Method for ascertaining the pressure pulse and related parameter

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128672, G06F 1542, A61B 502

Patent

active

052650111

ABSTRACT:
The system measures the pressure pulses in an upper body peripheral artery and produces an electrical signal which represents the contours of these pulses. It then digitizes the signal and synthesizes the pressure pulses in the ascending aorta using either a frequency-domain or a time-domain calculation method. Next, the system separately averages the signals corresponding to the measured pulses and those corresponding to the synthesized pulses, and forms for each an "average pulse." The system identifies the wave foot in each of the average pulses, identifies the incisura in the average peripheral pulse, determines the amount of time associated with systole and, based on this time, segments the synthesized pulse into systolic and diastolic components. The system then identifies the two pressure peaks and determines their amplitudes using either the average peripheral pulse or the average synthesized pulse, by taking first and third derivatives of the pulses and determining the locations of the relevant minimum and maximum points. The system then determines the peak and mean pressures throughout the wave and at various critical points such as the primary pressure peak, the reflective wave peak, and throughout systole and diastole. Using these peaks and pressures, the system calculates maximum and mean systolic and diastolic pressures, an augmentation index, a measure of subendocardial viability, and the pressure at the end of systole.

REFERENCES:
Kelly et al., "Noninvasive determination of age-related changes in the human arterial pulse", St. Vincent's Hospital, Sydney, Australia, 80 (6), Dec. 1989, pp. 1652-1659 (abstract only).
Lasance et al., "Peripheral pulse contour analysis in determining stroke volume", PROG. REP. MED. FYS. INST. TNO (Netherlands), No. 4, 1976, pp. 59-62.
Kelly et al., "Nitrogylcerin has more favorable effects on left ventricular afterload than apparent from measurement of pressure in a peripheral artery", EUR. HEART J., 11(2), 1990, pp. 138-144 (abstract only).
Simkus et al., "Radial arterial pressure measurements may be a poor guide to the beneficial effects of nitroprusside on left ventricular systolic pressure in congestive heart failure", AM. J. CARDIOL., 66(3), 1990, pp 323-326 (abstract only).
Waldman, "Modeling of the coupling of the left ventricle to the peripheral circulation" Ventricular/Vascular Coupling:Clinical, Physiological, and Engineering Aspects, Springer Verlag Inc., 1987, pp. 301-333 (abstract only).
O'Rourke, "Systolic blood pressure:arterial compliance and early wave reflection, and their modification by antihypertensive therapy", J HUM. HYPERTENS. (UNITED KINGDOM), 1989 pp. 47-52 (abstract only).
Szucs, "Approximate Identification of the Aortic Pressure Transfer", IFAC Theory and Application of Digital Control, New Delhi, India, 1982, pp. 393-394.

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