Wave Interval Research Articles

Predictors of impending cardiac arrhythmias by electrocardiographic markers in proven obstructive sleep apnea patients

Background: Obstructive sleep apnoea is proved to be one of the causes of sudden cardiac death due to undocumented transient cardiac arrhythmias.So we studied the changes in various electrocardiographic parameters (P wave duration, QRS duration and Tpeak to Tend interval) and its association with increasing severity of OSA by AHI to predict the risk of impending cardiac atrial and ventricular arrhythmias in these patients. Objective: This study compares the risk of impending cardiac arrhythmias by electrocardiographic parameters with the increasing severity of obstructive sleep apnoea by AHI (apnoea-hypopnea index) in polysomnnography. Methodology: The study was conducted in a rural based teaching tertiary care hospital in Puducherry,India. The electrocardiogram(ECG) of the 30 proven OSA patients were analysed for parameters like P wave duration, QRS duration and peak of T wave to end of T wave interval. Any deviation from the normal duration is recorded and compared with the severity of OSA by AHI to estimate the risk of arrhythmogenicity Results: Out of 30 OSA patients in the study group 7 (23.3%) were found to have mild OSA [i.e AHI= 5 TO 14 events/hr] , 6 (20%) were found to have moderate OSA [i.e AHI=15 to 29 events/hr] and 17(56.7%) were found to have severe OSA[i.e AHI=30 and above]. The p value is significant [ Conclusion: We concluded that the increase in duration of P wave, QRS duration and prolongation of Tp-Te interval in electrocardiogram is associated with increasing severity of obstructive sleep apnoea tends to possess significant risk of developing impending cardiac atrial and ventricular arrhythmias respectively which can be attributed to one of the causes of sudden cardiac death in OSA patients.

Design of Portable Electrocardiograph Monitoring System

Cardiovascular disease is one of the major diseases that threaten the human health. But the existing electrocardiograph (ECG) monitoring system has many limitations in practical application. In order to monitor ECG in real time, a portable ECG monitoring system based on the Android platform is developed to meet the needs of the public. The system uses BMD101 ECG chip to collect and process ECG signals in the Android system, where data storage and waveform display of ECG data can be realized. The Bluetooth HC-07 module is used for ECG data transmission. The abnormal ECG can be judged by P wave, QRS bandwidth, and RR interval. If abnormal ECG is found, an early warning mechanism will be activated to locate the user’s location in real time and send preset short messages, so that the user can get timely treatment, avoiding dangerous occurrence. The monitoring system is convenient and portable, which brings great convenie to the life of ordinary cardiovascular users.

The effects of breed, age, sex, and body weight on electrocardiographic parameters in military working dogs

Aim:This study aimed to investigate the effects of breed, sex, age, and body weight on different electrocardiographic parameters in military working dogs (Labrador Retriever and German Shepherd).Materials and Methods:Electrocardiographic recordings (paper speed = 25 mm/s and calibration = 10 mm/mV) were performed to obtain all the standard bipolar limb leads (leads I, II, and III) and unipolar augmented limb leads (leads aVR, aVL, and aVF). A total of 16 Labrador Retrievers and 14 German Shepherds were restrained manually in the right lateral recumbency without any tranquilizer or anesthetic drug. Amplitude and duration of P, QRS, and T wave, PR and QT interval, mean electrical axis, and heart rate were measured in each recording.Results:There was no significant difference in electrocardiographic parameters across breed and sex. However, QRS duration tended to alter by breed (p<0.1) in Labrador Retrievers (0.04±0.005 s), which is lower than German Shepherds (0.05±0.005 s). PR interval was influenced by sex (p<0.1). PR interval was higher in females (0.13±0.005 s) than males (0.11±0.008 s). In addition, electrocardiographic values were not significantly affected by age and body weight, except that the amplitude of R wave was statistically affected by age (p<0.05). A correlation was found between the decrease in R wave amplitude and increase in age of dogs.Conclusion:Different electrocardiographic parameters were within the normal range. A significant effect of age was seen on amplitude of R wave. However, the effect of breed, sex, and body weight was not significant on different electrocardiographic parameters in Labrador Retriever and German Shepherd dogs.

Evaluation of a smartphone-based electrocardiogram device accuracy in field and in hospital conditions in horses

BackgroundDue to compactness and cheapness, smartphone ECG (sECG) could be very useful to equine practitioners. However, previous studies have evaluated the accuracy of sECG in hospitalised horses only. Different conditions...

ECG changes in pregnancy - An observational study

Introduction: Arrhythmias in pregnancy may cause concern for the wellbeing of mothers and fetuses. Understanding the physiologic changes and types of arrhythmias that occur during pregnancy can help in identifying cases requiring intervention. This study aimed to determine the prevalence and types of electrocardiography changes and cardiac arrhythmias in normal pregnancy. Materials and Methods: This observational study was conducted at a tertiary care hospital. Four hundred and fifty women aged 20–35 years with singleton pregnancy in early gestation, irrespective of parity, comprised the study group. A baseline ECG of the first trimester was reviewed with repeat ECG at 22–24 weeks and 32 weeks along with 24-h Holter studies during 20–24 weeks. Results: The most common rhythm disturbance was ventricular premature contractions (1.8%), followed by atrial fibrillation (0.7%). A significant association was seen between rhythm disturbances with advancing age and pregnancy-induced hypertension. No difference was observed between P-axis wave and PR interval. QRS axis and duration decreased significantly from the time of enrollment to 22–24 weeks to 32 weeks, whereas QTc interval increased during the course of pregnancy. No ST/T-wave changes were seen in any of the cases at enrollment, whereas at 22–24 and at 32 weeks, new T-wave inversion was observed in 8.2%. Conclusion: ECG changes such as reduction in QRS axis, T-wave inversion in lead III and V1–2, and prolonged QTc were observed in pregnant women. The prevalence of rhythm disturbances was low, with ventricular premature complex being the most common pathology. Minor electrocardiographic changes may be considered normal in pregnancy unless associated with significant symptoms.

Detection and analysis of pulse waves during sleep via wrist-worn actigraphy.

The high temporal and intensity resolution of modern accelerometers gives the opportunity of detecting even tiny body movements via motion-based sensors. In this paper, we demonstrate and evaluate an approach to identify pulse waves and heartbeats from acceleration data of the human wrist during sleep. Specifically, we have recorded simultaneously full-night polysomnography and 3d wrist actigraphy data of 363 subjects during one night in a clinical sleep laboratory. The acceleration data was segmented and cleaned, excluding body movements and separating episodes with different sleep positions. Then, we applied a bandpass filter and a Hilbert transform to uncover the pulse wave signal, which worked well for an average duration of 1.7 h per subject. We found that 81 percent of the detected pulse wave intervals could be correctly associated with the R peak intervals from independently recorded ECGs and obtained a median Pearson cross-correlation of 0.94. While the low-frequency components of both signals were practically identical, the high-frequency component of the pulse wave interval time series was increased, indicating a respiratory modulation of pulse transit times, probably as an additional contribution to respiratory sinus arrhythmia. Our approach could be used to obtain long-term nocturnal heartbeat interval time series and pulse wave signals from wrist-worn accelerometers without the need of recording ECG or photoplethysmography. This is particularly useful for an ambulatory monitoring of high-risk cardiac patients as well as for assessing cardiac dynamics in large cohort studies solely with accelerometer devices that are already used for activity tracking and sleep pattern analysis.

SEL120 - a First-in-Class CDK8/19 Inhibitor As a Novel Option for the Treatment of Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome - Data from Preclinical Studies and Introduction to a Phase Ib Clinical Trial

SEL120 - a First-in-Class CDK8/19 Inhibitor As a Novel Option for the Treatment of Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome - Data from Preclinical Studies and Introduction to a Phase Ib Clinical Trial

Preprocessing Techniques and Area Estimation of ECG from a Wireless ECG Patch

In electrocardiograms (ECGs), most of the clinically helpful information is found within the wave intervals, amplitudes, or morphology. This is principally motivated by increasing aid prices and propelled by recent technological advances in miniature bio sensing devices, electronics, and wireless communications. This paper tries to comprehensively review and experiment economical and strong strategies for machine driven ECG pre-processing and delineation for ECG information from a wearable device named WiPoint Patch HP111x developed by HMicro, Inc. ECG signal quality is the key factor in determining the diseases of the heart. The proposed methods delineate the P and T waves and helps to get the area of the wave. This information can be further used to identify the specific cardiac problems.

P4654Clinical and electrocardiographic features of restrictive cardiomyopathy in children

Abstract Introduction Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. The mean survival duration after a diagnosis of RCM is reported to be around 2 years in children and most need heart transplantations. Purpose This study aimed to determine the 12-lead electrocardiogram (ECG) diagnostic criteria of RCM based on the initial diagnostic electrocardiogram. Methods ECGs in pediatric cardiomyopathy patients were collected from 15 institutes in Japan between 1979 and 2013. We compared the ECG findings, especially of the P wave, in RCM patients between the cardiomyopathy group and healthy children group separately for each gender and the age. The ECGs in the healthy group were obtained from school heart screening in Japan of first-graders, and seventh-graders. Statistical significance was determined as p&lt;0.001. Results Among 376 registered cardiomyopathy patients, 63 had hypertrophic cardiomyopathy (HCM) (36%), 91 (24%) dilated cardiomyopathy (DCM), 106 (28%) a left ventricular myocardial noncompaction (LVNCs), 25 (7%) restrictive cardiomyopathy (RCM), 14 (4%) arrhythmogenic right ventricular cardiomyopathy (ARVC), and 5 (1%) other cardiomyopathies. Of the 25 RCM patients (9.9±3.4 years old, F:M=11:14), 36% were discovered during school heart screening. The first onset was an abnormal ECG in 9, symptoms of heart failure in 6, respiratory tract infections in 3, syncope in 1, and 6 with other. Of those patients, 2 (8%) had a family history of RCM, 24 (92%) no family history. A genetic diagnosis was performed in 5 of the 25 cases, and 3 had genetic abnormalities related to RCM. The mean follow-up period was 65±95 months (mean±standard deviation). During follow up, 19 patients (76%) survived, 6 (24%) died, 7 (28%) had heart transplantations, and 3 (12%) were waiting for heart transplantations with a left ventricular assist device. The P wave was bimodal in lead I or biphasic in lead V1 in 15 patients (93%), and 13 (81%) patients had both variations. We evaluated the duration and amplitude of the first and second component of the P wave as P1 and P2. The number of control and RCM patients (control/RCM), duration of P1+P2, and sum total absolute value of the amplitude of P1+P2 in lead V1 were 8350/5, 90±9/116±10ms, and 72±28/528±278μV in first grade boys, 8423/3, 91±10/120±22ms, and 66±28/326±229μV in first grade girls, 8943/1, 97±1/100ms, and 71±31/328μV in seventh grade boys, and 9183/5, 98±11/112±10ms, and 55±27/315±56μV in seventh grade girls. Although the number of patients in the RCM group was small, sum total absolute value of the amplitude of P1+P2 in lead V1 showed a significant difference in any group. Conclusion The ECG in children with RCM exhibits P wave abnormalities in almost all patients. In particular, not the P wave interval but P wave shape in I and V1 and the sum total absolute value of the amplitude of P1+P2 in lead V1 were observed differences.

Effects of Dexmedetomidine on Myocardial Repolarization in Children Undergoing General Anesthesia: A Randomized Controlled Trial.

Dexmedetomidine is a highly selective α2-adrenergic agonist, which is increasingly used in pediatric anesthesia and intensive care. Potential adverse effects that have not been rigorously evaluated in children include its effects on myocardial repolarization, which is important given that the drug is listed as a possible risk factor for torsades de pointes. We investigated the effect of 3 different doses of dexmedetomidine on myocardial repolarization and transmural dispersion in children undergoing elective surgery with total IV anesthesia. Sixty-four American Society of Anesthesiologists I-II children 3-10 years of age were randomized to receive dexmedetomidine 0.25 µg/kg, 0.5 µg/kg, 0.75 µg/kg, or 0 µg/kg (control), as a bolus administered over 60 seconds, after induction of anesthesia. Pre- and postintervention 12-lead electrocardiograms were recorded. The interval between the peak and the end of the electrocardiogram T wave (Tp-e; transmural dispersion) and heart rate-corrected QT intervals (myocardial repolarization) were measured by a pediatric electrophysiologist blinded to group allocation. Data were analyzed using an analysis of covariance regression model. The study was powered to detect a 25-millisecond difference in Tp-e. Forty-eight children completed the study, with data analyzed from 12 participants per group. There were no instances of dysrhythmias. Tp-e values were unaffected by dexmedetomidine administration at any of the studied doses (F = 0.09; P = .96). Mean (99% CI) within-group differences were all <2 milliseconds (-5 to 8). Postintervention, corrected QT interval increased in the control group, but decreased in some dexmedetomidine groups (F = 7.23; P < .001), specifically the dexmedetomidine 0.5 and 0.75 µg/kg doses. Within groups, the mean (99% CI) differences between pre- and postintervention corrected QT interval were 12.4 milliseconds (-5.8 to 30.6) in the control group, -9.0 milliseconds (-24.9 to 6.9) for dexmedetomidine 0.25 µg/kg, -18.6 milliseconds (-33.7 to -3.5) for dexmedetomidine 0.5 µg/kg, and -14.1 milliseconds (-27.4 to -0.8) for dexmedetomidine 0.75 µg/kg. Of the bolus doses of dexmedetomidine studied, none had an effect on Tp-e and the dexmedetomidine 0.5 and 0.75 µg/kg doses shortened corrected QT intervals when measured at 1 minute after dexmedetomidine bolus injection during total IV anesthesia. There is no evidence for an increased risk of torsades de pointes in this context.

Quantifying the Delays Between Multi-Site Photoplethysmography Pulse and Electrocardiogram R-R Interval Changes Under Slow-Paced Breathing.

Objective: Objective assessment of autonomic function is important, including the investigation of slow-paced breathing to induce associated periodic changes in the cardiovascular system – such as blood pressure and heart rate. However, pulse changes across a range of peripheral body sites have seldom been explored with this challenge. The primary aim of this pilot study was to utilize multi-site photoplethysmography (MPPG) technology to quantify the phase delays, i.e., correlation lags, between changes in heart rate and changes in key pulse features with slow-paced breathing (0.1 Hz).Methods: Waveforms were collected simultaneously from the right and left ear lobes, thumbs, and great toes of 18 healthy adult subjects. Cross correlation lags between reference beat-to-beat changes in electrocardiogram (ECG) R-R wave interval and changes in pulse arrival time (foot of pulse; PATf) and also for pulse amplitude (foot-to-peak; AMP) were determined.Results: Relative to R-R changes, the median ear, thumb, and toe PATf correlation lags were 3.4, 2.9, and 2.1 beats, respectively; contrasting to AMP with 5.7, 6.0, and 6.9 beats, respectively. These PATf correlation lags in beats were significantly lower than for the AMP measure. Segmental differences between sites and timing measure variability have also been quantified.Conclusion: This pilot study has indicated bilateral similarity plus segmental differences for relative delays in PPG pulse timing and amplitude measures relative to R-R interval changes with paced breathing. These correlation and variability data are now available for comparison with cardiovascular patient groups to support development of autonomic function assessment techniques.

Application of a Speedy Modified Entropy Method in Assessing the Complexity of Baroreflex Sensitivity for Age-Controlled Healthy and Diabetic Subjects

The percussion entropy index (PEIorginal) was recently introduced to assess the complexity of baroreflex sensitivity. This study aimed to investigate the ability of a speedy modified PEI (i.e., PEINEW) application to distinguish among age-controlled subjects with or without diabetes. This was carried out using simultaneous photo-plethysmo-graphy (PPG) pulse amplitude series and the R wave-to-R wave interval (RRI) series acquired from healthy subjects (Group 1, number = 42), subjects diagnosed as having diabetes mellitus type 2 with satisfactory blood sugar control (Group 2, number = 38), and type 2 diabetic patients with poor blood sugar control (Group 3, number = 35). Results from PEIorginal and multiscale cross-approximate entropy (MCAE) were also addressed with the same datasets for comparison. The results show that optimal prolongation between the amplitude series and RRI series could be delayed by one to three heartbeat cycles for Group 2, and one to four heartbeat cycles for Group 3 patients. Group 1 subjects only had prolongation for one heartbeat cycle. This study not only demonstrates the sensitivity of PEINEW and PEIorginal in differentiating between Groups 2 and 3 compared with MCAE, highlighting the feasibility of using percussion entropy applications in autonomic nervous function assessments, it also shows that PEINEW can considerably reduce the computational time required for such processes.

Application of auditory brainstem response in hearing impairment and prognosis of neonatal hypoxic ischemic encephalopathy

Objective:To investigate the effect of auditory brainstem response in hearing impairment and prognosis of neonatal hypoxic ischemic encephalopathy（HIE）. Method:Forty-five children with HIE admitted were enrolled. All patients were tested for auditory brainstem response and followed up for 3 years to observe the prognosis of the children. Result:A total of 90 ears were included in 45 children, of which 77 ears had hearing impairment, accounting for 85.6%; 38 ears had mild hearing impairment, accounting for 49.4%; 19 ears had moderate hearing impairment, accounting for 24.7%; 20 ears had severe hearing impairment, accounting for 26.0%; the difference was statistically significant（P<0.05）. Children with moderate and severe HIE had better hearing impairment than children with mild HIE. Serious, the difference was statistically significant（χ²=7.921, P=0.009）. A total of 90 ears were included in 45 patients, 40 of whom completed 3 years of follow-up. The prognosis of children with hearing threshold ≤60 dBnHL was worse than the threshold ≥61 dBnHL, and the difference was statistically significant（P=0.001）. Abnormal manifestations of auditory brainstem response were mainly in 13 children with mild HIE（76.5%） with poor differentiation or prolongation of Ⅰwave PL; 26 patients with moderate and severe HIE（92.9%） With Ⅲ, Ⅴ wave PL extension, Ⅲ-Ⅴ wave IPL extension, Ⅰ-Ⅲ wave IPL extension, Ⅰ-Ⅴ wave PL extension, Ⅰ-Ⅲ/Ⅲ-Ⅴ wave IPL wave interval ratio less than 1, and Ⅴ/Ⅰ amplitude less than 0.5. Conclusion:The auditory brainstem response in the hearing impairment and prognosis of HIE can effectively reflect the relationship between the severity of HIE and the severity of hearing impairment, and the relationship between the prognosis of children and the severity of hearing impairment. It can be used as an effective means to help determine the degree of HIE hearing loss and prognosis.

CROSSTALK BETWEEN ELECTROCARDIOGRAPHIC AND CENTRAL HEMODYNAMIC VARIABLES IN PATIENTS WITH HYPERTENSION AND HIGH NORMAL BLOOD PRESSURE

Objective: To explore the relationship between electrocardiographic (ECG) and central hemodynamic variables in patients with hypertension and high normal blood pressure. Design and method: A total of 56 patients with hypertension and high normal blood pressure, aged 48 ± 6 years, 57% male, underwent pulse wave analysis (PWA) and standard 12 lead ECG. PWA was performed using a Mobil-O-Graph. Results: Central systolic blood pressure (cSBP), central pulse pressure (cPP), pulse pressure (PP), diastolic blood pressure (DBP), augmentation index (AI) were: 127 ± 13 mmHg, 35 ± 9 mmHg, 45 ± 10 mmHg, 91 ± 11 mmHg and 20 ± 14%, respectively. P wave, PR and QT interval duration, R in V5 and V6 and S in V1 were, as follows: 105 ± 22 ms, 147 ± 31 ms, 409 ± 64 ms, 11 ± 6 mm, 11 ± 5 mm, and 7 ± 4 mm, respectively. Significant correlations were obtained between ECG and central hemodynamic variables. Regression analysis revealed P wave duration, S in V1, R in V5 and QT interval exceeding 450 ms, as predictors of cPP, AI and cSBP, respectively. Pulse pressure predicted P wave and PR interval duration, respectively, cPP predicted QT interval duration, cSBP predicted R in V5 and V6, respectively, and DBP predicted S in V1. Conclusions: ECG provides information about central hemodynamic variables, and central and peripheral blood pressure values predict P wave, PR and QT interval duration, amplitude of R in V5 and V6 and S in V1, respectively, in patients with hypertension and high normal blood pressure.

Characteristics of secretory otitis media in children with cleft palate and timing of intervention of tympanic membrane

Objective:To explore the characteristics of otitis media with effusion(OME) in children with cleft palate(CP),including the incidence rate, age peak,relationship between cleft palate type and OME. And to explore the timing of VTI intervention in CP children with OME.Method: This study included congenital CP children who were plant to do palatoplasty.They all finished acoustic impedance tests and auditory brainstem responses(ABR) before surgery.Analyze the characteristics of OME and compare the hearing effects and complications between CP children underwent palatoplasty with VTI and those underwent palatoplasty without VTI.Result:The incidence of OME in CP children is 82% and the average is (11.59±6.60) months.The average ABR V wave threshold of CP children with OME is 46.5 dB nHL,of which about 68% children had moderate hearing loss. The latency of Ⅰ,Ⅲ and Ⅴ waves was prolonged, and there was no change in wave interval compared with whom without OME. The type of cleft palate was not related to the incidence of OME(χ²=2.532, P=0.639).Compared with the preoperative hearing thresholds, the percentage of hearing recovery in 1 month,6 months and 12 months after VTI was 92.4%, 92.2% and 96.2% respectively.Persistent OME still exists in 41% of the children in the only palatoplasty group after operation.Conclusion: It is found that the incidence of OME in CP children is higher, the average age is earlier, and the degree of hearing loss is greater. Thus, no matter what the the type of cleft palate is,the doctors should pay attention to the hearing status of the CP children.If they are accompanied by OME with hearing loss, VTI is needed at the same time of palatoplasty.Palatoplasty alone has limitations on hearing improvement in some children with cleft palate.

ECG Feature Extraction for Automatic Classification of Ischemic Events

A fundamental part of the analysis of electrocardiographic signals (ECG) lies in the transformation of the data or samples of the signal, with the aim of improving the effectiveness of the processing and the subsequent interpretation of the results obtained from it. Thus, a certain number of features are extracted, which are expected to have high discriminatory properties. In this way, the next step of the analysis must be the construction of a vector of features, which must be a set of descriptors that completely transmit the essence of the signal being studied. These features can focus on different aspects of the signal, for example, durations of intervals or segments, amplitudes of different wave peaks, deviations with respect to the isoelectric line, and areas under curves, among others. In this paper we present a method that includes the detection of temporal events of the ECG signal, such as ST segment, T wave, QRS complex and QT interval, several features are extracted using these events. The features are validated with the K-means algorithm and the feature vector is used as input in the ischemia classifier.

Melatonin attenuates bisphenol A‐induced alterations in the cardio‐renal system of rats through the antioxidant defense mechanism

Bisphenol A (BPA), an endocrine disrupting chemical (EDC) used in the production of plastics and epoxy resins has been incriminated in a number of biological dysfunctions while melatonin (MLT) is a known antioxidant capable of ameliorating EDC‐induced perturbations. Although limited number of studies exist on the effect of BPA on the cardio‐renal system, there is the dearth of research information on the effect of MLT on rats exposed to environmentally relevant doses of BPA. This study was therefore designed to investigate the effects of MLT on BPA‐induced alterations in the cardio‐renal system of rats. Gravid rats were randomly assigned into five groups (n=5): Group 1 (control) received 0.2 mL 1% dimethyl sulfoxide (DMSO)/99% canola oil as vehicle; Group 2 received BPA at 25 μg/kg/day; Group 3 received BPA at 250 μg/kg/day; Group 4 received BPA at 25 μg/kg/day with concurrent MLT 1 mg/kg/day; and Group 5 received BPA at 250 μg/kg/day with concurrent MLT 1 mg/kg/day. All treatments were administered by gavage from gestational day (GD) 10–21. Thereafter, three male offspring randomly from each litter per group (n=15) were weighed; blood pressure parameters and electrocardiogram taken on post‐natal day (PND) 120. The heart and kidney samples were harvested for markers of oxidative stress and antioxidant defense system, histopathology and histochemistry using standard methods. BPA induced a significant increase in heart rate but significantly decrease systolic, diastolic and mean arterial blood pressure. Exposure to BPA caused significant decrease in P wave interval, PR duration, R wave amplitude and QT interval but significant increase in QRS duration. Also, BPA significantly elevated both cardiac and renal MDA, H2O2, GSH and GPx. Cardiac and renal lesions induced by BPA included erosion of epithelial cells, congestion of blood vessels as well as necrosis. Moreover, BPA induced a significant reduction in cardiac and renal polysaccharide activities. However, the concomitant treatment with MLT attenuated all the observed BPA‐induced alterations of the cardio‐renal system. Hence, MLT attenuates alterations induced by environmentally relevant doses of BPA in the cardio‐renal system.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Pacemaker network properties determine intestinal motor pattern behaviour.

Pacemaker network properties determine intestinal motor pattern behaviour.

Effect of neonatal hyper bilirubinemia on brain stem auditory evoked response

Introduction: Neonatal hyperbilirubinemia is a major cause of morbidity in neonates. The long term neurological sequel can be prevented and reversed by timely and aggressive management of hyperbilirubinemia. Brain stem auditory evoked response (BAER) is an assessment tool to help predictimpeding bilirubin neurotoxicity. This study was conducted to evaluate the effect of hyperbilirubinemia on auditory system of newborn and the effect of therapy on BAER. Materials and Methods: In this case control study, 50 term neonates with hyperbilirubinemia (total serum bilirubin > 15 mg/dl) were included in the study group and 25 normal term neonates were taken as controls. Baseline BAER was recorded in study group before therapy and after therapy. Results were compared with controls and intra group comparison was also done. Continuous data with normal distribution was analysed by student t-test, and categorical data was analysed using chi-square test. Results: Most common BAER abnormality noted in jaundiced neonates was prolonged latency of wave V (42%) andprolonged inter wave interval I–V (32%). Significant increase in the absolute latencies of waves III and V was noted in hyperbilirubinemic neonates as compared to controls (p<0.05). I-III and I-V inter-peak latencies were also significantly prolonged in neonates with hyper bilirubinemia (p<0.05). There was significant improvement in the latency of wave III and wave V, I – III inter- peak latency and I – V inter-peak latency after treatment (P<0.05). Conclusion: Results of our study demonstrate the importance of early ABR screening as an efficient tool for monitoring the neonates at risk of bilirubin neurotoxicity. Diagnosing the early changes in ABR caused by hyperbilirubinemia before appearance of clinical abnormality will help prevent bilirubin neurotoxicity.

Pulse Arrival Time and Pulse Interval as Accurate Markers to Detect Mechanical Alternans

Mechanical alternans (MA) is a powerful predictor of adverse prognosis in patients with heart failure and cardiomyopathy, but its use remains limited due to the need of invasive continuous arterial pressure recordings. This study aims to assess novel cardiovascular correlates of MA in the intact human heart to facilitate affordable and non-invasive detection of MA and advance our understanding of the underlying pathophysiology. Arterial pressure, respiration, and ECG were recorded in 12 subjects with healthy ventricles during voluntarily controlled breathing at different respiratory rate, before and after administration of beta-blockers. MA was induced by ventricular pacing. A total of 67 recordings lasting approximately 90 s each were analyzed. Mechanical alternans (MA) was measured in the systolic blood pressure. We studied cardiovascular correlates of MA, including maximum pressure rise during systole (dPdtmax), pulse arrival time (PAT), pulse wave interval (PI), RR interval (RRI), ECG QRS complexes and T-waves. MA was detected in 30% of the analyzed recordings. Beta-blockade significantly reduced MA prevalence (from 50 to 11%, p < 0.05). Binary classification showed that MA was detected by alternans in dPdtmax (100% sens, 96% spec), PAT (100% sens, 81% spec) and PI (80% sens, 81% spec). Alternans in PAT and in PI also showed high degree of temporal synchronization with MA (80 ± 33 and 73 ± 40%, respectively). These data suggest that cardiac contractility is a primary factor in the establishment of MA. Our findings show that MA was highly correlated with invasive measurements of PAT and PI. Since PAT and PI can be estimated using non-invasive technologies, these markers could potentially enable affordable MA detection for risk-prediction.