Endovascular Treatment of a Popliteal Artery Aneurysm Via Transpedal Approach: A Case Report.

Popliteal artery aneurysm (PAA) has been increasingly treated with endovascular intervention in recent years. However, whether transpedal access can be utilized to treat PAA has not been widely reported. We report a case of successful treatment of a PAA with a covered stent via retrograde transpedal approach in an 80-year male with prohibitive surgical risk who initially failed antegrade approach. This case demonstrates the feasibility of treating PAA via a retrograde transpedal access in selected patients.

Mean Pressure Gradient Prediction Based on Chest Angular Movements and Heart Rate Variability Parameters.

This study presents our recent findings on the classification of mean pressure gradient using angular chest movements in aortic stenosis (AS) patients. Currently, the severity of aortic stenosis is measured using ultra-sound echocardiography, which is an expensive technology. The proposed framework motivates the use of low-cost wearable sensors, and is based on feature extraction from gyroscopic readings. The feature space consists of the cardiac timing intervals as well as heart rate variability (HRV) parameters to determine the severity of disease. State-of-the-art machine learning (ML) methods are employed to classify the severity levels into mild, moderate, and severe. The best performance is achieved by the Light Gradient-Boosted Machine (Light GBM) with an F1-score of 94.29% and an accuracy of 94.44%. Additionally, game theory-based analyses are employed to examine the top features along with their average impacts on the severity level. It is demonstrated that the isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) are the most representative features for AS severity.Clinical Relevance- The proposed framework could be an appropriate low-cost alternative to ultra-sound echocardiography, which is a costly method.

Efficient detection of aortic stenosis using morphological characteristics of cardiomechanical signals and heart rate variability parameters.

Recent research has shown promising results for the detection of aortic stenosis (AS) using cardio-mechanical signals. However, they are limited by two main factors: lacking physical explanations for decision-making on the existence of AS, and the need for auxiliary signals. The main goal of this paper is to address these shortcomings through a wearable inertial measurement unit (IMU), where the physical causes of AS are determined from IMU readings. To this end, we develop a framework based on seismo-cardiogram (SCG) and gyro-cardiogram (GCG) morphologies, where highly-optimized algorithms are designed to extract features deemed potentially relevant to AS. Extracted features are then analyzed through machine learning techniques for AS diagnosis. It is demonstrated that AS could be detected with 95.49-100.00% confidence. Based on the ablation study on the feature space, the GCG time-domain feature space holds higher consistency, i.e., 95.19-100.00%, with the presence of AS than HRV parameters with a low contribution of 66.00-80.00%. Furthermore, the robustness of the proposed method is evaluated by conducting analyses on the classification of the AS severity level. These analyses are resulted in a high confidence of 92.29%, demonstrating the reliability of the proposed framework. Additionally, game theory-based approaches are employed to rank the top features, among which GCG time-domain features are found to be highly consistent with both the occurrence and severity level of AS. The proposed framework contributes to reliable, low-cost wearable cardiac monitoring due to accurate performance and usage of solitary inertial sensors.

An Open-Access Database for the Evaluation of Cardio-Mechanical Signals From Patients With Valvular Heart Diseases.

This paper describes an open-access database for seismo-cardiogram (SCG) and gyro-cardiogram (GCG) signals. The archive comprises SCG and GCG recordings sourced from and processed at multiple sites worldwide, including Columbia University Medical Center and Stevens Institute of Technology in the United States, as well as Southeast University, Nanjing Medical University, and the first affiliated hospital of Nanjing Medical University in China. It includes electrocardiogram (ECG), SCG, and GCG recordings collected from 100 patients with various conditions of valvular heart diseases such as aortic and mitral stenosis. The recordings were collected from clinical environments with the same types of wearable sensor patch. Besides the raw recordings of ECG, SCG, and GCG signals, a set of hand-corrected fiducial point annotations is provided by manually checking the results of the annotated algorithm. The database also includes relevant echocardiogram parameters associated with each subject such as ejection fraction, valve area, and mean gradient pressure.

Classification of Aortic Stenosis Before and After Transcatheter Aortic Valve Replacement Using Cardio-mechanical Modalities.

This paper reports our study on the impact of transcatheter aortic valve replacement (TAVR) on the classification of aortic stenosis (AS) patients using cardio-mechanical modalities. Machine learning algorithms such as decision tree, random forest, and neural network were applied to conduct two tasks. Firstly, the pre- and post-TAVR data are evaluated with the classifiers trained in the literature. Secondly, new classifiers are trained to classify between pre- and post-TAVR data. Using analysis of variance, the features that are significantly different between pre- and post-TAVR patients are selected and compared to the features used in the pre-trained classifiers. The results suggest that pre-TAVR subjects could be classified as AS patients but post-TAVR could not be classified as healthy subjects. The features which differentiate pre- and post-TAVR patients reveal different distributions compared to the features that classify AS patients and healthy subjects. These results could guide future work in the classification of AS as well as the evaluation of the recovery status of patients after TAVR treatment.

Classification of aortic stenosis using conventional machine learning and deep learning methods based on multi-dimensional cardio-mechanical signals.

This paper introduces a study on the classification of aortic stenosis (AS) based on cardio-mechanical signals collected using non-invasive wearable inertial sensors. Measurements were taken from 21 AS patients and 13 non-AS subjects. A feature analysis framework utilizing Elastic Net was implemented to reduce the features generated by continuous wavelet transform (CWT). Performance comparisons were conducted among several machine learning (ML) algorithms, including decision tree, random forest, multi-layer perceptron neural network, and extreme gradient boosting. In addition, a two-dimensional convolutional neural network (2D-CNN) was developed using the CWT coefficients as images. The 2D-CNN was made with a custom-built architecture and a CNN based on Mobile Net via transfer learning. After the reduction of features by 95.47%, the results obtained report 0.87 on accuracy by decision tree, 0.96 by random forest, 0.91 by simple neural network, and 0.95 by XGBoost. Via the 2D-CNN framework, the transfer learning of Mobile Net shows an accuracy of 0.91, while the custom-constructed classifier reveals an accuracy of 0.89. Our results validate the effectiveness of the feature selection and classification framework. They also show a promising potential for the implementation of deep learning tools on the classification of AS.

The effects of manganese overexposure on brain health.

Manganese (Mn) is the twelfth most abundant element on the earth and an essential metal to human health. Mn is present at low concentrations in a variety of dietary sources, which provides adequate Mn content to sustain support various physiological processes in the human body. However, with the rise of Mn utility in a variety of industries, there is an increased risk of overexposure to this transition metal, which can have neurotoxic consequences. This risk includes occupational exposure of Mn to workers as well as overall increased Mn pollution affecting the general public. Here, we review exposure due to air pollution and inhalation in industrial settings; we also delve into the toxic effects of manganese on the brain such as oxidative stress, inflammatory response and transporter dysregulation. Additionally, we summarize current understandings underlying the mechanisms of Mn toxicity.

Classification of Aortic Stenosis Using Time-Frequency Features From Chest Cardio-Mechanical Signals.

OBJECTIVES: This paper introduces a novel method for the detection and classification of aortic stenosis (AS) using the time-frequency features of chest cardio-mechanical signals collected from wearable sensors, namely seismo-cardiogram (SCG) and gyro-cardiogram (GCG) signals. Such a method could potentially monitor high-risk patients out of the clinic. METHODS: Experimental measurements were collected from twenty patients with AS and twenty healthy subjects. Firstly, a digital signal processing framework is proposed to extract time-frequency features. The features are then selected via the analysis of variance test. Different combinations of features are evaluated using the decision tree, random forest, and artificial neural network methods. Two classification tasks are conducted. The first task is a binary classification between normal subjects and AS patients. The second task is a multi-class classification of AS patients with co-existing valvular heart diseases. RESULTS: In the binary classification task, the average accuracies achieved are 96.25% from decision tree, 97.43% from random forest, and 95.56% from neural network. The best performance is from combined SCG and GCG features with random forest classifier. In the multi-class classification, the best performance is 92.99% using the random forest classifier and SCG features. CONCLUSION: The results suggest that the solution could be a feasible method for classifying aortic stenosis, both in the binary and multi-class tasks. It also indicates that most of the important time-frequency features are below 11 Hz. SIGNIFICANCE: The proposed method shows great potential to provide continuous monitoring of valvular heart diseases to prevent patients from sudden critical cardiac situations.

A Binary Classification of Cardiovascular Abnormality Using Time-Frequency Features of Cardio-mechanical Signals.

This paper introduces a novel method of binary classification of cardiovascular abnormality using the time-frequency features of cardio-mechanical signals, namely seismocardiography (SCG) and gyrocardiography (GCG) signals. A digital signal processing framework is proposed which utilizes decision tree and support vector machine methods with features generated by continuous wavelet transform. Experimental measurements were collected from twelve patients with cardiovascular diseases as well as twelve healthy subjects to evaluate the proposed method. Results reveal an overall accuracy of more than 94% with the best performance achieved from SVM classifiers with GCG training features. This suggests that the proposed solution could be a promising method for classifying cardiovascular abnormalities.