Istituto di Fisiologia Clinica     
Bombardini T., Gemignani V., Bianchini E., Pasanisi E., Pratali L., Pianelli M., Faita F., Giannoni M., Arpesella G., Sicari R., Picano E. Post-exercise contractility, diastolic function, and pressure: Operator-independent sensor-based intelligent monitoring for heart failure telemedicine. In: Cardiovascular Ultrasound, vol. 7 pp. 21 - 28. BioMed Central Ltd, 2009.
Background: New sensors for intelligent remote monitoring of the heart should be developed. Recently, a cutaneous force-frequency relation recording system has been validated based on heart sound amplitude and timing variations at increasing heart rates. Aim: To assess sensor-based post-exercise contractility, diastolic function and pressure in normal and diseased hearts as a model of a wireless telemedicine system. Methods: We enrolled 150 patients and 22 controls referred for exercise-stress echocardiography, age 55 18 years. The sensor was attached in the precordial region by an ECG electrode. Stress and recovery contractility were derived by first heart sound amplitude vibration changes; diastolic times were acquired continuously. Systemic pressure changes were quantitatively documented by second heart sound recording. Results: Interpretable sensor recordings were obtained in all patients (feasibility = 100%). Postexercise contractility overshoot (defined as increase > 10% of recovery contractility vs exercise value) was more frequent in patients than controls (27% vs 8%, p < 0.05). At 100 bpm stress heart rate, systolic/diastolic time ratio (normal, < 1) was > 1 in 20 patients and in none of the controls (p < 0.01); at recovery systolic/diastolic ratio was > 1 in only 3 patients (p < 0.01 vs stress). Postexercise reduced arterial pressure was sensed. Conclusion: Post-exercise contractility, diastolic time and pressure changes can be continuously measured by a cutaneous sensor. Heart disease affects not only exercise systolic performance, but also post-exercise recovery, diastolic time intervals and blood pressure changes - in our study, all of these were monitored by a non-invasive wearable sensor.
DOI: 10.1186/1476-7120-7-21
Subject Heart failure

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