Department of Biomedical Engineering, Key Laboratory for Biomedical Engineering of Education Ministry, Zhejiang University, Hangzhou 310027, People's Republic of China.
Cyrus Tang Center for Sensor Materials and Applications, Zhejiang University, Hangzhou 310058, People's Republic of China.
Physiol Meas. 2021 Jun 17;42(5). doi: 10.1088/1361-6579/abf889.
Noninvasive blood pressure (BP) measurement technologies have been widely studied, but they still have the disadvantages of low accuracy, the requirement for frequent calibration and limited subjects. This work considers the regulation of vascular activity by the sympathetic nervous system and proposes a method for estimating BP using multiple physiological parameters.The parameters used in the model consist of heart rate variability (HRV), pulse transit time (PTT) and pulse wave morphology features extracted from electrocardiogram (ECG) and photoplethysmogram (PPG) signals. Through four classic machine learning algorithms, a hybrid data set of 3337 subjects from two databases is evaluated to verify the ability of cross-database migration. We also recommend an individual calibration procedure to further improve the accuracy of the method.The mean absolute error (MAE) and the root mean square error (RMSE) of the proposed algorithm is 10.03 and 14.55 mmHg for systolic BP (SBP), and 5.42 and 8.19 mmHg for diastolic BP (DBP). With individual calibration, the MAE and standard deviation (SD) is -0.16 ± 7.96 (SBP) and -0.13 ± 4.50 (DBP) mmHg, which satisfied the Advancement of Medical Instrumentation (AAMI) standard. In addition, the models are used to test single databases to evaluate their performance on different data sources. The overall performance of the Adaboost algorithm is better on the Multi-parameter Intelligent Monitoring in Intensive Care Unit (MIMIC) database; the MAE between its predicted value and true value reaches 6.6mmHg (SBP) and 3.12mmHg (DBP), respectively.The proposed method considers the regulation of blood vessels and the heart by the autonomic nervous system, and verifies its effectiveness and robustness across data sources, which is promising for improving the accuracy of continuous and cuffless BP estimation.
非侵入式血压(BP)测量技术已经得到了广泛的研究,但它们仍然存在准确性低、需要频繁校准以及适用范围有限的缺点。本工作考虑了交感神经系统对血管活动的调节,并提出了一种使用多个生理参数来估计血压的方法。模型中使用的参数包括心率变异性(HRV)、脉搏传输时间(PTT)和从心电图(ECG)和光电容积脉搏波(PPG)信号中提取的脉搏波形态特征。通过四种经典的机器学习算法,评估了来自两个数据库的 3337 名受试者的混合数据集,以验证跨数据库迁移的能力。我们还建议了一种个体校准程序,以进一步提高该方法的准确性。所提出算法的平均绝对误差(MAE)和均方根误差(RMSE)分别为收缩压(SBP)的 10.03 和 14.55mmHg,舒张压(DBP)的 5.42 和 8.19mmHg。通过个体校准,MAE 和标准差(SD)分别为 -0.16 ± 7.96(SBP)和 -0.13 ± 4.50(DBP)mmHg,满足医疗器械促进协会(AAMI)标准。此外,模型还用于测试单数据库,以评估它们在不同数据源上的性能。Adaboost 算法在多参数智能重症监护(MIMIC)数据库中的整体性能更好;其预测值与真实值之间的 MAE 分别达到 6.6mmHg(SBP)和 3.12mmHg(DBP)。该方法考虑了自主神经系统对血管和心脏的调节,验证了其在不同数据源之间的有效性和鲁棒性,有望提高连续无袖带血压估计的准确性。