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Keywords = cardiac force index

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20 pages, 12454 KiB  
Article
Dynamic Virtual Simulation with Real-Time Haptic Feedback for Robotic Internal Mammary Artery Harvesting
by Shuo Wang, Tong Ren, Nan Cheng, Rong Wang and Li Zhang
Bioengineering 2025, 12(3), 285; https://doi.org/10.3390/bioengineering12030285 - 13 Mar 2025
Viewed by 1037
Abstract
Coronary heart disease, a leading global cause of mortality, has witnessed significant advancement through robotic coronary artery bypass grafting (CABG), with the internal mammary artery (IMA) emerging as the preferred “golden conduit” for its exceptional long-term patency. Despite these advances, robotic-assisted IMA harvesting [...] Read more.
Coronary heart disease, a leading global cause of mortality, has witnessed significant advancement through robotic coronary artery bypass grafting (CABG), with the internal mammary artery (IMA) emerging as the preferred “golden conduit” for its exceptional long-term patency. Despite these advances, robotic-assisted IMA harvesting remains challenging due to the absence of force feedback, complex surgical maneuvers, and proximity to the beating heart. This study introduces a novel virtual simulation platform for robotic IMA harvesting that integrates dynamic anatomical modeling and real-time haptic feedback. By incorporating a dynamic cardiac model into the surgical scene, our system precisely simulates the impact of cardiac pulsation on thoracic cavity operations. The platform features high-fidelity representations of thoracic anatomy and soft tissue deformation, underpinned by a comprehensive biomechanical framework encompassing fascia, adipose tissue, and vascular structures. Our key innovations include a topology-preserving cutting algorithm, a bidirectional tissue coupling mechanism, and dual-channel haptic feedback for electrocautery simulation. Quantitative assessment using our newly proposed Spatial Asymmetry Index (SAI) demonstrated significant behavioral adaptations to cardiac motion, with dynamic scenarios yielding superior SAI values compared to static conditions. These results validate the platform’s potential as an anatomically accurate, interactive, and computationally efficient solution for enhancing surgical skill acquisition in complex cardiac procedures. Full article
(This article belongs to the Section Biomedical Engineering and Biomaterials)
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21 pages, 6656 KiB  
Article
A Flexible PVDF Sensor for Forcecardiography
by Salvatore Parlato, Jessica Centracchio, Eliana Cinotti, Gaetano D. Gargiulo, Daniele Esposito, Paolo Bifulco and Emilio Andreozzi
Sensors 2025, 25(5), 1608; https://doi.org/10.3390/s25051608 - 6 Mar 2025
Cited by 1 | Viewed by 1641
Abstract
Forcecardiography (FCG) uses force sensors to record the mechanical vibrations induced on the chest wall by cardiac and respiratory activities. FCG is usually performed via piezoelectric lead-zirconate titanate (PZT) sensors, which simultaneously record the very slow respiratory movements of the chest, the slow [...] Read more.
Forcecardiography (FCG) uses force sensors to record the mechanical vibrations induced on the chest wall by cardiac and respiratory activities. FCG is usually performed via piezoelectric lead-zirconate titanate (PZT) sensors, which simultaneously record the very slow respiratory movements of the chest, the slow infrasonic vibrations due to emptying and filling of heart chambers, the faster infrasonic vibrations due to movements of heart valves, which are usually recorded via Seismocardiography (SCG), and the audible vibrations corresponding to heart sounds, commonly recorded via Phonocardiography (PCG). However, PZT sensors are not flexible and do not adapt very well to the deformations of soft tissues on the chest. This study presents a flexible FCG sensor based on a piezoelectric polyvinylidene fluoride (PVDF) transducer. The PVDF FCG sensor was compared with a well-assessed PZT FCG sensor, as well as with an electro-resistive respiratory band (ERB), an accelerometric SCG sensor, and an electronic stethoscope for PCG. Simultaneous recordings were acquired with these sensors and an electrocardiography (ECG) monitor from a cohort of 35 healthy subjects (16 males and 19 females). The PVDF sensor signals were compared in terms of morphology with those acquired simultaneously via the PZT sensor, the SCG sensor and the electronic stethoscope. Moreover, the estimation accuracies of PVDF and PZT sensors for inter-beat intervals (IBIs) and inter-breath intervals (IBrIs) were assessed against reference ECG and ERB measurements. The results of statistical analyses confirmed that the PVDF sensor provides FCG signals with very high similarity to those acquired via PZT sensors (median cross-correlation index of 0.96 across all subjects) as well as with SCG and PCG signals (median cross-correlation indices of 0.85 and 0.80, respectively). Moreover, the PVDF sensor provides very accurate estimates of IBIs, with R2 > 0.99 and Bland–Altman limits of agreement (LoA) of [−5.30; 5.00] ms, and of IBrIs, with R2 > 0.96 and LoA of [−0.510; 0.513] s. The flexibility of the PVDF sensor makes it more comfortable and ideal for wearable applications. Unlike PZT, PVDF is lead-free, which increases safety and biocompatibility for prolonged skin contact. Full article
(This article belongs to the Special Issue Sensors for Heart Rate Monitoring and Cardiovascular Disease)
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15 pages, 1058 KiB  
Article
The Effect of Rehabilitation Therapy in Children with Intervened Congenital Heart Disease: A Study Protocol of Randomized Controlled Trial Comparing Hospital and Home-Based Rehabilitation
by Mónica Menéndez Pardiñas, Ángeles Sara Fuertes Moure, José Manuel Sanz Mengíbar, Fernando Rueda Núñez, Jorge Cabrera Sarmiento, Javier Martín-Vallejo, Rita Jácome Feijoó, Isabel Duque-Salanova and Juan Luis Sánchez González
J. Clin. Med. 2025, 14(3), 816; https://doi.org/10.3390/jcm14030816 - 26 Jan 2025
Viewed by 2488
Abstract
Background/Objectives: Children who suffer from congenital heart defects (CHDs) have a decreased ability to perform physical exercise and consequently have a decrease in their functional capacity. The main causes of this decrease in functional capacity have been related on the one hand to [...] Read more.
Background/Objectives: Children who suffer from congenital heart defects (CHDs) have a decreased ability to perform physical exercise and consequently have a decrease in their functional capacity. The main causes of this decrease in functional capacity have been related on the one hand to residual hemodynamic defects and, at the same time, to a situation of physical deconditioning due to inactivity, as well as problems in lung function, especially the presence of restrictive patterns that influence the amount of O2 insufflated (decreased maximum VO2), consequently generating a deficient maximum O2 consumption and maximum work rate. This represents an important prognostic value, since it constitutes an independent predictor of death and hospitalization. This study aims to determine the benefits obtained regarding respiratory function, exercise capacity, and quality of life after implementing a hospital-based cardio-respiratory rehabilitation program compared to a home-based Cardio-respiratory Physical Activity Program in patients with intervened CHDs. Methods: This is a randomized controlled trial on the effectiveness of two different rehabilitation programs on respiratory function, exercise capacity, and quality of life in patients with CHDs conducted at the Child Cardiology and Congenital Heart Disease Unit of the University Hospital Complex of A Coruña (CHUAC). There will be two groups: Cardio-respiratory rehabilitation group program conducted in a face-to-face format at the hospital (n = 26) and a study group that follows a home-based Cardio-respiratory Physical Activity Program (TELEA) (n = 26). The measurement variables will be respiratory function, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), maximum expiratory flow (PEF), the Tiffeneau index (FEV1 /FVC), forced expiratory flow (FEF25%, FEF50%, FEF75%, FEF25–75%), exercise capacity (peak VO2), and the quality of life of these children and their families. Conclusions: The implementation of cardiac and pulmonary rehabilitation programs in children with CHDs is essential to improve their quality of life, exercise tolerance, and socialization. These programs optimize life expectancy and promote integration, being crucial for their physical and emotional well-being Full article
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28 pages, 734 KiB  
Protocol
A Protocol Investigation Comparing Transcatheter Repair with the Standard Surgical Procedure for Secondary Mitral Regurgitation
by Francesco Nappi, Sanjeet Singh Avtaar Singh, Antonio Salsano, Aubin Nassif, Yasushige Shingu, Satoru Wakasa, Antonio Fiore, Cristiano Spadaccio and Zein EL-Dean
J. Clin. Med. 2024, 13(24), 7742; https://doi.org/10.3390/jcm13247742 - 18 Dec 2024
Viewed by 1133
Abstract
Background: Secondary mitral regurgitation (SMR) is characterized by a pathological process impacting the left ventricle (LV) as opposed to the mitral valve (MV). In the absence of structural alterations to the MV, the expansion of the LV or impairment of the papillary muscles [...] Read more.
Background: Secondary mitral regurgitation (SMR) is characterized by a pathological process impacting the left ventricle (LV) as opposed to the mitral valve (MV). In the absence of structural alterations to the MV, the expansion of the LV or impairment of the papillary muscles (PMs) may ensue. A number of technical procedures are accessible for the purpose of determining the optimal resolution for MR. Nevertheless, there is a dearth of rigorous data to facilitate a comparative analysis of MV replacement, MV repair (including subvalvular repair), and transcatheter mitral valve interventions (TMV-Is). The objective of this investigation is to evaluate and compare the efficacy and clinical outcomes of transcatheter mitral valve repair (TMV-r) utilizing the edge-to-edge mitral valve repair (TEER) procedure in comparison to conventional surgical mitral valve interventions (S-SMVis) in patients with secondary mitral regurgitation. Methods and analysis: A consortium of five cardiac surgery institutions from four European states and Japan have joined forces to establish a multicenter observational registry, designated TEERMISO. Patients who underwent technical procedures for SMR between January 2007 and December 2023 will be enrolled consecutively into the TEERMISO registry. The investigation team evaluated the comparative efficacy of replacement and repair techniques, utilizing both the standard surgical methodology and the transcatheter intervention. The primary clinical outcome will be the degree of left ventricular remodeling, as assessed by the left ventricular end-diastolic volume index, at 10 years. The forthcoming research will assess a variety of secondary endpoints, among which all-cause mortality will be the primary endpoint. Subsequent assessments will be made in the following order: functional status, hospitalization, neurocognition, physiological measures (echocardiographic assessment), occurrence of adverse clinical incidents, and reoperation. Ethics and dissemination: The multicenter design of the database is anticipated to reduce the potential for bias associated with institutional caseload and surgical experience. All participating centers possess an established mitral valve protocol that facilitates comprehensive follow-up and management of any delayed mitral complications following replacement surgery or surgical repair of the secondary mitral regurgitation. The data collected will provide insights into the impact of diverse surgical approaches on standard mitral valve surgery and TEER. This will facilitate the evaluation of LV remodeling over the course of long-term post-procedural follow-up. Trial Registration: ClinicalTrials.gov ID: NCT05090540; IRB ID: 202201143 Full article
(This article belongs to the Section Cardiology)
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18 pages, 677 KiB  
Article
Comparative Analysis of Heart Rate Variability and Arterial Stiffness in Elite Male Athletes after COVID-19
by Mohamed M. Ammar, Noureddine M. Ben Said, Younes N. Ben Said, Ahmed M. Abdelsalam, Sergey P. Levushkin, Aleksey Laptev, Mokhtar Inoubli and Mehdi Chlif
J. Clin. Med. 2024, 13(19), 5990; https://doi.org/10.3390/jcm13195990 - 8 Oct 2024
Viewed by 2290
Abstract
This study investigated the long-term cardiovascular effects of coronavirus disease (COVID-19) in elite male athletes by comparing the heart rate variability (HRV), arterial stiffness, and other cardiovascular parameters between those with and without prior COVID-19 infection. Methods: This cross-sectional study evaluated 120 elite [...] Read more.
This study investigated the long-term cardiovascular effects of coronavirus disease (COVID-19) in elite male athletes by comparing the heart rate variability (HRV), arterial stiffness, and other cardiovascular parameters between those with and without prior COVID-19 infection. Methods: This cross-sectional study evaluated 120 elite male athletes (60 post COVID-19, 60 controls) using anthropometric measurements, body composition analysis, pulmonary function tests, HRV analysis, arterial stiffness assessments, hemodynamic monitoring, and microcirculatory function tests. Results: Athletes post COVID-19 showed significantly higher lean mass (p = 0.007), forced vital capacity (p = 0.001), and forced expiratory volume in 1 s (p = 0.007) than controls. HRV parameters did not significantly differ between the groups. Post-COVID-19 athletes exhibited peripheral vascular resistance (p = 0.048) and reflection index (p = 0.038). No significant differences were observed in the blood pressure, cardiac output, oxygen saturation, or microcirculatory oxygen absorption. Conclusions: Elite male athletes showed notable cardiovascular resilience after COVID-19, with only minor differences in vascular function. The maintained cardiac autonomic function and improved lung parameters in post-COVID-19 athletes suggests an adaptive response. These findings support the cardiovascular health of elite athletes following COVID-19 but emphasize the importance of continued monitoring. Full article
(This article belongs to the Section Sports Medicine)
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18 pages, 6416 KiB  
Article
The Impact of Contact Force on Signal Quality Indices in Photoplethysmography Measurements
by Joan Lambert Cause, Ángel Solé Morillo, Juan C. García-Naranjo, Johan Stiens and Bruno da Silva
Appl. Sci. 2024, 14(13), 5704; https://doi.org/10.3390/app14135704 - 29 Jun 2024
Cited by 4 | Viewed by 2200
Abstract
Photoplethysmography (PPG) is widely used to assess cardiovascular health. Yet, its effectiveness is often hindered by external factors like contact force (CF), which significantly affects the accuracy and reliability of measurements. This study investigates how variations in the CF at the index fingertips [...] Read more.
Photoplethysmography (PPG) is widely used to assess cardiovascular health. Yet, its effectiveness is often hindered by external factors like contact force (CF), which significantly affects the accuracy and reliability of measurements. This study investigates how variations in the CF at the index fingertips influence six signal quality indices (SQIs)—including the perfusion index, skewness, kurtosis, entropy, zero-crossing rate, and relative power—using data from 11 healthy participants. Our analysis of normalized CF values reveals that lower CF ranges (0.2 to 0.4) may be optimal for extracting information about perfusion and blood flow. However, they may not be the best range to capture all the physiological details within the PPG pulse. In contrast, higher CF ranges (0.4 to 0.6) enable capturing more complex signals that could be physiologically representative. The findings underscore the necessity of considering viscoelastic tissue properties and individual biomechanical differences, advocating for both the normalization of CF for improved cross-subject comparison and personalized CF calibration to adapt PPG devices to diverse populations. These strategies ensure measurement reliability and consistency, thereby advancing the accuracy of cardiac and vascular assessments. Our study offers guidelines for adjusting the CF levels to balance signal detail and perfusion quality, customized to meet specific analytical requirements, with direct implications for both clinical and research environments. Full article
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50 pages, 6181 KiB  
Article
Conocarpus lancifolius (Combretaceae): Pharmacological Effects, LC-ESI-MS/MS Profiling and In Silico Attributes
by Muhammad Khurm, Yuting Guo, Qingqing Wu, Xinxin Zhang, Muhammad Umer Ghori, Muhammad Fawad Rasool, Imran Imran, Fatima Saqib, Muqeet Wahid and Zengjun Guo
Metabolites 2023, 13(7), 794; https://doi.org/10.3390/metabo13070794 - 27 Jun 2023
Cited by 3 | Viewed by 3419
Abstract
In folklore medicine, Conocarpus lancifolius is used to treat various illnesses. The main objective of this study was a comprehensive investigation of Conocarpus lancifolius leaf aqueous extract (CLAE) for its antioxidant, cardioprotective, anxiolytic, antidepressant and memory-enhancing capabilities by using different in vitro, in [...] Read more.
In folklore medicine, Conocarpus lancifolius is used to treat various illnesses. The main objective of this study was a comprehensive investigation of Conocarpus lancifolius leaf aqueous extract (CLAE) for its antioxidant, cardioprotective, anxiolytic, antidepressant and memory-enhancing capabilities by using different in vitro, in vivo and in silico models. The in vitro experimentation revealed that CLAE consumed an ample amount of total phenolics (67.70 ± 0.15 µg GAE/mg) and flavonoids (47.54 ± 0.45 µg QE/mg) with stronger antiradical effects through DPPH (IC50 = 16.66 ± 0.42 µg/mL), TAC (77.33 ± 0.41 µg AAE/mg) and TRP (79.11 ± 0.67 µg GAE/mg) assays. The extract also displayed suitable acetylcholinesterase (AChE) inhibitory (IC50 = 110.13 ± 1.71 µg/mL) activity through a modified Ellman’s method. The toxicology examination presented no mortality or any signs of clinical toxicity in both single-dose and repeated-dose tests. In line with the cardioprotective study, the pretreatment of CLAE was found to be effective in relieving the isoproterenol (ISO)-induced myocardial injury in rats by normalizing the heart weight index, serum cardiac biomarkers, lipid profile and various histopathological variations. In the noise-stress-induced model for behavior attributes, the results demonstrated that CLAE has the tendency to increase the time spent in the central zone and elevated open arms in the open field and elevated plus maze tests (examined for anxiety assessment), reduced periods of immobility in the forced swimming test (for depression) and improved recognition and working memory in the novel object recognition and Morris water maze tests, respectively. Moreover, the LC-ESI-MS/MS profiling predicted 53 phytocompounds in CLAE. The drug-likeness and ADMET analysis exhibited that the majority of the identified compounds have reasonable physicochemical and pharmacokinetic profiles. The co-expression of molecular docking and network analysis indicated that top-ranked CLAE phytoconstituents act efficiently against the key proteins and target multiple signaling pathways to exert its cardiovascular-protectant, anxiolytic, antidepressant and memory-enhancing activity. Hence, this artifact illustrates that the observed biological properties of CLAE elucidate its significance as a sustainable source of bioactive phytochemicals, which appears to be advantageous for pursuing further studies for the development of new therapeutic agents of desired interest. Full article
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14 pages, 1085 KiB  
Article
Diagnostic Usefulness of Spiroergometry and Risk Factors of Long COVID in Patients with Normal Left Ventricular Ejection Fraction
by Katarzyna Gryglewska-Wawrzak, Agata Sakowicz, Maciej Banach, Ibadete Bytyçi and Agata Bielecka-Dabrowa
J. Clin. Med. 2023, 12(12), 4160; https://doi.org/10.3390/jcm12124160 - 20 Jun 2023
Cited by 3 | Viewed by 2434
Abstract
The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has brought forth various clinical manifestations and long-term complications, including a condition known as long COVID. Long COVID refers to a persistent set of symptoms that continue beyond the acute phase of the disease. [...] Read more.
The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has brought forth various clinical manifestations and long-term complications, including a condition known as long COVID. Long COVID refers to a persistent set of symptoms that continue beyond the acute phase of the disease. This study investigated the risk factors and the utility of spiroergometry parameters for diagnosing patients with long COVID symptoms. The 146 patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with normal left ventricular ejection fraction and without respiratory diseases were included and divided into two groups: the group demonstrating long COVID symptoms [n = 44] and the group without long COVID symptoms [n = 102]. The clinical examinations, laboratory test results, echocardiography, non-invasive body mass analysis, and spiroergometry were evaluated. ClinicalTrials.gov Identifier: NCT04828629. Patients with long COVID symptoms had significantly higher age [58 (vs.) 44 years; p < 0.0001], metabolic age [53 vs. 45 years; p = 0.02)], left atrial diameter (LA) [37 vs. 35 mm; p = 0.04], left ventricular mass index (LVMI) [83 vs. 74 g/m2, p = 0.04], left diastolic filling velocity (A) [69 vs. 64 cm/s, p = 0.01], the ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic mitral annular motion (E/E’) [7.35 vs. 6.05; p = 0.01], and a lower ratio of early to late diastolic transmitral flow velocity (E/A) [1.05 vs. 1.31; p = 0.01] compared to the control group. In cardiopulmonary exercise testing (CPET), long COVID patients presented lower forced vital capacity (FVC) [3.6 vs. 4.3 L; p < 0.0001], maximal oxygen consumption measured during incremental exercise indexed per kilogram (VO2max) [21 vs. 23 mL/min/kg; p = 0.04], respiratory exchange ratio (RER) [1.0 vs. 1.1; p = 0.04], forced expiratory volume in one second (FEV1) [2.90 vs. 3.25 L; p = 0.04], and a higher ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC%) [106 vs. 100%; p = 0.0002]. The laboratory results pointed out that patients with long COVID symptoms also had a lower rate of red blood cells (RBC) [4.4 vs. 4.6 × 106/uL; p = 0.01]; a higher level of glucose [92 vs. 90 mg/dL; p = 0.03]; a lower glomerular filtration rate (GFR) estimate by Modification of Diet in Renal Disease (MDRD) [88 vs. 95; p = 0.03]; and a higher level of hypersensitive cardiac Troponin T (hs-cTnT) [6.1 vs. 3.9 pg/mL; p = 0.04]. On the multivariate model, only FEV1/FVC% (OR 6.27, 95% CI: 2.64–14.86; p < 0.001) independently predicted the long COVID symptoms. Using the ROC analysis, the FEV1/FVC% ≥ 103 was the most powerful predictor of spiroergometry parameters (0.67 sensitive, 0.71 specific, AUC of 0.73; p < 0.001) in predicting the symptoms of long COVID. Spiroergometry parameters are useful in diagnosing long COVID and differentiating it from cardiovascular disease. Full article
(This article belongs to the Special Issue JCM-Advances in Cardiology, Part 2)
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10 pages, 938 KiB  
Article
Value of Left Atrial Strain in Predicting Recurrence after Atrial Fibrillation Ablation
by Marek Kiliszek, Beata Uziębło-Życzkowska, Krystian Krzyżanowski, Agnieszka Jurek, Robert Wierzbowski, Magdalena Smalc-Stasiak and Paweł Krzesiński
J. Clin. Med. 2023, 12(12), 4034; https://doi.org/10.3390/jcm12124034 - 13 Jun 2023
Cited by 9 | Viewed by 1817
Abstract
This study tested the relationship between left atrial (LA) function parameters and the results of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Consecutive patients undergoing PVI for the first time between 2019 and 2021 were included. Patients underwent radiofrequency ablation [...] Read more.
This study tested the relationship between left atrial (LA) function parameters and the results of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Consecutive patients undergoing PVI for the first time between 2019 and 2021 were included. Patients underwent radiofrequency ablation using contact force catheters and an electroanatomical system. Follow-up consisted of ambulatory visits/televisits and 7-day Holter monitoring (at 6 and 12 months after ablation). On the day of ablation, all patients underwent transesophageal and transthoracic echocardiography with LA strain analysis. The primary endpoint was atrial tachyarrhythmia recurrence during the follow-up period. Of 221 patients, 22 did not meet the echocardiographic quality criteria, leaving 199 patients. The median follow-up period was 12 months, and 12 patients were lost to follow-up. Recurrences were observed in 67 patients (35.8%) after a mean of 1.06 procedures per patient. The patients were divided into a sinus rhythm (SR, n = 109) group and an AF (n = 90) group based on their cardiac rhythm at the time of echocardiography. In the SR group, univariable analysis showed that LA reservoir strain, LA appendage emptying velocity (LAAV), and LA volume index predicted AF recurrence, with only LAAV being significant in the multivariable analysis. In AF patients, univariable analysis revealed no LA strain parameters predicting AF recurrence. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
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12 pages, 267 KiB  
Article
Echocardiographic Findings in Asymptomatic Mediastinal Lymphoma Survivors Years after Treatment Termination
by Izabela Nabiałek-Trojanowska, Hanna Jankowska, Grzegorz Sławiński, Alicja Dąbrowska-Kugacka and Ewa Lewicka
J. Clin. Med. 2023, 12(10), 3427; https://doi.org/10.3390/jcm12103427 - 12 May 2023
Viewed by 2192
Abstract
Patients treated due to mediastinal lymphomas are at risk of cardiovascular complications, as they receive chemotherapy, usually containing anthracyclines, often combined with thoracic radiotherapy. The aim of this prospective study was to assess early asymptomatic cardiac dysfunction using resting and dobutamine stress echocardiography [...] Read more.
Patients treated due to mediastinal lymphomas are at risk of cardiovascular complications, as they receive chemotherapy, usually containing anthracyclines, often combined with thoracic radiotherapy. The aim of this prospective study was to assess early asymptomatic cardiac dysfunction using resting and dobutamine stress echocardiography (DSE) at least 3 years after the end of mediastinal lymphoma treatment. Two groups of patients were compared: those treated with chemoradiotherapy and those exclusively treated with chemotherapy. Left ventricular contractile reserve (LVCR) during DSE was assessed using changes in LV ejection fraction (LVEF), LV global longitudinal strain (LV GLS), and a novel parameter—Force, which is the ratio of the systolic blood pressure to the LV end-systolic volume. The study included 60 patients examined at a median of 89 months after the end of treatment. Resting echocardiography showed normal LVEF of 58.9 ± 9.6%, borderline LV GLS of −17.7 ± 3%, decreased mean stroke volume (SV) of 51.4 ± 17 mL, and indexed SV of 27.3 ± 8 mL/m2, and the right ventricular free wall longitudinal strain (LS) was impaired in some patients but not in all. There were no significant differences between the groups, with the exception of arterial hypertension, which was more common in the chemotherapy group (32% vs. 62.5%, p = 0.04). In resting echocardiography, only LV posterior wall LS differed significantly and was impaired in patients treated with chemotherapy (−19.1 ± 3.1% vs. −16.5 ± 5.1%, p = 0.04). DSE, performed in 21 patients after a median of 166 months from the end of cancer treatment, detected new contractility disorders in 1 patient (4.8%) and decreased LVCR in the majority of patients when determined using changes in LVEF or LV GLS, and in all patients when assessed with changes in Force. Conclusions: Most asymptomatic mediastinal lymphoma survivors showed preserved ventricular function on resting echocardiography. However, all of them showed impaired LV contractile reserve on DSE, as assessed with a simple parameter—Force. This may indicate subtle LV dysfunction and confirms the need for long-term monitoring of patients with potentially cardiotoxic cancer treatment. Full article
17 pages, 3403 KiB  
Article
Changes in Forcecardiography Heartbeat Morphology Induced by Cardio-Respiratory Interactions
by Jessica Centracchio, Daniele Esposito, Gaetano D. Gargiulo and Emilio Andreozzi
Sensors 2022, 22(23), 9339; https://doi.org/10.3390/s22239339 - 30 Nov 2022
Cited by 12 | Viewed by 2500
Abstract
The cardiac function is influenced by respiration. In particular, various parameters such as cardiac time intervals and the stroke volume are modulated by respiratory activity. It has long been recognized that cardio-respiratory interactions modify the morphology of cardio-mechanical signals, e.g., phonocardiogram, seismocardiogram (SCG), [...] Read more.
The cardiac function is influenced by respiration. In particular, various parameters such as cardiac time intervals and the stroke volume are modulated by respiratory activity. It has long been recognized that cardio-respiratory interactions modify the morphology of cardio-mechanical signals, e.g., phonocardiogram, seismocardiogram (SCG), and ballistocardiogram. Forcecardiography (FCG) records the weak forces induced on the chest wall by the mechanical activity of the heart and lungs and relies on specific force sensors that are capable of monitoring respiration, infrasonic cardiac vibrations, and heart sounds, all simultaneously from a single site on the chest. This study addressed the changes in FCG heartbeat morphology caused by respiration. Two respiratory-modulated parameters were considered, namely the left ventricular ejection time (LVET) and a morphological similarity index (MSi) between heartbeats. The time trends of these parameters were extracted from FCG signals and further analyzed to evaluate their consistency within the respiratory cycle in order to assess their relationship with the breathing activity. The respiratory acts were localized in the time trends of the LVET and MSi and compared with a reference respiratory signal by computing the sensitivity and positive predictive value (PPV). In addition, the agreement between the inter-breath intervals estimated from the LVET and MSi and those estimated from the reference respiratory signal was assessed via linear regression and Bland–Altman analyses. The results of this study clearly showed a tight relationship between the respiratory activity and the considered respiratory-modulated parameters. Both the LVET and MSi exhibited cyclic time trends that remarkably matched the reference respiratory signal. In addition, they achieved a very high sensitivity and PPV (LVET: 94.7% and 95.7%, respectively; MSi: 99.3% and 95.3%, respectively). The linear regression analysis reported almost unit slopes for both the LVET (R2 = 0.86) and MSi (R2 = 0.97); the Bland–Altman analysis reported a non-significant bias for both the LVET and MSi as well as limits of agreement of ±1.68 s and ±0.771 s, respectively. In summary, the results obtained were substantially in line with previous findings on SCG signals, adding to the evidence that FCG and SCG signals share a similar information content. Full article
(This article belongs to the Special Issue Human Signal Processing Based on Wearable Non-invasive Device)
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11 pages, 1765 KiB  
Article
Feasibility of Brachial Occlusion Technique for Beat-to-Beat Pulse Wave Analysis
by Lukas Matera, Pavol Sajgalik, Vratislav Fabian, Yegor Mikhailov, David Zemanek and Bruce D. Johnson
Sensors 2022, 22(19), 7285; https://doi.org/10.3390/s22197285 - 26 Sep 2022
Viewed by 2035
Abstract
Czech physiologist Penaz tried to overcome limitations of invasive pulse-contour methods (PCM) in clinical applications by a non-invasive method (finger mounted BP cuff) for continuous arterial waveform detection and beat-to-beat analysis. This discovery resulted in significant interest in human physiology and non-invasive examination [...] Read more.
Czech physiologist Penaz tried to overcome limitations of invasive pulse-contour methods (PCM) in clinical applications by a non-invasive method (finger mounted BP cuff) for continuous arterial waveform detection and beat-to-beat analysis. This discovery resulted in significant interest in human physiology and non-invasive examination of hemodynamic parameters, however has limitations because of the distal BP recording using a volume-clamp method. Thus, we propose a validation of beat-to-beat signal analysis acquired by novel a brachial occlusion-cuff (suprasystolic) principle and signal obtained from Finapres during a forced expiratory effort against an obstructed airway (Valsalva maneuver). Twelve healthy adult subjects [2 females, age = (27.2 ± 5.1) years] were in the upright siting position, breathe through the mouthpiece (simultaneously acquisition by brachial blood pressure monitor and Finapres) and at a defined time were asked to generate positive mouth pressure for 20 s (Valsalva). For the purpose of signal analysis, we proposed parameter a “Occlusion Cuff Index” (OCCI). The assumption about similarities between measured signals (suprasystolic brachial pulse waves amplitudes and Finapres’s MAP) were proved by averaged Pearson’s correlation coefficient (r- = 0.60, p < 0.001). The averaged Pearson’s correlation coefficient for the comparative analysis of OCCI between methods was r- = 0.88, p < 0.001. The average percent change of OCCI during maneuver: 8% increase, 19% decrease and percent change of max/min ratio is 35%. The investigation of brachial pulse waves measured by novel brachial blood pressure monitor shows positive correlation with Finapres and the parameter OCCI shows promise as an index, which could describe changes during beat-to-beat cardiac cycles. Full article
(This article belongs to the Topic Machine Learning and Biomedical Sensors)
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10 pages, 972 KiB  
Article
Prognostic Significance of the N-Terminal Pro-B-Type Natriuretic Peptide in Lung Transplant Candidates on the Waiting List
by Shimon Izhakian, Assaf Frajman, Lev Freidkin, Osnat Shtraichman, Dror Rosengarten, Barak Pertzov, Yaron D. Barac and Mordechai Reuven Kramer
Diagnostics 2022, 12(9), 2112; https://doi.org/10.3390/diagnostics12092112 - 31 Aug 2022
Cited by 3 | Viewed by 1643
Abstract
We investigated the prognostic significance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in lung transplant candidates, in a retrospective single-center study. Data regarding various baseline characteristics and all-cause mortality were collected for 205 lung transplant candidates placed on waitlist for transplantation from November 2017 [...] Read more.
We investigated the prognostic significance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in lung transplant candidates, in a retrospective single-center study. Data regarding various baseline characteristics and all-cause mortality were collected for 205 lung transplant candidates placed on waitlist for transplantation from November 2017 to December 2019. Associations of NT-proBNP levels with baseline characteristics and mortality were analyzed. Results showed NT-proBNP values correlated positively with age, forced vital capacity, mean pulmonary artery pressure (MPAP), and pulmonary capillary wedge pressure; and negatively with diffusing lung capacity for carbon monoxide and cardiac index. The optimal cut-off of NT-proBNP for predicting MPAP levels > 35 mmHg was 251 pg/mL; with 58.1% sensitivity, 85.7% specificity, 45.0% positive predictive value, and 91.0% negative predictive value. During a median follow-up period of 2.2 years, 97 patients underwent lung transplantation, 42 died waiting for donation, and 66 were alive and still waiting for transplantations. On multivariate analysis, higher NT-proBNP levels were strongly associated with increased mortality among waitlisted lung transplant candidates (HR 1.49, 95% CI 1.10–2.03, p = 0.01). In conclusion NT-proBNP can predict mortality among waitlisted lung transplant candidates. Lower levels of NT-proBNP can preclude severe pulmonary artery hypertension. Assessment of NT-proBNP may improve risk stratification among lung transplant candidates. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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11 pages, 812 KiB  
Article
Olfactory Stimulation with Volatile Aroma Compounds of Basil (Ocimum basilicum L.) Essential Oil and Linalool Ameliorates White Fat Accumulation and Dyslipidemia in Chronically Stressed Rats
by Da-Som Kim, Seong-Jun Hong, Sojeong Yoon, Seong-Min Jo, Hyangyeon Jeong, Moon-Yeon Youn, Young-Jun Kim, Jae-Kyeom Kim and Eui-Cheol Shin
Nutrients 2022, 14(9), 1822; https://doi.org/10.3390/nu14091822 - 27 Apr 2022
Cited by 9 | Viewed by 9056
Abstract
We explored the physiological effects of inhaling basil essential oil (BEO) and/or linalool and identified odor-active aroma compounds in BEO using gas chromatography/mass spectrometry (GC–MS) and GC–olfactometry (GC–O). Linalool was identified as the major volatile compound in BEO. Three groups of rats were [...] Read more.
We explored the physiological effects of inhaling basil essential oil (BEO) and/or linalool and identified odor-active aroma compounds in BEO using gas chromatography/mass spectrometry (GC–MS) and GC–olfactometry (GC–O). Linalool was identified as the major volatile compound in BEO. Three groups of rats were administered BEO and linalool via inhalation, while rats in the control group were not. Inhalation of BEO for 20 min only reduced the total weight gain (190.67 ± 2.52 g) and increased the forced swimming time (47.33 ± 14.84 s) compared with the control group (219.67 ± 2.08 g, 8.33 ± 5.13 s). Inhalation of BEO for 5 min (392 ± 21 beats/min) only reduced the pulse compared with the control group (420 ± 19 beats/min). Inhalation of linalool only reduced the weight of white adipose tissue (5.75 ± 0.61 g). The levels of stress-related hormones were not significantly different among the groups. The total cholesterol and triglyceride levels decreased after inhalation of BEO for 20 min (by more than −10% and −15%, respectively). Low-density lipoprotein cholesterol levels were lowered (by more than −10%) by the inhalation of BEO and linalool, regardless of the inhalation time. In particular, BEO inhalation for 20 min was associated with the lowest level of low-density lipoprotein cholesterol (53.94 ± 2.72 mg/dL). High-density lipoprotein cholesterol levels increased after inhalation of BEO (by more than +15%). The atherogenic index and cardiac risk factors were suppressed by BEO inhalation. Animals exposed to BEO and linalool had no significant differences in hepatotoxicity. These data suggest that the inhalation of BEO and linalool may ameliorate cardiovascular and lipid dysfunctions. These effects should be explored further for clinical applications. Full article
(This article belongs to the Special Issue Functional Properties of Natural Products and Human Health)
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12 pages, 2240 KiB  
Article
A Comparison of Heart Pulsations Provided by Forcecardiography and Double Integration of Seismocardiogram
by Emilio Andreozzi, Jessica Centracchio, Daniele Esposito and Paolo Bifulco
Bioengineering 2022, 9(4), 167; https://doi.org/10.3390/bioengineering9040167 - 9 Apr 2022
Cited by 24 | Viewed by 3424
Abstract
Seismocardiography (SCG) is largely regarded as the state-of-the-art technique for continuous, long-term monitoring of cardiac mechanical activity in wearable applications. SCG signals are acquired via small, lightweight accelerometers fixed on the chest. They provide timings of important cardiac events, such as heart valves [...] Read more.
Seismocardiography (SCG) is largely regarded as the state-of-the-art technique for continuous, long-term monitoring of cardiac mechanical activity in wearable applications. SCG signals are acquired via small, lightweight accelerometers fixed on the chest. They provide timings of important cardiac events, such as heart valves openings and closures, thus allowing the estimation of cardiac time intervals of clinical relevance. Forcecardiography (FCG) is a novel technique that records the cardiac-induced vibrations of the chest wall by means of specific force sensors, which proved capable of monitoring respiration, heart sounds and infrasonic cardiac vibrations, simultaneously from a single contact point on the chest. A specific infrasonic component captures the heart walls displacements and looks very similar to the Apexcardiogram. This low-frequency component is not visible in SCG recordings, nor it can be extracted by simple filtering. In this study, a feasible way to extract this information from SCG signals is presented. The proposed approach is based on double integration of SCG. Numerical double integration is usually very prone to large errors, therefore a specific numerical procedure was devised. This procedure yields a new displacement signal (DSCG) that features a low-frequency component (LF-DSCG) very similar to that of the FCG (LF-FCG). Experimental tests were carried out using an FCG sensor and an off-the-shelf accelerometer firmly attached to each other and placed onto the precordial region. Simultaneous recordings were acquired from both sensors, together with an electrocardiogram lead (used as a reference). Quantitative morphological comparison confirmed the high similarity between LF-FCG and LF-DSCG (normalized cross-correlation index >0.9). Statistical analyses suggested that LF-DSCG, although achieving a fair sensitivity in heartbeat detection (about 90%), has not a very high consistency within the cardiac cycle, leading to inaccuracies in inter-beat intervals estimation. Future experiments with high-performance accelerometers and improved processing methods are envisioned to investigate the potential enhancement of the accuracy and reliability of the proposed method. Full article
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