Underwater near-infrared spectroscopy measurements of muscle oxygenation: laboratory validation and preliminary observations in swimmers and triathletes.

The purpose of this research was to waterproof a near-infrared spectroscopy device (PortaMon, Artinis Medical Systems) to enable NIR measurement during swim exercise. Candidate materials were initially tested for waterproof suitability by comparing light intensity values during phantom-based tissue assessment. Secondary assessment involved repeated isokinetic exercises ensuring reliability of the results obtained from the modified device. Tertiary assessment required analysis of the effect of water immersion and temperature upon device function. Initial testing revealed that merely covering the PortaMon light sources with waterproof materials considerably affected the NIR light intensities. Modifying a commercially available silicone covering through the addition of a polyvinyl chloride material (impermeable to NIR light transmission) produces an acceptable compromise. Bland­Altman analysis indicated that exercise-induced changes in tissue saturation index (TSI %) were within acceptable limits during laboratory exercise. Although water immersion had a small but significant effect upon NIR light intensity, this resulted in a negligible change in the measured TSI (%). We then tested the waterproof device in vivo illustrating oxygenation changes during a 100 m freestyle swim case study. Finally, a full study compared club level swimmers and triathletes. Significant changes in oxygenation profiles when comparing upper and lower extremities for the two groups were revealed, reflecting differences in swim biomechanics.

Continuous-flow cardiac assistance: effects on aortic valve function in a mock loop.

BACKGROUND: As the use of left ventricular assist devices (LVADs) to treat end-stage heart failure has become more widespread, leaflet fusion--with resul-tant aortic regurgitation--has been observed more frequently. To quantitatively assess the effects of nonpulsatile flow on aortic valve function, we tested a continuous-flow LVAD in a mock circulatory system (MCS) with an interposed valve. MATERIALS AND METHODS: To mimic the hemodynamic characteristics of LVAD patients, we utilized an MCS in which a Jarvik 2000 LVAD was positioned at the base of a servomotor-operated piston pump (left ventricular chamber). We operated the LVAD at 8000 to 12,000 rpm, changing the speed in 1000-rpm increments. At each speed, we first varied the outflow resistance at a constant stroke volume, then varied the stroke volume at a constant outflow resistance. We measured the left ventricular pressure, aortic pressure, pump flow, and total flow, and used these values to compute the change, if any, in the aortic duty cycle (aortic valve open time) and transvalvular aortic pressure loads. RESULTS: Validation of the MCS was demonstrated by the simulation of physiologic pressure and flow waveforms. At increasing LVAD speeds, the mean aortic pressure load steadily increased, while the aortic duty cycle steadily decreased. Changes were consistent for each MCS experimental setting, despite variations in stroke volume and outflow resistance. CONCLUSIONS: Increased LVAD flow results in an impaired aortic valve-open time due to a pressure overload above the aortic valve. Such an overload may initiate structural changes, causing aortic leaflet fusion and/or regurgitation.

Validation of a preterm infant cardiovascular system model under baroreflex control with heart rate and blood pressure data.

In this paper we present an autonomic cardiovascular model of a preterm infant of 28 weeks of gestation with a birth weight of 1000 g and a closed ductus arteriosus by the end of the first week, that is capable of describing the complex interactions between heart rate, blood pressure and respiration. The hemodynamic model consists of a pulsatile heart and several vascular compartments, and is regulated by a baroreflex control system. The model is relatively simple to allow for a mathematical analysis of the dynamics but sufficiently complex to provide a realistic representation of the underlying physiology. The model provides (beat-to-beat) values of R-R interval and blood pressure that resemble realistic signals of preterm infants. The model is validated with experimental data obtained in preterm infants.