Search results for: cardiac autonomic dysfunction

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

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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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Authors: V. I. Thajudin Ahamed, P. Dhanasekaran, A. Naseem, N. G. Karthick, T. K. Abdul Jaleel, Paul K.Joseph

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It is established that the instantaneous heart rate (HR) of healthy humans keeps on changing. Analysis of heart rate variability (HRV) has become a popular non invasive tool for assessing the activities of autonomic nervous system. Depressed HRV has been found in several disorders, like diabetes mellitus (DM) and coronary artery disease, characterised by autonomic nervous dysfunction. A new technique, which searches for pattern repeatability in a time series, is proposed specifically for the analysis of heart rate data. These set of indices, which are termed as pattern repeatability measure and pattern repeatability ratio are compared with approximate entropy and sample entropy. In our analysis, based on the method developed, it is observed that heart rate variability is significantly different for DM patients, particularly for patients with diabetic foot ulcer.

Keywords: Autonomic nervous system, diabetes mellitus, heart rate variability, pattern identification, sample entropy

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Authors: Dae Won Lee, Ji Hyung Park, Sinae Eom, Syung Hyun Cho, Jong Soo Lee, Han Sung Kim

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The autonomic nervous system has a regulatory structure that helps people adapt to changes in their environment by adjusting or modifying some functions in response to stress, and regulating involuntary function of human organs. The purpose of this study was to investigate the effect of combined stimulation, both far-infrared heating and chiropractic, on the autonomic nervous system activities using thermal image and heart rate variability. Six healthy subjects participated in this test. We compared the before and after autonomic nervous system activities through obtaining thermal image and photoplethysmogram signal. The thermal images showed that the combined stimulation changed subject-s body temperature more highly and widely than before. The result of heart rate variability indicated that LF/HF ratio decreased. We concluded that combined stimulation activates autonomic nervous system, and expected other possibilities of this combined stimulation.

Keywords: Far-infrared heating, Chiropractic, Autonomic nervous system, Heart rate variability

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Authors: P. T. Ahamed Seyd, V. I. Thajudin Ahamed, Jeevamma Jacob, Paul Joseph K

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Diabetes mellitus (DM) is frequently characterized by autonomic nervous dysfunction. Analysis of heart rate variability (HRV) has become a popular noninvasive tool for assessing the activities of autonomic nervous system (ANS). In this paper, changes in ANS activity are quantified by means of frequency and time domain analysis of R-R interval variability. Electrocardiograms (ECG) of 16 patients suffering from DM and of 16 healthy volunteers were recorded. Frequency domain analysis of extracted normal to normal interval (NN interval) data indicates significant difference in very low frequency (VLF) power, low frequency (LF) power and high frequency (HF) power, between the DM patients and control group. Time domain measures, standard deviation of NN interval (SDNN), root mean square of successive NN interval differences (RMSSD), successive NN intervals differing more than 50 ms (NN50 Count), percentage value of NN50 count (pNN50), HRV triangular index and triangular interpolation of NN intervals (TINN) also show significant difference between the DM patients and control group.

Keywords: Autonomic nervous system, diabetes mellitus, frequency domain and time domain analysis, heart rate variability.

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Authors: Blesson Varghese, Gerard T. McKee

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The work reported in this paper is motivated by the fact that there is a need to apply autonomic computing concepts to parallel computing systems. Advancing on prior work based on intelligent cores [36], a swarm-array computing approach, this paper focuses on 'Intelligent agents' another swarm-array computing approach in which the task to be executed on a parallel computing core is considered as a swarm of autonomous agents. A task is carried to a computing core by carrier agents and is seamlessly transferred between cores in the event of a predicted failure, thereby achieving self-ware objectives of autonomic computing. The feasibility of the proposed swarm-array computing approach is validated on a multi-agent simulator.

Keywords: Autonomic computing, intelligent agents, swarm-array computing.

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Authors: Blesson Varghese, Gerard McKee

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The work reported in this paper proposes Swarm-Array computing, a novel technique inspired by swarm robotics, and built on the foundations of autonomic and parallel computing. The approach aims to apply autonomic computing constructs to parallel computing systems and in effect achieve the self-ware objectives that describe self-managing systems. The constitution of swarm-array computing comprising four constituents, namely the computing system, the problem/task, the swarm and the landscape is considered. Approaches that bind these constituents together are proposed. Space applications employing FPGAs are identified as a potential area for applying swarm-array computing for building reliable systems. The feasibility of a proposed approach is validated on the SeSAm multi-agent simulator and landscapes are generated using the MATLAB toolkit.

Keywords: Swarm-Array computing, Autonomic computing, landscapes.

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Authors: F. Pourhasanzade, S. H. Sabzpoushan

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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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Authors: Martin Doran, Roy Sterritt, George Wilkie

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NASA, ESA, and NSSC space agencies have plans to put planetary rovers on Mars in 2020. For these future planetary rovers to succeed, they will heavily depend on sensors to detect obstacles. This will also become of vital importance in the future, if rovers become less dependent on commands received from earth-based control and more dependent on self-configuration and self-decision making. These planetary rovers will face harsh environments and the possibility of hardware failure is high, as seen in missions from the past. In this paper, we focus on using Autonomic principles where self-healing, self-optimization, and self-adaption are explored using the MAPE-K model and expanding this model to encapsulate the attributes such as Awareness, Analysis, and Adjustment (AAA-3). In the experimentation, a Pioneer P3-DX research robot is used to simulate a planetary rover. The sonar sensors on the P3-DX robot are used to simulate the sensors on a planetary rover (even though in reality, sonar sensors cannot operate in a vacuum). Experiments using the P3-DX robot focus on how our software system can be adapted with the loss of sonar sensor functionality. The autonomic manager system is responsible for the decision making on how to make use of remaining ‘enabled’ sonars sensors to compensate for those sonar sensors that are ‘disabled’. The key to this research is that the robot can still detect objects even with reduced sonar sensor capability.

Keywords: Autonomic, self-adaption, self-healing, self-optimization.

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Authors: Ali Hussian Ali AlTimemy, Fawzi M. Al Naima

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This paper presents the prediction of kidney dysfunction using different neural network (NN) approaches. Self organization Maps (SOM), Probabilistic Neural Network (PNN) and Multi Layer Perceptron Neural Network (MLPNN) trained with Back Propagation Algorithm (BPA) are used in this study. Six hundred and sixty three sets of analytical laboratory tests have been collected from one of the private clinical laboratories in Baghdad. For each subject, Serum urea and Serum creatinin levels have been analyzed and tested by using clinical laboratory measurements. The collected urea and cretinine levels are then used as inputs to the three NN models in which the training process is done by different neural approaches. SOM which is a class of unsupervised network whereas PNN and BPNN are considered as class of supervised networks. These networks are used as a classifier to predict whether kidney is normal or it will have a dysfunction. The accuracy of prediction, sensitivity and specificity were found for each type of the proposed networks .We conclude that PNN gives faster and more accurate prediction of kidney dysfunction and it works as promising tool for predicting of routine kidney dysfunction from the clinical laboratory data.

Keywords: Kidney Dysfunction, Prediction, SOM, PNN, BPNN, Urea and Creatinine levels.

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Authors: Hae-Yeoun Lee

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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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Authors: Martin Doran, Roy Sterritt, George Wilkie

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The majority of today’s mobile robots are very dependent on battery power. Mobile robots can operate untethered for a number of hours but eventually they will need to recharge their batteries in-order to continue to function. While computer processing and sensors have become cheaper and more powerful each year, battery development has progress very little. They are slow to re-charge, inefficient and lagging behind in the general progression of robotic development we see today. However, batteries are relatively cheap and when fully charged, can supply high power output necessary for operating heavy mobile robots. As there are no cheap alternatives to batteries, we need to find efficient ways to manage the power that batteries provide during their operational lifetime. This paper proposes the use of autonomic principles of self-adaption to address the behavioral changes a battery experiences as it gets older. In life, as we get older, we cannot perform tasks in the same way as we did in our youth; these tasks generally take longer to perform and require more of our energy to complete. Batteries also suffer from a form of degradation. As a battery gets older, it loses the ability to retain the same charge capacity it would have when brand new. This paper investigates how we can adapt the current state of a battery charge and cycle count, to the requirements of a mobile robot to perform its tasks.

Keywords: Autonomic, self-adaptive, self-optimizing, degradation.

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Authors: Sun K. Yoo, Chung K. Lee

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Determination of attentional status is important because working performance and an unexpected accident is highly related with the attention. The autonomic nervous and the central nervous systems can reflect the changes in person’s attentional status. Reduced number of suitable pysiological parameters among autonomic and central nervous systems related signal parameters will be critical in optimum design of attentional devices. In this paper, we analyze the EEG (Electroencephalography) and HRV (Heart Rate Variability) signals to demonstrate the effective relation with brain signal and cardiovascular signal during event-related attention, which will be later used in selecting the minimum set of attentional parameters. Time and frequency domain parameters from HRV signal and frequency domain parameters from EEG signal are used as input to the optimum feature parameters selector.

Keywords: EEG, HRV, attentional status.

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Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

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The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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Authors: Ek-Uma Imkome, Jintana Yunibhand, Waraporn Chaiyawat

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Background: Persons with schizophrenia patient and misusing methamphetamines suffering from social dysfunction that impact on their quality of life. Knowledge of factors related to social dysfunction will guide the effective intervention. Objectives: To determine the direct effect, indirect effect and total effect of an acerbate Psychotics’ Symptoms, Social Support, Stressful life events, Medication use self-efficacy impact on social dysfunction in Thai schizophrenic patient and methamphetamine misuse. Methods: Data were collected from schizophrenic and methamphetamine misuse patient by self report. A linear structural relationship was used to test the hypothesized path model. Results: The hypothesized model was found to fit the empirical data and explained 54% of the variance of the psychotic symptoms (X² = 114.35, df = 92, p-value = 0.05, X² /df = 1.24, GFI = 0.96, AGFI = 0.92, CFI = 1.00, NFI = 0.99, NNFI = 0.99, RMSEA = 0.02). The highest total effect on social dysfunction was psychotic symptoms (0.67, p<0.05). Medication use self-efficacy had a direct effect on psychotic symptoms (-0.25, p<0.01), and social support had direct effect on medication use self efficacy (0.36, p <0.01). Conclusions: Psychotic symptoms and stressful life events were the significance factors that influenced direct on social dysfunctioning. Therefore, interventions that are designed to manage these factors are crucial in order to enhance social functioning in this population.

Keywords: Psychotic symptoms, methamphetamine, schizophrenia, stressful life events, social dysfunction, social support, medication use self-efficacy.

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Authors: Prajna Metta, Yanti Rusyanti, Nunung Rusminah, Bremmy Laksono

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The decrease of neutrophil chemotaxis function may cause increased susceptibility to aggressive periodontitis (AP). Neutrophil chemotaxis is affected by formyl peptide receptor 1 (FPR1), which when activated will respond to bacterial chemotactic peptide formyl methionyl leusyl phenylalanine (FMLP). FPR1 protein value is decreased in response to a wide number of inflammatory stimuli in AP patients. This study was aimed to assess the alteration of FPR1 protein value in AP patients and if FPR1 protein value could be used as an indicator of neutrophil chemotaxis dysfunction in AP. This is a case control study with 20 AP patients and 20 control subjects. Three milliliters of peripheral blood were drawn and analyzed for FPR1 protein value with ELISA. The data were statistically analyzed with Mann-Whitney test (p>0,05). Results showed that the mean value of FPR1 protein value in AP group is 0,353 pg/mL (0,11 to 1,18 pg/mL) and the mean value of FPR1 protein value in control group is 0,296 pg/mL (0,05 to 0,88 pg/mL). P value 0,787 > 0,05 suggested that there is no significant difference of FPR1 protein value in both groups. The present study suggests that FPR1 protein value has no significance alteration in AP patients and could not be used as an indicator of neutrophil chemotaxis dysfunction.

Keywords: Aggressive periodontitis, chemotaxis dysfunction, FPR1 protein value, neutrophil.

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

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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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Authors: Daniel Olmos-Liceaga

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

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

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

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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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Authors: Alexandre Boum, Salomon Madinatou

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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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Authors: Desmond B. Keenan, Paul Grossman

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In order to provide accurate heart rate variability indices of sympathetic and parasympathetic activity, the low frequency and high frequency components of an RR heart rate signal must be adequately separated. This is not always possible by just applying spectral analysis, as power from the high and low frequency components often leak into their adjacent bands. Furthermore, without the respiratory spectra it is not obvious that the low frequency component is not another respiratory component, which can appear in the lower band. This paper describes an adaptive filter, which aids the separation of the low frequency sympathetic and high frequency parasympathetic components from an ECG R-R interval signal, enabling the attainment of more accurate heart rate variability measures. The algorithm is applied to simulated signals and heart rate and respiratory signals acquired from an ambulatory monitor incorporating single lead ECG and inductive plethysmography sensors embedded in a garment. The results show an improvement over standard heart rate variability spectral measurements.

Keywords: Heart rate variability, vagal tone, sympathetic, parasympathetic, spectral analysis, adaptive filter.

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

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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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Authors: Hong Ding, Fatiha Benslimane, Isra Marei, Chris R. Triggle

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Hyperglycaemia is a key factor that contributes to the development of diabetes-related microvascular disease and a major risk factor for endothelial dysfunction. In the current study, we have explored glucose-induced abnormal intracellular calcium (Ca2+ i) homeostasis in mouse microvessel endothelial cells (MMECs) in high glucose (HG) (40mmol/L) versus control (low glucose, LG) (11 mmol/L). We demonstrated that the exposure of MMECs to HG for 3 days did not change basal Ca2+ i, however, there was a significant increase of acetylcholine-induced Ca2+ entry. Western blots illustrated that exposure to HG also increased STIM1 (Stromal Interaction Molecule 1), but not Orai1 (the pore forming subunit), protein expression levels. Although the link between HG-induced changes in STIM1 expression, enhanced Ca2+ entry and endothelial dysfunction requires further study, the current data are suggestive that targeting these pathways may reduce the impact of HG on endothelial function.

Keywords: store-operated calcium entry, hyperglycaemia, STIM1, endothelial dysfunction

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

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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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Authors: M. Hakami, A. Jammaly, I. Attafi, M. Oraiby, M. Jeraiby

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We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.

Keywords: Cholinesterase inhibitors, thymol, anethole, butylated hydroxytoluene, cardiac toxicity and myocardial infarction.

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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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Authors: A. G. Abdellatif, H. M.Gargoum, A. A. Debani, M. Bengleil, S. Alshalmani, N. El Zuki, O. El Fitouri

Abstract:

In this study the administration of 660 mg/kg of the ethanolic extract of the Alhagigraecorum (Camel Thorn)to mice, showed a significant decrease in the level of transaminases in animals treated with a combination of CTE plus carbon tetrachloride (CCl₄) or acetaminophen as compared to animals receiving CCl₄ or acetaminophen alone. Histopatological investigation also confirmed that, camel thorn extract protects liver against damage-induced either by carbon tetrachloride or acetaminophen. On the other hand the cardiac toxicity produced by adriamycine was significantly increased in the presence of the ethanolic extract of camel thorn. Our study suggested that camel thorn can protect the liver against the injury produced by carbon tetrachloride or acetaminophen, with unexpected increase in the cardiac toxicity –induced by adriamycin in rodents.

Keywords: Acetaminophen, Adriamycin, Alhagi graecorum, Carbon tetrachloride.

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Authors: Suken Nayak, Aditya Kambli, Bharati Ingale, Gauri Shukla

Abstract:

The technological concepts such as wireless hospital and portable cardiac telemetry system require the development of physiological signal acquisition devices to be easily integrated into the hospital database. In this paper we present the low cost, portable wireless ECG acquisition hardware that transmits ECG signals to a dedicated computer.The front end of the system obtains and processes incoming signals, which are then transmitted via a microcontroller and wireless Bluetooth module. A monitoring purpose Bluetooth based end user application integrated with patient database management module is developed for the computers. The system will act as a continuous event recorder, which can be used to follow up patients who have been resuscitatedfrom cardiac arrest, ventricular tachycardia but also for diagnostic purposes for patients with arrhythmia symptoms. In addition, cardiac information can be saved into the patient-s database of the hospital.

Keywords: ECG, Bluetooth communication, monitoring application, patient database

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Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

Abstract:

Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: Business process model and notation, cardiac patient, cardiac monitoring, heart monitoring, healthcare, internet of things, remote patient monitoring system, process model, telemedicine, wearable sensors.

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