Combining Physiology-Based Modeling and Evolutionary Algorithms for Personalized, Noninvasive Cardiovascular Assessment Based on Electrocardiography and Ballistocardiography

Purpose: This study proposes a novel approach to obtain personalized estimates of cardiovascular parameters by combining (i) electrocardiography and ballistocardiography for noninvasive cardiovascular monitoring, (ii) a physiology-based mathematical model for predicting personalized cardiovascular variables, and (iii) an evolutionary algorithm (EA) for searching optimal model parameters.Methods: Electrocardiogram (ECG), ballistocardiogram (BCG), and a total of six blood pressure measurements are recorded on three healthy subjects. The R peaks in the ECG are used to segment the BCG signal into single BCG curves for each heart beat. The time distance between R peaks is used as an input for a validated physiology-based mathematical model that predicts distributions of pressures and volumes in the cardiovascular system, along with the associated BCG curve. An EA is designed to search the generation of parameter values of the cardiovascular model that optimizes the match between model-predicted and experimentally-measured BCG curves. The physiological relevance of the optimal EA solution is evaluated a posteriori by comparing the model-predicted blood pressure with a cuff placed on the arm of the subjects to measure the blood pressure.Results: The proposed approach successfully captures amplitudes and timings of the most prominent peak and valley in the BCG curve, also known as the J peak and K valley. The values of cardiovascular parameters pertaining to ventricular function can be estimated by the EA in a consistent manner when the search is performed over five different BCG curves corresponding to five different heart-beats of the same subject. Notably, the blood pressure predicted by the physiology-based model with the personalized parameter values provided by the EA search exhibits a very good agreement with the cuff-based blood pressure measurement.Conclusion: The combination of EA with physiology-based modeling proved capable of providing personalized estimates of cardiovascular parameters and physiological variables of great interest, such as blood pressure. This novel approach opens the possibility for developing quantitative devices for noninvasive cardiovascular monitoring based on BCG sensing.

Reduction of Artifacts in Capacitive Electrocardiogram Signals of Driving Subjects

The development of smart cars with e-health services allows monitoring of the health condition of the driver. Driver comfort is preserved by the use of capacitive electrodes, but the recorded signal is characterized by large artifacts. This paper proposes a method for reducing artifacts from the ECG signal recorded by capacitive electrodes (cECG) in moving subjects. Two dominant artifact types are coarse and slow-changing artifacts. Slow-changing artifacts removal by classical filtering is not feasible as the spectral bands of artifacts and cECG overlap, mostly in the band from 0.5 to 15 Hz. We developed a method for artifact removal, based on estimating the fluctuation around linear trend, for both artifact types, including a condition for determining the presence of coarse artifacts. The method was validated on cECG recorded while driving, with the artifacts predominantly due to the movements, as well as on cECG recorded while lying, where the movements were performed according to a predefined protocol. The proposed method eliminates 96% to 100% of the coarse artifacts, while the slow-changing artifacts are completely reduced for the recorded cECG signals larger than 0.3 V. The obtained results are in accordance with the opinion of medical experts. The method is intended for reliable extraction of cardiovascular parameters to monitor driver fatigue status.

Clinical Investigation on the Impact of Cannabis Abuse on Thyroid Hormones and Associated Psychiatric Manifestations in the Male Population

Cannabis abuse is a common public health issue and may lead to considerable adverse effects. Along with other effects, the dependence on cannabis consumption is a serious problem which has significant consequences on biochemical and clinical symptoms. This study intends to evaluate the harmful effects of the use of cannabis on thyroid hormonal levels, cardiovascular indicators, and psychotic symptoms in the included patients. This prospective multicenter study was conducted on cannabis-dependent patients with psychotic symptoms (n = 40) vs. healthy control subjects (n = 40). All participants were evaluated for psychiatric, biochemical, and cardiovascular physiological effects. Patients were selected through Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and urine samples, exclusively for the evaluation of cannabis presence. Serum thyroid stimulating hormone (TSH), T3, and T4 levels were measured using the immunoassay technique. Patients were assessed for severity of depressive, schizophrenic, and manic symptoms using international ranking scales. Various quantifiable factors were also measured for the development of tolerance by cannabis. Among the patients of cannabis abuse, 47.5% were found with schizophrenia, 20% with schizoaffective symptoms, 10% with manic symptoms, and 22.5% with both manic and psychotic symptoms. In the group–group and within-group statistical analysis, the results of thyroid hormones and cardiovascular parameters were non-significant. The psychiatric assessment has shown highly significant (p < 0.001) difference of positive, negative, general psychopathology, and total scores [through Positive and Negative Syndrome Scale (PANSS) rating scales] in patients vs. the healthy control subjects. The study revealed that cannabis abuse did not significantly alter thyroid hormones and cardiovascular parameters due to the development of tolerance. However, the cannabis abuse might have a significant contributing role in the positive, negative, and manic symptoms in different psychiatric disorders.

Correlation study of socio-demographic factors like gender, age, body mass index and some cardiovascular parameters in hypertensive subjects of Yenagoa, Bayelsa state, Nigeria

Hypertension is defined as a sustained elevated arterial pressure to a level that places the patient at increased risk of organ damage. It is a non-communicable disease which constitutes a public health importance. Its risk factors include advancing age, high salt intake, excessive alcohol consumption and stress. This study was performed to determine the correlation between some socio-demographic factors like gender, age, body mass index (BMI) and some cardiovascular parameters in hypertensive patients of Yenagoa, Bayelsa State, Nigeria. The study was carried out with 400 hypertensive subjects, whose blood pressures were determined using palpatory and auscultatory methods. The gender, age and body mass index of the subjects were also determined. Statistical analysis was done using Z-statistics. We found a significant positive relationship between the age and cardiovascular parameters. Gender and BMI were found to have an insignificant positive correlation with the cardiovascular parameters. The study demonstrated that body mass index, age and gender are closely associated with cardiovascular parameters, though the degree of correlation differed. The risk of hypertension is therefore expected to be higher among the aged and populations who are overweight or obese.

Indicators of Obesity and Cardiovascular Parameters in Obese and Non-Obese Subjects

Background and Aim: Obesity is a worldwide epidemic that is endangering an increasing number healthy populations. Obesity is caused by a sedentary lifestyle and poor dietary habits. Although numerous studies on obesity effects on cardiovascular parameters (CVP) are existing, associations between obese and non-obese people are limited. Therefore, the present study aimed to evaluate the indicators for obesity and compared obese and non-obese association with cardiovascular parameters. Materials and Methods: This cross-sectional study was carried out on 80 subjects in the Department of Physiology, Islamic International Medical College, Rawalpindi in collaboration with Railway General Hospital, Rawalpindi for duration of six months i.e from January 2020 to June 2021. All the subjects were divided into obese group-I and non-obese group-II. Each group consisted of 40 subjects. Individuals with body mass index 18 to 25 Kg/m2 and >26 Kg/m2 were considered as obese and non-obese respectively. Informed consent and ethical approval were taken from each individual and hospital ethical committee respectively. All the subjects (BMI> 26 Kg/m2) with medical issues specifically cardio-respiratory and smokers were excluded. Quetelet’s index and Vernier Caliper was used for physical examination and triceps skinfold girth (TSG). SPSS version 23 was used for data analysis. Results: Of the total 80 subjects, the study and control group had 40 subjects each. The overall mean age was 41.31±2.3 years. The mean value of body mass index in the study and control group was 34.6±5 Kg/m2 and 23.4±1.2 Kg/m2 respectively. Mean weight, body mass index, waist circumference (WC), and triceps skin girth (TSG) were found significantly higher in the study group as compared to the control group whereas study group subjects had lower height than the control group (p<0.005). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP) were significantly higher in the study group as compared to control group subjects considering 0.0005 level of significance, however, pulse rate (PR) was insignificant in the study group (0.05). Cardiovascular parameters were found significant and positive in the study group only with a 0.05 level of significance on Pearson’s Correlation. Conclusion: Our study found that shorter height with accelerated pulse rate subjects was prone to cardiovascular diseases. Also, short height with a higher pulse rate is obesity's best indicator correlating in obese or study group. Additionally, obesity has a significant association with subject lipid profile which may elevate the potential risk for cardiovascular disease development. Keywords: Obesity; Cardiovascular Parameters, Obesity Indicators

Sex-Disparity in the Association Between Birthweight and Cardiovascular Parameters in 4-Year-Old Children: A Chinese Cohort Study

Background: Sex-related differences in cardiovascular parameters have been well documented in adults, and the impact of birthweight on cardiovascular health in later life has been acknowledged. However, data was limited regarding the association between birthweight and cardiovascular outcomes at an early age, and the sex-disparity in the association remained unclear.Objective: To investigate the association between birthweight and cardiovascular parameters in 4-year-old children. Furthermore, to explore whether sex-disparity exist in this association or in cardiovascular risk.Methods: Follow-up data from the Shanghai Birth Cohort (SBC) was analyzed. Detailed perinatal information including both maternal and offspring datum were recorded. Blood pressure, echocardiography, and anthropometry assessment were conducted during the follow-up of 4-year-old children. Linear regression models were used to analyze the association between birthweight and left ventricle (LV) structure and function changes in each sex and birthweight category. Multivariable logistic regression models were used to compare risk of left ventricular hypertrophy (LVH) in different birthweight subgroups.Results: Overall, macrosomia was significantly associated with thickened LV posterior wall thickness in systole [LVPWs, (β = 0.26, 95% CI: 0.06, 0.45)] and diastole [LVPWd, (β = 0.18, 95% CI: 0.06, 0.30)], and thickened interventricular septal thickness in diastole [IVSd, (β = 0.16, 95% CI: 0.05, 0.28)]. Boys with macrosomia showed a higher left ventricle mass index [LVMI, (β = 1.29, 95% CI: 0.14, 2.43)], thickened LVPWs (β = 0.30, 95% CI: 0.05, 0.56) and LVPWd (β = 0.21, 95% CI: 0.06, 0.36), and thickened IVSd (β = 0.23, 95% CI: 0.09, 0.36). However, no significant association of structural changes was found in girls. Furthermore, an increased risk of LVH was found solely in macrosomic boys (OR = 2.79, 95% CI: 1.17, 6.63).Conclusion: Children with macrosomia developed cardiovascular changes as early as 4 years of age. Macrosomia was associated with LV structural changes and higher LVH risk in pre-school-aged boys, while no association was found in girls.