Solà Josep, Proença Martin, Ferrario Damien, Porchet Jacques-André, Falhi Abdessamad, Grossenbacher Olivier, Allemann Yves, Rimoldi Stefano F, Sartori Claudio
IEEE Trans Biomed Eng. 2013 Dec;60(12):3505-13. doi: 10.1109/TBME.2013.2272699. Epub 2013 Jul 10.
The clinical demand for a device to monitor blood pressure (BP) in ambulatory scenarios with minimal use of inflation cuffs is increasing. Based on the so-called pulse wave velocity (PWV) principle, this paper introduces and evaluates a novel concept of BP monitor that can be fully integrated within a chest sensor. After a preliminary calibration, the sensor provides nonocclusive beat-by-beat estimations of mean arterial pressure (MAP) by measuring the pulse transit time (PTT) of arterial pressure pulses travelling from the ascending aorta toward the subcutaneous vasculature of the chest. In a cohort of 15 healthy male subjects, a total of 462 simultaneous readings consisting of reference MAP and chest PTT were acquired. Each subject was recorded at three different days: D, D+3, and D+14. Overall, the implemented protocol induced MAP values to range from 80 ± 6 mmHg in baseline, to 107 ± 9 mmHg during isometric handgrip maneuvers. Agreement between reference and chest-sensor MAP values was tested by using intraclass correlation coefficient (ICC = 0.78) and Bland-Altman analysis (mean error = 0.7 mmHg, standard deviation = 5.1 mmHg). The cumulative percentage of MAP values provided by the chest sensor falling within a range of ±5 mmHg compared to reference MAP readings was of 70%, within ±10 mmHg was of 91%, and within ±15 mmHg was of 98%. These results point at the fact that the chest sensor complies with the British Hypertension Society requirements of Grade A BP monitors, when applied to MAP readings. Grade A performance was maintained even two weeks after having performed the initial subject-dependent calibration. In conclusion, this paper introduces a sensor and a calibration strategy to perform MAP measurements at the chest. The encouraging performance of the presented technique paves the way toward an ambulatory compliant, continuous, and nonocclusive BP monitoring system.
在动态场景中，对使用最少充气袖带的血压（BP）监测设备的临床需求日益增加。基于所谓的脉搏波速度（PWV）原理，本文介绍并评估了一种可完全集成在胸部传感器中的新型血压监测概念。经过初步校准后，该传感器通过测量从升主动脉向胸部皮下血管系统传播的动脉压力脉冲的脉搏传播时间（PTT），提供非阻塞性逐搏平均动脉压（MAP）估计值。在一组15名健康男性受试者中，共获取了462组由参考MAP和胸部PTT组成的同步读数。每个受试者在三个不同的日子进行记录：第1天、第4天和第15天。总体而言，实施的方案使MAP值从基线时的80±6 mmHg，增加到等长握力动作期间的107±9 mmHg。通过使用组内相关系数（ICC = 0.78）和Bland-Altman分析（平均误差 = 0.7 mmHg，标准差 = 5.1 mmHg）来测试参考MAP值与胸部传感器MAP值之间的一致性。与参考MAP读数相比，胸部传感器提供的MAP值落在±5 mmHg范围内的累积百分比为70%，在±10 mmHg范围内的为91%，在±15 mmHg范围内的为98%。这些结果表明，当应用于MAP读数时，胸部传感器符合英国高血压学会对A级血压监测仪的要求。即使在进行了最初的受试者依赖校准两周后，仍保持A级性能。总之，本文介绍了一种用于在胸部进行MAP测量的传感器和校准策略。所提出技术令人鼓舞的性能为一种动态兼容、连续且非阻塞性血压监测系统铺平了道路。
