| Summary: |
Despite public and health education interventions, population aging has contributed to a steady rise in cardiovascular disease prevalence and related health resource consumption. Diseases of the circulatory system place a considerable burden on healthcare systems and government budgets. Indeed, in 2016 1.83 million deaths resulted from diseases of thecirculatory system in the EU-28 (35.7 % of all deaths), considerably higher than the second most prevalent cause of death, cancer (26 .0 %). Among cardiovascular causes ofmortality, ischemic heart disease and other cardiac diseases such as valvular heart disease accounted for nearly 60% of all death related to the cardiovascular system's diseases.Cardiac surgical procedures, namely coronary artery bypass grafting (CABG), are amongst the most common surgical procedures in the European Union.
Although cardiac surgicalprocedures have been carried out with ever-increasing safety, these interventions still pose unique challenges, and the risk of death and disability is considerably higher than for non -cardiac surgery. Patients are at higher risk due to their underlying cardiovascular condition. Because in most procedures, there is a need to arrest the heart, cross clamp theascending aorta, and institute cardiopulmonary bypass to support vital functions while the surgeon performs the intervention. Strategies are tailored to each patient and interventionto prevent organ dysfunction and coagulation dyscrasias and minimize systemic inflammatory response. The surgical team would benefit from any real-time monitoring supportsystem able to match at least the information provided by blood gas exams since perfusion accidents would be promptly recognized, and actions to correct imbalances in tissueperfusion and insufficient myocardial protection during cardioplegia administration would be anticipated. Besides, hemodynamic coherence loss between macrocirculatory oxygenparameters and the peripheral microvasculature is frequently  |
Summary
Despite public and health education interventions, population aging has contributed to a steady rise in cardiovascular disease prevalence and related health resource consumption. Diseases of the circulatory system place a considerable burden on healthcare systems and government budgets. Indeed, in 2016 1.83 million deaths resulted from diseases of thecirculatory system in the EU-28 (35.7 % of all deaths), considerably higher than the second most prevalent cause of death, cancer (26 .0 %). Among cardiovascular causes ofmortality, ischemic heart disease and other cardiac diseases such as valvular heart disease accounted for nearly 60% of all death related to the cardiovascular system's diseases.Cardiac surgical procedures, namely coronary artery bypass grafting (CABG), are amongst the most common surgical procedures in the European Union.
Although cardiac surgicalprocedures have been carried out with ever-increasing safety, these interventions still pose unique challenges, and the risk of death and disability is considerably higher than for non -cardiac surgery. Patients are at higher risk due to their underlying cardiovascular condition. Because in most procedures, there is a need to arrest the heart, cross clamp theascending aorta, and institute cardiopulmonary bypass to support vital functions while the surgeon performs the intervention. Strategies are tailored to each patient and interventionto prevent organ dysfunction and coagulation dyscrasias and minimize systemic inflammatory response. The surgical team would benefit from any real-time monitoring supportsystem able to match at least the information provided by blood gas exams since perfusion accidents would be promptly recognized, and actions to correct imbalances in tissueperfusion and insufficient myocardial protection during cardioplegia administration would be anticipated. Besides, hemodynamic coherence loss between macrocirculatory oxygenparameters and the peripheral microvasculature is frequently present in postoperative cardiac surgery patients as well as in patients with peripheral artery disease (PAD).
Thus, the interest in minimally invasive methods to assess the microvasculature in addition to established systemic hemodynamic monitoring in patients subject to cardiac surgery is ofparamount relevance. This requirement has been partly dealt with by commercially available systems that allow for real-time blood oxygen estimates. Near-infrared spectroscopy(NIRS) is a rapid, simple, safe, and non-invasive analytical tool that has been increasingly used in biomedical research and with widespread clinical application. NIRS signals cancharacterize samples comprehensively and provide a fast and robust measure of the major properties (physical, chemical, rheological, etc.). The data integration of NIRS withsample traits may be a robust framework for gaining insight and providing information (clinical, molecular) enrichment of these complex cardiovascular systems. In tandem withpredictive modeling, data fusion, comprising information enrichment, will improve the model's robustness and performance. Conflating NIRS profiles with mass spectrometry features(specific protein variations or metabolites patterns) will gauge how well the NIRS can capture important metabolite patterns regarding the samples' traits being analyzed.
To captureall the signal complexity and clinical features involved, machine- and statistical learning, integrative approaches will be engaged to unravel the intertwined physiological routes andprovide pre-emptive warnings. The main targets of the CardioNIR project are the endorsement of this spectroscopic technique in a cardiac surgical context, in the patient's peripheralartery disease (PAD) management, and biomarkers swift screening. The aspiration is to provide a technological (portable) framework (device+ software application) to reduce thesurgical team's information burden. |