Search results for: arterial stenosis

Authors: Susannah G. Fleming Lionel Tarassenko

Abstract:

The photoplethysmogram (PPG) is the pulsatile waveform produced by the pulse oximeter, which is widely used for monitoring arterial oxygen saturation in patients. Various methods for extracting the breathing rate from the PPG waveform have been compared using a consistent data set, and a novel technique using autoregressive modelling is presented. This novel technique is shown to outperform the existing techniques, with a mean error in breathing rate of 0.04 breaths per minute.

Keywords: Autoregressive modelling, breathing rate, photoplethysmogram, pulse oximetry.

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Authors: Houman Tamaddon, Mehrdad Behnia, Masud Behnia

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An accurate study of blood flow is associated with an accurate vascular pattern and geometrical properties of the organ of interest. Due to the complexity of vascular networks and poor accessibility in vivo, it is challenging to reconstruct the entire vasculature of any organ experimentally. The objective of this study is to introduce an innovative approach for the reconstruction of a full vascular tree from available morphometric data. Our method consists of implementing morphometric data on those parts of the vascular tree that are smaller than the resolution of medical imaging methods. This technique reconstructs the entire arterial tree down to the capillaries. Vessels greater than 2 mm are obtained from direct volume and surface analysis using contrast enhanced computed tomography (CT). Vessels smaller than 2mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray’s Laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray’s Laws to every vessel bifurcation simultaneously, lead to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the first capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-defined Strahler system, are assigned. During the simulation, we used the averaged flow rate for each order to predict the pressure drop and once the pressure drop is predicted, the flow rate is corrected to match the computed pressure drop for each vessel. The final results for 3 cardiac cycles is presented and compared to the clinical data.

Keywords: Blood flow, Morphometric data, Vascular tree, Strahler ordering system.

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Authors: Ehsan Saghapour, Somayeh Zandian

Abstract:

Image segmentation is an important step in image processing. Major developments in medical imaging allow physicians to use potent and non-invasive methods in order to evaluate structures, performance and to diagnose human diseases. In this study, an active contour was used to extract vessel networks from color retina images. Automatic analysis of retina vessels facilitates calculation of arterial index which is required to diagnose some certain retinopathies.

Keywords: Active contour, retinal vessel segmentation, image processing.

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Authors: S. Seyedtabaii, L. Seyedtabaii

Abstract:

Artifact free photoplethysmographic (PPG) signals are necessary for non-invasive estimation of oxygen saturation (SpO2) in arterial blood. Movement of a patient corrupts the PPGs with motion artifacts, resulting in large errors in the computation of Sp02. This paper presents a study on using Kalman Filter in an innovative way by modeling both the Artillery Blood Pressure (ABP) and the unwanted signal, additive motion artifact, to reduce motion artifacts from corrupted PPG signals. Simulation results show acceptable performance regarding LMS and variable step LMS, thus establishing the efficacy of the proposed method.

Keywords: Kalman filter, Motion artifact, PPG, Photoplethysmography.

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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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Authors: Tae-Hyub Hong, Choeng-Ryul Choi, Chang-Nyung Kim

Abstract:

Human heart valves diseased by congenital heart defects, rheumatic fever, bacterial infection, cancer may cause stenosis or insufficiency in the valves. Treatment may be with medication but often involves valve repair or replacement (insertion of an artificial heart valve). Bileaflet mechanical heart valves (BMHVs) are widely implanted to replace the diseased heart valves, but still suffer from complications such as hemolysis, platelet activation, tissue overgrowth and device failure. These complications are closely related to both flow characteristics through the valves and leaflet dynamics. In this study, the physiological flow interacting with the moving leaflets in a bileaflet mechanical heart valve (BMHV) is simulated with a strongly coupled implicit fluid-structure interaction (FSI) method which is newly organized based on the Arbitrary-Lagrangian-Eulerian (ALE) approach and the dynamic mesh method (remeshing) of FLUENT. The simulated results are in good agreement with previous experimental studies. This study shows the applicability of the present FSI model to the complicated physics interacting between fluid flow and moving boundary.

Keywords: Bileaflet Mechanical Heart Valve, Fluid- Structure Interaction.

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Authors: L. Ashok Kumar, C. Nagarajan

Abstract:

The ultrasound imaging is very popular to diagnosis the disease because of its non-invasive nature. The ultrasound imaging slowly produces low quality images due to the presence of spackle noise and wave interferences. There are several algorithms to be proposed for the segmentation of ultrasound carotid artery images but it requires a certain limit of user interaction. The pixel in an image is highly correlated so the spatial information of surrounding pixels may be considered in the process of image segmentation which improves the results further. When data is highly correlated, one pixel may belong to more than one cluster with different degree of membership. There is an important step to computerize the evaluation of arterial disease severity using segmentation of carotid artery lumen in 2D and 3D ultrasonography and in finding vulnerable atherosclerotic plaques susceptible to rupture which can cause stroke.

Keywords: IMT measurement, Image Segmentation, common carotid artery, internal and external carotid arteries, ultrasound imaging.

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Authors: Pengdi Diao, Zhuo Wang, Zundong Zhang, Hua Cheng

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In the urban traffic network, the intersections are the “bottleneck point" of road network capacity. And the arterials are the main body in road network and the key factor which guarantees the normal operation of the city-s social and economic activities. The rapid increase in vehicles leads to seriously traffic jam and cause the increment of vehicles- delay. Most cities of our country are traditional single control system, which cannot meet the need for the city traffic any longer. In this paper, Synchro6.0 as a platform to minimize the intersection delay, optimizesingle signal cycle and split for Zhonghua Street in Handan City. Meanwhile, linear control system uses to optimize the phase for the t arterial road in this system. Comparing before and after use the control, capacities and service levels of this road and the adjacent road have improved significantly.

Keywords: linear control system; delay mode; signal optimization; synchro6.0 simulation

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Authors: Ali Pashaee, Parisa Shooshtari, Gholamreza Atae, Nasser Fatouraee

Abstract:

Phase-Contrast MR imaging methods are widely used for measurement of blood flow velocity components. Also there are some other tools such as CT and Ultrasound for velocity map detection in intravascular studies. These data are used in deriving flow characteristics. Some clinical applications are investigated which use pressure distribution in diagnosis of intravascular disorders such as vascular stenosis. In this paper an approach to the problem of measurement of intravascular pressure field by using velocity field obtained from flow images is proposed. The method presented in this paper uses an algorithm to calculate nonlinear equations of Navier- Stokes, assuming blood as an incompressible and Newtonian fluid. Flow images usually suffer the lack of spatial resolution. Our attempt is to consider the effect of spatial resolution on the pressure distribution estimated from this method. In order to achieve this aim, velocity map of a numerical phantom is derived at six different spatial resolutions. To determine the effects of vascular stenoses on pressure distribution, a stenotic phantom geometry is considered. A comparison between the pressure distribution obtained from the phantom and the pressure resulted from the algorithm is presented. In this regard we also compared the effects of collocated and staggered computational grids on the pressure distribution resulted from this algorithm.

Keywords: Flow imaging, pressure distribution estimation, phantom, resolution.

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Authors: Rassoli Aisa, Abrishami Movahhed Arezu, Faturaee Nasser, Seddighi Amir Saeed, Shafigh Mohammad

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Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.

Keywords: Fung’s quasilinear viscoelastic (QLV) model, strain rate, stress relaxation test, uniaxial tensile test, viscoelastic behavior.

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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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Authors: M. Maimunah, G. A. Froemming, H. Nawawi, M. I. Nafeeza, O. Effat, M. Y. Rosmadi, M. S. Mohamed Saifulaman

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Atherosclerosis was identified as a chronic inflammatory process resulting from interactions between plasma lipoproteins, cellular components (monocyte, macrophages, T lymphocytes, endothelial cells and smooth muscle cells) and the extracellular matrix of the arterial wall. Several types of genes were known to express during formation of atherosclerosis. This study is carried out to identify unknown differentially expressed gene (DEG) in atherogenesis. Rabbit’s aorta tissues were stained by H&E for histomorphology. GeneFishing™ PCR analysis was performed from total RNA extracted from the aorta tissues. The DNA fragment from DEG was cloned, sequenced and validated by Real-time PCR. Histomorphology showed intimal thickening in the aorta. DEG detected from ACP-41 was identified as cathepsin B gene and showed upregulation at week-8 and week-12 of atherogenesis. Therefore, ACP-based GeneFishing™ PCR facilitated identification of cathepsin B gene which was differentially expressed during development of atherosclerosis.

Keywords: Atherosclerosis, GeneFishing™ PCR, cathepsin B gene.

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Authors: Xi Gu, Guan Heng Yeoh, Victoria Timchenko

Abstract:

In the current work, a three-dimensional geometry of a 75% stenosed blood vessel is analyzed. Large eddy simulation (LES) with the help of a dynamic subgrid scale Smagorinsky model is applied to model the turbulent pulsatile flow. The geometry, the transmural pressure and the properties of the blood and the elastic boundary were based on clinical measurement data. For the flexible wall model, a thin solid region is constructed around the 75% stenosed blood vessel. The deformation of this solid region was modelled as a deforming boundary to reduce the computational cost of the solid model. Fluid-structure interaction is realized via a twoway coupling between the blood flow modelled via LES and the deforming vessel. The information of the flow pressure and the wall motion was exchanged continually during the cycle by an arbitrary Lagrangian-Eulerian method. The boundary condition of current time step depended on previous solutions. The fluctuation of the velocity in the post-stenotic region was analyzed in the study. The axial velocity at normalized position Z=0.5 shows a negative value near the vessel wall. The displacement of the elastic boundary was concerned in this study. In particular, the wall displacement at the systole and the diastole were compared. The negative displacement at the stenosis indicates a collapse at the maximum velocity and the deceleration phase.

Keywords: Large Eddy Simulation, Fluid Structural Interaction, Constricted Artery, Computational Fluid Dynamics.

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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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Authors: M. Ricardo Lang, A. Costa, I. Iesbik, K. Haag, L. Trindade Buffara, O. Reimann Junior, C. Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with systemic arterial hypertension (SAH) being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyslipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: Biomarkers, population, stroke, sex, stroke unit.

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Authors: Srimuruganandam. B, S.M. Shiva Nagendra

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In this paper the influence of heterogeneous traffic on the temporal variation of ambient PM10, PM2.5 and PM1 concentrations at a busy arterial route (Sardar Patel Road) in the Chennai city has been analyzed. The hourly PM concentration, traffic counts and average speed of the vehicles have been monitored at the study site for one week (19th-25th January 2009). Results indicated that the concentrations of coarse (PM10) and fine PM (PM2.5 and PM1) concentrations at SP road are having similar trend during peak and non-peak hours, irrespective of the days. The PM concentrations showed daily two peaks corresponding to morning (8 to 10 am) and evening (7 to 9 pm) peak hour traffic flow. The PM10 concentration is dominated by fine particles (53% of PM2.5 and 45% of PM1). The high PM2.5/PM10 ratio indicates that the majority of PM10 particles originate from re-suspension of road dust. The analysis of traffic flow at the study site showed that 2W, 3W and 4W are having similar diurnal trend as PM concentrations. This confirms that the 2W, 3W and 4W are the main emission source contributing to ambient PM concentration at SP road. The speed measurement at SP road showed that the average speed of 2W, 3W, 4W, LCV and HCV are 38, 40, 38, 40 and 38 km/hr and 43, 41, 42, 40 and 41 km/hr respectively for the weekdays and weekdays.

Keywords: particulate matter, heterogeneous traffic, fineparticles, coarse particles, vehicle speed, weekend and weekday.

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Authors: Muhibul Haque Bhuyan, Md. Refat Sarder

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If a person can monitor his/her oxygen saturation level intermittently then he/she can identify his/her condition early and thus he/she can seek a doctor’s help. This paper reports the design, simulation, and implementation of a low-cost pulse oxygen saturation measurement device based on a reflective photoplethysmography (PPG) system using an integrated circuit sensor as the fundamental component of this health status checking device. The measurement of the physiological parameter is the blood oxygen saturation level (SpO₂) in the peripheral capillary. This work has been implemented using an Arduino Uno R3 microcontroller along with this sensor integrated circuit (IC). The system is designed in the Proteus environment and then simulated to check its performance. After that, the hardware implementation is performed. We used a clipping type optical sensor to sense the arterial oxygen saturation level of blood signal from the fingertips of an individual and then transformed it into the digital data in the microcontroller through its programming its instruction. The designed system was tested by measuring the SpO₂ level for several people of different ages, from 12 to 57 years of age. Besides, the same people were tested using a standard machine purchased from the market. Test results were found very satisfactory as the average percentage of error was very low, 1.59% only.

Keywords: Digital pulse oxygen saturation level, oximeter, measurement, design, simulation, implementation, proteus, Arduino Uno microcontroller.

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Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

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Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the brief communication article type with the aim to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen's level in blood after non-surgical periodontal treatment of periodontitis in the patient's oral cavity, is a common consequence supported by literature sources. Also, the influence of a high amount of fibrinogen in blood on the occurrence of arteriosclerosis at the same patient, is also another important data that again rely on many sources of literature. Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: Fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment.

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Authors: Nahla H. Alaswadko, Rayya A. Hassan, Bayar N. Mohammed

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Empirical deterministic models have been developed to predict roughness progression of heavy duty spray sealed pavements for a dataset representing rural arterial roads. The dataset provides a good representation of the relevant network and covers a wide range of operating and environmental conditions. A sample with a large size of historical time series data for many pavement sections has been collected and prepared for use in multilevel regression analysis. The modelling parameters include road roughness as performance parameter and traffic loading, time, initial pavement strength, reactivity level of subgrade soil, climate condition, and condition of drainage system as predictor parameters. The purpose of this paper is to report the approaches adopted for models development and validation. The study presents multilevel models that can account for the correlation among time series data of the same section and to capture the effect of unobserved variables. Study results show that the models fit the data very well. The contribution and significance of relevant influencing factors in predicting roughness progression are presented and explained. The paper concludes that the analysis approach used for developing the models confirmed their accuracy and reliability by well-fitting to the validation data.

Keywords: Roughness progression, empirical model, pavement performance, heavy duty pavement.

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: Healthcare for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device.

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Authors: Gesine Hellwig

Abstract:

Functional imaging procedures for the non-invasive assessment of tissue microcirculation are highly requested, but require a mathematical approach describing the trans- and intercapillary passage of tracer particles. Up to now, two theoretical, for the moment different concepts have been established for tracer kinetic modeling of contrast agent transport in tissues: pharmacokinetic compartment models, which are usually written as coupled differential equations, and the indicator dilution theory, which can be generalized in accordance with the theory of lineartime- invariant (LTI) systems by using a convolution approach. Based on mathematical considerations, it can be shown that also in the case of an open two-compartment model well-known from functional imaging, the concentration-time course in tissue is given by a convolution, which allows a separation of the arterial input function from a system function being the impulse response function, summarizing the available information on tissue microcirculation. Due to this reason, it is possible to integrate the open two-compartment model into the system-theoretic concept of indicator dilution theory (IDT) and thus results known from IDT remain valid for the compartment approach. According to the long number of applications of compartmental analysis, even for a more general context similar solutions of the so-called forward problem can already be found in the extensively available appropriate literature of the seventies and early eighties. Nevertheless, to this day, within the field of biomedical imaging – not from the mathematical point of view – there seems to be a trench between both approaches, which the author would like to get over by exemplary analysis of the well-known model.

Keywords: Functional imaging, Tracer kinetic modeling, LTIsystem, Indicator dilution theory / convolution approach, Two-Compartment model.

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Authors: H. Naghawi, M. Abu Shattal, W. Idewu

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Side friction factors can be defined as all activities taking place at the side of the road and within the traffic stream, which would negatively affect the traffic stream performance. If the effect of these factors is adequately addressed and managed, traffic stream performance and capacity could be improved. The main objective of this paper is to identify and assess the impact of different side friction factors on traffic stream performance of a hypothesized urban arterial road. Hypothetical data were assumed mainly because there is no road operating under ideal conditions, with zero side friction, in the developing countries. This is important for the creation of the base model which is important for comparison purposes. For this purpose, three essential steps were employed. Step one, a hypothetical base model was developed under ideal traffic and geometric conditions. Step two, 18 hypothetical alternative scenarios were developed including side friction factors such as on-road parking, pedestrian movement, and the presence of trucks in the traffic stream. These scenarios were evaluated for one, two, and three lane configurations and under different traffic volumes ranging from low to high. Step three, the impact of side friction, of each scenario, on speed-flow models was evaluated using AIMSUN microscopic traffic simulation software. Generally, it was found that, a noticeable negative shift in the speed flow curves from the base conditions was observed for all scenarios. This indicates negative impact of the side friction factors on free flow speed and traffic stream average speed as well as on capacity.

Keywords: AIMSUN, parked vehicles, pedestrians, side friction, traffic performance, trucks.

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