Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood ...This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood pressure and analysis of cardiovascular-related indicators.The proposed platform measured the signal changes in PPG and converted them into physiological indicators,such as pulse transit time(PTT),pulse wave velocity(PWV),perfusion index(PI)and heart rate(HR);these indicators were then fed into the DL to calculate blood pressure.The hardware of the experiment comprised 2 PPG components(i.e.,Raspberry Pi 3 Model B and analog-todigital converter[MCP3008]),which were connected using a serial peripheral interface.The DL algorithm converted the stable dual PPG signals acquired from the strictly standardized experimental process into various physiological indicators as input parameters and finally obtained the systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP).To increase the robustness of the DL model,this study input data of 100 Asian participants into the training database,including those with and without cardiovascular disease,each with a proportion of approximately 50%.The experimental results revealed that the mean absolute error and standard deviation of SBP was 0.17±0.46 mmHg.The mean absolute error and standard deviation of DBP was 0.27±0.52 mmHg.The mean absolute error and standard deviation of MAP was 0.16±0.40 mmHg.展开更多
Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic ki...Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.展开更多
BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psy...BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psychological stress with long-term BPV in young male humans.METHODS We prospectively examined the association of chronic psychological stress with long-term BPV in 1112 healthy military males,averaged 32.2 years from the cardiorespiratory fitness and hospitalization events in armed forces study in Taiwan.Psychological stress was quantitatively evaluated with the Brief Symptom Rating Scale(BSRS-5),from the least symptom of 0 to the most severe of 20,and the five components of anxiety,insomnia,depression,interpersonal sensitivity,and hostility(the severity score in each component from 0 to 4).Longterm BPV was assessed by standard deviation(SD)for systolic and diastolic blood pressure(SBP and DBP),and average real variability(ARV),defined as the average absolute difference between successive measurements of SBP or DBP,across four visits in the study period from 2012 to 2018(2012-14,2014-15,2015-16,and 2016-18).RESULTS The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP,SDDBP,ARVSBP,and ARVDBP after adjusting for all the covariates[β(SE):-0.022(0.024),-0.023(0.026),-0.001(0.018),and 0.001(0.020),respectively;P>0.05 for all].In addition,there were also no correlations between each component of the BSRS score and the long-term BPV indexes.CONCLUSION Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young male humans.展开更多
Objective To explore the changes in plasma angiotensin II （Ang Ⅱ） and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome （SAS） before and after continuous positive airway pre...Objective To explore the changes in plasma angiotensin II （Ang Ⅱ） and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome （SAS） before and after continuous positive airway pressure （CPAP） or surgical treatment. Methods A total of 180 essential hypertension patients were enrolled in our study. The determination of plasma Ang Ⅱ concentration, ambulatory blood pressure （ABP）, and polysomnography （PSG） monitoring were performed before and 3 months after CPAP or surgical treatment. Results Patients were classified into three groups by their apnea-hypopnea index （AHI）： essential hypertension group （EH group, n=72; AHI〈5）, essential hypertension with mild SAS group （EH＋mild SAS group, n=60, 5≤AHI〈20）, and essential hypertension with moderate and severe SAS group （EH＋moderate-severe SAS group, n=48, AHI_〉20）. The concentrations of plasma AngⅡ in the above three groups were 13.42±3.27, 16.17±3.82, and 18.73±4.05 ng/mL respectively before treatment, and AngⅡ concentration in EH patients combined with SAS was significantly higher than that in EH group （all P〈0.05）. After treatment the values in the latter two groups significantly decreased to 14.67±2.56 and 15.03±3.41 ng/mL respectively （P〈0.05）. The incidence of non-dipper blood pressure curve in EH patients was 31.9%, and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%, respectively before treatment. The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone （P〈0.05）. After CPAP treatment or surgery, the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%, respectively （P〈0.05）. Conclusions Ang Ⅱ might play a role in blood pressure variability in patients with obstructive SAS. CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang Ⅱ level in patients with obstructive SAS.展开更多
This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, th...This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, the effectiveness of the estimation equation was confirmed using data obtained by a noncontact method while inducing variations in blood pressure. We considered that the Bramwell-Hill equation, which contains some parameters that directly indicate changes in blood pressure, would be an appropriate reference to construct an estimation equation for the noncontact method, because measurements using microwave radar sensors can measure minute scale motion on the skin surface induced by the pulsation of blood vessels. In order to estimate relative changes in blood pressure, we considered a simple equation including the pulse transit time (PTT), amplitude of signals and body dimensions as parameters. To verify the effectiveness of the equation for estimating changes in blood pressure, two experiments were conducted: a cycling task using an ergometer, which induces blood pressure fluctuations because of changes in cardiac output, and a task using the Valsalva maneuver, which induces blood pressure fluctuations because of changes in vascular resistance. The results obtained from the two experiments suggested that the proposed equation using microwave radar sensors can accurately estimate relative changes of blood pressure. In particular, relatively favorable results were obtained for the changes in blood pressure induced by the changes in cardiac volume. Although many issues remain, this method could be expected to contribute to the continuous evaluation of cardiac function while reducing the burden on patients.展开更多
目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP...目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。展开更多
目的:通过Meta分析综合定量评价低容量高强度间歇训练对预防肥胖或超重人群心血管疾病的效果,进一步验证低容量高强度间歇训练在肥胖等特殊人群中应用的可行性。方法:在中国知网、PubMed、Web of Science、Cochrane Library和EBSCO-SPO...目的:通过Meta分析综合定量评价低容量高强度间歇训练对预防肥胖或超重人群心血管疾病的效果,进一步验证低容量高强度间歇训练在肥胖等特殊人群中应用的可行性。方法:在中国知网、PubMed、Web of Science、Cochrane Library和EBSCO-SPORTD运动科学全文数据库检索关于低容量高强度间歇训练相关研究的随机对照试验文献,检索时限为各数据库建库至2024年2月。由2名研究人员对所纳入的研究进行筛选、质量评价和数据提取,采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析,包括合并效应量、亚组分析、Leave-One-Out敏感性分析以及发表Egger检验和绘制漏斗图。该方案已在国际系统综述前瞻性注册中心注册(CRD42024534409)。结果:①最终筛选纳入符合要求的13项随机对照试验,共包含349例受试者,纳入文献整体质量较高。②低容量高强度间歇训练干预对心肺适能(SMD=-0.65,95%CI:-0.87至-0.43,P<0.05)、收缩压(SMD=0.38,95%CI:0.11-0.65,P<0.05)、舒张压(SMD=0.42,95%CI:0.15-0.68,P<0.05)和体脂百分比(SMD=0.25,95%CI:0.02-0.49,P<0.05)4项指标具有改善效果。③低容量高强度间歇训练与中等强度持续训练相比在改善超重或肥胖人群心肺适能、收缩压、舒张压、体脂百分比、标准体质量、体质量指数、高密度脂蛋白、低密度脂蛋白和总胆固醇指标方面干预效果相似(P>0.05),但在改善三酰甘油效果方面中等强度持续训练优于低容量高强度间歇训练(SMD=-0.30,95%CI:-0.57至-0.02,P<0.05)。④亚组分析结果进一步显示,低容量高强度间歇训练和中等强度持续训练干预对各项指标的改善效果相似。结论:当前证据表明,低容量高强度间歇训练可以有效提升超重或肥胖人群的心肺适应能力以及促进减脂和血压调控,且改善效果与中等强度持续训练相似。短时间的低容量高强度间歇训练相比于长时间的中等强度持续训练更具有时间效益。建议未来通过更多研究确定适用于超重或肥胖人群最佳的低容量高强度间歇训练运动处方。展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
基金This study was supported in part by the Ministry of Science and Technology MOST 108-2221-E-150-022-MY3 and Taiwan Ocean University.
文摘This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood pressure and analysis of cardiovascular-related indicators.The proposed platform measured the signal changes in PPG and converted them into physiological indicators,such as pulse transit time(PTT),pulse wave velocity(PWV),perfusion index(PI)and heart rate(HR);these indicators were then fed into the DL to calculate blood pressure.The hardware of the experiment comprised 2 PPG components(i.e.,Raspberry Pi 3 Model B and analog-todigital converter[MCP3008]),which were connected using a serial peripheral interface.The DL algorithm converted the stable dual PPG signals acquired from the strictly standardized experimental process into various physiological indicators as input parameters and finally obtained the systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP).To increase the robustness of the DL model,this study input data of 100 Asian participants into the training database,including those with and without cardiovascular disease,each with a proportion of approximately 50%.The experimental results revealed that the mean absolute error and standard deviation of SBP was 0.17±0.46 mmHg.The mean absolute error and standard deviation of DBP was 0.27±0.52 mmHg.The mean absolute error and standard deviation of MAP was 0.16±0.40 mmHg.
文摘Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.
基金the Hualien Armed Forces General Hospital Grant,No.HAFGH-D-109007.
文摘BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psychological stress with long-term BPV in young male humans.METHODS We prospectively examined the association of chronic psychological stress with long-term BPV in 1112 healthy military males,averaged 32.2 years from the cardiorespiratory fitness and hospitalization events in armed forces study in Taiwan.Psychological stress was quantitatively evaluated with the Brief Symptom Rating Scale(BSRS-5),from the least symptom of 0 to the most severe of 20,and the five components of anxiety,insomnia,depression,interpersonal sensitivity,and hostility(the severity score in each component from 0 to 4).Longterm BPV was assessed by standard deviation(SD)for systolic and diastolic blood pressure(SBP and DBP),and average real variability(ARV),defined as the average absolute difference between successive measurements of SBP or DBP,across four visits in the study period from 2012 to 2018(2012-14,2014-15,2015-16,and 2016-18).RESULTS The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP,SDDBP,ARVSBP,and ARVDBP after adjusting for all the covariates[β(SE):-0.022(0.024),-0.023(0.026),-0.001(0.018),and 0.001(0.020),respectively;P>0.05 for all].In addition,there were also no correlations between each component of the BSRS score and the long-term BPV indexes.CONCLUSION Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young male humans.
文摘Objective To explore the changes in plasma angiotensin II （Ang Ⅱ） and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome （SAS） before and after continuous positive airway pressure （CPAP） or surgical treatment. Methods A total of 180 essential hypertension patients were enrolled in our study. The determination of plasma Ang Ⅱ concentration, ambulatory blood pressure （ABP）, and polysomnography （PSG） monitoring were performed before and 3 months after CPAP or surgical treatment. Results Patients were classified into three groups by their apnea-hypopnea index （AHI）： essential hypertension group （EH group, n=72; AHI〈5）, essential hypertension with mild SAS group （EH＋mild SAS group, n=60, 5≤AHI〈20）, and essential hypertension with moderate and severe SAS group （EH＋moderate-severe SAS group, n=48, AHI_〉20）. The concentrations of plasma AngⅡ in the above three groups were 13.42±3.27, 16.17±3.82, and 18.73±4.05 ng/mL respectively before treatment, and AngⅡ concentration in EH patients combined with SAS was significantly higher than that in EH group （all P〈0.05）. After treatment the values in the latter two groups significantly decreased to 14.67±2.56 and 15.03±3.41 ng/mL respectively （P〈0.05）. The incidence of non-dipper blood pressure curve in EH patients was 31.9%, and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%, respectively before treatment. The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone （P〈0.05）. After CPAP treatment or surgery, the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%, respectively （P〈0.05）. Conclusions Ang Ⅱ might play a role in blood pressure variability in patients with obstructive SAS. CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang Ⅱ level in patients with obstructive SAS.
文摘This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, the effectiveness of the estimation equation was confirmed using data obtained by a noncontact method while inducing variations in blood pressure. We considered that the Bramwell-Hill equation, which contains some parameters that directly indicate changes in blood pressure, would be an appropriate reference to construct an estimation equation for the noncontact method, because measurements using microwave radar sensors can measure minute scale motion on the skin surface induced by the pulsation of blood vessels. In order to estimate relative changes in blood pressure, we considered a simple equation including the pulse transit time (PTT), amplitude of signals and body dimensions as parameters. To verify the effectiveness of the equation for estimating changes in blood pressure, two experiments were conducted: a cycling task using an ergometer, which induces blood pressure fluctuations because of changes in cardiac output, and a task using the Valsalva maneuver, which induces blood pressure fluctuations because of changes in vascular resistance. The results obtained from the two experiments suggested that the proposed equation using microwave radar sensors can accurately estimate relative changes of blood pressure. In particular, relatively favorable results were obtained for the changes in blood pressure induced by the changes in cardiac volume. Although many issues remain, this method could be expected to contribute to the continuous evaluation of cardiac function while reducing the burden on patients.
文摘目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。
