Early Detection Of Heart Failure Research Articles

Wideband and Unidirectional Folded Antenna for Heart Failure Detection System

A wideband folded antenna, which is specifically designed for an early heart failure detection system operating at the ultra-high frequency (UHF) band, is presented. The design procedure starts with a planar structure that includes a loop antenna, a dual monopole, and a loaded parasitic patch. To significantly reduce the size of the antenna and achieve directional radiation as needed for the intended application, the planar structure is folded to form a three-dimensional antenna with the dimensions $0.1\lambda\times 0.29\lambda\times 0.09\lambda$ , where $\lambda$ is the wavelength at the lowest operating frequency. The final tested antenna achieves a peak gain of 4.2 dBi, front-to-back ratio of 7–13 dB and efficiency of more than 87% over 62% fractional bandwidth (560–1060 MHz) at 10-dB return-loss reference. The antenna in addition to a compact microwave transceiver and an adjustable platform are then used to build a monostatic-radar-based heart failure detection system. The system is tested on an artificial torso phantom to verify the potential of such a system in the early detection of heart failure. The used imaging algorithm and obtained promising results are reported in the letter.

Sensing Fluid: The Use of Remote Monitoring Early Detection of Heart Failure to Avert Hospital Admission

Heart failure is the leading cause of cardiovascular death in Canada and one of the most prevalent causes for hospitalization. Management of this patient population relies mainly on the ongoing medical optimization and early intervention to prevent decompensation and hospitalization.

Transjugular intrahepatic portosystemic shunt is associated with significant changes in mitral inflow parameters

Introduction. Liver cirrhosis is associated with hyperdynamic circulation which can result in heart failure. Transjugular intrahepatic portosystemic shunt (TIPS) due to increase of cardiac output is a stressful stimulus for cardiovascular system. Therefore, new methods for early detection of heart failure are needed. Transmitral flow is a marker of diastolic dysfunction.Aim. To analyze short- and long-term effect of TIPS procedure on transmitral flow.Material and Methods. 55 patients (38 men and 17 women, 55.6 ± 8.9 years) with liver cirrhosis treated with TIPS were enrolled in the study. Echocardiography was performed before, 24 h, 7, 30 and 180 days after the procedure. During 6 month follow up 22 patients died.Results. Left ventricle end-diastolic diameter was increasing during the follow-up [baseline: 47 (44.7–51.2) mm, day 7: 50 (46.5–51.3) mm, p < 0.05; day 30: 49.5 (46.7–55.2) mm, p < 0.01; 6 months: 52.5 (48.3–55.2) mm, p < 0.01)]. The peak early filling velocity (E) was significantly increasing [before: 75.5 (60.5–87.3) cm/s, 24 h: 88 (74.3–109.7), p < 0.01; day 7: 89 (81.5–105) p < 0.01; 1 month: 94 (82.7–108.5) p < 0.01; 6 month: 91 (80.1–120.2) p < 0.01]. Peak late atrial filling velocity (A) significantly increased within 24 h after the procedure: 85.1 (76.2–99.5) vs. 91.2 (81.5–104.5) cm/s, p < 0.05. The E/A ratio was increasing during the follow up (baseline: 0.88, 24 h after: 0.89, 1 week: 1.0, 30 days: 1.13, 6 month: 1.06 p < 0.01).Conclusion. Hemodynamic changes following TIPS procedure can be monitored using echocardiography. Transmitral flow analysis can serve as a useful tool for evaluating of diastolic function in these patients.

Multi-parametric MRI as an indirect evaluation tool of the mechanical properties of in-vitrocardiac tissues

BackgroundEarly detection of heart failure is essential to effectively reduce related mortality. The quantification of the mechanical properties of the myocardium, a primordial indicator of the viability of the cardiac tissue, is a key element in patient’s care. Despite an incremental utilization of multi-parametric magnetic resonance imaging (MRI) for cardiac tissue characteristics and function, the link between multi-parametric MRI and the mechanical properties of the heart has not been established. We sought to determine the parametric relationship between the myocardial mechanical properties and the MR parameters. The specific aim was to develop a reproducible evaluative quantitative tool of the mechanical properties of cardiac tissue using multi-parametric MRI associated to principal component analysis.MethodsSamples from porcine hearts were submitted to a multi-parametric MRI acquisition followed by a uniaxial tensile test. Multi linear regressions were performed between dependent (Young’s modulus E) and independent (relaxation times T1, T2 and T2*, magnetization transfer ratio MTR, apparent diffusion coefficient ADC and fractional anisotropy FA) variables. A principal component analysis was used to convert the set of possibly correlated variables into a set of linearly uncorrelated variables.ResultsValues of 46.1±12.7 MPa for E, 729±21 ms for T1, 61±6 ms for T2, 26±7 for T2*, 35±5% for MTRx100, 33.8±4.7 for FAx10-2, and 5.85±0.21 mm2/s for ADCx10-4 were measured. Multi linear regressions showed that only 45% of E can be explained by the MRI parameters. The principal component analysis reduced our seven variables to two principal components with a cumulative variability of 63%, which increased to 80% when considering the third principal component.ConclusionsThe proposed multi-parametric MRI protocol associated to principal component analysis is a promising tool for the evaluation of mechanical properties within the left ventricle in the in vitro porcine model. Our in vitro experiments will now allow us focused in vivo testing on healthy and infracted hearts in order to determine useful quantitative MR-based biomarkers.

CB4-02: Validation of a Natural Language Processing Protocol for Detecting Heart Failure Signs and Symptoms in Electronic Health Record Text Notes

Background/AimsEarly detection of Heart Failure (HF) could help change the natural history of one of the most costly and disabling conditions among older patients through early intervention with treatments. We describe natural language processing (NLP) methods and validation results for detection of major and minor Framingham criteria in electronic health record (EHR) clinical notes as a first step towards early detection of HF.MethodsData for this study were from 6,355 primary care incident heart failure cases identified using Geisinger EHR data between 2001 and 2010 and from 26,052 controls. Text data were from Office Visit, Case Manager, and Radiology notes in the four-year period before diagnosis of HF in cases and a comparable period for controls. Text analysis comprised:During training, NLP results were iteratively validated against the judgments of a cardiologist. The final system was tested against gold standard annotations reflecting the consensus judgments of four trained coding experts.ResultsOver an 8-week period of iterative training, the NLP results on a dataset of 65 encounter notes improved from a positive predictive value (PPV) of 0.741 and a sensitivity (Se) of 0.504 to a final PPV of 0.931 and a Se of 0.939. On the consensus gold standard dataset of 200 cases and 200 controls, the fully-trained system achieved a PPV of 0.925 and a Se of 0.896.DiscussionThe NLP system can accurately identify affirmations and denials of Framingham criteria, which can directly reduce physicians workload for HF-related chart reviews and for possible early detection of HF. In addition, the integrated NLP components and our validation methodology can be adapted for application beyond HF.

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2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults

published online Mar 26, 2009; J. Am. Coll. Cardiol. Lynne Warner Stevenson, and Clyde W. Yancy Ganiats, Marvin A. Konstam, Donna M. Mancini, Peter S. Rahko, Marc A. Silver, Abraham, Donald E. Casey, Arthur M. Feldman, Gary S. Francis, Theodore G. Silver, Lynne Warner Stevenson, Clyde W. Yancy, Mariell Jessup, William T. Konstam, Donna M. Mancini, Keith Michl, John A. Oates, Peter S. Rahko, Marc A. M. Feldman, Gary S. Francis, Theodore G. Ganiats, Mariell Jessup, Marvin A. Transplantation, Sharon Ann Hunt, William T. Abraham, Marshall H. Chin, Arthur Force on Practice Guidelines, International Society for Heart and Lung American College of Cardiology Foundation/American Heart Association Task Diagnosis and Management of Heart Failure in Adults 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the This information is current as of March 27, 2009 http://content.onlinejacc.org/cgi/content/full/j.jacc.2008.11.013v1 located on the World Wide Web at: The online version of this article, along with updated information and services, is

Serum Cystatin C, Renal Filtration Function, and Left Ventricular Remodeling

It is estimated that heart failure (HF) affects 5.7 million Americans and will have an estimated cost of $34.8 billion in 2009.1 However, definitions of HF are mainly symptom based and, therefore, may lead to a gross underestimation of the actual prevalence. One study has shown that only 50% of people with echocardiographic evidence of left ventricular (LV) dysfunction are symptomatic.2 Article see p 98 It is now accepted that there is a link between renal dysfunction and heart disease, although physiological mechanisms remain unclear. The incidence and prevalence of chronic kidney disease are increasing, and it is estimated that 26 million Americans now have chronic kidney disease.1 From a public health standpoint, HF and chronic kidney disease are similar in that the underlying pathology is underway long before symptoms are manifested, thereby causing them to be largely underdiagnosed in their early stages. Any advance or improvement in early detection of HF or chronic kidney disease could have enormous potential to reduce the morbidity and mortality from these treatable diseases. The Dallas Heart Study showed that serum levels of cystatin C were independently associated with LV mass, concentricity, and wall thickness as measured by MRI.3 Male gender, hypertension, and use of antihypertensive medications were all associated with elevations of cystatin C. However, even after adjustment for these and other traditional risk factors, including estimated glomerular filtration rate (eGFR), the associations of cystatin C with a pathological cardiac phenotype persisted. These findings show that the risk of HF predicted by elevations of cystatin C is more than can be explained by its surrogacy as a predictor of impaired renal function. Clinical inferences concerning renal filtration function have been fundamental to medical evaluation of patients for over half a century. Serum creatinine has been the laboratory mainstay measure, …

Pilot Investigation of Cardiogenic Impedance during Heart Failure Induction Using a New Prototype ICD

Introduction: Measurements of cardiogenic impedance (Zc), as defined by beat-to-beat impedance variations, may facilitate early detection of heart failure (HF). We evaluated changes in Zc waveform amplitude and morphology during progression of HF. Methods: A biventricular prototype ICD (St. Jude Medical) with RA, RV, LV bipolar leads and a single shock RV coil were implanted in 3 dogs (D) and 3 sheep (S). Continuous Zc signals were recorded using small current pulses (128 Hz) delivered over 3 bipolar (LVRing-RARing (V1), RVRing-LVRing (V2), RVRing–RVTip (V3)) and 1 quadripolar (RV-LV (V4)) vector configurations.

Cost‐Effective Strategies to Screen for Left Ventricular Systolic Dysfunction in the Community—A Concept

Early detection of heart failure caused by left ventricular systolic dysfunction (LVSD) is important, since early treatment has been shown to retard the progression of heart failure. While traditional echocardiography remains the standard for the detection of LVSD, electrocardiography and serum brain natriuretic peptide have also been shown to predict LVSD. Recently, hand-held echocardiography systems have been shown to have high predictive accuracy for assessment of LVSD. With the availability of the above bedside and relatively less-costly techniques, compared with traditional echocardiography, the major question now is what is the most cost-effective strategy for screening subjects for LVSD. To date, no studies have systematically addressed this issue, but preliminary data are becoming available. This review article discusses the pros and cons of various investigative strategies and likely cost-effectiveness of each strategy to screen for LVSD.

The use of NT-proBNP in clinical practice

Early detection of heart failure and the accurate diagnosis of heart failure remains a huge clinical challenge to family practitioners. ECGs and chest x-rays merely serve as baseline investigations and the diagnosis is eventually only confirmed by a two-dimensional echocardiogram coupled with Doppler-flow studies. Another biomarker of left ventricular dysfunction that could be added to the armamentarium of the generalist is the blood test proBNP, the precursor of brain natriuretic peptide (BNP). Studies have shown that, already in early phases of left-ventricular systolic dysfunction (asymptomatic left ventricular systolic dysfunction and diastolic dysfunction), BNP proved to be a good marker of both development of heart failure and prognosis. This article gives the generalist an approach to using proBNP in general practice for early detection of left ventricular dysfunction, exclusion of heart failure and prudent referral to the cardiologist.

Improving the detection and diagnosis of congestive heart failure.

Early detection of heart failure requires criteria by which to define the initial stages of a syndrome which often has an insidious onset and which may progress slowly for many years. The most specific definitions of heart failure are those obtained towards the end of the disease process, but reliance upon these means that, although few cases are misclassified, only manifest cases can be detected. Since prevention is the ultimate goal, early detection of subjects at risk and a wider understanding of the pathophysiological mechanisms and risk factors are necessary. The principal causes of heart failure in the Western world are coronary artery disease and hypertension; valvular heart disease and other cardiac disorders are relatively uncommon causes. The major risk factors are obesity, tobacco smoking and diabetes mellitus, and in a prospective large-scale study we have also shown that individuals who develop manifest symptoms of heart failure often have a long history of exercise-induced dyspnoea. Clearly, identification of the early symptoms of heart failure and prompt treatment of risk factors such as hypertension and obesity are important objectives. However, a better understanding of the underlying biochemical and structural abnormalities would help to define more appropriate preventive treatments.

Early detection of heart failure by central venous oxygen saturation monitoring

Early detection of heart failure by central venous oxygen saturation monitoring