Stress test devices and methods

• US 6,863,656 B2
• Filed: 09/20/2002
• Issued: 03/08/2005
• Est. Priority Date: 09/20/2002
• Status: Expired due to Fees

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G.
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US10/251,080
• Publication Number:
  US 20040059229A1
• Time in Patent Office: 900 Days
• Field of Search: 600/300, 600/481, 600/483, 600/484, 600/485, 600/500, 600/529, 600533-538, 600/487
• US Class Current: 600/481
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/097 Devices for facilitating collection of breath or for directing breath into or through measuring devices
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing

Abstract

One method for diagnosing a cardiovascular-related condition in a breathing person comprises interfacing a valve system to the person'"'"'s airway. The valve system is configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event. The person is permitted to inhale and exhale through the valve system. During inhalation, the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure. Further, at least one physiological parameter is measured while the person inhales and exhales through the valve system. The measured parameter is evaluated to diagnose a cardiovascular condition.

Claims

1. A method for diagnosing a cardiovascular-related condition in a breathing person, the method comprising:

interfacing a valve system to the person'"'"'s airway, the valve system being configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event;

permitting the person to inhale and exhale through the valve system, wherein during inhalation the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure;

measuring at least one physiological parameter while the person inhales and exhales through the valve system, and evaluating the measured parameter to diagnose a cardiovascular condition.

2. A method as in claim 1, further comprising measuring the physiological parameter in a base line state prior to permitting the person to inhale and exhale through the valve system, and further comprising comparing the measured physiological parameter in the base line state with the measured physiological parameter following inhaling and exhaling.

3. A method as in claim 1, wherein the valve system is incorporated into a facial mask, and further comprising coupling the facial mask to the person'"'"'s face.

4. A method as in claim 1, wherein the valve system include a pressure responsive inflow valve, and further comprising setting an actuating pressure of the valve to be in the range from about 0 cm H₂O to about −

50 cm H₂O.

5. A method as in claim 4, further comprising increasing or decreasing the actuating pressure over time, and re-measuring the physiological parameter.

6. A method as in claim 4, further comprising increasing or decreasing the actuating pressure based on the measured physiological parameter.

7. A method as in claim 1, wherein the valve system is further configured to prevent or decrease exhaled gases from exiting the person'"'"'s lungs during at least a portion of an exhalation, and further comprising measuring the physiological parameter following an exhalation.

8. A method as in claim 1, wherein the physiological parameter is measured by an imaging or mapping technique.

9. A method as in claim 8, wherein the imaging or mapping technique is selected from a group consisting of ECG, echo-imaging of the heart, imaging of radio-labeled markers in the blood, MRI imaging, CT imaging and imaging of markers for cardiac ischemic.

10. A method as in claim 1, wherein the measured physiological parameter is selected from a group consisting of blood pressure, expired CO₂, heart rate, air flow and pressure through the airway and lungs, oxygen saturation, blood levels of O₂, blood lactate, blood pH, tissue lactate, tissue pH and body temperature.

11. A system for diagnosing a cardiovascular-related condition in a breathing person, the system comprising:

a valve system that is capable of being coupled to the person'"'"'s airway, the valve system being configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure; and

a monitoring system to monitor changes in at least one physiological parameter while the person inhales and exhales through the valve system, wherein the monitoring system includes a computer for evaluating the measured parameter to diagnose a cardiovascular condition.

12. A system as in claim 11, wherein at least a portion of the monitoring system is physically incorporated into the valve system.

13. A system as in claim 11, further comprising a controller to change the configuration of the valve system over time to vary the level of inspiratory impedance.

14. A system as in claim 13, wherein the controller is configured to change the configuration of the valve system based on the measured parameters.

15. A system as in claim 11, wherein the valve system is configured to prevent or decrease exhaled gases from exiting the person'"'"'s lungs during at least a portion of an exhalation.

16. A system as in claim 11, wherein the valve system is incorporated into a facial mask that is configured to be coupled to the person'"'"'s face.

17. A system as in claim 11, wherein the valve system includes a pressure responsive inflow valve that has an actuating pressure in the range from about 0 cm H₂O to about −

50 cm H₂O.

18. A system as in claim 11, wherein the monitoring system comprises an imaging or mapping system.

19. A system as in claim 18, wherein the imaging or mapping system is selected from a group consisting of an ECG system, a heart echo-imaging system, a radio-labeled marker imaging system for measuring makers in the blood, an MRI imaging system, a CT imaging system and a cardiac ischemic imaging system.

20. A system as in claim 11, wherein the monitoring system comprises sensors that are selected from a group consisting of blood pressure sensors, expired CO₂ sensors, heart rate sensors, air flow and pressure sensors, oxygen saturation sensors, O₂ blood level sensors, blood lactate sensors, blood pH sensors, tissue lactate sensors, tissue pH sensors and body temperature sensors.

21. A method for diagnosing a cardiovascular-related condition in a breathing person, the method comprising:

interfacing a valve system to the person'"'"'s airway, the valve system being configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event;

coupling a monitoring system to the person, wherein the monitoring system is configured to monitor changes in at least one physiological parameter while the person inhales and exhales through the valve system;

permitting the person to inhale and exhale through the valve system, wherein during inhalation the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure;

measuring at least one physiological parameter while the person inhales and exhales through the valve system using the monitoring system, and evaluating the measured parameter to diagnose a cardiovascular condition.

22. A method for diagnosing a cardiovascular-related condition in a breathing person, the method comprising:

interfacing a valve system to the person'"'"'s airway, the valve system being configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event;

permitting the person to inhale and exhale through the valve system, wherein during inhalation the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure;

measuring at least one physiological parameter while the person inhales and exhales through the valve system, and evaluating the measured parameter to diagnose a cardiovascular condition;

wherein the measured physiological parameter comprises one or more markers of cardiac ischemia.

23. A method for diagnosing a cardiovascular-related condition in a breathing person, the method comprising:

interfacing a valve system to the person'"'"'s airway, the valve system being configured to decrease or prevent respiratory gas flow to the person'"'"'s lungs during at least a portion of an inhalation event;

permitting the person to inhale and exhale through the valve system, wherein during inhalation the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure;

measuring at least one physiological parameter while the person inhales and exhales through the valve system, and evaluating the measured parameter to diagnose a cardiovascular condition; and

introducing a substance into the person to stress the person'"'"'s heart.

24. A method as in claim 23, wherein the substance comprises a volume load of saline solution that is injected into the person'"'"'s blood stream.

25. A method as in claim 23, wherein the substance comprises nitroglycerine that is injected into the person to lower the person'"'"'s blood pressure.

26. A method as in claim 23, wherein the substance comprises a drug that is injected into the person and is selected from a group of drugs consisting of adenosine, adrenaline and dobutamine.