scholarly journals Multifractal Spectrum Curvature of RR Tachograms of Healthy People and Patients with Congestive Heart Failure, a New Tool to Assess Health Conditions

Entropy ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 581 ◽  
Author(s):  
Ana María Aguilar-Molina ◽  
Fernando Angulo-Brown ◽  
Alejandro Muñoz-Diosdado
Keyword(s):  
Heart Failure ◽  
New York ◽  
Time Series ◽  
Congestive Heart Failure ◽  
Healthy Subjects ◽  
Heart Association ◽  
Multifractal Spectrum ◽  
Multifractal Spectra ◽  
Two Parameters ◽  
Healthy Persons

We calculate the multifractal spectra of heartbeat RR-interval time series (tachograms) of healthy subjects and patients with congestive heart failure (CHF). From these time series, we obtained new subseries of 6 h durations when healthy persons and patients were asleep and awake respectively. For each time series and subseries, we worked out the multifractal spectra with the Chhabra and Jensen method and found that their graphs have different shapes for CHF patients and healthy persons. We suggest to measure two parameters: the curvature around the maximum and the symmetry for all these multifractal spectra graphs, because these parameters were different for healthy and CHF subjects. Multifractal spectra of healthy subjects tend to be right skewed especially when the subjects are asleep and the curvature around the maximum is small compared with the curvature around the maximum of the CHF multifractal spectra; that is, the spectra of patients tend to be more pointed around the maximum. In CHF patients, we also have encountered differences in the curvature of the multifractal spectra depending on their respective New York Heart Association (NYHA) index.

scholarly journals Moving From Heart Failure Guidelines to Clinical Practice: Gaps Contributing to Readmissions in Patients With Multiple Comorbidities and Older Age

2018 ◽  
Vol 12 ◽  
pp. 117954681880935 ◽  
Author(s):  
Pupalan Iyngkaran ◽  
Danny Liew ◽  
Christopher Neil ◽  
Andrea Driscoll ◽  
Thomas H Marwick ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Congestive Heart Failure ◽  
Heart Association ◽  
Multidisciplinary Care ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Chronic Obstructive ◽  
Common Denominator ◽  
Chronic Renal Impairment

This feature article for the thematic series on congestive heart failure (CHF) readmissions aims to outline important gaps in guidelines for patients with multiple comorbidities and the elderly. Congestive heart failure diagnosis manifests as a 3-phase journey between the hospital and community, during acute, chronic stable, and end-of-life (palliative) phases. This journey requires in variable intensities a combination of multidisciplinary care within tertiary hospital or ambulatory care from hospital outpatients or primary health services, within the general community. Management goals are uniform, ie, to achieve the lowest New York Heart Association class possible, with improvement in ejection fraction, by delivering gold standard therapies within a CHF program. Comorbidities are an important common denominator that influences outcomes. Comorbidities include diabetes mellitus, chronic obstructive airways disease, chronic renal impairment, hypertension, obesity, sleep apnea, and advancing age. Geriatric care includes the latter as well as syndromes such as frailty, falls, incontinence, and confusion. Many systems still fail to comprehensively achieve all aspects of such programs. This review explores these factors.

scholarly journals Classification of Congestive Heart Failure from ECG Segments with a Multi-Scale Residual Network

Symmetry ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 2019
Author(s):  
Dengao Li ◽  
Ye Tao ◽  
Jumin Zhao ◽  
Hang Wu
Keyword(s):  
Heart Failure ◽  
New York ◽  
Congestive Heart Failure ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Heart Association ◽  
Residual Network ◽  
Ecg Signals ◽  
Multi Scale ◽  
New York Heart Association

Congestive heart failure (CHF) poses a serious threat to human health. Once the diagnosis of CHF is established, clinical experts need to assess the severity of CHF in a timely manner. It is proved that electrocardiogram (ECG) signals are useful for assessing the severity of CHF. However, since the ECG perturbations are subtle, it is difficult for doctors to detect the differences of ECGs. In order to help doctors to make an accurate diagnosis, we proposed a novel multi-scale residual network (ResNet) to automatically classify CHF into four classifications according to the New York Heart Association (NYHA) functional classification system. Furthermore, in order to make the reported results more realistic, we used an inter-patient paradigm to divide the dataset, and segmented the ECG signals into two different intervals. The experimental results show that the proposed multi-scale ResNet-34 has achieved an average positive predictive value, sensitivity and accuracy of 93.49%, 93.44% and 93.60% respectively for two seconds of ECG segments. We have also obtained an average positive predictive value, sensitivity and accuracy of 94.16%, 93.79% and 94.29% respectively for five seconds of ECG segments. The proposed method can be used as an auxiliary tool to help doctors to classify CHF.

Plasma levels and molecular forms of proatrial natriuretic peptides in healthy subjects and in patients with congestive heart failure

1996 ◽  
Vol 148 (1) ◽  
pp. 51-57 ◽  
Author(s):  
C Azizi ◽  
G Maistre ◽  
H Kalotka ◽  
R Isnard ◽  
C Barthélemy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Plasma Levels ◽  
Healthy Subjects ◽  
Plasma Concentrations ◽  
Gel Filtration ◽  
Heart Association ◽  
Left Ventricular ◽  
Molecular Forms ◽  
Asymptomatic Patients

Abstract A specific and sensitive radioimmunoassay (RIA) for the N-terminal fragment of proatrial natriuretic peptide (NproANP) was developed. Antiserum raised in rabbits against a mixture enriched with prohormone was 100% cross-reactive with human proANP(1–30). Plasma concentrations of proANP(1–30) and ANP immunoreactivities (ir-) were simultaneously measured in healthy subjects and patients with congestive heart failure (CHF; 26 dilated cardiomyopathy and 5 ischemic heart disease). High plasma levels of both ir-proANP(1–30) and ir-ANP were detected in CHF patients. Circulating ir-ANP levels were elevated in New York Heart Association functional Classes II and III patients but not in Class I patients. However, plasma levels of ir-proANP(1–30) were higher in asymptomatic patients than in healthy subjects, and markedly increased in patients of Classes II and III. Analysis of ir-proANP(1–30) by gel filtration chromatography or reverse-phase high pressure liquid chromatography revealed a 10 kDa peptide circulating as a distinct entity. These findings indicate that: (i) the most probable form of NproANP in human plasma is a 10 kDa peptide and (ii) in CHF patients the rise in plasma ir-proANP(1–30) levels is more pronounced than the variation in plasma ir-ANP. Thus, NproANP plasma levels may prove to be a more sensitive marker of left ventricular dysfunction than ANP. Journal of Endocrinology (1996) 148, 51–57

Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review

2018 ◽  
Vol 25 (5) ◽  
pp. 472-481 ◽  
Author(s):  
Anneleen Baert ◽  
Delphine De Smedt ◽  
Johan De Sutter ◽  
Dirk De Bacquer ◽  
Paolo Emilio Puddu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
New York ◽  
Congestive Heart Failure ◽  
Heart Association ◽  
Functional Class ◽  
Factors Associated ◽  
Related Quality ◽  
New York Heart Association

Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.

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