Method and apparatus for deriving mean arterial pressure of a subject
11172891 · 2021-11-16
Assignee
Inventors
Cpc classification
A61B5/002
HUMAN NECESSITIES
A61B5/02416
HUMAN NECESSITIES
A61B5/7278
HUMAN NECESSITIES
International classification
Abstract
A method and related apparatus for deriving mean arterial pressure of a subject, including receiving data relating to at least one cardiac cycle of a bio-signal from the subject; normalizing the received data relating to the at least one cardiac cycle; calculating an area enclosed by the normalized received data to obtain a normalized area; calculating a heart rate of the subject from the at least one cardiac cycle; and deriving the mean arterial pressure from the normalized area and heart rate.
Claims
1. A method of deriving mean arterial pressure of a subject, the method comprising: (i) receiving data from an optical sensor relating to at east one cardiac cycle of a bio-signal from the subject including a waveform signal thereof; (ii) amplitude-normalizing the received data relating to the at least one cardiac cycle by subtracting a minimum value of the waveform signal from the waveform signal to obtain a subtracted signal, and dividing the subtracted signal by a maximum value of the subtracted signal; (iii) calculating an area enclosed by the amplitude-normalized received data to obtain an amplitude-normalized area; (iv) calculating a heart rate of the subject from the at least one cardiac cycle; and (v) deriving the mean arterial pressure according to the equation:
log(MAP)=b+a.sub.1 log(A)+a.sub.2 log(HR) wherein MAP is the mean arterial pressure, A is the amplitude-normalized area, HR is the heart rate, and a.sub.1, a.sub.2, and b are predetermined constants.
2. A method of claim 1, wherein the data relates to a plurality of cardiac cycles and the method includes amplitude-normalizing respective data relating to each of the cardiac cycles; calculating respective areas enclosed by respective amplitude-normalized data to obtain respective amplitude-normalized areas; and obtaining an average amplitude-normalized area from the calculated amplitude-normalized areas as the amplitude-normalized area.
3. A method of claim 2, wherein the method further includes calculating respective heart rates from respective pairs of the cardiac cycles that are arranged consecutively; and obtaining an average heart rate from the respective heart rates as the heart rate.
4. A method of claim 1, wherein the at least one cardiac cycle includes a pair of cardiac cycles, and wherein calculating the heart rate includes calculating the heart rate according to the equation: HR=60/T, where HR is the heart rate; and T is a time period determined between respective consecutive systolic peaks of the pair of cardiac cycles that are arranged consecutively.
5. A method of claim 1, wherein calculating the heart rate includes calculating the heart rate according to the equation: HR=60/T, where HR is the heart rate; and T is a time period determined between respective consecutive valleys of the at least one cardiac cycle.
6. A method of claim 1, wherein calculating the area enclosed by the amplitude-normalized received data includes calculating the area with respect to a time axis which defines the at least one cardiac cycle.
7. A method of claim 1, further comprising: obtaining pulse pressure of the subject; and deriving systolic blood pressure and diastolic blood pressure of the subject according to the respective equations: DBP=MAP−(⅓) PP, and SBP=MAP+(⅔) PP, where MAP is the mean arterial pressure; DBP is the diastolic blood pressure; SBP is the systolic blood pressure; and PP is the pulse pressure.
8. A non-transitory computer-readable medium storing instructions which when executed cause an electronic device to: (i) receive data from an optical sensor relating to at least one cardiac cycle of a bio-signal from a subject including a waveform signal thereof; (ii) amplitude-normalize the received data relating to the at least one cardiac cycle by subtracting a minimum value of the waveform signal from the waveform signal to obtain a subtracted signal, and dividing the subtracted signal by a maximum value of the subtracted signal; (iii) calculate an area enclosed by the amplitude-normalized received data to obtain an amplitude-normalized area; (iv) calculate a heart rate of the subject from the at least one cardiac cycle; and (v) derive mean arterial pressure of the subject according to the equation:
log(MAP)=b+a.sub.1 log(A)+a.sub.2 log(HR) wherein MAP is the mean arterial pressure, A is the amplitude-normalized area, HR is the heart rate, and a.sub.1, a.sub.2, and b are predetermined constants.
9. The non-transitory computer-readable medium according to claim 8, wherein the area enclosed by the amplitude-normalized received data is calculated by calculating the enclosed area with respect to a time axis which defines the at least one cardiac cycle.
10. Apparatus for deriving mean arterial pressure of a subject, the apparatus comprising: (i) a receiver for receiving data from an optical sensor relating to at least one cardiac cycle of a bio-signal from the subject including a waveform signal thereof; (ii) a processor for: (a) amplitude-normalizing the received data relating to the at least one cardiac cycle by subtracting a minimum value of the waveform signal from the waveform signal to obtain a subtracted signal, and dividing the subtracted signal by a maximum value of the subtracted signal; (b) calculating an area enclosed by the amplitude-normalized received data to obtain an amplitude-normalized area; (c) calculating a heart rate of the subject from the at least one cardiac cycle; and (d) deriving the mean arterial pressure according to the equation:
log(MAP)=b+a.sub.1 log(A)+a.sub.2 log(HR) wherein MAP is the mean arterial pressure, A is the amplitude-normalized area, HR is the heart rate, and a.sub.1, a.sub.2, and b are predetermined constants.
11. Apparatus of claim 10, wherein the apparatus is in the form of an electronic device.
12. Apparatus of claim 10, wherein the apparatus includes an optical measurement device and a telecommunications device having the receiver; and wherein the optical measurement device includes an optical sensor for obtaining the bio-signal from the subject, and a data processing module for determining data relating to the bio-signal, wherein the receiver of the telecommunications device is arranged to receive the determined data of the bio-signal.
13. Apparatus according to claim 10, wherein the area enclosed by the amplitude-normalized received data is calculated by calculating the enclosed area with respect to a time axis which defines the at least one cardiac cycle.
14. A method according to claim 1, wherein amplitude normalizing the received data relating to at least one cardiac cycle comprises amplitude-normalizing data relating to a single cardiac cycle to obtain amplitude-normalized received data relating to the single cardiac cycle; and wherein calculating an area enclosed by the amplitude-normalized received data to obtain an amplitude-normalized area comprises calculating an area enclosed by the amplitude-normalized received data relating to the single cardiac cycle to obtain the amplitude-normalized area.
15. A method according to claim 6, comprising calculating an outlier area and subtracting the outlier area from the calculated area to obtain the amplitude-normalized area.
16. A non-transitory computer-readable medium according to claim 9, wherein the instructions when executed cause electronic device to: calculate an outlier area and subtract the outlier area from the calculated area to obtain the amplitude-normalized area.
17. Apparatus according to claim 13, wherein the processor is used for calculating an outlier area and subtracting the outlier area from the calculated area to obtain the amplitude-normalized area.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) Embodiments of the invention are disclosed hereinafter with reference to the accompanying drawings, in which:
(2)
(3)
(4)
(5)
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DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
(12)
(13) The transmission module 116 of the optical measurement device 110 is arranged to communicate wirelessly/non-wirelessly with a telecommunications device 120 such as a mobile phone or other portable electronic devices. The telecommunications device 120, which is included as the apparatus 100, includes a receiving module 122 for receiving signals from the optical measurement device 110, a calculation module 124 (which may be in the form of a processor) and a display unit 126 for displaying a result or information to a user of the apparatus 100. Of course, the receiver 122 is configured to receive the signals from the optical measurement device 110 wired/wirelessly, depending on the corresponding setup of the transmission module 116 of the optical measurement device 110.
(14)
(15) A brief overview of steps of the method (of
(16) The above mentioned steps 202-210 of the method in
(17) 1. Step 202 of the Method
(18) At step 202, signal acquisition is performed by the optical measurement device 110 using the signal sensing module 112 to obtain the bio-signal from the subject 102 and as already mentioned, the bio-signal is the arterial PPG waveform signal 300 (hereinafter “PPG signal” for brevity) shown in
(19) 2. Step 204 of the Method
(20) The acquired PPG signal 300 is next passed to the data processing module 114 for processing at step 204. The data processing module 114 may include a predefined digital band pass filter (not shown) for filtering any noise and signal artifacts present in the acquired PPG signal 300 to thereby provide a filtered PPG signal (not shown). In this case, reference to the filtered PPG signal will instead be made to
(21) 3. Step 206 of the Method
(22) At step 206, the data processing module 114 calculates a normalized area of at least one cardiac cycle, although this does not preclude usage of a plurality of cardiac cycles (to be explained below). In this embodiment, the data processing module 114 is configured to calculate an area of a (selected) cardiac cycle 402 (i.e. with reference to
(23) As an example illustration,
(24) That is, the PPG signal (e.g. the filtered PPG signal 400) is first normalized prior to calculating a graphical area enclosed by the normalized PPG signal to obtain an associated normalized area—i.e. data (or bio-signal) relating to at least one cardiac cycle (of the bio-signal) is normalized, and then a graphical area enclosed by the normalized data (or bio-signal) is calculated accordingly to arrive at the normalized area.
(25)
(26) To further enhance an overall accuracy of the measurement result, the data processing module 114 may also be configured to additionally perform a further outlier filtering process to identify and remove outlier normalized areas that are affected by any noise and signal artifacts. Specifically, statistical operations such as calculating the mean, moving average, standard deviation or combinations thereof, may be used by the data processing module 114 to define outlier normalized areas. In an example, normalized areas not within one standard deviation (sigma) derived from all the normalized areas in a measurement window are classified as outliers and will be removed from subsequent calculations.
(27) As above mentioned, it is possible to further enhance the accuracy of the normalized area by determining an average normalized area based on a number of cardiac cycles of the PPG signal 400, instead of using one cardiac cycle. In this case, the average normalized area is subsequently to be used as the normalized area. Specifically, an average normalized area A is calculated based on all the non-outlier normalized areas according to equation (1):
A=Sum of all non-outlier areas/No. of non-outlier areas (1)
(28) That is, an associated area enclosed by each of the cardiac cycles is calculated, and then the average normalized area based on all the calculated associated areas is obtained as the normalized area.
(29) 4. Step 208 of the Method
(30) At step 208, the data processing module 114 calculates the heart rate (of the subject 102) within the measurement window using equation (2):
HR.sub.n=60/(TP.sub.n+1−TP.sub.n), n≥1 (2)
in which TP.sub.n+1 is the time at systolic peak P.sub.n+1, and TP.sub.n is the time at systolic peak P.sub.n. So from equation (2), it is to be appreciated that at least a pair of cardiac cycles that are arranged consecutively together is required for calculation of the heart rate, but is not to be construed as limiting since a number of cardiac cycles of the PPG signal 400 may also be used to improve the accuracy of the heart rate computed. Also, it is to be appreciated that the said systolic peak P.sub.n+1, and systolic peak P.sub.n are consecutively arranged systolic peaks of the at least a pair of cardiac cycles. In other words, the systolic peak P.sub.n+1 is the systolic peak of a first cardiac cycle (of the said pair of cardiac cycles), and the systolic peak P.sub.n is the systolic peak of a second cardiac cycle (of the said pair of cardiac cycles). The first and second cardiac cycles are arranged consecutively to each other.
(31) To illustrate,
(32) Likewise to step 206, a similar outlier filtering process is performed to identify and remove outlier heart rates that are affected by any noise and signal artifacts. Thereafter, an average heart rate HR is calculated based on all the non-outlier heart rates, as per equation (3):
HR=Sum of all non-outlier heart rates/No. of non-outlier heart rates (3)
(33) For completeness, for the example in
(34) That is, respective heart rates from respective pairs of the cardiac cycles that are arranged consecutively are calculated, and then an average heart rate based on all the respective heart rates is obtained as the heart rate.
(35) 5. Step 210 of the Method
(36) The calculated normalized area and heart rate are (wired/wirelessly) transmitted via the transmission module 116 of the apparatus 100 to the calculation module 124 of the telecommunications device 120 (i.e. received by the receiving module 122). The calculation module 124 calculates the mean arterial pressure (MAP) of the subject 102 based on equation (4):
log(MAP)=b+a.sub.1 log(A)+a.sub.2 log(HR) (4)
in which A is the average normalized area of an arterial waveform, HR is the average heart rate of the arterial waveform, whereas a.sub.1, a.sub.2, and b are predetermined coefficients. So equation (4) correlates the calculated average normalized area and average heart rate, each having inherent properties relating to hemodynamic state and cardiovascular functions of the subject 102, to determine the subject's mean arterial pressure.
(37) Of course, it will be appreciated that since the present embodiment is described with reference to the arterial PPG waveform signal 300 (in
(38) The predetermined coefficients, a.sub.1, a.sub.2, and b, in equation (4) are obtained empirically, for example using actual clinical data. The clinical data collection may include collecting various different combinations and relationships between features of equation (4), i.e. the MAP, A and HR from test subjects (not shown) involved in the clinical data collection. Determination of the said coefficients, a.sub.1, a.sub.2, and b, may be performed using a separate computing device (not shown), such as a PC computer, based on any number of optimization algorithms including evolutionary methods, Bayesian statistical methods, or gradient search techniques, as required. In this embodiment, a least square optimization algorithm is used for determining the coefficients, a.sub.1, a.sub.2, and b. Once the coefficients, a.sub.1, a.sub.2, and b, are determined, equation (4) is input and stored in the calculation module 124 (of the telecommunications device 120) to be used for any calculation of mean arterial pressure of a subject, without any need for patient-specific calibration procedures.
(39)
(40) The remaining configurations will be described hereinafter. For the sake of brevity, description of like elements, functionalities and operations that are common between the different configurations are not repeated; reference will instead be made to similar parts of the relevant configuration(s).
(41) In a second embodiment, equation (4) may alternatively be replaced by equation (5) set out below:
log(MAP)=b+a.sub.1 log(X.sub.1)+a.sub.2 log(X.sub.2)+ . . . +a.sub.n−1 log(X.sub.n−1)+a.sub.n log(X.sub.n) (5)
in which X.sub.1 to X.sub.n may be values based on: any physiological features of the subject (e.g. such as heart rate, respiratory rate, heart rate variability, blood pressure, pulse pressure etc.), and/or any arterial waveform features (e.g. derived from at least one data point on the waveform, the area under the waveform, frequency value or kurtosis value of the waveform's Power Spectral Density (PSD) graph etc.) which may be derived from the bio-signal. It is to be appreciated that a.sub.1 to a.sub.n, and b of equation (5) are predetermined coefficients. In this embodiment, the step of normalizing the cardiac cycle waveform signal may be optional, depending on the type of values to be used in any of X.sub.1 to X.sub.n, since, for example, computing the frequency value/kurtosis value may not require the said normalization to be performed, while computing the area under the waveform may first require performance of the said normalization (i.e. see step 206 of the first embodiment).
(42) Moreover, further mathematical operations (e.g. addition, subtraction, multiplication, division, power functions, differentiation, integration, normalization, ratios, statistical functions etc.) may also be performed on the said derived features (either individually or in combination with other features) before application into equation (5) for calculation of the MAP.
(43) In a third embodiment, instead of comprising two separate devices, i.e. the optical measurement device 110 and telecommunication device 120, the apparatus 100 itself may be implemented as a single equivalent electronic device, in which the optical measurement device 110 and telecommunication device 120 are (hardware) integrated and configured to perform all the same functions described in the first embodiment. Further, all the steps 202-210 in the flow diagram 200 of
(44) In a fourth embodiment, all the steps 202-210 in the flow diagram 200 of
(45) In a fifth embodiment, step 210 of the method in
(46) In a sixth embodiment, a pulse pressure (PP) of the subject 102 is further obtained in the method of
SBP=MAP+⅔PP (6)
DBP=MAP−⅓PP (7)
(47) In summary, the proposed method of
(48) While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary, and not restrictive; the invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practising the claimed invention. For example, in step 206 of the method of
(49) Also, in step 208 of the method of
HR.sub.n=60/(TV.sub.n+1−TV.sub.n), n≥1 (8)
in which TV.sub.n+1 is the time at valley V.sub.n+1, and TV.sub.n is the time at valley V.sub.n.