Vânia Almeida

Characterization of a double probe for local pulse wave velocity assessment.

Local pulse-wave velocity (PWV) is an accurate indicator of the degree of arteriosclerosis (stiffness) in an artery, providing a direct characterization of the properties of its wall. Devices currently available for local PWV measurement are mainly based on ultrasound systems and have not yet been generalized to clinical practice since they require high technical expertise and most of them are limited in precision, due to the lack of reliable signal processing methods. The present work describes a new type of probe, based on a double-headed piezoelectric (PZ) sensor. The principle of PWV measurement involves determination of the pulse transit time between the signals acquired simultaneously by both PZs, placed 23 mm apart. The double probe (DP) characterization is accomplished in three main studies, carried out in a dedicated test bench system, capable of reproducing a range of clinically relevant properties of the cardiovascular system. The first study refers to determination of the impulse response (IR) for each PZ sensor, whereas the second one explores the existence of crosstalk between both transducers. In the last one, DP time resolution is inferred from a set of three different algorithms based on (a) the maximum of cross-correlation function, (b) the maximum amplitude detection and (c) the zero-crossing point identification. These values were compared with those obtained by the reference method, which consists of the simultaneous acquisition of pressure waves by means of two pressure sensors. The new probe demonstrates good performance on the test bench system and results show that the signals do not exhibit crosstalk. A good agreement was also verified between the PWV obtained from the DP signals (19.55 ± 2.02  ms(-1)) and the PWV determined using the reference method (19.26 ± 0.04  ms(-1)). Although additional studies are still required, this probe seems to be a valid alternative to local PWV stand-alone devices.

Machine learning techniques for arterial pressure waveform analysis

The Arterial Pressure Waveform (APW) can provide essential information about arterial wall integrity and arterial stiffness. Most of APW analysis frameworks individually process each hemodynamic parameter and do not evaluate inter-dependencies in the overall pulse morphology. The key contribution of this work is the use of machine learning algorithms to deal with vectorized features extracted from APW. With this purpose, we follow a five-step evaluation methodology: (1) a custom-designed, non-invasive, electromechanical device was used in the data collection from 50 subjects; (2) the acquired position and amplitude of onset, Systolic Peak (SP), Point of Inflection (Pi) and Dicrotic Wave (DW) were used for the computation of some morphological attributes; (3) pre-processing work on the datasets was performed in order to reduce the number of input features and increase the model accuracy by selecting the most relevant ones; (4) classification of the dataset was carried out using four different machine learning algorithms: Random Forest, BayesNet (probabilistic), J48 (decision tree) and RIPPER (rule-based induction); and (5) we evaluate the trained models, using the majority-voting system, comparatively to the respective calculated Augmentation Index (AIx). Classification algorithms have been proved to be efficient, in particular Random Forest has shown good accuracy (96.95%) and high area under the curve (AUC) of a Receiver Operating Characteristic (ROC) curve (0.961). Finally, during validation tests, a correlation between high risk labels, retrieved from the multi-parametric approach, and positive AIx values was verified. This approach gives allowance for designing new hemodynamic morphology vectors and techniques for multiple APW analysis, thus improving the arterial pulse understanding, especially when compared to traditional single-parameter analysis, where the failure in one parameter measurement component, such as Pi, can jeopardize the whole evaluation.

Empirical mode decomposition for self-mixing Doppler signals of hemodynamic optical probes.

A new type of optical probe based on laser Doppler self-mixing technology, for a truly non-contact measurement in a single location, and extraction of the temporal features of the distension wave in the arterial wall, was developed. The monitoring of temporal features allows the assessment of cardiovascular function when measurement is carried out at the carotid artery. An algorithm based on the short-time Fourier transform and empirical mode decomposition was applied to the test setup self-mixing signals for the determination of waveform features, with an accuracy of a few milliseconds and a root mean square error less than 3 ms. In vivo testing signals show great consistency in the measured pulse pressure waveform.

Visible and infrared optical probes for hemodynamic parameters assessment

Four optical probes were developed to measure the arterial distension waveform generated by the ventricular contraction and assess clinically relevant information. The pressure wave propagates through the arterial tree and can be measured in the peripheral arteries. The probes make use of two distinct photo-detectors: planar and avalanche photodiodes. Independently, two different light sources were tested: visible and infrared light. Performance of the probes was evaluated in a test setup that simulates the fatty deposits commonly seen in the obese, between skin and the artery. The probes show good overall performance in the test setup with less than 8% root mean square error (RMSE). However, the probes lit with IR sources show better results for the more extreme cases, with a better resolution in the waveform, higher definition of notable points and higher SNR when compared to the visible source signals. In vivo, the IR probes allow easier waveform detection, even more relevant with the increasing of the deposit structures.

Comparison of Low-Cost and Noninvasive Optical Sensors for Cardiovascular Monitoring

New optical probes are developed for carotid distention waveform measurements, in order to assess the risk of cardiovascular diseases. The probes make use of two distinct photodetectors: planar and avalanche photodiodes. Their performance is compared for visible and infrared (IR) light wavelengths. The test setup designed for the evaluation of the probes simulates the fatty deposits commonly seen in the obese people, between skin and the artery. The performed tests show that the attenuation of the signal is lower for the IR light, with higher penetration and better resolution in the captured distension waveform, with higher definition in morphological features on the wave and higher signal-to-noise ratio when compared to the visible source signals. The probes show good overall performance in the test setup with a root mean square error lower than 8%. In vivo, the IR probes allow easier waveform detection, even more relevant with the increasing deposit structures.

Programmable Test Bench for Hemodynamic Studies

The non-invasive assessment of hemodynamic parameters has been a permanent challenge posed to the scientific community. The literature shows many contributions to this quest expressed as algorithms dedicated to revealing some of its characteristics and as new probes or electronics, featuring some enhanced instrumental capability that can improve their insight.

Non-contact Pulse Wave Velocity Assessment Using Optical Methods

The clinical relevance of pulse wave velocity (PWV), as an indicator of cardiac risk associated to arterial stiffness, has gained clinical relevance over the last years. Optic sensors are an attractive instrumental solution for this type of measurement due to their truly non-contact operation capability, which has the potential of an interference free measurement. The nature of the optically originated signals, however, poses new challenges to the designer, either at the probe design level as at the signal processing required to extract the timing information that yields PWV. In this work we describe the construction of two prototype optical probes and discuss their evaluation using three algorithms for pulse transit time (PTT) evaluation. Results, obtained in a dedicated test bench, that is also described, demonstrate the possibility of measuring pulse transit times as short as 1ms with less than 1% error.

Clinical Test for Validation of a New Optical Probe for Hemodynamic Parameters Assessment

The assessment of the cardiovascular system condition based on multiple parameters allows a more precise and accurate diagnosis of the heart and arterial tree condition. For this reason, the interest in non-invasive devices has presently increased in importance. In this work, an optical probe was tested in order to validate this technology for measuring multiple parameters such as Pulse Wave Velocity (PWV) or Augmentation Index (AIx), amongst others. The PWV measured by the optical probe was previously compared with the values obtained with the gold-standard system. Another analysis was performed in 131 young subjects to establish carotid PWV reference values as well as other hemodynamic parameters and to find correlations between these and the population characteristics. The results allowed us to conclude that this new technique is a reliable method to determine these parameters. The range of the obtained values for local PWV are in agreement with the values obtained by other studies, and significant correlations with age and smoking status were found. The AIx varied between −6.15 % and 11.46 % and exhibit a negative correlation with heart rate, and dP/dtmax shows a significant decrease with age.

Pine Decay Assessment by Means of Electrical Impedance Spectroscopy

Plant diseases, such as the pinewood disease, PWD, have become a problem of economical and forestall huge proportions. These diseases, that are asymptomatic and characterized by a fast spread, have no cure developed to date. Besides, there are no technical means to diagnose the disease in situ, without causing tree damage, and help to assist the forest management. Herein is proposed a portable and non-damage system, based on electrical impedance spectroscopy, EIS, for biological applications. In fact, EIS has been proving efficacy and utility in wide range of areas. However, although commercial equipment is available, it is expensive and unfeasible for in vivo and in field applications. The developed EIS system is able to perform AC current or voltage scans, within a selectable frequency range, and its effectiveness in assessing pine decay was proven. The procedure and the results obtained for a population of 24 young pine trees (Pinus pinaster Aiton) are presented. Pine trees were kept in a controlled environment and were inoculated with the nematode (Bursaphelenchus xylophilus Nickle), that causes the PWD, and also with bark beetles (Tomicus destruens Wollaston). The obtained results may constitute a first innovative approach to the diagnosis of such types of diseases.

Characterization of an Acoustic Based Device for Local Arterial Stiffness Assessment

Arterial stiffness, recognized as an independent predictor of cardiovascular events, can be assessed non-invasively by regional and local methods. The present work proposes and describes a novel and low-cost device, based on a double-headed acoustic probe (AP), to assess local arterial stiffness, by means of pulse wave velocity (PWV) measurements. Local PWV is measured over the carotid artery and relies on the determination of the time delay between the signals acquired simultaneously by both acoustic sensors, placed at a fixed distance. The AP was characterized with dedicated test setups, in order to evaluate its performance concerning waveform analysis, repeatability, crosstalk effect and time resolution. Results show that AP signals are repeatable and crosstalk effect do not interfere with its time resolution, when the cross-correlation algorithm for time delay estimation is used. The AP’s effectiveness in measuring higher PWV (14 m/s), with a relative error less than 5 %, when using two uncoupled APs, was also demonstrated. Finally, its clinical feasibility was investigated, in a set of 17 healthy subjects, in which local PWV and other hemodynamic parameters were measured. Carotid PWV yielded a mean value of 2.96 ± 1.08 m/s that is in agreement with the values obtained in other reference studies.