Respiratory monitoring is increasingly used in clinical and healthcare practices to diagnose chronic cardio-pulmonary functional diseases during various routine activities.Wearable medical devices have realized the po...Respiratory monitoring is increasingly used in clinical and healthcare practices to diagnose chronic cardio-pulmonary functional diseases during various routine activities.Wearable medical devices have realized the possibilities of ubiquitous respiratory monitoring,however,relatively little attention is paid to accuracy and reliability.In previous study,a wearable respiration biofeedback system was designed.In this work,three kinds of signals were mixed to extract respiratory rate,i.e.,respiration inductive plethysmography(RIP),3D-acceleration and ECG.In-situ experiments with twelve subjects indicate that the method significantly improves the accuracy and reliability over a dynamic range of respiration rate.It is possible to derive respiration rate from three signals within mean absolute percentage error 4.37%of a reference gold standard.Similarly studies derive respiratory rate from single-lead ECG within mean absolute percentage error 17%of a reference gold standard.展开更多
Introduction Twisted arteries and veins disrupt normal blood flow and elevate the risk for clinical complications such as thrombosis,heart attack,stroke,and organ dysfunction.Veins should remain mechanically stable fo...Introduction Twisted arteries and veins disrupt normal blood flow and elevate the risk for clinical complications such as thrombosis,heart attack,stroke,and organ dysfunction.Veins should remain mechanically stable for normal function.However,compared to arteries,veins are more vulnerable to collapse because they are thin-walled and under lower lumen pressure.Twisted veins have been shown to occur with head turning or after inadvertent twist during various vascular surgeries.In vivo and cadaver studies have demonstrated that turning the head to one side can result in torsion and compression of the internal jugular vein and can compromise cranial drain-展开更多
Point-of-care(POC)testing offers rapid results of diagnostics near the site of patient care,which can significantly improve health care and management of infectious diseases.POC testing now plays a crucial role in hea...Point-of-care(POC)testing offers rapid results of diagnostics near the site of patient care,which can significantly improve health care and management of infectious diseases.POC testing now plays a crucial role in healthcare delivery of both developed and developing countries,particularly in developing countries where medical resources are limited.Challenges remain for the biomedical engineering community to develop truly portable,automatic,low-cost and easyto-use POC tools.Blood tests are the most commonly-used diagnostic methods nowadays because blood analyses provide definitive information of medical conditions of patients.Traditional blood tests,including sample collection,preparation and detection,are conducted using large-scale blood an-展开更多
Introduction Tortuous veins are often seen in the retina,cerebrum,and human legs. Venous tortuosity may affect blood flow and the wall remodeling process,both of which are associated with venous diseases. It has been ...Introduction Tortuous veins are often seen in the retina,cerebrum,and human legs. Venous tortuosity may affect blood flow and the wall remodeling process,both of which are associated with venous diseases. It has been shown that tortuous or vari-展开更多
Introduction Trabeculae carneae are irregular structures that cover the endocardial surfaces of both ventricles of human heart and account for a significant portion of the ventricular mass.However,the role of trabecul...Introduction Trabeculae carneae are irregular structures that cover the endocardial surfaces of both ventricles of human heart and account for a significant portion of the ventricular mass.However,the role of trabeculae carneae in left ventricular(LV)function is not well understood.Previous reports suggested that trabeculae help squeeze blood from the apical region during systole[1].Our recent study suggests that trabeculae carneae hypertrophy and fibrosis contribute to increased LV stiffness in patients with diastolic heart failure,and severing free-running trabeculae carneae may improve diastolic compliance of the LV[2].Objective To understand the role of trabeculae carneae in the left ventricular diastolic and systolic functions using anatomically detailed patient-specific finite element models of the human LV.Methods(1)Image acquisition An explanted human heart was collected from a 63 year old female donor with a history of stroke and congestive heart failure within 24 hours postmortem from South Texas Blood and Tissue Center(San Antonio,TX).The heart was de-identified in accordance with Institutional Review Board(IRB)requirements and informed consent for research was obtained from the donor’s family.Three-dimensional MRI scanning was conducted on a 3T(128 MHz)MRI system(TIM Trio,Siemens Medical Solutions),comprised of a superconducting magnet with a 60 cm diameter accessible bore,when the heart was submerged in a saline filled plastic container.(2)Finite element analysis Three distinct LV models were derived from the MR images.The first model was the intact trabeculated model(TM)which contained all trabeculae carneae and papillary muscles.This high-resolution anatomically detailed 3D model of the LV was segmented from 2D MR images in DICOM format using Mimics(Materialise NV,Leuven,Belgium).The second model was the papillary model(PM),in which the papillary muscles remain intact but most of the trabeculae carneae were excluded in the smoothing process.The third model was the smooth model(SM)in which the trabeculae carneae and papillary muscles were excluded during image segmentation.Finite element(FE)models of the TM,PM and SM were created by meshing 3D reconstructions of the acquired MR images using tetrahedral elements(ICEM,Ansys Inc.,Canonsburg,PA).The mesh size was selected after a pilot study on mesh sensitivity.The passive cardiac muscle was characterized as a hyperelastic,incompressible,transversely isotropic material with a Fung exponential strain energy function.The material constants were determined by matching the end-diastolic pressure-volume relationship with the empirical Klotz relation[3].A rule-based myocardial fiber algorithm was adopted to generate the myofiber directions[4].The active contraction(i.e.,systolic contraction)was modeled by the time varying'Elastance'active contraction model.The contractile parameter Tmax was determined and calibrated so that the FE predicted ejection fraction(EF)of TM matched the EF of a normal human heart at the specified end-systolic pressure[3].The analysis of the TM,PM,and SM models were implemented using the open-source finite element package FEBio(www.febio.org).In all models,the rigid body motion was suppressed by constraining the base from moving in all directions.The end-diastolic and end-systolic pressure-volume relationships(EDPVR and ESPVR)were obtained and characterized by an exponential function and the slope,respectively.Results Our simulation results showed that independent of the material model,the EDPVR curve shifts to the right in PM and SM compared to TM.However,the ESPVR curve may shift to the right or left in PM compared to TM,while shifting tothe right in SM for all material models.EDPVR was steeper in TM compared to PM and SM;however,ESPVR was found to be steeper in PM than in TM and SM.The predicted parameters of EDPVR and ESPVR showed lower average exponential term in PM and SM compared to TM,indicating a significant improvement in the compliance and global diastolic function of less trabeculated LV models(P<0.01).Similarly,the higher average elastance EEs and lower volume intersect in PM compared to TM,suggests that mild cutting of trabeculae carneae slightly improves the global systolic function of the LV(P=0.89).However,cutting all trabeculae carneae and papillary muscles in SM had a significant adverse effect on the global systolic function(P<0.01).Discussion and conclusions Most patient-specific LV studies in the literature have used smoothed ventricular geometries.We used high resolution MRI to capture the endocardial details of the LV.Though reproducing very fine trabeculae carneae was restricted by the MRI resolution,our results demonstrated the importance of considering endocardial structures,i.e.papillary muscles and trabeculae carneae,in the assessment of LV global function in patient-specific computational LV models.The present work is consistent with the observation that diastolic performance improved after severing trabeculae carneae due to a reduction in LV stiffness[2].Furthermore,our results also suggest that severing trabeculae carneae(without affecting papillary muscle)may improve LV systolic function.Our model results are consistent with experimental measurements using ex vivo rabbit heart perfusion[5].This improvement would be greater in hypertrophic hearts because trabeculae carneae are also hypertrophic and more fibrotic.Left ventricular hypertrophy is often associated with heart failure with preserved ejection fraction(HFpEF).There is no effective treatment for HFpEF,which is characterized by impaired diastolic relaxation due to increased LV stiffness.Our results indicate that trabecular cutting could be an effective treatment for HFpEF.展开更多
基金Project(2012M510207)supported by the China Postdoctoral Science FoundationProjects(60932001,61072031)supported by the National Natural Science Foundation of China+2 种基金Project(2012AA02A604)supported by the National High Technology Research and Development Program of ChinaProject(2013ZX03005013)supported by the Next Generation Communication Technology Major Project of National Science and Technology,ChinaProject supported by the"One-hundred Talent"and the"Low-cost Healthcare"Programs of Chinese Academy of Sciences
文摘Respiratory monitoring is increasingly used in clinical and healthcare practices to diagnose chronic cardio-pulmonary functional diseases during various routine activities.Wearable medical devices have realized the possibilities of ubiquitous respiratory monitoring,however,relatively little attention is paid to accuracy and reliability.In previous study,a wearable respiration biofeedback system was designed.In this work,three kinds of signals were mixed to extract respiratory rate,i.e.,respiration inductive plethysmography(RIP),3D-acceleration and ECG.In-situ experiments with twelve subjects indicate that the method significantly improves the accuracy and reliability over a dynamic range of respiration rate.It is possible to derive respiration rate from three signals within mean absolute percentage error 4.37%of a reference gold standard.Similarly studies derive respiratory rate from single-lead ECG within mean absolute percentage error 17%of a reference gold standard.
基金supported by a CAREER award(0644646)from NSFa research grant (R01HL095852)and an MBRS-RISE fellowship(5R25GM060655-12)from the NIHa collaboration grant (11229202)from NNSF of China
文摘Introduction Twisted arteries and veins disrupt normal blood flow and elevate the risk for clinical complications such as thrombosis,heart attack,stroke,and organ dysfunction.Veins should remain mechanically stable for normal function.However,compared to arteries,veins are more vulnerable to collapse because they are thin-walled and under lower lumen pressure.Twisted veins have been shown to occur with head turning or after inadvertent twist during various vascular surgeries.In vivo and cadaver studies have demonstrated that turning the head to one side can result in torsion and compression of the internal jugular vein and can compromise cranial drain-
基金the financial support from Natural Science and Engineering Research Council of Canada(NSERC)
文摘Point-of-care(POC)testing offers rapid results of diagnostics near the site of patient care,which can significantly improve health care and management of infectious diseases.POC testing now plays a crucial role in healthcare delivery of both developed and developing countries,particularly in developing countries where medical resources are limited.Challenges remain for the biomedical engineering community to develop truly portable,automatic,low-cost and easyto-use POC tools.Blood tests are the most commonly-used diagnostic methods nowadays because blood analyses provide definitive information of medical conditions of patients.Traditional blood tests,including sample collection,preparation and detection,are conducted using large-scale blood an-
基金supported by a CAREER award (0644646) from the National Science Foundationa research grant (R01HL095852)+1 种基金a MBRS-RISE fellowship (GM60655) from the National Institute of Health,USAa research grant (10928206) from the National Natural Science Foundation of China
文摘Introduction Tortuous veins are often seen in the retina,cerebrum,and human legs. Venous tortuosity may affect blood flow and the wall remodeling process,both of which are associated with venous diseases. It has been shown that tortuous or vari-
基金supported by a National Innovation Award(15IRG23320009)from the American Heart Association
文摘Introduction Trabeculae carneae are irregular structures that cover the endocardial surfaces of both ventricles of human heart and account for a significant portion of the ventricular mass.However,the role of trabeculae carneae in left ventricular(LV)function is not well understood.Previous reports suggested that trabeculae help squeeze blood from the apical region during systole[1].Our recent study suggests that trabeculae carneae hypertrophy and fibrosis contribute to increased LV stiffness in patients with diastolic heart failure,and severing free-running trabeculae carneae may improve diastolic compliance of the LV[2].Objective To understand the role of trabeculae carneae in the left ventricular diastolic and systolic functions using anatomically detailed patient-specific finite element models of the human LV.Methods(1)Image acquisition An explanted human heart was collected from a 63 year old female donor with a history of stroke and congestive heart failure within 24 hours postmortem from South Texas Blood and Tissue Center(San Antonio,TX).The heart was de-identified in accordance with Institutional Review Board(IRB)requirements and informed consent for research was obtained from the donor’s family.Three-dimensional MRI scanning was conducted on a 3T(128 MHz)MRI system(TIM Trio,Siemens Medical Solutions),comprised of a superconducting magnet with a 60 cm diameter accessible bore,when the heart was submerged in a saline filled plastic container.(2)Finite element analysis Three distinct LV models were derived from the MR images.The first model was the intact trabeculated model(TM)which contained all trabeculae carneae and papillary muscles.This high-resolution anatomically detailed 3D model of the LV was segmented from 2D MR images in DICOM format using Mimics(Materialise NV,Leuven,Belgium).The second model was the papillary model(PM),in which the papillary muscles remain intact but most of the trabeculae carneae were excluded in the smoothing process.The third model was the smooth model(SM)in which the trabeculae carneae and papillary muscles were excluded during image segmentation.Finite element(FE)models of the TM,PM and SM were created by meshing 3D reconstructions of the acquired MR images using tetrahedral elements(ICEM,Ansys Inc.,Canonsburg,PA).The mesh size was selected after a pilot study on mesh sensitivity.The passive cardiac muscle was characterized as a hyperelastic,incompressible,transversely isotropic material with a Fung exponential strain energy function.The material constants were determined by matching the end-diastolic pressure-volume relationship with the empirical Klotz relation[3].A rule-based myocardial fiber algorithm was adopted to generate the myofiber directions[4].The active contraction(i.e.,systolic contraction)was modeled by the time varying'Elastance'active contraction model.The contractile parameter Tmax was determined and calibrated so that the FE predicted ejection fraction(EF)of TM matched the EF of a normal human heart at the specified end-systolic pressure[3].The analysis of the TM,PM,and SM models were implemented using the open-source finite element package FEBio(www.febio.org).In all models,the rigid body motion was suppressed by constraining the base from moving in all directions.The end-diastolic and end-systolic pressure-volume relationships(EDPVR and ESPVR)were obtained and characterized by an exponential function and the slope,respectively.Results Our simulation results showed that independent of the material model,the EDPVR curve shifts to the right in PM and SM compared to TM.However,the ESPVR curve may shift to the right or left in PM compared to TM,while shifting tothe right in SM for all material models.EDPVR was steeper in TM compared to PM and SM;however,ESPVR was found to be steeper in PM than in TM and SM.The predicted parameters of EDPVR and ESPVR showed lower average exponential term in PM and SM compared to TM,indicating a significant improvement in the compliance and global diastolic function of less trabeculated LV models(P<0.01).Similarly,the higher average elastance EEs and lower volume intersect in PM compared to TM,suggests that mild cutting of trabeculae carneae slightly improves the global systolic function of the LV(P=0.89).However,cutting all trabeculae carneae and papillary muscles in SM had a significant adverse effect on the global systolic function(P<0.01).Discussion and conclusions Most patient-specific LV studies in the literature have used smoothed ventricular geometries.We used high resolution MRI to capture the endocardial details of the LV.Though reproducing very fine trabeculae carneae was restricted by the MRI resolution,our results demonstrated the importance of considering endocardial structures,i.e.papillary muscles and trabeculae carneae,in the assessment of LV global function in patient-specific computational LV models.The present work is consistent with the observation that diastolic performance improved after severing trabeculae carneae due to a reduction in LV stiffness[2].Furthermore,our results also suggest that severing trabeculae carneae(without affecting papillary muscle)may improve LV systolic function.Our model results are consistent with experimental measurements using ex vivo rabbit heart perfusion[5].This improvement would be greater in hypertrophic hearts because trabeculae carneae are also hypertrophic and more fibrotic.Left ventricular hypertrophy is often associated with heart failure with preserved ejection fraction(HFpEF).There is no effective treatment for HFpEF,which is characterized by impaired diastolic relaxation due to increased LV stiffness.Our results indicate that trabecular cutting could be an effective treatment for HFpEF.
