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Ackermann SP, Raab M, Backschat S, Smith DJC, Javelle F, Laborde S. The diving response and cardiac vagal activity: A systematic review and meta-analysis. Psychophysiology 2023; 60:e14183. [PMID: 36219506 DOI: 10.1111/psyp.14183] [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: 11/29/2021] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 01/25/2023]
Abstract
This article aimed to synthesize the various triggers of the diving response and to perform a meta-analysis assessing their effects on cardiac vagal activity. The protocol was preregistered on PROSPERO (CRD42021231419; 01.07.2021). A systematic and meta-analytic review of cardiac vagal activity was conducted, indexed with the root mean square of successive differences (RMSSD) in the context of the diving response. The search on MEDLINE (via PubMed), Web of Science, ProQuest and PsycNet was finalized on November 6th, 2021. Studies with human participants were considered, measuring RMSSD pre- and during and/or post-exposure to at least one trigger of the diving response. Seventeen papers (n = 311) met inclusion criteria. Triggers examined include face immersion or cooling, SCUBA diving, and total body immersion into water. Compared to resting conditions, a significant moderate to large positive effect was found for RMSSD during exposure (Hedges' g = 0.59, 95% CI 0.36 to 0.82, p < .001), but not post-exposure (g = 0.11, 95% CI -0.14 to 0.36, p = .34). Among the considered moderators, total body immersion had a significantly larger effect than forehead cooling (QM = 23.46, df = 1, p < .001). No further differences were detected. Limitations were the small number of studies included, heterogenous triggers, few participants and low quality of evidence. Further research is needed to investigate the role of cardiac sympathetic activity and of the moderators.
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Affiliation(s)
- Stefan Peter Ackermann
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Markus Raab
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,School of Applied Sciences, London South Bank University, London, UK
| | - Serena Backschat
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - David John Charles Smith
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Florian Javelle
- Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,UFR STAPS, EA 4260, Cesams, Normandie Université, Caen, France
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2
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Trybek P, Sobotnicka E, Wawrzkiewicz-Jałowiecka A, Machura Ł, Feige D, Sobotnicki A, Richter-Laskowska M. A New Method of Identifying Characteristic Points in the Impedance Cardiography Signal Based on Empirical Mode Decomposition. SENSORS (BASEL, SWITZERLAND) 2023; 23:675. [PMID: 36679466 PMCID: PMC9861967 DOI: 10.3390/s23020675] [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: 11/25/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
The accurate detection of fiducial points in the impedance cardiography signal (ICG) has a decisive impact on the proper estimation of diagnostic parameters such as stroke volume or cardiac output. It is, therefore, necessary to find an algorithm that is able to assess their positions with great precision. The solution to this problem is, however, quite challenging with regard to the high sensitivity of the ICG technique to the noise and varying morphology of the acquired signals. The aim of this study is to propose a novel method that allows us to overcome these limitations. The developed algorithm is based on Empirical Mode Decomposition (EMD)-an effective technique for processing and analyzing various types of non-stationary signals. We find high correlations between the results obtained from the algorithm and annotated by an expert. This, in turn, implies that the difference in estimation of the diagnostic-relevant parameters is small, which suggests that the method can automatically provide precise clinical information.
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Affiliation(s)
- Paulina Trybek
- Institute of Physics, Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzow, Poland
| | - Ewelina Sobotnicka
- Łukasiewicz Research Network—Krakow Institute of Technology, The Centre for Biomedical Engineering, Zakopianska Str. 73, 30-418 Krakow, Poland
| | - Agata Wawrzkiewicz-Jałowiecka
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Łukasz Machura
- Institute of Physics, Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzow, Poland
| | - Daniel Feige
- Łukasiewicz Research Network—Krakow Institute of Technology, The Centre for Biomedical Engineering, Zakopianska Str. 73, 30-418 Krakow, Poland
- PhD School, Silesian University of Technology, 2A Akademicka, 44-100 Gliwice, Poland
| | - Aleksander Sobotnicki
- Łukasiewicz Research Network—Krakow Institute of Technology, The Centre for Biomedical Engineering, Zakopianska Str. 73, 30-418 Krakow, Poland
| | - Monika Richter-Laskowska
- Institute of Physics, Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzow, Poland
- Łukasiewicz Research Network—Krakow Institute of Technology, The Centre for Biomedical Engineering, Zakopianska Str. 73, 30-418 Krakow, Poland
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3
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Karpiel I, Richter-Laskowska M, Feige D, Gacek A, Sobotnicki A. An Effective Method of Detecting Characteristic Points of Impedance Cardiogram Verified in the Clinical Pilot Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22249872. [PMID: 36560238 PMCID: PMC9782651 DOI: 10.3390/s22249872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 05/12/2023]
Abstract
Accurate and reliable determination of the characteristic points of the impedance cardiogram (ICG) is an important research problem with a growing range of applications in the cardiological diagnostics of patients with heart failure (HF). The shapes of the characteristic waves of the ICG signal and the temporal location of the characteristic points B, C, and X provide significant diagnostic information. On this basis, essential diagnostic cardiological parameters can be determined, such as, e.g., cardiac output (CO) or stroke volume (SV). Although the importance of this problem is obvious, we face many challenges, including noisy signals and the big variability in the morphology, which altogether make the accurate identification of the characteristic points quite difficult. The paper presents an effective method of ICG points identification intended for conducting experimental research in the field of impedance cardiography. Its effectiveness is confirmed in clinical pilot studies.
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Affiliation(s)
- Ilona Karpiel
- Łukasiewicz Research Network, Institute of Medical Technology and Equipment, Roosevelt 118, 41-800 Zabrze, Poland
- Correspondence: ; Tel.: +48-(32)271-60-13
| | - Monika Richter-Laskowska
- Łukasiewicz Research Network, Institute of Medical Technology and Equipment, Roosevelt 118, 41-800 Zabrze, Poland
- Institute of Physics, University of Silesia, 75 Pułku Piechoty 1A, 41-500 Chorzów, Poland
| | - Daniel Feige
- Łukasiewicz Research Network, Institute of Medical Technology and Equipment, Roosevelt 118, 41-800 Zabrze, Poland
- PhD School, Silesian University of Technology, 2A Akademicka, 44-100 Gliwice, Poland
| | - Adam Gacek
- Łukasiewicz Research Network, Institute of Medical Technology and Equipment, Roosevelt 118, 41-800 Zabrze, Poland
| | - Aleksander Sobotnicki
- Łukasiewicz Research Network, Institute of Medical Technology and Equipment, Roosevelt 118, 41-800 Zabrze, Poland
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4
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Sheikh SAA, Gurel NZ, Gupta S, Chukwu IV, Levantsevych O, Alkhalaf M, Soudan M, Abdulbaki R, Haffar A, Vaccarino V, Inan OT, Shah AJ, Clifford GD, Rad AB. Data-driven approach for automatic detection of aortic valve opening: B point detection from impedance cardiogram. Psychophysiology 2022; 59:e14128. [PMID: 35717594 PMCID: PMC9643604 DOI: 10.1111/psyp.14128] [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: 11/27/2021] [Revised: 05/02/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022]
Abstract
Pre-ejection period (PEP), an indicator of sympathetic nervous system activity, is useful in psychophysiology and cardiovascular studies. Accurate PEP measurement is challenging and relies on robust identification of the timing of aortic valve opening, marked as the B point on impedance cardiogram (ICG) signals. The ICG sensitivity to noise and its waveform's morphological variability makes automated B point detection difficult, requiring inefficient and cumbersome expert visual annotation. In this article, we propose a machine learning-based automated algorithm to detect the aortic valve opening for PEP measurement, which is robust against noise and ICG morphological variations. We analyzed over 60 hr of synchronized ECG and ICG records from 189 subjects. A total of 3657 averaged beats were formed using our recently developed ICG noise removal algorithm. Features such as the averaged ICG waveform, its first and second derivatives, as well as high-level morphological and critical hemodynamic parameters were extracted and fed into the regression algorithms to estimate the B point location. The morphological features were extracted from our proposed "variable" physiologically valid search-window related to diverse B point shapes. A subject-wise nested cross-validation procedure was performed for parameter tuning and model assessment. After examining multiple regression models, Adaboost was selected, which demonstrated superior performance and higher robustness to five state-of-the-art algorithms that were evaluated in terms of low mean absolute error of 3.5 ms, low median absolute error of 0.0 ms, high correlation with experts' estimates (Pearson coefficient = 0.9), and low standard deviation of errors of 9.2 ms. For reproducibility, an open-source toolbox is provided.
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Affiliation(s)
- Shafa-at Ali Sheikh
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Nil Z. Gurel
- Neurocardiology Research Center of Excellence and Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Shishir Gupta
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Ikenna V. Chukwu
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Oleksiy Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Majd Soudan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rami Abdulbaki
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Ammer Haffar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, USA
- Atlanta Veterans Affairs Health Care System, Atlanta, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, USA
| | - Ali Bahrami Rad
- Department of Biomedical Informatics, Emory University, Atlanta, USA
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5
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Comparison of TWA and PEP as indices of α2- and ß-adrenergic activation. Psychopharmacology (Berl) 2022; 239:2277-2288. [PMID: 35394159 DOI: 10.1007/s00213-022-06114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE Pre-ejection period (PEP) and T-wave amplitude (TWA) have been used to assess sympathetic nervous system (SNS) activity. Here we report two single-blinded, placebo-controlled intravenous (IV) drug application studies in which we pharmacologically modified SNS activity with epinephrine (study 1) as well as dexmedetomidine (alpha2-agonist) and yohimbine (alpha2-antagonist) (study 2). Restricted heart rate (HR) intervals were analyzed to avoid confounding effects of HR changes. OBJECTIVE Study 1 served to replicate previous findings and to validate our approach, whereas study 2 aimed to investigate how modulation of central SNS activity affects PEP and TWA. METHODS Forty healthy volunteers (58% females) participated in study 1 (between-subject design). Twelve healthy men participated in study 2 (within-subject design). TWA and PEP were derived from ECG and impedance cardiography, respectively. RESULTS Epinephrine shortened PEP and induced statistically significant biphasic TWA changes. However, although the two alpha2-drugs significantly affected PEP as expected, no effects on TWA could be detected. CONCLUSION PEP is better suited to reflect SNS activity changes than TWA.
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Chabchoub S, Mansouri S, Ben Salah R. Signal processing techniques applied to impedance cardiography ICG signals - a review. J Med Eng Technol 2022; 46:243-260. [PMID: 35040738 DOI: 10.1080/03091902.2022.2026508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Over the last decade, Computer-Aided Diagnosis (CAD) systems have been provided significant research focus by researchers. CAD systems have been developed in order to minimise visual errors, to compensate manual interpretation, and to help medical staff to take decisions swiftly. These systems have been considered as powerful tools for a reliable, automatic, and low-cost monitoring and diagnosis. CAD systems are based on analysis and classification of several physiological signals for detecting and assessing different diseases related to the corresponding organ. The implementation of these systems requires the application of several advanced signal processing techniques. Specifically, in cardiology, CAD systems have achieved promising results in providing an accurate and rapid detection of cardiovascular diseases (CVDs). Particularly, the number of works on signal processing field for impedance cardiography (ICG) signals starts to grow slowly in recent years. This paper presents a review study of signal processing techniques applied to the ICG signal for the denoising, the analysis, the classification and the characterisation purposes. This review is intended to provide researchers with a broad overview of the currently used signal processing techniques for ICG signal analysis, as well as to improve future research by applying other recent advanced methods.
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Affiliation(s)
- Souhir Chabchoub
- Laboratory of Biophysics and Medical Technologies, University of Tunis El-Manar, ISTMT, Tunis, Tunisia
| | - Sofienne Mansouri
- Laboratory of Biophysics and Medical Technologies, University of Tunis El-Manar, ISTMT, Tunis, Tunisia.,Department of Medical Equipment Technology, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ridha Ben Salah
- Laboratory of Biophysics and Medical Technologies, University of Tunis El-Manar, ISTMT, Tunis, Tunisia
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7
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Finnegan E, Davidson S, Harford M, Jorge J, Watkinson P, Young D, Tarassenko L, Villarroel M. Pulse arrival time as a surrogate of blood pressure. Sci Rep 2021; 11:22767. [PMID: 34815419 PMCID: PMC8611024 DOI: 10.1038/s41598-021-01358-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Various models have been proposed for the estimation of blood pressure (BP) from pulse transit time (PTT). PTT is defined as the time delay of the pressure wave, produced by left ventricular contraction, measured between a proximal and a distal site along the arterial tree. Most researchers, when they measure the time difference between the peak of the R-wave in the electrocardiogram signal (corresponding to left ventricular depolarisation) and a fiducial point in the photoplethysmogram waveform (as measured by a pulse oximeter attached to the fingertip), describe this erroneously as the PTT. In fact, this is the pulse arrival time (PAT), which includes not only PTT, but also the time delay between the electrical depolarisation of the heart's left ventricle and the opening of the aortic valve, known as pre-ejection period (PEP). PEP has been suggested to present a significant limitation to BP estimation using PAT. This work investigates the impact of PEP on PAT, leading to a discussion on the best models for BP estimation using PAT or PTT. We conducted a clinical study involving 30 healthy volunteers (53.3% female, 30.9 ± 9.35 years old, with a body mass index of 22.7 ± 3.2 kg/m[Formula: see text]). Each session lasted on average 27.9 ± 0.6 min and BP was varied by an infusion of phenylephrine (a medication that causes venous and arterial vasoconstriction). We introduced new processing steps for the analysis of PAT and PEP signals. Various population-based models (Poon, Gesche and Fung) and a posteriori models (inverse linear, inverse squared and logarithm) for estimation of BP from PTT or PAT were evaluated. Across the cohort, PEP was found to increase by 5.5 ms ± 4.5 ms from its baseline value. Variations in PTT were significantly larger in amplitude, - 16.8 ms ± 7.5 ms. We suggest, therefore, that for infusions of phenylephrine, the contribution of PEP on PAT can be neglected. All population-based models produced large BP estimation errors, suggesting that they are insufficient for modelling the complex pathways relating changes in PTT or PAT to changes in BP. Although PAT is inversely correlated with systolic blood pressure (SBP), the gradient of this relationship varies significantly from individual to individual, from - 2946 to - 470.64 mmHg/s in our dataset. For the a posteriori inverse squared model, the root mean squared errors (RMSE) for systolic and diastolic blood pressure (DBP) estimation from PAT were 5.49 mmHg and 3.82 mmHg, respectively. The RMSEs for SBP and DBP estimation by PTT were 4.51 mmHg and 3.53 mmHg, respectively. These models take into account individual calibration curves required for accurate blood pressure estimation. The best performing population-based model (Poon) reported error values around double that of the a posteriori inverse squared model, and so the use of population-based models is not justified.
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Affiliation(s)
- Eoin Finnegan
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK.
| | - Shaun Davidson
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Mirae Harford
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - João Jorge
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Peter Watkinson
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Duncan Young
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Lionel Tarassenko
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Mauricio Villarroel
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
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8
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Pale U, Muller N, Arza A, Atienza D. ReBeatICG: Real-time Low-Complexity Beat-to-beat Impedance Cardiogram Delineation Algorithm. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5618-5624. [PMID: 34892398 DOI: 10.1109/embc46164.2021.9630170] [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
This work presents ReBeatICG, a real-time, low-complexity beat-to-beat impedance cardiography (ICG) delineation algorithm that allows hemodynamic parameters monitoring. The proposed procedure relies only on the ICG signal compared to most algorithms found in the literature that rely on synchronous electrocardiogram signal (ECG) recordings. ReBeatICG was designed with implementation on an ultra-low-power microcontroller (MCU) in mind. The detection accuracy of the developed algorithm is tested against points manually labeled by cardiologists. It achieves a detection Gmean accuracy of 94.9%, 98.6%, 90.3%, and 84.3% for the B, C, X, and O characteristic points, respectively. Furthermore, several hemodynamic parameters were calculated based on annotated characteristic points and compared with values generated from the cardiologists' annotations. ReBeatICG achieved mean error rates of 0.11 ms, 9.72 ms, 8.32 ms, and 3.97% for HR, LVET, IVRT, and relative C-point amplitude, respectively.
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9
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Xie Y, Song R, Yang D, Yu H, Sun C, Xie Q, Xu RX. Motion robust ICG measurements using a two-step spectrum denoising method. Physiol Meas 2021; 42. [PMID: 34433135 DOI: 10.1088/1361-6579/ac2131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/25/2021] [Indexed: 11/11/2022]
Abstract
Objective. Impedance cardiography (ICG) is a noninvasive and continuous method for evaluating stroke volume and cardiac output. However, the ICG measurement is easily interfered due to respiration and body movements. Taking into consideration about the spectral correlations between the simultaneously collected ICG, electrocardiogram (ECG), and acceleration signals, this paper introduces a two-step spectrum denoising method to remove motion artifacts of ICG measurements in both resting and exercising scenarios.Approach. First, the major motion artifacts of ECG and ICG are separately suppressed by the spectral subtraction with respect to acceleration signals. The obtained ECG and ICG are further decomposed into two sets of intrinsic mode functions (IMFs) through the ensemble empirical mode decomposition. We then extract the shared spectral information between the two sets of IMFs using the canonical correlation analysis in a spectral domain. Finally, the ICG signal is reconstructed using those canonical variates with largest spectral correlations with ECG IMFs.Main results. The denoising method was evaluated for 30 subjects under both resting and cycling scenarios. Experimental results show that the beat contribution factor of ICG signals increases from its original 80.1%-97.4% after removing the motion artifacts.Significance. The proposed denoising scheme effectively improves the reliability of diagnosis and analysis on cardiovascular diseases relying on ICG signals.
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Affiliation(s)
- Yao Xie
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China.,Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China
| | - Rencheng Song
- Department of Biomedical Engineering, Hefei University of Technology, Hefei, 230009, People's Republic of China
| | - Dong Yang
- Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China
| | - Honglong Yu
- Department of Biomedical Engineering, Hefei University of Technology, Hefei, 230009, People's Republic of China
| | - Cuimin Sun
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China
| | - Qilian Xie
- Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China.,Anhui Medical University, Hefei, 230032, People's Republic of China
| | - Ronald X Xu
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China
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10
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Groenendaal W, Lee S, van Hoof C. Wearable Bioimpedance Monitoring: Viewpoint for Application in Chronic Conditions. JMIR BIOMEDICAL ENGINEERING 2021. [DOI: 10.2196/22911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Currently, nearly 6 in 10 US adults are suffering from at least one chronic condition. Wearable technology could help in controlling the health care costs by remote monitoring and early detection of disease worsening. However, in recent years, there have been disappointments in wearable technology with respect to reliability, lack of feedback, or lack of user comfort. One of the promising sensor techniques for wearable monitoring of chronic disease is bioimpedance, which is a noninvasive, versatile sensing method that can be applied in different ways to extract a wide range of health care parameters. Due to the changes in impedance caused by either breathing or blood flow, time-varying signals such as respiration and cardiac output can be obtained with bioimpedance. A second application area is related to body composition and fluid status (eg, pulmonary congestion monitoring in patients with heart failure). Finally, bioimpedance can be used for continuous and real-time imaging (eg, during mechanical ventilation). In this viewpoint, we evaluate the use of wearable bioimpedance monitoring for application in chronic conditions, focusing on the current status, recent improvements, and challenges that still need to be tackled.
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11
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Hoemann K, Khan Z, Kamona N, Dy J, Barrett LF, Quigley KS. Investigating the relationship between emotional granularity and cardiorespiratory physiological activity in daily life. Psychophysiology 2021; 58:e13818. [PMID: 33768687 DOI: 10.1111/psyp.13818] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/09/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Emotional granularity describes the ability to create emotional experiences that are precise and context-specific. Despite growing evidence of a link between emotional granularity and mental health, the physiological correlates of granularity have been under-investigated. This study explored the relationship between granularity and cardiorespiratory physiological activity in everyday life, with particular reference to the role of respiratory sinus arrhythmia (RSA), an estimate of vagal influence on the heart often associated with positive mental and physical health outcomes. Participants completed a physiologically triggered experience-sampling protocol including ambulatory recording of electrocardiogram, impedance cardiogram, movement, and posture. At each prompt, participants generated emotion labels to describe their current experience. In an end-of-day survey, participants elaborated on each prompt by rating the intensity of their experience on a standard set of emotion adjectives. Consistent with our hypotheses, individuals with higher granularity exhibited a larger number of distinct patterns of physiological activity during seated rest, and more situationally precise patterns of activity during emotional events: granularity was positively correlated with the number of clusters of cardiorespiratory physiological activity discovered in seated rest data, as well as with the performance of classifiers trained on event-related changes in physiological activity. Granularity was also positively associated with RSA during seated rest periods, although this relationship did not reach significance in this sample. These findings are consistent with constructionist accounts of emotion that propose concepts as a key mechanism underlying individual differences in emotional experience, physiological regulation, and physical health.
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Affiliation(s)
- Katie Hoemann
- Department of Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Zulqarnain Khan
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, USA
| | - Nada Kamona
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Jennifer Dy
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, USA
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Karen S Quigley
- Department of Psychology, Northeastern University, Boston, MA, USA.,Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
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12
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Silvia PJ, McHone AN, Mironovová Z, Eddington KM, Harper KL, Sperry SH, Kwapil TR. RZ Interval as an Impedance Cardiography Indicator of Effort-Related Cardiac Sympathetic Activity. Appl Psychophysiol Biofeedback 2021; 46:83-90. [PMID: 33170410 PMCID: PMC7880868 DOI: 10.1007/s10484-020-09493-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 11/27/2022]
Abstract
Research on effort and motivation commonly assesses how the sympathetic branch of the autonomic nervous system affects the cardiovascular system. The cardiac pre-ejection period (PEP), assessed via impedance cardiography, is a common outcome, but assessing PEP requires identifying subtle points on cardiac waveforms. The present research examined the psychometric value of the RZ interval (RZ), which has recently been proposed as an indicator of sympathetic activity, for effort research. Also known as the initial systolic time interval (ISTI), RZ is the time (in ms) between the ECG R peak and the dZ/dt Z peak. Unlike PEP, RZ involves salient waveform points that are easily and reliably identified. Data from two experiments evaluated the suitability of RZ for effort paradigms and compared it to a popular automated PEP method. In Studies 1 (n = 89) and 2 (n = 71), participants completed a standard appetitive task in which each correct response earned a small amount of cash. As expected, incentives significantly affected PEP and RZ in both experiments. PEP and RZ were highly correlated (all rs ≥ 0.89), and RZ consistently yielded a larger effect size than PEP. In Study 3, a quantitative synthesis of the experiments indicated that the effect size of RZ's response to incentives (Hedges's g = 0.432 [0.310, 0.554]) was roughly 15% larger than PEP's effect size (g = 0.376 [0.256, 0.496]). RZ thus appears promising for future research on sympathetic aspects of effort-related cardiac activity.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Ashley N McHone
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Zuzana Mironovová
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Kelly L Harper
- Behavioral Science Division, VA Boston Healthcare System, National Center for PTSD, Boston, USA
| | - Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
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13
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de Zambotti M, Forouzanfar M, Javitz H, Goldstone A, Claudatos S, Alschuler V, Baker FC, Colrain IM. Impact of evening alcohol consumption on nocturnal autonomic and cardiovascular function in adult men and women: a dose-response laboratory investigation. Sleep 2021; 44:zsaa135. [PMID: 32663278 PMCID: PMC7819834 DOI: 10.1093/sleep/zsaa135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/07/2020] [Indexed: 12/12/2022] Open
Abstract
STUDY OBJECTIVES To investigate the dose-dependent impact of moderate alcohol intake on sleep-related cardiovascular (CV) function, in adult men and women. METHODS A total of 26 healthy adults (30-60 years; 11 women) underwent 3 nights of laboratory polysomnographic (PSG) recordings in which different doses of alcohol (low: 1 standard drink for women and 2 drinks for men; high: 3 standard drinks for women and 4 drinks for men; placebo: no alcohol) were administered in counterbalanced order before bedtime. These led to bedtime average breath alcohol levels of up to 0.02% for the low doses and around 0.05% for the high doses. Autonomic and CV function were evaluated using electrocardiography, impedance cardiography, and beat-to-beat blood pressure monitoring. RESULTS Presleep alcohol ingestion resulted in an overall increase in nocturnal heart rate (HR), suppressed total and high-frequency (vagal) HR variability, reduced baroreflex sensitivity, and increased sympathetic activity, with effects pronounced after high-dose alcohol ingestion (p's < 0.05); these changes followed different dose- and measure-dependent nocturnal patterns in men and women. Systolic blood pressure showed greater increases during the morning hours of the high-alcohol dose night compared to the low-alcohol dose night and placebo, in women only (p's < 0.05). CONCLUSIONS Acute evening alcohol consumption, even at moderate doses, has marked dose- and time-dependent effects on sleep CV regulation in adult men and women. Further studies are needed to evaluate the potential CV risk of repeated alcohol-related alterations in nighttime CV restoration in healthy individuals and in those at high risk for CV diseases, considering sex and alcohol dose and time effects.
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Affiliation(s)
| | | | - Harold Javitz
- Center for Health Sciences, SRI International, Menlo Park, CA
| | - Aimee Goldstone
- Center for Health Sciences, SRI International, Menlo Park, CA
| | | | - Vanessa Alschuler
- Center for Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
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14
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Alen NV, Deer LK, Hostinar CE. Autonomic nervous system activity predicts increasing serum cytokines in children. Psychoneuroendocrinology 2020; 119:104745. [PMID: 32535403 DOI: 10.1016/j.psyneuen.2020.104745] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/14/2020] [Accepted: 05/29/2020] [Indexed: 01/05/2023]
Abstract
UNLABELLED Systemic inflammation is associated with increased risk for prevalent and costly diseases, and animal models implicate the autonomic nervous system in the control of inflammatory processes. In humans, research on autonomic-immune connections has been much more limited, and has focused on single branch autonomic measures (i.e., either parasympathetic or sympathetic). The current study utilized cardiac autonomic balance (CAB), derived from dual-branch cardiac autonomic recordings, to test the relation between resting autonomic function and inflammatory reactivity to challenge in children. METHODS Participants included 96 children (51 boys, 45 girls) ages 9-11 years (mean age = 9.93 years, SD = 0.57 years). CAB values were calculated from standardized measures of parasympathetic and sympathetic activity, namely resting respiratory sinus arrhythmia and pre-ejection period data, respectively. Children provided two blood samples, one before and one following exposure to an acute social stressor or control condition. Serum was assayed for four cytokines that orchestrate inflammation: interleukin-6 (IL6), interleukin-8 (IL8), interleukin-10 (IL10), and tumor necrosis factor-alpha (TNFa). RESULTS We discovered large individual differences in inflammatory marker production across children, and no average main effect of stress condition. CAB significantly predicted these individual differences, such that children lower on CAB showed increasing serum cytokines from time 1 to time 2. In contrast, children with greater CAB tended to show declining inflammatory markers across the session. DISCUSSION Low cardiac autonomic balance (i.e., the combination of low parasympathetic and high sympathetic activity) may be a useful marker of proinflammatory tendencies in children, suggesting novel paths for early risk detection and intervention.
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Affiliation(s)
- Nicholas V Alen
- Psychology Department Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95618, United States.
| | - LillyBelle K Deer
- Psychology Department Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95618, United States
| | - Camelia E Hostinar
- Psychology Department Center for Mind and Brain, University of California, Davis, 267 Cousteau Place, Davis, CA 95618, United States.
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15
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Ali Sheikh SA, Shah A, Levantsevych O, Soudan M, Alkhalaf J, Bahrami Rad A, Inan OT, Clifford GD. An open-source automated algorithm for removal of noisy beats for accurate impedance cardiogram analysis. Physiol Meas 2020; 41:075002. [PMID: 32784269 DOI: 10.1088/1361-6579/ab9b71] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The impedance cardiogram (ICG) is a non-invasive sensing modality for assessing the mechanical aspects of cardiac function, but is sensitive to artifacts from respiration, speaking, motion, and electrode displacement. Electrocardiogram (ECG)-synchronized ensemble averaging of ICG (conventional ensemble averaging method) partially mitigates these disturbances, as artifacts from intra-subject variability (ISVar) of ICG morphology and event latency remain. This paper describes an automated algorithm for removing noisy beats for improved artifact suppression in ensemble-averaged (EA) ICG beats. APPROACH Synchronized ECG and ICG signals from 144 male subjects at rest in different psychological conditions were recorded. A 'three-stage EA ICG beat' was formed by passing 60-seconds non-overlapping ECG-synchronized ICG signals through three filtering stages. The amplitude filtering stage removed spikes/noisy beats with amplitudes outside of normal physiological ranges. Cross-correlation was applied to remove noisy beats in coarse and fine filtering stages. The accuracy of the algorithm-detected artifacts was measured with expert-identified artifacts. Agreement between the expert and the algorithm was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots. The ISVar of the cardiac parameters was evaluated to quantify improvement in these estimates provided by the proposed method. MAIN RESULTS The proposed algorithm yielded an accuracy of 96.3% and high inter-rater reliability (ICC > 0.997). Bland-Altman plots showed consistently accurate results across values. The ISVar of the cardiac parameters derived using the proposed method was significantly lower than those derived via conventional ensemble averaging method (p < 0.0001). Enhancement in resolution of fiducial points and smoothing of higher-order time derivatives of the EA ICG beats were observed. SIGNIFICANCE The proposed algorithm provides a robust framework for removal of noisy beats and accurate estimation of ICG-based parameters. Importantly, the methodology reduced the ISVar of cardiac parameters. An open-source toolbox has been provided to enable other researchers to readily reproduce and improve upon this work.
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Affiliation(s)
- Shafa-At Ali Sheikh
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States of America. School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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16
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Hoemann K, Khan Z, Feldman MJ, Nielson C, Devlin M, Dy J, Barrett LF, Wormwood JB, Quigley KS. Context-aware experience sampling reveals the scale of variation in affective experience. Sci Rep 2020; 10:12459. [PMID: 32719368 PMCID: PMC7385108 DOI: 10.1038/s41598-020-69180-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022] Open
Abstract
Emotion research typically searches for consistency and specificity in physiological activity across instances of an emotion category, such as anger or fear, yet studies to date have observed more variation than expected. In the present study, we adopt an alternative approach, searching inductively for structure within variation, both within and across participants. Following a novel, physiologically-triggered experience sampling procedure, participants' self-reports and peripheral physiological activity were recorded when substantial changes in cardiac activity occurred in the absence of movement. Unsupervised clustering analyses revealed variability in the number and nature of patterns of physiological activity that recurred within individuals, as well as in the affect ratings and emotion labels associated with each pattern. There were also broad patterns that recurred across individuals. These findings support a constructionist account of emotion which, drawing on Darwin, proposes that emotion categories are populations of variable instances tied to situation-specific needs.
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Affiliation(s)
| | | | | | | | | | | | - Lisa Feldman Barrett
- Northeastern University, Boston, USA
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, USA
| | - Jolie B Wormwood
- University of New Hampshire, Durham, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA
| | - Karen S Quigley
- Northeastern University, Boston, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA
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17
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Forouzanfar M, Baker FC, Colrain IM, de Zambotti M. Automatic Artifact Detection in Impedance Cardiogram Using Pulse Similarity Index. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2629-2632. [PMID: 31946435 DOI: 10.1109/embc.2019.8856542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Impedance cardiography (ICG) is a noninvasive technique for evaluation of cardiac hemodynamic parameters such as cardiac output and pre-ejection period. However, the sensitivity of the technique to motion artifact, electrode displacement, and cardiovascular pathologies can severely impact the accuracy of hemodynamic parameter estimates. In this paper, we proposed a new algorithm for the automatic detection and exclusion of corrupted ICG cardiac cycles by defining a pulse similarity index that quantifies the level of pulse corruption and its diversion from a typical-shaped pulse. The index considers different features (activity, structure, shape, and pattern) of the ICG cardiac cycles. The algorithm is compared on sleep data collected from 20 participants against expert identified corrupted cycles. The artifact rejection algorithm achieved a high accuracy of 96% in detection of expert-identified corrupted ICG cycles, including those with normal amplitude as well as out-of-range values, and was robust to different types and levels of artifact. The algorithm shows promise toward applications requiring accurate and reliable automatic measurement of cardiac hemodynamic parameters from prolonged data sets.
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18
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Baker FC, Forouzanfar M, Goldstone A, Claudatos SA, Javitz H, Trinder J, de Zambotti M. Changes in heart rate and blood pressure during nocturnal hot flashes associated with and without awakenings. Sleep 2019; 42:zsz175. [PMID: 31408175 PMCID: PMC6802629 DOI: 10.1093/sleep/zsz175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/21/2019] [Indexed: 11/12/2022] Open
Abstract
Hot flashes (HFs) are a hallmark of menopause in midlife women. They are beyond bothersome symptoms, having a profound impact on quality of life and wellbeing, and are a potential marker of cardiovascular (CV) disease risk. Here, we investigated the impact on CV functioning of single nocturnal HFs, considering whether or not they were accompanied by arousals or awakenings. We investigated changes in heart rate (HR, 542 HFs), blood pressure (BP, 261 HFs), and pre-ejection period (PEP, 168 HFs) across individual nocturnal physiological HF events in women in the menopausal transition or post-menopause (age: 50.7 ± 3.6 years) (n = 86 for HR, 45 for BP, 27 for PEP). HFs associated with arousals/awakenings (51.1%), were accompanied by an increase in systolic (SBP; ~6 mmHg) and diastolic (DBP; ~5 mmHg) BP and HR (~20% increase), sustained for several minutes. In contrast, HFs occurring in undisturbed sleep (28.6%) were accompanied by a drop in SBP and a marginal increase in HR, likely components of the heat dissipation response. All HFs were accompanied by decreased PEP, suggesting increased cardiac sympathetic activity, with a prolonged increase for HFs associated with sleep disruption. Older age predicted greater likelihood of HF-related sleep disturbance. HFs were less likely to wake a woman in rapid-eye-movement and slow-wave sleep. Findings show that HFs associated with sleep disruption, which are in the majority and more likely in older women, lead to increases in HR and BP, which could have long-term impact on nocturnal CV restoration in women with multiple HFs.
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Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA
- Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Aimée Goldstone
- Center for Health Sciences, SRI International, Menlo Park, CA
| | | | - Harold Javitz
- Center for Health Sciences, SRI International, Menlo Park, CA
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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19
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Forouzanfar M, Baker FC, Colrain IM, Goldstone A, de Zambotti M. Automatic analysis of pre-ejection period during sleep using impedance cardiogram. Psychophysiology 2019; 56:e13355. [PMID: 30835856 PMCID: PMC6824194 DOI: 10.1111/psyp.13355] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/19/2018] [Accepted: 01/31/2019] [Indexed: 12/17/2022]
Abstract
The pre-ejection period (PEP) is a valid index of myocardial contractility and beta-adrenergic sympathetic control of the heart defined as the time between electrical systole (ECG Q wave) to the initial opening of the aortic valve, estimated as the B point on the impedance cardiogram (ICG). B-point detection accuracy can be severely impacted if ICG cardiac cycles corrupted by motion artifact, noise, or electrode displacement are included in the analyses. Here, we developed new algorithms to detect and exclude corrupted ICG cycles by analyzing their level of activity. PEP was then estimated and analyzed on ensemble-averaged clean ICG cycles using an automatic algorithm previously developed by the authors for the detection of B point in awake individuals. We investigated the algorithms' performance relative to expert visual scoring on long-duration data collected from 20 participants during overnight recordings, where the quality of ICG could be highly affected by movement artifacts and electrode displacements and the signal could also vary according to sleep stage and time of night. The artifact rejection algorithm achieved a high accuracy of 87% in detection of expert-identified corrupted ICG cycles, including those with normal amplitude as well as out-of-range values, and was robust to different types and levels of artifact. Intraclass correlations for concurrent validity of the B-point detection algorithm in different sleep stages and in-bed wakefulness exceeded 0.98, indicating excellent agreement with the expert. The algorithms show promise toward sleep applications requiring accurate and reliable automatic measurement of cardiac hemodynamic parameters.
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Affiliation(s)
- Mohamad Forouzanfar
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Fiona C Baker
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Ian M Colrain
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Aimée Goldstone
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Massimiliano de Zambotti
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
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20
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Automatic Detection Algorithm for Atrial Fibrillation Based on Atrial Fibrillation and Suspicious Boundary of Sinus Rhythm. J Med Syst 2019; 43:160. [DOI: 10.1007/s10916-019-1283-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
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21
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Forouzanfar M, Zambotti MD, Goldstone A, Baker FC. Automatic Detection of Hot Flash Occurrence and Timing from Skin Conductance Activity. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1090-1093. [PMID: 30440580 DOI: 10.1109/embc.2018.8512492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hot flashes (HF) are intense, transient feelings of heat usually accompanied with flushed skin and sweating that are experienced by women around the time of menopause. HFs are associated with poor quality of life and increased cardiovascular risk. Automatic detection of HF occurrence and precise timing of HF onset could provide unique insight into the physiology of the HF and its effect on the cardiovascular system. A novel automatic algorithm is proposed for the detection of HFs occurrence and timing from the sternal skin conductance signal that is robust to noise and artifacts. The method is based on the gold standard rule (2μS rise in skin conductance within 30 s) and considers several conditions based on the skin conductance level and its derivative to reject unwanted events. ECG-derived heart rate pattern variations are studied prior to the detected HF onset. The algorithm is validated against expert detected HFs over 200 hours of sleep data collected from 12 perimenopausal women. It achieved a total accuracy of 93% and a total error of 3% in HF detection. It was observed that heart rate increased before the onset of 80% of the HFs occurring in undisturbed sleep. Application of this algorithm along with fusion of other simultaneously recorded physiological measures has the potential to advance understanding of the HF.
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22
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de Zambotti M, Trinder J, Silvani A, Colrain IM, Baker FC. Dynamic coupling between the central and autonomic nervous systems during sleep: A review. Neurosci Biobehav Rev 2018; 90:84-103. [PMID: 29608990 PMCID: PMC5993613 DOI: 10.1016/j.neubiorev.2018.03.027] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/16/2018] [Accepted: 03/24/2018] [Indexed: 12/19/2022]
Abstract
Sleep is characterized by coordinated cortical and cardiac oscillations reflecting communication between the central (CNS) and autonomic (ANS) nervous systems. Here, we review fluctuations in ANS activity in association with CNS-defined sleep stages and cycles, and with phasic cortical events during sleep (e.g., arousals, K-complexes). Recent novel analytic methods reveal a dynamic organization of integrated physiological networks during sleep and indicate how multiple factors (e.g., sleep structure, age, sleep disorders) affect "CNS-ANS coupling". However, these data are mostly correlational and there is a lack of clarity of the underlying physiology, making it challenging to interpret causality and direction of coupling. Experimental manipulations (e.g., evoking K-complexes or arousals) provide information on the precise temporal sequence of cortical-cardiac activity, and are useful for investigating physiological pathways underlying CNS-ANS coupling. With the emergence of new analytical approaches and a renewed interest in ANS and CNS communication during sleep, future work may reveal novel insights into sleep and cardiovascular interactions during health and disease, in which coupling could be adversely impacted.
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Affiliation(s)
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
| | - Alessandro Silvani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
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