A Novel Method for Measuring Myocardial Performance Index using Non-contact Ballistocardiogram System
Cardiology and Angiology: An International Journal,
Aim: The aim was to validate the Systolic Time Intervals (STI) measured by Ballistocardiography (BCG) with STI derived from simultaneously performed Transthoracic Echocardiogram (TTE) and attempt to create an AI algorithm that automatically calculates Tei Index from BCG tracings.
Study design: Cross-sectional study.
Place and Duration of Study: Department of Cardiology and Department of Electrophysiology of Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India, between January 2020 and January 2021.
Methodology: Two hundred seventy-four patients with clinically indicated TTE were enrolled in the study, average age was 52. Simultaneous recordings on BCG and TTE were done. 150 patients had clinically usable TTE images for accurate calculations. STI was calculated independently by operators experienced in TTE and BCG. Results were compared using Pearson’s R. A proprietary AI algorithm for automatically calculating the MPI, was trained over a subset of patients. Its accuracy in detecting STI was compared to that of TTE and manually calculated STI from BCG.
Results: There was a strong positive correlation (r=0.766, P<0.00, 99%CI [0.691,0.824]) between the TTE and BCG derived MPI values. The result was validated over predetermined subgroups of subjects with reduced EF (EF<50) and subjects with normal EF (EF>=50). The AI algorithm had correlation of 0.54(p<0.01) with the MPI calculated by TTE and 0.34(P<0.10) with the manually calculated MPI on the BCG.
Conclusion: BCG derived manual and automated MPI correlates well with TTE derived MPI in a variety of EF fraction subgroups. Automated calculation algorithms for MPI derived from BCG remain a work under progress.
- transthoracic echocardiogram
- systolic time intervals
- myocardial performance index
How to Cite
Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiolology. 1995;26(6):357–66.
Davies M, Hobbs F. Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. Lancet. 2001;358(9280):439–44.
Weissler A, Peeler R, Roehll J. Relationships between left ventricular ejection time, stroke volume, and heart rate in normal individuals and patients with cardiovascular disease. Am Heart J. 1961;62:367–78.
Morgan EE, Faulx MD, McElfresh TA, Kung TA, Zawaneh MS, Stanley WC, et al. Validation of echocardiographic methods for assessing left ventricular dysfunction in rats with myocardial infarction. Am J Physiol - Hear Circ Physiol. 2004;287(5 56-5):2049–53.
Lakoumentas J, Panou F, Kotseroglou V, Aggeli K, Harbis P. Right Ventricular Tei Index in Children: Effect of Method, Age, Body Surface Area, and Heart Rate. J Am Soc Echocardiogr. 2007;20(6):764–70.
Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, Seward JB. Prognostic value of a doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol. 1998;82(9):1071–6.
Tei C, Dujardin KS, Hodge DO, Kyle RA, Jamil Tajik A, Seward JB. Doppler index combining systolic and diastolic myocardial performance: Clinical value in cardiac amyloidisis. J Am Coll Cardiol. 1996;28(3):658–64.
Poulsen SH, Jensen SE, Nielsen JC, Møller JE, Egstrup K. Serial changes and prognostic implications of a Doppler-derived index of combined left ventricular systolic and diastolic myocardial performance in acute myocardial infarction. Am J Cardiol. 2000;85(1):19–25.
Møller JE, Søndergaard E, Poulsen SH, Egstrup K. The Doppler echocardiographic myocardial performance index predicts left-ventricular dilation and cardiac death after myocardial infarction. Cardiology. 2001;95(2):105–11.
Harjai KJ, Scott L, Vivekananthan K, Nunez E, Edupuganti R. The Tei index: A new prognostic index for patients with symptomatic heart failure. J Am Soc Echocardiograph. 2002;15(9):864–8.
Møller JE, Egstrup K, Køber L, Poulsen SH, Nyvad O, Torp-Pedersen C. Prognostic importance of systolic and diastolic function after acute myocardial infarction. Am Heart J. 2003;145(1):147–53.
Ärnlöv J, Lind L, Andrén B, Risérus U, Berglund L, Lithell H. A Doppler-derived index of combined left ventricular systolic and diastolic function is an independent predictor of cardiovascular mortality in elderly men. Am Heart J. 2005;149(5):902–7.
Parthenakis FI, Kanakaraki MK, Kanoupakis EM, Skalidis EI, Diakakis GF, Filippou OK, et al. Value of Doppler index combining systolic and diastolic myocardial performance in predicting cardiopulmonary exercise capacity in patients with congestive heart failure: Effects of dobutamine. Chest. 2002;121(6):1935–41.
Toumanidis ST, Papadopoulou ES, Saridakis NS, Kalantaridou AT, Agapitos E V., Nanas JN, et al. Evaluation of myocardial performance index to predict mild rejection in cardiac transplantation. Clin Cardiol [Internet]. 2004;27(6 suppl. 3):352–8.
Ärnlöv J, Ingelsson E, Risérus U, Andrén B, Lind L. Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J. 2004;25(24):2220–5.
Gillebert TC, Leite-Moreira AF, De Hert SG. Load dependent diastolic dysfunction in heart failure. Heart Fail Rev. 2000;5(4):345–55.
Gutgesell HP. Novel index relating both isovolumetric contraction time and isovolumetric relaxation time to ejection time. J Am Soc Echocardiogr. 1997;10(7):781—782.
Gillebert TC, de Veire N Van, De Buyzere ML, Sutter J De. Time intervals and global cardiac function. Use and limitations. Eur Heart J. 2004;25(24):2185–6.
Starr I, Rawson AJ, Schroeder HA, Joseph NR. Studies on the estimation of cardiac ouptut in man, and of abnormalities in cardiac function, from the heart’s recoil and the blood’s impacts; the ballistocardiogram. Am J Physiol Content. 1939;127(1):1–28.
Scarborough WR, Davis FW, Baker BM, Mason RE, Singewald ML, Lore SA, et al. A ballistocardiographic study of 369 apparently normal persons. An analysis of “normal” and “borderline” ballistocardiograms. Am Heart J. 1953;45(2):161–89.
Kim CS, Ober SL, McMurtry MS, Finegan BA, Inan OT, Mukkamala R, et al. Ballistocardiogram: Mechanism and Potential for Unobtrusive Cardiovascular Health Monitoring. Sci Rep. 2016;6(1):1–6.
Crow RS, Hannan P, Jacobs D, Hedquist L, Salerno DM. Relationship between seismocardiogram and echocardiogram for events in the cardiac cycle. Am J Noninvasive Cardiol. 1994;8(1):39–46.
Brüser C, Stadlthanner K, De Waele S, Leonhardt S. Adaptive beat-to-beat heart rate estimation in ballistocardiograms. IEEE Trans Inf Technol Biomed. 2011 Sep [cited 2021 May 24];15(5):778–86.
Albukhari A, Lima F, Mescheder U. Bed-embedded heart and respiration rates detection by longitudinal ballistocardiography and pattern recognition. Sensors (Switzerland). 2019;19(6):1451.
Saran V, Kumar G, Dhawan U, Parchani G. Unsupervised Identification of Cardiac Contraction through Ballistocardiography. In: Biomedical Engineering and Sciences (IECBES). Sarawak, Malaysia: IEEE-EMBS; 2018. p. 42–7.
Dinh A, Bui FM, Nguyen T. An accelerometer based system to measure myocardial performance index during stress testing. In: Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS [Internet]. Institute of Electrical and Electronics Engineers Inc.; 2016. p. 4877–80.
Di Rienzo M, Vaini E, Castiglioni P, Merati G, Meriggi P, Parati G, et al. Wearable seismocardiography: Towards a beat-by-beat assessment of cardiac mechanics in ambulant subjects. Auton Neurosci Basic Clin [Internet]. 2013;178(1–2):50–9.
Korzeniowska-Kubacka I, Kuśmierczyk-Droszcz B, Bilińska M, Dobraszkiewicz-Wasilewska B, Mazurek K, Piotrowicz R. Seismocardiography - A non-invasive method of assessing systolic and diastolic left ventricular function in ischaemic heart disease. Folia Cardiol. 2006;13(4):319–25.
Antink CH, Mai Y, Ranta J, Tamiceriu A, Brüser C, Leonhardt S, et al. On the Performance of Bed-Integrated Ballistocardiography in Long-Term Heart Rate Monitoring of Vascular Patients. In: Computing in Cardiology. IEEE Computer Society; 2019.
Gamage PT, Khurshidul.Azad M, Taebi A, Sandler RH, Mansy HA. Clustering Seismocardiographic Events using Unsupervised Machine Learning. In: 2018 IEEE Signal Processing in Medicine and Biology Symposium (SPMB). 2018. p. 1–5.
Taebi A, Solar BE, Mansy HA. An Adaptive Feature Extraction Algorithm for Classification of Seismocardiographic Signals. 2018 Mar 27 [cited 2021 May 24];
Starr I. The relation of the ballistocardiogram to cardiac function. Am J Cardiol. 1958;2(6):737–47.
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