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Rosato, A., Larsson, M., Rullman, E. & Dual, S. A. (2023). Probability Of Cardiac-Locomotor Coupling During Daily Activities. In: : . Paper presented at XXIX Congress of International Society of Biomechanics, ISB, Fukuoka, Japan.
Open this publication in new window or tab >>Probability Of Cardiac-Locomotor Coupling During Daily Activities
2023 (English)Conference paper, Oral presentation only (Other academic)
Abstract [en]

Human locomotion is typically studied independently ofthe cardiovascular system, although the two areintrinsically linked. An example of their interaction iscardiac-locomotor coupling (CLC), which refers to theentrainment of heart rate (HR) and step rate (SR) duringrhythmic exercise at a 1:1 ratio. Actively synchronizingthe stepping with each diastole of the cardiac cycle, hasbeen shown to provide improved cardiometabolicefficiency, demonstrated by a decrease in HR and inventilation [1]. Active CLC can therefore be one way toimprove hemodynamic efficiency, ensuring greaterendurance performances. Previous studies investigatedthe presence of CLC in laboratory settings whereasobservations during daily activities are still lacking. Wedo not know if and when CLC occurs physiologically.The aim of this study is to investigate the extent and theprobability of CLC during unsupervised daily activitiesin contrast to random chance.

National Category
Engineering and Technology Medical Engineering
Identifiers
urn:nbn:se:kth:diva-329775 (URN)
Conference
XXIX Congress of International Society of Biomechanics, ISB, Fukuoka, Japan
Funder
Promobilia foundation, VT 2023
Note

QC 20230630

Available from: 2023-06-22 Created: 2023-06-22 Last updated: 2023-06-30Bibliographically approved
Rosato, A., Larsson, M., Rullman, E. & Dual, S. A. (2023). Spontaneous Cardiac-Locomotor Coupling in Healthy Individuals During Daily Activities. In: Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023): Volume 4: BIOSIGNALS. Paper presented at 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023) (pp. 170-177). INSTICC, 4
Open this publication in new window or tab >>Spontaneous Cardiac-Locomotor Coupling in Healthy Individuals During Daily Activities
2023 (English)In: Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023): Volume 4: BIOSIGNALS, INSTICC , 2023, Vol. 4, p. 170-177Conference paper, Published paper (Refereed)
Abstract [en]

During exercise, the locomotor and the cardiovascular system work in synergy to control the blood flow through the body. In particular, the muscle contraction generates rhythmic raising and lowering of intramuscular pressure, which in synergy supports cardiovascular function. This study aims to analyze spontaneous cardiac-locomotor coupling (CLC) events during daily activities using weareable sensors.

We analyze the dataset PMData, containing recordings from sixteen healthy subjects during five months. The data were acquired with a smartwatch and consist of step rate (SR), heart rate (HR) and daily surveys reporting the training sessions. Coupling is defined as being present when SR and HR are within 1% of each other (strong coupling) and within the 10% of each other (weak coupling).

The results show that every subject presents occurrences of CLC while performing normal daily activities. In particular, strong coupling occurs more likely for longer activities (111 ± 34 min), at moderate intensity (100 steps/min < SR > 130 steps/min).

The presence of CLC during daily activities rises the question whether there is a physiological mechanism controlling this phenomenon, that should be investigated in future.

Place, publisher, year, edition, pages
INSTICC, 2023
Keywords
Cardiac-Locomotor Coupling, Wearable Sensor, Exercise, Lifelogging
National Category
Medical Engineering
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-328207 (URN)10.5220/0011632700003414 (DOI)
Conference
16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023)
Funder
Promobilia foundation, VT 2023
Note

QC 20230608

Available from: 2023-06-05 Created: 2023-06-05 Last updated: 2023-06-08Bibliographically approved
Nordenfur, T., Caidahl, K., Grishenkov, D., Maksuti, E., Marlevi, D., Urban, M. W. & Larsson, M. (2022). Safety of arterial shear wave elastography-ex-vivo assessment of induced strain and strain rates. Biomedical Engineering & Physics Express, 8(5), Article ID 055012.
Open this publication in new window or tab >>Safety of arterial shear wave elastography-ex-vivo assessment of induced strain and strain rates
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2022 (English)In: Biomedical Engineering & Physics Express, E-ISSN 2057-1976, Vol. 8, no 5, article id 055012Article in journal (Refereed) Published
Abstract [en]

Shear wave elastography (SWE) is a promising technique for characterizing carotid plaques and assessing local arterial stiffness. The mechanical stress to which the tissue is subjected during SWE using acoustic radiation force (ARF), leading to strain at a certain strain rate, is still relatively unknown. Because SWEis increasingly used for arterial applications where the mechanical stress could potentially lead to significant consequences, it is important to understand the risks of SWE-induced strain and strain rate. The aim of this study was to investigate the safety of SWE in terms of induced arterial strain and strain rate ex-vivo and in a human carotid artery in-vivo. SWE was performed on six porcine aortae as a model of the human carotid artery using different combinations of ARF push parameters (push voltage: 60/90 V, aperture width: f/1.0/1.5, push length: 100/150/200 mu s) and distance to push position. The largest induced strain and strain rate were 1.46% and 54 s(-1) (90 V, f/ 1.0, 200 mu s), respectively. Moreover, the SWE-induced strains and strain rates increased with increasing push voltage, aperture, push length, and decreasing distance between the region of interest and the push. In the human carotid artery, the SWE-induced maximum strain was 0.06% and the maximum strain rate was 1.58 s(-1), compared with the maximum absolute strain and strain rate of 12.61% and 5.12 s(-1), respectively, induced by blood pressure variations in the cardiac cycle. Our results indicate that ex-vivo arterial SWE does not expose the artery to higher strain rate than normal blood pressure variations, and to strain one order of magnitude higher than normal blood pressure variations, at the push settings and distances from the region of interest used in this study.

Place, publisher, year, edition, pages
IOP Publishing, 2022
Keywords
safety, elastography, shear wave elastography, acoustic radiation force, carotid, arterial stiffness, strain rate
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:kth:diva-315905 (URN)10.1088/2057-1976/ac7f39 (DOI)000827259000001 ()35797069 (PubMedID)2-s2.0-85134720409 (Scopus ID)
Note

QC 20220728

Available from: 2022-07-28 Created: 2022-07-28 Last updated: 2023-06-08Bibliographically approved
Rosato, A., Luis, I., Larsson, M., Gutierrez-Farewik, E. & Dual, S. A. (2022). Synchronization between Cardiac and Locomotor Rhythms during Walking. In: : . Paper presented at Medicinteknikdagarna 2022, Luleå, Sweden.
Open this publication in new window or tab >>Synchronization between Cardiac and Locomotor Rhythms during Walking
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2022 (English)Conference paper, Oral presentation only (Other academic)
National Category
Medical Engineering
Identifiers
urn:nbn:se:kth:diva-329776 (URN)
Conference
Medicinteknikdagarna 2022, Luleå, Sweden
Note

QC 20230627

Available from: 2023-06-22 Created: 2023-06-22 Last updated: 2023-06-27Bibliographically approved
Marques, G. L., Hayashi, S., Bjallmark, A., Larsson, M., Riella, M., Olandoski, M., . . . Nascimento, M. M. (2021). Osteoprotegerin is a marker of cardiovascular mortality in patients with chronic kidney disease stages 3-5. Scientific Reports, 11(1), Article ID 2473.
Open this publication in new window or tab >>Osteoprotegerin is a marker of cardiovascular mortality in patients with chronic kidney disease stages 3-5
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2021 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 2473Article in journal (Refereed) Published
Abstract [en]

Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD). Osteoprotegerin (OPG), known to regulate bone mass by inhibiting osteoclast differentiation and activation, might also play a role in vascular calcification. Increased circulating OPG levels in patients with CKD are associated with aortic calcification and increased mortality. We assessed the predictive role of OPG for all-cause and cardiovascular mortality in patients with CKD stages 3-5 over a 5-year follow-up period. We evaluated the relationship between OPG and all-cause and cardiovascular mortality in 145 CKD patients (stages 3-5) in a prospective observational follow-up study. Inflammation markers, including high-sensitivity C-reactive protein, standard echocardiography, and estimation of intima-media thickness in the common carotid artery, were assessed at baseline, and correlations with OPG levels were determined. The cutoff values for OPG were defined using ROC curves for cardiovascular mortality. Survival was assessed during follow up lasting for up to 5.5 years using Fine and Gray model. A total of 145 (89 men; age 58.9 +/- 15.0 years) were followed up. The cutoff value for OPG determined using ROC was 10 pmol/L for general causes mortality and 10.08 pmol/L for CV causes mortality. Patients with higher serum OPG levels presented with higher mortality rates compared to patients with lower levels. Aalen-Johansen cumulative incidence curve analysis demonstrated significantly worse survival rates in individuals with higher baseline OPG levels for all-cause and cardiovascular mortality (p<0.001). In multivariate analysis, OPG was a marker of general and cardiovascular mortality independent of sex, age, CVD, diabetes, and CRP levels. When CKD stages were included in the multivariate analysis, OPG was an independent marker of all-cause mortality but not cardiovascular mortality. Elevated serum OPG levels were associated with higher all-cause and cardiovascular mortality risk, independent of age, CVD, diabetes, and inflammatory markers, in patients with CKD.

Place, publisher, year, edition, pages
NATURE RESEARCH, 2021
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:kth:diva-291936 (URN)10.1038/s41598-021-82072-z (DOI)000616817000072 ()33510348 (PubMedID)2-s2.0-85099822187 (Scopus ID)
Note

QC 20210329

Available from: 2021-03-29 Created: 2021-03-29 Last updated: 2022-09-15Bibliographically approved
Marlevi, D., Mulvagh, S. L., Huang, R., Kevin DeMarco, J., Ota, H., Huston, J. ,., . . . Urban, M. W. (2020). Combined spatiotemporal and frequency-dependent shear wave elastography enables detection of vulnerable carotid plaques as validated by MRI. Scientific Reports, 10(1), Article ID 403.
Open this publication in new window or tab >>Combined spatiotemporal and frequency-dependent shear wave elastography enables detection of vulnerable carotid plaques as validated by MRI
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2020 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 403Article in journal (Refereed) Published
Abstract [en]

Fatal cerebrovascular events are often caused by rupture of atherosclerotic plaques. However, rupture-prone plaques are often distinguished by their internal composition rather than degree of luminal narrowing, and conventional imaging techniques might thus fail to detect such culprit lesions. In this feasibility study, we investigate the potential of ultrasound shear wave elastography (SWE) to detect vulnerable carotid plaques, evaluating group velocity and frequency-dependent phase velocities as novel biomarkers for plaque vulnerability. In total, 27 carotid plaques from 20 patients were scanned by ultrasound SWE and magnetic resonance imaging (MRI). SWE output was quantified as group velocity and frequency-dependent phase velocities, respectively, with results correlated to intraplaque constituents identified by MRI. Overall, vulnerable lesions graded as American Heart Association (AHA) type VI showed significantly higher group and phase velocity compared to any other AHA type. A selection of correlations with intraplaque components could also be identified with group and phase velocity (lipid-rich necrotic core content, fibrous cap structure, intraplaque hemorrhage), complementing the clinical lesion classification. In conclusion, we demonstrate the ability to detect vulnerable carotid plaques using combined SWE, with group velocity and frequency-dependent phase velocity providing potentially complementary information on plaque characteristics. With such, the method represents a promising non-invasive approach for refined atherosclerotic risk prediction.

Place, publisher, year, edition, pages
Springer Nature, 2020
National Category
Medical Engineering
Identifiers
urn:nbn:se:kth:diva-267772 (URN)10.1038/s41598-019-57317-7 (DOI)000546557700001 ()31942025 (PubMedID)2-s2.0-85077940693 (Scopus ID)
Note

Erratum on: https://doi.org/10.1038/s41598-020-69148-y

QC 20200304

Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2022-09-15Bibliographically approved
Marlevi, D., Ha, H., Dillon-Murphy, D., Fernandes, J. F., Fovargue, D., Colarieti-Tosti, M., . . . Nordsletten, D. A. (2020). Non-invasive estimation of relative pressure in turbulent flow using virtual work-energy. Medical Image Analysis, 60, Article ID 101627.
Open this publication in new window or tab >>Non-invasive estimation of relative pressure in turbulent flow using virtual work-energy
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2020 (English)In: Medical Image Analysis, ISSN 1361-8415, E-ISSN 1361-8423, Vol. 60, article id 101627Article in journal (Refereed) Published
Abstract [en]

Vascular pressure differences are established risk markers for a number of cardiovascular diseases. Relative pressures are, however, often driven by turbulence-induced flow fluctuations, where conventional non-invasive methods may yield inaccurate results. Recently, we proposed a novel method for non-turbulent flows, νWERP, utilizing the concept of virtual work-energy to accurately probe relative pressure through complex branching vasculature. Here, we present an extension of this approach for turbulent flows: νWERP-t. We present a theoretical method derivation based on flow covariance, quantifying the impact of flow fluctuations on relative pressure. νWERP-t is tested on a set of in-vitro stenotic flow phantoms with data acquired by 4D flow MRI with six-directional flow encoding, as well as on a patient-specific in-silico model of an acute aortic dissection. Over all tests νWERP-t shows improved accuracy over alternative energy-based approaches, with excellent recovery of estimated relative pressures. In particular, the use of a guaranteed divergence-free virtual field improves accuracy in cases where turbulent flows skew the apparent divergence of the acquired field. With the original νWERP allowing for assessment of relative pressure into previously inaccessible vasculatures, the extended νWERP-t further enlarges the method's clinical scope, underlining its potential as a novel tool for assessing relative pressure in-vivo.

Place, publisher, year, edition, pages
Elsevier B.V., 2020
Keywords
4D flow MRI, Fluid mechanics, Relative pressure, Turbulence, Turbulent energy dissipation, Virtual work-energy, Energy dissipation, Noninvasive medical procedures, Alternative energy, Aortic dissections, Cardio-vascular disease, Noninvasive methods, Pressure differences, Theoretical methods, Virtual works, Turbulent flow, Article, energy, non invasive procedure, nuclear magnetic resonance imaging, pressure, priority journal, work
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:kth:diva-267962 (URN)10.1016/j.media.2019.101627 (DOI)000527917100020 ()31865280 (PubMedID)2-s2.0-85076673140 (Scopus ID)
Note

QC 20200401

Not duplicate with DiVA 1344624 

Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2022-06-26Bibliographically approved
Marlevi, D., Ruijsink, B., Balmus, M., Dillon-Murphy, D., Fovargue, D., Pushparajah, K., . . . Nordsletten, D. A. (2019). Estimation of Cardiovascular Relative Pressure Using Virtual Work-Energy. Scientific Reports, 9(1), Article ID 1375.
Open this publication in new window or tab >>Estimation of Cardiovascular Relative Pressure Using Virtual Work-Energy
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2019 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 9, no 1, article id 1375Article in journal (Refereed) Published
Abstract [en]

Many cardiovascular diseases lead to local increases in relative pressure, reflecting the higher costs of driving blood flow. The utility of this biomarker for stratifying the severity of disease has thus driven the development of methods to measure these relative pressures. While intravascular catheterisation remains the most direct measure, its invasiveness limits clinical application in many instances. Non-invasive Doppler ultrasound estimates have partially addressed this gap; however only provide relative pressure estimates for a range of constricted cardiovascular conditions. Here we introduce a non-invasive method that enables arbitrary interrogation of relative pressures throughout an imaged vascular structure, leveraging modern phase contrast magnetic resonance imaging, the virtual work-energy equations, and a virtual field to provide robust and accurate estimates. The versatility and accuracy of the method is verified in a set of complex patient-specific cardiovascular models, where relative pressures into previously inaccessible flow regions are assessed. The method is further validated within a cohort of congenital heart disease patients, providing a novel tool for probing relative pressures in-vivo.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
National Category
Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:kth:diva-246401 (URN)10.1038/s41598-018-37714-0 (DOI)000457616300263 ()30718699 (PubMedID)2-s2.0-85061047544 (Scopus ID)
Note

QC 20190321

Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2024-03-15Bibliographically approved
Petrini, J., Eriksson, M. J., Caidahl, K. & Larsson, M. (2018). Circumferential strain by velocity vector imaging and speckle-tracking echocardiography: validation against sonomicrometry in an aortic phantom. Clinical Physiology and Functional Imaging, 38(2), 269-277
Open this publication in new window or tab >>Circumferential strain by velocity vector imaging and speckle-tracking echocardiography: validation against sonomicrometry in an aortic phantom
2018 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, no 2, p. 269-277Article in journal (Refereed) Published
Abstract [en]

Background: Evaluation of arterial deformation and mechanics using strain analysis on ultrasound greyscale images has gained increasing scientific interest. The aim of this study was to validate in vitro measurements of circumferential strain by velocity vector imaging (VVI) and speckle-tracking echocardiography (STE) against sonomicrometry as a reference method. Method: Two polyvinyl alcohol phantoms sized to mimic the descending aorta were constructed and connected to a pulsatile flow pump to obtain high-resistance flow profiles. The ultrasound images of the phantom used for strain analyses were acquired with a transesophageal probe. Global and regional circumferential strains were estimated using VVI and STE and were compared with the strain acquired by sonomicrometry. Results: Global circumferential peak strain estimated by VVI and STE correlated well to sonomicrometry (r = 0·90, P≤0·001; and r = 0·97, P≤0·01) with a systematic bias of −0·78% and +0·63%, respectively. The reference strain levels were 1·07–2·54%. Circumferential strain values obtained by VVI were significantly lower than those obtained by STE (bias −1·41%, P≤0·001). Conclusion: Global circumferential strain measured by VVI and STE correlates well with sonomicrometry. However, strain values obtained by VVI and STE differ significantly, which should be taken into consideration when comparing results from studies using different software for aortic strain measurements.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
aortic phantom, arterial strain, sonomicrometry, speckle-tracking
National Category
Physiology
Identifiers
urn:nbn:se:kth:diva-205226 (URN)10.1111/cpf.12410 (DOI)000424110900015 ()28168822 (PubMedID)2-s2.0-85012083441 (Scopus ID)
Funder
Swedish Research CouncilSwedish Heart Lung Foundation
Note

QC 20170419

Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2024-03-18Bibliographically approved
Smoljkić, M., Verbrugghe, P., Larsson, M., Widman, E., Fehervary, H., D'hooge, J., . . . Famaey, N. (2018). Comparison of in vivo vs. ex situ obtained material properties of sheep common carotid artery. Medical Engineering and Physics, 55, 16-24
Open this publication in new window or tab >>Comparison of in vivo vs. ex situ obtained material properties of sheep common carotid artery
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2018 (English)In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 55, p. 16-24Article in journal (Refereed) Published
Abstract [en]

Patient-specific biomechanical modelling can improve preoperative surgical planning. This requires patient-specific geometry as well as patient-specific material properties as input. The latter are, however, still quite challenging to estimate in vivo. This study focuses on the estimation of the mechanical properties of the arterial wall. Firstly, in vivo pressure, diameter and thickness of the arterial wall were acquired for sheep common carotid arteries. Next, the animals were sacrificed and the tissue was stored for mechanical testing. Planar biaxial tests were performed to obtain experimental stress-stretch curves. Finally, parameters for the hyperelastic Mooney–Rivlin and Gasser–Ogden–Holzapfel (GOH) material model were estimated based on the in vivo obtained pressure-diameter data as well as on the ex situ experimental stress-stretch curves. Both material models were able to capture the in vivo behaviour of the tissue. However, in the ex situ case only the GOH model provided satisfactory results. When comparing different fitting approaches, in vivo vs. ex situ, each of them showed its own advantages and disadvantages. The in vivo approach estimates the properties of the tissue in its physiological state while the ex situ approach allows to apply different loadings to properly capture the anisotropy of the tissue. Both of them could be further enhanced by improving the estimation of the stress-free state, i.e. by adding residual circumferential stresses in vivo and by accounting for the flattening effect of the tested samples ex vivo.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Common carotid artery, Constitutive modelling, Material properties, Parameter estimation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kth:diva-227579 (URN)10.1016/j.medengphy.2018.03.006 (DOI)000436635600003 ()29580793 (PubMedID)2-s2.0-85044339134 (Scopus ID)
Note

QC 20180516

Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2022-06-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5795-9867

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