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Journal of Hypertension Sep 2022Arterial stiffness (AS) and atrial fibrillation (AF) share commonalities in molecular and pathophysiological mechanisms and numerous studies have analyzed their... (Review)
Review
Arterial stiffness (AS) and atrial fibrillation (AF) share commonalities in molecular and pathophysiological mechanisms and numerous studies have analyzed their reciprocal influence. The gold standard for AS diagnosis is represented by aortic pulse wave velocity, whose measurement can be affected by arrhythmias characterized by irregularities in heart rhythm, such as AF. Growing evidence show that patients with AS are at high risk of AF development. Moreover, the subset of AF patients with AS seems to be more symptomatic and rhythm control strategies are less effective in this population. Reducing AS through de-stiffening interventions may be beneficial for patients with AF and can be a new appealing target for the holistic approach of AF management. In this review, we discuss the association between AS and AF, with particular interest in shared mechanisms, clinical implications and therapeutic options.
Topics: Aorta; Atrial Fibrillation; Humans; Pulse Wave Analysis; Vascular Stiffness
PubMed: 35943096
DOI: 10.1097/HJH.0000000000003223 -
Sensors (Basel, Switzerland) Jun 2023The number of people experiencing mental stress or emotional dysfunction has increased since the onset of the COVID-19 pandemic, as many individuals have had to adapt...
The number of people experiencing mental stress or emotional dysfunction has increased since the onset of the COVID-19 pandemic, as many individuals have had to adapt their daily lives. Numerous studies have demonstrated that mental health disorders can pose a risk for certain diseases, and they are also closely associated with the problem of mental workload. Now, wearable devices and mobile health applications are being utilized to monitor and assess individuals' mental health conditions on a daily basis using heart rate variability (HRV), typically measured by the R-to-R wave interval (RRI) of an electrocardiogram (ECG). However, portable or wearable ECG devices generally require two electrodes to perform bipolar limb leads, such as the Einthoven triangle. This study aims to develop a single-arm ECG measurement method, with lead I ECG serving as the gold standard. We conducted static and dynamic experiments to analyze the morphological performance and signal-to-noise ratio (SNR) of the single-arm ECG. Three morphological features were defined, RRI, the duration of the QRS complex wave, and the amplitude of the R wave. Thirty subjects participated in this study. The results indicated that RRI exhibited the highest cross-correlation (R = 0.9942) between the single-arm ECG and lead I ECG, while the duration of the QRS complex wave showed the weakest cross-correlation (R = 0.2201). The best SNR obtained was 26.1 ± 5.9 dB during the resting experiment, whereas the worst SNR was 12.5 ± 5.1 dB during the raising and lowering of the arm along the z-axis. This single-arm ECG measurement method offers easier operation compared to traditional ECG measurement techniques, making it applicable for HRV measurement and the detection of an irregular RRI.
Topics: Humans; Pandemics; COVID-19; Wearable Electronic Devices; Electrocardiography; Heart Rate
PubMed: 37447668
DOI: 10.3390/s23135818 -
Cardiology Research Feb 2022Quadricuspid aortic valve (QAV) is a congenital heart anomaly in which the aortic valve has four cusps of various size possibilities, as opposed to the three symmetrical... (Review)
Review
Quadricuspid aortic valve (QAV) is a congenital heart anomaly in which the aortic valve has four cusps of various size possibilities, as opposed to the three symmetrical cusps generally observed. This cardiac valvular abnormality is rarely identified, with an estimated incidence rate of 0.013% to 0.043%, although recent technological advancements in diagnostics have contributed to an increase in detection. Historically, it had been typically encountered during open heart surgery or postmortem; however, it is presently diagnosed primarily via ultrasound echocardiography, and could go undetected unless specifically considered. It was first reported by Babington in 1847, and since then approximately 300 cases have been published. This condition is sporadically associated with additional congenital cardiovascular defects, with coronary artery irregularities being the most common. In more than half of published QAV incidences it has led to the progressive development of aortic regurgitation (AR) usually aortic stenosis, particularly amongst elderly patients, often requiring surgical intervention after 50 years of age. A fifth of total instances, but two-thirds of instances with AR, warrant surgery seldom amidst complications, with reconstructive tricuspidization preferred over valve replacement.
PubMed: 35211218
DOI: 10.14740/cr1308 -
Prediction of atrial fibrillation using a home blood pressure monitor with a high-resolution system.Open Heart Sep 2022The usefulness of screening for atrial fibrillation (AF) using several home blood pressure (BP) monitors has been reported. We evaluated the accuracy of a...
OBJECTIVE
The usefulness of screening for atrial fibrillation (AF) using several home blood pressure (BP) monitors has been reported. We evaluated the accuracy of a high-resolution system (HiRS) for AF prediction and its usefulness when installed in home BP monitors.
METHODS
In patients with paroxysmal, persistent or permanent AF, ECG recording and BP measurements were performed simultaneously. The relationship between ECG rhythm diagnosis and pulse irregularity recognition, using a home BP monitor with HiRS, was investigated. The severity of a pulse disturbance during BP measurement was displayed as an irregular pulse rhythm symbol (IPRS) in three instances. The IPRS was not displayed if the pulse was regular, turned on if there was a weak variation in the pulse, and blinked if there was a strong variation in the pulse.
RESULTS
One hundred and seven patients (44 paroxysmal AF, 63 persistent or permanent AF) were enrolled, and a total of 333 recordings were analysed. The rhythms recorded by each ECG were 73 sinus regular rhythms, 35 extrasystoles, 222 AFs and 3 atrial flutters. Sensitivity and specificity for the prediction of any arrhythmia by the IPRS display of the BP monitor were 95.8% (95% CI 92.6% to 97.6%) and 96.8% (95% CI 92.6% to 100%), respectively. In addition, sensitivity and specificity for the prediction of AF were 100% (95% CI 97.5% to 100%) and 74.8% (95% CI 65.6% to 82.5%), respectively. Sensitivity and specificity for the prediction of AF by the IPRS blinking display were 88.3% (95% CI 83.3% to 92.2%) and 94.6% (95% CI 88.6% to 98.0%%), respectively. IPRS exhibited lighting or blinking during AF occurrence; however, during sinus rhythm, IPRS was not displayed in 72 out of 73 recordings.
CONCLUSION
The IPRS device predicted AF with precision and may be particularly useful for predicting an arrhythmia attack in patients with paroxysmal AF.
Topics: Atrial Fibrillation; Blood Pressure Monitors; Electrocardiography; Heart Rate; Humans; Sensitivity and Specificity
PubMed: 36170999
DOI: 10.1136/openhrt-2022-002006 -
Nederlands Tijdschrift Voor Geneeskunde May 2021Pulse oximetry detects hypoxemia non-invasively by measuring light absorption at different wave lengths, depending on the oxygenation of hemoglobin. The plethysmographic...
Pulse oximetry detects hypoxemia non-invasively by measuring light absorption at different wave lengths, depending on the oxygenation of hemoglobin. The plethysmographic signal is caused by volume changes in the arterial blood during systole. In this pulsatile flow, oxygen saturation is calculated using an algorithm. Use of the pulse oximeter has increased massively, especially in the COVID-era, and has a central role in managing patients at the emergency department. However, interpretation of the plethysmogram is frequently incorrect which may lead to incorrect conclusions. Moreover, an irregular plethysmographic signal may well 'give' a saturation percentage. We will discuss how pulse oximeters work and discuss some pitfalls. We hope that understanding the mechanism behind pulse oximetry, as well as an awareness of pitfalls, leads to improved management of patients with consequently less unnecessary care, as demonstrated in our case.
Topics: COVID-19; Humans; Hypoxia; Oximetry; Oxygen; SARS-CoV-2
PubMed: 34346633
DOI: No ID Found -
Clinical Cardiology May 2021The 2020 European Society of Cardiology atrial fibrillation guidelines recommend opportunistic screening for atrial fibrillation by pulse taking or ECG rhythm strip in...
BACKGROUND
The 2020 European Society of Cardiology atrial fibrillation guidelines recommend opportunistic screening for atrial fibrillation by pulse taking or ECG rhythm strip in those aged over 65 years.
HYPOTHESIS
We aimed to compare the diagnostic accuracy of pulse palpation to ECG rhythm strip when screening for atrial fibrillation. A secondary aim was to investigate whether participants with palpitations were more likely to be diagnosed with new atrial fibrillation.
METHODS
The study population were 75/76 year old individuals that participated in the STROKESTOP II study, a Swedish screening study for atrial fibrillation. Pulse palpation of the radial pulse for 30 sec was performed by healthcare professionals and recorded as regular or irregular. Thereafter a 30-sec single-lead ECG was registered. Patients were asked also if they had a history of palpitations.
RESULTS
Of the 6159 participants included in the study, 461 (7.5%) had irregular pulse. Twenty-two (4.8%) of those with irregular pulse were diagnosed with atrial fibrillation on single-lead ECG rhythm strip. Among those with regular pulse, 6 (0.1%) cases of new atrial fibrillation were found. The sensitivity of the pulse palpation test was 78.6% and positive predictive value 4.8%. The proportion of newly diagnosed atrial fibrillation was not different between those with and without history of palpitations.
CONCLUSION
Pulse palpation was inferior to single-lead ECG when screening for atrial fibrillation. We therefore advocate the use of single-lead ECG rather than pulse palpation when screening for atrial fibrillation. Palpitations did not predict atrial fibrillation.
Topics: Aged; Aged, 80 and over; Atrial Fibrillation; Cohort Studies; Electrocardiography; Female; Heart Rate; Humans; Male; Mass Screening; Palpation
PubMed: 33724492
DOI: 10.1002/clc.23595 -
Communications Biology Mar 2021Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a... (Comparative Study)
Comparative Study
Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a proof-of-concept system for acquiring individual heart beats using smart speakers in a fully contact-free manner. Our algorithms transform the smart speaker into a short-range active sonar system and measure heart rate and inter-beat intervals (R-R intervals) for both regular and irregular rhythms. The smart speaker emits inaudible 18-22 kHz sound and receives echoes reflected from the human body that encode sub-mm displacements due to heart beats. We conducted a clinical study with both healthy participants and hospitalized cardiac patients with diverse structural and arrhythmic cardiac abnormalities including atrial fibrillation, flutter and congestive heart failure. Compared to electrocardiogram (ECG) data, our system computed R-R intervals for healthy participants with a median error of 28 ms over 12,280 heart beats and a correlation coefficient of 0.929. For hospitalized cardiac patients, the median error was 30 ms over 5639 heart beats with a correlation coefficient of 0.901. The increasing adoption of smart speakers in hospitals and homes may provide a means to realize the potential of our non-contact cardiac rhythm monitoring system for monitoring of contagious or quarantined patients, skin sensitive patients and in telemedicine settings.
Topics: Acoustics; Aged; Algorithms; Arrhythmias, Cardiac; Case-Control Studies; Electrocardiography; Equipment Design; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Middle Aged; Predictive Value of Tests; Proof of Concept Study; Prospective Studies; Reproducibility of Results; Signal Processing, Computer-Assisted; Telemedicine; Time Factors; Transducers; Wireless Technology
PubMed: 33750897
DOI: 10.1038/s42003-021-01824-9 -
Medical Hypotheses Sep 2020The cranial nerve rhizophathy, commonly presented with trigeminal neuralgia (TN) or hemifacial spasm (HFS), is a sort of hyperexcitability disorders with higher...
The cranial nerve rhizophathy, commonly presented with trigeminal neuralgia (TN) or hemifacial spasm (HFS), is a sort of hyperexcitability disorders with higher incidence in senior Asian. In this paper, a novel hypothesis on the pathogenesis is proposed and with which some clinical phenomena are explained. In those with crowded cerebellopontine angle in anatomy, the cranial nerve root and surrounding vessel are getting closer and closer to each other with aging and finally the neurovascular conflict happens. As the interfacial friction associated with pulse, the nerve incurs demyelination. Since this pathological change develops to a certain degree, some transmembrane proteins emerge from the nerve due to a series of signaling pathway mediated by inflammatory cytokines. Among them, voltage-gated (Na1.3) and mechanosensitive (Piezo2) ion channels may play the important role. With pulsatile compressions, the Piezo2 drives the resting potential toward depolarization forming a state of subthreshold membrane potential oscillation. Under this condition, just an appropriate pressure can make the membrane potential easy to reach threshold and activate the sodium channel, eventually generating conductible action potentials from the axon. When these ectopic action potentials propagate to the central nerve system, an illusion of sharp pain is perceived; while to the nerve-muscle junctions, an attack of irregular muscle constriction occurs. This hypothesis can well explain the symptomatic manifestation of paroxysmal attacks aroused by emotions. When we get nervous or excited, our heart rate and blood pressure alter correspondingly, which may give rise to "a just right pressure" - with specific frequency, amplitude and angle - impacting the suffered nerve to reach the threshold of impulse ignition. After a successful microvascular decompression surgery, the trigger is gone (there is no compression anymore) and the symptom is alleviated. While the postoperative recurrence could be attributable to Teflon granuloma development if had been placed improperly - for this nerve root has been susceptible no matter to arteries or to neoplasms. Besides, it may illustrate the clinical phenomenon that secondary TN or HFS cases are seldom caused by schwannoma: with a proliferative sheath, the nerve root is actually insulated. By contrast, not all neurovascular contacts can lead to the onset: it demands an exclusive extent of demyelination firstly.
Topics: Arteries; Cranial Nerves; Hemifacial Spasm; Humans; Neoplasm Recurrence, Local; Trigeminal Neuralgia
PubMed: 32413700
DOI: 10.1016/j.mehy.2020.109801 -
Physical and Engineering Sciences in... Dec 2021Electrocardiogram (ECG) and photoplethysmograph (PPG) are non-invasive techniques that provide electrical and hemodynamic information of the heart, respectively. This... (Review)
Review
Electrocardiogram (ECG) and photoplethysmograph (PPG) are non-invasive techniques that provide electrical and hemodynamic information of the heart, respectively. This information is advantageous in the diagnosis of various cardiac abnormalities. Arrhythmia is the most common cardiovascular disease, manifested as single or multiple irregular heartbeats. However, due to the continuous manual observation, it becomes troublesome for experts sometimes to identify the paroxysmal nature of arrhythmia correctly. Moreover, due to advancements in technology, there is an inclination towards wearable sensors which monitor such patients continuously. Thus, there is a need for automatic detection techniques for the identification of arrhythmia. In the presented work, ECG and PPG-based state-of-the-art methods have been described, including preprocessing, feature extraction, and classification techniques for the detection of various arrhythmias. Additionally, this review exhibits various wearable sensors used in the literature and public databases available for the evaluation of results. The study also highlights the limitations of the current techniques and pragmatic solutions to improvise the ongoing effort.
Topics: Arrhythmias, Cardiac; Databases, Factual; Electrocardiography; Heart Rate; Humans; Photoplethysmography
PubMed: 34727361
DOI: 10.1007/s13246-021-01072-5 -
Nature Aging Oct 2021Gonadotropin-releasing hormone (GnRH) has a role in hypothalamic control of aging, but the underlying patterns and relationship with downstream reproductive hormones are...
Gonadotropin-releasing hormone (GnRH) has a role in hypothalamic control of aging, but the underlying patterns and relationship with downstream reproductive hormones are still unclear. Here we report that hypothalamic GnRH pulse frequency and irregularity increase before GnRH pulse amplitude slowly decreases during aging. GnRH is inhibited by nuclear factor (NF)-κB, and GnRH pulses were controlled by oscillations in the transcriptional activity of NF-κB. Exposure to testosterone under pro-inflammatory conditions stimulated both NF-κB oscillations and GnRH pulses. While castration of middle-aged mice induced short-term anti-aging effects, preventing elevation of luteinizing hormone (LH) levels after castration led to long-term anti-aging effects and lifespan extension, indicating that high-frequency GnRH pulses and high-magnitude LH levels coordinately mediate aging. Reprogramming the endogenous GnRH pulses of middle-aged male mice via an optogenetic approach revealed that increasing GnRH pulses frequency causes LH excess and aging acceleration, while lowering the frequency of and stabilizing GnRH pulses can slow down aging. In conclusion, GnRH pulses are important for aging in male mice.
Topics: Male; Mice; Animals; Gonadotropin-Releasing Hormone; Luteinizing Hormone; Follicle Stimulating Hormone; NF-kappa B; Aging; Orchiectomy
PubMed: 37118330
DOI: 10.1038/s43587-021-00116-5