ASSESSMENT OF CARDIAC HEART FAILURE AND CARDIAC ARTERY DISEASE BY THE HIGHER ORDER SPECTRA

Cardiac diseases are major reason of death in the world populace and the numeral of cases is upsurging every year. Due to cardiac artery disease (CAD), the strength of heart muscles becomes weak and heart pumping is disturbed which may eventually lead to abnormal heart beat and heart failure. Therefore, the beginning stage detection of CAD and cardiac heart failure (CHF) are of prime importance. In this work, we have used a non-invasive diagnosis method as higher order spectra (HOS) for assessment of cardiac diseases. The method indicates whether or not a cardiac heart disease is present, by assessing the cardiac health of subjects using extracted features from heart rate variability (HRV) signals. This assessment is based on 10 spectra nonlinear features. These features were extracted from HRV signals by using the HOS method. For this study, the R-R interval data (i.e. HRV signals) were taken from the standard database of cardiac heart failure (CHF), CAD patients, healthy young (YNG) and Self recorded of healthy young (SELF_YNG) subjects. Statistical assessments were performed on the group of database sets as YNG-CAD, YNG-CHF, SELF_YNG-CAD and Self_YNG-CHF subjects. A Wilcoxon rank sum test ([Formula: see text]-value) was used to statistically compare the features extracted by HOS for group of data sets. It indicates whether or not the same features of individual classes of HRV data sets are dissimilar. The results depicted that the all features are very significant ([Formula: see text]) except the phase entropy (PHE) feature which is not significant for CAD-CHF, SELF_YNG-CAD and SELF_YNG-CHF group of subjects. While in the case of YNG-CAD group of subjects, features like first-order spectral moment of amplitudes of diagonal elements (H3), PHE and logarithmic amplitudes of diagonal elements (H2) are significant ([Formula: see text]) and excluding these features, the remaining features are very significant except MM and H1 which are not significant. The results also depicted that the mean value of sum of logarithmic amplitude (H1), H2, normalized entropy (P1), normalized squared entropy (P2) and PHE features of healthy YNG subjects are having higher values than that of CAD and CHF patients. While weighted center of bi-spectrum (WCOB2) and FLAT spectrum features are lower than CAD and CHF patients compared to YNG subjects. In case of CAD and CHF patients, all the features of CAD patients are having higher values compared to CHF except P1, P2 and WCOB1.

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Abstract P216: Heart Failure Readmission Rates: Experience of St John's Physician Group Practice Demonstration

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap216 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Joseph P Drozda ◽

Donna A Smith ◽

Paul C Freiman ◽

Jeffrey A VanSlette ◽

Timothy R Smith

Keyword(s):

Heart Failure ◽

Readmission Rate ◽

Group Practice ◽

Data Sets ◽

Disease Registry ◽

Readmission Rates ◽

Annual Average ◽

Physician Group ◽

Period 2 ◽

Artery Disease

Objective: The appropriateness of using readmission rates alone as markers of the quality of Heart Failure (HF) care has been questioned. The HF program of St. John's Health System's Physician Group Practice (PGP) Demonstration provided an opportunity to assess a number of outcomes that help to put readmission rates in context. The HF program included disease and case management and a disease registry in the PCP office. Methods: Several data sets were analyzed including the EHR, an inpatient database, the disease registry, and the Social Security Death Master File. Traditional Medicare patients admitted to St. John's Hospital from 2000 to 2010 with a diagnosis of HF, were included resulting in data for 5 years before (Period 1) and 5 years after (Period 2) the 2005 inception of PGP. Results: Total admissions were 3559 in Period 1 and 3514 in Period 2. The prevalence of 3 co-morbid conditions in admitted patients increased during Period 2 [diabetes 35.3% (1256/3559) to 42.7% (1499/3514), p<0.001; hypertension 54.8% (1952/3559) to 70.4% (2475/3514), p<0.0001; and coronary artery disease 62.7% (2253/3559) to 66.4% (2332/3514), p=0.015] indicating that patients were getting more complex. HF admissions trended down significantly from Period 1 (709 annual average) to 2009 (637, p=0.007). The 30 day all cause readmission rate dropped in 2005 [16.9% (137/809)] from Period 1 [annual average 18.8% (671 / 3559), p=0.04] and remained stable thereafter [annual average 16.9% (595/3514)]. The 30 day mortality rate was flat from 2000 to 2009 [2.7(15/550)-5.0% (30/597), p=0.3] and increased in 2010 [8.6% (28/327), p<0.0001]. The use of pacemakers and ICDs was unchanged during Period 2 but ACE inhibitor and beta blocker use increased in PGP practices during 2005 and was constant thereafter. Conclusions: The HF program implemented by this PGP project was associated with decreased HF admissions and with increased clinical complexity of admitted patients. Despite this increasing complexity, the 30 day all cause readmission rate dropped in the first year of the program and remained stable thereafter. Finally, 30 day mortality rates were not adversely affected until the last year of the program. The increased mortality in 2010 may be due to a change in case mix but remains unexplained.

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Atrial fibrillation and COVID-19 in older patients: a complex, dangerous, association. An analysis of the GeroCovid Registry

EP Europace ◽

10.1093/europace/euab116.154 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

S Fumagalli ◽

G Pelagalli ◽

C Trevisan ◽

S Del Signore ◽

S Volpato ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Renal Failure ◽

Chronic Renal Failure ◽

Hospital Mortality ◽

Peripheral Artery Disease ◽

Older Patients ◽

Cardiac Diseases ◽

Peripheral Artery ◽

Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf the GeroCovid Investigators Introduction. Atrial fibrillation (AF) is the most frequent arrhythmia diagnosed in elderly patients. It often associates with disabling complications, such as stroke and systemic embolism. COVID-19 severely affects older subjects, who show a particularly high mortality, often related to relevant alterations in coagulation and inflammation cascade. Purpose. Aim of this study was to evaluate how the presence of a prevalent form of AF (at admission or in clinical history) influenced the clinical course of COVID-19 in an aged in-hospital population. Methods. We studied the acute patients included in GeroCovid, a multicenter retrospective-prospective registry designed by the Italian Society of Gerontology and Geriatric Medicine and the Norwegian Geriatrics Society. GeroCovid, independently of the healthcare setting and without exclusion criteria, enrolled subjects aged >60 years to analyze risk factors, signs, symptoms and outcomes of COVID-19 in older people. For the purpose of this study, only the acute, in-hospital, cohort was evaluated. Results. Between March 1st and June 6th 2020, 2474 patients were enrolled in GeroCovid. Of these, 806 (32.6%) were assisted in hospital, for an acute condition (age: 79 ± 9 years; men: 51.7%). The prevalence of AF was 21.8%. Patients with the arrhythmia were older (82 ± 8 vs. 77 ± 9 years; p < 0.001) and with a higher CHA2DS2-VASc score (4.1 ± 1.5 vs. 3.2 ± 1.5; p < 0.001). The prevalence of almost all comorbidities was higher in AF patients (in particular, hypertension, cardiac diseases, diabetes, heart failure, peripheral artery disease, chronic renal failure, COPD, stroke, obesity). At multivariable analysis, advanced age (p = 0.010), an increased number of white blood cells (p = 0.031), the presence of cardiac diseases (p < 0.001), peripheral artery disease (p = 0.030) and of signs or symptoms of heart failure (p = 0.003) characterized older patients with AF. In-hospital mortality was significantly higher in patients with the arrhythmia (36.9 vs. 27.5%; OR = 1.55, 95%CI = 1.09-2.20; p = 0.015). A multivariable logistic regression model showed that AF was an independent predictor of mortality (p = 0.021), such as male gender (p = 0.014) and the presence of peripheral artery disease (p = 0.003). COPD, stroke, chronic renal failure, diabetes and obesity were deleted from the final model. Conclusions. AF is frequently observed in older patients with COVID-19. Subjects with both conditions have a more complex clinical status and show a higher in-hospital mortality, thus requesting a particularly careful and intensive management.

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Application of higher-order spectra for the characterization of Coronary artery disease using electrocardiogram signals

Biomedical Signal Processing and Control ◽

10.1016/j.bspc.2016.07.003 ◽

2017 ◽

Vol 31 ◽

pp. 31-43 ◽

Cited By ~ 55

Author(s):

U. Rajendra Acharya ◽

Vidya K. Sudarshan ◽

Joel E.W. Koh ◽

Roshan Joy Martis ◽

Jen Hong Tan ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Higher Order ◽

Electrocardiogram Signals ◽

Artery Disease ◽

Higher Order Spectra

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Heart Disease: From Psychosocial to Pathophysiological to Treatment with Biofeedback—An Overview

Biofeedback ◽

10.5298/1081-5937-41.1.03 ◽

2013 ◽

Vol 41 (1) ◽

pp. 39-42

Author(s):

Jan B. Newman

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Stress Response ◽

Vagal Stimulation ◽

Cardiac Diseases ◽

Emotional States ◽

Sympathetic Activation ◽

Artery Disease

Emotions have been connected to the heart throughout the ages, yet they have been largely discounted as playing an important role in heart disease. There is mounting evidence that anxiety, anger, depression, and stress play significant contributing roles in cardiac diseases. These emotional states, coronary artery disease, and heart failure have physiology consistent with the ongoing stress response characterized by parasympathetic withdrawal and sympathetic activation. Pharmacological therapies, vagal stimulation, and sympathetic ablation have shown efficacy in these diseases. Similar results can be obtained by biofeedback therapies.

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