Instrumentation of fetal heart rate and fetal electrocardiography. III. Fetal ECG electrodes: further observations.
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Biomedical subjects
Publications and source records attributed to E H Hon.
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A simple, convenient to use apparatus suitable for patient self-monitoring is described and illustrated with graphs of mean arterial pressure determinants which provide clinically useful hemodynamic details unobtainable with cuff blood pressure measurements. A bathroom scale and a forearm cuff blood pressure system completes the home monitoring apparatus.
This report describes hemodynamic patterns recorded from patients who had spontaneous abortion, preterm, and term labor. A working hypothesis theorizes that specific patterns observed in these situations can be identified and correlated with those present in the preovulatory and postovulatory phases of the menstrual cycle and thereby provide a clue to endocrine imbalances that may occur during pregnancy and play a role in the pathophysiology of these complications.
A working hypothesis relative to detailed hemodynamic changes that occur during menstruation and pregnancy theorizes that the marked biophysical similarities existing between the postovulatory phase of the menstrual cycle and the latter half of pregnancy are endocrine based. The data are acquired with apparatus that records cutaneous pressure pulses and the maternal electrocardiogram, which together provide the basis for deriving the determinants of mean arterial pressure.
This report illustrates a working hypothesis that proposes a simple-to-use, noninvasive hemodynamic system to provide myocardial contractility and arterial compliance patterns that may be clinically useful adjuncts to insulin and glycemic measurements in diabetes mellitus. This proposition is based on the concept that biochemical cellular milieu may only obliquely predict cellular function, whereas in the biophysical domain, it may be more clearly delineated.
Heart rate variability (HRV) during deep breathing was studied with a neonatal heart monitor in 143 control subjects and 218 patients with diabetes (102 with IDDM and 116 with NIDDM). In the control group HRV decreased after age 20 by 4-5 beats per decade (from 29.7 +/- 5.8 beats at age 20-29 to 11.8 +/- 5.4 beats at age 60+). In all age groups HRV in IDDM was lower than in the controls, and both age and duration of diabetes played a role in the decrease of HRV (from 21.5 +/- 5.3 beats at age 20-29 to 6.3 +/- 5.4 at age 60+). In NIDDM aging seemed to play a less important role, and the influence of the duration of the disease was not statistically significant. In both groups of patients the frequency of HRV below the 2.5th percentile was 82% in those with symptoms and/or signs of autonomic neuropathy, 64% in patients with peripheral neuropathy only, and 36% in those who had no obvious signs or symptoms of neuropathy. Interindividual variability was pronounced, and age and duration of the disease together accounted for only 36% of the observed differences between IDDM and the controls. Determination of HRV with a standard neonatal heart monitor presents an easy, simple, and nonstressful test of cardiac autonomic neuropathy. The norms of the test are age related.
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