On-line computer processing of pressure data from cardiac catheterizations

Kinetics of hemodynamic and electrocardiographic changes following intravenous disopyramide

Changes in hemodynamic and ECG variables following disopyramide (1.7 mg = 3.9 mmol/kg b.wt.) were studied in 9 patients with ventricular arrhythmias. All patients displayed a marked reduction in the number of ventricular ectopic beats, all except one exhibiting complete abolition of the arrhythmia for at least 30 min. QT and QRS intervals showed statistically significant prolongations, and thereafter decreased exponentially with time. Above a certain concentration threshold that varied between the patients, systolic time intervals and aortic (dp/dt)max showed linear changes with increasing drug serum levels. Changes in diastolic pulmonary artery pressure showed no simple relationship with disopyramide concentration or time after injection. In 3 out of 4 patients studied, there was a good correlation between the lowest level of disopyramide that elicited both an antiarrhythmic effect and a demonstrable decrease in cardiac contractility.

Differences between middle cerebral artery blood velocity waveforms of young and postmenopausal women

OBJECTIVE

We characterized middle cerebral artery (MCA) blood flow velocity waveforms measured by transcranial Doppler ultrasonography in premenopausal (26.6 +/- 6.1 years, mean +/- SD) and postmenopausal (54.0 +/- 3.6 years) women, of whom six were receiving hormone therapy (PM-HT) and seven were not (PM-non-HT). We hypothesized that feature points on MCA waveforms are altered in postmenopausal women compared with those in young women.

DESIGN

A short protocol involved maintaining end-tidal PO2 at euoxia (88 mm Hg) and end-tidal PCO2 at 1.5 mm Hg above eucapnic values using a dynamic end-tidal forcing system. Doppler data for the velocity spectral outline (Vp) were collected every 10 ms, and velocity waveform analyses were done on a beat-by-beat basis. Waveform features were identified over each cardiac cycle, including the average Vp (VCYC), maximum acceleration (AMAX), and the ratio of the velocity at the reflected wave and the velocity at peak systole (VR:VMAX).

RESULTS

VCYC was unchanged between premenopausal and postmenopausal women (69.4 +/- 9.6 and 67.5 +/- 11.1 cm/s, respectively). AMAX was significantly higher (P = 0.007) in premenopausal women (987.9 +/- 280.7 cm/s) compared with postmenopausal women (743.1 +/- 100.3). Conversely, VR:VMAX was significantly smaller (P < 0.001) in premenopausal women (0.90 +/- 0.09) compared with postmenopausal women (1.11 +/- 0.05). In postmenopausal women, the reflected wave is higher than the maximum velocity at peak systole, suggesting the presence of a shoulder in the MCA waveform.

CONCLUSIONS

Further investigations are required to assess whether this waveform analysis can provide insight into pathophysiologic changes in cerebral hemodynamics with aging.

BIO-SPEAD: a parallel computing environment to accelerate development of biologic signal processing algorithms

We have created BIO-SPEAD (pronounced speed), a BIOlogical Signal Processing Environment for Algorithm Development. BIO-SPEAD is designed to accelerate development of complex algorithms which integrate information derived from single or multiple physiologic waveforms. BIO-SPEAD currently performs all of the basic analyses of several arterial blood pressure waveforms, and allows the user to utilize the results of those low-level analyses for development of more complex algorithms. We utilized a parallel programming architecture called the Process Trellis which keeps the different tasks, or processes, within BIO-SPEAD independent of each other. Additionally, we have developed a graphics interface to enable the user to visualize the waveform under analysis, the low-level system analysis, and the internal workings of the algorithm under development. The system has been used for several algorithm development projects and has demonstrated its utility.

A parallel computing interface to facilitate development of physiologic signal processing algorithms

We have created a system to aid in the development of algorithms related to the blood pressure waveform. The system performs all of the basic analyses of the waveform, and allows the user to utilize the results of those analyses for the algorithm under development. We have used a parallel programming architecture which keeps the different tasks, or processes, within the system independent of each other. Additionally, we have developed a graphics interface to enable the user to visualize the waveform, the system analysis, and the internal workings of the algorithm under development.

Electromechanical delay in the intact dog heart

A computer method was developed for the determination of electromechanical delay defined as the time between the onset of Q-wave and the onset of the left ventricular systolic pressure rise. It was validated for heart catheterization studies on 56 intact anaesthetized beagle dogs in 86 sessions. The mean basal value of the electromechanical delay was 22 +/- 4 msec. Heart rate, contractility, preload and afterload were changed by atrial pacing and by infusions of calcium chloride, isoproterenol, propranolol, dextran and phenylephrine. Increase of heart rate by pacing from the spontaneous rate of 90 per min to 240 per min prolonged the electromechanical delay from 21 +/- 5 to 33 +/- 14 msec (P less than 0.001). Otherwise the duration of electromechanical delay changed independently of the heart rate. If it changed, the direction of the change followed that of the pre-ejection period. Its proportion of the pre-ejection period varied from 26 to 52%. The electromechanical delay shortened when a positive inotropic effect was noticed or the presystolic fibre length increased.

The influence of day and night work on the circadian variations of cardiovascular performance

Circadian variations of the pre-ejection period, Q-T interval, heart rate and oral temperature at rest and in day and night shift work were investigated. At rest, pronounced circadian variation was found in heart rate, pre-ejection period and Q-T interval. The ratio between Q-T interval and heart rate also shows a distinct circadian variation. When working, the rest rhythms of the variables were obscured. The physiological implications for shift work are discussed.

Blood pressure and heart rate regulating capacity of the carotid sinus during changes in blood volume distribution in man

The influence of changes in blood volume distribution on the carotid baroreflex was studied in 18 subjects. Blood volume distribution was changed by varying the pressure around the lower body above and below ambient, thereby varying the amount of blood pooled in this region and exerting a secondary influence on the central blood volume. The carotid arterial stretch receptors were stimulated by varying the pressure in air-tight box enclosing the neck. To obtain a standardized carotid sinus stimulus (SCS) the pressure in the box was varied sinusoidally between - 10 and - 40 mmHg with a fixed freqency of 0.03 Hz. The effects on heart rate and blood pressure were assessed by harmonic analysis performed off-line on a digital computer. During lower body negative pressure of -40 mmHg (LBNP -40), i.e. during a procedure known to reduce the central blood volume, SCS induced an augmented effect on the blood pressure regulating capacity but not on the heart rate response. Expressing the blood pressure regulating capacity as peak-to-peak changes in systolic arterial pressure, the response during LBNP -40 mmHg was almost twice the control value. The opposite stimulus-lower body postive pressure-influenced the SCS-induced effects only slightly but on the average a minor reduction in both blood pressure and heart rate regulating capacity was found compared with the control condition, though the difference did not reach significant levels. The results support the hypothesis that changes in blood volume distribution modify the function of the carotid baroreflex, possibly via intrathoracic receptors sensitive to changes in central blood volume and/or central venous pressure.