Department of Biomedical Engineering, National Cheng Kung University, No 1, University Road, Tainan City, 701 Taiwan, ROC.
Med Biol Eng Comput. 2013 Sep;51(9):1011-9. doi: 10.1007/s11517-013-1077-y. Epub 2013 May 5.
To detect the early developmental stages of arteriovenous access (AVA) stenosis in hemodialysis patients, this study explored a stenosis detector based on the Burg method and the fractional-order chaos system (FOCS). The bruit developed by the blood flowing through AVA can be a viable noninvasive strategy for monitoring AVA functions. We used the Burg method of the autoregressive model to estimate the frequency spectra of phonographic signals recorded by an electronic stethoscope in patients' AVAs and to identify the spectral peaks in the region of 25-800 Hz. The frequency spectra differed significantly between normal and stenosis statuses in AVA. We found that the frequency and amplitude in power spectra analysis varied in accordance with the severity of AVA stenosis. However, the correlation of these parameters for classifying the degree of stenosis is limited when only using the Burg method. Therefore, we used an FOCS to monitor the differing frequency spectra between the normal condition and AVA stenosis. The variances of these two conditions were dynamic errors that were the coupling variables that tracked the responses between the master system and the slave system. A total of 42 patients who had received percutaneous transluminal angioplasty (PTA) for their failing AVAs was recruited for this study. In this study, the dynamic error, Index Ψ, was used to calculate the frequency spectrum redistribution in patients undergoing PTA. In addition, ΔImp was the index used to evaluate improvements in the luminal diameter between pre- and post-PTA. Therefore, we used linear regression to model the relationship between ΔImp and Index Ψ. The findings indicate that the proposed method has enhanced efficiency, especially in the venous anastomosis (V-site). The FOCS is a novel and simple algorithm for analyzing the residual AVA stenosis of PTA treatment.
为了检测血液透析患者动静脉吻合口(AVA)狭窄的早期发育阶段,本研究探索了一种基于 Burg 方法和分数阶混沌系统(FOCS)的狭窄检测器。通过AVA 中血流产生的杂音可以作为监测 AVA 功能的一种可行的无创策略。我们使用自回归模型的 Burg 方法来估计电子听诊器记录的患者 AVA 中的录音信号的频谱,并识别 25-800 Hz 区域内的谱峰。AVA 正常和狭窄状态下的频谱有显著差异。我们发现,在功率谱分析中,频率和幅度随 AVA 狭窄的严重程度而变化。然而,仅使用 Burg 方法时,这些参数的相关性在对狭窄程度进行分类方面是有限的。因此,我们使用 FOCS 来监测正常状态和 AVA 狭窄之间的不同频谱。这两种情况的方差是动态误差,是跟踪主系统和从系统之间响应的耦合变量。共有 42 名接受经皮腔内血管成形术(PTA)治疗失败的 AVA 的患者被招募到本研究中。在本研究中,动态误差 Index Ψ 用于计算接受 PTA 治疗的患者的频谱重新分配。此外,ΔImp 是用于评估 PTA 前后管腔直径改善的指标。因此,我们使用线性回归来模拟 ΔImp 和 Index Ψ 之间的关系。研究结果表明,该方法提高了效率,特别是在静脉吻合处(V-site)。FOCS 是一种分析 PTA 治疗后残余 AVA 狭窄的新颖而简单的算法。