Risk for Ischemic Heart Disease
Development of Risk Estimation Technology for Ischemic Heart Disease and Essential Hypertension Based on Creating a Non-Invasive Automated Diagnostics Complex of a Microcirculation State
Tech Area / Field
- MED-DID/Diagnostics & Devices/Medicine
- INF-SOF/Software/Information and Communications
3 Approved without Funding
Republican Science-Practical Center Cardiology, Belarus, Minsk
- National Academy of Sciences of the Republic of Belarus / Institute of Informatics Problems, Belarus, Minsk
- Institute for Heart- and Circulation Research, Germany, Saxony, Hoyerswerda\nCERAMM, France, Montpellier\nLaval University, Canada, QC, Quebec City
Introduction and Overview. The project’ purpose – development and demonstration of information-diagnostic technology of monitoring of the degree of risks of the ishemic heart disease and essential hypertension development among middle-aged people including primary examination algorithm for revealing persons with the raised risk of these diseases and dynamic control of quantitative parameters of microcirculation, characteristics of blood lipid composition and rheological properties, based on the creation of a medical-technological complex for the non-invasive automated estimation of microcirculation component of cardiovascular system and diagnostic complexes with prognostic importance.
The state of the art in the field of the diagnosis and monitoring of cardiovascular system diseases. In order to make predictions about the ishemic heart disease (IHD) a system providing estimation of age, sex, the level of essential hypertension (EH), the total and high density lipoprotein cholesterol levels and the presence of diabetes is used. However this approach does not take into account inpidual peculiarities of every person. The systemic blood circulation characteristics can not be regarded as complete without a study of microcirculatory network (MCN). However the microcirculatory disorders character at early stages of the cardiovascular pathology remains scarcely studied. It is the result of insufficient development of research methods of the microcirculation system (MS) morphology, among which the most perspective is conjunctival biomicroscopy (CBM). The value of this method is caused by the fact that in terms of biomicroscopy it is possible to receive objective estimation of the MCN. However the outdated methods of semi-quantitative criteria for the MS estimation causes subjectivity and incomparability of results received by different researchers. This approach is used in cases of diseases fixed clinical forms and for the estimation of the therapy efficiency (Komatsu R. Et al., 1997; Homma S., et al., 1999; Podelinskaja L.V. etc., 1995; Cheung ATW et al., 2001). The problem of IHD and EH «rejuvenation» takes place in the majority of industrially developed countries and has a global character. The sensitivity of the MS to the influence of risk-factors determines the great significance of its condition in diagnosing cardiovascular disorders at the pre-clinical stage of the diseases. Therefore the development of a diagnostic approach aimed at defining the degree of the IHD and АH risk at the pre-clinical stage, is an urgent task of international importance.
The impact of the proposed project on the progress in the field of cardiovascular diseases early diagnostics. The system of quantitative criteria will considerably increase the informatively of CBM method and the efficiency of the MS condition diagnosing. The results of the research will increase the informatively of defining risks of IHD and EH at pre-clinical stage. The monitoring technology of the degree of the IHD and EH risk on the basis of automated estimation of the MS condition will increase the significance of initial diagnostic measures in primary prevention of IHD and EH. Availability, rather low cost and the opportunity of dynamic control will allow to increase the efficiency of initial prophylaxis and to reduce the number of cases of IHD and EH among people of the most able-bodied age. Such a complex doesn't have world analogues. Both the complex as a whole and its separate components will be in demand at the world market.
Participants of the project. In the performance of the project will be involved medical scientists and specialists in the field of clinical hemorheology and microcirculation of the Belarusian center of Cardiology (BCC – the Leading Institution in the project), and the former «weapon» specialists in the field of digital imagery and information technologies from the State Scientific Institution “The United Institute of Informatics Problems of the National Academy of Sciences of Belarus” (UIIP NASB - the other institute-participant). BCC is the leading establishment of the Belarus in this field. The application of diagnostic approaches based on the condition of MS, lipid exchange and hemorheology estimation, has allowed to increase considerably the efficiency of IHD and EH diagnostics and treatment. The results of research-work allow to carry out differentiated diagnostics of various forms and to define in time the reason of unfavorable development of IHD and EH, to make a choice of optimum methods of treatment and supervise the efficiency of the applied therapy. The employees of BCC are well-experienced in applying CBM in the research of MCN in cases of different forms of IHD and EH. The studies results have been represented at international and national conferences and at workshops of different levels.
Weapon specialists of UIIP NASB have achieved considerable results in the field of the development of elements of system of prompting, in the target system and automatic self-prompting, and also in the field of digital processing and recognition of the images of air targets, the development and operation of information retrieval systems of military application. Over the past few years the weapon experts of this organization have carried out researches on creation of computer hardware-software complexes for collecting, processing and analysis of various medical images. Within the framework of realization of the above-stated developments the weapon experts of UIIP NASB have received great practical experience on hardware-software interface of computer systems with different medical diagnostic equipment.
Expected Results and their Application. In the course of the project realization:
· will be created a single, including international, approach to the estimation of the condition of MS;
· will be formed diagnostic complexes prognostically important in the estimation of the IHD and EH development risk;
· will be created the technique and medical-technological complex (MTC) of inpidualized estimation and monitoring of risk of the development of IHD and EH;
· will be worked out the expert-educational electronic atlas of images of MCN and the system of telediagnostic and electronic consultations with various medical centres.
As a result of performing the project a new informational-diagnostic technology of monitoring of the degree of risk of the IHD and EH among middle-aged people will be worked out and demonstrated. The scientific significance of the project results consists in obtaining new facts about condition of MS, hemostasis and hemorheology in norm, in conditions of IHD and EH risk. The practical benefit of the results is the creation of a new methodical approach to the estimation of IHD and EH risk, which will considerably increase the chances of revealing these diseases at early stages. The commercial significance of the project results consists in the creation of protecting means in the forms of the method of the estimation of the degree of IHD and EH risks, an electronic atlas of MS changes, software packages of processing, recognition and statistical analysis of biological objects on images, a drop in the cost of primary diagnostic measures when revealing IHD and EH.
The area of application - the results of the development will form a base for the creation of a single informational-diagnostic medium of medical establishments of the Republic of Belarus, giving specialized cardiological help, for improving the quality of medical diagnostic service and operative making decisions; realization of various international projects in cardiology, cardio surgery, sports medicine and could be used for training medical students and doctors.
Meeting ISTC Goals and Objectives. The project corresponds to the purposes and tasks of ISTC, as:
- it offers the participants of the project, connected with the development of elements of optical and television system of prompting, the target systems and automatic self-prompting, and also methods and means of protection of military engineering from the precision radio controlled weapon – the opportunity to switch their abilities to peaceful activity in the field of diagnostics of cardiovascular diseases;
- it supports applied researches and development of information technologies in the area of cardiological service of public health services;
- it stimulates the participants’ transition to the market economy by creating a commercial product in the field of the protection of the population’s health;
- it carries out the participants’ integration into the world scientific community by means of international publications, developing international contacts and creating universal standards in the field of the research.
Scope of Activities. The duration of the project – 36 months, labour expenses – 6878 person*days. The aim of the project will be achieved provided there is parallel step-by-step performance of the 4 tasks. Within the framework of task 1 the basic flows of the collection of information and the structure of data-registry will be determined, hardware-software means of visualization, processing and analysis of the images of MCN will be developed, no less than 4 050 researches of МS will be carried out, the technique and software of the algorithm of primary examination will be developed, the clinical approbation of the breadboard model of the automated work-place of the doctor (AWP) will be carried out. Within the framework of task 2 no less 4950 functional, biochemical and biophysical researches will be carried out, the system of the data standardization will be created, the software of preliminary and complex processing of images and of the formation of diagnostic complexes will be worked out. Within the framework of task 3 the criteria and standardization of the data of prognostic diagnostic complexes will be explained, the methodology and the software for the monitoring of the degree of risk of the IHD and EH development among middle-aged people will be created. Within the framework of task 4 pilot sample of MTC automated estimation of the MS condition will be created, no less than 800 images of MCN will be saved in archives, the expert-educational electronic atlas of the images of MCN, characteristic of different degrees of risks of the IHD and EH development, and the system of telediagnostic and electronic consultations will be created. The developed software on tasks 1-4 generally will consist of six software packages including about 75 basic and 180 service functions. All the tasks include scientific researches and developments on diagnostics of the condition of MS, hemostasis and hemorheology in conditions of norm, in cases of the influence of risk-factors and the development of IHD and EH (BCC), and researches on the processing and recognition of the images of the MCN (UIIP NASB).
Role of Foreign Collaborators. The forms of the collaborators’ participation: Service Central de physiologie Clinique, Centre d’Exploration et de rйadaptation des Anomalies du Mйtabolisme Musculaire (France); Institute for Heart and Circulation Research (Germany), Laboratoire de Vision et Systиmes Numйriques de l'Universitй Laval (Canada) in the offered project consist in:
· exchange of scientific and technical information and realization of joint seminars aiming at discussing the course of the project’s performance and estimation of the scientific and technical level of the received results;
· participation in the realization of clinical tests of the developed tool methods and the created hardware-software means;
· representation of the commentary to the technical reports of the participants of the project.
Technical Approach and Methodology. The available scientific undertaking - the results of research-work of the condition of MS, hemorheology and lipid exchange among healthy people and those with IHD and EH and in the field of digital processing and recognition of images of various structure and complexity and of the creation of information-retrieval systems - forms a real base for a successful performance of the project. In the course of the development of the methodology and hardware-software means of complex diagnostics of the MS condition the methods of CBM, of transcutaneous oxygen transfer and flowmetricy will be used, the means of the formation of the visualized register of data and the algorithm of primary examination will be created. CBM will be carried out with using of MTC in the structure of a slit lamp, a personal computer, a digital colour camera, a block of optical splicing and a developed specialized software complex. Thus, high-quality images of MCN will be received. The specialized software complex will allow to automate the process of collecting, processing and analysis of the images, to realize the technique of quantitative estimation of MS and prognostic criteria of microcircular disorders. In order to form prognostically important diagnostic complexes the researches of lipid structure, of blood cells functional state, of hemostasis and hemorheology in the 4 groups of the examined patients will be carried out, and the system of data standardization will be created. The methodology and the software for monitoring of the degree of risks of the IHD and EH development will be created on the basis of the results of the analysis of the diagnostic complexes which characterize the normal and the pathological condition, and the scale of the differentiated estimation of risk. The first sample of MTK for automated estimation of the condition of MS will include the developed software of estimation and monitoring of risk of the IHD and EH development and the expert-educational electronic atlas of the images of the MCN. In order to support the remote electronic consultations and the exchange of information with other medical centres the algorithms and software of the support of the system of telediagnosis will be developed. The developed techniques will be appreciated by experts of the national organs of public health services and will be recommended for introduction in the clinic. At the clinical tests of the developed diagnostic approaches it is planned to carry out independent testing of the received results with the participation of foreign collaborators.
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