Ballistocardiogram as Proximal Timing Reference for Pulse Transit Time Measurement: Potential for Cuffless Blood Pressure Monitoring
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TLDR
It is concluded that BCG is an adequate proximal timing reference in deriving PTT, and that BCg-based PTT may be superior to ECG-based PAT in estimating DP.Abstract:
Goal: We tested the hypothesis that the ballistocardiogram (BCG) waveform could yield a viable proximal timing reference for measuring pulse transit time (PTT). Methods: From 15 healthy volunteers, we measured PTT as the time interval between BCG and a noninvasively measured finger blood pressure (BP) waveform. To evaluate the efficacy of the BCG-based PTT in estimating BP, we likewise measured pulse arrival time (PAT) using the electrocardiogram (ECG) as proximal timing reference and compared their correlations to BP. Results: BCG-based PTT was correlated with BP reasonably well: the mean correlation coefficient ( r ) was 0.62 for diastolic (DP), 0.65 for mean (MP), and 0.66 for systolic (SP) pressures when the intersecting tangent method was used as distal timing reference. Comparing four distal timing references (intersecting tangent, maximum second derivative, diastolic minimum, and systolic maximum), PTT exhibited the best correlation with BP when the systolic maximum method was used (mean r value was 0.66 for DP, 0.67 for MP, and 0.70 for SP). PTT was more strongly correlated with DP than PAT regardless of the distal timing reference: mean r value was 0.62 versus 0.51 ( p = 0.07) for intersecting tangent, 0.54 versus 0.49 ( p = 0.17) for maximum second derivative, 0.58 versus 0.52 ( p = 0.37) for diastolic minimum, and 0.66 versus 0.60 ( p = 0.10) for systolic maximum methods. The difference between PTT and PAT in estimating DP was significant ( p = 0.01) when the r values associated with all the distal timing references were compared altogether. However, PAT appeared to outperform PTT in estimating SP ( p = 0.31 when the r values associated with all the distal timing references were compared altogether). Conclusion: We conclude that BCG is an adequate proximal timing reference in deriving PTT, and that BCG-based PTT may be superior to ECG-based PAT in estimating DP. Significance: PTT with BCG as proximal timing reference has potential to enable convenient and ubiquitous cuffless BP monitoring.read more
Citations
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Monitoring of the central blood pressure waveform via a conformal ultrasonic device.
Chonghe Wang,Xiaoshi Li,Hongjie Hu,Lin Zhang,Zhenlong Huang,Muyang Lin,Muyang Lin,Zhuorui Zhang,Zhenan Yin,Brady K. Huang,Hua Gong,Shubha Bhaskaran,Yue Gu,Mitsutoshi Makihata,Yuxuan Guo,Yusheng Lei,Yimu Chen,Chunfeng Wang,Chunfeng Wang,Yang Li,Tianjiao Zhang,Zeyu Chen,Albert P. Pisano,Liangfang Zhang,Qifa Zhou,Sheng Xu +25 more
TL;DR: The design and operation of an ultrasonic device that is conformal to the skin and capable of capturing blood pressure waveforms at deeply embedded arterial and venous sites is described, which enables the non-invasive, continuous and accurate monitoring of cardiovascular events from multiple body locations.
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Cuffless Blood Pressure Estimation Algorithms for Continuous Health-Care Monitoring
TL;DR: An efficient algorithm based on the pulse arrival time (PAT) for the continuous and cuffless estimation of the systolic BP, diastolic blood pressure (DBP), and mean arterial pressure (MAP) values is presented.
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Weighing Scale-Based Pulse Transit Time is a Superior Marker of Blood Pressure than Conventional Pulse Arrival Time.
Stephanie L.-O. Martin,Andrew M. Carek,Chang-Sei Kim,Hazar Ashouri,Omer T. Inan,Jin-Oh Hahn,Ramakrishna Mukkamala +6 more
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