Non-invasive method and device to monitor cardiac parameters

• US 8,843,194 B2
• Filed: 12/08/2009
• Issued: 09/23/2014
• Est. Priority Date: 10/31/2001
• Status: Expired due to Fees

• Current Assignee: Robert Hirsh
• Original Assignee: Robert Hirsh
• Inventors: Hirsh, Robert
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US12/633,521
• Publication Number:
  US 20100228140A1
• Time in Patent Office: 1,750 Days
• Field of Search: None
• US Class Current: 600/513
• 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 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00

Abstract

A method of and a device for non-invasively measuring the hemodynamic state of a subject or a human patient involve steps and units of non-invasively measuring cardiac cycle period, electrical-mechanical interval, mean arterial pressure, and ejection interval and converting the measured electrical-mechanical interval, mean arterial pressure and ejection interval into the cardiac parameters such as Preload, Afterload and Contractility, which are the common cardiac parameters used by an anesthesiologist.

The converted hemodynamic state of a patient is displayed on a screen as a three-dimensional vector with each of its three coordinates respectively representing Preload, Afterload and Contractility. Therefore, a medical practitioner looks at the screen and -quickly obtains the important and necessary information.

Claims

1. A method of monitoring an ischemic event, comprising the steps of:

non-invasively measuring a plurality of predetermined non-invasive cardiac parameters from a subject; and

converting the non-invasive cardiac parameters into a single invasive cardiac analogue indicative of the ischemic event based upon a predetermined conversion equation,

wherein the predetermined non-invasive cardiac parameters include heart rate as denoted by HR, ejection interval as denoted by EI, mean arterial pressure as denoted by MAP and electrical-mechanical interval as denoted by E-M, which is an interval between an electrical event E and a mechanical event M.

2. The method of monitoring an ischemic event according to claim 1 wherein the subject is a human.

3. The method of monitoring an ischemic event according to claim 1 wherein the subject is an animal.

4. The method of monitoring an ischemic event according to claim 1 wherein the predetermined conversion equation includes CP=A3*[EI/(T-EI)]*[exp(1/E-M)/(MAP*E-M)]+A4, where T is cardiac period, which is obtained from the heartrate HR, A3 and A4 are empirical proportionality constants and wherein the M in the E-M is further defined as a time when, a second derivative of the M with respect to time, M″

(t), reaches a maximum value.

5. The method of monitoring an ischemic event according to claim 4 wherein an electrical event in determining the E-M is selected from the group consisting of a Q-wave as denoted by Q, a R-wave as denoted by R, a S-wave as denoted by S and an artificial ventricular pacemaker spike.

6. The method of monitoring an ischemic event according to claim 4 wherein the electrical event in determining the E-M interval is determined by double differentiating an EKG voltage curve which corresponds to ventricular depolarization, V(t), with respect to time and defining the electrical event as a time when V″

(t) reaches a maximum positive value.

7. The method of monitoring an ischemic event according to claim 4 wherein the mechanical event selected from the group consisting of a time of an arterial blood pressure upstroke as denoted by TA, a time of a flow velocity upstroke as denoted by TF, and a time of plethysmographic upstroke as denoted by TOP.

8. A system for monitoring an ischemic event, comprising:

a measuring unit for non-invasively measuring a plurality of predetermined non-invasive cardiac parameters from a subject; and

a converting unit connected to said measuring unit for converting the non-invasive cardiac parameters into a single invasive cardiac analogue indicative of the ischemic event based upon a predetermined conversion equation,

wherein said measuring unit measures the predetermined non-invasive cardiac parameters including heart rate as denoted by HR, ejection interval as denoted by EI, mean arterial pressure as denoted by MAP and electrical-mechanical interval as denoted by E-M.

9. The system for monitoring an ischemic event according to claim 8 wherein the subject is a human.

10. The system for monitoring an ischemic event according to claim 8 wherein the subject is an animal.

11. The system of monitoring an ischemic event according to claim 8 wherein the predetermined conversion equation includes

CP=A3*[EI/(T-EI)]*[exp(1/E-M)/(MAP*E-M)]+A4, where T is cardiac period, which is obtained from the heartrate HR, A3 and A4 are empirical proportionality constants and

wherein the M in the E-M is further defined as a time when, a second derivative of the M with respect to time, M″

(t), reaches a maximum value.

12. The system of monitoring an ischemic event according to claim 11 wherein an electrical event in determining the E-M is selected from the group consisting of a Q-wave as denoted by Q, a R-wave as denoted by R, a S-wave as denoted by S and an artificial ventricular pacemaker spike.

13. The system of monitoring an ischemic event according to claim 12 wherein the second mechanical event selected from the group consisting of a time of an arterial blood pressure upstroke as denoted by TA, a time of a flow velocity upstroke as denoted by TF, and a time of plethysmographic upstroke as denoted by TOP.

14. The system of monitoring an ischemic event according to claim 11 wherein the electrical event in determining the E-M interval is determined by double differentiating an EKG voltage curve which corresponds to ventricular depolarization, V(t), with respect to time and defining the electrical event as a time when V″

(t) reaches a maximum positive value.