Blood pressure regulation is commonly addressed in terms of local mechanisms such as vascular resistance, compliance and neurohumoral control. However, the human vasculature encompasses multiple quasi-closed flow loops under both physiological and pathological conditions. To test whether these loops could influence pressure dynamics beyond local control, we address the role of vascular topology in blood pressure regulation. Using one dimensional flow simulation models, we compared pressure dynamics in open vascular segments and closed vascular loops. We found that in open segments pressure fades away and remains spatially localized, whereas in closed loops pressure can keep circulating around the loop even if resistance in one spot is modified. Since parallel pathways within loops are dynamically coupled rather than independent, pressure changes in one place can affect the entire closed loop, allowing system level pressure patterns to emerge. Also, we assessed the temporal evolution of pressure fluctuations within closed vascular loops in normotensive and hypertensive parameter regimes, before and after loop breaking intervention. This topological approach helps clarifying why drugs or local interventions may fail to lower blood pressure in looped vascular architectures, providing a theoretical interpretation of some forms of resistant hypertension. Because disrupting a loop restores pressure relaxation, it may also help explain the disproportionate pressure changes observed after topology altering events like thrombosis, vascular surgery or embolization of arteriovenous malformations and shunts. Therefore, vascular topology can influence cardiovascular physiology by coupling local pressure flow relations to global constraints on blood pressure regulation, with physiological, pathological and clinical implications.
A novel model of thermal regulation of homoeothermic animals has been implemented. The model is based on a non-equilibrium thermodynamic approach which introduces entropy balance and the rate of entropy generation as a formulation of The Second Law. The model explains linear correlation between an animals skin and environment temperatures using the first principles and demonstrates the role of blood circulation in the thermoregulation of homoeothermic animals.
In this work, we present the Senbiosys blood pressure monitoring algorithm (SB-BPM) that solely requires a photoplethysmography (PPG) signal. The technology is based on pulse wave analysis (PWA) of PPG signals retrieved from different body locations to continuously estimate the systolic blood pressure (SBP) and the diastolic blood pressure (DBP).
This paper presents the mathematical modeling-based design and simulation of normal mode MEMS capacitive pressure sensor for blood pressure sensing application. The normal blood pressure of human being is 120/80 mmHg. But this range varies in case of any stress, hypertension and some other health issues. Analytical simulation is implemented using MATLAB. Basically, normal mode capacitive pressure sensors have a fixed plate and a moveable diaphragm which deflects on application of pressure with the condition that it must not touch the fixed plate. Deflection depends on material as well as thick…
In this paper we present an acquisition chain for the measurement of blood arterial pressure based on the oscillometric method. This method does not suffer from any limitation as the well-known auscultatory method and it is suited for wearable health monitoring systems. The device uses a pressure sensor whose signal is filtered, digitalized and analyzed by a microcontroller. Local analysis allows the evaluation of the systolic and diastolic pressure values which can be used for local alarms, data collection and remote monitoring.
A new Rayleigh-type instability is proposed to explain the `sausage-string' pattern of alternating constrictions and dilatations formed in blood vessels under influence of a vasoconstricting agent. Our theory involves the nonlinear elasticity characteristics of the vessel wall, and provides predictions for the conditions under which the cylindrical form of a blood vessel becomes unstable.
Cerebral autoregulation refers to regulation mechanisms that aim to maintain cerebral blood flow approximately constant. It is often assessed by autoregulation index (ARI), which uses arterial blood pressure and cerebral blood flow velocity time series to produce a ten-scale index of autoregulation performance (0 denoting the absence of and 9 the strongest autoregulation). Unfortunately, data are rarely free from various artefacts. Here, we consider four of the most common non-physiological blood pressure artefacts (saturation, square wave, reduced pulse pressure and impulse) and study their e…
Using a three-compartment model of blood pressure dynamics, we analyze theoretically the short term cardiovascular variability: how the respiratory-related blood pressure fluctuations are buffered by appropriate heart rate changes: i.e. the respiratory sinus arrhythmia. The buffering is shown to be crucially dependent on the time delay between the stimulus (such as e.g. the inspiration onset) and the application of the control (the moment in time when the efferent response is delivered to the heart). This theoretical analysis shows that the buffering mechanism is effective only in the upright …
The fundamentals of near infrared spectroscopy (NIRS) are reviewed. Among the major factors controlling the cerebral blood flow (CBF), the effect of PaCO2 is peculiar in that it violates autoregulatory CBF mechanisms and allows to explore the full range of the CBF. A simple physical model, with a four parameter formula, relating the CBF to PaCO2 is presented. It can be used to transform the fits of one animal to the fits of another one. It enable the use of rats data as monkeys data simply by rescaling the PaCO2 values and the CBF data. Controlled breathing can change the PaCO2. Experiments on…
It is shown that the dependence of the cerebral blood flow (CBF) on mean arterial blood pressure (MABP) can be described with a simple model having the following assumptions. Below certain MABP (denoted as MABP1) there are no autoregulatory or feedback mechanisms influencing CBF. Between MABP1 and MABP2 (MABP at which breakthrough accurs) there is a linear (on MABP) dependent feedback with a sloap depending very much on the individual considered. The classical autoregulation model with a plateau in between MABP1 and MABP2 is a particular case of this model. The model describes well the experim…
Recent developments in cardiovascular modelling allow us to simulate blood flow in an entire human body. Such model can also be used to create databases of virtual subjects, with sizes limited only by computational resources. In this work, we study if it is possible to estimate cardiovascular health indices using machine learning approaches. In particular, we carry out theoretical assessment of estimating aortic pulse wave velocity, diastolic and systolic blood pressure and stroke volume using pulse transit/arrival timings derived from photopletyshmography signals. For predictions, we train Ga…
This paper is written in the context of the international Eurostars project, i-bracelet. The main objective of the i-bracelet project - "Intelligent bracelet for blood pressure monitoring and detection of preeclampsia" is the creation of a portable medical device for uninterrupted monitoring of blood pressure and to detect the blood pressure problems (such as hypertension) and, in particular, preeclampsia. In the current paper is described the software component of this system used for monitoring, viewing and analyzing the blood pressure values coming from a smart bracelet developed in the con…
We describe the multiresolution wavelet analysis of blood pressure waves in vasovagal syncope affected patients compared with healthy people. We argue that there exist discriminating criteria which allow us to isolate particular features, common to the syncope-affected patients sample, indicating an alternative diagnosis methodology for this syndrome. We perform a throughout analysis both in the Haar basis and in a Gaussian one, with an attempt to grasp the underlying dynamics.
In this paper we present an electronic system to perform a non-invasive measurement of the blood pressure based on the oscillometric method, which does not suffer from the limitations of the well-known auscultatory one. Moreover the proposed system is able to evaluate both the systolic and diastolic blood pressure values and makes use of a microcontroller and a Sallen-Key active filter. With reference to other similar devices, a great improvement of our measurement system is achieved since it performs the transmission of the systolic and diastolic pressure values to a remote computer. This asp…
We present the multiscale entropy analysis of short term physiological time series of simultaneously acquired samples of heart rate, blood pressure and lung volume, from healthy subjects and from subjects with Chronic Heart Failure. Evaluating the complexity of signals at the multiple time scales inherent in physiologic dynamics, we find that healthy subjects show more complex time series at large time scales; on the other hand, at fast time scales, which are more influenced by respiration, the pathologic dynamics of blood pressure is the most random. These results robustly separate healthy an…
Differentiating patients with obstructive sleep apnea from healthy controls based on heart rate - blood pressure coupling quantified by entropy-based indices
Gdańsk University of Technology（格但斯克工业大学）；Universidad Miguel Hernández（米格尔·埃尔南德斯大学）；Medical University of Gdańsk（格但斯克医科大学）
Objective: Evaluate a method for the estimation of the nocturnal systolic blood pressure (SBP) dip from 24-hour blood pressure trends using a wrist-worn photoplethysmography (PPG) sensor and a deep neural network in free-living individuals, comparing the deep neural network to traditional machine learning and non-machine learning baselines. Approach: A wrist-worn PPG sensor was worn by 106 healthy individuals for 226 days during which 5111 reference values for blood pressure (BP) were obtained with a 24-hour ambulatory BP monitor and matched with the PPG sensor data. Features based on heart ra…
Among the major factors controlling the cerebral blood flow (CBF) - cerebral perfusion pressure, arterial partial pressure of oxygen (PaO2), cerebral metabolism, arterial partial pressure of carbon dioxide (PaCO2), and cardiac output, the effect of PaCO2 is peculiar in being independent of autoregulatory CBF mechanisms and it allows to explore the full range of the CBF. We have developed a simple physical model, and have derived a simple four parameter formula, relating the CBF to PaCO2. The parameters can be extracted in an easy way, directly from the experimental data. With this model five e…
MIT（麻省理工学院）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）
Determining whether hypotensive patients in intensive care units (ICUs) should receive fluid bolus therapy (FBT) has been an extremely challenging task for intensive care physicians as the corresponding increase in blood pressure has been hard to predict. Our study utilized regression models and attention-based recurrent neural network (RNN) algorithms and a multi-clinical information system large-scale database to build models that can predict the successful response to FBT among hypotensive patients in ICUs. We investigated both time-aggregated modeling using logistic regression algorithms w…
Background and Objectives: In a significant portion of surgeries, blood pressure (BP) is often measured non-invasively in an intermittent manner. This practice has a risk of missing clinically relevant BP changes between two adjacent intermittent BP measurements. This study proposes a method to non-invasively estimate systolic blood pressure (SBP) with high accuracy in patients undergoing surgery. Methods: Continuous arterial BP, electrocardiography (ECG), and photoplethysmography (PPG) signals were acquired from 29 patients undergoing surgery. After extracting 9 features from the PPG and ECG …
Blood Pressure (BP) is a biological signal related to the cardiovascular system that inevitably is affected by ageing. Moreover, it is also influenced by the presence of cardiovascular risk factors. To evaluate how the relationship be-tween BP and age changes with the presence of risk factors in hypertensive and normotensive subjects, we analyzed 880 subjects with and without smoking, obe-sity, diabetes mellitus and dyslipidemia. A regression line fitted each BP/Age relation calculated separately for normotensive and hypertensive subjects with and without risk factors. For each of the four con…
Purpose: To show some preliminary results about the possibility to exploit a cardiovascular mathematical model - made patient-specific by noninvasive data routinely measured during ordinary clinical examinations - in order to obtain sufficiently accurate central blood pressure (BP) estimates. Methods: A closed-loop multiscale (0D and 1D) model of the cardiovascular system is made patient-specific by using as model inputs the individual mean heart rate and left-ventricular contraction time, weight, height, age, sex and mean/pulse brachial BPs. The resulting framework is used to determine centra…
The simulation of blood flow and pressure in arteries requires outflow boundary conditions that incorporate models of downstream domains. We previously described a coupled multidomain method to couple analytical models of the downstream domains with 3D numerical models of the upstream vasculature. This prior work either included pure resistance boundary conditions or impedance boundary conditions based on assumed periodicity of the solution. However, flow and pressure in arteries are not necessarily periodic in time due to heart rate variability, respiration, complex transitional flow or acute…
Blood Pressure (BP) and Heart Rate (HR) provide information on clin-ical condition along 24h. Both signals present circadian changes due to sympa-thetic/parasympathetic control system that influence the relationship between them. Moreover, also the gender could modify this relation, acting on both con-trol systems. Some studies, using office measurements examined the BP/HR re-lation, highlighting a direct association between the two variables, linked to sus-pected coronary heart disease. Nevertheless, till now such relation has not been studied yet using ambulatory technique that is known to l…
We study the phase-synchronization properties of systolic and diastolic arterial pressure in healthy subjects. We find that delays in the oscillatory components of the time series depend on the frequency bands that are considered, in particular we find a change of sign in the phase shift going from the Very Low Frequency band to the High Frequency band. This behavior should reflect a collective behavior of a system of nonlinear interacting elementary oscillators. We prove that some models describing such systems, e.g. the Winfree and the Kuramoto models offer a clue to this phenomenon. For the…
Elastic properties of arteries have long been recognized as playing a major role in the cardiovascular system. However, non-invasive in vivo assessment of local arterial stiffness remains challenging and imprecise as current techniques rely on indirect estimates such as wall deformation or pulse wave velocity. Recently, Shear Wave Elastography (SWE) has been proposed to non-invasively assess the intrinsic arterial stiffness. In this study, we applied SWE in the abdominal aortas of rats while increasing blood pressure (BP) to investigate the dependence of shear wave speed with invasive arterial…
The clinical and economic burden of cardiovascular diseases (CVDs) poses a global challenge. Growing evidence suggests an early assessment of arterial stiffness can provide insights into the pathogenesis of CVDs. However, it remains difficult to quantitatively characterize the arterial stiffness in vivo. Here we utilize the guided elastic waves continuously excited and detected by ultrasound as a tool to probe the blood pressure (BP) and mechanical properties of the common carotid artery (CCA) simultaneously. In a pilot study of 17 healthy volunteers, we obverse a ~20% variation in the group v…
Sleep apnea is the most common sleep disturbance and it is an important risk factor for cardiovascular disorders. Its detection relies on a polysomnography, a combination of diverse exams. In order to detect changes due to sleep disturbances such as sleep apnea occurrences, without the need of combined recordings, we mainly analyze systolic blood pressure signals (maximal blood pressure value of each beat to beat interval). Nonstationarities in the data are uncovered by a segmentation procedure, which provides local quantities that are correlated to apnea-hypopnea events. Those quantities are …
The use of office measurement of Blood Pressure (BP) as well as of the mean on day-time, on night-time or on 24h does not accurately describe the changes of the BP circadian rhythm. Moreover, several risk factors affect this rhythm but until now possible alterations, due to the presence of such risk factors considered separately, were not been yet studied. Cigarette smoking is one of the most relevant risk factors increasing cardiovascular morbidity and mortality. The aim of this study is to evaluate quantitatively and with a suitable temporal detail how the smoking influences the BP circadian…
Mechanistic multiphysics modeling reveals how blood pulsation drives CSF flow, pressure, and brain deformation under physiological and injection conditions
