Abstract: Dilated cardiomyopathy (DCM) is a severe
cardiovascular disorder characterized by progressive systolic
dysfunction due to cardiac chamber dilatation and inefficient
myocardial contractility often leading to chronic heart failure.
Recently, a genome-wide association studies (GWASs) on DCM
indicate that the ZBTB17 gene rs10927875 single nucleotide
polymorphism is associated with DCM. The aim of the study was to
identify the distribution of ZBTB17 gene rs10927875 polymorphism
in 50 Slovak patients with DCM and 80 healthy control subjects
using the Custom Taqman®SNP Genotyping assays. Risk factors
detected at baseline in each group included age, sex, body mass
index, smoking status, diabetes and blood pressure. The mean age of
patients with DCM was 52.9±6.3 years; the mean age of individuals
in control group was 50.3±8.9 years. The distribution of investigated
genotypes of rs10927875 polymorphism within ZBTB17 gene in the
cohort of Slovak patients with DCM was as follows: CC (38.8%), CT
(55.1%), TT (6.1%), in controls: CC (43.8%), CT (51.2%), TT
(5.0%). The risk allele T was more common among the patients with
dilated cardiomyopathy than in normal controls (33.7% versus
30.6%). The differences in genotype or allele frequencies of ZBTB17
gene rs10927875 polymorphism were not statistically significant
(p=0.6908; p=0.6098). The results of this study suggest that ZBTB17
gene rs10927875 polymorphism may be a risk factor for
susceptibility to DCM in Slovak patients with DCM. Studies of
numerous files and additional functional investigations are needed to
fully understand the roles of genetic associations.
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.
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.
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.
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.
Abstract: In this paper we use data mining techniques to investigate factors that contribute significantly to enhancing the risk of acute coronary syndrome. We assume that the dependent variable is diagnosis – with dichotomous values showing presence or absence of disease. We have applied binary regression to the factors affecting the dependent variable. The data set has been taken from two different cardiac hospitals of Karachi, Pakistan. We have total sixteen variables out of which one is assumed dependent and other 15 are independent variables. For better performance of the regression model in predicting acute coronary syndrome, data reduction techniques like principle component analysis is applied. Based on results of data reduction, we have considered only 14 out of sixteen factors.
Abstract: An electrocardiogram (ECG) feature extraction system
based on the calculation of the complex resonance frequency
employing Prony-s method is developed. Prony-s method is applied
on five different classes of ECG signals- arrhythmia as a finite sum
of exponentials depending on the signal-s poles and the resonant
complex frequencies. Those poles and resonance frequencies of the
ECG signals- arrhythmia are evaluated for a large number of each
arrhythmia. The ECG signals of lead II (ML II) were taken from
MIT-BIH database for five different types. These are the ventricular
couplet (VC), ventricular tachycardia (VT), ventricular bigeminy
(VB), and ventricular fibrillation (VF) and the normal (NR). This
novel method can be extended to any number of arrhythmias.
Different classification techniques were tried using neural networks
(NN), K nearest neighbor (KNN), linear discriminant analysis (LDA)
and multi-class support vector machine (MC-SVM).
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.
Abstract: Various sounds generated in the chest are included in
auscultation sound. Adaptive Noise Canceller (ANC) is one of the
useful techniques for biomedical signal. But the ANC is not suitable
for auscultation sound. Because the ANC needs two input channels as
a primary signal and a reference signals, but a stethoscope can
provide just one input sound. Therefore, in this paper, it was
proposed the Single Input ANC (SIANC) for suppression of breath
sound in a cardiac auscultation sound. For the SIANC, it was
proposed that the reference generation system which included Heart
Sound Detector, Control and Reference Generator. By experiment
and comparison, it was confirmed that the proposed SIANC was
efficient for heart sound enhancement and it was independent of
variations of a heartbeat.
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.
Abstract: This paper presents a low cost design of heart beat monitoring device using reflectance mode PhotoPlethysmography (PPG). PPG is known for its simple construction, ease of use and cost effectiveness and can provide information about the changes in cardiac activity as well as aid in earlier non-invasive diagnostics. The proposed device is divided into three phases. First is the detection of pulses through the fingertip. The signal is then passed to the signal processing unit for the purpose of amplification, filtering and digitizing. Finally the heart rate is calculated and displayed on the computer using parallel port interface. The paper is concluded with prototyping of the device followed by verification procedure of the heartbeat signal obtained in laboratory setting.
Abstract: This paper describes a new supervised fusion (hybrid)
electrocardiogram (ECG) classification solution consisting of a new
QRS complex geometrical feature extraction as well as a new version
of the learning vector quantization (LVQ) classification algorithm
aimed for overcoming the stability-plasticity dilemma. Toward this
objective, after detection and delineation of the major events of ECG
signal via an appropriate algorithm, each QRS region and also its
corresponding discrete wavelet transform (DWT) are supposed as
virtual images and each of them is divided into eight polar sectors.
Then, the curve length of each excerpted segment is calculated
and is used as the element of the feature space. To increase the
robustness of the proposed classification algorithm versus noise,
artifacts and arrhythmic outliers, a fusion structure consisting of
five different classifiers namely as Support Vector Machine (SVM),
Modified Learning Vector Quantization (MLVQ) and three Multi
Layer Perceptron-Back Propagation (MLP–BP) neural networks with
different topologies were designed and implemented. The new proposed
algorithm was applied to all 48 MIT–BIH Arrhythmia Database
records (within–record analysis) and the discrimination power of the
classifier in isolation of different beat types of each record was
assessed and as the result, the average accuracy value Acc=98.51%
was obtained. Also, the proposed method was applied to 6 number
of arrhythmias (Normal, LBBB, RBBB, PVC, APB, PB) belonging
to 20 different records of the aforementioned database (between–
record analysis) and the average value of Acc=95.6% was achieved.
To evaluate performance quality of the new proposed hybrid learning
machine, the obtained results were compared with similar peer–
reviewed studies in this area.
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.).
Abstract: Compensating physiological motion in the context
of minimally invasive cardiac surgery has become an attractive
issue since it outperforms traditional cardiac procedures offering
remarkable benefits. Owing to space restrictions, computer vision
techniques have proven to be the most practical and suitable solution.
However, the lack of robustness and efficiency of existing methods
make physiological motion compensation an open and challenging
problem. This work focusses on increasing robustness and efficiency
via exploration of the classes of 1−and 2−regularized optimization,
emphasizing the use of explicit regularization. Both approaches are
based on natural features of the heart using intensity information.
Results pointed out the 1−regularized optimization class as the best
since it offered the shortest computational cost, the smallest average
error and it proved to work even under complex deformations.
Abstract: The linear methods of heart rate variability analysis
such as non-parametric (e.g. fast Fourier transform analysis) and
parametric methods (e.g. autoregressive modeling) has become an
established non-invasive tool for marking the cardiac health, but their
sensitivity and specificity were found to be lower than expected with
positive predictive value
Abstract: The application of Neural Network for disease
diagnosis has made great progress and is widely used by physicians.
An Electrocardiogram carries vital information about heart activity and physicians use this signal for cardiac disease diagnosis which
was the great motivation towards our study. In our work, tachycardia
features obtained are used for the training and testing of a Neural
Network. In this study we are using Fuzzy Probabilistic Neural
Networks as an automatic technique for ECG signal analysis. As
every real signal recorded by the equipment can have different
artifacts, we needed to do some preprocessing steps before feeding it
to our system. Wavelet transform is used for extracting the
morphological parameters of the ECG signal. The outcome of the
approach for the variety of arrhythmias shows the represented
approach is superior than prior presented algorithms with an average
accuracy of about %95 for more than 7 tachy arrhythmias.
Abstract: Many recent electrophysiological studies have
revealed the importance of investigating meditation state in order to
achieve an increased understanding of autonomous control of
cardiovascular functions. In this paper, we characterize heart rate
variability (HRV) time series acquired during meditation using
nonlinear dynamical parameters. We have computed minimum
embedding dimension (MED), correlation dimension (CD), largest
Lyapunov exponent (LLE), and nonlinearity scores (NLS) from HRV
time series of eight Chi and four Kundalini meditation practitioners.
The pre-meditation state has been used as a baseline (control) state to
compare the estimated parameters. The chaotic nature of HRV during
both pre-meditation and meditation is confirmed by MED. The
meditation state showed a significant decrease in the value of CD and
increase in the value of LLE of HRV, in comparison with premeditation
state, indicating a less complex and less predictable nature
of HRV. In addition, it was shown that the HRV of meditation state
is having highest NLS than pre-meditation state. The study indicated
highly nonlinear dynamic nature of cardiac states as revealed by
HRV during meditation state, rather considering it as a quiescent
state.
Abstract: In this paper we used data mining techniques to
identify outlier patients who are using large amount of drugs over a
long period of time. Any healthcare or health insurance system
should deal with the quantities of drugs utilized by chronic diseases
patients. In Kingdom of Bahrain, about 20% of health budget is spent
on medications. For the managers of healthcare systems, there is no
enough information about the ways of drug utilization by chronic
diseases patients, is there any misuse or is there outliers patients. In
this work, which has been done in cooperation with information
department in the Bahrain Defence Force hospital; we select the data
for Cardiac patients in the period starting from 1/1/2008 to
December 31/12/2008 to be the data for the model in this paper. We
used three techniques for finding the drug utilization for cardiac
patients. First we applied a clustering technique, followed by
measuring of clustering validity, and finally we applied a decision
tree as classification algorithm. The clustering results is divided into
three clusters according to the drug utilization, for 1603 patients, who
received 15,806 prescriptions during this period can be partitioned
into three groups, where 23 patients (2.59%) who received 1316
prescriptions (8.32%) are classified to be outliers. The classification
algorithm shows that the use of average drug utilization and the age,
and the gender of the patient can be considered to be the main
predictive factors in the induced model.
Abstract: Electrocardiogram (ECG) is considered to be the
backbone of cardiology. ECG is composed of P, QRS & T waves and
information related to cardiac diseases can be extracted from the
intervals and amplitudes of these waves. The first step in extracting
ECG features starts from the accurate detection of R peaks in the
QRS complex. We have developed a robust R wave detector using
wavelets. The wavelets used for detection are Daubechies and
Symmetric. The method does not require any preprocessing therefore,
only needs the ECG correct recordings while implementing the
detection. The database has been collected from MIT-BIH arrhythmia
database and the signals from Lead-II have been analyzed. MatLab
7.0 has been used to develop the algorithm. The ECG signal under
test has been decomposed to the required level using the selected
wavelet and the selection of detail coefficient d4 has been done based
on energy, frequency and cross-correlation analysis of decomposition
structure of ECG signal. The robustness of the method is apparent
from the obtained results.