SYSTEM INDIVIDUAL MONITORING OF FUNCTIONAL AND ADAPTIVE HUMAN RESERVES Konstantin Apykhtin, Ph.D., M.D., Institute for Occupational Health of NAMS of Ukraine,

SYSTEM INDIVIDUAL MONITORING OF FUNCTIONAL AND ADAPTIVE

HUMAN RESERVES

Konstantin Apykhtin, Ph.D., M.D., Institute for Occupational Health of NAMS of Ukraine, Kyiv

Vladimir Petrukhin, Prof., Dr. ; Sabir Shaykhlislamov, Anton Danshin, AlexeyZapara, Moscow

Institute of Physics and Technology, Department of Control and Applied Mathematics

• According to the WHO Constitution, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity“ (1946).

• Health is primarily a state of the organism, which is characterized by the relation of structure and function, as well as the ability of regulatory systems to maintain a constant internal environment (homeostasis). (Nikolay N. Zajko, Prof., Dr. Med., Soviet pathophysiologist, 1908-1991).

• The disease is a disruption of the normal functioning of the body when exposed to damaging agents, resulting in a decrease of its adaptive capabilities (Nikolay N. Zajko).

• The disease is a dynamic state of an organism characterized by disruption of normal flow of life processes, resulting in reduced biological and social abilities of a person.

Health

Disease

?

Health

Disease

Prenosologicalchanges

The levels of the organization

Biorhythms, coherence phase processes in time

Neuro-humoral regulation. The hormone-receptor and synaptic interaction.

Temporary

Informational

Energy

Functional

Structural

ATP synthesis in mitochondria, the reactions of glycolysis.

The functioning of the organs and systems of the body

Cell organelles, components, membranes, structural proteins, enzymes, DNA

The sequence of development of pathological process

Temporary level

Informational level

Energy level

Functional level

Structural level

The time of occurrence of violations1 2 3 4 5

Prenosological approach

• Proposed by Soviet scientists Roman M. Baevsky, Vasily V. Parin and other (1966).

• Based on the analysis of subtle changes in the temporal organization of control actions of the nervous and endocrine systems on chronotropic function of the sinus node of the heart.

• Assumes a three-level hierarchical model of heart rhythm control.

Reaction time:

n.n. vagus

truncus sympathicus

baroreflex center of the medulla oblongata

subcortical sympathetic

ergotrop nerve centers

Levels:

I.

II.

III.

2.5 – 6 sec

6 – 25 sec

25 – 300 sec

Spectral domain:

VLF

LF

HF

sequence of P-P (or R-R)

HRV

ECG

Rhytmogramm (graph of R-R intervals)

R-R

Our body works according to the following rules:

• Normally, when the workload or everyday activity demands do not exceed the capacity of CVS (e.g. rest or light intensity work), the heart is regulated predominantly by autonomic level.

• When the workload becomes higher, the organism starts to involve baroreflex level of regulation.

• When the workload becomes too high or external conditions become too severe, the organism starts to involve sympathetic ergotropic and humoral level.

• So, the higher intensity of work or adaptation, the higher level of regulation is involved.

• Each higher level of regulation inhibits activity of lower levels.• The state of stress is characterized by increased heart rate (HR), increased

sympathetic tone of ANS, increased blood pressure.• State of relaxation is characterized by decrease of HR, increase of

parasympathetic tone (synonym – vagal tone) of ANS.

Stress-index of Roman M. Baevsky

n

Range (Δ RR)

N

n

Amplitude of mode (AMo) SI = AMo (%) / (2*Mo*Δ RR)

AMo (%) = n / N * 100%

RRRR maxRR min

[Mo] = sec

[ВР] = sec

Mode(Mo)

0,05 sec Rest : ≈ 50 - 120

Sleep : < 50

Stress : 200 - 1000

Miocardial infarction : 1000 - 2000

Indexes of vagal tone

RMSSD =

HRV = 20*ln (RMSSD)

Used in USA

R-R(i)R-R(i+1)

CardioMood website

www.cardiomood.com

CardioMood project: the team

Sitewww.home.cardiomood.co

m

Bluetooth

Bluetooth

System requirements and compatibility

• Smartphone or tablet requirements:– OS: Android 4.3+– Bluetooth: 4.0 Low Energy

• Heart rate sensor:– Bluetooth Smart (e.g. Polar H7)

HRV Expert for Android

http://bit.do/hrv-expert

Recording screen History

Report includes time and frequency domain parameters, histogram analysis and Poincare plot

All calculated values as well as raw data can be exported to a text file

User home page

• All data from smartphone is synchronized with website

• Profound analysis of RR-intervals with HRV methods

• Data export to Excel tables• User groups and roles (users

and doctors accounts on home.cardiomood.com and doctor.cardiomood.com respectively)

HRV analysis

• Artifacts filtration• Different analysis

epochs• Analysis of selected

area• Over 20 calculated

HRV parameters• Data export and

printing

Key features Flexible measurement duration limits

Comprehensive report• Time-domain parameters (SDNN, RMSSD, pNN50, etc)• Frequency-domain parameters (VLF, LF, HF, etc)• Histogram analysis• Poincare plot analysis

Artifacts and ectopic beat elimination

Raw-data export

Remote real-time monitoring (Internet required)

Cloud synchronization

Evolution of the modes of transmission of emotions

carrier pigeons

Evolution of the modes of transmission of emotions

Telegraph

Evolution of the modes of transmission of emotions

telephone cell phone

Evolution of the modes of transmission of emotions

Evolution of the modes of transmission of emotions

CardioMood