System for Cardiac Pathology Detection and Characterization

• US 20100280396A1
• Filed: 04/28/2010
• Published: 11/04/2010
• Est. Priority Date: 05/04/2009
• Status: Active Grant

• Current Assignee: Siemens Healthineers AG (Siemens AG)
• Original Assignee: Siemens Medical Solutions USA Incorporated (Siemens AG)
• Inventors: Zhang, Hongxuan
• Granted Patent: US 8,388,542 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 5/02116 of pulse wave amplitude A61B5/02225 takes precedence
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7289 Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition

Abstract

A system for heart performance characterization and abnormality detection includes an interface for receiving an electrical signal comprising a pressure indicative waveform indicating a heart blood pressure of a patient over a heart beat cycle. A timing detector determines multiple different time periods in at least one heart cycle from the pressure indicative waveform. A patient monitor monitors the multiple different time periods and in response to detection of a variation in at least one of the multiple different time periods exceeding a predetermined threshold or range, generates an alert message associated with the variation.

Claims

1. A system for heart performance characterization and abnormality detection, comprising:

an interface for receiving an electrical signal comprising a pressure indicative waveform indicating a heart blood pressure of a patient over a heart beat cycle;

a timing detector for determining a plurality of different time periods in at least one heart cycle of the pressure indicative waveform, said plurality of different time periods comprising at least two of

(a) a time interval T1 substantially between successive peaks in the pressure indicative waveform,

(b) a time interval T2 substantially comprising a duration of a Systolic period,

(c) a time interval T3 substantially comprising a duration of a Diastolic period and

(d) a time interval T4 substantially between a pressure peak and a successive end of Systolic point; and

a patient monitor for monitoring said plurality of different time periods and in response to detection of a variation in at least one of said plurality of different time periods exceeding a predetermined threshold or range, generating an alert message associated with said variation.

2. A system according to claim 1, wherein

said patient monitor monitors a plurality of different ratios derived using said plurality of different time periods and in response to a ratio or a variation in a ratio exceeding a predetermined threshold, generates an alert message associated with the ratio.

3. A system according to claim 2, wherein

said patient monitor substantially continuously monitors said plurality of different ratios for at least a 24 hour period.

4. A system according to claim 2, wherein

said patient monitor uses predetermined mapping information, associating ranges of said different ratios with corresponding medical conditions, in comparing a ratio with said ranges and generates an alert message indicating a potential medical condition.

5. A system according to claim 4, wherein

said predetermined mapping information associates ranges of said different ratios with particular patient demographic characteristics and with corresponding medical conditions and said patient monitor uses patient demographic data including at least one of, age weight, gender and height in comparing a ratio with said ranges and generating an alert message indicating a potential medical condition.

6. A system according to claim 1, wherein

said patient monitor substantially continuously monitors said plurality of different time periods for at least a 24 hour period.

7. A system according to claim 1, wherein

said plurality of different time periods include a time interval T5 substantially between a pressure minimum point and a successive end of Diastolic point.

8. A system according to claim 1, wherein

said electrical signal comprises at least one of, (a) digital data representing said pressure indicative waveform and (b) an analog pressure indicative waveform and

said electrical signal is acquired at a particular anatomical location.

9. A system according to claim 1, wherein

said patient monitor uses predetermined mapping information, associating ranges of said plurality of different time periods with corresponding medical conditions, in comparing a time period with said ranges and generates an alert message indicating a potential medical condition.

10. A system according to claim 9, wherein

said predetermined mapping information associates ranges of said different time periods with particular patient demographic characteristics and with corresponding medical conditions and said patient monitor uses patient demographic data including at least one of, age weight, gender and height in comparing a time period with said ranges and generating an alert message indicating a potential medical condition.

11. A system according to claim 1, including

an amplitude processor for determining a plurality of different amplitude characteristics in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different amplitude characteristics substantially comprising at least one of,

(i) an amplitude of said pressure indicative waveform occurring in time interval T1, T2, T3 or T4,

(ii) an amplitude of said pressure indicative waveform occurring at an end-Diastolic point and

(iii) an amplitude of said pressure indicative waveform occurring at an end-systolic point, and

said patient monitor monitors said plurality of different amplitude characteristics and in response to detection of an amplitude characteristic exceeding a predetermined threshold, generates an alert message associated with the detected amplitude characteristic.

12. A system according to claim 1, including

a frequency processor for determining a plurality of different frequency characteristics in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different frequency characteristics substantially comprising at least one of,

(i) a frequency of a frequency component of said pressure indicative waveform occurring in time interval T1, T2, T3 or T4,

(ii) a ratio of frequencies of frequency components of said pressure indicative waveform occurring in time intervals T1, T2, T3 or T4;

and

said patient monitor monitors said plurality of different frequency characteristics and in response to detection of a frequency characteristic exceeding a predetermined threshold, generates an alert message associated with the detected frequency characteristic.

13. A system according to claim 1, including

a blood volume processor for determining a plurality of different blood volume characteristics occurring in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different blood volume characteristics substantially comprising at least two of

(i) a blood volume characteristic occurring in time interval T1, T2, T3 or T4 of said pressure indicative waveform and

(ii) a ratio of blood volumes occurring in a vessel or chamber in time intervals T1, T2, T3 or T4 of said pressure indicative waveform;

and

said patient monitor monitors said plurality of different blood volume characteristics and in response to detection of an blood volume characteristic exceeding a predetermined threshold, generates an alert message associated with the detected blood volume characteristic.

14. A system for heart performance characterization and abnormality detection, comprising:

an amplitude processor for determining a plurality of different amplitude characteristics in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different amplitude characteristics substantially comprising at least two of,

(i) an amplitude of said pressure indicative waveform occurring in time interval T1, T2, T3 or T4,

(ii) a ratio of amplitudes of said pressure indicative waveform occurring in time intervals T1, T2, T3 or T4,

(iii) an amplitude of said pressure indicative waveform occurring at an end-Diastolic point and

(iv) an amplitude of said pressure indicative waveform occurring at an end-systolic point; and

said patient monitor monitors said plurality of different amplitude characteristics and in response to detection of an amplitude characteristic exceeding a predetermined threshold, generating an alert message associated with the detected amplitude characteristic.

15. A system according to claim 14, wherein

said amplitude processor determines a mean of at least one of said plurality of different amplitude characteristics and

said patient monitor monitors said mean and in response to detection of said mean exceeding a predetermined threshold, generates an alert message associated with the detected mean.

16. A system according to claim 14, wherein

said amplitude processor determines a standard deviation or variance of at least one of said plurality of different amplitude characteristics and

said patient monitor monitors said standard deviation or variance and in response to detection of said standard deviation or variance exceeding a predetermined threshold, generates an alert message associated with the detected standard deviation or variance.

17. A system according to claim 14, wherein

T1 is substantially a time interval between successive peaks in the pressure indicative waveform,

T2 is substantially a time interval comprising a duration of a Systolic period,

T3 is substantially a time interval comprising a duration of a Diastolic period and

T4 is substantially a time interval between a pressure peak and a successive end of Systolic point.

18. A system for heart performance characterization and abnormality detection, comprising:

a frequency processor for determining a plurality of different frequency characteristics in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different frequency characteristics substantially comprising at least one of,

(i) a frequency of a frequency component of said pressure indicative waveform occurring in time interval T1, T2, T3 or T4,

(ii) a ratio of frequencies of frequency components of said pressure indicative waveform occurring in time intervals T1, T2, T3 or T4; and

said patient monitor monitors said plurality of different frequency characteristics and in response to detection of a frequency characteristic exceeding a predetermined threshold, generating an alert message associated with the detected frequency characteristic.

19. A system according to claim 18, wherein

a frequency of a frequency component is a peak frequency.

20. A system according to claim 18, wherein

a frequency of a frequency component is a mean frequency.

21. A system according to claim 18, wherein

a frequency of a frequency component is a minimum frequency.

22. A system according to claim 18, wherein

said frequency processor determines a mean of at least one of said plurality of different frequency characteristics and

said patient monitor monitors said mean and in response to detection of said mean exceeding a predetermined threshold, generates an alert message associated with the detected mean.

23. A system according to claim 18, wherein

said frequency processor determines a standard deviation or variance of at least one of said plurality of different frequency characteristics and

said patient monitor monitors said standard deviation or variance and in response to detection of said standard deviation or variance exceeding a predetermined threshold, generates an alert message associated with the detected standard deviation or variance.

24. A system for heart performance characterization and abnormality detection, comprising:

a blood volume processor for determining a plurality of different blood volume characteristics occurring in at least one heart cycle of a heart blood pressure indicative waveform, said plurality of different blood volume characteristics substantially comprising at least two of

(i) a blood volume characteristic occurring in time interval T1, T2, T3 or T4 of said pressure indicative waveform and

(ii) a ratio of blood volumes occurring in a vessel or chamber in time intervals T1, T2, T3 or T4 of said pressure indicative waveform; and

a patient monitor for monitoring said plurality of different blood volume characteristics and in response to detection of an blood volume characteristic exceeding a predetermined threshold, generating an alert message associated with the detected blood volume characteristic.

25. A system according to claim 24, wherein

said blood volume processor determines a mean of at least one of said plurality of different blood volume characteristics and

said patient monitor monitors said mean and in response to detection of said mean exceeding a predetermined threshold, generates an alert message associated with the detected mean.

26. A system according to claim 24, wherein

said blood volume processor determines a standard deviation or variance of at least one of said plurality of different blood volume characteristics and

said patient monitor monitors said standard deviation or variance and in response to detection of said standard deviation or variance exceeding a predetermined threshold, generates an alert message associated with the detected standard deviation or variance.