Novel wearable device can monitor physiological parameters associated with heart failure in real-time

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There are about 64 million cases of heart failure worldwide. According to the American Heart Association, 6.2 million adults in the United States have heart failure and that number is estimated to increase to 8 million by 2030. Heart failure is a progressive clinical syndrome characterized by a structural abnormality of the heart, in which the heart is unable to pump sufficient blood to meet the body's requirements.

There are currently two heart failure monitoring systems available. However, they are costly and pose risks because they are surgically implanted under the skin. Moreover, about half of patients with heart failure do not need an implantable device or do not qualify for the thoracic (area between the neck and abdomen) monitoring these devices provide. There is a critical need for non-invasive solutions to monitor heart failure progression around the clock.

Researchers from Florida Atlantic University's College of Engineering and Computer Science in collaboration with FAU's Christine E. Lynn College of Nursing have developed a prototype of novel wearable device that can continuously monitor all of the physiological parameters associated with heart failure in real-time.

The technology is based on sensors embedded in a lightweight belt conveniently worn around the waist to monitor thoracic impedance, electrocardiogram (ECG), heart rate and motion activity detection. The system uses different sensors for sensing these parameters. Thoracic impedance is a critical bio-signal to monitor heart failure progression. Similarly, ECG is a vital bio-signal to diagnose and predict cardiovascular diseases. ECG measures electrical signals through the heart using a Holter monitor, which is not suitable for point-of-care use.

For the study, published in Scientific Reports, researchers tested the wearable device in different conditions including sitting, standing, lying down and walking. For each condition, results were obtained for each of the sensors sequentially. The physiological parameters selected are significant in determining heart failure symptoms.

Findings showed that all of sensors kept track of the changes for all of the different conditions. The position sensor correctly highlighted the change in position in different conditions and could be used to identify different states of the wearer of the device. In addition, the heart rate sensor continually kept track of the heart rate. Importantly, the device correctly highlighted minute changes in thoracic impedance.

Like most ECG monitors, the ECG sensor in the wearable device was very sensitive to motion, particularly while walking. However, even while walking the ECG sensor retained its QRS complex (the electrical impulse as it spreads through the ventricles of the heart) along with R-peaks (intervals of the QRS complex), which are important indicators for left ventricular hypertrophy, indicative of an increase in the size of myocardial fibers in the main cardiac pumping chamber.

All of the sensors we integrated into our belt module can easily be worn for a long period of time without affecting the patient's daily activities. Importantly, continuous and real-time monitoring of heart failure symptoms could alert patients and their health care providers of the patient's declining health. In turn, health care providers could intervene with medications to avoid patient hospitalization."

Waseem Asghar, Ph.D., senior author and associate professor in FAU's Department of Electrical Engineering and Computer Science

The researchers expect that their technology will have higher predictive values for heart failure with increased specificity and high sensitivity.

Approximately 1 in 4 patients with heart failure are readmitted within 30 days of discharge from the hospital and about half are readmitted within six months. Health care wearable devices such as the prototype we have developed have the potential to decrease hospital readmissions in a cost-effective way that also is safe and convenient for the wearer."

Mary Ann Leavitt, Ph.D., co-author and assistant professor, FAU's Christine E. Lynn College of Nursing

Based on the study results, the researchers are currently testing the module over a set of diverse subjects to develop an algorithm to predict heart failure over the test set.

"This wearable device to monitor heart failure is my main project in Dr. Asghar's Micro and Nanotechnology Lab in Medicine, which has important social implications for the fastest-growing cardiovascular disease in the U.S.," said Sheikh Muhammad Asher Iqbal, first author, a research assistant and a Ph.D. student in FAU's Department of Electrical Engineering and Computer Science. "We are developing a noninvasive solution that can be used by all heart failure patients for better management, diagnosis and prognosis that will be able to serve the masses."

Study co-authors are Imadeldin Mahgoub, Ph.D., Tecore Professor; and Sarah E. Du, Ph.D., an associate professor, both in FAU's Department of Electrical Engineering and Computer Science.

This research was supported by FAU's Institute for Sensing and Embedded Network Systems Engineering (I-SENSE) and FAU's College of Engineering and Computer Science.

全文翻譯（僅供參考）

全世界約有6400萬例心力衰竭。根據(jù)美國心臟協(xié)會的數(shù)據(jù)，美國有620萬成年人患有心力衰竭，預(yù)計到2030年該數(shù)字將增加到800萬。心力衰竭是一種以心臟結(jié)構(gòu)異常為特征的進行性臨床綜合征，心臟無法泵出足夠的血液以滿足身體需求。

目前有兩種心力衰竭監(jiān)測系統(tǒng)可供使用，然而，由于它們是通過外科手術(shù)植入皮膚下的，因此價格昂貴且存在風(fēng)險，而且，大約一半的心力衰竭患者不需要植入式器械或不符合胸腔鏡檢查的條件（頸部和腹部之間的區(qū)域）監(jiān)測這些設(shè)備提供。迫切需要非全天候監(jiān)測心力衰竭進展的侵入性解決方案。

佛羅里達大西洋大學(xué)工程與計算機科學(xué)學(xué)院的研究人員與FAU的克莉絲汀E.林恩護理學(xué)院合作開發(fā)了一種新型可穿戴設(shè)備的原型，該設(shè)備可以實時連續(xù)監(jiān)測與心力衰竭相關(guān)的所有生理參數(shù)。

該技術(shù)基于嵌入在輕便腰帶中的傳感器，腰帶可以方便地佩戴在腰部，用于監(jiān)測胸阻抗、心電圖（ECG）、心率和運動活動檢測。系統(tǒng)使用不同的傳感器來感測這些參數(shù)。胸阻抗是監(jiān)測心力衰竭進展的關(guān)鍵生物信號。類似地，ECG是診斷和預(yù)測心血管疾病的重要生物信號，ECG使用霍爾特監(jiān)護儀測量通過心臟的電信號，不適合床旁使用。

該研究發(fā)表于科學(xué)報告，研究人員在不同的條件下測試了這款可穿戴設(shè)備，包括坐著、站著、躺下和行走。在每種條件下，每個傳感器都會依次獲得結(jié)果。所選的生理參數(shù)對判斷心力衰竭癥狀至關(guān)重要。

研究結(jié)果表明，所有傳感器都能跟蹤所有不同條件下的變化。位置傳感器能正確地突出顯示不同條件下位置的變化，并可用于識別設(shè)備佩戴者的不同狀態(tài)。此外，心率傳感器能持續(xù)跟蹤心率。重要的是，該設(shè)備能正確地突出顯示胸部阻抗的微小變化。

與大多數(shù)ECG監(jiān)護儀一樣，可穿戴設(shè)備中的ECG傳感器對運動非常敏感，尤其是在行走時。然而，即使在行走時，ECG傳感器仍保留其QRS波群（通過心室傳播的電脈沖）沿著R峰（QRS復(fù)合波的間期），其是左心室肥大的重要指標，指示主心臟泵血腔中心肌纖維尺寸的增加。

我們集成到腰帶模塊中的所有傳感器都可以很容易地長時間佩戴，而不會影響患者的日常活動。重要的是，對心力衰竭癥狀的持續(xù)和實時監(jiān)測可以提醒患者及其醫(yī)療保健提供者患者的健康狀況正在惡化。反過來，醫(yī)療保健提供者可以通過藥物干預(yù)，避免患者住院。”

Waseem Asghar博士，F(xiàn)AU電氣工程和計算機科學(xué)系資深作者和副教授

研究人員預(yù)計他們的技術(shù)將對心力衰竭有更高的預(yù)測價值，特異性增加，靈敏度高。

約有1/4的心力衰竭患者在出院后30天內(nèi)再次入院，約有一半在6個月內(nèi)再次入院。醫(yī)療保健可穿戴設(shè)備（如我們開發(fā)的原型）有可能以經(jīng)濟高效的方式減少再次入院，同時對佩戴者來說也是安全和方便的?！?/p>

瑪麗Ann Leavitt，博士，合著者，F(xiàn)AU克莉絲汀E.林恩護理學(xué)院助理教授

根據(jù)研究結(jié)果，研究人員目前正在一組不同的受試者身上測試該模塊，以開發(fā)一種算法來預(yù)測測試集上的心力衰竭。

第一作者Sheikh Muhammad Asher Iqbal說：“這種監(jiān)測心力衰竭的可穿戴設(shè)備是我在Asghar博士的醫(yī)學(xué)微納米技術(shù)實驗室的主要項目，它對美國增長最快的心血管疾病具有重要的社會意義?！盕AU電氣工程和計算機科學(xué)系的研究助理和博士生?！拔覀冋陂_發(fā)一種無創(chuàng)解決方案，可供所有心力衰竭患者使用，以獲得更好的管理、診斷和預(yù)后，從而能夠服務(wù)于大眾?！?/p>

研究的共同作者是Imadeldin Mahgoub博士，Tecore教授; Sarah E. Du博士，副教授，均就職于FAU電氣工程與計算機科學(xué)系。

本研究得到了FAU傳感與嵌入式網(wǎng)絡(luò)系統(tǒng)工程研究所（I-SENSE）和FAU工程與計算機科學(xué)學(xué)院的支持。

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