Design and control of the atrio-aortic left ventricular assistdevice based on O2 consumption

The left ventricular assist device (LVAD) is used in parallel with the left ventricle to temporarily assist patients with diminished cardiac function for the purpose of minimizing heart workload and to maintain systemic arterial perfusion. The proper adjustment and timing of the pneumatic LVAD is important such that this goal is achieved. Previous investigations into the left ventricular assist device are inconclusive regarding the optimal utilization of this device. This paper documents a protocol for optimal timing of the LVAD. Timing is studied using a closed-loop analog model of the heart, vascular system, and the LVAD. The model is tested for basic representation of the physiological system. The LVAD is incorporated into the model to discover its interaction with cardiac preload and afterload. Heart workload is computed via the pressure-volume-area method. The normal and impaired heart are modeled, in each case the pump control variables are adjusted. A protocol for adjustment of the LVAD is proposed based on reduced heart oxygen consumption. It was found that the pump should begin ejection immediately after the close of the aortic valve and that the pump filling pressure should be set to a value which produces maximum filling of the pump. Although aortic pressure and flow could be improved at pump rates above the heart rate, oxygen utilization of the heart could only be minimized for synchronous pumping. The adjustment of the pump ejection pressure is a tradeoff between d/dt (LVO2) and stroke volume and mean arterial pressure. The LVAD should be designed to minimize inflow and outflow resistance and to maximize pump compliance. The process of weaning the patient from the LVAD is considered. The overall results provide quantitative guidance for the use of the AA-LVAD.     

Echocardiographic strain and strain-rate imaging: a new tool to study regional myocardial function

Ultrasonic imaging is the noninvasive clinical imaging modality of choice for diagnosing heart disease. At present, two-dimensional ultrasonic grayscale images provide a relatively cheap, fast, bedside method to study the morphology of the heart. Several methods have been proposed to assess myocardial function. These have been based on either grayscale or motion (velocity) information measured in real-time. However, the quantitative assessment of regional myocardial function remains an important goal in clinical cardiology. To do this, ultrasonic strain and strain-rate imaging have been introduced. In the clinical setting, these techniques currently only allow one component of the true three-dimensional deformation to be measured. Clinical, multidimensional strain (rate) information can currently thus only be obtained by combining data acquired using different transducer positions. Nevertheless, given the appropriate postprocessing, the clinical value of these techniques has already been shown. Moreover, multidimensional strain and strain-rate estimation of the heart in vivo by means of a single ultrasound acquisition has been shown to be feasible. In this paper, the new techniques of ultrasonic strain rate and strain imaging of the heart are reviewed in terms of definitions, data acquisition, strain-rate estimation, postprocessing, and parameter extraction. Their clinical validation and relevance will be discussed using clinical examples on relevant cardiac pathology. Based on these examples, suggestions are made for future developments of these techniques.     

On-line pressure estimation for a left heart assist device

Long term measurement of blood pressures is essential for control of circulatory systems with artificial hearts or circulatory assist devices. Efforts to obtain reliable continuous direct measurements of blood pressures, however, have not been successful. This paper describes an on-line pressure estimation technique for use with a portable pneumatically driven left heart assist device. The on-line maximum likelihood algorithms are used for the estimation with the technique based on the use of physical models of the components of the driver and blood pump system. This technique estimates the inlet and outlet pressures of the blood pump. The directly measured driving air pressure and piston position of the pneumatic actuator are used for the estimation. In vitro and in vivo experiments were made to test the use of the on-line estimation technique. The results show successful linear correlations between the actual pressures and their estimates. This technique offers the following advantages: accurate pressure information for on-line control, accessibility to the transducers for recalibration, and noninvasive location of the transducers.     

A less invasive Emax estimation method for weaning fromcardiac assistance

The maximum elastance of the ventricle (E_max) is a strong candidate for a quantitative index used for determination of the timing of weaning the patient from a left ventricular assist device (LVAD). The authors present a new and less invasive method for deriving E_max of the left ventricle under the LVAD assistance. In this method (the CoP method), E_max can be calculated from two different end-systolic points which are produced by changing the drive phase of LVAD without any vascular clamping and any direct measurement of the left ventricular volume. Animal experiments indicated that the CoP method is useful when the measured left ventricular flow and pressure are employed. Moreover, a new technique for estimating the left ventricular flow was developed to make the CoP method less invasive without direct measurement of the flow. The technique could considerably improve the estimation accuracy of the flow in the co-pulsation mode in comparison with the previous one proposed by the authors. However, it has been revealed that the estimation accuracy of the left ventricular flow was not globally high enough to apply the CoP method to clinical cases in spite of its much less invasiveness     

Left ventricular volume estimation for real-time three-dimensional echocardiography

The application of level set techniques to echocardiographic data is presented. This method allows semiautomatic segmentation of heart chambers, which regularizes the shapes and improves edge fidelity, especially in the presence of gaps, as is common in ultrasound data. The task of the study was to reconstruct left ventricular shape and to evaluate left ventricular volume. Data were acquired with a real-time three-dimensional (3-D) echocardiographic system. The method was applied directly in the three-dimensional domain and was based on a geometric-driven scheme. The numerical scheme for solving the proposed partial differential equation is borrowed from numerical methods for conservation law. Results refer to in vitro and human in vivo acquired 3-D + time echocardiographic data. Quantitative validation was performed on in vitro balloon phantoms. Clinical application of this segmentation technique is reported for 20 patient cases providing measures of left ventricular volumes and ejection fraction.     

自适应滤波在光电技术提取心率方法中的应用

针对利用光电容积脉搏波提取心率时,传统方法光电检测电路复杂,容易受运动干扰等缺陷,设计了一种实时高效的心率提取方案。采用发光二极管产生的单束波长为940 nm的红外光,利用光电容积脉搏波原理,采集手腕处PPG信号,实现对心率信号的实时监测;并针对运动干扰提出一种自适应滤波方法,利用三轴加速度计获取噪声信号消除运动伪差。实验表明,设计与医用监测仪有良好的一致性,且提出的自适应算法比传统快速傅里叶方法具有更高的准确性,在穿戴设备允许的误差范围内,可以利用本文设计进行无创实时的心率监测。     

Analysis of heart rate variability in the presence of ectopic beats using the heart timing signal

The time-domain signals representing the heart rate variability (HRV) in the presence of an ectopic beat exhibit a sharp transient at the position of the ectopic beat, which corrupts the signal, particularly the power spectral density (PSD) of the HRV. Consequently, there is a need for correction of this type of beat prior to any HRV analysis. This paper deals with the PSD estimation of the HRV by means of the heart timing (HT) signal when ectopic beats are present. These beat occurrence times are modeled from a generalized, continuous time integral pulse frequency modulation model and, from this point of view, a specific method for minimizing the effect of the presence of ectopic beats is presented to work together with the HT signal. By using both, a white noise driven autoregressive model of the HRV signal with artificially introduced ectopic beats and actual heart rate series including ectopic beats, the more usual methods of HRV spectral estimation are compared. Results of the PSD estimation error function of the number of ectopic beats are presented. These results demonstrate that the proposed method has one order of magnitude lower error than usual ectopic beats removal strategies in preserving PSD, thus, this strategy better recovers the original clinical indexes of interest.     

Laguerre-model blind system identification: cardiovascular dynamics estimated from multiple peripheral circulatory signals

This paper presents a method for comparing multiple circulatory waveforms measured at different locations to improve cardiovascular parameter estimation from these signals. The method identifies the distinct vascular dynamics that shape each waveform signal, and estimates the common cardiac flow input shared by them. This signal-processing algorithm uses the Laguerre function series expansion for modeling the hemodynamics of each arterial branch, and identifies unknown parameters in these models from peripheral waveforms using multichannel blind system identification. An effective technique for determining the Laguerre base pole is developed, so that the Laguerre expansion captures and quickly converges to the intrinsic arterial dynamics observed in the two circulatory signals. Furthermore, a novel deconvolution method is developed in order to stably invert the identified dynamic models for estimating the cardiac output (CO) waveform from peripheral pressure waveforms. The method is applied to experimental swine data. A mean error of less than 5% with the measured peripheral pressure waveforms has been achieved using the models and excellent agreement between the estimated CO waveforms and the gold standard measurements have been obtained.     

The integral pulse frequency modulation model with time-varying threshold: application to heart rate variability analysis during exercise stress testing

In this paper, an approach for heart rate variability analysis during exercise stress testing is proposed based on the integral pulse frequency modulation (IPFM) model, where a time-varying threshold is included to account for the nonstationary mean heart rate. The proposed technique allows the estimation of the autonomic nervous system (ANS) modulating signal using the methods derived for the IPFM model with constant threshold plus a correction, which is shown to be needed to take into account the time-varying mean heart rate. On simulations, this technique allows the estimation of the ANS modulation on the heart from the beat occurrence time series with lower errors than the IPFM model with constant threshold (1.1% ± 1.3% versus 15.0% ± 14.9%). On an exercise stress testing database, the ANS modulation estimated by the proposed technique is closer to physiology than that obtained from the IPFM model with constant threshold, which tends to overestimate the ANS modulation during the recovery and underestimate it during the initial rest.     

基于FPGA的三维视频系统实时深度估计

深度估计是基于视频加深度图像的三维视频系统中前端预处理的核心技术,其主要技术难题包括准确性、实时处理和大分辨率深度图获取等。本文提出一种实时深度估计的硬件实现方案,主要解决处理速度问题,并兼顾了准确性和大分辨率问题。本方案采用单片FPGA实现深度估计,其中采用census变换与SAD(Sum of Absolute Differences)混合的算法进行逐点匹配得到稠密深度图。硬件设计充分利用FPGA的大规模并行能力,并采用流水线设计提高数据通路的数据吞吐量,提升整个设计的时钟频率。实验表明,所提出的方案可实现全高清(1 920×1 080)分辨率视频实时深度估计。为了支持大分辨率图像并能观测距离相机较近的物体深度,本文方案视差搜索范围可以达到240pixels,帧率最高可达69.6fps,达到了实时和高清的处理目的。     

Adaptive control of blood pressure

Stochastic adaptive controllers have been developed for automatic control of blood pressure during infusions of cardiostimulatory or vasoactive drugs. An adaptive algorithm based upon a minimum variance control law is presented. A more advanced algorithm obtained by augmenting the performance measure to include the rate of charge of the control signal is also presented. An autoregressive-moving-average (ARMA) model, representing the dynamics of the system, and a recursive least-squares parameter estimation technique are used for both algorithms. A series of experiments was performed in dogs, utilizing an electronically activated drug infuser. Stable control was achieved, even when the circulatory state of the animal underwent major changes, using either algorithm. On the basis of theoretical considerations and experimental results, we expect that these adaptive controllers will significantly improve the performance of drug infusion systems in clinical applications.     

人体指示位置实时估计系统的DSP实现

为了实现更为自然的人机交互,利用机器视觉方法,设计了人体指示位置实时估计系统,建立了系统的几何模型.并利用DM642芯片在图像处理中的优异性能,开发了集图像采集、处理以及传输功能于一体的通用硬件平台.通过在实际工程中的应用和精度实验分析,证明了系统的有效性和实用性.     

Gaze estimation using a webcam for region of interest detection

In this paper, a real-time gaze estimation system using a webcam is proposed, in which variation of head pose is tracked. At first, variation of head position and pose are estimated by using facial features. Then, an iterative iris center detection method is proposed for tracking iris in eye image. Finally, gaze is estimated by using estimated head pose and position, and iris center position. The proposed gaze estimation system is applied to four different applications. Experimental results show that the proposed iterative iris center detection method has a higher accuracy than conventional ones. Also, the proposed gaze estimation system shows about 98 % accuracy using \(640\times 480\) resolution webcam and 42-inch monitor that are 0.75 m apart.     

Comparison of doppler ultrasound and direct electrocardiography acquisition techniques for quantification of fetal heart rate variability

A method for comparison of two acquisition techniques that are applied in clinical practice to provide information on fetal condition is presented. The aim of this work was to evaluate the commonly used Doppler ultrasound technique for monitoring of mechanical activity of fetal heart. Accuracy of beat-to-beat interval determination together with its influence on indices describing the fetal heart rate (FHR) variability calculated automatically using computer-aided fetal monitoring system were examined. We considered the direct fetal electrocardiography as a reference technique because it ensures the highest possible accuracy of heart interval measurement, and additionally all the definitions of popular time domain parameters quantifying FHR variability formerly have been created using the fetal electrocardiogram. We evaluated the reliability of various so called short-term and long-term variability indices, when they are calculated automatically using the signal obtained via the Doppler US from a fetal monitor. The results proved that evaluation of the acquisition technique influence on fetal well-being assessment can not be accomplished basing on direct measurements of heartbeats only. The more relevant is the estimation of accuracy of the variability indices, since analysis of their changes can significantly increase predictability of fetal distress.     

Laser Doppler Technique for Absolute Measurement of Blood Speed in Retinal Vessels

We describe an electrooptical laser Doppler system and technique of data analysis that provides absolute measurements of the speed of red blood cells flowing at discrete, selectable sites in the retinal vasculature. We present in vitro test measurements of the instrumentation as well as an example of an in vivo measurement from a patient with retinal vascular disease. We also present experimental data leading to the derivation of the relationship between the blood speeds measured in retinal arteries during the minimum diastolic and maximum systolic phases of the cardiac cycle and the time-averaged blood speed. Mean blood flow rate is calculated using the time-averaged speed and the cross-sectional area of the vessel at the measurement site. We discuss the criteria for selection of the measurement sites and assess the reproducibility of the measurements. We conclude that measurements on retinal arteries are less susceptible to experimental artifacts and provide more information than do measurements on retinal veins. The system is currently being used clinically in studies of retinal circulatory alterations in patients with diabetic retinopathy, arterial occlusive disease, retinal detachment, and carotid artery disease.     

基于多项式拟合的二维OFDM信道估计算法

该文提出了一种内插导频的二维信道估计算法,用于无线移动信道下的正交频分复用(OFDM)系统。该算法能够适用于矩形内插的导频信号内插方式,相比于梳状内插的导频信号内插方式,矩形内插具有更高的数据传输效率。与已有线性最小均方差(LMMSE)信道估计方法相比,该算法简单并且不需要预先知道信道相关矩阵以及信噪比等信道信息。仿真结果表明,在各种的衰落环境下,该算法都有良好的性能。     

用均匀圆阵实现宽频段来波信号频率和二维角估计

本文提出了一种在DFT波束空间实时估计入射到均匀圆阵(UCA)上宽频段(1～18GHz)信号的频率、方位角和仰角的方法。该方法可在时间欠采样条件下实现频率无模糊估计,在空间欠采样条件下,用整数搜索法实现方位角和仰角无模糊估计,且频率、方位角和仰角估计可自动配对。模拟频率间接估计算法的估计方差比直接估计算法的方差要小2～3个数量级。仿真实验表明了算法是有效的。     

Objective comparison of quantitative imaging modalities without the use of a gold standard

Imaging is often used for the purpose of estimating the value of some parameter of interest. For example, a cardiologist may measure the ejection fraction (EF) of the heart in order to know how much blood is being pumped out of the heart on each stroke. In clinical practice, however, it is difficult to evaluate an estimation method because the gold standard is not known, e.g., a cardiologist does not know the true EF of a patient. Thus, researchers have often evaluated an estimation method by plotting its results against the results of another (more accepted) estimation method, which amounts to using one set of estimates as the pseudogold standard. In this paper, we present a maximum-likelihood approach for evaluating and comparing different estimation methods without the use of a gold standard with specific emphasis on the problem of evaluating EF estimation methods. Results of numerous simulation studies will be presented and indicate that the method can precisely and accurately estimate the parameters of a regression line without a gold standard, i.e., without the x axis.     

Real-time fetal heart monitoring in biomagnetic measurements using adaptive real-time ICA

Electrophysiological signals of the developing fetal brain and heart can be investigated by fetal magnetoencephalography (fMEG). During such investigations, the fetal heart activity and that of the mother should be monitored continuously to provide an important indication of current well-being. Due to physical constraints of an fMEG system, it is not possible to use clinically established heart monitors for this purpose. Considering this constraint, we developed a real-time heart monitoring system for biomagnetic measurements and showed its reliability and applicability in research and for clinical examinations. The developed system consists of real-time access to fMEG data, an algorithm based on Independent Component Analysis (ICA), and a graphical user interface (GUI). The algorithm extracts the current fetal and maternal heart signal from a noisy and artifact-contaminated data stream in real-time and is able to adapt automatically to continuously varying environmental parameters. This algorithm has been named Adaptive Real-time ICA (ARICA) and is applicable to real-time artifact removal as well as to related blind signal separation problems.