Instytut Podstawowych Problemów Techniki

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Brachial aortic Pulse Wave Velocity (baPWV) and bone mineral density (BMD) are important indicators of cardiovascular health and bone strength, respectively. However, the gender-specific association between baPWV and BMD remains unclear. The aim of our study is to evaluate the relationship between baPWV and
BMD in men and women populations Methods: A comprehensive search was conducted in electronic databases for relevant studies published between the 1th and 30rd of April 2023. Studies reporting the correlation between baPWV and BMD in both males and
females were considered. A random-effects model was used to calculate pooled correlation coefficients (r). Results: Relevant data for both genders were found in six articles. In all publications included in the meta-analysis, the total number of studied individuals was 3800, with 2054 women and 1746 men. Pooled correlation coefficient was -0,24 (95% CI: -0.34; -0.15) in women population, and -0.12 (95%CI: -0.16, -0.06) in
men. Conclusions: Based on the published data, we found that baPWV is negatively correlated with bone density in women. However, in men we do not find such a
relationship. These findings suggest the importance of considering gender-specific factors when assessing the cardiovascular and bone health relationship.

Słowa kluczowe:

Bone mineral density, osteoporosis, brachial aortic Pulse Wave Velocity, arterial stiffness, gender differences

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Streszczenie:

Pulse wave velocity (PWV) is commonly used for assessing arterial stiffness and it is a useful and accurate cardiovascular mortality predictor. Currently, many techniques and devices for PWV measurement are known, but they are usually expensive and require operator experience. One possible solution for PWV measurement is photoplethysmography (PPG), which is convenient, inexpensive and provides continuous PWV results. The aim of this paper is validation of a new device for PPG sensor-based measurement of multi-site arterial PWV using a SphygmoCor XCEL (as the reference device) according to the recommendations of the Artery Society Guidelines (ASG). In this study, 108 subjects (56 men and 52 women, 20–91 years in 3 required age groups) were enrolled. The multi-site PWV was simultaneous measured by 7 PPG sensors commonly used in pulse oximetry in clinical settings. These sensors were placed on the forehead, and right and left earlobes, fingers and toes. Pulse transit time (PTT) was measured offline as the difference of time delay between two onsets of the pulse wave determined by the intersecting tangent method. The PWV was calculated by dividing the distance between PPG sensors by PTT. During PPG signals measurement, reference carotid to femoral PWV (cfPWV) was performed with a SphygmoCor XCEL system. The Pearson correlation coefficient (r) between the obtained PWV results was calculated. The Bland-Altman method was used to establish the level of agreement between the two devices. Mean difference (md) and standard deviation (SD) were also calculated. The multi-site PWV was highly correlated with accuracy at the ASG-defined level of “Acceptable” (md < 1.0 m/s and SD ≤ 1.5 m/s) with cfPWV: forehead - right toe (r = 0.75, md = 0.20, SD = 0.97), forehead - left toe (r = 0.79, md = 0.18, SD = 0.91), right ear - right toe (r = 0.79, md = 0.11, SD = 0.96), left ear - left toe (r = 0.75, md = 0.43, SD = 0.99), right ear - left toe (r = 0.78, md = 0.40, SD = 0.93), left ear - right toe (r = 0.78, md = 0.11, SD = 0.96), right finger - right toe (r = 0.66, md = 0.95, SD = 1.29), left finger - left toe (r = 0.67, md = 0.68, SD = 1.35). This study showed that PWV measured with the multi-site PPG system, in relation to the obtained numerical values, correlated very well with that measured using the commonly known applanation tonometry method. However, it should be noted, that the measured PWV concerns the central and muscular part of the arterial tree while the cfPWV is only for the central one. The best results were obtained when the proximal PPG sensor was placed on the head (ear or forehead) and the distal PPG sensor on the toe. PPG sensors can be placed in many sites at the same time, which provides greater freedom of their configuration. Multi-site photoplethysmography is an alternative method for PWV measurement and creates new possibilities for the diagnostics of cardiovascular diseases.

Słowa kluczowe:

photoplethysmography, pulse wave velocity, multi-site pulse wave velocity, pulse transmit time, arterial stiffness, cardiovascular diseases

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Układ oddechowy pacjenta jest początkowo diagnozowany przy zastosowaniu stetoskopu. Osłuchowa interpretacja zjawisk fizycznych jest skomplikowana i wymaga od lekarza doświadczenia oraz predyspozycji. W niniejszym artykule zaprezentowano system pomiarowy i oprogramowanie badawcze, a także proces generacji cech dystynktywnych szmerów oddechowych różnicujących przypadki chorobowe od zdrowych. Wybrane reprezentacje stanowią obiecującą podstawę do opracowania systemu klasyfikującego wspierającego proces diagnostyczny

Słowa kluczowe:

szmery oddechowe, klasyfikacja, cyfrowe przetwarzanie sygnałów

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Streszczenie:

Acoustocerebrography is a novel, non-invasive, transcranial ultrasonic diagnostic method based on the transmission of multispectral ultrasound signals propagating through the brain tissue. Dedicated signal processing enables the estimation of absorption coefficient, frequency-dependent attenuation, speed of sound and tissue elasticity. Hypertension and atrial fibrillation are well known factors correlated with white matter lesions, intracerebral hemorrhage and cryptogenic stroke numbers. The aim of this study was to compare the acoustocerebrography signal in the brains of asymptomatic atrial fibrillation patients with and without hypertension. The study included 97 asymptomatic patients (40 female and 57 male, age 66.26 +/- 6.54 years) who were clinically monitored for atrial fibrillation. The patients were divided into two groups: group I (patients with hypertension) n = 75, and group II (patients without hypertension) n = 22. Phase and amplitude of all spectral components for the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. Next, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation was performed and its features were extracted. After introducing a machine learning technique, the ROC plot of differentiations between group I and group II with an AUC of 0.958 (sensitivity 0.99 and specificity 0.968) was obtained. It can be assumed that the significant difference in the acoustocerebrography signals in patients with hypertension is due to changes in the brain tissue, and it allows for the differentiating of high-risk patients with asymptomatic atrial fibrillation and hypertension.

Słowa kluczowe:

changes in the brain, hypertension in atrial, acoustocerebrography

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Streszczenie:

Background: Hypertension (HT) is the leading cause of global disease burden and overall health loss. The brain is one of the main target organs affected by HT. HT is a potentially modifiable risk factor that leads to the formation of large vessel macroangiopathy, small vessel disease, microangiopathy, and microhemorrhages. Early detection of the brain changes (BC) gives a chance to receive appropriate treatment and protection from irreversible damage. Acoustocerebrography (ACG) is a set of techniques to capture the states of human brain tissue, and its changes on its molecular and cellular level. It is based on noninvasive measurements of various parameters obtained by analyzing an ultrasound pulse emitted across the human's skull. The main idea of this method relies in the relation between the tissue density, bulk modulus, and speed of propagation, for ultrasound waves in this medium. In our previous studies we showed that ACG is an effective method for detecting white matter lesions compared to the Magnetic Resonance Imaging. Additionally we showed that ACG allows to obtain a differentiated signal originates from atrial fibrillation (AF) patients and high-risk patients wit AF and HT.
Aim: The aim of the study was early detection of the BC in patients with HT using ACG.
Methods: The study included 136 female and 98 male patients (age 43.6±15.7 years) who were surveyed in the clinical research. The patients were divided into two groups: group I (patients with HT) n=33, and control group II (patients without HT) n=201. Phase and amplitude of all frequency components of the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. By doing so, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation (FFT) was performed and its features were extracted.
Results: After introducing a machine learning technique, the ROC plot with an AUC of 0.929 with sensitivity 0.879 and specificity 0.831 was obtained (Fig. 1).
Conclusion: ACG is new promising method, which allows for early detection of change in the brain in the patients with HT.

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