Auricall®. A new device for a non-invasive, wireless, continuous monitoring of oxygen saturation and heart rate in patients with heart failure

Tobacco smoke is enormously harmful to human health, thereâ€™s no safe way to smoke. The primary objective of this study is to analyze the role of tobacco smoke compounds and their ability to damage the cardiovascular system and, in particular, to interfere with blood pressure (Brachial and radial pressure), heart rate and partly on the percentage blood Oxygen saturation. A new device has been manufactured which is unique for measuring the level of smoke, to obtained privies readings, the device had fixed to the first reference level آ and starting up from it. The effect of smoking has been studied on (26) male passive (26) active smoker volunteer, (14) female passive and (14) female active smoker participants. The results has been showed that the blood pressure and heart rate has been increased with increasing the number of cigarettes in both genders for passive and active smokers. However, this effect for male was more pronounced comparing with females for passive and active smokers. In the case of oxygen saturation concentration percentage, for males the change of oxygen concentration percentage was not stable. In other words, it was fluctuated with the number of cigarettes. But for females the oxygen concentration was decreased but not too much. This means that this effect was not pronounced. this study found آ that the most pronounced effect has been shown by maleâ€™s comparison to females for both passive and active smokers. As well as in nonsmokerâ€™s males, the relation between heart rate and smoke level is inversely proportional. While in male and female smokers and female nonsmokers the relation is proportional. In all cases the relation between the smoke level and time of smoking is inversely proportional. Finally males& females are affected differently by tobacco use; the sensitivities to smoke for males are higher than in females for passive and active smokers in both brachial and radial blood pressure measurement.

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Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan

European Heart Journal ◽

10.1093/ehjci/ehaa946.0040 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Galli ◽

Y Bouali ◽

C Laurin ◽

A Gallard ◽

A Hubert ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Rank Test ◽

Reduced Ejection Fraction ◽

Non Invasive ◽

Patients With Heart Failure ◽

Increase Risk ◽

Echocardiographic Examination ◽

Constructive Work

Abstract Background The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs). Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients. Methods 79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan. Results Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B). Conclusions In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs. Funding Acknowledgement Type of funding source: None

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Remote monitoring of patients with heart failure during the first national lockdown for COVID-19 in France

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab044 ◽

2021 ◽

Author(s):

Sylvain Ploux ◽

Marc Strik ◽

Saer Abu-Alrub ◽

F Daniel Ramirez ◽

Samuel Buliard ◽

...

Keyword(s):

Heart Failure ◽

Health Care ◽

Heart Rate ◽

Remote Monitoring ◽

Marked Decrease ◽

Clinical Status ◽

Health Care Use ◽

Physiological Variables ◽

Patients With Heart Failure ◽

Vital Parameters

Abstract Background Multiparametric remote monitoring of patients with heart failure (HF) has the potential to mitigate the health risks of lockdowns for COVID-19. Aims To compare health care use, physiological variables, and HF decompensations during one month before and during the first month of the first French national lockdown for COVID-19 among patients undergoing remote monitoring. Methods Transmitted vital parameters and data from cardiac implantable electronic devices were analyzed in 51 patients. Medical contact was defined as the sum of visits and days of hospitalization. Results The lockdown was associated with a marked decrease in cardiology medical contact (118 days before vs 26 days during, -77%, p = 0.003) and overall medical contact (180 days before vs 79 days during, -58%, p = 0.005). Patient adherence with remote monitoring was 84±21% before and 87±19% during lockdown. The lockdown was not associated with significant changes in various parameters, including physical activity (2±1 to 2±1 h/day), weight (83±16 to 83±16 kg), systolic blood pressure (121±19 to 121±18 mmHg), heart rate (68±10 to 67±10 bpm), heart rate variability (89±44 to 78±46 ms, p = 0.05), atrial fibrillation burden (84±146 vs 86±146 h/month), or thoracic impedance (66±8 to 66±9 Ω). Seven cases of HF decompensations were observed before lockdown, all but one of which required hospitalization, versus six during lockdown, all but one of which were managed remotely. Conclusions The lockdown restrictions caused a marked decrease in health care use but no significant change in the clinical status of HF patients under multiparametric remote monitoring. lay summary The first French COVID-19 lockdown had a huge detrimental impact on conventional health care use (-78% in cardiology medical contact). However the lockdown had little impact over the short-term, if any, on vital parameters and the clinical status of patients with heart failure who were adherent to multiparametric remote monitoring. This remote monitoring strategy allowed early identification and home management of most of the heart failure decompensations during the lockdown.

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Heart Rate–Induced Myocardial Ca 2+ Retention and Left Ventricular Volume Loss in Patients With Heart Failure With Preserved Ejection Fraction

Journal of the American Heart Association ◽

10.1161/jaha.120.017215 ◽

2020 ◽

Vol 9 (17) ◽

Author(s):

Daniel N. Silverman ◽

Mehdi Rambod ◽

Daniel L. Lustgarten ◽

Robert Lobel ◽

Martin M. LeWinter ◽

...

Keyword(s):

Heart Failure ◽

Heart Rate ◽

Ejection Fraction ◽

Sinus Rhythm ◽

Left Ventricular ◽

Atrial Pacing ◽

Preserved Ejection Fraction ◽

Volume Loss ◽

Heart Rates ◽

Patients With Heart Failure

Background Increases in heart rate are thought to result in incomplete left ventricular (LV) relaxation and elevated filling pressures in patients with heart failure with preserved ejection fraction (HFpEF). Experimental studies in isolated human myocardium have suggested that incomplete relaxation is a result of cellular Ca 2+ overload caused by increased myocardial Na + levels. We tested these heart rate paradigms in patients with HFpEF and referent controls without hypertension. Methods and Results In 22 fully sedated and instrumented patients (12 controls and 10 patients with HFpEF) in sinus rhythm with a preserved ejection fraction (≥50%) we assessed left‐sided filling pressures and volumes in sinus rhythm and with atrial pacing (95 beats per minute and 125 beats per minute) before atrial fibrillation ablation. Coronary sinus blood samples and flow measurements were also obtained. Seven women and 15 men were studied (aged 59±10 years, ejection fraction 61%±4%). Patients with HFpEF had a history of hypertension, dyspnea on exertion, concentric LV remodeling and a dilated left atrium, whereas controls did not. Pacing at 125 beats per minute lowered the mean LV end‐diastolic pressure in both groups (controls −4.3±4.1 mm Hg versus patients with HFpEF −8.5±6.0 mm Hg, P =0.08). Pacing also reduced LV end‐diastolic volumes. The volume loss was about twice as much in the HFpEF group (controls −15%±14% versus patients with HFpEF −32%±11%, P =0.009). Coronary venous [Ca 2+ ] increased after pacing at 125 beats per minute in patients with HFpEF but not in controls. [Na + ] did not change. Conclusions Higher resting heart rates are associated with lower filling pressures in patients with and without HFpEF. Incomplete relaxation and LV filling at high heart rates lead to a reduction in LV volumes that is more pronounced in patients with HFpEF and may be associated with myocardial Ca 2+ retention.

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