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 these theoretical models there is a linear relationship between phase shifts and the difference of natural frequencies of oscillators and a change of sign in the phase shift naturally emerges.
King's College London（伦敦国王学院）；Guy’s and St Thomas' Hospital（盖伊和圣托马斯医院）；University Medical Center Utrecht（乌得勒支大学医学中心）；Royal Brompton Hospital (Guy’s and St Thomas' NHS Foundation Trust)（皇家布朗普顿医院（盖伊和圣托马斯NHS基金会信托））
Left ventricular (LV) function is an important factor in terms of patient management, outcome, and long-term survival of patients with heart disease. The most recently published clinical guidelines for heart failure recognise that over reliance on only one measure of cardiac function (LV ejection fraction) as a diagnostic and treatment stratification biomarker is suboptimal. Recent advances in AI-based echocardiography analysis have shown excellent results on automated estimation of LV volumes and LV ejection fraction. However, from time-varying 2-D echocardiography acquisition, a richer descr…
A minimal model for mechanical motion of the left ventricle is proposed. The model assumes the left ventricle to be a harmonic oscillator with two distinct phases, simulating the systolic and diastolic phases, at which both the amplitude and the elastic constant of the oscillator are different. Taking into account the pressure within the left ventricle, the model shows qualitative agreement with functional parameters of the left ventricle. The model allows for a natural explanation of heart failure with preserved systolic left ventricular function, also termed diastolic heart failure. Specific…
Electromechanical Dynamics of the Heart: A Study of Cardiac Hysteresis During Physical Stress Test
School of Medicine, Emory University（埃默里大学医学院）；Department of Biomedical Engineering, Georgia Institute of Technology and Emory University（佐治亚理工学院与埃默里大学生物医学工程系）
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).
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 …
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…
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…
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…
Two mathematical methods, the Fourier and wavelet transforms, were used to study the short term cardiovascular control system. Time series, picked from electrocardiogram and arterial blood pressure lasting 6 minutes, were analyzed in supine position (SUP), during the first (HD1), and the second parts (HD2) of $90^{\circ}$ head down tilt and during recovery (REC). The wavelet transform was performed using the Haar function of period $T=2^j$ ($% j=1$,2,$... $,6) to obtain wavelet coefficients. Power spectra components were analyzed within three bands, VLF (0.003-0.04), LF (0.04-0.15) and HF (0.1…
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.
In this paper we show that different physiological states and pathological conditions may be characterized in terms of predictability of time series signals from the underlying biological system. In particular we consider systolic arterial pressure time series from healthy subjects and Chronic Heart Failure patients, undergoing paced respiration. We model time series by the regularized least squares approach and quantify predictability by the leave-one-out error. We find that the entrainment mechanism connected to paced breath, that renders the arterial blood pressure signal more regular, thus…
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…
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…
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…
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 …
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…
This paper proposes a novel, simple and minimally invasive method for stroke volume variation assessment using arterial blood pressure measurements. The arterial blood pressure signal is reconstructed using a semi-classical signal analysis method allowing the computation of a parameter, called the first systolic invariant INVS1. We show that INVS1 is linearly related to stroke volume. To validate this approach, a statistical comparaison between INVS1 and stroke volume measured with the PiCCO technique was performed during a 15-mn recording in 21 mechanically ventilated patients in intensive ca…
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…
