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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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141 records · Page 8

Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy: results from a prospective observational study

OBJECTIVES: This study was designed to evaluate the ability of microvolt-level T-wave alternans (MTWA) to identify prospectively patients with idiopathic dilated cardiomyopathy (DCM) at risk of ventricular tachyarrhythmic events and to compare its predictive accuracy with that of conventional risk stratifiers. BACKGROUND: Patients with DCM are at increased risk of sudden death from ventricular tachyarrhythmias. At present, there are no established methods of assessing this risk. METHODS: A total of 137 patients with DCM underwent risk stratification through assessment of MTWA, left ventricular ejection fraction, baroreflex sensitivity (BRS), heart rate variability, presence of nonsustained ventricular tachycardia (VT), signal-averaged electrocardiogram, and presence of intraventricular conduction defect. The study end point was either sudden death, resuscitated ventricular fibrillation, or documented hemodynamically unstable VT. RESULTS: During an average follow-up of 14 +/- 6 months, MTWA and BRS were significant univariate predictors of ventricular tachyarrhythmic events (p < 0.035 and p < 0.015, respectively). Multivariate Cox regression analysis revealed that only MTWA was a significant predictor. CONCLUSIONS: Microvolt-level T-wave alternans is a powerful independent predictor of ventricular tachyarrhythmic events in patients with DCM.

Evaluation Studies↗

Efficacy of anticoagulation in resolving left atrial and left atrial appendage thrombi: A transesophageal echocardiographic study

BACKGROUND: Transesophageal echocardiography (TEE) is the gold standard for evaluation of the left atrium and the left atrial appendage (LAA) for the presence of thrombi. Anticoagulation is conventionally used for patients with atrial fibrillation to prevent embolization of atrial thrombi. The mechanism of benefit and effectiveness of thrombi resolution with anticoagulation is not well defined. METHODS AND RESULTS: We used a TEE database of 9058 consecutive studies performed between January 1996 and November 1998 to identify all patients with thrombi reported in the left atrium and/or LAA. One hundred seventy-four patients with thrombi in the left atrial cavity (LAC) and LAA were identified (1.9% of transesophageal studies performed). The incidence of LAA thrombi was 6.6 times higher than LAC thrombi (151 vs 23, respectively). Almost all LAC thrombi were visualized on transthoracic echocardiography (90.5%). Mitral valve pathology was associated with LAC location of thrombi (P <.0001), whereas atrial fibrillation or flutter was present in most patients with LAA location of thrombi. Anticoagulation of 47 +/- 18 days was associated with thrombus resolution in 80.1% of the patients on follow-up TEE. Further anticoagulation resulted in limited additional benefit. CONCLUSIONS: LAC thrombi are rare and are usually associated with mitral valve pathology. Transthoracic echocardiography is effective in identifying these thrombi. LAA thrombi occur predominantly in patients with atrial fibrillation or flutter. Short-term anticoagulation achieves a high rate of resolution of LAA and LAC thrombi but does not obviate the need for follow-up TEE.

NASA Discipline Cardiopulmonary↗

Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling (exponent beta) were studied in 159 patients with depressed LV function (ejection fraction <35%) after an AMI. By the end of 4-year follow-up, 72 patients (45%) had died and 87 (55%) were still alive. Short-term scaling exponent alpha (1.07 +/- 0.26 vs 0.90 +/- 0.26, p <0.001) and power-law slope beta (-1.35 +/- 0.23 vs -1.44 +/- 0.25, p <0.05) differed between survivors and those who died, but none of the traditional HR variability measures differed between these groups. Among all analyzed variables, reduced scaling exponent alpha (<0.85) was the best univariable predictor of mortality (relative risk 3.17, 95% confidence interval 1.96 to 5.15, p <0.0001), with positive and negative predictive accuracies of 65% and 86%, respectively. In the multivariable Cox proportional hazards analysis, mortality was independently predicted by the reduced exponent alpha (p <0.001) after adjustment for several clinical variables and LV function. A short-term fractal-like scaling exponent was the most powerful HR variability index in predicting mortality in patients with depressed LV function. Reduction in fractal correlation properties implies more random short-term HR dynamics in patients with increased risk of death after AMI.

Non-NASA Center↗

Prognostic significance of electrical alternans versus signal averaged electrocardiography in predicting the outcome of electrophysiological testing and arrhythmia-free survival

OBJECTIVE: To investigate the accuracy of signal averaged electrocardiography (SAECG) and measurement of microvolt level T wave alternans as predictors of susceptibility to ventricular arrhythmias. DESIGN: Analysis of new data from a previously published prospective investigation. SETTING: Electrophysiology laboratory of a major referral hospital. PATIENTS AND INTERVENTIONS: 43 patients, not on class I or class III antiarrhythmic drug treatment, undergoing invasive electrophysiological testing had SAECG and T wave alternans measurements. The SAECG was considered positive in the presence of one (SAECG-I) or two (SAECG-II) of three standard criteria. T wave alternans was considered positive if the alternans ratio exceeded 3.0. MAIN OUTCOME MEASURES: Inducibility of sustained ventricular tachycardia or fibrillation during electrophysiological testing, and 20 month arrhythmia-free survival. RESULTS: The accuracy of T wave alternans in predicting the outcome of electrophysiological testing was 84% (p < 0.0001). Neither SAECG-I (accuracy 60%; p < 0.29) nor SAECG-II (accuracy 71%; p < 0.10) was a statistically significant predictor of electrophysiological testing. SAECG, T wave alternans, electrophysiological testing, and follow up data were available in 36 patients while not on class I or III antiarrhythmic agents. The accuracy of T wave alternans in predicting the outcome of arrhythmia-free survival was 86% (p < 0.030). Neither SAECG-I (accuracy 65%; p < 0.21) nor SAECG-II (accuracy 71%; p < 0.48) was a statistically significant predictor of arrhythmia-free survival. CONCLUSIONS: T wave alternans was a highly significant predictor of the outcome of electrophysiological testing and arrhythmia-free survival, while SAECG was not a statistically significant predictor. Although these results need to be confirmed in prospective clinical studies, they suggest that T wave alternans may serve as a non-invasive probe for screening high risk populations for malignant ventricular arrhythmias.

Non-NASA Center↗

Preservation of auditory and vestibular function after surgical removal of bilateral vestibular schwannomas in a patient with neurofibromatosis type 2

The outcome of acoustic neuroma (vestibular schwannoma) surgery continues to improve rapidly. Advances can be attributed to several fields, but the most important contributions have arisen from the identification of the genes responsible for the dominant inheritance of neurofibromatosis types 1 (NF1) and 2 (NF2) and the development of magnetic resonance imaging with gadolinium enhancement for the early anatomic confirmation of the pathognomonic, bilateral vestibular schwannomas in NF2. These advances enable early diagnosis and treatment when the tumors are small in virtually all subjects at risk for NF2. The authors suggest that advising young NF2 patients to wait until complications develop, especially hearing loss, before diagnosing and operating for bilateral eighth nerve schwannomas may not always be in the best interest of the patient. To the authors' knowledge, this is the first reported case of preservation of both auditory and vestibular function in a patient after bilateral vestibular schwannoma excision.

Case Reports↗

Advances in integrated system heath management system technologies : overview of NASA and industry collaborative activities

This paper will describe recent advances in ISHM technologies made through collaboration between NASA and industry. In particular, the paper will focus on past, present, and future technology development and maturation efforts at the Jet Propulsion Laboratory (JPL) and its industry partner, Northrop Grumman lntegrated Systems (NGIS).

integrated system health management↗

Application of Model-based Prognostics to a Pneumatic Valves Testbed

Pneumatic-actuated valves play an important role in many applications, including cryogenic propellant loading for space operations. Model-based prognostics emphasizes the importance of a model that describes the nominal and faulty behavior of a system, and how faulty behavior progresses in time, causing the end of useful life of the system. We describe the construction of a testbed consisting of a pneumatic valve that allows the injection of faulty behavior and controllable fault progression. The valve opens discretely, and is controlled through a solenoid valve. Controllable leaks of pneumatic gas in the testbed are introduced through proportional valves, allowing the testing and validation of prognostics algorithms for pneumatic valves. A new valve prognostics approach is developed that estimates fault progression and predicts remaining life based only on valve timing measurements. Simulation experiments demonstrate and validate the approach.

prediction↗

Advanced Methods for Determining Prediction Uncertainty in Model-Based Prognostics with Application to Planetary Rovers

Prognostics is centered on predicting the time of and time until adverse events in components, subsystems, and systems. It typically involves both a state estimation phase, in which the current health state of a system is identified, and a prediction phase, in which the state is projected forward in time. Since prognostics is mainly a prediction problem, prognostic approaches cannot avoid uncertainty, which arises due to several sources. Prognostics algorithms must both characterize this uncertainty and incorporate it into the predictions so that informed decisions can be made about the system. In this paper, we describe three methods to solve these problems, including Monte Carlo-, unscented transform-, and first-order reliability-based methods. Using a planetary rover as a case study, we demonstrate and compare the different methods in simulation for battery end-of-discharge prediction.

prognosis↗

Model-Based Prognostics of Hybrid Systems

Model-based prognostics has become a popular approach to solving the prognostics problem. However, almost all work has focused on prognostics of systems with continuous dynamics. In this paper, we extend the model-based prognostics framework to hybrid systems models that combine both continuous and discrete dynamics. In general, most systems are hybrid in nature, including those that combine physical processes with software. We generalize the model-based prognostics formulation to hybrid systems, and describe the challenges involved. We present a general approach for modeling hybrid systems, and overview methods for solving estimation and prediction in hybrid systems. As a case study, we consider the problem of conflict (i.e., loss of separation) prediction in the National Airspace System, in which the aircraft models are hybrid dynamical systems.

prognosis↗

Real-Time Prognostics of a Rotary Valve Actuator

Valves are used in many domains and often have system-critical functions. As such, it is important to monitor the health of valves and their actuators and predict remaining useful life. In this work, we develop a model-based prognostics approach for a rotary valve actuator. Due to limited observability of the component with multiple failure modes, a lumped damage approach is proposed for estimation and prediction of damage progression. In order to support the goal of real-time prognostics, an approach to prediction is developed that does not require online simulation to compute remaining life, rather, a function mapping the damage state to remaining useful life is found offline so that predictions can be made quickly online with a single function evaluation. Simulation results demonstrate the overall methodology, validating the lumped damage approach and demonstrating real-time prognostics.

actuator↗

Real-Time Monitoring and Prediction of Airspace Safety

The U.S. National Airspace System (NAS) has reached an extremely high level of safety in recent years. However, it will only become more difficult to maintain the current level of safety with the forecasted increase in operations, and so the FAA has been making revolutionary changes to the NAS to both expand capacity and ensure safety. Our work complements these efforts by developing a novel model-based framework for real-time monitoring and prediction of the safety of the NAS. Our framework is divided into two parts: (offline) safety analysis and modeling part, and a real-time (online) monitoring and prediction of safety. The goal of the safety analysis task is to identify hazards to flight (distilled from several national databases) and to codify these hazards within our framework such that we can monitor and predict them. From these we define safety metrics that can be monitored and predicted using dynamic models of airspace operations, aircraft, and weather, along with a rigorous, mathematical treatment of uncertainty. We demonstrate our overall approach and highlight the advantages of this approach over the current state-of-the-art through simulated scenarios.

safety metrics↗

Demonstration of Prognostics-Enabled Decision Making Algorithms on a Hardware Mobile Robot Test Platform

Prognostics-enabled Decision Making (PDM) is an emerging research area that aims to integrate prognostic health information and knowledge about the future operating conditions into the process of selecting subsequent actions for the system. Previous work developing and testing PDM algorithms has been done in simulation; this paper describes the effort leading to a successful demonstration of PDM algorithms on a hardware mobile robot platform. The hardware platform, based on the K11 planetary rover prototype, was modified to allow injection of selected fault modes related to the rover’s electrical power subsystem. The PDM algorithms were adapted to the hardware platform, including development of a software module framework, a new route planner, and modifications to increase the algorithms’ robustness to sensor noise and system timing issues. A set of test scenarios was chosen to demonstrate the algorithms’ capabilities. The modifications to run with a hardware platform, the test scenarios, and the test results are described in detail. The results show a successful use of PDM algorithms on a hardware test platform to optimize mission planning in the presence of electrical system faults.

Prognosis↗

Real-Time UAV Trajectory Prediction for Safety Monitoring in Low-Altitude Airspace

The rising number of small unmanned aerial vehicles (UAVs) expected in the next decade will enable a new series of commercial, service, and military operations in low altitude airspace as well as above densely populated areas. These operations may include on-demand delivery, medical transportation services, law enforcement operations, traffic surveillance and many more. Such unprecedented scenarios create the need for robust, efficient ways to monitor the UAV state in time to guarantee safety and mitigate contingencies throughout the operations. This work proposes a generalized monitoring and prediction methodology that utilizes realtime measurements of an autonomous UAV following a series of way-points. Two different methods, based on sinusoidal acceleration profiles and high-order splines, are utilized to generate the predicted path. The monitoring approach includes dynamic trajectory re-planning in the event of unexpected detour or hovering of the UAV during flight. It can be further extended to different vehicle types, to quantify uncertainty affecting the state variables, e.g., aerodynamic and other environmental effects, and can also be implemented to prognosticate safety-critical metrics which depend on the estimated flight path and required thrust. The proposed framework is implemented on a simplified, scalable UAV modeling and control system traversing 3D trajectories. Results presented include examples of real-time predictions of the UAV trajectories during flight and a critical analysis of the proposed scenarios under uncertainty constraints.

UAV trajectory prognosis↗