Cardiac syndrome X: relevance of arterial pressure waveform analysis to patients with chest pain and normal coronary arteries

We report the case study of a 68-year-old female with cardiac syndrome X presenting with abnormal pressure waveforms and a hypertensive response to exercise with ST-segment depression. After amlodipine treatment, pressure waveform morphology was significantly improved, exercise testing was normal and symptoms had resolved. This case emphasizes the potential clinical value of arterial waveform analysis.

Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre-existing diabetes

Background: The usefulness of umbilical artery Doppler velocimetry for the monitoring of diabetic pregnancies is controversial. The aim of the present study was to assess whether umbilical artery Doppler velocity waveform analysis can predict adverse perinatal outcomes for pregnancies complicated by pre-existing diabetes mellitus. Methods: All diabetic pregnancies (type 1 and 2) delivered at Mater Mothers' Hospital, Queensland, between 1 January 1995 and 31 December 1999 were included. All pregnant diabetic women were monitored with umbilical artery Doppler velocimetry at 28, 32, 36, and 38 weeks' gestation. Adverse perinatal outcome was defined as pregnancies with one or more of the following: small-for-gestational age, Caesarean section for non-reassuring cardiotocography, fetal acidaemia at delivery, 1-min Apgar of 3 or less, 5-min Apgar of less than 7, hypoxic ischaemic encephalopathy or perinatal death. Abnormal umbilical artery Doppler velocimetry was defined as a pulsatility index of 95th centile or higher for gestation. Results: One hundred and four pregnancies in women with pre-existing diabetes had umbilical arterial Doppler studies carried out during the study period. Twenty-three pregnancies (22.1%) had an elevated pulsatility index. If the scans were carried out within 2 weeks of delivery, 71% of pregnancies with abnormal umbilical Doppler had adverse outcomes (P < 0.01; likelihood ratio, 4.2). However, the sensitivity was 35%; specificity was 94%; positive predictive value was 80%; and negative predictive value was 68%. Only 30% of women with adverse perinatal outcomes had abnormal umbilical arterial Doppler flow. Conclusion: Umbilical artery Doppler velocimetry is not a good predictor of adverse perinatal outcomes in diabetic pregnancies.

Automated Analysis of the Auditory Brainstem Response Using Derivative Estimation Wavelets

In this paper, we describe an algorithm that automatically detects and labels peaks I - VII of the normal, suprathreshold auditory brainstem response (ABR). The algorithm proceeds in three stages, with the option of a fourth: ( 1) all candidate peaks and troughs in the ABR waveform are identified using zero crossings of the first derivative, ( 2) peaks I - VII are identified from these candidate peaks based on their latency and morphology, ( 3) if required, peaks II and IV are identified as points of inflection using zero crossings of the second derivative and ( 4) interpeak troughs are identified before peak latencies and amplitudes are measured. The performance of the algorithm was estimated on a set of 240 normal ABR waveforms recorded using a stimulus intensity of 90 dBnHL. When compared to an expert audiologist, the algorithm correctly identified the major ABR peaks ( I, III and V) in 96 - 98% of the waveforms and the minor ABR peaks ( II, IV, VI and VII) in 45 - 83% of waveforms. Whilst peak II was correctly identified in only 83% and peak IV in 77% of waveforms, it was shown that 5% of the peak II identifications and 31% of the peak IV identifications came as a direct result of allowing these peaks to be found as points of inflection. Copyright (C) 2005 S. Karger AG, Basel.

Super-fast scanning technique for phased array weather radar aplications

The authors present a super-fast scanning (SFS) technique for phased array weather radar applications. The fast scanning feature of the SFS technique is described and its drawbacks identified. Techniques which combat these drawbacks are also presented. A concept design phased array radar system (CDPAR) is used as a benchmark to compare the performance of a conventional scanning phased array radar system with the SFS technique. It is shown that the SFS technique, in association with suitable waveform processing, can realise four times the scanning speed and achieve similar accuracy compared to the conventional phased array benchmark.

The relationship between the auditory brain-stem response and its reconstructed waveforms following discrete wavelet transformation

Objective: To examine the relationship between the auditory brain-stem response (ABR) and its reconstructed waveforms following discrete wavelet transformation (DWT), and to comment on the resulting implications for ABR DWT time-frequency analysis. Methods: ABR waveforms were recorded from 120 normal hearing subjects at 90, 70, 50, 30, 10 and 0 dBnHL, decomposed using a 6 level discrete wavelet transformation (DWT), and reconstructed at individual wavelet scales (frequency ranges) A6, D6, D5 and D4. These waveforms were then compared for general correlations, and for patterns of change due to stimulus level, and subject age, gender and test ear. Results: The reconstructed ABR DWT waveforms showed 3 primary components: a large-amplitude waveform in the low-frequency A6 scale (0-266.6 Hz) with its single peak corresponding in latency with ABR waves III and V; a mid-amplitude waveform in the mid-frequency D6 scale (266.6-533.3 Hz) with its first 5 waves corresponding in latency to ABR waves 1, 111, V, VI and VII; and a small-amplitude, multiple-peaked waveform in the high-frequency D5 scale (533.3-1066.6 Hz) with its first 7 waves corresponding in latency to ABR waves 1, 11, 111, IV, V, VI and VII. Comparisons between ABR waves 1, 111 and V and their corresponding reconstructed ABR DWT waves showed strong correlations and similar, reliable, and statistically robust changes due to stimulus level and subject age, gender and test ear groupings. Limiting these findings, however, was the unexplained absence of a small number (2%, or 117/6720) of reconstructed ABR DWT waves, despite their corresponding ABR waves being present. Conclusions: Reconstructed ABR DWT waveforms can be used as valid time-frequency representations of the normal ABR, but with some limitations. In particular, the unexplained absence of a small number of reconstructed ABR DWT waves in some subjects, probably resulting from 'shift invariance' inherent to the DWT process, needs to be addressed. Significance: This is the first report of the relationship between the ABR and its reconstructed ABR DWT waveforms in a large normative sample. (C) 2004 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Influence of anodising current on the corrosion resistance of anodised AZ91D magnesium alloy

The thickness, chemical composition and microstructure of anodised coatings formed on magnesium alloy AZ91D at various anodising current densities were measured. It was found that all these parameters could be affected by anodising current density, and hence the coatings formed at different anodising current densities had different corrosion resistances. This suggests that the corrosion performance of an anodised coating could be improved if a properly designed current waveform is used for anodising. In addition, based on the experimental results, some physical, chemical and electrochemical reactions involved in the anodising process were proposed to explain the anodising behaviour in this paper. (c) 2005 Elsevier Ltd. All rights reserved.

On the dual structure of the auditory brainstem response in dogs

Objective: To use the over-complete discrete wavelet transform (OCDWT) to further examine the dual structure of auditory brainstem response (ABR) in the dog. Methods: ABR waveforms recorded from 20 adult dogs at supra-threshold (90 and 70 dBnHL) and threshold (0-15 dBSL) levels were decomposed using a six level OCDWT and reconstructed at individual scales (frequency ranges) A6 (0-391 Hz), D6 (391-781 Hz), and D5 (781-1563 Hz). Results: At supra-threshold stimulus levels, the A6 scale (0-391 Hz) showed a large amplitude waveform with its prominent wave corresponding in latency with ABR waves II/III; the D6 scale (391-781 Hz) showed a small amplitude waveform with its first four waves corresponding in latency to ABR waves I, II/III, V, and VI; and the D5 scale (781-1563 Hz) showed a large amplitude, multiple peaked waveform with its first six waves corresponding in latency to ABR waves I, II, III, IV, V, and VI. At threshold stimulus levels (0-15 dBSL), the A6 scale (0-391 Hz) continued to show a relatively large amplitude waveform, but both the D6 and D5 scales (391781 and 781-1563 Hz, respectively) now showed relatively small amplitude waveforms. Conclusions: A dual structure exists within the ABR of the dog, but its relative structure changes with stimulus level. Significance: The ABR in the dog differs from that in the human both in the relative contributions made by its different frequency components, and the way these components change with stimulus level. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise

Exercise brachial blood pressure ( BP) predicts mortality, but because of wave reflection, central ( ascending aortic) pressure differs from brachial pressure. Exercise central BP may be clinically important, and a noninvasive means to derive it would be useful. The purpose of this study was to test the validity of a noninvasive technique to derive exercise central BP. Ascending aortic pressure waveforms were recorded using a micromanometer-tipped 6F Millar catheter in 30 patients (56 +/- 9 years; 21 men) undergoing diagnostic coronary angiography. Simultaneous recordings of the derived central pressure waveform were acquired using servocontrolled radial tonometry at rest and during supine cycling. Pulse wave analysis of the direct and derived pressure signals was performed offline (SphygmoCor 7.01). From rest to exercise, mean arterial pressure and heart rate were increased by 20 +/- 10 mm Hg and 15 +/- 7 bpm, respectively, and central systolic BP ranged from 77 to 229 mm Hg. There was good agreement and high correlation between invasive and noninvasive techniques with a mean difference (+/- SD) for central systolic BP of -1.3 +/- 3.2 mm Hg at rest and -4.7 +/- 3.3 mm Hg at peak exercise ( for both r=0.995; P < 0.001). Conversely, systolic BP was significantly higher peripherally than centrally at rest (155 +/- 33 versus 138 +/- 32mm Hg; mean difference, -16.3 +/- 9.4mm Hg) and during exercise (180 +/- 34 versus 164 +/- 33 mm Hg; mean difference, -15.5 +/- 10.4 mm Hg; for both P < 0.001). True myocardial afterload is not reliably estimated by peripheral systolic BP. Radial tonometry and pulse wave analysis is an accurate technique for the noninvasive determination of central BP at rest and during exercise.