SYSTEM INDIVIDUAL MONITORING OF FUNC T IONAL AND ADAPTIVE HUMAN RESERVES

1. 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

2. 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).

3. 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.

4. Health ? Disease

5. Health Prenosological changes Disease

6. The levels of the organization Biorhythms, coherence phase processes in time Temporary Neuro-humoral regulation. The hormone-receptor and synaptic interaction. Informational ATP synthesis in mitochondria, the reactions of glycolysis. Energy The functioning of the organs and systems of the body Functional Cell organelles, components, membranes, structural proteins, enzymes, DNA Structural

7. The sequence of development of pathological process Temporary level Informational level Energylevel Functional level Structural level 1 2 3 4 5 The time of occurrence of violations

8. Prenosological approach • Proposed by Soviet scientists Roman M. Baevsky, Vasily V. Parinand 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.

9. Levels: subcorticalsympatheticergotropnervecenters Spectral domain: Reaction time: III. 25 – 300 sec VLF baroreflexcenter of the medulla oblongata 6 – 25 sec LF II. truncussympathicus I. n.n. vagus HF 2.5 – 6 sec sequence of P-P (or R-R) HRV

10. ECG R-R Rhytmogramm (graph of R-R intervals)

11. 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.

12. Stress-index ofRoman M. Baevsky SI = AMo (%) / (2*Mo*Δ RR) Amplitude of mode (AMo) N n AMo (%) = n / N * 100% n [Mo] = sec [ВР] = sec RR RR min RR max Rest : ≈ 50 - 120 0,05 sec Mode (Mo) Sleep : < 50 Stress : 200 - 1000 Range (Δ RR) Miocardial infarction : 1000 - 2000

13. Indexes of vagal tone R-R(i) R-R(i+1) RMSSD = HRV = 20*ln (RMSSD) Used in USA

14. CardioMoodwebsite www.cardiomood.com

15. CardioMood project: the team

16. Bluetooth Site www.home.cardiomood.com Bluetooth

17. 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)

18. HRV Expert for Android http://bit.do/hrv-expert

19. Recording screen History

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

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

22. 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)

23. HRV analysis • Artifacts filtration • Different analysis epochs • Analysis of selected area • Over 20 calculated HRV parameters • Data export and printing

24. 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

25. Evolution of the modes of transmission of emotions carrier pigeons

26. Evolution of the modes of transmission of emotions Telegraph

27. Evolution of the modes of transmission of emotions cell phone telephone

28. Evolution of the modes of transmission of emotions

29. Evolution of the modes of transmission of emotions CardioMood

30. Thank you for attention!