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At least 181 records · Page 10

Noninvasive Diagnosis of Coronary Artery Disease Using 12-Lead High-Frequency Electrocardiograms

A noninvasive, sensitive method of diagnosing certain pathological conditions of the human heart involves computational processing of digitized electrocardiographic (ECG) signals acquired from a patient at all 12 conventional ECG electrode positions. In the processing, attention is focused on low-amplitude, high-frequency components of those portions of the ECG signals known in the art as QRS complexes. The unique contribution of this method lies in the utilization of signal features and combinations of signal features from various combinations of electrode positions, not reported previously, that have been found to be helpful in diagnosing coronary artery disease and such related pathological conditions as myocardial ischemia, myocardial infarction, and congestive heart failure. The electronic hardware and software used to acquire the QRS complexes and perform some preliminary analyses of their high-frequency components were summarized in Real-Time, High-Frequency QRS Electrocardiograph (MSC- 23154), NASA Tech Briefs, Vol. 27, No. 7 (July 2003), pp. 26-28. To recapitulate, signals from standard electrocardiograph electrodes are preamplified, then digitized at a sampling rate of 1,000 Hz, then analyzed by the software that detects R waves and QRS complexes and analyzes them from several perspectives. The software includes provisions for averaging signals over multiple beats and for special-purpose nonrecursive digital filters with specific low- and high-frequency cutoffs. These filters, applied to the averaged signal, effect a band-pass operation in the frequency range from 150 to 250 Hz. The output of the bandpass filter is the desired high-frequency QRS signal. Further processing is then performed in real time to obtain the beat-to-beat root mean square (RMS) voltage amplitude of the filtered signal, certain variations of the RMS voltage, and such standard measures as the heart rate and R-R interval at any given time. A key signal feature analyzed in the present method is the presence versus the absence of reduced-amplitude zones (RAZs). In terms that must be simplified for the sake of brevity, an RAZ comprises several cycles of a high-frequency QRS signal during which the amplitude of the high-frequency oscillation in a portion of the signal is abnormally low (see figure). A given signal sample exhibiting an interval of reduced amplitude may or may not be classified as an RAZ, depending on quantitative criteria regarding peaks and troughs within the reduced-amplitude portion of the high-frequency QRS signal. This analysis is performed in all 12 leads in real time.

Schlegel, Todd T.↗

Placental Induced Growth Factor (PIGf) in Coronary Artery Disease

Our previous studies on normal human lymphocytes have shown a five-fold increase (p less than 0.001) in angiogenic inducers such as Placental Induced Growth Factor (PIGf) in physiologically stressful environments such as modeled microgravity, a space analog. This suggests de-regulation of cardiovascular signalling pathways indicated by upregulation of PIGf. In the current study, we measured PIGf in the plasma of 33 patients with and without coronary artery disease (CAD) to investigate whether such disease is associated with increased levels of PIGf. A control consisting of 31 sex matched apparently healthy subjects was also included in the study. We observed that the levels of PIGf in CAD patients were significantly increased compared to those in healthy control subjects (p less than 0.001) and usually increased beyond the clinical threshold level (greater than 27ng/L). The mechanisms leading to up-regulation of angiogenic factors and the adaptation of organisms to stressful environments such as isolation, high altitude, hypoxia, ischemia, microgravity, increased radiation, etc are presently unknown and require further investigation in spaceflight and these other physiologically stressed environments.

Sundaresan, Alamelu↗

Terrestrial Cardiovascular Coronary Artery Disease (CAD) Screening, Treatment and Risk Mitigation - Lessons Learned from Space Medicine

The Bellagio II Summit sought to correlate current ISS (International Space Station) Space Medicine practice in the screening/assessment and management of CAD (Coronary Artery Disease) and to identify terrestrial applications for the general population pertaining to primary, secondary and tertiary diagnoses and treatments. We identified current Space Medicine practice for screening and monitoring cosmonaut and astronaut in the pre-, in-, and post-flight mission phases. We will discuss current Space Medicine standards and guidelines in the recognition and monitoring of CAD development, stabilization, and regression.

Johnston, Smith↗

Integrating vehicle trajectory planning and arterial traffic management to facilitate eco-approach and departure deployment

Eco-approach and departure (EAD) enable continuous vehicle motion in urban signalized corridors. Since such a motion can extend to the EAD vehicles’ followers, it makes EAD a promising technology to benefit the traffic flow where automated vehicles and conventional vehicles coexist. Most existing EAD studies envision an ideal setting that neglects real-world operational conditions such as lane changes, multi-movement intersection configuration, partially automated fleet, and/or limited traffic state awareness. This study aims to fill the gap by designing an EAD algorithm considering real-world traffic operation constraints. The proposed algorithm uses a model predictive controller to minimize vehicle speed reduction and variation based on the real-time traffic signal control plan and measured queues at the intersection. The required inputs are readily available at many modern intersections. We observed that the proposed controller’s performance might degrade because of lane-changing maneuvers and lead-left turn traffic signals. These observations motivated our development of a lane change management strategy and a signal control implementation strategy to facilitate the EAD implementation. The lane change management strategies separate the EAD operations and lane-changing maneuvers in time and space. The signal control implementation strategy applies lag-left turn signals to enable EAD operation for both the through and left-turn vehicles. Compared to the non-EAD case, our EAD approach produces 2.5% to 7.8% energy savings while keeping similar intersection mobility. Notably, this approach brings about 2.5% to 3.6% energy savings in a 2% CAV case. This result demonstrates the feasibility of deploying EAD at low connected automated vehicle penetration rates.

Arterial corridor management↗

Heterogeneity of neutrophils in arterial hypertension

Highlights: • Normal-density and low-density neutrophils from patients with hypertension influx more Na{sup +} compared to normotensive individuals. • Normal-density neutrophils from patients with hypertension generate low levels of reactive oxygen species. • Normal-density and low-density neutrophils from patients with hypertension exhibit lower levels of apoptosis. • Normal-density neutrophils from patients with hypertension maintain an activated and degranulated phenotype. • Low-density neutrophils from patients with hypertension show atypical mitochondrial morphology. Cellular heterogeneity and diversity are recognized to contribute to the functions of neutrophils under homeostatic and pathological conditions. We previously suggested that the chronic inflammatory responses associated with hypertension (HTN) are related to the participation of different subpopulations of neutrophils. Two populations of neutrophils can be obtained by density gradient centrifugation: normal-density neutrophils (NDN) and low-density neutrophils (LDN). However, the lack of standardized functional protocols has limited phenotypic characterization and functional comparisons of LDN and NDN. Based on their capability to incorporate Na{sup +}, maturity and activation stage, we characterized NDN and LDN in blood samples from ten patients with HTN and ten healthy individuals (HI) using flow cytometry. We compared the levels of reactive oxygen species (ROS), generation of neutrophil extracellular traps (NETs) and levels of apoptosis in NDN and LDN. In general, the NDN and LDN subpopulations from patients with HTN exhibited higher levels of sodium influx and ROS, and lower levels of apoptosis than the corresponding NDN and LDN subsets from HI. Transmission electron microscopy revealed NDN and LDN from patients with HTN exhibited alterations to mitochondrial morphology and fewer cytoplasmic granules than the corresponding HI subpopulations. Our results indicate both the NDN and LDN subpopulations enhance the effects of inflammation that contribute to the pathophysiology of HTN. Further detailed studies are required to characterize the events during ontogeny of the myeloid lineage that result in the diverse phenotypic characteristics of each subpopulation of LDN and NDN.

60 APPLIED LIFE SCIENCES↗

Genetics of varicose veins reveals polygenic architecture and genetic overlap with arterial and venous disease

Varicose veins represent a common cause of cardiovascular morbidity, with limited available medical therapies. Although varicose veins are heritable and epidemiologic studies have identified several candidate varicose vein risk factors, the molecular and genetic basis remains uncertain. Here we analyzed the contribution of common genetic variants to varicose veins using data from the Veterans Affairs Million Veteran Program and four other large biobanks. Among 49,765 individuals with varicose veins and 1,334,301 disease-free controls, we identified 139 risk loci. We identified genetic overlap between varicose veins, other vascular diseases and dozens of anthropometric factors. Using Mendelian randomization, we prioritized therapeutic targets via integration of proteomic and transcriptomic data. Finally, topological enrichment analyses confirmed the biologic roles of endothelial shear flow disruption, inflammation, vascular remodeling and angiogenesis. Further, these findings may facilitate future efforts to develop nonsurgical therapies for varicose veins.

59 BASIC BIOLOGICAL SCIENCES↗

Hybrid Recurrent Neural Network Modeling for Traffic Delay Prediction at Signalized Intersections Along an Urban Arterial

This paper studies the traffic delay prediction modeling for multiple signalized intersections along the Ala Moana Boulevard and Nimitz Highway in Hawaii. Several machine learning (ML) based approaches have been studied in the literature, and most of them focused on prediction accuracy rather than the end use of real-time control and implementation. These ML models tend to be very complex and non-linear in nature, making it challenging to achieve fast inferences and are computationally heavy for real-time signal control implementation. As such, in this paper, a simple yet accurate hybrid modeling method is proposed to predict traffic delay one-step ahead with the model made suitable for real-time implementation to control traffic flow. Since real-time road-side measurements are recorded in unstructured form, the paper also discusses other issues related to data extraction and the pre-processing process. Finally, a simple signal control loop is developed to demonstrate the proposed modeling approach, which has shown advantages in model accuracy and computation efficiency compared against several existing modeling methods.

42 ENGINEERING↗