; Iric-Cupic, Violeta; Milanov, Srdjan; Dimitijevic, Aleksandra; Petrovic-Janicijevic, Mirjana

    2013-01-01

    Many prospective studies established association between high heart rate and increased cardiovascular morbidity and mortality, independently of other risk factors. Heart rate over 80 beats per minute more often leads to atherosclerotic plaque disruption, the main step in developing acute coronary syndrome. Purpose was to investigate the incidence of higher heart rate levels in patients with anterior wall acute myocardial infarction with ST-segment elevation and the influence of heart rate on ...

  16. Preserving and evaluating hearts with ex vivo machine perfusion: an avenue to improve early graft performance and expand the donor pool.

    Science.gov (United States)

    Collins, Michael J; Moainie, Sina L; Griffith, Bartley P; Poston, Robert S

    2008-08-01

    Cardiac transplantation remains the first choice for the surgical treatment of end stage heart failure. An inadequate supply of donor grafts that meet existing criteria has limited the application of this therapy to suitable candidates and increased interest in extended criteria donors. Although cold storage (CS) is a time-tested method for the preservation of hearts during the ex vivo transport interval, its disadvantages are highlighted in hearts from the extended criteria donor. In contrast, transport of high-risk hearts using hypothermic machine perfusion (MP) provides continuous support of aerobic metabolism and ongoing washout of metabolic byproducts. Perhaps more importantly, monitoring the organ's response to this intervention provides insight into the viability of a heart initially deemed as extended criteria. Obviously, ex vivo MP introduces challenges, such as ensuring homogeneous tissue perfusion and avoiding myocardial edema. Though numerous groups have experimented with this technology, the best perfusate and perfusion parameters needed to achieve optimal results remain unclear. In the present review, we outline the benefits of ex vivo MP with particular attention to how the challenges can be addressed in order to achieve the most consistent results in a large animal model of the ideal heart donor. We provide evidence that MP can be used to resuscitate and evaluate hearts from animal and human extended criteria donors, including the non-heart beating donor, which we feel is the most compelling argument for why this technology is likely to impact the donor pool.

  17. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; D