Search results for: cardiac left ventricle.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 315

Search results for: cardiac left ventricle.

315 Modeling of Blood Flow Velocity into the Main Artery via Left Ventricle of Heart during Steady Condition

Authors: Mohd Azrul Hisham Mohd Adib, Nur Hazreen Mohd Hasni

Abstract:

A three-dimensional and pulsatile blood flow in the left ventricle of heart model has been studied numerically. The geometry was derived from a simple approximation of the left ventricle model and the numerical simulations were obtained using a formulation of the Navier-Stokes equations. In this study, simulation was used to investigate the pattern of flow velocity in 3D model of heart with consider the left ventricle based on critical parameter of blood under steady condition. Our results demonstrate that flow velocity focused from mitral valve channel and continuous linearly to left ventricle wall but this skewness progresses into outside wall in atrium through aortic valve with random distribution that is irregular due to force subtract from ventricle wall during cardiac cycle. The findings are the prediction of the behavior of the blood flow velocity pattern in steady flow condition which can assist the medical practitioners in their decision on the patients- treatments.

Keywords: Mitral Valve, Aortic Valve, Cardiac Cycle, Leaflet, Biomechanics, Left Ventricle

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314 Automatic LV Segmentation with K-means Clustering and Graph Searching on Cardiac MRI

Authors: Hae-Yeoun Lee

Abstract:

Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring, which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.

Keywords: Cardiac MRI, Graph searching, Left ventricle segmentation, K-means clustering.

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313 A Robust and Efficient Segmentation Method Applied for Cardiac Left Ventricle with Abnormal Shapes

Authors: Peifei Zhu, Zisheng Li, Yasuki Kakishita, Mayumi Suzuki, Tomoaki Chono

Abstract:

Segmentation of left ventricle (LV) from cardiac ultrasound images provides a quantitative functional analysis of the heart to diagnose disease. Active Shape Model (ASM) is widely used for LV segmentation, but it suffers from the drawback that initialization of the shape model is not sufficiently close to the target, especially when dealing with abnormal shapes in disease. In this work, a two-step framework is improved to achieve a fast and efficient LV segmentation. First, a robust and efficient detection based on Hough forest localizes cardiac feature points. Such feature points are used to predict the initial fitting of the LV shape model. Second, ASM is applied to further fit the LV shape model to the cardiac ultrasound image. With the robust initialization, ASM is able to achieve more accurate segmentation. The performance of the proposed method is evaluated on a dataset of 810 cardiac ultrasound images that are mostly abnormal shapes. This proposed method is compared with several combinations of ASM and existing initialization methods. Our experiment results demonstrate that accuracy of the proposed method for feature point detection for initialization was 40% higher than the existing methods. Moreover, the proposed method significantly reduces the number of necessary ASM fitting loops and thus speeds up the whole segmentation process. Therefore, the proposed method is able to achieve more accurate and efficient segmentation results and is applicable to unusual shapes of heart with cardiac diseases, such as left atrial enlargement.

Keywords: Hough forest, active shape model, segmentation, cardiac left ventricle.

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312 Left Ventricular Model Using Second Order Electromechanical Coupling: Effects of Viscoelastic Damping

Authors: Elie H. Karam, Antoine B. Abche

Abstract:

It is known that the heart interacts with and adapts to its venous and arterial loading conditions. Various experimental studies and modeling approaches have been developed to investigate the underlying mechanisms. This paper presents a model of the left ventricle derived based on nonlinear stress-length myocardial characteristics integrated over truncated ellipsoidal geometry, and second-order dynamic mechanism for the excitation-contraction coupling system. The results of the model presented here describe the effects of the viscoelastic damping element of the electromechanical coupling system on the hemodynamic response. Different heart rates are considered to study the pacing effects on the performance of the left-ventricle against constant preload and afterload conditions under various damping conditions. The results indicate that the pacing process of the left ventricle has to take into account, among other things, the viscoelastic damping conditions of the myofilament excitation-contraction process.

Keywords: Myocardial sarcomere, cardiac pump, excitationcontraction coupling, viscoelasicity

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311 Left Ventricular Model to Study the Combined Viscoelastic, Heart Rate, and Size Effects

Authors: Elie H. Karam, Antoine B. Abche

Abstract:

It is known that the heart interacts with and adapts to its venous and arterial loading conditions. Various experimental studies and modeling approaches have been developed to investigate the underlying mechanisms. This paper presents a model of the left ventricle derived based on nonlinear stress-length myocardial characteristics integrated over truncated ellipsoidal geometry, and second-order dynamic mechanism for the excitation-contraction coupling system. The results of the model presented here describe the effects of the viscoelastic damping element of the electromechanical coupling system on the hemodynamic response. Different heart rates are considered to study the pacing effects on the performance of the left-ventricle against constant preload and afterload conditions under various damping conditions. The results indicate that the pacing process of the left ventricle has to take into account, among other things, the viscoelastic damping conditions of the myofilament excitation-contraction process. The effects of left ventricular dimensions on the hemdynamic response have been examined. These effects are found to be different at different viscoelastic and pacing conditions.

Keywords: Myocardial sarcomere, cardiac pump, excitationcontractioncoupling, viscoelasicity

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310 3D Shape Modelling of Left Ventricle: Towards Correlation of Myocardial Scintigraphy Data and Coronarography Result

Authors: A. Ben Abdallah, H. Essabbah, M. H. Bedoui

Abstract:

The myocardial sintigraphy is an imaging modality which provides functional informations. Whereas, coronarography modality gives useful informations about coronary arteries anatomy. In case of coronary artery disease (CAD), the coronarography can not determine precisely which moderate lesions (artery reduction between 50% and 70%), known as the “gray zone", are haemodynamicaly significant. In this paper, we aim to define the relationship between the location and the degree of the stenosis in coronary arteries and the observed perfusion on the myocardial scintigraphy. This allows us to model the impact evolution of these stenoses in order to justify a coronarography or to avoid it for patients suspected being in the gray zone. Our approach is decomposed in two steps. The first step consists in modelling a coronary artery bed and stenoses of different location and degree. The second step consists in modelling the left ventricle at stress and at rest using the sphercical harmonics model and myocardial scintigraphic data. We use the spherical harmonics descriptors to analyse left ventricle model deformation between stress and rest which permits us to conclude if ever an ischemia exists and to quantify it.

Keywords: Spherical harmonics model, vascular bed, 3D reconstruction, left ventricle, myocardial scintigraphy.

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309 Development and Evaluation of a Dynamic Cardiac Phantom for use in Nuclear Medicine

Authors: Marcos A. Dullius, Ramon C. Fernandes, Divanízia N. Souza

Abstract:

The aim of this study was to develop a dynamic cardiac phantom for quality control in myocardial scintigraphy. The dynamic heart phantom constructed only contained the left ventricle, made of elastic material (latex), comprising two cavities: one internal and one external. The data showed a non-significant variation in the values of left ventricular ejection fraction (LVEF) obtained by varying the heart rate. It was also possible to evaluate the ejection fraction (LVEF) through different arrays of image acquisition and to perform an intercomparison of LVEF by two different scintillation cameras. The results of the quality control tests were satisfactory, showing that they can be used as parameters in future assessments. The new dynamic heart phantom was demonstrated to be effective for use in LVEF measurements. Therefore, the new heart simulator is useful for the quality control of scintigraphic cameras.

Keywords: sheart, nuclear medicine, phantom

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308 Shape Restoration of the Left Ventricle

Authors: May-Ling Tan, Yi Su, Chi-Wan Lim, Liang Zhong, Ru-San Tan

Abstract:

This paper describes an automatic algorithm to restore the shape of three-dimensional (3D) left ventricle (LV) models created from magnetic resonance imaging (MRI) data using a geometry-driven optimization approach. Our basic premise is to restore the LV shape such that the LV epicardial surface is smooth after the restoration. A geometrical measure known as the Minimum Principle Curvature (κ2) is used to assess the smoothness of the LV. This measure is used to construct the objective function of a two-step optimization process. The objective of the optimization is to achieve a smooth epicardial shape by iterative in-plane translation of the MRI slices. Quantitatively, this yields a minimum sum in terms of the magnitude of κ 2, when κ2 is negative. A limited memory quasi-Newton algorithm, L-BFGS-B, is used to solve the optimization problem. We tested our algorithm on an in vitro theoretical LV model and 10 in vivo patient-specific models which contain significant motion artifacts. The results show that our method is able to automatically restore the shape of LV models back to smoothness without altering the general shape of the model. The magnitudes of in-plane translations are also consistent with existing registration techniques and experimental findings.

Keywords: Magnetic Resonance Imaging, Left Ventricle, ShapeRestoration, Principle Curvature, Optimization

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307 Cardiac Function and Morphological Adaptations in Endurance and Resistance Athletes: Evaluation using a new Method

Authors: K. Hosseini, MD., R. Mazaheri, MD., H.R. Khoddami Vishteh, MD., M.A. Mansournia, MD., H. Angoorani, MD

Abstract:

Background: Tissue Doppler Echocardiography (TDE) assesses diastolic function more accurately than routine pulse Doppler echo. Assessment of the effects of dynamic and static exercises on the heart by using TDE can provides new information about the athlete-s heart syndrome. Methods: This study was conducted on 20 elite wrestlers, 14 endurance runners at national level and 21 non-athletes as the control group. Participants underwent two-dimensional echocardiography, standard Doppler and TDE. Results: Wrestlers had the highest left ventricular mass index, enddiastolic inter-ventricular septum thickness and left ventricular Posterior wall thickness. Runners had the highest Left ventricular end-diastolic volume, LV ejection fraction, stroke volume and cardiac output. In TDE, the early diastolic velocity of mitral annulus to the late diastolic velocity ratio in athletic groups was greater than the controls with no significant difference. Conclusion: In spite of cardiac morphological changes in athletes, TDE shows that cardiac diastolic function won-t be adversely affected.

Keywords: Tissue Doppler Echocardiography, Diastolic function, Athlete's heart syndrome, Static exercise, Dynamic exercise

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306 Another Structure of Weakly Left C-wrpp Semigroups

Authors: Enxiao Yuan, Xiaomin Zhang

Abstract:

It is known that a left C-wrpp semigroup can be described as curler structure of a left band and a C-wrpp semigroup. In this paper, we introduce the class of weakly left C-wrpp semigroups which includes the class of weakly left C-rpp semigroups as a subclass. We shall particularly show that the spined product of a left C-wrpp semigroup and a right normal band is a weakly left C-wrpp semifroup. Some equivalent characterizations of weakly left C-wrpp semigroups are obtained. Our results extend that of left C-wrpp semigroups.

Keywords: Left C-wrpp semigroup, left quasi normal regular band, weakly left C-wrpp semigroup.

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305 The Structure of Weakly Left C-wrpp Semigroups

Authors: Xiaomin Zhang

Abstract:

In this paper, the class of weakly left C-wrpp semigroups which includes the class of weakly left C-rpp semigroups as a subclass is introduced. To particularly show that the spined product of a left C-wrpp semigroup and a right normal band which is a weakly left C-wrpp semifroup by virtue of left C-full Ehremann cyber groups recently obtained by authors Li-Shum, results obtained by Tang and Du-Shum are extended and strengthened.

Keywords: Left C-semigroup, left C-wrpp semigroup, left quasinormal band, weakly left C-wrpp semigroup

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304 A Sensorless Robust Tracking Control of an Implantable Rotary Blood Pump for Heart Failure Patients

Authors: Mohsen A. Bakouri, Andrey V. Savkin, Abdul-Hakeem H. Alomari, Robert F. Salamonsen, Einly Lim, Nigel H. Lovell

Abstract:

Physiological control of a left ventricle assist device (LVAD) is generally a complicated task due to diverse operating environments and patient variability. In this work, a tracking control algorithm based on sliding mode and feed forward control for a class of discrete-time single input single output (SISO) nonlinear uncertain systems is presented. The controller was developed to track the reference trajectory to a set operating point without inducing suction in the ventricle. The controller regulates the estimated mean pulsatile flow Qp and mean pulsatility index of pump rotational speed PIω that was generated from a model of the assist device. We recall the principle of the sliding mode control theory then we combine the feed-forward control design with the sliding mode control technique to follow the reference trajectory. The uncertainty is replaced by its upper and lower boundary. The controller was tested in a computer simulation covering two scenarios (preload and ventricular contractility). The simulation results prove the effectiveness and the robustness of the proposed controller

Keywords: robust control system, discrete-sliding mode, left ventricularle assist devicse, pulsatility index.

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303 Study of Chest Pain and its Risk Factors in Over 30 Year-Old Individuals

Authors: S. Dabiran

Abstract:

Chest pain is one of the most prevalent complaints among adults that cause the people to attend to medical centers. The aim was to determine the prevalence and risk factors of chest pain among over 30 years old people in Tehran. In this cross-sectional study, 787 adults took part from Apr 2005 until Apr 2006. The sampling method was random cluster sampling and there were 25 clusters. In each cluster, interviews were performed with 32 over 30 years old, people lived in those houses. In cases with chest pain, extra questions asked. The prevalence of CP was 9% (71 cases). Of them 21 cases (6.5%) were in 41-60 year age ranges and the remainders were over 61 year old. 19 cases (26.8%) mentioned CP in resting state and all of the cases had exertion onset CP. The CP duration was 10 minutes or less in all of the cases and in most of them (84.5%), the location of pain mentioned left anterior part of chest, left anterior part of sternum and or left arm. There was positive history of myocardial infarction in 12 cases (17%). There was significant relation between CP and age, sex and between history of myocardial infarction and marital state of study people. Our results are similar to other studies- results in most parts, however it is necessary to perform supplementary tests and follow up studies to differentiate between cardiac and non-cardiac CP exactly.

Keywords: Chest pain, myocardial infarction, risk factor, prevalence

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302 S-Fuzzy Left h-Ideal of Hemirings

Authors: D.R Prince Williams

Abstract:

The notion of S-fuzzy left h-ideals in a hemiring is introduced and it's basic properties are investigated.We also study the homomorphic image and preimage of S-fuzzy left h-ideal of hemirings.Using a collection of left h-ideals of a hemiring, S-fuzzy left h-ideal of hemirings are established.The notion of a finite-valued S-fuzzy left h-ideal is introduced,and its characterization is given.S-fuzzy relations on hemirings are discussed.The notion of direct product and S-product are introduced and some properties of the direct product and S-product of S-fuzzy left h-ideal of hemiring are also discussed.

Keywords: hemiring, left h-ideal, anti fuzzy h-ideal, S-fuzzy left hideal, t-conorm , homomorphism.

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301 Involving Action Potential Morphology on a New Cellular Automata Model of Cardiac Action Potential Propagation

Authors: F. Pourhasanzade, S. H. Sabzpoushan

Abstract:

Computer modeling has played a unique role in understanding electrocardiography. Modeling and simulating cardiac action potential propagation is suitable for studying normal and pathological cardiac activation. This paper presents a 2-D Cellular Automata model for simulating action potential propagation in cardiac tissue. We demonstrate a novel algorithm in order to use minimum neighbors. This algorithm uses the summation of the excitability attributes of excited neighboring cells. We try to eliminate flat edges in the result patterns by inserting probability to the model. We also preserve the real shape of action potential by using linear curve fitting of one well known electrophysiological model.

Keywords: Cellular Automata, Action Potential Propagation, cardiac tissue, Isotropic Pattern, accurate shape of cardiac actionpotential.

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300 Amelioration of Cardiac Arrythmias Classification Performance Using Artificial Neural Network, Adaptive Neuro-Fuzzy and Fuzzy Inference Systems Classifiers

Authors: Alexandre Boum, Salomon Madinatou

Abstract:

This paper aims at bringing a scientific contribution to the cardiac arrhythmia biomedical diagnosis systems; more precisely to the study of the amelioration of cardiac arrhythmia classification performance using artificial neural network, adaptive neuro-fuzzy and fuzzy inference systems classifiers. The purpose of this amelioration is to enable cardiologists to make reliable diagnosis through automatic cardiac arrhythmia analyzes and classifications based on high confidence classifiers. In this study, six classes of the most commonly encountered arrhythmias are considered: the Right Bundle Branch Block, the Left Bundle Branch Block, the Ventricular Extrasystole, the Auricular Extrasystole, the Atrial Fibrillation and the Normal Cardiac rate beat. From the electrocardiogram (ECG) extracted parameters, we constructed a matrix (360x360) serving as an input data sample for the classifiers based on neural networks and a matrix (1x6) for the classifier based on fuzzy logic. By varying three parameters (the quality of the neural network learning, the data size and the quality of the input parameters) the automatic classification permitted us to obtain the following performances: in terms of correct classification rate, 83.6% was obtained using the fuzzy logic based classifier, 99.7% using the neural network based classifier and 99.8% for the adaptive neuro-fuzzy based classifier. These results are based on signals containing at least 360 cardiac cycles. Based on the comparative analysis of the aforementioned three arrhythmia classifiers, the classifiers based on neural networks exhibit a better performance.

Keywords: Adaptive neuro-fuzzy, artificial neural network, cardiac arrythmias, fuzzy inference systems.

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299 Linear Maps That Preserve Left Spectrum of Diagonal Quaternionic Matrices

Authors: Geng Yuan, Yiwan Guo, Fahui Zhai, Shuhua Zhang

Abstract:

In this paper, we discuss some properties of left spectrum and give the representation of linear preserver map the left spectrum of diagonal quaternionic matrices.

Keywords: Quaternionic matrix, left spectrum, linear preserver map.

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298 Relative Injective Modules and Relative Flat Modules

Authors: Jianmin Xing, Rufeng Xing

Abstract:

Let R be a ring, n a fixed nonnegative integer. The concepts of (n, 0)-FI-injective and (n, 0)-FI-flat modules, and then give some characterizations of these modules over left n-coherent rings are introduced . In addition, we investigate the left and right n-FI-resolutions of R-modules by left (right) derived functors Extn(−,−) (Torn(−,−) ) over a left n-coherent ring, where n-FI stands for the categories of all (n, 0)- injective left R-modules. These modules together with the left or right derived functors are used to study the (n, 0)-injective dimensions of modules and rings.

Keywords: (n, 0)-injective module, (n, 0)-injective dimension, (n, 0)-FI-injective(flat) module, (Pre)cover, (Pre)envelope.

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297 Computational Study on Cardiac-Coronary Interaction in Terms of Coronary Flow-Pressure Waveforms in Presence of Drugs: Comparison Between Simulated and In Vivo Data

Authors: C. De Lazzari, E. Del Prete, I. Genuini, F. Fedele

Abstract:

Cardiovascular human simulator can be a useful tool in understanding complex physiopathological process in cardiocirculatory system. It can also be a useful tool in order to investigate the effects of different drugs on hemodynamic parameters. The aim of this work is to test the potentiality of our cardiovascular numerical simulator CARDIOSIM© in reproducing flow/pressure coronary waveforms in presence of two different drugs: Amlodipine (AMLO) and Adenosine (ADO). In particular a time-varying intramyocardial compression, assumed to be proportional to the left ventricular pressure, was related to the venous coronary compliances in order to study its effects on the coronary blood flow and the flow/pressure loop. Considering that coronary circulation dynamics is strongly interrelated with the mechanics of the left ventricular contraction, relaxation, and filling, the numerical model allowed to analyze the effects induced by the left ventricular pressure on the coronary flow.

Keywords: Cardiovascular system, Coronary blood flow, Hemodynamic, Numerical simulation.

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296 Neighbors of Indefinite Binary Quadratic Forms

Authors: Ahmet Tekcan

Abstract:

In this paper, we derive some algebraic identities on right and left neighbors R(F) and L(F) of an indefinite binary quadratic form F = F(x, y) = ax2 + bxy + cy2 of discriminant Δ = b2 -4ac. We prove that the proper cycle of F can be given by using its consecutive left neighbors. Also we construct a connection between right and left neighbors of F.

Keywords: Quadratic form, indefinite form, cycle, proper cycle, right neighbor, left neighbor.

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295 Powering Pacemakers from Heart Pressure Variation with Piezoelectric Energy Harvesters

Authors: A. Mathieu, B. Aubry, E. Chhim, M. Jobe, M. Arnaud

Abstract:

Present project consists in a study and a development of piezoelectric devices for supplying power to new generation pacemakers. They are miniaturized leadless implants without battery placed directly in right ventricle. Amongst different acceptable energy sources in cardiac environment, we choose the solution of a device based on conversion of the energy produced by pressure variation inside the heart into electrical energy. The proposed energy harvesters can meet the power requirements of pacemakers, and can be a good solution to solve the problem of regular surgical operation. With further development, proposed device should provide enough energy to allow pacemakers autonomy, and could be good candidate for next pacemaker generation.

Keywords: Energy harvester, heart, leadless pacemaker, piezoelectric cells, pressure variation.

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294 New Echocardiographic Morphofunctional Diastolic Index (MFDI) in Differentiation of Normal Left Ventricular Filling from Pseudonormal and Restrictive

Authors: N. Nelasov, D. Safonov, M. Babaev, E. Mirzojan, O. Eroshenko, M. Morgunov, A. Erofeeva

Abstract:

We have shown previously that reflected high intensity motion signals (RIMS) can be used for detection of left ventricular (LV) diastolic dysfunction (DD). It is also well known, that left atrial (LA) dimension can be used as a marker of DD. In this study we decided to analyze the diagnostic role of new echocardiographic morphofunctional diastolic index (MFDI) in differentiation of normal filling of LV from pseudonormal and restrictive. MFDI includes LA dimension and velocity of early diastolic component ea of RIMS (MFDI = LA/ea).  

343 healthy subjects and patients with various cardiac pathology underwent dopplerechocardiographic exam. According to the criteria of "Don" classification scheme 155 subjects had signs of normal LV filling (N) and 55 - of pseudonormal and restrictive filling (PN + R). LA dimension was performed in standard manner. RIMS were registered by conventional pulsed wave Doppler from apical 4-chamber view, when the sample volume was positioned between the tips of mitral leaflets. The velocity of early diastolic component of RIMS was measured. After calculation of MFDI mean values of this index in two groups (N and PN + R) were compared. The cutoff value of MFDI for differentiation of patients with N and PN + R was determined.

Mean value of MFDI in subjects with normal filling was 1.38+0.33 and in patients with pseudonormal and restrictive filling 2.43+0.43; p<0.0001. The cutoff value of MFDI > 2.0 separated subjects with normal LV filling from subjects with pseudonormal and restrictive filling with sensitivity 89.1% and specificity 97.4%.

Keywords: Dopplerechocardiography, diastolic dysfunction, left atrium, reflected high intensity motion signals.

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293 On Weakly Prime and Weakly Quasi-Prime Fuzzy Left Ideals in Ordered Semigroups

Authors: Jian Tang

Abstract:

In this paper, we first introduce the concepts of weakly prime and weakly quasi-prime fuzzy left ideals of an ordered semigroup S. Furthermore, we give some characterizations of weakly prime and weakly quasi-prime fuzzy left ideals of an ordered semigroup S by the ordered fuzzy points and fuzzy subsets of S.

Keywords: Ordered semigroup, ordered fuzzy point, weakly prime fuzzy left ideal, weakly quasi-prime fuzzy left ideal.

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292 Thermosensitive Hydrogel Development for Its Possible Application in Cardiac Cell Therapy

Authors: Lina Paola Orozco-Marín, Yuliet Montoya, John Bustamante

Abstract:

Ischemic events can culminate in acute myocardial infarction with irreversible cardiac lesions that cannot be restored due to the limited regenerative capacity of the heart. Tissue engineering proposes therapeutic alternatives by using biomaterials to resemble the native extracellular medium combined with healthy and functional cells. This research focused on developing a natural thermosensitive hydrogel, its physical-chemical characterization and in vitro biocompatibility determination. Hydrogels’ morphological characterization was carried out through scanning electron microscopy and its chemical characterization by employing Infrared Spectroscopy technic. In addition, the biocompatibility was determined using fetal human ventricular cardiomyocytes cell line RL-14 and the MTT cytotoxicity test according to the ISO 10993-5 standard. Four biocompatible and thermosensitive hydrogels were obtained with a three-dimensional internal structure and two gelation times. The results show the potential of the hydrogel to increase the cell survival rate to the cardiac cell therapies under investigation and lay the foundations to continue with its characterization and biological evaluation both in vitro and in vivo models.

Keywords: cardiac cell therapy, cardiac ischemia, natural polymers, thermosensitive hydrogel

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291 Obstacles as Switches between Different Cardiac Arrhythmias

Authors: Daniel Olmos-Liceaga

Abstract:

Ventricular fibrillation is a very important health problem as is the cause of most of the sudden deaths in the world. Waves of electrical activity are sent by the SA node, propagate through the cardiac tissue and activate the mechanisms of cell contraction, and therefore are responsible to pump blood to the body harmonically. A spiral wave is an abnormal auto sustainable wave that is responsible of certain types of arrhythmias. When these waves break up, give rise to the fibrillation regime, in which there is a complete loss in the coordination of the contraction of the heart muscle. Interaction of spiral waves and obstacles is also of great importance as it is believed that the attachment of a spiral wave to an obstacle can provide with a transition of two different arrhythmias. An obstacle can be partially excitable or non excitable. In this talk, we present a numerical study of the interaction of meandering spiral waves with partially and non excitable obstacles and focus on the problem where the obstacle plays a fundamental role in the switch between different spiral regimes, which represent different arrhythmic regimes. Particularly, we study the phenomenon of destabilization of spiral waves due to the presence of obstacles, a phenomenon not completely understood (This work will appear as a Chapter in a Book named Cardiac Arrhytmias by INTECH under the name "Spiral Waves, Obstacles and Cardiac Arrhythmias", ISBN 979-953-307-050-5.).

Keywords: Arrhythmias, Cardiac tissue, Obstacles, Spiral waves

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290 Impact of Standardized Therapeutic Hypothermia Protocol on Neurological Performance after Resuscitation from Cardiac Arrest

Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

Abstract:

We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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289 Design and Simulation of Portable Telemedicine System for High Risk Cardiac Patients

Authors: V. Thulasi Bai, Srivatsa S. K.

Abstract:

Deaths from cardiovascular diseases have decreased substantially over the past two decades, largely as a result of advances in acute care and cardiac surgery. These developments have produced a growing population of patients who have survived a myocardial infarction. These patients need to be continuously monitored so that the initiation of treatment can be given within the crucial golden hour. The available conventional methods of monitoring mostly perform offline analysis and restrict the mobility of these patients within a hospital or room. Hence the aim of this paper is to design a Portable Cardiac Telemedicine System to aid the patients to regain their independence and return to an active work schedule, there by improving the psychological well being. The portable telemedicine system consists of a Wearable ECG Transmitter (WET) and a slightly modified mobile phone, which has an inbuilt ECG analyzer. The WET is placed on the body of the patient that continuously acquires the ECG signals from the high-risk cardiac patients who can move around anywhere. This WET transmits the ECG to the patient-s Bluetooth enabled mobile phone using blue tooth technology. The ECG analyzer inbuilt in the mobile phone continuously analyzes the heartbeats derived from the received ECG signals. In case of any panic condition, the mobile phone alerts the patients care taker by an SMS and initiates the transmission of a sample ECG signal to the doctor, via the mobile network.

Keywords: WET, ECG analyzer, Bluetooth, mobilecellular network, high risk cardiac patients.

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288 Human Immunodeficiency Virus Infection and Cardiac Autonomic Neuropathy

Authors: Sharan Badiger, Prema T. Akkasaligar, Deepak Kadeli

Abstract:

Human Immunodeficiency Virus is known to affect almost all organ systems in the body. In addition to central nervous system it also affects the autonomic nervous system. Autonomic nervous dysfunction has been known to severely affect the quality of life in human immunodeficiency virus positive patients. It is known to have caused fatal consequences in late stages of the disease in patients who go in for invasive diagnostic or therapeutic procedures. The aim of this review is to determine the incidence, clinical significance and frequency of cardiac autonomic neuropathy in patients human immunodeficiency virus infection.

Keywords: Autonomic nervous system, autonomic nervous dysfunction, cardiac autonomic dysfunction, human immunodeficiency virus.

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287 Possible Exposure of Persons with Cardiac Pacemakers to Extremely Low Frequency (ELF) Electric and Magnetic Fields

Authors: Leena Korpinen, Rauno Pääkkönen, Fabriziomaria Gobba, Vesa Virtanen

Abstract:

The number of persons with implanted cardiac pacemakers (PM) has increased in Western countries. The aim of this paper is to investigate the possible situations where persons with a PM may be exposed to extremely low frequency (ELF) electric (EF) and magnetic fields (MF) that may disturb their PM. Based on our earlier studies, it is possible to find such high public exposure to EFs only in some places near 400 kV power lines, where an EF may disturb a PM in unipolar mode. Such EFs cannot be found near 110 kV power lines. Disturbing MFs can be found near welding machines. However, we do not have measurement data from welding. Based on literature and earlier studies at Tampere University of Technology, it is difficult to find public EF or MF exposure that is high enough to interfere with PMs.

Keywords: Cardiac Pacemaker, Electric Field, Magnetic Field.

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286 Brief Review of the Self-Tightening, Left-Handed Thread

Authors: Robert S. Giachetti, Emanuele Grossi

Abstract:

Loosening of bolted joints in rotating machines can adversely affect their performance, cause mechanical damage, and lead to injuries. In this paper, two potential loosening phenomena in rotating applications are discussed. First, ‘precession,’ is governed by thread/nut contact forces, while the second is based on inertial effects of the fastened assembly. These mechanisms are reviewed within the context of historical usage of left-handed fasteners in rotating machines which appears absent in the literature and common machine design texts. Historically, to prevent loosening of wheel nuts, vehicle manufacturers have used right-handed and left-handed threads on different sides of the vehicle, but most modern vehicles have abandoned this custom and only use right-handed, tapered lug nuts on all sides of the vehicle. Other classical machines such as the bicycle continue to use different handed threads on each side while other machines such as, bench grinders, circular saws and brush cutters still use left-handed threads to fasten rotating components. Despite the continued use of left-handed fasteners, the rationale and analysis of left-handed threads to mitigate self-loosening of fasteners in rotating applications is not commonly, if at all, discussed in the literature or design textbooks. Without scientific literature to support these design selections, these implementations may be the result of experimental findings or aged institutional knowledge. Based on a review of rotating applications, historical documents and mechanical design references, a formal study of the paradoxical nature of left-handed threads in various applications is merited.

Keywords: Rotating machinery, self-loosening fasteners, wheel fastening, vibration loosening.

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