Rapid Ejection Phase Research Articles

Исследование динамики фазовых портретов пульсовых сигналов

The article proposes a method of phase representation of dynamic systems for the analysis of pulse waves. A phase portrait is constructed, which is a set of phase trajectories obtained over a certain period of time. The technique of quantitative assessment of the blood ejection intensity in the rapid ejection phase of the cardiac cycle by a pulse wave is substantiated. It establishes quantitative criteria for the blood ejection intensity parameter in chronic and acute forms of diseases. Phase portraits of pulse waves are investigated. It is shown that the contour of the phase portrait mainly reflects the pulse wave amplitude parameters and intensity of the fast and slow ejection phases. The main qualitative regularities of various types of pulse waves are revealed. A quantitative indicator characterizing the geometry of the phase portrait is introduced and experimentally investigated. It allows you to differentiate pulse waves for their compliance with acute or chronic diseases. It is shown that the feature of the phase representation is that it demonstrates the dynamic properties of the system in a compact form. It can be used to evaluate the velocity characteristics of the process, its stationarity.

Vector Flow Mapping Application in Local Cardiac Function in Hypertension Assessment.

ObjectiveThis study aims to investigate the clinical significance of vector flow mapping (VFM) by observing and quantifying energy loss (EL) during different phases and in different left ventricle (LV) segments.Methods42 healthy physical examination subjects and 89 patients with hypertension (HTN) were enrolled in the present study. The patients with HTN were divided into two groups: the left ventricular hypertrophy group (LVH) (n = 51) and the non-left ventricular hypertrophy group (NLVH) (n = 38), while the healthy patients were control group. VFM analysis software DSA-RS1 was used to calculate EL during the rapid filling phase (P1), slow filling phase (P2), atrial contraction phase (P3), and rapid ejection phase (P4). The energy loss of basal segment (EL-B), middle segment (EL-M) and apical segment (EL-A) of left ventricle in different phases was calculated and compared among the three groups.ResultsIn controls, segmental EL showed a gradual increase from the apex to the base during diastole; however, the regularity was not found in the HTN patients. During both P1 and P2 EL-B, EL-M and EL-A were significantly higher in the NLVH group and the LVH group compared with the control group (P < 0.05). EL in LVH group was the highest among the three groups (P < 0.05). During P3, EL-B, EL-M and EL-A were increased in the NLVH group and LVH group compared with the control group. However, EL-M and EL-A in LVH group were significantly lower than the NLVH group (P < 0.05). During P4, EL of all segments was significantly higher in the NLVH group and LVH group compared with the control group (P < 0.05).ConclusionVFM can visually quantify hydrodynamic LV changes in healthy subjects. The EL levels in the different LV segments during different phases were significantly higher in the patients with HTN compared with the healthy subjects.

Effects of joy and sorrow on pulse-graph parameters in healthy female college students based on emotion-evoked experiments

ObjectiveTo explore the effects of joy and sorrow on pulse-graph parameters in healthy subjects and analyze their potential effect to provide preliminary evidence that pulse diagnosis can identify human emotional changes. Design and interventionForty healthy female college students from Beijing University of Chinese Medicine were recruited. The emotion-evoking experiment was conducted to observe the effects of joy and sorrow on pulse-graph parameters, taking neutral emotion as a control. The experiment included the following criteria. (1) Emotions evoked and evaluated: the same subjects watched three emotional videos which were, respectively, neutral, joyful and sorrowful to evoke the corresponding emotions. They completed the “subjective emotion evaluation form” (SEEF) before watching each video (T0), immediately after watching the video (T1) and 15 min after watching the video (T2) to conduct subjective emotion evaluation. Simultaneously, their heart rate, galvanic skin response and heart rate variability were collected with a 16-lead physiological recorder to conduct an objective evaluation of emotional arousal. (2) Collection of pulse-graph parameters: pulse-graph parameters of the subjects at T0, T1 and T2 were collected with a pulse condition analyzer. ResultsWhen watching the joy video, the rapid ejection phase extended significantly, both the left ventricular diastole and the cardiac cycle shortened significantly. When watching the sorrow video, the left ventricular diastole extended significantly, the cardiac cycle showed an upward trend, and heart rate showed a downward trend. ConclusionJoy and sorrow have a certain effect on pulse-graph parameters of the subjects. The mechanisms may be that joy contributes to rapid ejection phase extension and a shortening of the left ventricular diastole and the cardiac cycle, while sorrow extends the left ventricular diastole. According to the theory of Traditional Chinese Medicine (TCM), the visceral functions can be mediated through human qi flow. Moderate joy and sorrow can promote, respectively, the smooth qi flow of the heart and the lung. However, excessive or long-term joy and sorrow can lead to disharmonious qi flow of the two viscera. Therefore, maintaining moderate emotions is beneficial to the physiological functions of the viscera. Great emotional fluctuations may damage the visceral functions. Future studies with effects of other emotions on pulse-graph parameters are warranted to determine the reliability of the association of emotions and pulse diagnosis.

Quantitative Analysis of Left Ventricular Flow Dynamics in Latent Obstructive Hypertrophic Cardiomyopathy Using Vector Flow Mapping

Objectives: This study aimed to assess left ventricular (LV) energy loss (EL), circulation and vortex area using vector flow mapping (VFM) in patients with latent obstructive hyper­trophic cardiomyopathy (LOHCM) and nonobstructive hypertrophic cardiomyopathy (NOHCM). Methods: Fourteen LOHCM patients, 10 NOHCM patients, and 11 healthy individuals were evaluated by transthoracic echocardiography. An offline VFM workstation was used to analyze the LV blood flow patterns and fluid dynamics. The hemodynamic parameters, EL, circulation, and vortex area in 7 cardiac phases were calculated and analyzed. Results: Compared with controls and NOHCM patients, EL was significantly higher in ­LOHCM patients during the rapid ejection phase, slow ejection (SE) phase, and isovolumetric relaxation phase (p < 0.05). LOHCM patients also showed increased circulation during SE compared to the other two groups (p < 0.05). The ability to discriminate between NOHCM and LOHCM was assessed by the area under the receiver-operating characteristic curve (AUC), and EL during SE was found to have the largest AUC (0.964); the best cutoff value was 6.34 J/m³/s, with a sensitivity of 100% and specificity of 80%. Conclusions: The VFM technique can detect abnormal changes of LV EL and vortex characteristics in hypertrophic cardiomyopathy patients. Compared with controls and NOHCM patients, the LOHCM patients have worse systolic and diastolic functions.

Left ventricular energy loss during systole in patients with hypertension detected by ultrasonic vector flow mapping

Objective To evaluate the value of left ventricular energy loss (EL) in the systolic left ventricular hemodynamic changes in hypertensive patients by ultrasonic flow vector imaging(VFM). Methods Ninty-eight hypertensive patients were divided into non left ventricular hypertrophy group (NLVH group) and left ventricular hypertrophy group (LVH group) according to the left ventricular mass index(LVMI). Thirty-one healthy adults were erolled as control group. The average total energy loss (EL-T), basal energy loss (EL-B), middle energy loss (EL-M) and apical energy loss (EL-A) of each isovolumic contraction phase, fast ejection phase and slow ejection phase were obtained by VFM, the difference among the three groups were compared. Results ①EL-T and EL-B in isovolumic phase, rapid ejection phase and slow ejection phase in NLVH group were higher than those in control group (P<0.05 or P<0.01); EL-T, EL-B, EL-M and EL-A in isovolumic phase, rapid ejection phase and slow ejection phase in LVH group were all higher than those in control group (P<0.05 or P<0.01); EL-M in isovolumic phase and rapid ejection phase, EL-T, EL-B, EL-M and EL-A in slow ejection phase in LVH group were higher than those in the NLVH group (P<0.05 or P<0.01). ②There was a positive correlation between EL-T and LVMI (r=0.311, P<0.01), EL-B and LVMI (r=0.219, P<0.05), EL-M and LVMI(r=0.207, P<0.05), EL-T and LVEF(r=0.340, P<0.05), EL-B and LVEF(r=0.367, P<0.01) in isovolumic contraction phase. There was a positive correlation between EL-B and LVEF(r=0.359, P<0.01) in rapid ejection phase. There was a positive relation between EL-B and LVEF(r=0.352, P<0.05) in slow ejection phase. Conclusions The EL of systolic peroid in hypertensive patients increased, which suggests that the left ventricular hemodynamic changes abnormally, VFM can accurately evaluate the changes of hemodynamic during systole. Key words: Echocardiography; Hypertension; Ventricular function, left; Vector flow mapping

The Regulation of ATP-Binding, PI Release and ADP Dissociation from Myosin II in Native Cardiac Myofibrils by the N-Terminal Extension of Cardiac Troponin T

Cardiac troponin T (cTnT) has an amino-terminal variable region that plays a role in modifying the overall protein conformation and functions in the calcium-dependent regulation of cardiac muscle contraction. Previous studies have shown that the N-terminal domain of cTnT mainly affects the tropomyosin binding site 1 that binds to the head-tail junction of tropomyosins in thin filament, a moiety involved in the cooperativity of the myofilaments upon calcium activation. It has also been shown that in comparison with wild type controls, transgenic mouse hearts over-expressing cTnT lacking the N-terminal variable region (cTnT-ND) had a decreased rate of contraction, which specifically elongates the rapid ejection phase while keeping total ejection time unchanged, suggesting that the altered cTnT molecule affects the actomyosin crossbridge kinetics. In the present study, we employed stopped flow analysis of mant-ATP binding, ADP dissociation and phosphate release in order to investigate which step(s) of the ATPase cycle is regulated by the N-terminal variable region of cTnT. The results showed that cTnT-ND myofibrils exhibited a maximum mant-ATP binding rate constant (k2) significantly lower than that of WT control, while the equilibrium constant K1 for the initial actomyosin complex formation remained unchanged over calcium concentration. ADP dissociation and Pi release from cTnT-ND myofibrils showed no significant change with increasing calcium concentration, however ADP release is slower in cTnT-ND myofibrils when compared to WT control. These results provide novel information regarding the function of the N-terminal variable region in modulating specific kinetic steps and selectively altering systolic but not diastolic function of the heart.

Cardiometry: new options in cardiology

Cardiometry as a new fundamental field of cardiology is described in the paper. The laws of cardiometry are identified herein. Cardiometry is based on an adequate mathematical model of hemodynamics that is described by the PoyedintsevVoronova equations. The mode of elevated blood fluidity was first described by the mathematics. This allows both to properly interpret the mechanism of the heart performance and to calculate phase-related volumes of blood in each cardiac cycle. The new interpretation of the SA and AV nodes functioning as baroreceptors is provided by the authors. A new classification for all of the varieties of ECG curve shapes has been proposed [1 - 13]. Clearly identified boundaries in each phase are provided according to the new theory of hemodynamics, and some new symbols for newly defined ECG points has been proposed. Point L which denotes the beginning of the rapid ejection phase has been introduced. The exact location of point j that is the end of the rapid ejection phase has been given by the authors [5, 13-16]. The existing ECG recording methods has been revised, and an original single-lead ECG of the ascending aorta has been developed. A rheogram is recorded in synchronism with obtaining the original single-lead ECG. Phase synchronization of the ECG and Rheo curves supplies us with a new source of data on all phase-related changes in arterial pressure. A new diagnostic device CARDIOCODE has been developed on the basis of the new theoretical basis. CARDIOCODE delivers non-invasively data on 7 phase-related volumes of blood in every cardiac cycle that was absolutely incredible in the past [1 - 11].

Analysis on pulse diagram characteristics of subjects with subhealth state

To study the pulse diagram parameters of subjects with subhealth state and to find the pulse parameters for subhealth state evaluation. A total of 1 275 subjects without diagnosed diseases were recruited and their health conditions were assessed with Health Evaluating Questionnaire H20 V2009. The subjects were assigned to health group or subhealth group according to the scale score. Subjects' syndrome in the subhealth group was differentiated using score of "subhealth state of syndrome differentiation V2010". Another 121 patients with cardiovascular diseases were enrolled as a control. The pulse information was collected with YJJ-101 subhealth pulse monitoring system and the parameters include amplitude of main wave (h₁), amplitude of repeat wave (h₅) and its front wave (h₃), 1/3 or 1/5 width of main wave (w₁) or (w₂), time of rapid ejection phase (t₂), period of pulse (t), pulse pressure (Pp), square (S), area in systole (As) and area in diastole (Ad) of pulse diagram and ratios of h₃/h₁, h₅/h₁, w₁/t, w₂/t and h₁/t₁. Pulse diagram analysis showed significant differences among health, subhealth and disease group in Pp, h₁, S and As and ratios of h₅/h₁ and w₂/t. Compared with the health group, the values of w₁/t and w₂/t of the subhealth group increased (P<0.05), and Pp, h₁, h₅, h₅/h₁, S, As and Ad decreased (P<0.05). Compared with health group, the parameters of pulse of the subhealth group were increased in Pp and h₅/h₁ (P<0.05) and decreased in h1, w₂/t, S and As (P<0.05). Compared with health group, pulse parameters h₃/h₁, w₁, w₁/t, w₂/t of excess and deficiency syndrome group increased, and h₁, h₅, h₁/t ₁and h₅/h₁ decreased. Among different syndromes of subhealth state, pulse diagram parameters h₁, h₅, h₃/h₁, h₅/h₁ and w₁/t of yin deficiency, qi deficiency, liver stagnation and excess heat group were significantly different (P<0.05) from the health group, for example, pulse parameters h₁ and h₅ of stagnation, yin deficiency, qi deficiency and excess heat group declined in order, and pulse parameters h₃/h₁ and w₁/t of liver stagnation, excess heat, yin deficiency and qi deficiency group increased in order. Pulse index h₁ in the kidney deficiency group was higher than that in the health group and the other syndrome groups. Results of analyzing sphygmogram parameters showed different characteristics among different health status and the subhealth state due to different syndromes. Sphygmogram parameters may be used for objective evaluation of health status or subhealth syndrome differentiation.

A simple model to demonstrate the isovolumic contraction and rapid ejection phases of the cardiac cycle.

A simple model to demonstrate the isovolumic contraction and rapid ejection phases of the cardiac cycle.

On the source of peak first time derivative (dZ/dt) during impedance cardiography

This paper deals primarily with the timing and source of peak (dZ/dt). In observations on human volunteers and anesthetized dogs, the peak (dZ/dt) occurred during the rapid ejection phase of the ventricles. Evidence is presented that the ascending aorta is the source of peak (dZ/dt).