System and method for evaluating the circulatory system of a living subject

• US 5,921,936 A
• Filed: 06/03/1997
• Issued: 07/13/1999
• Est. Priority Date: 12/22/1995
• Status: Expired due to Fees

• Current Assignee: Omron Healthcare Company Limited (Omron Corporation)
• Original Assignee: Colin Corporation (Fukuda Denshi Company Limited)
• Inventors: Inukai, Hidekatsu, Sakai, deceased, Hiroshi
• Primary Examiner(s): Nasser, Robert L.
• Assistant Examiner(s): ASTORINO, MICHAEL C
• Application Number:
  US08/867,814
• Time in Patent Office: 770 Days
• Field of Search: 600/490, 600/485, 600/493, 600/494, 600/495, 600/496, 600/500, 600/504
• US Class Current: 600/490
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/0285 Measuring or recording phase velocity of blood waves

Abstract

A system that accurately evaluates a living subject'"'"'s circulatory system, even if the living subject is taking high blood pressure medication includes a time-difference determining device that determines a time difference between predetermined periodic points on a subject'"'"'s electrocardiographic waveform and predetermined periodic points on corresponding oscillatory pressure-pulse waves of the living subject. A strain application device applies a physical strain to the subject'"'"'s body for a predetermined period of time so that the subject'"'"' blood pressure changes. A blood-pressure measurement device measures the subject'"'"'s blood pressure while the subject'"'"'s blood pressure is changing. A circulatory-system evaluation device determines a relationship between changes in the subject'"'"'s blood pressure and corresponding time differences determined by the time-difference determining. The circulatory-system evaluation device evaluates the subject'"'"'s circulatory system based on the hysteresis present in the relationship.

Claims

1. A device for evaluating a circulatory system of a living subject, comprising:

a blood-pressure changing device that changes a blood pressure of the living subject;

a blood-pressure measuring device that measures the blood pressure of the living subject while the living subject'"'"'s blood pressure is changing;

an oscillatory pressure-pulse wave detector that detects oscillatory pressure-pulse waves of the living subject while the living subject'"'"'s blood pressure is changing, the oscillatory pressure-pulse waves produced by a cardiac muscle of the living subject propagating along an artery of the living subject;

an electrocardiographic waveform detector that detects an electrocardiographic waveform of the living subject;

a time-difference determining circuit that determines time differences between predetermined periodic points on the electrocardiographic waveform of the living subject and predetermined periodic points on corresponding oscillatory pressure-pulse waves of the living subject; and

a circulatory-system evaluation circuit that evaluates the living subject'"'"'s circulatory system based on a relationship between changes in the living subject'"'"'s blood pressure and changes in the corresponding time differences determined by the time-difference determining circuit.

2. The device of claim 1, wherein the blood-pressure changing device comprises a strain application device that applies a strain to the living subject for a predetermined period of time, the subject'"'"'s blood pressure increasing from an initial value in response to the strain and decreasing back to the initial value when the strain is removed.

3. The device of claim 2, wherein the strain application device comprises:

a pressure gauge that measures an air pressure;

a mouthpiece; and

a hollow tube connecting the mouthpiece to the pressure gauge, wherein the living subject begins a strain operation by blowing into the mouthpiece with a force sufficient to register a predetermined air pressure value on the pressure gauge.

4. The device of claim 3, wherein the pressure gauge comprises a mercury pressure gauge.

5. The device of claim 2, further comprising a signaling device that signals the living subject to begin a strain operation with the strain application device.

6. The device of claim 5, wherein the signaling device comprises a lamp.

7. The device of claim 1, wherein the blood-pressure measuring device comprises:

a blood-pressure measuring circuit that determines a systolic blood pressure and a diastolic blood pressure of the living subject;

a relationship determining circuit that determines a first relationship between the blood pressure values determined by the blood-pressure measuring circuit and magnitudes of corresponding oscillatory pressure-pulse waves detected by the oscillatory pressure-pulse-wave detector; and

a monitor-blood-pressure determining circuit that determines monitor-blood-pressure values based on the first relationship determined by the relationship determining circuit and magnitudes of the oscillatory pressure-pulse wave.

8. The device of claim 7, wherein the monitor-blood-pressure determining circuit determines systolic monitor-blood-pressure values and diastolic monitor-blood-pressure values.

9. The device of claim 7, wherein the circulatory-system evaluation circuit determines a second relationship between the monitor-blood-pressure values determined by the monitor-blood-pressure determining circuit and corresponding time differences determined by the time-difference determining circuit.

10. The device of claim 9, wherein the circulatory-system evaluation circuit evaluates the living subject'"'"'s circulatory system based on an amount of hysteresis present in the second relationship.

11. The device of claim 1, wherein the oscillatory pressure-pulse wave detector comprises:

a housing having an opening;

a diaphragm attached to the housing;

a sensor capable of sensing the oscillatory pressure-pulse wave and supported by the diaphragm so that the sensor is movable relative to the housing and is advanceable through the opening of the housing; and

an attachment mechanism capable of attaching the oscillatory pressure-pulse wave detector to a portion of the living subject;

the housing, the diaphragm and the sensor defining a pressure chamber capable of receiving pressurized air, the pressurized air applying a pressing force to the sensor to press the sensor against the living subject when the oscillatory pressure-pulse wave detector is attached to the living subject.

12. The device of claim 1, wherein the electrocardiographic waveform detector comprises:

a plurality of electrocardio electrodes, the electrocardio electrodes capable of sensing an electrocardiographic signal from the living subject when the electrocardio electrodes are in electrical contact with the living subject; and

an electrocardiographic-waveform detection circuit that detects the living subject'"'"'s electrocardiographic waveform based on the electrocardiographic signals sensed by the electrocardio electrodes.

13. A device for evaluating a circulatory system of a living subject, comprising:

a blood-pressure changing device that changes a blood pressure of the living subject;

a blood-pressure measuring device that measures the blood pressure of the living subject while the living subject'"'"'s blood pressure is changing;

an electrocardiographic waveform detector that detects an electrocardiographic waveform of the living subject;

an oscillatory pressure-pulse wave detector that detects oscillatory pressure-pulse waves of the living subject while the living subject'"'"'s blood pressure is changing, that oscillatory pressure-pulse wave produced by a cardiac muscle of the living subject and propagating along an artery of the living subject;

an oscillatory pressure-pulse wave velocity determining device that determines propagation velocities of the oscillatory pressure-pulse waves; and

a circulatory-system evaluation circuit that evaluates the living subject'"'"'s circulatory system based on a relationship between changes in the living subject'"'"'s blood pressure and changes in the propagation velocities of corresponding oscillatory pressure-pulse waves.

14. The device of claim 13, wherein the blood-pressure changing device comprises a strain application device that applies a strain to the living subject for a predetermined period of time, the subject'"'"'s blood pressure increasing from an initial value in response to the strain and decreasing back to the initial value when the strain is removed.

15. The device of claim 14, wherein the strain application device comprises:

a pressure gauge that measures an air pressure;

a mouthpiece; and

a hollow tube connecting the mouthpiece to the pressure gauge, wherein the living subject begins a strain operation by blowing into the mouthpiece with a force sufficient to register a predetermined air pressure value on the pressure gauge.

16. The device of claim 15, wherein the pressure gauge comprises a mercury pressure gauge.

17. The device of claim 14, further comprising a signaling device that signals the living subject to begin a strain operation with the strain application device.

18. The device of claim 17, wherein the signaling device comprises a lamp.

19. The device of claim 13, wherein the blood-pressure measuring device comprises:

a blood-pressure measuring circuit that determines a systolic blood pressure and a diastolic blood pressure of the living subject;

a relationship determining circuit that determines a first relationship between the blood pressure values determined by the blood-pressure measuring circuit and magnitudes of corresponding oscillatory pressure-pulse waves detected by the oscillatory pressure-pulse wave detector; and

a monitor-blood-pressure determining circuit that determines monitor-blood-pressure values based on the first relationship determined by the relationship determining circuit and magnitudes of the oscillatory pressure waves.

20. The device of claim 19, wherein the monitor-blood-pressure determining circuit determines systolic monitor-blood-pressure values and diastolic monitor-blood-pressure values.

21. The device of claim 19, wherein the circulatory-system evaluation circuit determines a second relationship between the monitor-blood-pressure values determined by the monitor-blood-pressure determining circuit and propagation velocities of corresponding oscillatory pressure-pulse waves determined by the oscillatory pressure-pulse wave velocity determining device.

22. The device of claim 21, wherein the circulatory-system evaluation circuit evaluates the living subject'"'"'s circulatory system based on an amount of hysteresis present in the second relationship.

23. The device of claim 13, wherein the oscillatory pressure-pulse wave detector comprises:

a housing having an opening;

a diaphragm attached to the housing;

a sensor capable of sensing the pressure-pulse-wave and supported by the diaphragm so that the sensor is movable relative to the housing and is advanceable through the opening of the housing; and

an attachment mechanism capable of attaching the oscillatory pressure-pulse wave detector to a portion of the living subject;

the housing, the diaphragm and the sensor defining a pressure chamber capable of receiving pressurized air, the pressurized air applying a pressing force to the sensor to press the sensor against the living subject when the oscillatory pressure-pulse wave detector is attached to the living subject.

24. The device of claim 13, wherein the oscillatory pressure-pulse wave velocity determining device comprises:

a time-difference determining device that determines time differences between predetermined periodic points on the electrocardiographic waveform of the living subject and predetermined periodic points on the oscillatory pressure-pulse waves of the living subject; and

a oscillatory pressure-pulse wave velocity determining circuit that determines a propagation velocity of the oscillatory pressure-pulse waves based on the time differences determined by the time-difference determining device.

25. The device of claim 24, wherein the electrocardiographic waveform detector comprises:

a plurality of electrocardio electrodes, the electrocardio electrodes capable of sensing an electrocardiographic signal from the living subject when the electrocardio electrodes are in electrical contact with the living subject; and

an electrocardiographic-waveform detection circuit that detects the living subject'"'"'s electrocardiographic waveform based on the electrocardiographic signals sensed by the electrocardio electrodes.

26. A device for evaluating a circulatory system of a living subject, comprising:

a blood-pressure measuring device that successively measures the blood pressure of the living subject while the living subject is subjected to a physical load;

a means for creating the physical load;

a pressure-pulse wave propagation velocity information obtaining device that, while the living subject is subjected to the physical load, successively obtains pressure-pulse wave propagation velocity information relating to a propagation velocity of a pressure-pulse wave through an artery of the living subject; and

a circulatory-system evaluation circuit that evaluates the circulatory system of the living subject based on a relationship between changes in the blood pressure of the living subject and changes in the pressure-pulse wave propagation velocity information.

27. The device of claim 26, wherein the pressure-pulse wave propagation velocity information obtaining device comprises:

a first pulse wave detection circuit that detects first pulse waves from a first portion of the subject;

a second pulse wave detection circuit that detects second pulse waves from a second portion of the subject; and

a time-difference determining circuit that determines, as the pressure-pulse wave propagation velocity information, time differences between predetermined periodic points on the first pulse waves and predetermined periodic points on the corresponding second pulse waves.

28. The device of claim 27, wherein the circulatory-system evaluation circuit comprises evaluating means for evaluating the circulatory system of the subject based on a relationship between changes in the blood pressure of the subject and changes in the time differences determined by the time-difference determining circuit.

29. The device of claim 28, wherein the pressure-pulse wave propagation velocity information obtaining device further comprises a propagation-velocity determining circuit that determines the propagation velocity of the pulse wave based on each of the time differences determined by the time-difference determining circuit, and wherein the circulatory-system evaluation circuit comprises evaluating means for evaluating the circulatory system of the subject based on a relationship between changes in the blood pressure of the subject and changes in the propagation velocities determined by the propagation-velocity determining circuit.

30. The device of claim 26, wherein the circulatory-system evaluation circuit comprises hysteresis determining means for determining an amount of hysteresis present in the relationship between the changes in the blood pressure of the subject and the changes in the pressure-pulse wave propagation velocity information.

31. The device of claim 30, wherein the hysteresis determining means comprises area-calculating means for calculating, as the amount of hysteresis, an area defined by a closed line representing the relationship between the changes in the blood pressure of the subject and the changes in the pressure-pulse wave propagation velocity information.

32. A method of evaluating a circulatory system of a living subject, comprising:

changing a blood pressure of the living subject over a predetermined period of time;

measuring the subject'"'"'s blood pressure while the subject'"'"'s blood pressure is changing;

measuring oscillatory pressure-pulse waves of the living subject while the living subject'"'"'s blood pressure is changing, the oscillatory pressure-pulse waves produced by a cardiac muscle of the living subject and propagating along an artery of the living subject;

measuring an electrocardiographic waveform of the living subject while the living subject'"'"'s blood pressure is changing;

determining time differences between predetermined periodic points on the electrocardiographic waveform of the living subject and predetermined periodic points on corresponding oscillatory pressure-pulse waves of the living subject; and

evaluating the living subject'"'"'s circulatory system based on a relationship between changes in the living subject'"'"'s blood pressure and changes in corresponding time differences.

33. The method of claim 32, changing the blood pressure of the living subject comprises:

applying a strain on the living subject for a predetermined period of time to raise a blood pressure of the living subject from an initial value; and

removing the strain applied to the living subject to lower the subject'"'"'s blood pressure back to the initial value.

34. The method of claim 33, wherein applying a strain on the living subject comprises causing the living subject to blow into a mouthpiece of an air pressure gauge with a predetermined force for a predetermined period of time.

35. The method of claim 32, wherein measuring the subject'"'"'s blood pressure comprises:

determining a systolic blood pressure value of the subject and a diastolic blood pressure value of the subject;

determining a first relationship between the blood pressure values and magnitudes of corresponding oscillatory pressure-pulse waves; and

determining systolic and diastolic monitor-blood-pressure values based on the first relationship.

36. The method of claim 35, wherein evaluating the living subject'"'"'s circulatory system comprises determining a second relationship between the monitor-blood-pressure values and corresponding time differences between predetermined periodic points on the electrocardiographic waveform of the living subject and predetermined periodic points on corresponding oscillatory pressure-pulse waves of the living subject.

37. The method of claim 36, wherein the subject'"'"'s circulatory system is evaluated based on an amount of hysteresis present in the second relationship.

38. The method of claim 35, wherein propagation velocities of the oscillatory pressure-pulse waves are determined based on the time differences between predetermined periodic points on the electrocardiographic waveform of the living subject and predetermined periodic points on the oscillatory pressure-pulse waves of the living subject.

39. The method of claim 35, evaluating the living subject'"'"'s circulatory system comprises determining a second relationship between the monitor-blood-pressure values and the propagation velocities of corresponding oscillatory pressure-pulse waves.

40. The method of claim 39, wherein the subject'"'"'s circulatory system is evaluated based on an amount of hysteresis present in the second relationship.