Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.

Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications

Objective: We present the design and experimental validation of an arterial compliance probe with dual magnetic plethysmograph (MPG) transducers for local pulse wave velocity (PWV) measurement. The MPG transducers (positioned at 23 mm distance apart) utilizes Hall-effect sensors and permanent magnets for arterial blood pulse detection. Methods: The MPG probe was initially validated on an arterial flow phantom using a reference method. Further, 20 normotensive subjects (14 males, age = 24 ± 3.5 years) were studied under two different physical conditions: 1) Physically relaxed condition, 2) Postexercise condition. Local PWV was measured from the left carotid artery using the MPG probe. Brachial blood pressure (BP) was measured to investigate the correlation of BP with local PWV. Results: The proposed MPG arterial compliance probe was capable of detecting high-fidelity blood pulse waveforms. Reliable local pulse transit time estimates were assessed by the developed measurement system. Beat-by-beat local PWV was measured from multiple subjects under different physical conditions. A profound increment was observed in the carotid local PWV for all subjects after exercise (average increment = 0.42 ± 0.22 m/s). Local PWV values and brachial BP parameters were significantly correlated ( r ≥ 0.72), except for pulse pressure ( r = 0.42). Conclusion: MPG arterial compliance probe for local PWV measurement was validated. Carotid local PWV measurement, its variations due to physical exercise and correlation with BP levels were examined during the in vivo study. Significance: A novel dual MPG probe for local PWV measurement and potential use in cuffless BP measurement.

A Magnetic Plethysmograph Probe for Local Pulse Wave Velocity Measurement

A transducer of the preferred embodiment including a transducer and a plurality of adjacent, tapered cantilevered beams. Each of the beams define a beam base, a beam tip, and a beam body disposed between the beam base and the beam tip. The beams are arranged such that each of the beam tips extends toward a common area. Each beam is joined to the substrate along the beam base and is free from the substrate along the beam body. A preferred method of manufacturing a transducer can include: depositing alternating layers of piezoelectric and electrode onto the substrate in block, processing the deposited layers to define cantilever geometry in block, depositing metal traces in block, and releasing the cantilevered beams from the substrate in block.

Acoustic transducer with gap-controlling geometry and method of manufacturing an acoustic transducer

Cardiovascular disease remains the leading cause of death in Western society. Recent technological advances have opened the opportunity of developing new and innovative smart stent devices that have advanced electrical properties that can improve diagnosis and even treatment of previously intractable conditions, such as central line access failure, atherosclerosis and reporting on vascular grafts for renal dialysis. Here we review the latest advances in the field of cardiovascular medical implants, providing a broad overview of the application of their use in the context of cardiovascular disease rather than an in-depth analysis of the current state of the art. We cover their powering, communication and the challenges faced in their fabrication. We focus specifically on those devices required to maintain vascular access such as ones used to treat arterial disease, a major source of heart attacks and strokes. We look forward to advances in these technologies in the future and their implementation to improve the human condition.

Future of Smart Cardiovascular Implants.

https://www.oto.theclinics.com/article/S0030-6665(14)00094-2/pdf

Sound transfer of active middle ear implants.

Concept and evaluation of an endaurally insertable middle-ear implant.

The invention relates to a sound transducer for producing sound vibrations, which can be inserted in an ear and can be used in particular for an implantable hearing aid. The sound transducer has at least one carrier layer and at least one piezoelectric layer, as a result of which a deflection via a bimorph principle is achieved, or a deflection can be detected by picking up a voltage.

Sound transducer for insertion in an ear

Bimorph structures are a standard method for transforming the high force of piezoelectric materials into a large deflection. In micro electromechanical systems (MEMS) applications, it is preferable to use structures consisting of a passive substrate (usually silicon) and one or more piezoelectric layers on the top. Such structures are called heterogeneous bimorphs or enakemesomorphs. In some MEMS applications- for example, for use as acoustic transducers-it is desirable to arrange such heterogeneous bimorphs in a circular shape, which results in trapezoidal cantilever structures. In this paper, an analytic dynamic description of such actuators is obtained. The resulting model is proved to be compatible with existing models for heterogeneous bimorphs with constant width. A comparison to a finite element analysis model of an exemplary layout shows divergences wholly within the same range as found for published models for constant-width structures.finite element analysis modelexemplary layout

Admittance matrix of a trapezoidal piezoelectric heterogeneous bimorph

In-stent restenosis is a frequent complication after stent implantation. This article investigates the design of a passive sensor system to be integrated into a stent for the detection of an in-stent restenosis by measuring the local pulse wave velocity (PWV). The proposed system uses two resonant circuits consisting of a capacitive pressure sensor and a coil as transponders. The pressure sensors are located at the proximal and distal end of the stent. An alternating external magnetic field with a constant frequency is applied such that the resonance frequencies of the transponders cross the excitation frequency when the pulse wave passes. The time delay between the resonances at the transponders can be captured to obtain the PWV. A model for the measurement system and a correlation between transponder design parameters and minimal resolvable time delay are derived. This correlation is based on the criterion that the 3 dB bandwidth of the transponder resonances may not overlap in the measurement time interval. This correlation can be used to design and analyze a transponder system for the proposed measurement system. In an experiment, in which the pressure sensors have been emulated by varactor diodes, it could be shown that the model is valid and that the criterion is suitable. Finally, the relevant design parameters of the transponders have been identified and their limitations investigated.

On the Design of Passive Resonant Circuits to Measure Local Pulse Wave Velocity in a Stent

People suffering from moderate to severe hearing loss can be treated with active middle ear implants A new approach in this field is to implant an electromechanical transducer onto the round window membrane in order to improve coupling and be able to treat patients with middle-ear problems In this paper the design study for a miniaturized displacement transducer (MDT) for the round window is presented Based on a requirement analysis, the basic principle and analytical modeling of the actuator is shown A parameter variation study results in an optimized actuator configuration that is able to generate an amplification of 110 dB SPL theoretically As a next step this actuator has to be manufactured and tested

Jonathan Schächtele

Papers

Concept and evaluation of an endaurally insertable middle-ear implant.

Sound transducer for insertion in an ear

Admittance matrix of a trapezoidal piezoelectric heterogeneous bimorph

On the Design of Passive Resonant Circuits to Measure Local Pulse Wave Velocity in a Stent

Design study of a Miniaturized Displacement Transducer (MDT) for an active middle ear implant system