Apparatus for evaluating cardiac function of living subject

• US 5,772,601 A
• Filed: 08/26/1996
• Issued: 06/30/1998
• Est. Priority Date: 08/26/1996
• Status: Expired due to Fees

• Current Assignee: Omron Healthcare Company Limited (Omron Corporation)
• Original Assignee: Colin Corporation (Fukuda Denshi Company Limited)
• Inventors: Oka, Tohru, Tsuda, Hideichi
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US08/703,360
• Time in Patent Office: 673 Days
• Field of Search: 128/670, 128/700, 128/680
• US Class Current: 600/495
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• 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 5/02208 using the Korotkoff method
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/0225 the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
• CPC Class Codes: A61B 5/0285 Measuring or recording phase velocity of blood waves
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence

Abstract

An apparatus for evaluating a blood-ejecting function of a heart of a living subject, including a pressure pulse wave sensor which is adapted to be worn on a body portion of the subject to detect a pressure pulse wave which is produced from an artery of the subject in synchronism with a heartbeat of the subject, a first determining device for determining a first value of an index corresponding to a systolic area which is defined by a waveform of a first heartbeat-synchronous pulse of the pressure pulse wave detected by the pressure pulse wave sensor before the subject undergoes a physical exercise, a second determining device for determining a second value of the index corresponding to a systolic area which is defined by a waveform of a second heartbeat-synchronous pulse of the pressure pulse wave detected by the pressure pulse wave sensor after the subject undergoes the physical exercise, and an evaluating device for evaluating the blood-ejecting function of the heart of the subject, based on the determined first and second values of the index.

Claims

1. An apparatus for providing physical information relating to a blood-ejecting function of a heart of a living subject, comprising:

a pressure pulse wave sensor which is adapted to be worn on a body portion of the subject to detect a pressure pulse wave produced from an artery of the subject in synchronism with a heartbeat of the subject;

first determining means for determining a first value of an index corresponding to a systolic area which is defined by a waveform of a first heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor before the subject undergoes a physical exercise;

second determining means for determining a second value of said index corresponding to a systolic area which is defined by a waveform of a second heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor after the subject undergoes said physical exercise; and

a display device which displays, as said physical information, the determined first and second values of said index in comparison with each other, so that an observer evaluates the blood-ejecting function of the heart of the subject based on said determined first and second values of the index displayed by said display device.

2. An apparatus according to claim 1, further comprising evaluating means for evaluating said blood-ejecting function of the heart of the subject, based on said determined first and second values of the index, and wherein said display device displays information indicative of a result of evaluation of the blood-ejecting function by said evaluating means.

3. An apparatus according to claim 1, further comprising:

a blood pressure measuring device which measures a blood pressure of the subject, said blood pressure measuring device including an inflatable cuff which is adapted to be worn on the subject; and

calibrating means for determining a first relationship between blood pressure and magnitude of said pressure pulse wave, based on at least one magnitude of at least one heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor before the subject undergoes said physical exercise, and at least one blood pressure value of the subject measured by said blood pressure measuring device before the subject undergoes said physical exercise, and determining a second relationship between blood pressure and magnitude of said pressure pulse wave, based on at least one magnitude of at least one heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor after the subject undergoes said physical exercise, and at least one blood pressure value of the subject measured by said blood pressure measuring device after the subject undergoes said physical exercise, said calibrating means calibrating, according to said first relationship, said waveform of said first heartbeat-synchronous pulse and calibrating, according to said second relationship, said waveform of said second heartbeat-synchronous pulse, wherein said first determining means determines said first value of the index corresponding to said systolic area defined by the calibrated waveform of said first heartbeat-synchronous pulse, and said second determining means determines said second value of the index corresponding to said systolic area defined by the calibrated waveform of said second heartbeat-synchronous pulse.

4. An apparatus according to claim 1, further comprising a blood-pressure measuring device comprising:

an inflatable cuff which is adapted to be worn on the subject;

a distal and a proximal microphone which are provided at a distal and a proximal position on said cuff worn on the subject, respectively, and which detect a plurality of distal arterial sounds at said distal position and a plurality of proximal arterial sounds at said proximal position, respectively, while a pressure in said cuff is changed;

delay-time determining means for determining a delay time of a time of detection of each of said distal arterial sounds detected by said distal microphone, from a time of detection of a corresponding one of said proximal arterial sounds detected by said proximal microphone;

curve providing means for determining a product of each of respective magnitudes of said distal arterial sounds and a corresponding one of the respective delay times of the distal arterial sounds, and providing a curve by connecting the respective determined products with one another along an axis indicative of said pressure of said cuff; and

blood-pressure determining means for determining a blood pressure of the subject based on the curve provided by said curve providing means.

5. An apparatus for evaluating a blood-ejecting function of a heart of a living subject, comprising:

a pressure pulse wave sensor which is adapted to be worn on a body portion of the subject to detect a pressure pulse wave which is produced from an artery of the subject in synchronism with a heartbeat of the subject;

first determining means for determining a first value of an index corresponding to a systolic area which is defined by a waveform of a first heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor before the subject undergoes a physical exercise;

second determining means for determining a second value of said index corresponding to a systolic area which is defined by a waveform of a second heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor after the subject undergoes said physical exercise; and

evaluating means for evaluating said blood-ejecting function of the heart of the subject, based on the determined first and second values of said index.

6. An apparatus according to claim 5, wherein said evaluating means comprises first means for evaluating said blood-ejecting function of the heart of the subject, based on at least one of an amount of change of said determined second value from said determined first value and a rate of change of the determined second value from the determined first value.

7. An apparatus according to claim 6, wherein said first means of said evaluating means comprises judging means for judging whether said blood-ejecting function of the heart of the subject is normal, by comparing said one of said amount of change and said rate of change with a corresponding one of a first reference value and a second reference value.

8. An apparatus according to claim 5, wherein said second determining means comprises means for determining a plurality of said second values of the index each of which corresponds to a systolic area defined by a waveform of a corresponding one of a plurality of said second heartbeat-synchronous pulses of the pressure pulse wave detected by said pressure pulse wave sensor after the subject undergoes said physical exercise, and wherein said evaluating means comprises second means for evaluating said blood-ejecting function of the heart of the subject, based on at least one of a time of recovering of the determined second values back to a value substantially equal to said determined first value and a rate of recovering of said determined second values back to a value substantially equal to the determined first value.

9. An apparatus according to claim 8, wherein said second means of said evaluating means comprises judging means for judging whether said blood-ejecting function of the heart of the subject is normal, by comparing said one of said time of recovering and said rate of recovering with a corresponding one of a third reference value and a fourth reference value.

10. An apparatus according to claim 5, further comprising converting means for converting said waveform of each of said first and second heartbeat-synchronous pulses, to a converted waveform, according to a predetermined mathematical transfer function defining a relationship between a waveform of a heartbeat-synchronous pulse of a pulse wave detected in an aorta of the subject and a waveform of a corresponding heartbeat-synchronous pulse of a pulse wave detected from said artery of said body portion of the subject, wherein said first determining means determines said first value of the index corresponding to said systolic area defined by said converted waveform of said first heartbeat-synchronous pulse, and said second determining means determines said second value of the index corresponding to said systolic area defined by said converted waveform of said second heartbeat-synchronous pulse.

11. An apparatus according to claim 5, further comprising:

a blood pressure measuring device which measures a blood pressure of the subject, said blood pressure measuring device including an inflatable cuff which is adapted to be worn on the subject; and

calibrating means for determining a first relationship between blood pressure and magnitude of said pressure pulse wave, based on at least one magnitude of at least one heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor before the subject undergoes said physical exercise, and at least one blood pressure value of the subject measured by said blood pressure measuring device before the subject undergoes said physical exercise, and determining a second relationship between blood pressure and magnitude of said pressure pulse wave, based on at least one magnitude of at least one heartbeat-synchronous pulse of the pressure pulse wave detected by said pressure pulse wave sensor after the subject undergoes said physical exercise, and at least one blood pressure value of the subject measured by said blood pressure measuring device after the subject undergoes said physical exercise, said calibrating means calibrating, according to said first relationship, said waveform of said first heartbeat-synchronous pulse and calibrating, according to said second relationship, said waveform of said second heartbeat-synchronous pulse, wherein said first determining means determines said first value of the index corresponding to said systolic area defined by the calibrated waveform of said first heartbeat-synchronous pulse, and said second determining means determines said second value of the index corresponding to said systolic area defined by the calibrated waveform of said second heartbeat-synchronous pulse.

12. An apparatus according to claim 5, further comprising a blood-pressure measuring device comprising:

an inflatable cuff which is adapted to be worn on the subject;

a distal and a proximal microphone which are provided at a distal and a proximal position on said cuff worn on the subject, respectively, and which detect a plurality of distal arterial sounds at said distal position and a plurality of proximal arterial sounds at said proximal position, respectively, while a pressure in said cuff is changed;

delay-time determining means for determining a delay time of a time of detection of each of said distal arterial sounds detected by said distal microphone, from a time of detection of a corresponding one of said proximal arterial sounds detected by said proximal microphone;

curve providing means for determining a product of each of respective magnitudes of said distal arterial sounds and a corresponding one of the respective delay times of the distal arterial sounds, and providing a curve by connecting the respective determined products with one another along an axis indicative of said pressure of said cuff; and

blood-pressure determining means for determining a blood pressure of the subject based on the curve provided by said curve providing means.

13. An apparatus for providing physical information relating to a myocardial ischemia of a heart of a living subject, comprising:

a continuous blood-pressure measuring device which continuously measures a blood pressure of the subject, thereby providing continuously measured blood-pressure values of the subject;

first frequency-analysis means for analyzing respective frequencies of a plurality of blood-pressure fluctuating components occurring in said continuously measured blood-pressure values, thereby providing a frequency spectrum of said blood-pressure fluctuating components, said first frequency-analysis means extracting, from said continuously measured blood-pressure values, a first one of said blood-pressure fluctuating components which has a frequency lower than a frequency of a second one of said blood-pressure fluctuating components which corresponds to a respiration of the subject; and

a display device which displays, as said physical information, at least one of (a1) the first blood-pressure fluctuating component extracted from the continuously measured blood pressure values provided by said blood-pressure measuring device before the subject undergoes a physical exercise and (a2) a first value of an index derived from the first blood-pressure fluctuating component obtained before the exercise, and at least one of (b1) the first blood-pressure fluctuating component extracted from the continuously measured blood pressure values provided by said blood-pressure measuring device after the subject undergoes said physical exercise and (b2) a second value of said index derived from the first blood-pressure fluctuating component obtained after the exercise, in comparison with each other, so that an observer evaluates the myocardial ischemia of the heart of the subject based on said one of said first blood-pressure fluctuating component obtained before said exercise and said first value of the index and said one of said first blood-pressure fluctuating component obtained after said exercise and said second value of the index displayed by said display device.

14. An apparatus according to claim 13, further comprising:

a continuous pulse-interval measuring device which continuously measures a time interval between successive two heartbeat-synchronous pulses of a pulse wave of the subject, thereby providing continuously measured pulse-interval values of the subject;

second frequency-analysis means for analyzing respective frequencies of a plurality of pulse-interval fluctuating components occurring in said continuously measured pulse-interval values, thereby providing a frequency spectrum of said pulse-interval fluctuating components, said second frequency-analysis means extracting, from said continuously measured pulse-interval values, one of said pulse-interval fluctuating components which has a frequency substantially equal to the frequency of said second blood-pressure fluctuating component which corresponds to the respiration of the subject; and

means for determining, as said first value of the index, a ratio of a magnitude of the first blood-pressure fluctuating component to a magnitude of the one pulse-interval fluctuating component both of which are obtained before said exercise, and determining, as said second value of the index, a ratio of a magnitude of the first blood-pressure fluctuating component to a magnitude of the one pulse-interval fluctuating component both of which are obtained after said exercise.

15. An apparatus according to claim 14, wherein said first frequency-analysis means comprises means for producing a signal representing said first blood-pressure fluctuating component, and said second frequency-analysis means comprises means for producing a signal representing said one pulse-interval fluctuating component.

16. An apparatus for evaluating a myocardial ischemia of a heart of a living subject, comprising:

a continuous blood-pressure measuring device which continuously measures a blood pressure of the subject, thereby providing continuously measured blood pressure values of the subject;

first frequency-analysis means for analyzing respective frequencies of a plurality of blood-pressure fluctuating components occurring in said continuously measured blood pressure values, thereby providing a frequency spectrum of said blood-pressure fluctuating components, said first frequency-analysis means extracting, from said continuously measured blood pressure values, a first one of said blood-pressure fluctuating components which has a frequency lower than a frequency of a second one of said blood-pressure fluctuating components which corresponds to a respiration of the subject; and

evaluating means for evaluating the myocardial ischemia of the subject based on at least one of (a1) the first blood-pressure fluctuating component extracted from the continuously measured blood pressure values provided by said blood-pressure measuring device before the subject undergoes a physical exercise and (a2) a first value of an index derived from the first blood-pressure fluctuating component obtained before the exercise, and at least one of (b1) the first blood-pressure fluctuating component extracted from the continuously measured blood pressure values provided by said blood-pressure measuring device after the subject undergoes said physical exercise and (b2) a second value of said index derived from the first blood-pressure fluctuating component obtained after the exercise.

17. An apparatus according to claim 16, wherein said continuous blood-pressure measuring device comprises a pressure pulse wave sensor which is adapted to be worn on a body portion of the subject to detect a pressure pulse wave which is produced from an artery of the subject in synchronism with a heartbeat of the subject, and means for continuously determining, as said continuously measured blood-pressure values, a systolic blood-pressure value of the subject based on an upper-peak magnitude of each of a plurality of heartbeat-synchronous pulses of the pressure pulse wave detected by said pressure pulse wave sensor.

18. An apparatus according to claim 16, further comprising:

a continuous pulse-interval measuring device which continuously measures a time interval between successive two heartbeat-synchronous pulses of a pulse wave of the subject, thereby providing continuously measured pulse-interval values of the subject; and

second frequency-analysis means for analyzing respective frequencies of a plurality of pulse-interval fluctuating components occurring in said continuously measured pulse-interval values, thereby providing a frequency spectrum of said pulse-interval fluctuating components, said second frequency-analysis means extracting, from said continuously measured pulse-interval values, one of said pulse-interval fluctuating components which has a frequency substantially equal to the frequency of said second blood-pressure fluctuating component which corresponds to the respiration of the subject,

wherein said evaluating means comprises means for determining, as said first value of the index, a first ratio of a magnitude of the first blood-pressure fluctuating component to a magnitude of the one pulse-interval fluctuating component both of which are obtained before the exercise, and determining, as said second value of the index, a second ratio of a magnitude of the first blood-pressure fluctuating component to a magnitude of the one pulse-interval fluctuating component both of which are obtained after the exercise.

19. An apparatus according to claim 18, wherein said first frequency-analysis means comprises means for producing a signal representing said first blood-pressure fluctuating component, and said second frequency-analysis means comprises means for producing a signal representing said one pulse-interval fluctuating component.

20. An apparatus according to claim 18, wherein said evaluating means comprises means for evaluating the myocardial ischemia by judging whether at least one of an amount of change of said second ratio from said first ratio and a rate of change of said second ratio from said first ratio is greater than a corresponding one of a first reference value and a second reference value.

21. An apparatus according to claim 18, wherein said evaluating means comprises means for determining a plurality of said second ratios after the subject undergoes said physical exercise, and evaluating the myocardial ischemia of the subject, based on at least one of a time of recovering of the determined second ratios back to a value substantially equal to said first ratio and a rate of recovering of said determined second ratios back to a value substantially equal to said determined first ratio.

22. An apparatus according to claim 18, wherein said continuous pulse-interval measuring device comprises a pressure pulse wave sensor which is adapted to be worn on a body portion of the subject to detect a pressure pulse wave which is produced from an artery of the subject in synchronism with a heartbeat of the subject, and means for continuously determining, as said continuously measured pulse-interval values, a time interval between respective upper peaks of each pair of successive two pulses of a plurality of heartbeat-synchronous pulses of the pressure pulse wave detected by said pressure pulse wave sensor.

23. An apparatus for evaluating a blood-ejecting function of a heart of a living subject, comprising:

an electrocardiograph which provides an electrocardiogram of the subject;

at least one pulse-wave sensor which is adapted to be worn on the subject to detect at least one pulse wave from the subject;

pre-ejection period determining means for determining a pre-ejection period between a Q point of a heartbeat-synchronous pulse of the electrocardiogram provided by said electrocardiograph, and a minimum point of a corresponding heartbeat-synchronous pulse of an intra-aortic pulse wave of the subject, based on a waveform of said electrocardiogram and a waveform of the pulse wave detected by said pulse-wave sensor; and

evaluating means for evaluating the blood-ejecting function of the heart of the subject based on the pre-ejection period determined by said pre-ejection period determining means.

24. An apparatus according to claim 23, wherein said pre-ejection period determining means comprises means for determining a first value of said pre-ejection period before the subject undergoes a physical exercise, and determining a second value of said pre-ejection period after the subject undergoes said physical exercise, and said evaluating means comprises means for evaluating said blood-ejecting function based on a change of said second value of said pre-ejection period relative to said first value of the pre-ejection period.

25. An apparatus according to claim 23, wherein said at least one pulse-wave sensor comprises a first and a second pulse-wave sensor which are adapted to be worn on a first and a second predetermined position on the subject, respectively, to detect a first and a second pulse wave from the subject, respectively.

26. An apparatus according to claim 25, wherein said pre-ejection period determining means comprises:

time-difference determining means for determining a time difference between a time of detection of a heartbeat-synchronous pulse of said first pulse wave detected by said first pulse wave sensor and a time of detection of a corresponding heartbeat-synchronous pulse of said second pulse wave detected by said second pulse wave sensor,

Q-point determining means for determining a first time of production of said Q point of said heartbeat-synchronous pulse of the electrocardiogram, and

pre-ejection period calculating means for calculating said pre-ejection period based on said first time of said Q point determined by said Q-point determining means and said time difference determined by said time-difference determining means.

27. An apparatus according to claim 26, wherein said pre-ejection period determining means further comprises minimum-point estimating means for estimating a second time of production of said minimum point of said corresponding heartbeat-synchronous pulse of said intra-aortic pulse wave, based on said time difference determined by said time-difference determining means, wherein said pre-ejection period calculating means calculates said pre-ejection period based on said first time determined by said Q-point determining means and said second time estimated by said minimum-point estimating means.