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Complications associated with myocardial bridging in four children without underlying cardiac disease: a case series.

Paediatr Int Child Health 2021 Jun 11:1-7. Epub 2021 Jun 11.

Department of Life Sciences and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Myocardial bridging is largely considered to be a benign, symptomless congenital anomaly of the coronary arteries in which the intramyocardial coronary course is partially 'tunnelled' and leads to vessel compression during ventricular systole. There are few data regarding children. To report on myocardial bridging observed in children seeking medical help in the paediatric emergency room. Read More

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SCNN: Scalogram-based convolutional neural network to detect obstructive sleep apnea using single-lead electrocardiogram signals.

Comput Biol Med 2021 May 29;134:104532. Epub 2021 May 29.

WHO Collaborating Centre on eHealth, UNSW Digital Health, School of Public Health and Community Medicine, University of New South Wales, Australia. Electronic address:

Sleep apnea is a common symptomatic disease affecting nearly 1 billion people around the world. The gold standard approach for determining the severity of sleep apnea is full-night polysomnography conducted in the laboratory, which is very costly and cumbersome. In this work, we propose a novel scalogram-based convolutional neural network (SCNN) to detect obstructive sleep apnea (OSA) using single-lead electrocardiogram (ECG) signals. Read More

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Identification of 27 abnormalities from multi-lead ECG signals: an ensembled SE_ResNet framework with sign loss function.

Physiol Meas 2021 Jun 7. Epub 2021 Jun 7.

Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, SINGAPORE.

Objective: Cardiovascular disease is a major threat to health and one of the primary causes of death globally. The 12-lead ECG is a cheap and commonly accessible tool to identify cardiac abnormalities. Early and accurate diagnosis will allow early treatment and intervention to prevent severe complications of cardiovascular disease. Read More

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[A High-definition Recording Method of Electrocardiogram].

Zhongguo Yi Liao Qi Xie Za Zhi 2021 Jun;45(3):276-279

Department of Public Foundation, Bengbu Medical College, Bengbu, 233030.

In order to improve the clarity of ECG waveforms and the anti-interference ability of ECG acquisition under abnormal conditions, this study proposes a high-definition ECG recording method based on superimposed averaging algorithm. The results show that the proposed method can more clearly reflect the details of the ECG. Meanwhile, it has a significant inhibitory effect on EMG interference. Read More

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The Prognostic Value of Cardiac Axis Deviation in Systemic Sclerosis-related Pulmonary Hypertension.

Arthritis Care Res (Hoboken) 2021 Jun 3. Epub 2021 Jun 3.

The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.

Objective: Systemic sclerosis-related pulmonary hypertension (SSc-PH) is a common complication of SSc associated with accelerated mortality. We hypothesized that cardiac axis deviation may indicate abnormalities in cardiac function allowing for prognostication of disease severity and mortality.

Methods: This was a retrospective study where electrocardiograms (ECGs) were reviewed for cardiac axis deviation and their association with echocardiography and cardiopulmonary hemodynamics on right heart catheterization. Read More

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Clinical Variants, Characteristics, and Outcomes Among COVID-19 Patients: A Case Series Analysis at a Tertiary Care Hospital in Karachi, Pakistan.

Cureus 2021 Apr 29;13(4):e14761. Epub 2021 Apr 29.

Internal Medicine, OMI Institute, Karachi, PAK.

Introduction Coronavirus disease 2019 (COVID-19) has become a global threat to public health. The current study investigates alterations in the biological estimates concerning the severity, recovery, mortality, and assessment of treatment-based outcomes. Methods A case series of 165 COVID-19 patients admitted to OMI Institute (a tertiary care hospital) was conducted between May and August 2020. Read More

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Single-centre retrospective analysis of the best timing for the QTc interval length assessment in neonates.

BMJ Paediatr Open 2021 18;5(1):e001026. Epub 2021 May 18.

Pediatrics and Neonatology Unit, Maternal-Child Department, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.

Objective: To evaluate the best timing for ECG screening in order to diagnose long QT syndrome and lower, at the same time, the false positives.

Design: We retrospectively evaluated the corrected QT (QTc) interval in the clinical reports of the ECG screening performed, as per internal protocol.

Setting: An outpatient setting in our Unit of Neonatology and Pediatrics, Santa Maria Goretti Hospital in Latina, Italy. Read More

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Recurrence Plot-Based Approach for Cardiac Arrhythmia Classification Using Inception-ResNet-v2.

Front Physiol 2021 17;12:648950. Epub 2021 May 17.

School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.

The present study addresses the cardiac arrhythmia (CA) classification problem using the deep learning (DL)-based method for electrocardiography (ECG) data analysis. Recently, various DL techniques have been utilized to classify arrhythmias, with one typical approach to developing a one-dimensional (1D) convolutional neural network (CNN) model to handle the ECG signals in the time domain. Although the CA classification in the time domain is very prevalent, current methods' performances are still not robust or satisfactory. Read More

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Automated Detection of Hypertension Using Physiological Signals: A Review.

Int J Environ Res Public Health 2021 May 29;18(11). Epub 2021 May 29.

Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore 639798, Singapore.

Arterial hypertension (HT) is a chronic condition of elevated blood pressure (BP), which may cause increased incidence of cardiovascular disease, stroke, kidney failure and mortality. If the HT is diagnosed early, effective treatment can control the BP and avert adverse outcomes. Physiological signals like electrocardiography (ECG), photoplethysmography (PPG), heart rate variability (HRV), and ballistocardiography (BCG) can be used to monitor health status but are not directly correlated with BP measurements. Read More

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The Use of Samsung Health and ECG M-Trace Base II Applications for the Assessment of Exercise Tolerance in the Secondary Prevention in Patients after Ischemic Stroke.

Int J Environ Res Public Health 2021 May 27;18(11). Epub 2021 May 27.

Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str. No. 135/147, 60-545 Poznań, Poland.

: The aim of the study was to use the mobile application Samsung Health for the assessment of parameters of exercise tolerance and the ECG (electrocardiogram) M-Trace Base II for the assessment of cardiological parameters. : The measurements were conducted during rest and after performing SMWT (Six Minute Walk Test) and SCT (Stair Climb Test) in 26 patients after ischemic stroke (IS) and 26 healthy individuals. : In the SMWT, the post-stroke group (SG) walked a shorter distance ( < 0. Read More

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Automatic Detection of Atrial Fibrillation in ECG Using Co-Occurrence Patterns of Dynamic Symbol Assignment and Machine Learning.

Sensors (Basel) 2021 May 19;21(10). Epub 2021 May 19.

Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, 38106 Lower Saxony, Germany.

Early detection of atrial fibrillation from electrocardiography (ECG) plays a vital role in the timely prevention and diagnosis of cardiovascular diseases. Various algorithms have been proposed; however, they are lacking in considering varied-length signals, morphological transitions, and abnormalities over long-term recordings. We propose dynamic symbolic assignment (DSA) to differentiate a normal sinus rhythm (SR) from paroxysmal atrial fibrillation (PAF). Read More

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The Natural History of Aerosolized Infection in Cynomolgus Macaques.

Pathogens 2021 May 13;10(5). Epub 2021 May 13.

Core Support Directorate, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD 21702, USA.

Tularemia is a severe, zoonotic infection caused by the Gram-negative bacterium . Inhalation results in a rapid, severe bacterial pneumonia and sepsis, which can be lethal. Because the cynomolgus macaque is the accepted nonhuman primate model for tularemia, we conducted a natural history study of pneumonic tularemia by exposing macaques to target inhaled doses of 50, 500, or 5000 colony forming units (CFU) of subsp. Read More

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Prognostically relevant periprocedural myocardial injury and infarction associated with percutaneous coronary interventions: a Consensus Document of the ESC Working Group on Cellular Biology of the Heart and European Association of Percutaneous Cardiovascular Interventions (EAPCI).

Eur Heart J 2021 May 31. Epub 2021 May 31.

Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.

A substantial number of chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI) experience periprocedural myocardial injury or infarction. Accurate diagnosis of these PCI-related complications is required to guide further management given that their occurrence may be associated with increased risk of major adverse cardiac events (MACE). Due to lack of scientific data, the cut-off thresholds of post-PCI cardiac troponin (cTn) elevation used for defining periprocedural myocardial injury and infarction, have been selected based on expert consensus opinions, and their prognostic relevance remains unclear. Read More

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Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID).

Heart Lung Circ 2021 May 16. Epub 2021 May 16.

Royal Melbourne Hospital, Melbourne, Vic, Australia; University of Melbourne, Melbourne, Vic, Australia. Electronic address:

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region.

Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. Read More

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Electrocardiogram machine learning for detection of cardiovascular disease in African Americans: the Jackson Heart Study.

Eur Heart J Digit Health 2021 Mar 20;2(1):137-151. Epub 2021 Jan 20.

Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA.

Aims: Almost half of African American (AA) men and women have cardiovascular disease (CVD). Detection of prevalent CVD in community settings would facilitate secondary prevention of CVD. We sought to develop a tool for automated CVD detection. Read More

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Evaluation of the Effectiveness of Telemedicine in the Management of Cardiovascular Diseases in Primary Health Care in Cameroon: An Interventional Study.

Stud Health Technol Inform 2021 May;281:615-619

Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon.

Objective: This study aimed to evaluate the effectiveness of tele-expertise (tele-ECG) in primary health care in Cameroon for the management of patients with cardiovascular diseases or risk factors.

Method: It is a controlled multicenter study carried out in Cameroon's two health facilities where tele-ECG has been implemented (intervention centers) and two other where telemedicine has been not implemented (control centers). Patients having cardiovascular risk factors or diseases received usual primary health care in the control centers. Read More

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Combining ECG and echocardiography to identify transthyretin cardiac amyloidosis in heart failure.

Clin Physiol Funct Imaging 2021 May 25. Epub 2021 May 25.

Heart Centre, Clinical Physiology, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.

Aims/background: Transthyretin amyloid (ATTR) amyloidosis cardiomyopathy is an underdiagnosed, causatively treatable cause of heart failure (HF). The aim of this study was to evaluate the efficacy of electrocardiogram (ECG) and echocardiography on patients with increased interventricular septum diameter (IVSd) to identify ATTR cardiac amyloidosis (ATTR-CA) patients.

Methods: We investigated 58 patients with HF and an IVSd > 14 mm. Read More

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Atrial fibrillation and risk of incident heart failure with reduced versus preserved ejection fraction.

Heart 2021 May 24. Epub 2021 May 24.

Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology, Division of Public Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Objective: Associations between atrial fibrillation (AF) and heart failure (HF) have been established. We compared the extent to which AF is associated with each primary subtype of HF, with reduced (HFrEF) versus preserved ejection fraction (HFpEF).

Methods: We included 25 787 participants free of baseline HF from the REGARDS (REasons for Geographic And Racial Differences in Stroke) cohort. Read More

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Protecting children from tobacco smoke exposure: A randomized controlled trial of Project Zero Exposure.

Nicotine Tob Res 2021 May 22. Epub 2021 May 22.

Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University.

Introduction: Young children are vulnerable to harm from tobacco smoke exposure (TSE). This study assessed the effect of Project Zero Exposure - an intervention program designed to help parents protect children from TSE - on children's exposure.

Methods: Randomized controlled trial of a home-based, theory-driven intervention. Read More

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Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis.

Tuberc Respir Dis (Seoul) 2021 May 20. Epub 2021 May 20.

Department of Public Health and Nutrition, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Pluit Raya No. 2, North Jakarta 14440, Indonesia.

The lack of effective medications for COVID-19 has led to a trend of drug repurposing, such as the case of Azithromycin, which showed an immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results and it is not clear whether the available evidence is in favour or against the use of Azithromycin in COVID-19 patients. We aim to investigate the efficacy and safety of Azithromycin in COVID-19 patients. Read More

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Longitudinal Measures of Blood Pressure and Subclinical Atrial Arrhythmias: The MESA and the ARIC Study.

J Am Heart Assoc 2021 Jun 20;10(11):e020260. Epub 2021 May 20.

Cardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MN.

Background High blood pressure (BP) is a well-known risk factor for atrial fibrillation (AF), but a single BP measurement may provide limited information about AF risk in older adults. Methods and Results This study included 1256 MESA (Multi-Ethnic Study of Atherosclerosis) and 1948 ARIC (Atherosclerosis Risk in Communities) study participants who underwent extended ambulatory electrocardiographic monitoring and who were free of clinically detected cardiovascular disease, including AF. Using BP measurements from 6 examinations (2000-2018 in MESA and 1987-2017 in ARIC study), we calculated individual long-term mean, trend, and detrended visit-to-visit variability in systolic BP and pulse pressure for each participant. Read More

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P-wave signal-averaged electrocardiography: Reference values, clinical correlates, and heritability in the Framingham Heart Study.

Heart Rhythm 2021 May 11. Epub 2021 May 11.

National Heart, Lung, and Blood Institute and Boston University's Framingham Heart Study, Framingham, Massachusetts; Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.

Background: P-wave signal-averaged electrocardiography (P-SAECG) quantifies atrial electrical activity. P-SAECG measures and their clinical correlates and heritability have had limited characterization in community-based cohorts.

Objective: The purpose of this study was to (1) establish reference values; (2) identify clinical risk factors associated with P-SAECG; and (3) estimate genetic heritability for P-SAECG traits. Read More

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Machine learning model on heart rate variability metrics identifies asymptomatic toddlers exposed to zika virus during pregnancy.

Physiol Meas 2021 Jun 17;42(5). Epub 2021 Jun 17.

Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States of America.

. Although the Zika virus (ZIKV) seems to be prominently neurotropic, there are some reports of involvement of other organs, particularly the heart. Of special concern are those children exposed prenatally to ZIKV and born without microcephaly or other congenital anomalies. Read More

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Interpretable deep learning for automatic diagnosis of 12-lead electrocardiogram.

iScience 2021 Apr 29;24(4):102373. Epub 2021 Mar 29.

Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA.

Electrocardiogram (ECG) is a widely used reliable, non-invasive approach for cardiovascular disease diagnosis. With the rapid growth of ECG examinations and the insufficiency of cardiologists, accurate and automatic diagnosis of ECG signals has become a hot research topic. In this paper, we developed a deep neural network for automatic classification of cardiac arrhythmias from 12-lead ECG recordings. Read More

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Artificial intelligence-enabled fully automated detection of cardiac amyloidosis using electrocardiograms and echocardiograms.

Nat Commun 2021 05 11;12(1):2726. Epub 2021 May 11.

One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Patients with rare conditions such as cardiac amyloidosis (CA) are difficult to identify, given the similarity of disease manifestations to more prevalent disorders. The deployment of approved therapies for CA has been limited by delayed diagnosis of this disease. Artificial intelligence (AI) could enable detection of rare diseases. Read More

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Frequency of cardiac arrhythmias in older adults: Findings from the Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study.

Int J Cardiol 2021 May 6. Epub 2021 May 6.

Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America. Electronic address:

Background: Prolonged monitoring of cardiac rhythm has been used to screen for subclinical atrial fibrillation (AF); little is known about other arrhythmias in the general population, especially in the elderly, who are at higher risk of arrhythmias.

Methods: We evaluated the frequency of arrhythmias in the tri-ethnic (white, Black, Hispanic), community-based Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study using a patch-based recorder for up to 14 days in 527 participants free of AF, congestive heart failure (CHF) or history of stroke. Differences according to gender, age, ethnicity and presence of hypertension, diabetes and pertinent ECG and echocardiographic variables were examined. Read More

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Effect of ECG-gating Retinal Photographs on Retinal Vessel Caliber Measurements in Subjects with and without Type 2 Diabetes.

Curr Eye Res 2021 May 26:1-9. Epub 2021 May 26.

Department of Cardiology, Westmead Hospital, Sydney, Australia.

: Retinal vessel caliber is an independent risk marker of cardiovascular disease risk. However, variable mechanical delays in capturing retinal photographs and cardiac cycle-induced retinal vascular changes have been shown to reduce the accuracy of retinal vessel caliber measurements, but this has only ever been investigated in healthy subjects. This cross-sectional study is the first study to investigate this issue in type 2 diabetes. Read More

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The association between insulin sensitivity indices, ECG findings and mortality: a 40-year cohort study.

Cardiovasc Diabetol 2021 05 6;20(1):97. Epub 2021 May 6.

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Type 2 Diabetes is a major risk factor for cardiovascular (CV) mortality. Insulin resistance can be evaluated non-invasively by insulin sensitivity indices (ISI) such as the Mcauley index (MCAi), which is a function of the fasting insulin and triglycerides. Currently, the association between ISIs and ECG findings and all-cause and CV mortality is still not established in a large scale and heterogeneous population. Read More

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A Novel mHealth Monitoring System during Cycling in Elite Athletes.

Int J Environ Res Public Health 2021 04 30;18(9). Epub 2021 Apr 30.

Sports Medicine Laboratory, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece.

Background: Cycling is a very demanding physical activity that may create various health disorders during an athlete's career. Recently, smart mobile and wearable technologies have been used to monitor physiological responses and possible disturbances during physical activity. Thus, the application of mHealth methods in sports poses a challenge today. Read More

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