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Ebrahimian S, Sillanmäki S, Hietakoste S, Kulkas A, Töyräs J, Bailón R, Hernando D, Lombardi C, Grote L, Bonsignore MR, Saaresranta T, Pépin JL, Leppänen T, Kainulainen S. Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients. Am J Physiol Heart Circ Physiol 2024; 326:H1094-H1104. [PMID: 38426864 DOI: 10.1152/ajpheart.00760.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/02/2024]
Abstract
Obstructive sleep apnea (OSA) is associated with the progression of cardiovascular diseases, arrhythmias, and sudden cardiac death (SCD). However, the acute impacts of OSA and its consequences on heart function are not yet fully elucidated. We hypothesized that desaturation events acutely destabilize ventricular repolarization, and the presence of accompanying arousals magnifies this destabilization. Ventricular repolarization lability measures, comprising heart rate corrected QT (QTc), short-time-variability of QT (STVQT), and QT variability index (QTVI), were calculated before, during, and after 20,955 desaturations from lead II electrocardiography signals of 492 patients with suspected OSA (52% men). Variations in repolarization parameters were assessed during and after desaturations, both with and without accompanying arousals, and groupwise comparisons were performed based on desaturation duration and depth. Regression analyses were used to investigate the influence of confounding factors, comorbidities, and medications. The standard deviation (SD) of QT, mean QTc, SDQTc, and STVQT increased significantly (P < 0.01), whereas QTVI decreased (P < 0.01) during and after desaturations. The changes in SDQT, mean QTc, SDQTc, and QTVI were significantly amplified (P < 0.01) in the presence of accompanying arousals. Desaturation depth was an independent predictor of increased SDQTc (β = 0.405, P < 0.01), STVQT (β = 0.151, P < 0.01), and QTVI (β = 0.009, P < 0.01) during desaturation. Desaturations cause acute changes in ventricular repolarization, with deeper desaturations and accompanying arousals independently contributing to increased ventricular repolarization lability. This may partially explain the increased risk of arrhythmias and SCD in patients with OSA, especially when the OSA phenotype includes high hypoxic load and fragmented sleep.NEW & NOTEWORTHY Nocturnal desaturations are associated with increased ventricular repolarization lability. Deeper desaturations with accompanying arousals increase the magnitude of alterations, independent of confounding factors, comorbidities, and medications. Changes associated with desaturations can partially explain the increased risk of arrhythmias and sudden cardiac death in patients with OSA, especially in patients with high hypoxic load and fragmented sleep. This highlights the importance of detailed electrocardiogram analytics for patients with OSA.
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Affiliation(s)
- Serajeddin Ebrahimian
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Saara Sillanmäki
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Salla Hietakoste
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Antti Kulkas
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Raquel Bailón
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - David Hernando
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Carolina Lombardi
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Ludger Grote
- Department of Sleep Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sleep and Vigilance Laboratory, Department of Internal Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Tarja Saaresranta
- Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, University of Turku, Turku, Finland
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Jean-Louis Pépin
- Inserm U1300, HP2 Laboratory, University of Grenoble Alpes, Grenoble, France
| | - Timo Leppänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | - Samu Kainulainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. Clinical impact of the suspension of the ERAS protocol on patients undergoing radical cystectomy during the COVID-19 pandemic. Actas Urol Esp 2023:S2173-5786(23)00014-8. [PMID: 36842706 PMCID: PMC9957335 DOI: 10.1016/j.acuroe.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st, 2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. [CLINICAL IMPACT OF THE SUSPENSION OF THE ERAS PROTOCOL ON PATIENTS UNDERGOING RADICAL CYSTECTOMY DURING THE COVID-19 PANDEMIC.]. Actas Urol Esp 2023; 47:S0210-4806(23)00012-8. [PMID: 36776227 PMCID: PMC9905094 DOI: 10.1016/j.acuro.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st,2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
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Castellarnau S, Espinosa J, Sierra P, Gaya J, Sabaté S, Hernando D. Impact of the COVID-19 pandemic in patients who underwent radical cystectomy during the first wave, one-year follow-up. Clin Nutr ESPEN 2022. [PMCID: PMC9519846 DOI: 10.1016/j.clnesp.2022.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Kadri A, Binkley N, Hernando D, Anderson PA. Opportunistic Use of Lumbar Magnetic Resonance Imaging for Osteoporosis Screening. Osteoporos Int 2022; 33:861-869. [PMID: 34773484 DOI: 10.1007/s00198-021-06129-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/20/2021] [Indexed: 12/21/2022]
Abstract
UNLABELLED Magnetic resonance imaging (MRI) is a routine assessment before spine surgery. We found that the opportunistic use of MRI with the vertebral bone quality (VBQ) score has good diagnostic ability, with a threshold value of VBQ > 3.0, in recognizing patients who may need further osteoporosis evaluation. INTRODUCTION The purpose of this study was to determine whether the opportunistic use of magnetic resonance imaging (MRI) is useful for identifying spine surgical patients who need further osteoporosis evaluation. METHODS This retrospective study evaluated 83 thoracolumbar spine surgery patients age ≥ 50 who received T1-weighted MRI. Opportunistic MRI was evaluated with the vertebral bone quality (VBQ) score, VBQ (fat) score, and signal-to-noise ratio (SNR). Each uses the median L1-L4 vertebral body signal intensities (SI) divided by either the L3 cerebrospinal fluid (CSF) SI, average SI of the L1 and S1 dorsal fat, or standard deviation (SD) of the background SI dorsal to the skin. Single-level VBQ was calculated as the ratio of the L1 vertebral body and L1 CSF SIs. Receiver-operator curve analysis was performed to determine diagnostic ability. RESULTS The mean age was 70.10, 80% were female, and 96% were Caucasian. The mean ± SD VBQ, single-level VBQ, VBQ (fat), and SNR were 3.39 ± 0.68, 3.56 ± 0.81, 3.95 ± 1.89, and 113.18 ± 77.26, respectively. Using area under the curve, the diagnostic ability of VBQ, single-level VBQ, VBQ (fat), and SNR for clinical osteoporosis were 0.806, 0.779, 0.608, and 0.586, respectively. Diagnostic threshold values identified with optimal sensitivity and specificity were VBQ of 2.95 and single-level VBQ of 3.06. CONCLUSION Opportunistic use of MRI is a simple, effective tool that may help recognize patients who are at risk for complications related to bone disease. A VBQ > 3.0 can identify patients who need additional diagnostic evaluation.
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Affiliation(s)
- A Kadri
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, UW Medical Foundation Centennial Building, 1685 Highland Avenue, 6th Floor, Madison, WI, 53705, USA
| | - N Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin, School of Medicine and Public Health, 2870 University Ave, Suite 100, Madison, WI, 53705, USA
| | - D Hernando
- Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53705, USA
| | - P A Anderson
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, UW Medical Foundation Centennial Building, 1685 Highland Avenue, 6th Floor, Madison, WI, 53705, USA.
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Del Castillo MG, Hernando D, Orini M, Laguna P, Viik J, Bailón R, Pueyo E. QT variability unrelated to RR variability during stress testing for identification of coronary artery disease. Philos Trans A Math Phys Eng Sci 2021; 379:20200261. [PMID: 34689618 DOI: 10.1098/rsta.2020.0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 06/13/2023]
Abstract
Stress test electrocardiogram (ECG) analysis is widely used for coronary artery disease (CAD) diagnosis despite its limited accuracy. Alterations in autonomic modulation of cardiac electrical activity have been reported in CAD patients during acute ischemia. We hypothesized that those alterations could be reflected in changes in ventricular repolarization dynamics during stress testing that could be measured through QT interval variability (QTV). However, QTV is largely dependent on RR interval variability (RRV), which might hinder intrinsic ventricular repolarization dynamics. In this study, we investigated whether different markers accounting for low-frequency (LF) oscillations of QTV unrelated to RRV during stress testing could be used to separate patients with and without CAD. Power spectral density of QTV unrelated to RRV was obtained based on time-frequency coherence estimation. Instantaneous LF power of QTV and QTV unrelated to RRV were obtained. LF power of QTV unrelated to RRV normalized by LF power of QTV was also studied. Stress test ECG of 100 patients were analysed. Patients referred to coronary angiography were classified into non-CAD or CAD group. LF oscillations in QTV did not show significant differences between CAD and non-CAD groups. However, LF oscillations in QTV unrelated to RRV were significantly higher in the CAD group as compared with the non-CAD group when measured during the first phases of exercise and last phases of recovery. ROC analysis of these indices revealed area under the curve values ranging from 61 to 73%. Binomial logistic regression analysis revealed LF power of QTV unrelated to RRV, both during the first phase of exercise and last phase of recovery, as independent predictors of CAD. In conclusion, this study highlights the importance of removing the influence of RRV when measuring QTV during stress testing for CAD identification and supports the added value of LF oscillations of QTV unrelated to RRV to diagnose CAD from the first minutes of exercise. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Affiliation(s)
| | - David Hernando
- I3A, University of Zaragoza, IIS Aragón, Spain
- CIBER-BBN, Zaragoza, Spain
| | | | - Pablo Laguna
- I3A, University of Zaragoza, IIS Aragón, Spain
- CIBER-BBN, Zaragoza, Spain
| | - Jari Viik
- Tampere University of Technology, Tampere, Finland
| | - Raquel Bailón
- I3A, University of Zaragoza, IIS Aragón, Spain
- CIBER-BBN, Zaragoza, Spain
| | - Esther Pueyo
- I3A, University of Zaragoza, IIS Aragón, Spain
- CIBER-BBN, Zaragoza, Spain
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Navarra-Ventura G, Gomà G, de Haro C, Jodar M, Sarlabous L, Hernando D, Bailón R, Ochagavía A, Blanch L, López-Aguilar J, Fernández-Gonzalo S. Virtual Reality-Based Early Neurocognitive Stimulation in Critically Ill Patients: A Pilot Randomized Clinical Trial. J Pers Med 2021; 11:jpm11121260. [PMID: 34945732 PMCID: PMC8703623 DOI: 10.3390/jpm11121260] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/09/2021] [Accepted: 11/24/2021] [Indexed: 01/04/2023] Open
Abstract
This study focuses on the application of a non-immersive virtual reality (VR)-based neurocognitive intervention in critically ill patients. Our aim was to assess the feasibility of direct outcome measures to detect the impact of this digital therapy on patients’ cognitive and emotional outcomes. Seventy-two mechanically ventilated adult patients were randomly assigned to the “treatment as usual” (TAU, n = 38) or the “early neurocognitive stimulation” (ENRIC, n = 34) groups. All patients received standard intensive care unit (ICU) care. Patients in the ENRIC group also received adjuvant neurocognitive stimulation during the ICU stay. Outcome measures were a full neuropsychological battery and two mental health questionnaires. A total of 42 patients (21 ENRIC) completed assessment one month after ICU discharge, and 24 (10 ENRIC) one year later. At one-month follow-up, ENRIC patients had better working memory scores (p = 0.009, d = 0.363) and showed up to 50% less non-specific anxiety (11.8% vs. 21.1%) and depression (5.9% vs. 10.5%) than TAU patients. A general linear model of repeated measures reported a main effect of group, but not of time or group–time interaction, on working memory, with ENRIC patients outperforming TAU patients (p = 0.008, ηp2 = 0.282). Our results suggest that non-immersive VR-based neurocognitive stimulation may help improve short-term working memory outcomes in survivors of critical illness. Moreover, this advantage could be maintained in the long term. An efficacy trial in a larger sample of participants is feasible and must be conducted.
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Affiliation(s)
- Guillem Navarra-Ventura
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-937-23-66-73
| | - Gemma Gomà
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Candelaria de Haro
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercè Jodar
- Department of Neurology, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Leonardo Sarlabous
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - David Hernando
- Instituto Universitario de Investigación en Ingeniería de Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain; (D.H.); (R.B.)
- Instituto de Investigación Sanitaria Aragón, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Raquel Bailón
- Instituto Universitario de Investigación en Ingeniería de Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain; (D.H.); (R.B.)
- Instituto de Investigación Sanitaria Aragón, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ana Ochagavía
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lluís Blanch
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josefina López-Aguilar
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sol Fernández-Gonzalo
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (G.G.); (C.d.H.); (L.S.); (A.O.); (L.B.); (J.L.-A.); (S.F.-G.)
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Hernández-Vicente A, Hernando D, Vicente-Rodríguez G, Bailón R, Garatachea N, Pueyo E. ECG Ventricular Repolarization Dynamics during Exercise: Temporal Profile, Relation to Heart Rate Variability and Effects of Age and Physical Health. Int J Environ Res Public Health 2021; 18:9497. [PMID: 34574421 PMCID: PMC8469015 DOI: 10.3390/ijerph18189497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022]
Abstract
Periodic repolarization dynamics (PRD) is a novel electrocardiographic marker of cardiac repolarization instability with powerful risk stratification capacity for total mortality and sudden cardiac death. Here, we use a time-frequency analysis approach to continuously quantify PRD at rest and during exercise, assess its dependence on heart rate variability (HRV) and characterize the effects of age (young adults/middle-aged adults/older adults), body mass index (non-overweight/overweight) and cardiorespiratory fitness level (fit/unfit). Sixty-six male volunteers performed an exercise test. RR and dT variabilities (RRV, dTV), as well as the fraction of dT variability unrelated to RR variability, were computed based on time-frequency representations. The instantaneous LF power of dT (PdTV), representing the same concept as PRD, and of its RRV-unrelated component (PdTVuRRV) were quantified. dT angle was found to mostly oscillate in the LF band. Overall, 50-70% of PdTV was linearly unrelated to RRV. The onset of exercise caused a sudden increase in PdTV and PdTVuRRV, which returned to pre-exercise levels during recovery. Clustering analysis identified a group of overweight and unfit individuals with significantly higher PdTV and PdTVuRRV values at rest than the rest of the population. Our findings shed new light on the temporal profile of PRD during exercise, its relationship to HRV and the differences in PRD between subjects according to phenotypic characteristics.
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Affiliation(s)
- Adrián Hernández-Vicente
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), 50009 Zaragoza, Spain
| | - David Hernando
- Biomedical Signal Interpretation and Computational Simulation (BSICoS), Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50018 Zaragoza, Spain; (D.H.); (R.B.); (E.P.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Germán Vicente-Rodríguez
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), 28029 Madrid, Spain
- Instituto Agroalimentario de Aragón -IA2- CITA-Universidad de Zaragoza, 50013 Zaragoza, Spain
| | - Raquel Bailón
- Biomedical Signal Interpretation and Computational Simulation (BSICoS), Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50018 Zaragoza, Spain; (D.H.); (R.B.); (E.P.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Nuria Garatachea
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), 28029 Madrid, Spain
- Instituto Agroalimentario de Aragón -IA2- CITA-Universidad de Zaragoza, 50013 Zaragoza, Spain
| | - Esther Pueyo
- Biomedical Signal Interpretation and Computational Simulation (BSICoS), Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50018 Zaragoza, Spain; (D.H.); (R.B.); (E.P.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
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9
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Muehler MR, Vigen K, Hernando D, Zhu A, Colgan TJ, Reeder SB. Reproducibility of liver R2* quantification for liver iron quantification from cardiac R2* acquisitions. Abdom Radiol (NY) 2021; 46:4200-4209. [PMID: 33982186 PMCID: PMC8346410 DOI: 10.1007/s00261-021-03099-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To evaluate the reproducibility of liver R2* measurements between a 2D cardiac ECG-gated and a 3D breath-hold liver CSE-MRI acquisition for liver iron quantification. METHODS A total of 54 1.5 T MRI exams from 51 subjects (18 women, 36 men, age 35.2 ± 21.8) were included. These included two sub-studies with 23 clinical MRI exams from 19 patients identified retrospectively, 24 participants with known or suspected iron overload, and 7 healthy volunteers acquired prospectively. The 2D cardiac and the 3D liver R2* maps were acquired in the same exam. Either acquisitions were reconstructed using a complex R2* algorithm that accounts for the presence of fat and residual phase errors due to eddy currents. Data were analyzed using colocalized ROIs in the liver. RESULTS Linear regression analysis demonstrated high Pearson's correlation and Lin's concordance coefficient for the overall study and both sub-studies. Bland-Altman analysis also showed good agreement, except for a slight increase of the mean R2* value above ~ 400 s-1. The Kolmogorow-Smirnow test revealed a non-normal distribution for (R2* 3D-R2* 2D) values from 0 to 600 s-1 in contrast to the 0-200 s-1 and 0-400 s-1 subpopulations. Linear regression analysis showed no relevant differences other than the intercept, likely due to only 7 measurements above 400 s-1. CONCLUSIONS The results demonstrate that R2*-measurements in the liver are feasible using 2D cardiac R2* maps compared to 3D liver R2* maps as the reference. Liver R2* may be underestimated for R2* > 400 s-1 using the 2D cardiac R2* mapping method.
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Affiliation(s)
- M R Muehler
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA.
- Department of Radiology and Neuroradiology, University Greifswald, Greifswald, Germany.
| | - K Vigen
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - D Hernando
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
- Department of Electrical and Computer Engineering, University of Wisconsin, Madison, WI, USA
| | - A Zhu
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - T J Colgan
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA
| | - S B Reeder
- Department of Radiology, Wisconsin Institutes of Medical Research, University of Wisconsin, Room 2478, 1111 Highland Avenue, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
- Department of Electrical and Computer Engineering, University of Wisconsin, Madison, WI, USA
- Department of Medicine, University of Wisconsin, Madison, WI, USA
- Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA
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10
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Armañac-Julián P, Hernando D, Lázaro J, de Haro C, Magrans R, Morales J, Moeyersons J, Sarlabous L, López-Aguilar J, Subirà C, Fernández R, Orini M, Laguna P, Varon C, Gil E, Bailón R, Blanch L. Cardiopulmonary coupling indices to assess weaning readiness from mechanical ventilation. Sci Rep 2021; 11:16014. [PMID: 34362950 PMCID: PMC8346488 DOI: 10.1038/s41598-021-95282-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
The ideal moment to withdraw respiratory supply of patients under Mechanical Ventilation at Intensive Care Units (ICU), is not easy to be determined for clinicians. Although the Spontaneous Breathing Trial (SBT) provides a measure of the patients' readiness, there is still around 15-20% of predictive failure rate. This work is a proof of concept focused on adding new value to the prediction of the weaning outcome. Heart Rate Variability (HRV) and Cardiopulmonary Coupling (CPC) methods are evaluated as new complementary estimates to assess weaning readiness. The CPC is related to how the mechanisms regulating respiration and cardiac pumping are working simultaneously, and it is defined from HRV in combination with respiratory information. Three different techniques are used to estimate the CPC, including Time-Frequency Coherence, Dynamic Mutual Information and Orthogonal Subspace Projections. The cohort study includes 22 patients in pressure support ventilation, ready to undergo the SBT, analysed in the 24 h previous to the SBT. Of these, 13 had a successful weaning and 9 failed the SBT or needed reintubation -being both considered as failed weaning. Results illustrate that traditional variables such as heart rate, respiratory frequency, and the parameters derived from HRV do not differ in patients with successful or failed weaning. Results revealed that HRV parameters can vary considerably depending on the time at which they are measured. This fact could be attributed to circadian rhythms, having a strong influence on HRV values. On the contrary, significant statistical differences are found in the proposed CPC parameters when comparing the values of the two groups, and throughout the whole recordings. In addition, differences are greater at night, probably because patients with failed weaning might be experiencing more respiratory episodes, e.g. apneas during the night, which is directly related to a reduced respiratory sinus arrhythmia. Therefore, results suggest that the traditional measures could be used in combination with the proposed CPC biomarkers to improve weaning readiness.
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Affiliation(s)
- Pablo Armañac-Julián
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - David Hernando
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Lázaro
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria de Haro
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació Parc Taulí I3PT, Universitat Autónoma de Barcelona, Sabadell, Spain
- CIBER de Enfermedades Respiratorias (CIBER-ES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - John Morales
- Department of Electrical Engineering-ESAT, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Jonathan Moeyersons
- Department of Electrical Engineering-ESAT, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Leonardo Sarlabous
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació Parc Taulí I3PT, Universitat Autónoma de Barcelona, Sabadell, Spain
| | - Josefina López-Aguilar
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació Parc Taulí I3PT, Universitat Autónoma de Barcelona, Sabadell, Spain
- CIBER de Enfermedades Respiratorias (CIBER-ES), Instituto de Salud Carlos III, Madrid, Spain
| | - Carles Subirà
- Department of Intensive Care, Fundació Althaia, Universitat Internacional de Catalunya, Manresa, Spain
| | - Rafael Fernández
- CIBER de Enfermedades Respiratorias (CIBER-ES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Intensive Care, Fundació Althaia, Universitat Internacional de Catalunya, Manresa, Spain
| | - Michele Orini
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomews Hospital, University College London, London, UK
| | - Pablo Laguna
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Varon
- Department of Electrical Engineering-ESAT, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
- Circuits and Systems (CAS) group, Delft University of Technology, Delft, The Netherlands
| | - Eduardo Gil
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Bailón
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) group at the Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lluís Blanch
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació Parc Taulí I3PT, Universitat Autónoma de Barcelona, Sabadell, Spain
- CIBER de Enfermedades Respiratorias (CIBER-ES), Instituto de Salud Carlos III, Madrid, Spain
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11
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Hernández-Vicente A, Hernando D, Marín-Puyalto J, Vicente-Rodríguez G, Garatachea N, Pueyo E, Bailón R. Validity of the Polar H7 Heart Rate Sensor for Heart Rate Variability Analysis during Exercise in Different Age, Body Composition and Fitness Level Groups. Sensors (Basel) 2021; 21:902. [PMID: 33572800 PMCID: PMC7866245 DOI: 10.3390/s21030902] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/12/2022]
Abstract
This work aims to validate the Polar H7 heart rate (HR) sensor for heart rate variability (HRV) analysis at rest and during various exercise intensities in a cohort of male volunteers with different age, body composition and fitness level. Cluster analysis was carried out to evaluate how these phenotypic characteristics influenced HR and HRV measurements. For this purpose, sixty-seven volunteers performed a test consisting of the following consecutive segments: sitting rest, three submaximal exercise intensities in cycle-ergometer and sitting recovery. The agreement between HRV indices derived from Polar H7 and a simultaneous electrocardiogram (ECG) was assessed using concordance correlation coefficient (CCC). The percentage of subjects not reaching excellent agreement (CCC > 0.90) was higher for high-frequency power (PHF) than for low-frequency power (PLF) of HRV and increased with exercise intensity. A cluster of unfit and not young volunteers with high trunk fat percentage showed the highest error in HRV indices. This study indicates that Polar H7 and ECG were interchangeable at rest. During exercise, HR and PLF showed excellent agreement between devices. However, during the highest exercise intensity, CCC for PHF was lower than 0.90 in as many as 60% of the volunteers. During recovery, HR but not HRV measurements were accurate. As a conclusion, phenotypic differences between subjects can represent one of the causes for disagreement between HR sensors and ECG devices, which should be considered specifically when using Polar H7 and, generally, in the validation of any HR sensor for HRV analysis.
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Affiliation(s)
- Adrián Hernández-Vicente
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (J.M.-P.); (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Spain
| | - David Hernando
- BSICOS, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50015 Zaragoza, Spain; (D.H.); (E.P.); (R.B.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50009 Zaragoza, Spain
| | - Jorge Marín-Puyalto
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (J.M.-P.); (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Spain
| | - Germán Vicente-Rodríguez
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (J.M.-P.); (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), 28029 Madrid, Spain
- Instituto Agroalimentario de Aragón-IA2- CITA-Universidad de Zaragoza), 50013 Zaragoza, Spain
| | - Nuria Garatachea
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (J.M.-P.); (G.V.-R.); (N.G.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, 22002 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), 28029 Madrid, Spain
- Instituto Agroalimentario de Aragón-IA2- CITA-Universidad de Zaragoza), 50013 Zaragoza, Spain
| | - Esther Pueyo
- BSICOS, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50015 Zaragoza, Spain; (D.H.); (E.P.); (R.B.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50009 Zaragoza, Spain
| | - Raquel Bailón
- BSICOS, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50015 Zaragoza, Spain; (D.H.); (E.P.); (R.B.)
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50009 Zaragoza, Spain
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12
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Milagro J, Hernández-Vicente A, Hernando D, Casajús JA, Garatachea N, Bailón R, Pueyo E. Estimation of the second ventilatory threshold through ventricular repolarization profile analysis. Scand J Med Sci Sports 2020; 31:339-349. [PMID: 33038026 DOI: 10.1111/sms.13849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/13/2020] [Accepted: 09/25/2020] [Indexed: 11/27/2022]
Abstract
Under the hypothesis that sympathetic control of ventricular repolarization may change once the second ventilatory threshold (VT2) has been reached, a novel methodology for non-invasive VT2 estimation based on the analysis of the T wave from the electrocardiogram (ECG) is proposed, and potential underlying physiological mechanisms are suggested. 25 volunteers (33.4 ± 5.2 years) underwent an incremental power cycle ergometer test (25 W/minute). During the test, respiratory gas exchange and multi-lead ECG were acquired. The former was employed to determine VT2, used here as a reference, whereas the latter was used to compute the temporal profiles of an index of ventricular repolarization instability (dT) and its low-frequency (LF) oscillations (LFdT). The sudden increases observed in dT and LFdT profiles above an established heart rate threshold were employed to derive VT2 estimates, referred to as VT2d T and VT2LF d T , respectively. Estimation errors of -4.7 ± 25.2 W were obtained when considering VT2d T . Errors were lower than the one-minute power increment of 25 W in 68% of the subjects and lower than 50 W in 89.5% of them. When using VT2LF d T , estimation error was of 15.3 ± 32.4 W. Most of the subjects shared common characteristic dT and LFdT profiles, which could be reflecting changes in the autonomic control of ventricular repolarization before and after reaching VT2. The analysis of ventricular repolarization dynamics during exercise allows non-invasive ECG-based estimation of VT2, possibly in relation to changes in the autonomic control of ventricular electrical activity when VT2 is reached.
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Affiliation(s)
- Javier Milagro
- Biomedical Signal Interpretation and Computational Simulation Group, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain.,CIBER in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - Adrián Hernández-Vicente
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
| | - David Hernando
- Biomedical Signal Interpretation and Computational Simulation Group, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain.,CIBER in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - José A Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.,Faculty of Health Sciences (FCS), Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain.,Agro-alimentary Institute of Aragón -IA2- (CITA-University of Zaragoza), Zaragoza, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBER-Obn), Madrid, Spain
| | - Nuria Garatachea
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agro-alimentary Institute of Aragón -IA2- (CITA-University of Zaragoza), Zaragoza, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBER-Obn), Madrid, Spain.,Consejo Superior de Deportes, Madrid, Spain
| | - Raquel Bailón
- Biomedical Signal Interpretation and Computational Simulation Group, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain.,CIBER in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - Esther Pueyo
- Biomedical Signal Interpretation and Computational Simulation Group, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain.,CIBER in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
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13
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Hernández-Vicente A, Hernando D, Santos-Lozano A, Rodríguez-Romo G, Vicente-Rodríguez G, Pueyo E, Bailón R, Garatachea N. Heart Rate Variability and Exceptional Longevity. Front Physiol 2020; 11:566399. [PMID: 33041862 PMCID: PMC7527628 DOI: 10.3389/fphys.2020.566399] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/21/2020] [Indexed: 11/13/2022] Open
Abstract
Centenarians are the paradigm of human extreme longevity and healthy aging, because they have postponed, if not avoided, mayor age-related diseases. The purpose of this study was to investigate potential differences in resting heart rate variability (HRV) between young adults, octogenarians, and centenarians and assess whether HRV variables are predictors of all-cause mortality in centenarians. To this end, three groups of participants: young adults (N = 20; 20.6 ± 2.3 years), octogenarians (N = 18; 84.1 ± 2.6 years), and centenarians (N = 17; 101.9 ± 1.9 years) were monitored for 15 min at rest (seated, without moving or talking) to measure RR intervals, from which HRV was evaluated. Our results showed a clear decrease with age in the main parasympathetic HRV variables, as well as in the standard deviation (SD) of the RR series [SD of normal-to-normal interval (SDNN)] and in low frequency (LF) heart rate (HR) oscillations, although differences between octogenarians and centenarians did not reach statistical significance. In 14 centenarians followed until death, only SDNN showed significant correlation (ρ = 0.536; p = 0.048) with survival prognosis. Additionally, SDNN <19 ms was associated with early mortality (≤1 year) in centenarians (Hazard Ratio = 5.72). In conclusion, HRV indices reflecting parasympathetic outflow as well as SDNN and LF all present an age-related reduction, which could be representative of a natural exhaustion of allostatic systems related to age. Moreover, low SDNN values (<19 ms) could be associated with early mortality in centenarians. HRV seems to play a role in exceptional longevity, which could be accounted for by centenarians' exposome.
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Affiliation(s)
- Adrián Hernández-Vicente
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), University of Zaragoza, Huesca, Spain
| | - David Hernando
- BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain.,Research Institute of Hospital 12 de Octubre ("i+12"), Madrid, Spain
| | - Gabriel Rodríguez-Romo
- Faculty of Physical Activity and Sports Sciences, INEF, Universidad Politécnica de Madrid, Madrid, Spain.,CIBERFES, Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), University of Zaragoza, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), Madrid, Spain.,Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Esther Pueyo
- BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Raquel Bailón
- BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Nuria Garatachea
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), University of Zaragoza, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), Madrid, Spain.,Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Zaragoza, Spain
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Calleja-Romero A, López-Laval I, Sitko S, Hernando D, Vicente-Rodríguez G, Bailón R, Garatachea N. Effects of a 75-km mountain ultra-marathon on heart rate variability in amateur runners. J Sports Med Phys Fitness 2020; 60:1401-1407. [PMID: 32550715 DOI: 10.23736/s0022-4707.20.10860-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study examined the effects of a mountain ultra-marathon (MUM) on the activity of the autonomous nervous system through heart rate variability (HRV) monitoring and determined whether this variable related to final performance. METHODS Heart rate and HRV were measured in eight male amateur runners (aged 37-60 years). Measurements were recorded before and after the event, in resting conditions, as well as continuously throughout the whole MUM. In addition, percentage (%) of heart rate reserve (HR<inf>res</inf>) and partial and total times during the race were analyzed. RESULTS Average heart rate (HR<inf>avg</inf>) measured at rest was increased after the event (+37%). Standard deviation of successive differences (SDSD) and the square root of the mean squared differences of successive NN intervals (RMSSD) were reduced after the MUM (-56% and -59%, respectively). There was a positive relationship between the frequency-domain index normalized low frequency power (PLFn) measured at rest before the event and race time (0.79) while there was a negative relationship between race time and the difference in HR<inf>avg</inf> before and after the event. In the last half of the event, there was a high correlation (Spearman coefficient of correlation >0.9) between race time and the standard deviation of the NN intervals (SDNN) registered during the race. CONCLUSIONS Autonomous cardiac regulation can be related to the performance in a mountain ultra-marathon. HRV monitoring could represent a practical tool for the evaluation of the relationship between the autonomous nervous system activity and performance in a mountain ultra-marathon.
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Affiliation(s)
- Alberto Calleja-Romero
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, Huesca, Spain -
| | - Isaac López-Laval
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, Huesca, Spain
| | - Sebastian Sitko
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, Huesca, Spain
| | - David Hernando
- BSICoS Group, Aragon Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,CIBER- Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Germán Vicente-Rodríguez
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), Madrid, Spain.,Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Raquel Bailón
- BSICoS Group, Aragon Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,CIBER- Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Nuria Garatachea
- Department of Physiatry and Nursing, Faculty of Health and Sport Science (FCSD), University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER-Obn), Madrid, Spain.,Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Zaragoza, Spain.,National Sports Council, Madrid, Spain
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15
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Hernando D, Laguna P, Brophy C, Bailon R, Nardelli M, Hocking K, Lazaro J, Alvis B, Gil E, Scilingo EP, Brophy DR, Valenza G. Effect of yoga on pulse rate variability measured from a venous pressure waveform. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2019:372-375. [PMID: 31945918 DOI: 10.1109/embc.2019.8856657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The benefits of yoga have been studied in different fields, from chronic health conditions to mental disorders, showing that it can help to improve the overall health. In particular, it has been proven that yoga also improves the autonomic function. Heart rate variability (HRV) at rest is commonly used as a non-invasive measure of autonomic regulation of heart rate. Alternatively, pulse rate variability (PRV) has been proposed as a surrogate of HRV. VoluMetrix has developed a novel technology that captures venous waveforms via sensors on the volar aspect of the wrist, called NIVAband. This study aims to assess the effect of yoga in the autonomic nervous system by analyzing the PRV obtained from the NIVA signal. Temporal (statistics of the normal-to-normal intervals), spectral (power in low and high frequency bands) and nonlinear (lagged Poincaré Plot analysis) parameters are analyzed before and after a yoga session in 20 healthy volunteers. The PRV analysis shows an increase in parameters related to parasympathetic activity and overall variability, and a decrease in parameters related to sympathetic activity and mean heart rate. These results support the beneficial effect of yoga in autonomic nervous system, increasing the parasympathetic activity.
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16
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Castellarnau S, Sierra P, Espinosa J, Sabaté S, Hernando D. Enhanced recovery after surgery program in radical cystectomy surgery: Impact on perioperative outcomes. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Milagro J, Hernando D, Lazaro J, Casajus JA, Garatachea N, Gil E, Bailon R. Electrocardiogram-Derived Tidal Volume During Treadmill Stress Test. IEEE Trans Biomed Eng 2019; 67:193-202. [PMID: 30990416 DOI: 10.1109/tbme.2019.2911351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Electrocardiogram (ECG) has been regarded as a source of respiratory information with the main focus in the estimation of the respiratory rate. Although little research concerning the estimation of tidal volume (TV) has been conducted, there are several ECG-derived features that have been related with TV in the literature, such as ECG-derived respiration, heart rate variability, and respiratory rate. In this paper, we exploited these features for estimating TV using a linear model. METHODS 25 young (33.4 ± 5.2 years) healthy male volunteers were recruited for performing a maximal (MaxT) and a submaximal (SubT) treadmill stress test, which were conducted on different days. Both tests were automatically segmented in stages attending to the heart rate. Afterwards, a subject-specific TV model was calibrated for each stage, employing features from MaxT, and the model was later used for estimating the TV in SubT. RESULTS During exercise, the different proposed approaches led to relative fitting errors lower than 14% in most of the cases and 6% in some of them. CONCLUSION Low achieved fitting errors suggest that TV can be estimated from ECG during a treadmill stress test. SIGNIFICANCE The results suggest that it is possible to estimate TV during exercise using only ECG-derived features.
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Howell S, Hoeks S, West R, Wheatcroft S, Hoeft A, Leva B, Plichon B, Damster S, Momeni M, Watremez C, Kahn D, Dincq AS, Danila A, Wittmann M, Struck R, Rüddel T, Kessler F, Rasche S, Matsota P, Hasani A, Gudaityte J, Karbonskiene A, Ferreira R, Carvalho S, Tomescu D, Martac C, Grintescu I, Mirea L, Serrano L, Serrano L, Sierra P, Sabaté S, Hernando D, Matute P, Trashorras M, Suñé M, Sarmiento L, Hervias A, González O, Hermina A, González O, Hermina A, Navarro Perez R, Orts M, Fernandez-Garcia R, Sanchez Pérez D, Sepulveda Gil I, Monedero P, Hidalgo F, Mbongo C, Pont A, Reyes H, Bartolo C, Galera S, Valentijn T, Stolker R, Tugrul M, Emre Demirel E, Hough M, Griffiths K, Birch S, Beardow Z, Elliot S, Thompson J, Bowrey S, Northey M, Melson H, Telford R, Nadolski M, Potter A, Fuller D, Rose A, Varma S, Simeson K, Pettit J, Smith N, Martinson V, Sleight L, Naylor C, Watt P, Raymode P, Dunk N, Twohey L, Hollos L, Davies S, Gibson A, Coleman Z, Tamm T, Joscak J, Zsisku L, Zuleika M, Carvalho P, Collyer T, Ryan J, Colling K, Dharmarajah S, Krishnan A, Paddle J, Fouracres A, Arnell K, Muhammad K. Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery. Br J Anaesth 2019; 122:170-179. [DOI: 10.1016/j.bja.2018.09.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/16/2018] [Accepted: 09/24/2018] [Indexed: 01/19/2023] Open
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Hernando D, Roca S, Sancho J, Alesanco Á, Bailón R. Validation of the Apple Watch for Heart Rate Variability Measurements during Relax and Mental Stress in Healthy Subjects. Sensors (Basel) 2018; 18:E2619. [PMID: 30103376 PMCID: PMC6111985 DOI: 10.3390/s18082619] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
Heart rate variability (HRV) analysis is a noninvasive tool widely used to assess autonomic nervous system state. The market for wearable devices that measure the heart rate has grown exponentially, as well as their potential use for healthcare and wellbeing applications. Still, there is a lack of validation of these devices. In particular, this work aims to validate the Apple Watch in terms of HRV derived from the RR interval series provided by the device, both in temporal (HRM (mean heart rate), SDNN, RMSSD and pNN50) and frequency (low and high frequency powers, LF and HF) domain. For this purpose, a database of 20 healthy volunteers subjected to relax and a mild cognitive stress was used. First, RR interval series provided by Apple Watch were validated using as reference the RR interval series provided by a Polar H7 using Bland-Altman plots and reliability and agreement coefficients. Then, HRV parameters derived from both RR interval series were compared and their ability to identify autonomic nervous system (ANS) response to mild cognitive stress was studied. Apple Watch measurements presented very good reliability and agreement (>0.9). RR interval series provided by Apple Watch contain gaps due to missing RR interval values (on average, 5 gaps per recording, lasting 6.5 s per gap). Temporal HRV indices were not significantly affected by the gaps. However, they produced a significant decrease in the LF and HF power. Despite these differences, HRV indices derived from the Apple Watch RR interval series were able to reflect changes induced by a mild mental stress, showing a significant decrease of HF power as well as RMSSD in stress with respect to relax, suggesting the potential use of HRV measurements derived from Apple Watch for stress monitoring.
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Affiliation(s)
- David Hernando
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50018 Zaragoza, Spain.
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain.
| | - Surya Roca
- Communications Networks and Information Technologies (CeNIT) Group, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain.
| | - Jorge Sancho
- Communications Networks and Information Technologies (CeNIT) Group, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain.
| | - Álvaro Alesanco
- Communications Networks and Information Technologies (CeNIT) Group, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain.
| | - Raquel Bailón
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, 50018 Zaragoza, Spain.
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain.
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20
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Hernando D, Garatachea N, Almeida R, Casajús JA, Bailón R. Validation of Heart Rate Monitor Polar RS800 for Heart Rate Variability Analysis During Exercise. J Strength Cond Res 2018; 32:716-725. [DOI: 10.1519/jsc.0000000000001662] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Turon M, Fernandez-Gonzalo S, Jodar M, Gomà G, Montanya J, Hernando D, Bailón R, de Haro C, Gomez-Simon V, Lopez-Aguilar J, Magrans R, Martinez-Perez M, Oliva JC, Blanch L. Feasibility and safety of virtual-reality-based early neurocognitive stimulation in critically ill patients. Ann Intensive Care 2017; 7:81. [PMID: 28770543 PMCID: PMC5540744 DOI: 10.1186/s13613-017-0303-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/23/2017] [Indexed: 02/06/2023] Open
Abstract
Background Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention. Methods Twenty critically ill adult patients undergoing or having undergone mechanical ventilation for ≥24 h received daily 20-min neurocognitive stimulation sessions when awake and alert during their ICU stay. The difficulty of the exercises included in the sessions progressively increased over successive sessions. Physiological data were recorded before, during, and after each session. Safety was assessed through heart rate, peripheral oxygen saturation, and respiratory rate. Heart rate variability analysis, an indirect measure of autonomic activity sensitive to cognitive demands, was used to assess the efficacy of the exercises in stimulating attention and working memory. Results Patients successfully completed the sessions on most days. No sessions were stopped early for safety concerns, and no adverse events occurred. Heart rate variability analysis showed that the exercises stimulated attention and working memory. Critically ill patients considered the sessions enjoyable and relaxing without being overly fatiguing. Conclusions The results in this proof-of-concept study suggest that a virtual-reality-based neurocognitive intervention is feasible, safe, and tolerable, stimulating cognitive functions and satisfying critically ill patients. Future studies will evaluate the impact of interventions on neurocognitive outcomes. Trial registration Clinical trials.gov identifier: NCT02078206 Electronic supplementary material The online version of this article (doi:10.1186/s13613-017-0303-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marc Turon
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. .,Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain. .,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Spain.
| | - Sol Fernandez-Gonzalo
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain.,Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Jodar
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Spain.,Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Neurology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Gemma Gomà
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain.,Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Jaume Montanya
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - David Hernando
- BSICOS Group, 13A, Universidad de Zaragoza&CIBER-BBN, Saragossa, Spain
| | - Raquel Bailón
- BSICOS Group, 13A, Universidad de Zaragoza&CIBER-BBN, Saragossa, Spain
| | - Candelaria de Haro
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Victor Gomez-Simon
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Josefina Lopez-Aguilar
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain
| | - Rudys Magrans
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain
| | - Melcior Martinez-Perez
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Joan Carles Oliva
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain
| | - Lluís Blanch
- Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí (I3PT), Fundació Parc Taulí, Sabadell, Spain.,Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
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22
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Bannas P, Kramer H, Hernando D, Agni R, Cunningham A, Mandal R, Motosugi U, Sharma S, Munoz del Rio A, Adam G, Fernandez L, Reeder S. Quantitative MRT-Bildgebung der hepatischen Steatose: Ex vivo Validierung in humanen Lebern. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Hernando A, Hernando D, Garatachea N, Casajus JA, Bailon R. Attenuation of the influence of cardiolocomotor coupling in heart rate variability interpretation during exercise test. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:1508-11. [PMID: 26736557 DOI: 10.1109/embc.2015.7318657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
During exercise test, cardiolocomotor coupling related components appear in heart rate variability (HRV), blurring its interpretation as autonomic nervous system (ANS) marker. These cardiolocomotor coupling related components are centered at the pedalling and running stride frequency, as well as at their aliases, and may overlap with the low frequency (LF) and high frequency (HF) components of HRV. In this work cardiolocomotor-related HRV components are studied during maximal exercise test on treadmill and cycle ergometer. Power in the bands related to cardiolocomotor coupling increases with exercise intensity in cycle ergometer but not in treadmill exercise test, where it displays higher values for all exercise intensities. A method is proposed to reduce the effect of this coupling in the interpretation of HRV. Evolution of the power in the low frequency (LF) and high frequency (HF) bands are studied after the proposed reduction of cardiolocomotor coupling, showing more significant changes with exercise intensity than before the method is applied.
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Hernando D, Sörnmo L, Sandberg F, Laguna P, Llamedo M, Bailón R. Identification of patients prone to hypotension during hemodialysis based on the analysis of cardiovascular signals. Med Eng Phys 2015; 37:1156-61. [PMID: 26525780 DOI: 10.1016/j.medengphy.2015.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
Intradialytic hypotension (IDH) is a major complication during hemodialysis treatment, and therefore it is highly desirable to identify, at an early stage during treatment, whether the patient is prone to IDH. Heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were analyzed during the first 30 min of treatment to assess information on the autonomic nervous system. Using the sequential floating forward selection method and linear classification, the set of features with the best discriminative power was selected, resulting in an accuracy of 92.1%. Using a classifier based on the HRV features only, thereby avoiding that continuous blood pressure has to be recorded, accuracy decreased to 90.2%. The results suggest that an HRV-based classifier is useful for determining whether a patient is prone to IDH at the beginning of the treatment.
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Affiliation(s)
- D Hernando
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.
| | - L Sörnmo
- Signal Processing Group, Department of Biomedical Engineering and Center for Integrative Electrocardiology, Lund University, Lund, Sweden.
| | - F Sandberg
- Signal Processing Group, Department of Biomedical Engineering and Center for Integrative Electrocardiology, Lund University, Lund, Sweden.
| | - P Laguna
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.
| | - M Llamedo
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.
| | - R Bailón
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.
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25
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Marín T, Hernando D, Kinast N, Churruca I, Sabate S. Anaesthetic management of Stiff Man syndrome. Rev Esp Anestesiol Reanim 2015; 62:222-227. [PMID: 25060949 DOI: 10.1016/j.redar.2014.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/23/2014] [Accepted: 04/29/2014] [Indexed: 06/03/2023]
Abstract
Stiff Man syndrome or stiff-person syndrome is a rare autoimmune disorder. It is characterized by increased axial muscular tone and limb musculature, and painful spasms triggered by stimulus. The case is presented of a 44-year-old man with stiff-person syndrome undergoing an injection of botulinum toxin in the urethral sphincter under sedation. Before induction, all the surgical team were ready in order to minimise the anaesthetic time. The patient was monitored by continuous ECG, SpO2 and non-invasive blood pressure. He was induced with fractional dose of propofol 150 mg, fentanyl 50 μg and midazolam 1mg. Despite careful titration, the patient had an O2 saturation level of 90%,which was resolved by manual ventilation. There was no muscle rigidity or spasm during the operation. Post-operative recovery was uneventful and the patient was discharged 2 days later. A review of other cases is presented. The anaesthetic concern in patients with stiff-person syndrome is the interaction between the anaesthetic agents, the preoperative medication, and the GABA system. For a safe anaesthetic management, total intravenous anaesthesia is recommended instead of inhalation anaesthetics, as well as the close monitoring of the respiratory function and the application of the electrical nerve stimulator when neuromuscular blockers are used.
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Affiliation(s)
- T Marín
- Servicio de Anestesia y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - D Hernando
- Servicio de Anestesia y Reanimación, Fundación Puigvert, Barcelona, España
| | - N Kinast
- Servicio de Anestesia y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Churruca
- Servicio de Anestesia y Reanimación, Fundación Puigvert, Barcelona, España
| | - S Sabate
- Servicio de Anestesia y Reanimación, Fundación Puigvert, Barcelona, España
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Sandberg F, Bailón R, Hernando D, Laguna P, Martínez JP, Solem K, Sörnmo L. Prediction of hypotension in hemodialysis patients. Physiol Meas 2014; 35:1885-98. [DOI: 10.1088/0967-3334/35/9/1885] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kramer H, Kliewer MA, Pickhardt PJ, Hernando D, Chen GH, Reiser MF, Reeder SB. Genauigkeit der Leber-Fettquantifizierung mittels CT, MRT und Ultraschall: ein prospektiver Vergleich zur MR Spektroskopie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Kramer H, Corcos AR, Hernando D, Berry JF, Schiebler ML, Reeder SB. Effekt von molekularem Sauerstoff auf Relaxationszeiten bei klinischen Feldstärken. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Caballero L, Magariños M, García del Castillo I, Elizagárate E, Sanchez P, Hernando D. 2869 – Preliminary results of a controlled clinical trial with a group technique for cognitive training in schizophrenia based in the understanting of fictions films. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Hernando D, Alcaine A, Laguna P, Pueyo E, Bailon R. Very low frequency modulation in QRS slopes and its relation with respiration and heart rate variability during hemodialysis. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:5365-5368. [PMID: 24110948 DOI: 10.1109/embc.2013.6610761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this work, we study the very low frequency (VLF) modulation (range 0.01-0.03 Hz) in QRS slopes, heart rate variability (HRV) and ECG-derived respiration in hemodialysis patients. First, the relation between QRS slopes and HRV in the VLF band is measured using ordinary coherence. Then, partial coherence is used to measure the former relationship once the effect related to respiration is removed. Ordinary coherence values above a statistical threshold revealed linear relationship between VLF modulation in QRS slopes and HRV in about 10% of analyzed segments, with mean ± SD values of 0.79 ± 0.07 for upward slope and 0.77 ± 0.06 for downward slope. For these segments, partial coherence values drop below the threshold for 64% of the cases for upward slope and 76% for downward slope, suggesting that the origin of the VLF modulation in QRS slopes is mainly driven by respiration or linearly related to it. In the rest of the cases, partial coherence values dropped with respect to ordinary coherence from 0.89 to 0.77 for upward slope and from 0.86 to 0.75 for downward slope, suggesting that other ANS effects non-linearly related to respiration also contribute to the VLF modulation in QRS slopes.
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Kühn JP, Hernando D, Reeder SB, Hosten N. Stellenwert der Multispektralen Fettkorrektur für eine akkurate Bestimmung von Lebereisen und Leberfett in Chemical Shift Gradienten-Echo-Sequenzen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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32
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Hernando D, Hines CDG, Yu H, Reeder SB. Addressing phase errors in fat-water imaging using a mixed magnitude/complex fitting method. Magn Reson Med 2012; 67:638-44. [PMID: 21713978 PMCID: PMC3525711 DOI: 10.1002/mrm.23044] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 04/20/2011] [Accepted: 05/21/2011] [Indexed: 11/12/2022]
Abstract
Accurate, noninvasive measurements of liver fat content are needed for the early diagnosis and quantitative staging of nonalcoholic fatty liver disease. Chemical shift-based fat quantification methods acquire images at multiple echo times using a multiecho spoiled gradient echo sequence, and provide fat fraction measurements through postprocessing. However, phase errors, such as those caused by eddy currents, can adversely affect fat quantification. These phase errors are typically most significant at the first echo of the echo train, and introduce bias in complex-based fat quantification techniques. These errors can be overcome using a magnitude-based technique (where the phase of all echoes is discarded), but at the cost of significantly degraded signal-to-noise ratio, particularly for certain choices of echo time combinations. In this work, we develop a reconstruction method that overcomes these phase errors without the signal-to-noise ratio penalty incurred by magnitude fitting. This method discards the phase of the first echo (which is often corrupted) while maintaining the phase of the remaining echoes (where phase is unaltered). We test the proposed method on 104 patient liver datasets (from 52 patients, each scanned twice), where the fat fraction measurements are compared to coregistered spectroscopy measurements. We demonstrate that mixed fitting is able to provide accurate fat fraction measurements with high signal-to-noise ratio and low bias over a wide choice of echo combinations.
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Affiliation(s)
- D Hernando
- Department of Radiology, University of Wisconsin, Madison, Wisconsin 53705, USA.
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Hernando D, Karampinos DC, King KF, Haldar JP, Majumdar S, Georgiadis JG, Liang ZP. Removal of olefinic fat chemical shift artifact in diffusion MRI. Magn Reson Med 2010; 65:692-701. [PMID: 21337402 DOI: 10.1002/mrm.22670] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 08/11/2010] [Accepted: 09/13/2010] [Indexed: 01/09/2023]
Abstract
Diffusion-weighted (DW) MRI has emerged as a key tool for assessing the microstructure of tissues in healthy and diseased states. Because of its rapid acquisition speed and insensitivity to motion, single-shot echo-planar imaging is the most common DW imaging technique. However, the presence of fat signal can severely affect DW-echo planar imaging acquisitions because of the chemical shift artifact. Fat suppression is usually achieved through some form of chemical shift-based fat saturation. Such methods effectively suppress the signal originating from aliphatic fat protons, but fail to suppress the signal from olefinic protons. Olefinic fat signal may result in significant distortions in the DW images, which bias the subsequently estimated diffusion parameters. This article introduces a method for removing olefinic fat signal from DW images, based on an echo time-shifted acquisition. The method is developed and analyzed specifically in the context of single-shot DW-echo-planar imaging, where image phase is generally unreliable. The proposed method is tested with phantom and in vivo datasets, and compared with a standard acquisition to demonstrate its performance.
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Affiliation(s)
- D Hernando
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Bausili M, Cruz C, Alvarez AM, Baxarias P, Hernando D. [Peritoneal absorption of vesical irrigation fluid]. Rev Esp Anestesiol Reanim 2010; 57:190-192. [PMID: 20422857 DOI: 10.1016/s0034-9356(10)70199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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35
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Agcaoili S, Pineda-Paner B, Hernando D, Rosales I, Morales M, Morabe F, Fernandez A, Zialcita H. UP-1.117: The Role of Transrectal Power Doppler Imaging in the Detection of Prostate Cancer: A Preliminary Study. Urology 2009. [DOI: 10.1016/j.urology.2009.07.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hernando D, Kellman P, Haldar JP, Liang ZP. A network flow method for improved MR field map estimation in the presence of water and fat. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2008:82-5. [PMID: 19162599 DOI: 10.1109/iembs.2008.4649096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Field map estimation is an important problem in MRI, with applications such as water/fat separation and correction of fast acquisitions. However, it constitutes a nonlinear and severely ill-posed problem requiring regularization. In this paper, we introduce an improved method for regularized field map estimation, based on a statistically motivated formulation, as well as a novel algorithm for the solution of the corresponding optimization problem using a network flow approach. The proposed method provides theoretical guarantees (local optimality with respect to a large move), as well as an efficient implementation. It has been applied to the water/fat separation problem and tested on a number of challenging datasets, showing high-quality results.
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Affiliation(s)
- D Hernando
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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Abstract
Water/fat separation in the presence of B 0 field inhomogeneity is a problem of considerable practical importance in MRI. This article describes two complementary methods for estimating the water/fat images and the field inhomogeneity map from Dixon-type acquisitions. One is based on variable projection (VARPRO) and the other on linear prediction (LP). The VARPRO method is very robust and can be used in low signal-to-noise ratio conditions because of its ability to achieve the maximum-likelihood solution. The LP method is computationally more efficient, and is shown to perform well under moderate levels of noise and field inhomogeneity. These methods have been extended to handle multicoil acquisitions by jointly solving the estimation problem for all the coils. Both methods are analyzed and compared and results from several experiments are included to demonstrate their performance.
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Affiliation(s)
- D Hernando
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
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Abstract
The technical feasibility and performance of photocatalytic degradation of aqueous methomyl (50 mg/L) have been studied at pilot scale in two well-defined systems of special interest because natural-solar UV light can be used: heterogeneous photocatalysis with titanium dioxide and homogeneous photocatalysis by photo-Fenton. The pilot plant is made up of compound parabolic collectors specially designed for solar photocatalytic applications. Experimental conditions allowed pesticide disappearance, degree of mineralisation and toxicity achieved in the two photocatalytic systems to be compared. Total disappearance of methomyl is attained by photo-Fenton in 60 min and by TiO2 in 100 min. Hundred percent of nitrogen and sulphur are recovered as ammonium and sulphate. By contrast, complete mineralisation of total organic carbon (TOC) is not achieved even after quite a long time (more than 300 min). Three different bioassays (Vibrio fischeri, Daphnia magna and a Microalga) have been used for testing the progress of toxicity during treatment. All remained toxic down to very low-pesticide concentrations and in some bioassays were still toxic after total disappearance of the pesticide. Only if treatment is maintained throughout enough mineralisation (i.e. TOC disappearance), the toxicity is reduced to below the threshold (EC50%).
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Malato S, Caceres J, Agüera A, Mezcua M, Hernando D, Vial J, Fernández-Alba AR. Degradation of imidacloprid in water by photo-Fenton and TiO2 photocatalysis at a solar pilot plant: a comparative study. Environ Sci Technol 2001; 35:4359-4366. [PMID: 11718357 DOI: 10.1021/es000289k] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The technical feasibility, mechanisms, and performance of degradation of aqueous imidacloprid have been studied at pilot scale in two well-defined photocatalytic systems of special interest because natural UV light can be used: heterogeneous photocatalysis with titanium dioxide and homogeneous photocatalysis by photo-Fenton. Equivalent pilot-scale and field conditions used for both allowed adequate comparison of the degree of mineralization and toxicity achieved as well as the transformation products generated in route to mineralization by both systems. Ninety-five percent of mineralization (<2.0 mg/L) was reached after 250 min of photocatalytic treatment with Fenton and 450 min with TiO2, meaning that TOC disappears 2.4 times faster with photo-Fenton photocatalytic treatment than with TiO2. The Daphnia Magna test for final residual TOC does not reveal anytoxic behavior. Transformation products evaluated by GC-MS/AED after two SPE procedures and LC-IC were the same in both cases. The main differences between the two processes are in the amount of transformation products (TPs) generated, not in the TPs detected which were always the same. At the end of both processes low concentration (<0.1 mg/L) of 2 pyrrolidinone (transformation product) remains in the dissolution and around 1 mg/L of formate in the case of photo-Fenton.
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Affiliation(s)
- S Malato
- Plataforma Solar de Almería-CIEMAT, Spain
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Hernando D, Saurina J, Hernández-Cassou S. Liquid chromatographic determination of aniline in table-top sweeteners based on pre-column derivatization with 1,2-naphthoquinone-4-sulfonate. J Chromatogr A 1999; 859:227-33. [PMID: 10574215 DOI: 10.1016/s0021-9673(99)00897-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A liquid chromatographic method for the determination of aniline in cyclamate sweeteners based on a pre-column derivatization with 1,2-naphthoquinone-4-sulfonate (NQS) is proposed. Aniline traces were extracted from the cyclamate samples using dichloromethane. After solvent evaporation, the dry residue was derivatized with NQS at pH 9.5 and 85 degrees C for 1 min. The aniline derivative, which was extracted from the reacting mixture, was redissolved in the eluent solution and injected into the chromatographic system. The separation of aniline derivative from other amine impurities was carried out in a C18 column using a 2% acetic acid-methanol (40:60, v/v) mobile phase. Results from the analysis of aniline in the sweetener samples with the proposed method were compared with those from the standard method. A good concordance between the two methods was observed.
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Affiliation(s)
- D Hernando
- Department of Analytical Chemistry, University of Barcelona, Spain
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Casals P, Hernando D, Martínez D, Mulas D, Cochs J, Viguera M, Muñoz L. [Use of the fiberoptic bronchoscope for intubation in maxillofacial surgery]. Rev Esp Anestesiol Reanim 1987; 34:138-40. [PMID: 3589085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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42
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Maestre MP, Suárez M, Villalonga R, Batlle M, Fuentelsaz MT, Lorente L, Hernando D. [Anesthesia in liver transplantation]. Rev Esp Anestesiol Reanim 1985; 32:214-21. [PMID: 3909260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Skaredoff MN, Viguera MG, Casals P, Hernando D. [Butorphanol. A new synthetic analgesic]. Rev Esp Anestesiol Reanim 1984; 31:192-6. [PMID: 6505342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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