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Fassina L, Muzio FPL, Berboth L, Ötvös J, Faragli A, Alogna A. Prediction of Left Ventricle Pressure Indices Via a Machine Learning Approach Combining ECG, Pulse Oximetry, and Cardiac Sounds: a Preclinical Feasibility Study. J Cardiovasc Transl Res 2024:10.1007/s12265-024-10546-2. [PMID: 39017912 DOI: 10.1007/s12265-024-10546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
Heart failure (HF) is defined as the inability of the heart to meet body oxygen demand requiring an elevation in left ventricular filling pressures (LVP) to compensate. LVP increase can be assessed in the cardiac catheterization laboratory, but this procedure is invasive and time-consuming to the extent that physicians rather rely on non-invasive diagnostic tools. In this work, we assess the feasibility to develop a novel machine-learning (ML) approach to predict clinically relevant LVP indices. Synchronized invasive (pressure-volume tracings) and non-invasive signals (ECG, pulse oximetry, and cardiac sounds) were collected from anesthetized, closed-chest Göttingen minipigs. Animals were either healthy or had HF with reduced ejection fraction and circa 500 heartbeats were included in the analysis for each animal. The ML algorithm showed excellent prediction of LVP indices estimating, for instance, the end-diastolic pressure with a R2 of 0.955. This novel ML algorithm could assist clinicians in the care of HF patients.
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Affiliation(s)
- Lorenzo Fassina
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Via Ferrata 5, Pavia, 27100, Italy.
| | - Francesco Paolo Lo Muzio
- Department of Cardiology, Deutsches Herzzentrum Der Charité, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, 13353, Germany
| | - Leonhard Berboth
- Department of Cardiology, Deutsches Herzzentrum Der Charité, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, 13353, Germany
| | - Jens Ötvös
- Department of Cardiology, Deutsches Herzzentrum Der Charité, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, 13353, Germany
| | - Alessandro Faragli
- Department of Cardiology, Deutsches Herzzentrum Der Charité, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, 13353, Germany
| | - Alessio Alogna
- Department of Cardiology, Deutsches Herzzentrum Der Charité, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, 13353, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, 10785, Germany.
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Fallahi MJ, Pezeshkian F, Ranjbar K, Javaheri R, Shahriarirad R. Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study. HEALTH CARE SCIENCE 2024; 3:172-180. [PMID: 38947362 PMCID: PMC11212329 DOI: 10.1002/hcs2.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 07/02/2024]
Abstract
Background Silent hypoxemia is when patients do not experience breathing difficulty in the presence of alarmingly low O2 saturation. It could cause rapid deterioration and higher mortality rates among patients, so prompt detection and identifying predictive factors could result in significantly better outcomes. This study aims to document the evidence of silent hypoxemia in patients with COVID-19 and its clinical features. Methods A total of 78 hospitalized, nonintubated patients with confirmed COVID-19 infection were included in this study. Their O2 saturation was measured with a pulse oximeter (PO), and arterial blood gas (ABG) was taken. Demographic and clinical features were recorded. The Borg scale was used to evaluate dyspnea status, and patients with a score of less than two accompanied by O2 saturation of less than 94% were labeled as silent hypoxic. Univariate analysis was utilized to evaluate the correlation between variables and their odds ratio (OR) and 95% confidence interval (CI). Results Silent hypoxemia was observed in 20 (25.6%) of the participants. The average difference between the PO and ABG methods was 4.36 ± 3.43. Based on regression analysis, dyspnea and respiratory rate demonstrated a statistically significant correlation with the O2 saturation difference between PO and ABG (OR: 2.05; p = 0.026; 95% CI: 0.248-3.847 and OR: 0.144; p = 0.048, 95% CI: 0.001-0.286). Furthermore, the Borg scale (OR: 0.29; p = 0.009; 95% CI: 0.116-0.740) had a significant reverse correlation with silent hypoxia. Conclusions Silent hypoxemia can be a possible complication that affects some COVID-19 patients. Further care should be bestowed upon the younger population and those with underlying neurological or mental illnesses. Furthermore, the respiratory rate, pulse oximeter, and arterial blood gas O2 levels should be considered alongside each other.
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Affiliation(s)
- Mohammad Javad Fallahi
- Department of Internal MedicineShiraz University of Medical SciencesShirazIran
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical ScienceShirazIran
| | | | - Keivan Ranjbar
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical ScienceShirazIran
- School of MedicineShiraz University of Medical SciencesShirazIran
| | - Rojan Javaheri
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical ScienceShirazIran
- School of MedicineShiraz University of Medical SciencesShirazIran
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Li H, Yuan J, Fennell G, Abdulla V, Nistala R, Dandachi D, Ho DKC, Zhang Y. Recent advances in wearable sensors and data analytics for continuous monitoring and analysis of biomarkers and symptoms related to COVID-19. BIOPHYSICS REVIEWS 2023; 4:031302. [PMID: 38510705 PMCID: PMC10903389 DOI: 10.1063/5.0140900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/19/2023] [Indexed: 03/22/2024]
Abstract
The COVID-19 pandemic has changed the lives of many people around the world. Based on the available data and published reports, most people diagnosed with COVID-19 exhibit no or mild symptoms and could be discharged home for self-isolation. Considering that a substantial portion of them will progress to a severe disease requiring hospitalization and medical management, including respiratory and circulatory support in the form of supplemental oxygen therapy, mechanical ventilation, vasopressors, etc. The continuous monitoring of patient conditions at home for patients with COVID-19 will allow early determination of disease severity and medical intervention to reduce morbidity and mortality. In addition, this will allow early and safe hospital discharge and free hospital beds for patients who are in need of admission. In this review, we focus on the recent developments in next-generation wearable sensors capable of continuous monitoring of disease symptoms, particularly those associated with COVID-19. These include wearable non/minimally invasive biophysical (temperature, respiratory rate, oxygen saturation, heart rate, and heart rate variability) and biochemical (cytokines, cortisol, and electrolytes) sensors, sensor data analytics, and machine learning-enabled early detection and medical intervention techniques. Together, we aim to inspire the future development of wearable sensors integrated with data analytics, which serve as a foundation for disease diagnostics, health monitoring and predictions, and medical interventions.
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Affiliation(s)
- Huijie Li
- Department of Biomedical Engineering and the Institute of Materials Science, University of Connecticut, Storrs, Connecticut 06269, USA
| | - Jianhe Yuan
- Department of Electrical Engineering and Computer Science, University of Missouri-Columbia, Columbia, Missouri 65211, USA
| | - Gavin Fennell
- Department of Biomedical Engineering and the Institute of Materials Science, University of Connecticut, Storrs, Connecticut 06269, USA
| | - Vagif Abdulla
- Department of Biomedical Engineering and the Institute of Materials Science, University of Connecticut, Storrs, Connecticut 06269, USA
| | - Ravi Nistala
- Division of Nephrology, Department of Medicine, University of Missouri-Columbia, Columbia, Missouri 65212, USA
| | - Dima Dandachi
- Division of Infectious Diseases, Department of Medicine, University of Missouri-Columbia, 1 Hospital Drive, Columbia, Missouri 65212, USA
| | - Dominic K. C. Ho
- Department of Electrical Engineering and Computer Science, University of Missouri-Columbia, Columbia, Missouri 65211, USA
| | - Yi Zhang
- Department of Biomedical Engineering and the Institute of Materials Science, University of Connecticut, Storrs, Connecticut 06269, USA
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Elron E, Bromiker R, Gleisner O, Yosef-Hai O, Goldberg O, Nitzan I, Nitzan M. Overestimation of Oxygen Saturation Measured by Pulse Oximetry in Hypoxemia. Part 1: Effect of Optical Pathlengths-Ratio Increase. SENSORS (BASEL, SWITZERLAND) 2023; 23:1434. [PMID: 36772474 PMCID: PMC9921559 DOI: 10.3390/s23031434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/06/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
On average, arterial oxygen saturation measured by pulse oximetry (SpO2) is higher in hypoxemia than the true oxygen saturation measured invasively (SaO2), thereby increasing the risk of occult hypoxemia. In the current article, measurements of SpO2 on 17 cyanotic newborns were performed by means of a Nellcor pulse oximeter (POx), based on light with two wavelengths in the red and infrared regions (660 and 900 nm), and by means of a novel POx, based on two wavelengths in the infrared region (761 and 820 nm). The SpO2 readings from the two POxs showed higher values than the invasive SaO2 readings, and the disparity increased with decreasing SaO2. SpO2 measured using the two infrared wavelengths showed better correlation with SaO2 than SpO2 measured using the red and infrared wavelengths. After appropriate calibration, the standard deviation of the individual SpO2-SaO2 differences for the two-infrared POx was smaller (3.6%) than that for the red and infrared POx (6.5%, p < 0.05). The overestimation of SpO2 readings in hypoxemia was explained by the increase in hypoxemia of the optical pathlengths-ratio between the two wavelengths. The two-infrared POx can reduce the overestimation of SpO2 measurement in hypoxemia and the consequent risk of occult hypoxemia, owing to its smaller increase in pathlengths-ratio in hypoxemia.
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Affiliation(s)
- Eyal Elron
- Neonatal Intensive Care Unit, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel
| | - Ruben Bromiker
- Neonatal Intensive Care Unit, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | | | | | - Ori Goldberg
- Neonatal Intensive Care Unit, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Pediatric Pulmonology Institute, Schneider Children’s Medical Center, Petach Tikva 4920235, Israel
| | - Itamar Nitzan
- Shaare Zedek Medical Center, Jerusalem 9103102, Israel
- Department of Pediatrics, Hebrew University of Jerusalem Medical School, Jerusalem 9112102, Israel
| | - Meir Nitzan
- Lev Academic Center, Jerusalem 9116001, Israel
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Nemomssa HD, Raj H. Development of Low-Cost and Portable Pulse Oximeter Device with Improved Accuracy and Accessibility. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:121-129. [PMID: 35547098 PMCID: PMC9084508 DOI: 10.2147/mder.s366053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Hundessa Daba Nemomssa
- School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Oromia, Ethiopia
- Correspondence: Hundessa Daba Nemomssa, Tel +251913763777, Email
| | - Hakkins Raj
- School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Oromia, Ethiopia
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