Non-invasive determination of aortic flow velocity waveforms

• US 6,010,457 A
• Filed: 09/12/1997
• Issued: 01/04/2000
• Est. Priority Date: 03/15/1996
• Status: Expired due to Term

• Current Assignee: Atcor Medical Pty Ltd (CardieX Ltd.)
• Original Assignee: PMV Medical Pty Limited
• Inventors: O'Rourke, Michael Francis
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US08/913,334
• Time in Patent Office: 844 Days
• Field of Search: 600/485, 600/500, 600/503, 600/504, 600/505, 600/526
• US Class Current: 600/500
• CPC Class Codes: A61B 5/0285 Measuring or recording phase velocity of blood waves
• CPC Class Codes: A61B 5/7257 using Fourier transforms

Abstract

A method is disclosed for determining the aortic flow velocity waveform non-invasively. A calibrated ascending aorta pressure waveform can be derived from peripheral measurements, for example at the radial artery, and calibrated from conventional syphgmomanometry, for example at the brachial artery. From the calibrated ascending aorta pressure waveform the flow velocity waveform in the ascending aorta can be determined, by using the Fourier transform of the pressure waveform and the age-related phase and modulus values. The method can also be used for invasively measured pressure waveforms to provide a flow waveform.

Claims

1. A method for determining an aortic flow velocity waveform, including the steps of:

a. measuring non-invasively at a peripheral site a blood pressure pulse waveform;

b. calibrating said blood pressure pulse waveform by reference to systolic and diastolic pressures measured at a site comparable to said peripheral site; and

c. calculating the calibrated aortic pressure pulse waveform at the ascending aorta using said calibrated blood pressure pulse waveform and a predetermined transfer function;

d. calculating the aortic flow velocity waveform from said aortic pressure pulse waveform by reference to predetermined values for age dependent impedance modulus and phase difference between said aortic pressure pulse waveform and said aortic flow velocity waveform.

2. A method according to claim 1, including the further step of:

(e) determining whether the waveform calculated at (d) meets predefined criteria, and if it does not, then repeating step (d) iteratively using different values for age until said waveform meets said predefined criteria.

3. A method according to claim 2, wherein said method includes storing an input or calculated time value for the point of incisura for said calibrated aortic pressure pulse waveform, and said predefined criteria include that at the point of incisura, the flow is substantially zero.

4. A method according to claim 3, wherein said predefined criteria include that after incisura flow remains beneath a predetermined percentage of peak flow.

5. A method according to claim 2, and including outputting a value for the imputed age at which said predefined criteria are met.

6. A method according to claim 1, including performing step (d) by using the Fourier transform of said calibrated aortic pressure pulse waveform, calculating the flow wave components corresponding to each frequency component of the pressure wave separately, and combining the resulting waveforms to provide a derived flow velocity waveform.

7. A method according to claim 6, including in step (d) determining the flow wave component for each frequency component of the Fourier transform by reference to values for modulus and phase for each frequency within predefined age bands stored in a look up table.

8. A method for determining an aortic flow velocity waveform from a measured or derived ascending aortic pressure pulse waveform, comprising calculating the aortic flow velocity waveform from said aortic pressure pulse waveform by reference to predetermined values for age dependent impedance modulus and phase difference between said aortic pressure pulse waveform and said aortic flow velocity waveform.

9. A method according to claim 8, including the further step of determining whether the flow waveform meets predefined criteria, and if it does not, then repeating said calculation step iteratively using different values for age until said waveform meets said predefined criteria.

10. A method according to claim 9, wherein said method includes storing an input or calculated time value for the point of incisura for said ascending aortic pressure pulse waveform, and said predefined criteria include that at the point of incisura, the flow is substantially zero.

11. A method according to claim 9, and outputting a value for the imputed age at which said predefined criteria are met.

12. A method according to claim 8, including performing said calculating step by using the Fourier transform of said ascending aortic pressure pulse waveform, calculating the flow wave components corresponding to each frequency component of the pressure wave separately, and combining the resulting waveforms to provide a derived flow velocity waveform.

13. A method according to claim 8, wherein said calculating step is performed using the Fourier transform of said ascending aortic pressure pulse waveform, calculating the flow wave components corresponding to each frequency component of the pressure wave separately, and combining the resulting waveforms to provide a derived flow velocity waveform.

14. A method according to claim 13, and including in said calculating step, determining the flow wave component for each frequency component of the Fourier transform by reference to values for modulus and phase for each frequency within predefined age bands stored in a look up table.

15. A method for representing an aortic flow velocity waveform by calculating parameters defining an aortic flow velocity waveform as a function of:

parameters defining an ascending aortic pressure pulse waveform and predetermined values for age dependent impedance modulus and phase difference between said aortic pressure pulse wavefom and said aortic flow velocity waveform;

and plotting an aortic flow velocity waveform defined by said aortic flow velocity waveform parameters.

16. A method according to claim 15 wherein said calculated parameters are examined to determine if they meet predefined criteria before plotting, and if determined not determined to meet said criteria then said calculation is repeated iteratively using different values for age until said calculated parameters do meet said predefined criteria.

17. A method according to claim 16 wherein said method includes storing an input or calculated time value for the point of incisura for said ascending aortic pressure pulse waveform, and said predefined criteria include that at the point of incisura, the flow is substantially zero.

18. A method according to claim 17, wherein said predefined criteria include that the after incisura flow remains beneath a predetermined percentage of peak flow.

19. A method according to claim 18, including performing said calculating step by using the Fourier transform of said ascending aortic pressure pulse waveform, calculating the flow wave components corresponding to each frequency component of the pressure wave separately, and combining the resulting waveforms to provide a derived flow velocity waveform.

20. A method according to claim 19, and in said calculating step, determining the flow wave component for each frequency component of the Fourier transform by reference to values for modulus and phase for each frequency within predefined age bands stored in a look up table.

21. A method according to claim 20, and outputing a value for the imputed age at which said predefine criteria are met.

22. A method according to claim 15 and causing said representation to appear on a computer monitor.