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Pulantara IW, Wang Y, Burke LE, Sereika SM, Bizhanova Z, Kariuki JK, Cheng J, Beatrice B, Loar I, Cedillo M, Conroy MB, Parmanto B. Data Collection and Management of mHealth, Wearables, and Internet of Things in Digital Behavioral Health Interventions With the Awesome Data Acquisition Method (ADAM): Development of a Novel Informatics Architecture. JMIR Mhealth Uhealth 2024; 12:e50043. [PMID: 39113371 PMCID: PMC11322796 DOI: 10.2196/50043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 04/30/2024] [Accepted: 06/05/2024] [Indexed: 08/16/2024] Open
Abstract
Unlabelled The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires. As a clinical trial management system, ADAM integrates clinical trial management processes and efficiently supports recruitment, screening, randomization, data tracking, data reporting, and data analysis during the entire research study process. We used a behavioral weight-loss intervention study (SMARTER trial) as a test case to evaluate the ADAM system. SMARTER was a randomized controlled trial that screened 1741 participants and enrolled 502 adults. As a result, the ADAM system was efficiently and successfully deployed to organize and manage the SMARTER trial. Moreover, with its versatile integration capability, the ADAM system made the necessary switch to fully remote assessments and tracking that are performed seamlessly and promptly when the COVID-19 pandemic ceased in-person contact. The remote-native features afforded by the ADAM system minimized the effects of the COVID-19 lockdown on the SMARTER trial. The success of SMARTER proved the comprehensiveness and efficiency of the ADAM system. Moreover, ADAM was designed to be generalizable and scalable to fit other studies with minimal editing, redevelopment, and customization. The ADAM system can benefit various behavioral interventions and different populations.
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Affiliation(s)
- I Wayan Pulantara
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yuhan Wang
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zhadyra Bizhanova
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jacob K Kariuki
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Jessica Cheng
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Britney Beatrice
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - India Loar
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maribel Cedillo
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Molly B Conroy
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Bambang Parmanto
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, United States
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Fabre O, Bailly S, Mithieux G, Legrand R, Costentin C, Astrup A, Pépin JL. Long-term trajectories of weight loss and health outcomes: protocol of the SCOOP-RNPC nationwide observational study. BMJ Open 2024; 14:e082575. [PMID: 38991672 PMCID: PMC11243209 DOI: 10.1136/bmjopen-2023-082575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/17/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Behavioural weight loss programmes are generally accepted as being beneficial in reducing cardiometabolic risk and improving patient-reported outcomes. However, prospective data from large real-world cohorts are scarce concerning the mid-term and long-term impact of such interventions. The objective of this large prospective cohort study (n>10 000 participants) is to demonstrate the effectiveness of the standardised Nutritional and Psycho-Behavioural Rehabilitation programme (RNPC Programme) in reducing the percentage of subjects requiring insulin and/or other diabetes drug therapy, antihypertensive drugs, lipid-lowering therapies and continuous positive airway pressure therapy for obstructive sleep apnoea after the end of the intervention. The rate of remission of hypertension, type 2 diabetes and sleep apnoea will also be prospectively assessed. METHODS This is a prospective multicentre observational study carried out in 92 RNPC centres in France. Participants will follow the standardised RNPC Programme. The prospective dataset will include clinical, anthropometric and biochemical data, comorbidities, medications, body composition, patient-reported outcome questionnaire responses, sleep study data with objective measurements of sleep apnoea severity and surrogate markers of cardiovascular risk (ie, blood pressure and arterial stiffness). About 10 000 overweight or obese participants will be included over 2 years with a follow-up duration of up to 5 years. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by the Ethics Committee (Comité de protection des personnes Sud-Est I) of Saint-Etienne University Hospital, France (SI number: 23.00174.000237). Results will be submitted for publication in peer-review journals, presented at conferences and inform the design of a future randomised controlled trial in the specific population identified as good responders to the RNPC Programme. TRIAL REGISTRATION NUMBER NCT05857319.
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Affiliation(s)
- Odile Fabre
- SARL Groupe Ethique & Santé, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Sébastien Bailly
- University Grenoble Alpes, Grenoble, France
- Grenoble Alpes University Hospital, Grenoble, France
| | | | - Rémy Legrand
- SARL Groupe Ethique & Santé, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Charlotte Costentin
- INSERM U1209/CNRS UMR 5309, University Grenoble Alpes, Grenoble, France
- University Clinic of Hepato-Gastroenterology, Grenoble Alpes University Hospital, Grenoble, France
| | - Arne Astrup
- Department of Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark
| | - Jean-Louis Pépin
- University Grenoble Alpes, Grenoble, France
- Grenoble Alpes University Hospital, Grenoble, France
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Malik MI, Nagpal D. Estimated pulse-wave velocity predicts survival in patients requiring extracorporeal membrane oxygenation. Perfusion 2024; 39:344-352. [PMID: 36419384 DOI: 10.1177/02676591221141963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
INTRODUCTION Arterial stiffness, measured by estimated pulse-wave velocity is a known predictor of major adverse cardiovascular events, however its predictive value in patients requiring extracorporeal membrane oxygenation (ECMO) is unknown. METHODS A retrospective cohort study was performed at the London Health Science Centre in London, Canada between 1996-2021, totaling 255 patients requiring ECMO. Estimated pulse-wave velocity (ePWV) was calculated using an algorithm from the Reference Values for Arterial Stiffness Collaboration. Recorded outcomes included in-hospital death, ischemic stroke, hemorrhagic stroke, renal failure and need for renal replacement therapy (RRT). For adjusted analysis, survival-to-discharge was used. Multivariate logistic regression and propensity-score matching were utilized to control for confounding. RESULTS On univariate analysis, higher ePWV was significantly predictive of ischemic stroke (OR 1.676, p = 0.0002) and in-hospital death (OR 1.20, p = 0.006), but insignificant for predicting hemorrhagic stroke (OR 1.07, p = 0.710), and appeared protective for renal failure (OR 0.88 [0.78-0.99], p = 0.034) and RRT (OR 0.87, p = 0.027). On multivariate analysis and propensity-score matching, five of six models demonstrated ePWV as an independent predictor of survival-to-discharge. (OR 0.70, p = 0.00,021; OR 0.72, p = 0.0002; OR 0.87, p = 0.045; OR 0.85, p = 0.013; OR 0.57, p = 0.012). CONCLUSIONS ePWV is a promising marker for risk-stratification in ECMO patients. Further investigation is required to better delineate the role of arterial health assessment in disease trajectory and strengthen the validity of AS as a marker of interest in medical and surgical management.
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Affiliation(s)
- Mohsyn I Malik
- Department of Cardiac Surgery, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Dave Nagpal
- Department of Cardiac Surgery, Schulich School of Medicine and Dentistry, London, ON, Canada
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Spronck B, Terentes-Printzios D, Avolio AP, Boutouyrie P, Guala A, Jerončić A, Laurent S, Barbosa EC, Baulmann J, Chen CH, Chirinos JA, Daskalopoulou SS, Hughes AD, Mahmud A, Mayer CC, Park JB, Pierce GL, Schutte AE, Urbina EM, Wilkinson IB, Segers P, Sharman JE, Tan I, Vlachopoulos C, Weber T, Bianchini E, Bruno RM. 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension 2024; 81:183-192. [PMID: 37975229 PMCID: PMC10734786 DOI: 10.1161/hypertensionaha.123.21618] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Arterial stiffness, as measured by arterial pulse wave velocity (PWV), is an established biomarker for cardiovascular risk and target-organ damage in individuals with hypertension. With the emergence of new devices for assessing PWV, it has become evident that some of these devices yield results that display significant discrepancies compared with previous devices. This discrepancy underscores the importance of comprehensive validation procedures and the need for international recommendations. METHODS A stepwise approach utilizing the modified Delphi technique, with the involvement of key scientific societies dedicated to arterial stiffness research worldwide, was adopted to formulate, through a multidisciplinary vision, a shared approach to the validation of noninvasive arterial PWV measurement devices. RESULTS A set of recommendations has been developed, which aim to provide guidance to clinicians, researchers, and device manufacturers regarding the validation of new PWV measurement devices. The intention behind these recommendations is to ensure that the validation process can be conducted in a rigorous and consistent manner and to promote standardization and harmonization among PWV devices, thereby facilitating their widespread adoption in clinical practice. CONCLUSIONS It is hoped that these recommendations will encourage both users and developers of PWV measurement devices to critically evaluate and validate their technologies, ultimately leading to improved consistency and comparability of results. This, in turn, will enhance the clinical utility of PWV as a valuable tool for assessing arterial stiffness and informing cardiovascular risk stratification and management in individuals with hypertension.
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Affiliation(s)
- Bart Spronck
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Netherlands (B.S.)
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Dimitrios Terentes-Printzios
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Alberto P. Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca, Barcelona, Spain (A.G.)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain (A.G.)
| | - Ana Jerončić
- Laboratory of Vascular Aging and Cardiovascular Prevention, Department of Research in Biomedicine and Health, University of Split School of Medicine, Croatia (A.J.)
| | - Stéphane Laurent
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | | | - Johannes Baulmann
- Praxis Dres. Gille/Baulmann, Rheinbach, Germany (J.B.)
- Division of Cardiology, Medical University of Graz, Austria (J.B.)
| | - Chen-Huan Chen
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (C.-H.C.)
| | - Julio A. Chirinos
- Cardiovascular Division, University of Pennsylvania Perelman School of Medicine and Hospital of the University of Pennsylvania, Philadelphia, PA (J.A.C.)
| | - Stella S. Daskalopoulou
- Department of Medicine, Research Institute McGill University Health Centre, McGill University, Montreal, QC, Canada (S.S.D.)
| | - Alun D. Hughes
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, United Kingdom (A.D.H.)
| | - Azra Mahmud
- Department of Internal Medicine, Pharmacology, and Clinical Research, Shalamar Medical and Dental College, Lahore, Pakistan (A.M.)
| | - Christopher C. Mayer
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Medical Signal Analysis, Vienna (C.C.M.)
| | - Jeong Bae Park
- JB Lab and Clinic, Department of Precision Medicine and Biostatistics, Wonju College of Medicine, Yonsei University, Seoul, Republic of Korea (J.B.P.)
| | - Gary L. Pierce
- Department of Health and Human Physiology, University of Iowa, IA (G.L.P.)
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, Sydney, Australia (A.E.S.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Elaine M. Urbina
- Cincinnati Children’s Hospital Medical Center, OH (E.M.U.)
- University of Cincinnati, OH (E.M.U.)
| | - Ian B. Wilkinson
- Experimental Medicine and Therapeutics, University of Cambridge, United Kingdom (I.B.W.)
| | | | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (J.E.S.)
| | - Isabella Tan
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Charalambos Vlachopoulos
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council, Pisa (E.B.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
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Climie RE, Alastruey J, Mayer CC, Schwarz A, Laucyte-Cibulskiene A, Voicehovska J, Bianchini E, Bruno RM, Charlton PH, Grillo A, Guala A, Hallab M, Hametner B, Jankowski P, Königstein K, Lebedeva A, Mozos I, Pucci G, Puzantian H, Terentes-Printzios D, Yetik-Anacak G, Park C, Nilsson PM, Weber T. Vascular ageing: moving from bench towards bedside. Eur J Prev Cardiol 2023; 30:1101-1117. [PMID: 36738307 PMCID: PMC7614971 DOI: 10.1093/eurjpc/zwad028] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
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Affiliation(s)
- Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, 7000 Hobart, Australia
- Sports Cardiology, Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne 3000, Australia
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, 249 Westminster Bridge Rd, London SE1 7EH, UK
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Achim Schwarz
- ALF Distribution GmbH, Stephanstrasse 19, 52064 Aachen, Germany
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
- Faculty of Medicine, Vilnius University, M. K. C iurlionio g. 21, 03101 Vilnius, Lithuania
| | - Julija Voicehovska
- Department of Internal Diseases, Riga Stradins University, Dzirciema str. 16, Riga, L-1007, Latvia
- Nephrology and Renal Replacement Therapy Clinics, Riga East University Hospital, Hipokrata str. 2, Riga, LV-1079, Latvia
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa (PI), Italy
| | - Rosa-Maria Bruno
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Andrea Grillo
- Medicina Clinica, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Paseo de la Vall d’Hebron, 129, 08035 Barcelona, Spain
| | - Magid Hallab
- Clinique Bizet, 23 Georges Bizet, 75116 Paris, France
| | - Bernhard Hametner
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 231 Czerniakowska St., 00-416 Warsaw, Poland
| | - Karsten Königstein
- Department of Sport, Exercise and Health (DSBG) University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Anna Lebedeva
- Department of Internal Medicine and Cardiology, Dresden Heart Centre, Dresden University of Technology, Fetscher str. 76, 01307 Dresden, Germany
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, T. Vladimirescu Street 14, 300173 Timisoara, Romania
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Houry Puzantian
- Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32 Atasehir, 34752 Istanbul, Turkey
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK; and
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600 Wels, Austria
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Steffensen TL, Schjerven FE, Flade HM, Kirkeby-Garstad I, Ingeström E, Solberg FS, Steinert M. Wrist ballistocardiography and invasively recorded blood pressure in healthy volunteers during reclining bike exercise. Front Physiol 2023; 14:1189732. [PMID: 37250120 PMCID: PMC10213206 DOI: 10.3389/fphys.2023.1189732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
Objective: Ballistocardiogram (BCG) features are of interest in wearable cardiovascular monitoring of cardiac performance. We assess feasibility of wrist acceleration BCG during exercise for estimating pulse transit time (PTT), enabling broader cardiovascular response studies during acute exercise and improved monitoring in individuals at risk for cardiovascular disease (CVD). We also examine the relationship between PTT, blood pressure (BP), and stroke volume (SV) during exercise and posture interventions. Methods: 25 participants underwent a bike exercise protocol with four incremental workloads (0 W, 50 W, 100 W, and 150 W) in supine and semirecumbent postures. BCG, invasive radial artery BP, tonometry, photoplethysmography (PPG) and echocardiography were recorded. Ensemble averages of BCG signals determined aortic valve opening (AVO) timings, combined with peripheral pulse wave arrival times to calculate PTT. We tested for significance using Wilcoxon signed-rank test. Results: BCG was successfully recorded at the wrist during exercise. PTT exhibited a moderate negative correlation with systolic BP (ρSup = -0.65, ρSR = -0.57, ρAll = -0.54). PTT differences between supine and semirecumbent conditions were significant at 0 W and 50 W (p < 0.001), less at 100 W (p = 0.0135) and 150 W (p = 0.031). SBP and DBP were lower in semirecumbent posture (p < 0.01), while HR was slightly higher. Echocardiography confirmed association of BCG features with AVO and indicated a positive relationship between BCG amplitude and SV (ρ = 0.74). Significance: Wrist BCG may allow convenient PTT and possibly SV tracking during exercise, enabling studies of cardiovascular response to acute exercise and convenient monitoring of cardiovascular performance.
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Affiliation(s)
- Torjus L. Steffensen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Filip E. Schjerven
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans M. Flade
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav’s University Hospital, Trondheim, Norway
| | - Idar Kirkeby-Garstad
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav’s University Hospital, Trondheim, Norway
| | - Emma Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Fredrik S. Solberg
- Department of Mechanical Engineering, Stanford University, Palo Alto, CA, United States
| | - Martin Steinert
- Department of Mechanical Engineering, Norwegian University of Science and Technology, Trondheim, Norway
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Johannessen E, Johansson J, Hartvigsen G, Horsch A, Årsand E, Henriksen A. Collecting health-related research data using consumer-based wireless smart scales. Int J Med Inform 2023; 173:105043. [PMID: 36934610 DOI: 10.1016/j.ijmedinf.2023.105043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/26/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Serious public-health concerns such as overweight and obesity are in many cases caused by excess intake of food combined with decreases in physical activity. Smart scales with wireless data transfer can, together with smart watches and trackers, observe changes in the population's health. They can present us with a picture of our metabolism, body health, and disease risks. Combining body composition data with physical activity measurements from devices such as smart watches could contribute to building a human digital twin. OBJECTIVE The objectives of this study were to (1) investigate the evolution of smart scales in the last decade, (2) map status and supported sensors of smart scales, (3) get an overview of how smart scales have been used in research, and (4) identify smart scales for current and future research. METHOD We searched for devices through web shops and smart scale tests/reviews, extracting data from the manufacturer's official website, user manuals when available, and data from web shops. We also searched scientific literature databases for smart scale usage in scientific papers. RESULT We identified 165 smart scales with a wireless connection from 72 different manufacturers, released between 2009 and end of 2021. Of these devices, 49 (28%) had been discontinued by end of 2021. We found that the use of major variables such as fat and muscle mass have been as good as constant over the years, and that minor variables such as visceral fat and protein mass have increased since 2015. The main contribution is a representative overview of consumer grade smart scales between 2009 and 2021. CONCLUSION The last six years have seen a distinct increase of these devices in the marketplace, measuring body composition with bone mass, muscle mass, fat mass, and water mass, in addition to weight. Still, the number of research projects featuring connected smart scales are few. One reason could be the lack of professionally accurate measurements, though trend analysis might be a more feasible usage scenario.
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Affiliation(s)
- Erlend Johannessen
- Department of Computer Science, UiT, The Arctic University of Norway, Tromsø, Norway.
| | - Jonas Johansson
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Eirik Årsand
- Department of Computer Science, UiT, The Arctic University of Norway, Tromsø, Norway
| | - André Henriksen
- Department of Computer Science, UiT, The Arctic University of Norway, Tromsø, Norway
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Canaud B, Kooman J, Davenport A, Campo D, Carreel E, Morena-Carrere M, Cristol JP. Digital health technology to support care and improve outcomes of chronic kidney disease patients: as a case illustration, the Withings toolkit health sensing tools. FRONTIERS IN NEPHROLOGY 2023; 3:1148565. [PMID: 37675376 PMCID: PMC10479582 DOI: 10.3389/fneph.2023.1148565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/07/2023] [Indexed: 09/08/2023]
Abstract
Cardiovascular disease (CVD) is a major burden in dialysis-dependent chronic kidney disease (CKD5D) patients. Several factors contribute to this vulnerability including traditional risk factors such as age, gender, life style and comorbidities, and non-traditional ones as part of dialysis-induced systemic stress. In this context, it appears of utmost importance to bring a closer attention to CVD monitoring in caring for CKD5D patients to ensure early and appropriate intervention for improving their outcomes. Interestingly, new home-used, self-operated, connected medical devices offer convenient and new tools for monitoring in a fully automated and ambulatory mode CKD5D patients during the interdialytic period. Sensoring devices are installed with WiFi or Bluetooth. Some devices are also available in a cellular version such as the Withings Remote Patient Monitoring (RPM) solution. These devices analyze the data and upload the results to Withings HDS (Hybrid data security) platform servers. Data visualization can be viewed by the patient using the Withings Health Mate application on a smartphone, or with a web interface. Health Care Professionals (HCP) can also visualize patient data via the Withings web-based RPM interface. In this narrative essay, we analyze the clinical potential of pervasive wearable sensors for monitoring ambulatory dialysis patients and provide an assessment of such toolkit digital medical health devices currently available on the market. These devices offer a fully automated, unobtrusive and remote monitoring of main vital functions in ambulatory subjects. These unique features provide a multidimensional assessment of ambulatory CKD5D patients covering most physiologic functionalities, detecting unexpected disorders (i.e., volume overload, arrhythmias, sleep disorders) and allowing physicians to judge patient's response to treatment and recommendations. In the future, the wider availability of such pervasive health sensing and digital technology to monitor patients at an affordable cost price will improve the personalized management of CKD5D patients, so potentially resulting in improvements in patient quality of life and survival.
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Affiliation(s)
- Bernard Canaud
- Montpellier University, School of Medicine, Montpellier, France
- Global Medical Office, Fresenius Medical Care (FMC), Fresnes, France
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Andrew Davenport
- UCL Department of Renal Medicine, Royal Free Hospital, University College, London, United Kingdom
| | | | | | - Marion Morena-Carrere
- PhyMedExp, University of Montpellier, INSERM, CNRS, Department of Biochemistry and Hormonology, University Hospital Center of Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, University of Montpellier, INSERM, CNRS, Department of Biochemistry and Hormonology, University Hospital Center of Montpellier, Montpellier, France
- AIDER-Santé, Ch. Mion Foundation, Montpellier, France
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9
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Park JB, Sharman JE, Li Y, Munakata M, Shirai K, Chen CH, Jae SY, Tomiyama H, Kosuge H, Bruno RM, Spronck B, Kario K, Lee HY, Cheng HM, Wang J, Budoff M, Townsend R, Avolio AP. Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia. Pulse (Basel) 2022; 10:1-18. [PMID: 36660436 PMCID: PMC9843646 DOI: 10.1159/000528208] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022] Open
Abstract
Arterial stiffness is a progressive aging process that predicts cardiovascular disease. Pulse wave velocity (PWV) has emerged as a noninvasive, valid, and reliable measure of arterial stiffness and an independent risk predictor for adverse outcomes. However, up to now, PWV measurement has mostly been used as a tool for risk prediction and has not been widely used in clinical practice. This consensus paper aims to discuss multiple PWV measurements currently available in Asia and to provide evidence-based assessment together with recommendations on the clinical use of PWV. For the methodology, PWV measurement including the central elastic artery is essential and measurements including both the central elastic and peripheral muscular arteries, such as brachial-ankle PWV and cardio-ankle vascular index, can be a good alternative. As Asian populations are rapidly aging, timely detection and intervention of "early vascular aging" in terms of abnormally high PWV values are recommended. More evidence is needed to determine if a PWV-guided therapeutic approach will be beneficial to the prevention of cardiovascular diseases beyond current strategies. Large-scale randomized controlled intervention studies are needed to guide clinicians.
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Affiliation(s)
- Jeong Bae Park
- JB Lab and Clinic, And Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Yan Li
- Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Masanori Munakata
- Research Center for Lifestyle-related Disease, Tohoku Rosai Hospital, Sendai, Japan
| | - Kohji Shirai
- Research Center, Seijinkai, Mihama Hospital, Chiba, Japan
| | - Chen-Huan Chen
- Department of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | | | - Hisanori Kosuge
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Rosa Maria Bruno
- Université Paris Cité, INSERM, PARCC, Paris, France
- Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kazuomi Kario
- Department of Medicine, Jichi Medical University School of Medicine (JMU), Shimotsuke, Japan
| | - Hae Young Lee
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hao-Min Cheng
- Division of Faculty Development, Taipei Veterans General Hospital, Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University, College of Medicine, Taipei, Taiwan
| | - Jiguang Wang
- Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Matthew Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, California, USA
| | - Raymond Townsend
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alberto P. Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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10
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Bruno RM, Pépin JL, Empana JP, Yang RY, Vercamer V, Jouhaud P, Escourrou P, Boutouyrie P. Home monitoring of arterial pulse-wave velocity during COVID-19 total or partial lockdown using connected smart scales . EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2022; 3:362-372. [PMID: 36712157 PMCID: PMC9384477 DOI: 10.1093/ehjdh/ztac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 11/19/2022]
Abstract
Aims To investigate the impact of coronavirus disease 2019 lockdown on trajectories of arterial pulse-wave velocity in a large population of users of connected smart scales that provide reliable measurements of pulse-wave velocity. Methods and results Pulse-wave velocity recordings obtained by Withings Heart Health & Body Composition Wi-Fi Smart Scale users before and during lockdown were analysed. We compared two demonstrative countries: France, where strict lockdown rules were enforced (n = 26 196) and Germany, where lockdown was partial (n = 26 847). Subgroup analysis was conducted in users of activity trackers and home blood pressure monitors. Linear growth curve modelling and trajectory clustering analyses were performed. During lockdown, a significant reduction in vascular stiffness, weight, blood pressure, and physical activity was observed in the overall population. Pulse-wave velocity reduction was greater in France than in Germany, corresponding to 5.2 month reduction in vascular age. In the French population, three clusters of stiffness trajectories were identified: decreasing (21.1%), stable (60.6%), and increasing pulse-wave velocity clusters (18.2%). Decreasing and increasing clusters both had higher pulse-wave velocity and vascular age before lockdown compared with the stable cluster. Only the decreasing cluster showed a significant weight reduction (-400 g), whereas living alone was associated with increasing pulse-wave velocity cluster. No clusters were identified in the German population. Conclusions During total lockdown in France, a reduction in pulse-wave velocity in a significant proportion of French users of connected smart bathroom scales occurred. The impact on long-term cardiovascular health remains to be established.
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Affiliation(s)
- Rosa Maria Bruno
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
- Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, F-75015 Paris, France
| | - Jean Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | | | | | | | | | - Pierre Escourrou
- Centre Interdisciplnaire du Sommeil, 20 rue St SaënsParis 15, France
- Université Paris Saclay, Paris, France
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
- Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, F-75015 Paris, France
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11
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Spronck B. Arterial stiffness on a different scale . EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2022; 3:359-361. [PMID: 36712161 PMCID: PMC9707999 DOI: 10.1093/ehjdh/ztac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.356, 6229ER Maastricht, The Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Level 3, 75 Talavera Road, Macquarie University, NSW 2109, Australia
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12
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Boutouyrie P. Estimating Is Not Measuring: The Lessons About Estimated Pulse Wave Velocity. J Am Heart Assoc 2022; 11:e025830. [PMID: 35535609 PMCID: PMC9238559 DOI: 10.1161/jaha.122.025830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pierre Boutouyrie
- Université de Paris Cité HEGP Assistance Publique hôpitaux de ParisINSERM U970 Paris France
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13
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Benchemoul M, Mateo T, Savery D, Gehin C, Massot B, Ferin G, Vince P, Flesch M. Pulse wave velocity measurement along the ulnar artery in the wrist region using a high frequency ultrasonic array. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:4123-4127. [PMID: 34892134 DOI: 10.1109/embc46164.2021.9629889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A pulse wave velocity (PWV) measurement method performed above a small blood vessel using an ultrasonic probe is studied and reported in this paper. These experimentations are carried out using a high-frequency probe (14-22 MHz), allowing a high level of resolution compatible with the vessel dimensions, combined with an open research ultrasound scanner. High frame-rate (HFR) imaging (10 000 frames per second) is used for a precise PWV estimation. The measurements are performed in-vivo on a healthy volunteer. The probe is placed above the ulnar artery on the wrist in order to make longitudinal scans. In addition to conventional duplex ultrasound evaluation, the measurement of the PWV using this method at this location could strengthen the detection and diagnosis of cardiovascular diseases (CVDs), in particular for arm artery diseases (AADs). Moreover, these experimentations are also carried out within the scope of a demonstration for a potential miniaturized and wearable device (i.e., a probe with fewer elements, typically less than 32, and its associated electronics). The study has shown results coherent with expected PWV and also promising complementary results such as intima-media thickness (IMT) with spatiotemporal resolution on the order of 6.2 μm and 0.1 ms.
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14
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Bikia V, Fong T, Climie RE, Bruno RM, Hametner B, Mayer C, Terentes-Printzios D, Charlton PH. Leveraging the potential of machine learning for assessing vascular ageing: state-of-the-art and future research. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:676-690. [PMID: 35316972 PMCID: PMC7612526 DOI: 10.1093/ehjdh/ztab089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Vascular ageing biomarkers have been found to be predictive of cardiovascular risk independently of classical risk factors, yet are not widely used in clinical practice. In this review, we present two basic approaches for using machine learning (ML) to assess vascular age: parameter estimation and risk classification. We then summarize their role in developing new techniques to assess vascular ageing quickly and accurately. We discuss the methods used to validate ML-based markers, the evidence for their clinical utility, and key directions for future research. The review is complemented by case studies of the use of ML in vascular age assessment which can be replicated using freely available data and code.
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Affiliation(s)
- Vasiliki Bikia
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Swiss Federal Institute of Technology, CH-1015 Lausanne, Vaud, Switzerland
| | - Terence Fong
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Victoria, 3004 Australia,Department of Cardiometabolic Health, Melbourne Medical School, University of Melbourne, Grattan Street, Parkville, Victoria, 3010 Australia
| | - Rachel E Climie
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Victoria, 3004 Australia,Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Rosa-Maria Bruno
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Bernhard Hametner
- Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Christopher Mayer
- Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527, Athens, Greece
| | - Peter H Charlton
- Department of Public Health and Primary Care, Strangeways Research Laboratory, 2 Worts' Causeway, Cambridge, CB1 8RN, UK,Research Centre for Biomedical Engineering, City, University of London, Northampton Square, London, EC1V 0HB, UK,Corresponding author.
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15
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The Latest Progress and Development Trend in the Research of Ballistocardiography (BCG) and Seismocardiogram (SCG) in the Field of Health Care. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11198896] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current status of the research of Ballistocardiography (BCG) and Seismocardiogram (SCG) in the field of medical treatment, health care and nursing was analyzed systematically, and the important direction in the research was explored, to provide reference for the relevant researches. This study, based on two large databases, CNKI and PubMed, used the bibliometric analysis method to review the existing documents in the past 20 years, and made analyses on the literature of BCG and SCG for their annual changes, main countries/regions, types of research, frequently-used subject words, and important research subjects. The results show that the developed countries have taken a leading position in the researches in this field, and have made breakthroughs in some subjects, but their research results have been mainly gained in the area of research and development of the technologies, and very few have been actually industrialized into commodities. This means that in the future the researchers should focus on the transformation of BCG and SCG technologies into commercialized products, and set up quantitative health assessment models, so as to become the daily tools for people to monitor their health status and manage their own health, and as the main approaches of improving the quality of life and preventing diseases for individuals.
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16
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De Luca M, Iacono O, Valente V, Giardino F, Crisci G, Lettieri M, Marra A, Giallauria F, Oliviero U. Can pulse wave velocity (PWV) alone express arterial stiffness? A neglected tool for vascular function assessment. J Basic Clin Physiol Pharmacol 2021; 33:373-379. [PMID: 34284526 DOI: 10.1515/jbcpp-2021-0193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 12/20/2022]
Abstract
Arterial stiffness, defined as the rigidity of the arterial wall, is the consequence of vascular aging and is associated with the full spectrum of cardiovascular diseases. Carotid-femoral pulse wave velocity (cf-PWV) is the gold standard method for arterial stiffness evaluation: it measures the velocity of the arterial pulse along the thoracic and abdominal aorta alongside arterial distensibility. Its value rises as stiffness progresses. Cf-PWV is helpful to assess residual cardiovascular risk (CVR) in hypertension (HT). In fact, an increase in pulsatility and arterial stiffness predicts CVR in patients affected by arterial HT, independently of other risk factors. Arterial stiffness can predict cardiovascular events in several other clinical conditions such as heart failure, diabetes, and pulmonary HT. However, cf-PWV has not been yet included in routine clinical practice so far. A possible reason might be its methodological and theoretical limitations (inaccuracy in the traveled distance, intra and interindividual variability, lack of well-defined references values, and age- and blood pressure-independent cutoff). To exceed these limits a strict adherence to guidelines, use of analytical approaches, and possibility of integrating the results with other stiffness examinations are essential approaches.
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Affiliation(s)
- Mariarosaria De Luca
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Olimpia Iacono
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Valeria Valente
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Federica Giardino
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Giulia Crisci
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Maddalena Lettieri
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Alberto Marra
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
- Center for Pulmonary Hypertension, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Francesco Giallauria
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Ugo Oliviero
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
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Abstract
Arterial stiffness, a leading marker of risk in hypertension, can be measured at material or structural levels, with the latter combining effects of the geometry and composition of the wall, including intramural organization. Numerous studies have shown that structural stiffness predicts outcomes in models that adjust for conventional risk factors. Elastic arteries, nearer to the heart, are most sensitive to effects of blood pressure and age, major determinants of stiffness. Stiffness is usually considered as an index of vascular aging, wherein individuals excessively affected by risk factor exposure represent early vascular aging, whereas those resistant to risk factors represent supernormal vascular aging. Stiffness affects the function of the brain and kidneys by increasing pulsatile loads within their microvascular beds, and the heart by increasing left ventricular systolic load; excessive pressure pulsatility also decreases diastolic pressure, necessary for coronary perfusion. Stiffness promotes inward remodeling of small arteries, which increases resistance, blood pressure, and in turn, central artery stiffness, thus creating an insidious feedback loop. Chronic antihypertensive treatments can reduce stiffness beyond passive reductions due to decreased blood pressure. Preventive drugs, such as lipid-lowering drugs and antidiabetic drugs, have additional effects on stiffness, independent of pressure. Newer anti-inflammatory drugs also have blood pressure independent effects. Reduction of stiffness is expected to confer benefit beyond the lowering of pressure, although this hypothesis is not yet proven. We summarize different steps for making arterial stiffness measurement a keystone in hypertension management and cardiovascular prevention as a whole.
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Affiliation(s)
- Pierre Boutouyrie
- Faculté de Médecine, Université de Paris, INSERM U970, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, France (P.B.)
| | - Phil Chowienczyk
- King's College London British Heart Foundation Centre, Department of Clinical Pharmacology, St Thomas' Hospital, London, United Kingdom (P.C.)
| | - Jay D Humphrey
- Department of Biomedical Engineering and Vascular Biology and Therapeutics Program, Yale University, New Haven, CT (J.D.H.)
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18
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Withings Body Cardio versus Gold Standards of Pulse-Wave Velocity and Body Composition. J Pers Med 2020; 10:jpm10010017. [PMID: 32168728 PMCID: PMC7151625 DOI: 10.3390/jpm10010017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 01/10/2023] Open
Abstract
Home blood pressure monitors are widely used by consumers yet cardiovascular health may be better defined by pulse-wave velocity (PWV). So far, the Withings Body Cardio scale is the only consumer device that has been designed to measure PWV and body composition, including fat mass (FM) and fat-free mass (FFM), in the home setting. While one study has demonstrated that this device meets the acceptable accuracy standards of the ARTERY Society, no study has accounted for the gravitational effect of standing on a scale on aortic-leg PWV. PURPOSE The purpose of this study was to assess the accuracy of PWV and body composition as determined by the Body Cardio scale. METHODS Measurements of PWV and body composition in healthy, young males and females (n = 20) using the Body Cardio device were compared to PWV assessed by applanation tonometry (SphygmoCor) and body composition analysis determined by air displacement plethysmography (Bod Pod). Bland-Altman analysis and mean absolute percent error (MAPE) were used to assess accuracy. RESULTS Data are reported as the mean bias (95% confidence interval). The Body Cardio overestimated PWV by 0.68 m/s (-0.16, 1.51) and FM by 2.91 kg (-2.91, 8.73). Body Cardio PWV and FM estimations had a MAPE of 9.7% and 25.8%, respectively. The Body Cardio underestimated body mass (BM) and FFM by 0.11 kg (-0.41, 0.18) and 2.87 kg (-9.04, 3.30), respectively. Body Cardio BM and FFM estimations had a MAPE of 0.15% and 5.6%, respectively. CONCLUSIONS The Body Cardio scale provides accurate measures of BM and PWV; however, it should be used cautiously for measures of FM and FFM.
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Arumugam S, Colburn DAM, Sia SK. Biosensors for Personal Mobile Health: A System Architecture Perspective. ADVANCED MATERIALS TECHNOLOGIES 2020; 5:1900720. [PMID: 33043127 PMCID: PMC7546526 DOI: 10.1002/admt.201900720] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Indexed: 05/29/2023]
Abstract
Advances in mobile biosensors, integrating developments in materials science and instrumentation, are fueling an expansion in health data being collected and analyzed in decentralized settings. For example, semiconductor-based sensors are enabling measurement of vital signs, and microfluidic-based sensors are enabling measurement of biochemical markers. As biosensors for mobile health are becoming increasingly paired with smart devices, it will become critical for researchers to design biosensors - with appropriate functionalities and specifications - to work seamlessly with accompanying connected hardware and software. This article describes recent research in biosensors, as well as current mobile health devices in use, as classified into four distinct system architectures that take into account the biosensing and data processing functions required in personal mobile health devices. We also discuss the path forward for integrating biosensors into smartphone-based mobile health devices.
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Affiliation(s)
- Siddarth Arumugam
- Department of Biomedical Engineering, Columbia University, 10027 New York, United States
| | - David A M Colburn
- Department of Biomedical Engineering, Columbia University, 10027 New York, United States
| | - Samuel K Sia
- Department of Biomedical Engineering, Columbia University, 10027 New York, United States
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20
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Rastegar S, GholamHosseini H, Lowe A. Non-invasive continuous blood pressure monitoring systems: current and proposed technology issues and challenges. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2019; 43:10.1007/s13246-019-00813-x. [PMID: 31677058 DOI: 10.1007/s13246-019-00813-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/25/2019] [Indexed: 01/03/2023]
Abstract
High blood pressure (BP) or hypertension is the single most crucial adjustable risk factor for cardiovascular diseases (CVDs) and monitoring the arterial blood pressure (ABP) is an efficient way to detect and control the prevalence of the cardiovascular health of patients. Therefore, monitoring the regulation of BP during patients' daily life plays a critical role in the ambulatory setting and the latest mobile health technology. In recent years, many studies have been conducted to explore the feasibility and performance of such techniques in the health care system. The ultimate aim of these studies is to find and develop an alternative to conventional BP monitoring by using cuff-less, easy-to-use, fast, and cost-effective devices for controlling and lowering the physical harm of CVDs to the human body. However, most of the current studies are at the prototype phase and face a range of issues and challenges to meet clinical standards. This review focuses on the description and analysis of the latest continuous and cuff-less methods along with their key challenges and barriers. Particularly, most advanced and standard technologies including pulse transit time (PTT), ultrasound, pulse arrival time (PAT), and machine learning are investigated. The accuracy, portability, and comfort of use of these technologies, and the ability to integrate to the wearable healthcare system are discussed. Finally, the future directions for further study are suggested.
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Affiliation(s)
- Solmaz Rastegar
- School of Engineering, Computer, and Mathematical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand.
| | - Hamid GholamHosseini
- School of Engineering, Computer, and Mathematical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand
| | - Andrew Lowe
- School of Engineering, Computer, and Mathematical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand
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Karampela M, Isomursu M, Porat T, Maramis C, Mountford N, Giunti G, Chouvarda I, Lehocki F. The Extent and Coverage of Current Knowledge of Connected Health: Systematic Mapping Study. J Med Internet Res 2019; 21:e14394. [PMID: 31573915 PMCID: PMC6785722 DOI: 10.2196/14394] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/27/2019] [Accepted: 08/18/2019] [Indexed: 01/09/2023] Open
Abstract
Background This study examines the development of the connected health (CH) research landscape with a view to providing an overview of the existing CH research. The research field of CH has experienced rapid growth coinciding with increasing pressure on health care systems to become more proactive and patient centered. Objective This study aimed to assess the extent and coverage of the current body of knowledge in CH. In doing so, we sought to identify specific topics that have drawn the attention of CH researchers and to identify research gaps, in particular those offering opportunities for further interdisciplinary research. Methods A systematic mapping study that combined scientific contributions from research in the disciplines of medicine, business, computer science, and engineering was used. Overall, seven classification criteria were used to analyze the papers, including publication source, publication year, research type, empirical type, contribution type, research topic, and the medical condition studied. Results The search resulted in 208 papers that were analyzed by a multidisciplinary group of researchers. The results indicated a slow start for CH research but showed a more recent steady upswing since 2013. The majority of papers proposed health care solutions (77/208, 37.0%) or evaluated CH approaches (49/208, 23.5%). Case studies (59/208, 28.3%) and experiments (55/208, 26.4%) were the most popular forms of scientific validation used. Diabetes, cancer, multiple sclerosis, and heart conditions were among the most prevalent medical conditions studied. Conclusions We conclude that CH research has become an established field of research that has grown over the last five years. The results of this study indicate a focus on technology-driven research with a strong contribution from medicine, whereas the business aspects of CH have received less research attention.
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Affiliation(s)
| | | | - Talya Porat
- Imperial College London, London, United Kingdom
| | | | | | | | | | - Fedor Lehocki
- Slovak University of Technology, Bratislava, Slovakia
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22
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Unobtrusive Estimation of Cardiovascular Parameters with Limb Ballistocardiography. SENSORS 2019; 19:s19132922. [PMID: 31266256 PMCID: PMC6651596 DOI: 10.3390/s19132922] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 01/13/2023]
Abstract
This study investigates the potential of the limb ballistocardiogram (BCG) for unobtrusive estimation of cardiovascular (CV) parameters. In conjunction with the reference CV parameters (including diastolic, pulse, and systolic pressures, stroke volume, cardiac output, and total peripheral resistance), an upper-limb BCG based on an accelerometer embedded in a wearable armband and a lower-limb BCG based on a strain gauge embedded in a weighing scale were instrumented simultaneously with a finger photoplethysmogram (PPG). To standardize the analysis, the more convenient yet unconventional armband BCG was transformed into the more conventional weighing scale BCG (called the synthetic weighing scale BCG) using a signal processing procedure. The characteristic features were extracted from these BCG and PPG waveforms in the form of wave-to-wave time intervals, wave amplitudes, and wave-to-wave amplitudes. Then, the relationship between the characteristic features associated with (i) the weighing scale BCG-PPG pair and (ii) the synthetic weighing scale BCG-PPG pair versus the CV parameters, was analyzed using the multivariate linear regression analysis. The results indicated that each of the CV parameters of interest may be accurately estimated by a combination of as few as two characteristic features in the upper-limb or lower-limb BCG, and also that the characteristic features recruited for the CV parameters were to a large extent relevant according to the physiological mechanism underlying the BCG.
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23
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Yousefian P, Shin S, Mousavi AS, Kim CS, Finegan B, McMurtry MS, Mukkamala R, Jang DG, Kwon U, Kim YH, Hahn JO. Physiological Association between Limb Ballistocardiogram and Arterial Blood Pressure Waveforms: A Mathematical Model-Based Analysis. Sci Rep 2019; 9:5146. [PMID: 30914687 PMCID: PMC6435670 DOI: 10.1038/s41598-019-41537-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/12/2019] [Indexed: 01/20/2023] Open
Abstract
By virtue of its direct association with the cardiovascular (CV) functions and compatibility to unobtrusive measurement during daily activities, the limb ballistocardiogram (BCG) is receiving an increasing interest as a viable means for ultra-convenient CV health and disease monitoring. However, limited insights on its physical implications have hampered disciplined interpretation of the BCG and systematic development of the BCG-based approaches for CV health monitoring. In this study, a mathematical model that can predict the limb BCG in responses to the arterial blood pressure (BP) waves in the aorta was developed and experimentally validated. The validated mathematical model suggests that (i) the limb BCG waveform reveals the timings and amplitudes associated with the aortic BP waves; (ii) mechanical filtering exerted by the musculoskeletal properties of the body can obscure the manifestation of the arterial BP waves in the limb BCG; and (iii) the limb BCG exhibits meaningful morphological changes in response to the alterations in the CV risk predictors. The physical insights garnered by the analysis of the mathematical model may open up new opportunities toward next generation of the BCG-based CV healthcare techniques embedded with transparency, interpretability, and robustness against the external variability.
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Affiliation(s)
- Peyman Yousefian
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA
| | - Sungtae Shin
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA
| | - Azin Sadat Mousavi
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA
| | - Chang-Sei Kim
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Barry Finegan
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - M Sean McMurtry
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ramakrishna Mukkamala
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, USA
| | - Dae-Geun Jang
- Device & System Research Center, Samsung Advanced Institute of Technology, Suwon, Gyeonggi, Korea
| | - Uikun Kwon
- Device & System Research Center, Samsung Advanced Institute of Technology, Suwon, Gyeonggi, Korea
| | - Youn Ho Kim
- Device & System Research Center, Samsung Advanced Institute of Technology, Suwon, Gyeonggi, Korea
| | - Jin-Oh Hahn
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA.
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24
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Yao Y, Ghasemi Z, Shandhi MMH, Ashouri H, Xu L, Mukkamala R, Inan OT, Hahn JO. Mitigation of Instrument-Dependent Variability in Ballistocardiogram Morphology: Case Study on Force Plate and Customized Weighing Scale. IEEE J Biomed Health Inform 2019; 24:69-78. [PMID: 30802877 DOI: 10.1109/jbhi.2019.2901635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objective of this study was to investigate the measurement instrument-dependent variability in the morphology of the ballistocardiogram (BCG) waveform in human subjects and computational methods to mitigate the variability. The BCG was measured in 22 young healthy subjects using a high-performance force plate and a customized commercial weighing scale under upright standing posture. The timing and amplitude features associated with the major I, J, K waves in the BCG waveforms were extracted and quantitatively analyzed. The results indicated that 1) the I, J, K waves associated with the weighing scale BCG exhibited delay in the timings within the cardiac cycle relative to the ECG R wave as well as attenuation in the absolute amplitudes than the respective force plate counterparts, whereas 2) the time intervals between the I, J, K waves were comparable. Then, two alternative computational methods were conceived in an attempt to mitigate the discrepancy between force plate versus weighing-scale BCG: a transfer function and an amplitude-phase correction. The results suggested that both methods effectively mitigated the discrepancy in the timings and amplitudes associated with the I, J, K waves between the force plate and weighing-scale BCG. Hence, signal processing may serve as a viable solution to the mitigation of the instrument-induced morphological variability in the BCG, thereby facilitating the standardized analysis and interpretation of the timing and amplitude features in the BCG across wide-ranging measurement platforms.
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25
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Boutouyrie P, Bruno RM. The Clinical Significance and Application of Vascular Stiffness Measurements. Am J Hypertens 2019; 32:4-11. [PMID: 30289432 DOI: 10.1093/ajh/hpy145] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/04/2018] [Indexed: 01/08/2023] Open
Abstract
Increasing evidence points out at vascular stiffness (and in particular aortic stiffness measured by pulse wave velocity) as a reliable biomarker of vascular aging, able to integrate in a single measure the overall burden of cardiovascular (CV) risk factors on the vasculature over time; furthermore, it may be per se a mechanism of disease, by inducing microcirculatory damage and favoring CV events. Increased aortic stiffness has been shown to predict future CV events and improve risk reclassification in those at intermediate risk. However, several questions in this field are still open, limiting the wide use of these tools in the clinical practice. This article will review the basic aspects of physiology of large artery stiffness, as well as current evidence about its possible clinical applications.
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Affiliation(s)
- Pierre Boutouyrie
- Pharmacology unit, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
- INSERM U970, Team, Paris, France
| | - Rosa-Maria Bruno
- INSERM U970, Team, Paris, France
- Department of Internal Medicine, University of Pisa, Pisa, Italy
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26
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Matsushita K, Ding N, Kim ED, Budoff M, Chirinos JA, Fernhall B, Hamburg NM, Kario K, Miyoshi T, Tanaka H, Townsend R. Cardio-ankle vascular index and cardiovascular disease: Systematic review and meta-analysis of prospective and cross-sectional studies. J Clin Hypertens (Greenwich) 2018; 21:16-24. [DOI: 10.1111/jch.13425] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/09/2018] [Accepted: 08/19/2018] [Indexed: 01/15/2023]
Affiliation(s)
| | - Ning Ding
- Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland
| | - Esther D. Kim
- Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA; Torrance California
| | - Julio A. Chirinos
- Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennysylvania
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences; University of Illinois at Chicago; Chicago Illinois
| | - Naomi M. Hamburg
- Section of Vascular Biology; Boston University School of Medicine; Boston Massachusetts
| | | | - Toru Miyoshi
- Department of Cardiovascular Medicine; Okayama University; Okayama Japan
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education; The University of Texas at Austin; Austin Texas
| | - Raymond Townsend
- Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennysylvania
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27
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Modena BD, Bellahsen O, Nikzad N, Chieh A, Parikh N, Dufek DM, Ebner G, Topol EJ, Steinhubl S. Advanced and Accurate Mobile Health Tracking Devices Record New Cardiac Vital Signs. Hypertension 2018; 72:503-510. [PMID: 29967036 PMCID: PMC6044460 DOI: 10.1161/hypertensionaha.118.11177] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 03/28/2018] [Accepted: 05/18/2018] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease remains the leading cause of death and disease worldwide. As demands on an already resource-constrained healthcare system intensify, disease prevention in the future will likely depend on out-of-office monitoring of cardiovascular risk factors. Mobile health tracking devices that can track blood pressure and heart rate, in addition to new cardiac vital signs, such as physical activity level and pulse wave velocity (PWV), offer a promising solution. An initial barrier is the development of accurate and easily-scalable platforms. In this study, we made a customized smartphone app and used mobile health devices to track PWV, blood pressure, heart rate, physical activity, sleep duration, and multiple lifestyle risk factors in ≈250 adults for 17 continual weeks. Eligible participants were identified by a company database and then were consented and enrolled using only a smartphone app, without any special training given. Study participants reported high overall satisfaction, and 73% of participants were able to measure blood pressure and PWV, <1 hour apart, for at least 14 of 17 weeks. The study population's blood pressure, PWV, heart rate, activity levels, sleep duration, and the interrelationships among these measurements were found to closely match either population averages or values obtained from studies performed in a controlled setting. As a proof-of-concept, we demonstrated the accuracy and ease, as well as many challenges, of using mHealth technology to accurately track PWV and new cardiovascular vital signs at home.
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Affiliation(s)
- Brian D Modena
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Otmane Bellahsen
- Division of Digital Health, Withings, Paris, France (O.B., A.C.)
| | - Nima Nikzad
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Angela Chieh
- Division of Digital Health, Withings, Paris, France (O.B., A.C.)
| | - Nathan Parikh
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Danielle Marie Dufek
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Gail Ebner
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Eric J Topol
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Steven Steinhubl
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
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28
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Ghasemi Z, Lee JC, Kim CS, Cheng HM, Sung SH, Chen CH, Mukkamala R, Hahn JO. Estimation of Cardiovascular Risk Predictors from Non-Invasively Measured Diametric Pulse Volume Waveforms via Multiple Measurement Information Fusion. Sci Rep 2018; 8:10433. [PMID: 29992978 PMCID: PMC6041350 DOI: 10.1038/s41598-018-28604-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 06/25/2018] [Indexed: 11/23/2022] Open
Abstract
This paper presents a novel multiple measurement information fusion approach to the estimation of cardiovascular risk predictors from non-invasive pulse volume waveforms measured at the body's diametric (arm and ankle) locations. Leveraging the fact that diametric pulse volume waveforms originate from the common central pulse waveform, the approach estimates cardiovascular risk predictors in three steps by: (1) deriving lumped-parameter models of the central-diametric arterial lines from diametric pulse volume waveforms, (2) estimating central blood pressure waveform by analyzing the diametric pulse volume waveforms using the derived arterial line models, and (3) estimating cardiovascular risk predictors (including central systolic and pulse pressures, pulse pressure amplification, and pulse transit time) from the arterial line models and central blood pressure waveform in conjunction with the diametric pulse volume waveforms. Experimental results obtained from 164 human subjects with a wide blood pressure range (systolic 144 mmHg and diastolic 103 mmHg) showed that the approach could estimate cardiovascular risk predictors accurately (r ≥ 0.78). Further analysis showed that the approach outperformed a generalized transfer function regardless of the degree of pulse pressure amplification. The approach may be integrated with already available medical devices to enable convenient out-of-clinic cardiovascular risk prediction.
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Affiliation(s)
- Zahra Ghasemi
- Department of Mechanical Engineering, University of Maryland, College Park, USA
| | - Jong Chan Lee
- Department of Mechanical Engineering, University of Maryland, College Park, USA
| | - Chang-Sei Kim
- School of Mechanical Engineering, Chonnam National University, Gwangju, South Korea
| | - Hao-Min Cheng
- Department of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Shih-Hsien Sung
- Department of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Chen-Huan Chen
- Department of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Ramakrishna Mukkamala
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, USA
| | - Jin-Oh Hahn
- Department of Mechanical Engineering, University of Maryland, College Park, USA.
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29
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Dumor K, Shoemaker-Moyle M, Nistala R, Whaley-Connell A. Arterial Stiffness in Hypertension: an Update. Curr Hypertens Rep 2018; 20:72. [DOI: 10.1007/s11906-018-0867-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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30
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Sandberg K, Wright SP, Umans JG. Activity Tracking's Newest Companion: Pulse Wave Velocity. Hypertension 2018; 72:294-295. [PMID: 29967043 DOI: 10.1161/hypertensionaha.118.11276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kathryn Sandberg
- From the Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC (K.S., S.P.W., J.G.U.)
| | - Stephen P Wright
- From the Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC (K.S., S.P.W., J.G.U.)
| | - Jason G Umans
- From the Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC (K.S., S.P.W., J.G.U.).,MedStar Health Research Institute, Hyattsville, MD (J.G.U.)
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31
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Tavallali P, Razavi M, Pahlevan NM. Artificial Intelligence Estimation of Carotid-Femoral Pulse Wave Velocity using Carotid Waveform. Sci Rep 2018; 8:1014. [PMID: 29343797 PMCID: PMC5772510 DOI: 10.1038/s41598-018-19457-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/02/2018] [Indexed: 12/13/2022] Open
Abstract
In this article, we offer an artificial intelligence method to estimate the carotid-femoral Pulse Wave Velocity (PWV) non-invasively from one uncalibrated carotid waveform measured by tonometry and few routine clinical variables. Since the signal processing inputs to this machine learning algorithm are sensor agnostic, the presented method can accompany any medical instrument that provides a calibrated or uncalibrated carotid pressure waveform. Our results show that, for an unseen hold back test set population in the age range of 20 to 69, our model can estimate PWV with a Root-Mean-Square Error (RMSE) of 1.12 m/sec compared to the reference method. The results convey the fact that this model is a reliable surrogate of PWV. Our study also showed that estimated PWV was significantly associated with an increased risk of CVDs.
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Affiliation(s)
| | | | - Niema M Pahlevan
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, CA, USA
- Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Huntington Medical Research Institutes, Advanced Imaging Center, Pasadena, CA, USA
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