This study investigates use of echocardiography to assess the related issues about whether the heart function of a subject examined is normal or not. Two-dimensional echocardiography can make the heart inspection, and provide very detailed informations for each part of the cardiovascular structures with a high degree of accuracy. Many studies indicated that the systolic and diastolic function with left ventricle of heart disease in patients was poorer than those of normal patients. Therefore it is of interest to study the systolic and diastolic function for examining whether there are heart problems. In this work, the data is the gray-scale values of left ventricular static ultrasound images. The gray-scale differences between systolic and diastolic period, are used to assess whether the patient suffers from the heart diseases or not. Here, we use factor analysis to simplify and select the crucial factors, namely the function in different area of the left ventricle. Finally, linear and quadratic discriminant analyses are used to distinguish the normal and the abnormal subjects.

Non-invasive physical examination helps to make disease diagnosis with minimum injury to the body. Cardiology ultrasound is a non-invasive examination which can be used as a auxiliary tool for diagnose cardiac structure abnormalities. With more understanding of heart diseases, it has been recognized that heart failures are closely related to left ventricular systolic and diastolic function. Following Chen (2011) and Kao (2011), we study association of heart diseases with the change of gray-scale values in the cardiology ultrasound images of left ventricular systolic and diastolic. Since data obtained from ultrasound image is of matrix type with high dimensions, following the method proposed by Chen (2011) and Kao (2011), factor scores obtained from factor analysis are used as a basis for classification. We take the factor scores of normal subjects to establish the bench mark and calculate the Mahalanobis distance of each abnormal subject with the model established by the data from normal group. Later based on this distance to the normal group, cardiac function of the subject is distinguished as normal or not. In order to improve the accuracy of the classification, influential points which may cause inaccurate covariance matrix estimate on the subjects in normal group are identified. Based on concepts from optimal designs theory, some criteria are established for screening out the influential points.

Bakgrund: I hälso-och sjukvården är blodtrycksmätning en viktig och grundläggande metod vid korrekt diagnostik och hantering av högt blodtryck. Forskning har under flera år påvisat att olika komponenter påverkar noggrannheten av blodtrycksmätningen. Eftersom auskultatorisk och oscillometrisk blodtrycksmätning utförs på två olika sätt finns en risk att blodtrycksvärdet kan variera mellan metoderna. Syfte: Syftet med studien var att undersöka om det finns någon skillnad mellan auskultatorisk och oscillometrisk blodtrycksmätning utfört i både vila och efter ansträngning. Material och metod: Studien bestod av 20 slumpmässigt utvalda studenter från Hälsohögskolan i Jönköping. Blodtrycksmätning utfördes med hjälp av auskultatorisk blodtrycksmanschett med handmanometer och stetoskop samt oscillometrisk modalitet (OMRON M7). Resultat: Statistisk signifikant skillnad observerades mellan auskultatorisk och oscillometrisk modalitet, både i vila och efter ansträngning. Skillnaden är som störst efter ansträngning för auskultatorisk och oscillometrisk mätmetod, i både systoliskt och diastoliskt blodtrycksvärde. Diskussion: I vården har användning av oscillometrisk blodtrycksmodalitet ökat och därmed finns en risk för minskad reliabilitet och validitet av blodtrycksvärdet. Slutsatser: Statistisk signifikant skillnad föreligger mellan modaliteterna, både i vila och efter ansträngning. / Background: Blood pressure measurement is an important and fundamental method for correct diagnosis and management of high blood pressure, in healthcare. For several years, research has shown that different components affect the accuracy of blood pressure measurement. There is a risk that the blood pressure value may vary between auscultatory and oscillometric measurements because they are performed in two different ways. Purpose: The purpose was to investigate whether there is any difference between auscultatory and oscillometric blood pressure values performed in both rest and after stress. Material and method: The study consists of 20 randomly selected students from the School of Health and Welfare of Jönköping. The measurement was performed using auscultatory blood pressure cuff, sphygmomanometer with stethoscope and oscillometric modality (OMRON M7). Result: Statistically significant difference was observed between auscultatory and oscillometric values, both in rest and stress. The difference is greater after stress for both methods, in systolic and diastolic values. Discussion: In healthcare, use of oscillometric modality has increased thus there is a risk of reduced reliability and validity of the blood pressure value. Conclusion: Statistically significant difference was observed between auscultatory and oscillometric values, both in rest and after stress.

Cette thèse étudie certaines inégalités isopérimétriques globales sur les graphes métriques et les variétés riemanniennes. Tout d'abord, nous établissons pour un graphe métrique une inégalité isopérimétrique entre l'entropie volumique et la systole, puis étudions la géométrie de la boule unité de la norme stable en fonction de la combinatoire du graphe. Nous poursuivons en montrant que, pour une variété riemannienne fermée (M,g) de dimension au moins trois et de premier nombre de Betti non nul, une large classe de polytopes apparaît comme boule unité de la norme stable d'une métrique dans la classe conforme de g. Nous exhibons ensuite une borne supérieure de la constante systolique de la somme connexe de n exemplaires d'une variété M, montrant ainsi que la croissance de la constante systolique en fonction de n est toujours plus lente que la croissance linéaire. Enfin, nous démontrons une inégalité entre la systole, la longueur du lacet systolique et le diamètre d'une variété riemannienne simplement connexe dont le second groupe homotopique est non trivial.

Most of the cardiac structural abnormalities will be examined by echocardiography. With more understanding of heart diseases, it is commonly recognized that heart failures are closely related to left ventricular systolic and diastolic functions. This work discusses the association between gray-scale differences and the risk of heart disease from the changes in left ventricular systole and diastole of ultrasound image. Owing to the large dimension of data matrix, following Chen (2011), we also simplify the influence factors by factor analysis and calculate factor scores to present the characteristics of subjects. Two kinds of classification criteria are used in this work, namely logistic model with distance indicator and discriminant function. According to Guo et al. (2001), we calculate the Mahalanobis distance from each subject to the center of normal and abnormal group, then use logistic model to fit the distances for classification later. This is called logistic model with distance indicator. For the discriminant analysis, the regularized method by Friedman (1989) for estimation of covariance matrix is used, which is more flexible and can improve the covariance matrix estimates when the sample size is small. As far as the cut-point of ROC curve, following the approach as in Hanley et al. (1982), we find the most appropriate cut-point which has good performances for both sensitivity and specificity under the same classification criteria. Then the regularized method and the cut-point of ROC curve are combined to be a new classification criterion. The results under the new classification criterion are presented to classify normal and abnormal groups.

No description available.

Dans le cadre de la géométrie riemannienne globale sans hypothèse de courbure en lien avec la topologie, nous nous intéressons au volume maximal des boules de rayon fixé dans les revêtements universels des graphes et des surfaces. Dans la première partie, nous prouvons que si l'aire d'une surface riemannienne fermée M de genre au moins 2 est suffisamment petite par rapport à son aire hyperbolique, alors pour chaque rayon R>0, le revêtement universel de M contient une R-boule d'aire au moins l'aire d'une cR-boule dans le plan hyperbolique, où c<1 est une constante universelle. En particulier (quitte à prendre l'aire de la surface encore plus petite), nous démontrons que pour chaque rayon R plus grand ou égal à 1, le revêtement universel de M contient une R-boule d'aire au moins l'aire d'une R-boule dans le plan hyperbolique. Ce résultat répond positivement pour les surfaces, à une question de L. Guth. Nous démontrons également que si Gamma est un graphe connexe de premier nombre de Betti b et de longueur su suffisamment petite par rapport à la longueur d'un graphe trivalent Gamma_b de premier nombre de Betti b dont la longueur de chaque arête est 1, alors pour chaque rayon R>0, le revêtement universel de Gamma contient une R-boule d'aire au moins c fois l'aire d'une R-boule dans le revêtement universel de Gamma_b, où c est dans l'intervalle (1/2 ,1). Dans la deuxième partie, nous généralisons un théorème de M. Gromov concernant le nombre maximal de courts lacets homotopiquement indépendants basés en un même point. Plus précisément, nous prouvons que sur toute surface riemannienne fermée M de genre g et d'aire normalisée à g, il existe au moins log(2g) lacets homotopiquement indépendants basés en un même point de longueur au plus C log(g), où C est une constante positive indépendante du genre. Comme corollaire immédiat de ce théorème, nous redémontrons l'inégalité systolique asymptotique sur la systole séparante. Nous démontrons également un théorème analogue pour les graphes métriques. Plus précisément, nous prouvons que sur chaque graphe métrique Gamma de premier nombre de Betti b et de longueur b, il existe au moins log(b) lacets homologiquement indépendants basés en un même point de longueur au plus 48 log(b). Ce résultat étend la borne en log(b) sur la systole homologique dûe à Bollobàs-Szemerédi-Thomason à au moins log(b) lacets homologiquement indépendants basés en un même point. En outre, nous donnons des exemples de graphes où notre résultat est optimal (à une constante multiplicative près).

<p>Cilj: Kod trećine bolesnika sa akutnim ST-eleviranim infarktom (STEMI) nakon primarne angioplastike (pPCI) razvije se postinfarktno remodelovanje leve komore (LK). Cilj istraživanja je nalaženje ranih prediktora post-infarktnog remodelovanja leve komore nakon akutnog STEMI i pPCI. Metodologija: Uključeno je 210 ispitanika sa prvim akutnim STEMI prednjeg zida, lečenih pPCI. Urađena je ehokardiografija u prva 24h, a zatim nakon 6 meseci, kada su ispitanici podeljeni u 2 grupe: ispitivanu sa remodelovanjem (n=55; 26%) i kontrolnu bez remodelovanja (n=155; 74%). Ispitanici su klinički praćeni godinu dana. Rezultati i dikusija: Multivarijantnom regresionom analizom, kao najsnažniji rani prediktori post-infarktnog remodelovanja izdvojili su se: postojanje &quot;no reflow&quot; fenomena nakon pPCI (OR=30.0 95% CI, p&lt;0.0001), pojava dijastolne disfunkcije u prva 24h (OR=27.7 95% CI, p&lt;0.0001), povećan dijametar leve pretkomore - LA (OR=5.0 95% CI, p=0,044) i srčana slabost na prijemu - Killip klasa 2-4 (OR=3.4 95% CI, p=0.003.). Univarijantnom regresionom analizom, snažni prediktori su neadekvatna rezolucija ST segmenta - STR (OR 2.0 95% CI, p=0.024) i zbirni indeks zidne pokretljivosti &ndash; WMSI &gt;2 (OR 21.6 95% CI, p&lt;0.0001). Totalno ishemijsko vreme nije imalo uticaja na post-infarktno remodelovanje (p=0.546). Tokom jednogodi&scaron;njeg praćenja ispitanici sa post-infarktnim remodelovanjem su imali značajno veću incidencu glavnih neželjenih kardiolo&scaron;kih događaja: rehospitalizacija (61.8% vs 22.6%; p&lt;0.0001) / najvi&scaron;e rehospitalizacija zbog srčane slabosti (40% vs 2.6%; p&lt;0.0001), sa mortalitetom 5.5%/; reinfarkta (20% vs 7.1%; p=0.007); rekoronarografija (45.5% vs 18.1%; p&lt;0.0001); revaskularizacija (30.9% vs 11%; p=0.001). Zaključak: Kod pacijenata sa akutnim STEMI prednjeg zida lečenih pPCI, pojava &quot;no reflow&quot; fenomena, dijastolne disfunkcije, povećana LA i srčana slabosti na prijemu su najjači rani nezavisni prediktivni faktori za nastanak post-infarktnog remodelovanja. Značajni prediktori su i neadekvatna STR i WMSI&gt;2. Pacijenti sa post-infarktnim remodelovanjem imaju veću incidencu glavnih neželjenih kardiolo&scaron;kih događaja i mortaliteta.</p> / <p>Objective: Patients with ST-elevated myocardial infarction (STEMI) treated by primary angioplasty (pPCI) will develop left ventricular (LV) remodeling in one third of the cases. The purpose of this study is to determine early predictors of LV remodeling after acute STEMI and pPCI. Methods: 210 patients with a first acute anterior STEMI treated by pPCI were included. All participants underwent echocardiography in the first 24hrs and again after 6 months, after which they were divided into two groups: remodeling (n=55; 26%) and nonremodeling (n=155; 74%). Results and discussion: The most powerful independent early predictors were: &quot;no reflow&quot; after pPCI (OR=30.0 95% CI, p&lt;0.0001), diastolic dysfunction in the first 24hrs (OR=27.7 95% CI, p&lt;0.0001), increased diameter of the left atrium - LA (OR=5.0 95% CI, p=0.044) and at admission Killip class 2-4 (OR=3.4 95% CI, p=0.003), by multivariant regression analysis. Also, strong predictors were incomplete ST-resolution - STR (OR 2.0 95% CI, p=0.024) and Wall motion score index - WMSI &gt;2 (OR 21.6 95% CI, p&lt;0.0001), by univariant regression analysis. Total ischaemic time had no influence on LV remodeling. The group with remodeling had more frequent major adverse cardiac events (MACE) during one year follow-up: re-hospitalisation (61.8% vs 22.6%; p&lt;0.0001) / mostly re-hospitalisation due to heart failure (40% vs 2.6%; p&lt;0.0001) and mortality 5.5%; reinfarction (20% vs 7.1%; p=0.007); recoronagraphy (45.5% vs 18.1%; p&lt;0.0001); revascularisation (30.9% vs 11%; p=0.001). Conclusion: For the patients with a first acute anterior STEMI, treated by pPCI, development of &quot;no reflow&quot; after pPCI, diastolic dysfunction, increased LA and heart failure on admission are the most powerful early independent predictors for LV remodeling. Incomplete STR and WMSI&gt;2 are strong predictors too. Remodeling patients will have a more frequent incidence of MACE and mortality.</p>

This thesis deals with classification of different types of time courses of ECG signals. Main objective was to recognize the normal cycles and several forms of arrhythmia and to classify the exact types of them. Classification has been done with usage of algorithms of Neural Networks in Matlab program, with its add-on (Neural Network Toolbox). The result of this thesis is application, which makes possible to load an ECG signal, pre-process it and classify its each cycle into five classes. Percentage results of this classification are in the conclusion of this thesis.