Noninvasive apparatus and method for estimating blood pressure

• US 20080027333A1
• Filed: 07/30/2007
• Published: 01/31/2008
• Est. Priority Date: 08/03/2005
• Status: Active Grant

• Current Assignee: Luca Longhini
• Original Assignee: Brendan Investments Ltd. BVI
• Inventors: Peretto, Lorenzo
• Granted Patent: US 8,585,603 B2
• Time in Patent Office: Days
• US Class Current: 600/485
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R

Abstract

Methods and apparatus for noninvasively estimating a blood pressure are provided. A target interval is determined from a diastolic signal such that the target interval includes an S2 component. The S2 component is extracted from the diastolic signal using the target interval and is analyzed in the target interval to obtain a number of oscillations in the S2 component. A predetermined relationship between the number of oscillations in the S2 component and blood pressure is used to generate a blood pressure estimate.

Claims

1. A method for noninvasively estimating a blood pressure, the method comprising:

a) extracting a diastolic signal from a phonocardiogram (PCG) signal;

b) determining a target interval from the diastolic signal such that the target interval of the diastolic signal includes an S2 component;

c) extracting the S2 component from the diastolic signal using the target interval;

d) analyzing the extracted S2 component in the target interval to obtain a number of oscillations in the extracted S2 component;

e) applying a predetermined relationship between the obtained number of oscillations and blood pressure to generate a blood pressure estimate; and

f) displaying the blood pressure estimate.

2. The method according to claim 1, wherein step (b) includes the steps of:

integrating a portion of the diastolic signal within an integration window to determine a first integration value, the integration window including at least the S2 component;

adjusting an onset time of the integration window to determine a second integration value, the onset time being adjusted until a decrease in the second integration value relative to the first integration value is greater than or equal to an onset threshold; and

separately adjusting an end time of the integration window to determine a third integration value, the end time being adjusted until a decrease in the third integration value relative to the first integration value is greater than or equal to an end threshold,

wherein the adjusted onset time and the adjusted end time are used to define the target interval.

3. The method according to claim 2, wherein the integration window includes a number of integration windows and the method includes the steps of, prior to the step of integrating the portion of the diastolic signal:

integrating corresponding portions of the diastolic signal within each of the number of integration windows to determine a number of respective integration values; and

selecting the integration window having a largest integration value from among the number of integration windows.

4. The method according to claim 2, wherein the integration window is between about 100-150 ms.

5. The method according to claim 2, wherein each of the onset threshold and the end threshold are between about 5-20%.

6. The method according to claim 1, wherein the blood pressure includes a pulmonary artery pressure (PAP) and step (e) includes applying the predetermined relationship between the obtained number of oscillations and PAP to generate a PAP estimate.

7. The method according to claim 1, wherein step (d) includes normalizing the number of oscillations in the target interval relative to a fixed time interval and step (e) includes applying the predetermined relationship between the normalized number of oscillations and the blood pressure to generate the blood pressure estimate.

8. The method according to claim 1, wherein step (d) includes determining the number of oscillations using a derivative with respect to time of the S2 component.

9. A physical computer-readable carrier including computer program instructions that cause a computer to perform the method according to claim 1.

10. The method according to claim 1, wherein the diastolic signal includes a plurality of diastolic signals and the blood pressure estimate is generated according to the plurality of S2 components of the respective plurality of diastolic signals.

11. The method according to claim 10, further including the step of determining a confidence interval measure associated with the blood pressure estimate.

12. The method according to claim 10, further including the steps of:

repeating steps (b)-(e) over the plurality of diastolic signals to generate a corresponding plurality of blood pressure estimates; and

determining a median of the plurality of blood pressure estimates to generate an average blood pressure estimate.

13. The method according to claim 10, wherein step (a) includes the step of:

determining a mean diastolic signal from the plurality of diastolic signals,

wherein steps (b)-(e) are performed using the mean diastolic signal.

14. The method according to claim 1, wherein step (a) includes the steps of:

synchronously receiving the PCG signal and an electrocardiogram (ECG) signal; and

extracting the diastolic signal from the received PCG signal using the received ECG signal.

15. The method according to claim 14, further including the step of determining a confidence interval measure associated with the blood pressure estimate.

16. The method according to claim 15, further including the step of storing at least one of the received PCG signal, the received ECG signal, the extracted diastolic signal, the target interval, the extracted S2 component, the confidence interval measure and the blood pressure estimate.

17. The method according to claim 15, wherein step (f) includes presenting, on a display device, the blood pressure estimate and at least one of the received PCG signal, the received ECG signal, the extracted diastolic signal, the target interval, the extracted S2 component and the confidence interval measure.

18. Apparatus for noninvasively estimating a blood pressure, the apparatus comprising:

means for obtaining a diastolic signal from a phonocardiogram (PCG) signal;

means for determining a target interval from the diastolic signal such that the target interval of the diastolic signal includes an S2 component;

means for extracting the S2 component from the diastolic signal using the target interval;

means for analyzing the extracted S2 component in the target interval to obtain a number of oscillations in the extracted S2 component;

means for applying a predetermined relationship between the obtained number of oscillations and blood pressure to generate a blood pressure estimate; and

means for displaying the blood pressure estimate.

19. Apparatus according to claim 18, wherein the blood pressure includes a pulmonary artery pressure (PAP) and the means for applying the predetermined relationship includes means for applying the predetermined relationship between the obtained number of oscillations and the PAP to generate a PAP estimate.

20. Apparatus according to claim 18, the apparatus further comprising:

means for receiving the PCG signal; and

means for extracting the diastolic signal from the received PCG signal,

wherein the means for determining the target interval includes means for determining the target interval from the extracted diastolic signal and the means for extracting the S2 component includes means for extracting the S2 component from the extracted diastolic signal.

21. Apparatus according to claim 18, wherein the means for analyzing normalizes the number of oscillations in the target interval relative to a fixed time interval and the means for applying the predetermined relationship applies the predetermined relationship between the normalized number of oscillations and the blood pressure to generate the blood pressure estimate

22. A blood pressure analyzer for noninvasively estimating a blood pressure, the blood pressure analyzer comprising:

a target interval estimator configured to determine a target interval from a diastolic signal such that the target interval includes an S2 component;

a memory configured to store at least the S2 component that is extracted from the diastolic signal using the target interval;

an S2 component oscillation calculator configured to obtain a number of oscillations in the extracted S2 component using the target interval;

a blood pressure estimator configured to apply a predetermined relationship between blood pressure and the number of oscillations obtained by the S2 component oscillation calculator to generate a blood pressure estimate; and

an output port configured to provide the blood pressure estimate and at least one of the diastolic signal, the target interval and the extracted S2 component.

23. The blood pressure analyzer according to claim 22, wherein the blood pressure includes a pulmonary artery pressure (PAP) and the blood pressure estimator is configured to generate a PAP estimate by applying the predetermined relationship between the PAP and the obtained number of oscillations.

24. The blood pressure analyzer according to claim 22, the blood pressure analyzer further comprising:

an input port for receiving a phonocardiogram (PCG) signal;

a diastolic signal extractor coupled to the input port, the diastolic signal extractor configured to extract the diastolic signal from the PCG signal; and

an S2 component extractor configured to extract the S2 component from the extracted diastolic signal using the target interval received from the target interval estimator,

wherein the S2 component oscillation calculator is configured to obtain the number of oscillations in the extracted S2 component from the extracted diastolic signal and to normalize the number of oscillations in the target interval relative to a fixed target interval, and

the blood pressure estimator is configured to apply the predetermined relationship between blood pressure and the normalized number of oscillations received from the S2 component oscillation calculator.

25. The blood pressure analyzer according to claim 24, the blood pressure analyzer further comprising:

an S2 time derivative estimator configured to receive the extracted S2 component from the S2 component extractor and to estimate the time derivative of the extracted S2 component,

wherein the S2 component oscillation calculator is configured to obtain the number of oscillations using the time derivative of the extracted S2 component received from the S2 time derivative estimator.

26. The blood pressure analyzer according to claim 24, the input port further configured to receive an electrocardiogram (ECG) signal corresponding to the PCG signal,

wherein the diastolic signal extractor is configured to extract the diastolic signal using the corresponding ECG signal.

27. The blood pressure analyzer according to claim 26, wherein the memory further stores at least one of the received PCG signal, the received ECG signal, the extracted diastolic signal, the target interval and the blood pressure estimate.

28. The blood pressure analyzer according to claim 24, wherein:

the PCG signal includes a plurality of PCG signals,

the input port receives the plurality of PCG signals, and

the blood pressure analyzer generates the blood pressure estimate according to the plurality of PCG signals received from the input port.

29. The blood pressure analyzer according to claim 28, further comprising a confidence interval evaluator configured to evaluate a confidence interval measure associated with the blood pressure estimate receive dorm the blood pressure estimator.

30. The blood pressure analyzer according to claim 28, wherein the diastolic signal extractor extracts a corresponding plurality of diastolic signals from the plurality of PCG signals and the blood pressure analyzer further comprises a mean diastolic signal estimator configured to estimate a mean diastolic signal from the plurality of extracted diastolic signals,

wherein the target interval estimator uses the mean diastolic signal to determine the target interval and the S2 component extractor uses the mean diastolic signal to extract the S2 component.