Method and apparatus for diastolic pressure measurement

• US 4,271,843 A
• Filed: 10/10/1978
• Issued: 06/09/1981
• Est. Priority Date: 10/10/1978
• Status: Expired due to Term

• Current Assignee: George J. Flynn
• Original Assignee: George J. Flynn
• Inventors: Flynn, George J.
• Primary Examiner(s): Michell, Robert W.
• Assistant Examiner(s): Jaworski, Francis J.
• Application Number:
  US05/949,674
• Time in Patent Office: 973 Days
• Field of Search: 128/667, 128/679-684
• US Class Current: 600/494
• CPC Class Codes: A61B 5/02225 using the oscillometric method

Abstract

The rate of change in a selected portion of an arterial pressure pulse changes with applied constricting pressure, and the pattern of the change undergoes a progressive transition at a value of constricting pressure that is offset by a fixed amount below the true diastolic value. Diastolic pressure measurement based on this transition examines the rate of change of the arterial pressure pulse as the constricting pressure changes over a range of sub-diastolic values, determines the occurrence of the transition, and identifies the applied pressure at which the transition occurs. The offset pressure is added to the determined value of applied pressure to yield the desired measure of diastolic pressure.

Claims

1. A method for measuring diastolic pressure of a subject comprising the steps of

A. sensing arterial pressure signals with a pressure transducer applied non-intrusively to the subject'"'"'s body,

B. applying arterially-constricting pressure to the artery being sensed and changing the applied pressure value over a range of at least sub-diastolic values,

C. determining the minimum sub-diastolic value of applied pressure at which the rate of change of the portion of sensed signal corresponding to left ventricle ejection undergoes a progressive change in response to monodirectionally-changing applied pressure, and

D. producing a value indicative of diastolic pressure for the subject in response to said determined value of sub-diastolic applied pressure for that subject.

2. A method according to claim 1 in which said value-producing step includes the step of adding a subject-independent pressure value to said determined value of applied pressure.

3. A method according to claim 1 in which said determining step comprises the steps of

A. producing a measure of the rate of change of the portion of sensed signal corresponding to left ventricle ejection, for each of a succession of arterial pressure pulses sensed at different applied pressures,

B. producing a representation of the graph of said measures for said successive signals as a function of applied pressure,

C. identifying a progressive change in the slope of said graphical representation, and

D. identifying the applied pressure at which said progressive change occurs.

4. A method according to claim 3 in which said step of producing said measure of rate of change includes the step of filtering each sensed pressure signal for removing selected low frequency components thereof.

5. A method according to claim 3 in which said step of producing said measure of rate of change includes differentiating each sensed pressure signal as a function of time and thereby providing a derivative signal providing said measure of rate of change.

6. A method according to claim 3 including the further steps of storing information identifying each measure of rate of change and storing information identifying the corresponding value of applied pressure.

7. A method according to claim 3 in which said step of producing said measure of rate of change includes verifying each measure of rate of change signal by testing the duration thereof.

8. A method according to claim 1 in which said pressure-applying step includes

A. changing the applied pressure monodirectionally over said range of sub-diastolic values, and

B. extending said range above and below a pressure value below the expected diastolic value by an offset amount of substantially 26 millimeters of mercury for monodirectionally-increasing applied pressure, and of substantially 16 millimeters of mercury for monodirectionally-decreasing applied pressure.

9. A method according to claim 1 in which said determining step includes

A. sensing plural pressure signals at different sub-diastolic values of applied pressure,

B. producing for each sensed pressure signal a signal having a parameter which is a measure of the rate of change of the portion of the sensed signal corresponding to left ventrical ejection, and

C. determining said progressive change as a progressive change in said signal parameter as a function of applied pressure.

10. A method according to claim 1 in which said determining step includes

A. sensing plural pressure signals at different sub-diastolic values of applied pressure,

B. producing, for each sensed arterial pressure signal, a measure of the rate of change of the portion of sensed signal corresponding to left ventricle ejection,

C. producing a graphical representation of the slope of said rate of change measures as a function of applied pressure,

D. determining said progressive change as a progressive change in the slope of said graphical representation, and

E. identifying the value of applied pressure at which said change in slope occurs.

11. A method for measuring diastolic pressure of a subject with the steps of

(i) sensing arterial pressure signals with a pressure transducer applied non-intrusively to the subject'"'"'s body, and

(ii) applying arterially-constricting pressure to the artery being sensed and changing the applied pressure monodirectionally over a selected range,

said method comprising the further steps of

A. identifying the occurrence of a progressive change in the rate of change of the portion of sensed signal corresponding to left ventricle ejection at a value of applied pressure between 20 millimeters of mercury and 125 millimeters of mercury, and

B. determining the value of applied pressure at which said progressive change occurs, thereby to determine, at said value of applied pressure, a sub-diastolic pressure which is offset below the diastolic value of the subject by a known amount.

12. In apparatus for measuring diastolic pressure of a subject in response to arterial pressure signals sensed for each of a succession of arterial pulses under different values of applied arterially-constricting pressure, the combination comprising

A. means for changing the applied pressure over a range of sub-diastolic values,

B. means responsive to said sensed pressure signals and to said applied pressure for determining the minimum subdiastolic value of applied pressure at which the rate of change of the portion of sensed signal corresponding to left ventricle ejection undergoes a progressive change as a function of monodirectionally-changing applied pressure, and

C. means responsive to said determining means for producing a value indicative of diastolic pressure in response to said determined value of sub-diastolic applied pressure for that subject.

13. In apparatus according to claim 12, the further combination in which said value-producing means includes means for adding a known subject-independent pressure value to said determined applied pressure.

14. In apparatus according to claim 12, the further combination in which said means for determining comprises

A. means for producing a measure of rate of change of the portion of sensed signal corresponding to left ventricle ejection for each of a succession of arterial pressure signals sensed at different applied pressures,

B. means for producing a representation of a graph of said measures as a function of applied pressure,

C. means for identifying a progressive change in slope of the graphical representation in response to a monodirectionally-changing sub-diastolic applied pressure, and

D. means for identifying the value of applied pressure at which said progressive change occurred.

15. In apparatus according to claim 14, the further combination in which said means for producing a measure includes means for filtering each sensed pressure signal for removing selected low frequency components thereof.

16. In apparatus according to claim 14, the further combination in which said means for producing a measure includes means for differentiating each sensed pressure signal as a function of time and thereby producing a derivative signal providing said measure of rate of change.

17. In apparatus according to claim 14, the further combination of means for storing information identifying each measure of rate of change and means for storing information identifying the value of applied pressure corresponding with each such measure.

18. In apparatus according to claim 14, the further combination in which said means for producing a measure includes timing verification means for verifying each measure of rate of change signal by testing the duration thereof.

19. In apparatus according to claim 12, the further combination in which said pressure-changing means includes means for changing the applied pressure monodirectionally over a range of sub-diastolic pressure values extending above and below a pressure value below the expected diastolic value of the subject by an offset amount of approximately 26 millimeters of mercury for a monodirectionally increasing applied pressure and of substantially 16 millimeters of mercury for monodirectionally decreasing applied pressure.

20. In apparatus according to claim 12 the further combination in which said means responsive to signals includes

A. means for sensing plural pressure signals at different sub-diastolic values of applied pressure,

B. means for producing for each sensed pressure signal a signal having a parameter which is a measure of the rate of change of the portion of the sensed signal corresponding to left ventricle ejection, and

C. means for determining said progressive change as a progressive change in said signal parameter as a function of applied pressure.

21. In apparatus according to claim 12, the further combination in which said means responsive to sensed signals comprises

A. means for sensing plural pressure signals at different sub-diastolic values of applied pressure,

B. means for producing, for each sensed arterial pressure signal, a measure of the rate of change of the portion of sensed signal corresponding to left ventricle ejection,

C. means for producing a graphical representation of the slope of said rate of change measures as a function of applied pressure,

D. means for determining said progressive change as a progressive change in the slope of said graphical representation, and

E. means for identifying the value of applied pressure at which said change in slope occurs.

22. In apparatus for measuring diastolic pressure of a subject in response to arterial pressure signals sensed with a pressure transducer applied non-intrusively to the subject'"'"'s body for each of a succession of arterial pulses produced under different values of applied arterially-constricting pressure and having means for applying arterially-constricting pressure to the artery being sensed and for changing the applied pressure monodirectionally over a selected range, the further combination comprising

A. means for identifying the occurrence of a progressive change in the rate of change of the portion of sensed signal corresponding to left ventricle ejection at a value of applied pressure between 20 millimeters of mercury and 125 millimeters of mercury, and

B. means for determining the applied pressure at which said identified progressive change occurs, thereby for determining a sub-diastolic pressure which is offset below the diastolic value of the subject by a known amount.