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At least 73 records · Page 4

Quantifying and Visualizing Uncertainty for Source Localisation in Electrocardiographic Imaging

Electrocardiographic imaging (ECGI) presents a clinical opportunity to noninvasively understand the sources of arrhythmias for individual patients. To help increase the effectiveness of ECGI, we provide new ways to visualise associated measurement and modelling errors. Here, we study source localisation uncertainty in two steps: First, we perform Monte Carlo simulations of a simple inverse ECGI source localisation model with error sampling to understand the variations in ECGI solutions. Second, we present multiple visualisation techniques, including confidence maps, level-sets, and topology-based visualisations, to better understand uncertainty in source localization. Our approach offers a new way to study uncertainty in the ECGI pipeline.

47 OTHER INSTRUMENTATION↗

Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes

Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention. Our goal is to quantify T2DM-driven abnormalities in ECG and cardiac imaging biomarkers leading to cardiovascular disease. Methods We quantified ECG and cardiac magnetic resonance imaging biomarkers in two matched cohorts of 1781 UK Biobank participants, with and without T2DM, and no diagnosed cardiovascular disease at the time of assessment. We performed a pair-matched cross-sectional study to compare cardiac biomarkers in both cohorts, and examined the association between T2DM and these biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates. Results Participants with T2DM had a higher resting heart rate (66 vs. 61 beats per minute,p < 0.001), longer QTc interval (424 vs. 420ms,p < 0.001), reduced T wave amplitude (0.33 vs. 0.37mV,p < 0.001), lower stroke volume (72 vs. 78ml,p < 0.001) and thicker left ventricular wall (6.1 vs. 5.9mm,p < 0.001) despite a decreased Sokolow-Lyon index (19.1 vs. 20.2mm,p < 0.001). T2DM was independently associated with higher heart rate (beta = 3.11, 95% CI = [2.11,4.10],p < 0.001), lower stroke volume (beta = −4.11, 95% CI = [−6.03, −2.19],p < 0.001) and higher left ventricular wall thickness (beta = 0.133, 95% CI = [0.081,0.186],p < 0.001). Trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were observed in participants of non-white ethnic background. QRS duration and Sokolow-Lyon index showed a positive association with the development of cardiovascular disease in cohorts with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups. Conclusion T2DM prior to cardiovascular disease was linked with a higher heart rate, QTc prolongation, T wave amplitude reduction, as well as lower stroke volume and increased left ventricular wall thickness. Increased QRS duration and left ventricular wall thickness and mass were most strongly associated with future cardiovascular disease. Although subclinical, these changes may indicate the presence of autonomic dysfunction and diabetic cardiomyopathy. Graphical Abstract

Cardiovascular System & Cardiology↗

Mechanisms of QT prolongation by buprenorphine cannot be explained by direct hERG channel block

Buprenorphine is a μ-opioid receptor (MOR) partial agonist used to manage pain and addiction. QT C prolongation that crosses the 10 msec threshold of regulatory concern was observed at a supratherapeutic dose in two thorough QT studies for the transdermal buprenorphine product BUTRANS®. Because QT C prolongation can be associated with Torsades de Pointes (TdP), a rare but potentially fatal ventricular arrhythmia, these results have led to further investigation of the electrophysiological effects of buprenorphine. Drug-induced QT C prolongation and TdP are most commonly caused by acute inhibition of hERG current (I hERG ) that contribute to the repolarizing phase of the ventricular action potentials (APs). Concomitant inhibition of inward late Na + (I NaL ) and/or L-type Ca 2+ (I CaL ) current can offer some protection against proarrhythmia. Therefore, we characterized the effects of buprenorphine and its major metabolite norbuprenorphine on cardiac hERG, Ca 2+ , and Na + ion channels, as well as cardiac APs. For comparison, methadone, a MOR agonist associated with QT C prolongation and high TdP risk, and naltrexone and naloxone, two opioid receptor antagonists, were also studied. Whole cell recordings were performed at 37°C on cells stably expressing hERG, Ca V 1.2, and Na V 1.5 proteins. Microelectrode array (MEA) recordings were made on human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). The results showed that buprenorphine, norbuprenorphine, naltrexone, and naloxone had no effect on I hERG , I CaL , I NaL , and peak Na + current (I NaP ) at clinically relevant concentrations. In contrast, methadone inhibited I hERG , I CaL , and I NaL . Experiments on iPSC-CMs showed a lack of effect for buprenorphine, norbuprenorphine, naltrexone, and naloxone, and delayed repolarization for methadone at clinically relevant concentrations. The mechanism of QT C prolongation is opioid moiety-specific. This remains undefined for buprenorphine, while for methadone it involves direct hERG channel block. There is no evidence that buprenorphine use is associated with TdP. Whether this lack of TdP risk can be generalized to other drugs with QT C prolongation not mediated by acute hERG channel block warrants further study.

59 BASIC BIOLOGICAL SCIENCES↗

AI-powered topic modeling: comparing LDA and BERTopic in analyzing opioid-related cardiovascular risks in women

Topic modeling is a crucial technique in natural language processing (NLP), enabling the extraction of latent themes from large text corpora. Traditional topic modeling, such as Latent Dirichlet Allocation (LDA), faces limitations in capturing the semantic relationships in the text document although it has been widely applied in text mining. BERTopic, created in 2022, leveraged advances in deep learning and can capture the contextual relationships between words. In this work, we integrated Artificial Intelligence (AI) modules to LDA and BERTopic and provided a comprehensive comparison on the analysis of prescription opioid-related cardiovascular risks in women. Opioid use can increase the risk of cardiovascular problems in women such as arrhythmia, hypotension etc. 1,837 abstracts were retrieved and downloaded from PubMed as of April 2024 using three Medical Subject Headings (MeSH) words: “opioid,” “cardiovascular,” and “women.” Machine Learning of Language Toolkit (MALLET) was employed for the implementation of LDA. BioBERT was used for document embedding in BERTopic. Eighteen was selected as the optimal topic number for MALLET and 23 for BERTopic. ChatGPT-4-Turbo was integrated to interpret and compare the results. The short descriptions created by ChatGPT for each topic from LDA and BERTopic were highly correlated, and the performance accuracies of LDA and BERTopic were similar as determined by expert manual reviews of the abstracts grouped by their predominant topics. The results of the t-SNE (t-distributed Stochastic Neighbor Embedding) plots showed that the clusters created from BERTopic were more compact and well-separated, representing improved coherence and distinctiveness between the topics. Our findings indicated that AI algorithms could augment both traditional and contemporary topic modeling techniques. In addition, BERTopic has the connection port for ChatGPT-4-Turbo or other large language models in its algorithm for automatic interpretation, while with LDA interpretation must be manually, and needs special procedures for data pre-processing and stop words exclusion. Therefore, while LDA remains valuable for large-scale text analysis with resource constraints, AI-assisted BERTopic offers significant advantages in providing the enhanced interpretability and the improved semantic coherence for extracting valuable insights from textual data.

Research & Experimental Medicine↗

Action of acetylstrophanthidin on experimental myocardial infarction.

An experimental animal model with acute myocardial infarction of a size insufficient to produce profound heart failure or shock was used to study the effects of acute infarction on digitalis tolerance and the hemodynamic changes produced by moderate and large doses of acetylstrophanthidin. With acute myocardial infarction, digitalis toxic arrhythmias could be precipitated with significantly lower doses of digitalis than in animals without myocardial infarction. There was no precise correlation between the size of infarction and the toxic dose of glycoside. Coronary artery ligation produced a stable but relatively depressed circulatory state, as evidenced by lowered cardiac output and stroke volume and elevated systemic vascular resistance and left atrial mean pressure. When digitalis was infused, the following significant changes were observed at nontoxic doses: (1) elevation of aortic and left ventricular pressures; (2) further decline in cardiac output; and (3) decreased left atrial mean pressure.

Nola, G. T.↗

Method for analyses of cyclic physiological data that are nonstationary in time.

The proposed method of studying biologic rhythms permits the biologist to view physiological data dynamically without assuming that the data are stationary in time. Vector representation of data points is employed, and the summation of the vectors (train of vectors) produces a summation dial that is able to detect dynamic changes in the time of the peak as well as random walks (arrhythmia).

Winget, C. M.↗

Biomedical engineering tasks

Electrocardiographic and vectorcardiographic bioinstrumentation work centered on the development of a new electrode system harness for Project Skylab. Evaluation of several silver electrode configurations proved superior impedance voltage performance for silver/silver chloride electrodes mounted flush by using a paste adhesive. A portable ECG processor has been designed and a breadboard unit has been built to sample ECG input data at a rate of 500 samples per second for arrhythmia detection. A small real time display driver program has been developed for statistical analysis on selected QPS features. Engineering work on a sleep monitoring cap assembly continued.

Source record↗

Medical legacy of Apollo

Since Apollo crews enjoyed freedom of movement and experienced many of the same problems as earlier crews, confinement had to be ruled out in the etiology of space flight-related changes. Apollo was a mission of physiological firsts: the first inflight illnesses were reported, and a series of cardiac arrhythmias occurred. The most important physiological changes were decreased cardiovascular responsiveness, reduced red blood cell mass, and musculoskeletal deterioration. Vestibular-related problems were also noted for the first time. Crewmen lost weight as a result of a hypocaloric regimen inflight and a tendency to lose body tissue under hypogravic conditions. Aldosterone production increased causing some intracellular fluid loss. Very few of the crewmen experienced any psychological problems after Apollo.

Berry, C. A.↗

Electrocardiogram signal analyzer

Algorithm based on Taylor series expansion of Fourier transform has been developed and used for detection of cardiac arrhythmias in real-time electrocardiogram signal.

Portnoy, W. M.↗

Vectorcardiographic changes during extended space flight

To assess the effects of space flight on cardiac electrical properties, vectorcardiograms were taken on the 9 Skylab astronauts during the flights of 28, 59, and 84 days. The Frank lead system was used and observations were made at rest; during 25%, 50% and 75% of maximum exercise; during a short pulse of exercise (150 watts, 2 minutes); and after exercise. Data from 131 in-flight tests were analyzed by computer and compared to preflight and postflight values. Statistically significant increase in QRS vector magnitude (six of nine crewmen); T vector magnitude (five of nine crewmen); and resting PR interval duration (six of nine crewmen) occurred. During exercise the PR interval did not differ from preflight. Exercise heart rates inflight were the same as preflight, but increased in the immediate postflight period. With the exception of the arrhythmias, no deleterious vectorcardiographic changes were observed during the Skylab missions.

Smith, R. F.↗

Animal exposure during burn tests

An animal exposure test system has been designed and fabricated for the purpose of collecting physiological and environmental (temperature) data from animal subjects exposed to combustion gases in large scale fire tests. The AETS consists of an open wire mesh, two-compartment cage, one containing an exercise wheel for small rodents, and the other containing one rat instrumented externally for electrocardiogram and respiration. The ECG and respiration sensors are located in a belt placed around the torso of the subject, electrode wires forming an umbilical to a connector in the top of the compartment. A cable extends from the connector to the power supply and signal conditioning electronics. These are connected to a dual-beam oscilloscope for real time monitoring and a magnetic tape recorder having three or more channels. Endpoints observed are bradycardia, cardiac arrhythmias, changes in respiratory pattern, respiratory arrest and cardiac arrest. The ECG record also appears to be a good method of monitoring animal activity as indicated by an increase in EMG noise superimposed on the record during increased activity of the torso musculature. Examples of the recordings are presented and discussed as to their significance regarding toxicity of fire gases.

Gaume, J. G.↗

Physiologic and anti-G suit performance data from YF-16 flight tests

Biomedical data were collected during high-G portions of 11 YF-16 test flights. Test pilots monitored revealed increased respiratory rate and volume, decreased tidal volume, and increased heart rate at higher G levels, with one pilot exhibiting various cardiac arrhythmias. Anti-G suit inflation and pressurization lags varied inversely with G-onset rate, and suit pressurization slope was near the design value.

Gillingham, K. K.↗

Cardiovascular function during sustained +G/z/ stress

The development of aerospace systems capable of very high levels of positive vertical accelerators stress has created a need for a better understanding of the cardiovascular responses to acceleration. Using a canine model, the heart and cardiovascular system were instrumented to continuously measure coronary blood flow, cardiac output, left ventricular and aortic root pressure, and oxygen saturation in the aorta, coronary sinus, and right ventricle. The animals were exposed to acceleration profiles up to +6 G, 120 s at peak G; a seatback angle of 45 deg was simulated in some experiments. Radiopaque contrast medium was injected to visualize the left ventricular chamber, coronary vasculature, aorta, and branches of the aorta. The results suggest mechanisms responsible for arrhythmias which may occur, and subendocardial hemorrhage which has been reported in other animals.

Erickson, H. H.↗

Vectorcardiographic changes during extended space flight (M093): Observations at rest and during exercise

The objectives of Skylab Experiment M093 were to measure electrocardiographic signals during space flight, to elucidate the electrophysiological basis for the changes observed, and to assess the effect of the change on the human cardiovascular system. Vectorcardiographic methods were used to quantitate changes, standardize data collection, and to facilitate reduction and statistical analysis of data. Since the Skylab missions provided a unique opportunity to study the effects of prolonged weightlessness on human subjects, an effort was made to construct a data base that contained measurements taken with precision and in adequate number to enable conclusions to be made with a high degree of confidence. Standardized exercise loads were incorporated into the experiment protocol to increase the sensitivity of the electrocardiogram for effects of deconditioning and to detect susceptability for arrhythmias.

Smith, R. F.↗

Pathogenesis of sudden death following water immersion (immersion syndrome)

Sympathetic activity under cold stress is investigated. Predominantly vagal cardio-depressive reflexes are discussed besides currently known mechanisms of sudden death after water immersion. Pronounced circulatory centralization in diving animals as well as following exposure in cold water indicates additional sympathetic activity. In cold water baths of 15 C, measurements indicate an increase in plasma catecholamine levels by more than 300 percent. This may lead to cardiac arrhythmias by the following mechanisms: cold water essentially induces sinus bradycardia; brady-and tachycardiarrhythmias may supervene as secondary complications; sinusbradycardia may be enhanced by sympathetic hypertonus. Furthermore, ectopic dysrhythmias are liable to be induced by the strictly sympathetic innervation of the ventricle. Myocardial ischemia following a rise in peripheral blood pressure constitutes another arrhythmogenic factor. Some of these reactions are enhanced by alcohol intoxication.

Buhring, M.↗

Vagal tone as an index of mental state

The utility of monitoring oscillations in the heart rate pattern as a window to the brain is discussed as an index of general central nervous system status. Quantification of the amplitude of respiratory sinus arrhythmia provides an accurate index of cardiac vagal tone. A number of studies have demonstrated the validity of this measure; the relationship between flight performance and vagal tone has also been studied. In general, the vagal tone index appears to monitor global states of the central nervous system and may be useful in screening the general state of pilots.

Porges, Stephen W.↗