Method and instrument to measure vascular impedance

• US 6,623,434 B2
• Filed: 09/17/2001
• Issued: 09/23/2003
• Est. Priority Date: 12/28/1990
• Status: Expired due to Term

• Current Assignee: Hypertension Diagnostics, Inc.
• Original Assignee: Hypertension Diagnostics, Inc.
• Inventors: Cohn, Jay N., Finkelstein, Stanley M., Chesney, Charles F.
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US09/954,673
• Publication Number:
  US 20020028998A1
• Time in Patent Office: 736 Days
• Field of Search: 600/481, 600/485, 600/500, 600/504, 600/508, 600/526, 600/483, 128/920
• US Class Current: 600/485
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: G09B 23/28 for medicine
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics

Abstract

A vascular impedance measurement instrument includes a transducer to obtain a digitized arterial blood pressure waveform. The digitized data is used to determine cardiac output, and to subsequently obtain measurements of impedance parameters using the modified Windkessel model of the arterial system. The instrument is used as an aid in diagnosing, treating and monitoring patients with cardiovascular disease.

Claims

1. A method for measuring vascular impedance properties of a patient, the method comprising:

noninvasively measuring an arterial blood-pressure waveform of a patient;

processing the measured arterial blood-pressure waveform to determine a cardiac ejection time;

processing the arterial blood pressure waveform and the ejection time; and

determining, based on the processing, for the patient one or more parameters of a vascular impedance model, the parameters being measures of vascular impedance properties including a value for a compliance.

2. The method of claim 1, further comprising:

determining a cardiac output value for the patient based at least in part on patient data; and

wherein the processing further includes processing the arterial blood pressure waveform and the cardiac output value to determine, for the patient, the one or more parameters of a vascular impedance model, the parameters being measures of vascular impedance properties.

3. The method of claim 2, wherein the determining of the cardiac output value for the patient is based at least in part on a value of the cardiac ejection time.

4. The method of claim 3, wherein the one or more parameters of vascular impedance include a measure of resistance of the patient'"'"'s blood vessels to the flow of blood.

5. The method of claim 4, further comprising:

marking a segment of the arterial blood-pressure waveform corresponding to systole; and

determining the ejection time by measuring the duration of said segment, wherein the determining the cardiac output measurement value is based at least in part on the ejection time.

6. The method of claim 1, wherein the vascular impedance model is a modified Windkessel model of the vasculature.

7. The method of claim 1, wherein the vascular impedance model is a first-order.

8. The method of claim 7, wherein the processing to determine one or more parameters of vascular impedance further includes determining a measure of resistance of the patient'"'"'s blood vessels to the flow of blood.

9. The method of claim 1, wherein the processing to determine one or more parameters of vascular impedance includes determining at least two measures of compliance of the patient'"'"'s blood vessels.

10. A vascular impedance measurement instrument, comprising:

a sensor system that noninvasively measures an arterial blood pressure of a patient and produces a corresponding series of digitized data samples representing a waveform of the arterial blood pressure;

a computing device operatively coupled to the sensor system that computes one or more parameters of a vascular impedance model for the patient based at least in part on the sample series, the one or more parameters including a value for a compliance; and

an output device, operatively coupled to the computing device, that reports the one or more parameters, the one or more parameters including a value for a compliance.

11. The instrument of claim 10, wherein the computing device further determines a mean arterial pressure value of the patient from the sample series, and determines the one or more parameters of the vascular impedance model based at least in part on the mean arterial pressure value.

12. The instrument of claim 10, wherein the computing device further determines a cardiac output value for the patient based at least in part on the sample series and clinically derived patient data, that determines one or more parameters of a vascular impedance model for the patient based at least in part on the cardiac output value.

13. The instrument of claim 10, wherein the one or more parameters of vascular impedance include a measure of compliance of the patient'"'"'s blood vessels.

14. The instrument of claim 13, wherein the one or more parameters of vascular impedance further include a measure of resistance of the patient'"'"'s blood vessels to the flow of blood.

15. A vascular impedance measurement instrument, comprising:

a sensor that noninvasively measures an arterial blood pressure of a patient and produces a corresponding series of digitized data samples representing a waveform of the arterial blood pressure of the patient; and

a computing device operatively coupled to the sensor and configured to determine for the patient one or more parameters of a vascular impedance model based at least in part on the sample series and on an ejection time obtained from the series, and to output the one or more parameters, the one or more parameters including a value for a compliance.

16. The instrument of claim 15, wherein the sensor comprises:

a pressure transducer; and

an analog-to-digital converter operatively coupled to receive a signal from the transducer and to output the sample series.

17. The instrument of claim 15, wherein the one or more parameters of vascular impedance include a measure of compliance of the patient'"'"'s blood vessels.

18. The instrument of claim 17, wherein the one or more parameters of vascular impedance further include a measure of resistance of the patient'"'"'s blood vessels to the flow of blood.

19. The instrument of claim 15, wherein the computing device is further configured to mark a segment of the arterial blood-pressure waveform corresponding to systole, to determine the ejection time by measuring the duration of the segment, to determine a cardiac output measurement value based at least in part on the ejection time, and to determine the one or more parameters of the vascular impedance model based at least in part on the cardiac output measurement value.

20. The instrument of claim 15, wherein the vascular impedance model is a modified Windkessel model of the vasculature.

21. A vascular impedance measurement instrument, comprising:

apparatus that noninvasively measures an arterial blood pressure of a patient and produces a corresponding series of digitized data samples representing a waveform of the arterial blood pressure of the patient;

means for determining a cardiac output measurement value for the patient from the sample series and from clinically derived patient data, including ejection time of the heart as determined from the series of samples and from a heart rate, body surface area and age of the patient;

means for determining for the patient one or more parameters of a vascular impedance model from the sample series and from the cardiac output value; and

a output device that displays the one or more parameters, the one or more parameters including a value for a compliance.

22. The instrument of claim 21, further comprising means for determining a stroke volume of the heart substantially in accordance with the following formula:

23. The instrument of claim 21, wherein the vascular impedance model is a modified Windkessel model of the vasculature.

24. A vascular impedance measurement instrument, comprising:

apparatus that noninvasively measures an arterial blood pressure of a patient and produces a corresponding series of digitized data samples representing a waveform of the arterial blood pressure of the patient;

means for determining a mean arterial pressure of the patient from the sample series;

means for determining a cardiac output measurement value for the patient from the sample series and from clinically derived patient data, including ejection time of the heart as determined from the series of samples and from a heart rate, body surface area and age of the patient;

means for determining for the patient one or more parameters of a vascular impedance model from the sample series and from the cardiac output value; and

a output device that outputs the one or more parameters.

25. The instrument of claim 24, further comprising means for determining a stroke volume of the heart substantially in accordance with the following formula:

26. The instrument of claim 24, wherein the vascular impedance model is a modified Windkessel model of the vasculature.