Distribution of aortic mechanical prosthetic valve closure soundmodel parameters on the surface of the chest

If has been previously proposed that heart valve closure sounds can be modeled by a sum of decaying sinusoids, based on the hypothesis that the heart cavity, heart walls, major vessels, and other structures in the chest constitute a frequency selective linear acoustic system and this system is excited by the rapidly decelerating valve occluder. In this study, the distribution of the parameters of this model for the second heart sound is investigated. For this purpose, heart sounds of 10 patients who have a St. Jude-type bileaflet mechanical heart valve prosthesis in the aortic position are recorded. Recordings are performed at 12 different locations on the surface of the chest. To reliably assign representative parameters to each recording site, signal averaging, model order selection, and a special filtration technique are employed. The results of the analyses are discussed in relation to the above hypothesis on the heart sound generation mechanism. It is observed that site-to-site variation of frequencies of modes does not exceed the accuracy limit of proposed analysis method, but energies of these modes vary on the surface of the chest, and as a result of statistical analysis, it appears that energy of some modes are significantly different between two recording sites     

Spectral composition of heart sounds before and after mechanicalheart valve implantation using a modified forward-backward Prony'smethod

This paper investigates the impact of the lung-thorax and heart-valve system on the overall spectral composition of the externally recorded heart sounds. The study concentrates on the case of the first and the second heart sounds for normal patients and patients before and after implantation of a mechanical valve in the mitral or aortic position. The analysis is performed using a modified forward-backward overdetermined Prony's method (MFBPM) which uses a forward-backward mean filter and a modified procedure for estimating the position of the signal poles. In terms of the normalized cross-correlation coefficient, this method has an average modeling accuracy of 99.62% for representing the first and second heart sounds and an average least square time-domain error of 0.43%. Results obtained from 40 subjects show that the condition of the native mitral or aortic valve affects mostly the distribution of the amplitudes of the spectral components, whereas the number of the spectral components or their respective relative energy remains more or less unchanged. It has been found that the amplitudes of frequency components in the range 120-250 Hz are more affected by abnormalities of native mitral valves. Furthermore, in the case of the second heart sound the region 250-400 Hz has been found to be more affected by abnormalities in the aortic valve. It has also been found that the mechanical prosthetic heart valve affects mostly the spectrum beyond 400 Hz. A clear difference has been observed in the frequency spectrum above 400 Hz between both normally and abnormally functioning native valves and normally functioning mechanical valves. Preliminary results in some malfunctioning cases of mechanical prosthesis suggest that spectral components beyond 400 Hz can be used to monitor the condition of these prostheses     

Comments on "Pole-zero modeling and classification of phonocardiograms"

Recently,1 the Steiglitz-McBride method was used to identify the two most dominant frequencies in aortic heart sounds from porcine prosthetic heart valves. A quadratic classifier was developed to evaluate valve sounds in a test set. We have corrected computational errors, recomputed their results, and interchanged the training and test sets to yield new results.     

Control of an air pressure actuated disposable bioreactor for cultivating heart valves

A disposable injection molded bioreactor for growing tissue-engineered heart valves is controlled to mimic the physiological heart cycle. Tissue-engineered heart valves, cultured from human stem cells, are a possible alternative for replacing failing aortic heart valves, where nowadays biological and mechanical heart valves are used. Growing and conditioning is done by mechanically stimulating the tissue in a bioreactor. The disposable injection molded bioreactor uses flexible membranes and steering valves to mimic a physiological heart cycle. In this work, an air pressure actuation control system for this bioreactor is designed. One membrane is position controlled to achieve a desired flow through the heart valve, while another membrane controls the aortic pressure. A third actuator controls a steering valve used to impose a resistance on the flow back to the first membrane, in order to control the heart valve closing pressure. Due to the repetitive character of the setpoints, repetitive controllers are designed and implemented. A high position tracking performance is achieved and pressure setpoints are mimicked successfully, while preventing large pressure oscillations and suppressing disturbances that could be damaging for the tissue heart valve. The control system allows full adjustability of operating conditions needed for the growing, conditioning and testing phases of tissue engineered heart valves.     

The Recording of Echocardiograms with an Intensity-Modulated Ink-Jet Oscillograph

Echocardiography is today well established and has gained widespread acceptance as a clinical routine method, especially for the diagnosis of mitral valve stenosis. Since heart structure movements are relatively fast, only information of limited medical value can be obtained from direct inspection of the A-scope display. Ideally, an apparatus for recording the movements of heart structures in the form of curves should record multiple reflected echoes and should also be able to record simultaneously other heart parameters such as ECG, phonocardiogram, or blood pressure.     

衬底温度对机械瓣膜上沉积的类金刚石薄膜的影响

为掌握机械瓣膜衬底温度对类金刚石薄膜的影响规律,在实验中保持其它实验参数不变,机械瓣膜衬底温度分别取室温和150℃时,用脉冲激光沉积法在机械瓣膜上制备类金刚石薄膜。用Raman光谱仪对薄膜的微观结构进行检测;用原子力显微镜对薄膜的表面形貌和粗糙度进行检测。结果表明：当其它实验参数不变时,机械瓣膜衬底温度从室温升高到150℃时,薄膜的微观结构没有发生明显改变;薄膜表面的粗糙度减小。类金刚石薄膜和机械瓣膜衬底之间具有很好的黏附性。     

Comparison of pattern recognition methods for computer-assistedclassification of spectra of heart sounds in patients with a porcinebioprosthetic valve implanted in the mitral position

The diagnostic performance of two pattern recognition methods (or classifiers) to detect valvular degeneration was evaluated in 48 patients with a porcine bioprosthetic heart valve inserted in the mitral position. Twenty patients had a normal porcine bioprosthetic valve and 28 patients had a degenerated bioprosthetic valve. One method was based on the Gaussian-Bayes model and the second on the "nearest neighbor" algorithm using three distance measurements. Eighteen diagnostic features were extracted from the sound spectrum of each patient and, for each method, a two-class supervised learning approach was used to determine the most discriminant diagnostic patterns composed of 6 features or less. The probability of error of the classifiers was estimated with the leave-one-out approach. The performance of each method to discriminate between normal and degenerated bioprosthetic valves was verified by clinical evaluation of the valves. The best performance in evaluation of the sound spectrum (98% correct classifications) was obtained with the Bayes classifier and two patterns of six features each. The percentage of false positive classifications of valve degeneration was 0% and the percentage of false negative classifications was 4%. Sensitivity for the detection of valve degeneration was 96%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 95%. The best performance of the nearest neighbor method (94% correct classifications) was obtained by using the Mahalanobis distance and five patterns composed of three, four, five, or six diagnostic features. Using a pattern composed of only three features, the percentage of false positive classifications for degeneration was 10% and the percentage of false negative classifications was 4%.(ABSTRACT TRUNCATED AT 250 WORDS)     

Nitric Oxide Generation and Endothelial Progenitor Cells Recruitment for Improving Hemocompatibility and Accelerating Endothelialization of Tissue Engineering Heart Valve

Tissue engineering heart valve (TEHV) offers great potential to overcome the limitations of commercial artificial valves used in clinical practice as a permanent prosthetic valve. Currently, decellularized heart valve (DHV) is the most widely used scaffold for TEHV, but showed suboptimal performance due to difficulty of endothelialization. Facilitating endothelialization of DHV is indispensable for better valve performance, and excellent hemocompatibility guarantees enough time windows for endothelialization process. Herein, a dual-functional TEHV scaffold with improving hemocompatibility and accelerating endothelialization is constructed by modifying DHV with copper ions (Cu) and growth differentiation factor 11 (GDF11). Results show the newly-constructed scaffold successfully generates endogenous nitric oxide (NO) through catalysis of Cu, and possesses improved hemocompatibility by down-regulating platelets activation and adhesion. Furthermore, GDF11 immobilization significantly accelerates scaffold endothelialization through facilitating recruitment, supporting growth, and alleviating apoptosis of endothelial progenitor cells . This TEHV scaffold shows favorable performance under in vivo hemodynamic environment with intact endothelial coverage and adaptive ECM remodeling, and without thrombus or calcification formation. This newly-constructed TEHV scaffold is expected to make up for the shortcomings of currently available prosthetic valves in clinical practice and has the potential possibility of rapid translation to the clinic as a better prosthetic valve.     

A computerized system for video analysis of the aortic valve

A novel technique was developed to study the dynamic behavior of the porcine aortic valve in an isolated heart preparation. Under the control of a personal computer, a video frame grabber board continuously acquired and digitized images of the aortic valve, and an analog-to-digital (A/D) converter read four channels of physiological data (flow rate, aortic and ventricular pressure, and aortic root diameter). The valve was illuminated with a strobe light synchronized to fire at the field acquisition rate of the CCD video camera. Using the overlay bits in the video board, the measured parameters were super-imposed over the live video as graphical tracing, and the resultant composite images were recorded on-line to video tape. The overlaying of the valve images with the graphical tracings of acquired data enabled the data tracings to be precisely synchronized with the video images of the aortic valve. This technique enabled us to observe the relationship between aortic root expansion and valve function.     

心脏瓣膜置换术后并发精神异常的护理

目的:探讨心脏瓣膜置换术后并发精神异常的临床护理特点.方法:对我院2004.1～2006.8共行心脏瓣膜置换152例,术后并发精神异常11例的临床资料进行回顾性的分析.结果:全部患者治愈出院,无护理并发症的发生.结论:认为深入了解病情特点,做好心理护理,使病人理解并积极配合各项治疗,保持舒适的环境,重视安全护理,发挥其社会支持系统的作用,利用护理人员的情绪感染患者,促进病人早日康复.     

A Study of Prosthetic Heart Valve Sounds

In this paper a new mechanism is proposed for the generation of phonocardiogram (PCG) sounds from implanted mechanical prosthetic heart valves. The structures in the chest, the heart, its partitions, and major vessels, constitute a frequency selective system excited by the rapidly decelerating valve occluder. It is shown that the source, the rapidly decelerating valve, has a wide and flat power spectrum and hence is an impulsive excitation that couples energy to the resonance modes specified by the structures in the chest. Consequently, the PCG signal is composed of decaying sinusoids. The parameters of the decaying sinusoids are estimated, and it is observed that the power spectra of the PCG signals have two dominant peaks in the frequency band of 200-500 Hz. The energy coupled to these two modes depends on the state of the valve. With thrombus the decelerating occluder slows down and becomes a broader pulse concentrating the energy to the lower resonance mode. This is verified by experiments on 30 patients during postoperative time course. However, no significant change in the resonance frequencies are observed which is an evidence for their anatomical and not valvular dependence.     

二尖瓣大量返流对风湿性心脏病人左房血栓形成的保护作用

目的 :评价风湿性瓣膜病患者二尖瓣返流与左房血栓形成的关系。方法 :在经胸超声的基础上 ,应用多平面经食道超声检查 48例非巨大左房 (LA <60mm)的二尖瓣疾病患者 ,比较分析二尖瓣返流程度与血栓形成的相关关系。结果 :合并二尖瓣大量返流的风湿性瓣膜病人较少出现左房血栓和 或左房自发声学显影。结论 :二尖瓣大量返流的风湿性心脏病患者形成左房血栓的可能性减低 ,因而是一种保护机制。     

Effects of Unphysiological Factors on Cardiac Output Regulation During Artificial Heart Pumping

Several Factors affecting artificial heart output were studied employing two mathematical models of prosthetic hearts, i.e., sac and diaphragm heart models. The stroke volume sensitivity to changes in venous pressure was analyzed by numerical computations. Increased inflow valve resistance, increased pump vacuum pressure, decreased elasticity of the ventricular sac or diaphragm and decreased size of the ventricle were shown to depress artificial heart function. In total prosthetic heart replacement experiments in calves, the resistance at the junction of the right heart to the natural atrium was measured by varying the pump vacuum pressure. When the vacuum pressure exceeded ?20 mmHg, the orifice resistance to flow increased approximately 4 times. Optimizing the above factors, a prosthetic heart should be designed that provides sufficient flow with a pump vacuum pressure not greater than ?20 mmHg.     

A Pneumatic Pressure Cycling System for an Artificial Heart

Included in this paper is a discussion of the operating principle, design, construction and testing of a stroke-limited, transistorized, pneumatic pressure cycling system for a single-chambered artificial heart. The system is free of valve-stiction catastrophes, and reveals that conventional calculations of heart power based on mean blood pressure, cardiac output and kinetic energy of the aortic blood should be augmented substantially to account for turbulence, valve resistance and pneumatic feedline distensibility. Graphs are presented to illustrate the over-all performance data.     

Vibration mode imaging

A new method for imaging the vibration mode of an object is investigated. The radiation force of ultrasound is used to scan the object at a resonant frequency of the object. The vibration of the object is measured by laser and the resulting acoustic emission from the object is measured by a hydrophone. It is shown that the measured signal is proportional to the value of the mode shape at the focal point of the ultrasound beam. Experimental studies are carried out on a mechanical heart valve and arterial phantoms. The mode images on the valve are made by the hydrophone measurement and confirmed by finite-element method simulations. Compared with conventional B-scan imaging on arterial phantoms, the mode imaging can show not only the interface of the artery and the gelatin, but also the vibration modes of the artery. The images taken on the phantom surface suggest that an image of an interior artery can be made by vibration measurements on the surface of the body. However, the image of the artery can be improved if the vibration of the artery is measured directly. Imaging of the structure in the gelatin or tissue can be enhanced by small bubbles and contrast agents.     

相关系数SVD增强随机共振的单向阀故障诊断

针对大型往复式高压隔膜泵关键部件单向阀的磨损击穿故障通常遭受强噪声污染,故障难以检测的问题,从单向阀振动信号分析入手,提出一种相关系数SVD增强随机共振的单向阀故障诊断方法.该方法首先将含有噪声的单向阀振动信号进行奇异值分解（SVD）,然后利用相关系数法筛选出包含故障特征信息最多的分量信号,再将其输入到随机共振系统中进行处理,达到检测强噪声背景下单向阀磨损击穿故障的目的.仿真结果表明,提出方法解决了强噪声背景下故障特征提取困难的问题;实测数据表明,该方法能够有效检测单向阀磨损击穿故障.     

Solid-state light valve

Recent developments in the solid-state light valve promise a high-quality projection display. The heart of the solid-state light valve is a cathode-ray tube which operates with a modulated and scanning write beam depositing charge on an electrooptic crystal target. The charge pattern on the target causes optical changes which result in modulation of an external light source. The tube incorporates an erase flood gun to control persistence of the display. This paper discusses an unique reflected light configuration with the target operating at reduced temperature and illustrates the resulting image performance. Accomplishments of contracts with Isomet Corporation on crystal targets of KD2P (potassium dideuterium phosphate) and with EDO, Ltd., on isomorphs of KDP (potassium dihydrogen phosphate) are included. Work being performed by the National Bureau of Standards on crystal perfection and electrode interaction is also presented. The paper concludes with a brief summary of various applications of the solid-state light valve concept, and a short synopsis of results obtained by others that support our enthusiasm for the device.     

基于SolidWorks的TGFZ系列关风机建模

目前很多中小型关风机制造企业,仍然停留在二维CAD的设计与制造模式。这导致产品的修改更新困难,制造周期长,对非标准机型的响应速度慢,相关技术文件的管理混乱。文中运用SolidWorks"系列零件设计表"和"配置零部件"功能,实现了关风机TGFZ系列的三维造型,大大提高了设计的速度与效率,减少了设计错误,保证了设备的制造质量。     

基于激光扫掠原理的人工心瓣关闭速率实时诊断技术

以激光扫掠法为基础,结合计数型信号处理技术和微机高速数据采集方法,构成了人工心瓣瞬时关闭速率的激光实时诊断系统。介绍了激光扫掠法的基本原理之后,讨论了各主要光学部件的作用及准直透镜和圆柱光栅的位置参数对测量结果的影响,分析了实时信号处理系统的构成及工作原理,并给出了单叶碟型机械心瓣关闭速率的实测结果。