Researches related to this Application were supported by the Korea Ministry of Science and ICT under the following projects.
Project number: 2016M3A9E8941259
Name of department: Ministry of Science and ICT
Research management institution: National Research Foundation of Korea
Research business name: Development of biomedical technology
Research project name: In-hospital smart monitoring system for vulnerable patients out of surveillance area
Main Institution: Asan Medical Center
Research period: Aug. 1, 2017 to May 31, 2018
Contribution rate: 50%
Project number: 2016R1C1B1012164
Name of department: Ministry of Science and ICT
Research management institution: National Research Foundation of Korea
Research business name: Personal Basic Research
Research project name: Development of non-invasive cardiovascular and respiratory monitoring system for critical patients receiving general anesthesia
Main Institution: University of Ulsan
Research period: Jun. 1, 2017 to Mar. 31, 2018
Contribution rate: 50%
The present invention relates to a device for calculating a systolic blood pressure using pulse transit time and a method therefor, and particularly to a device for calculating a systolic blood pressure which calculates a unique characteristic parameter of a patient by receiving a pulse transit time of a measurement subject once without body measurement information of the patient and calculates an absolute value and a trend of change of the systolic blood pressure on the basis of the characteristic parameter.
It is well known that pulse transit time (PTT) measured by combining a pulse oximeter and an electrocardiogram signal is inversely proportional to a systolic blood pressure (SBP).
In general, a relationship between the pulse transit time (PTT) and the systolic blood pressure (SBP) can be represented by SBP=a*PTT−1+y0, and since a and y0 which are parameter values inherently differ and greatly deviate for each person, it is known to be difficult to predict.
Since there are two mathematically unknown numbers a and y0, the unique values of a and y0 of the patient can be obtained by measuring the actual systolic blood pressure (SBP) and pulse transit time (PTT) twice. However, if the systolic blood pressure (SBP) and the pulse transit time (PTT) do not change significantly even after several consecutive measurements, each measured value is substantially constant within an error range, and thus, it is impossible to know the unique parameter values a and y0 of a patient. Therefore, it is known that a change of blood pressure can be estimated to some extent by observing a trend of the pulse transit time, an absolute value of the blood pressure cannot be known by a general method, and the blood pressure can be approximated to the absolute value to some extent when calibrated with various subject-related parameters such as body measurement information, disease information, and demographic characteristics of a subject, but, it is not clear which relevant parameters have to be selected and how much weight the parameters have to be calibrated.
A technology of the background of the present invention is disclosed in Japanese Patent Application No. 10-0638696 (issued on Oct. 26, 2006).
An object of the present invention is to provide a device for calculating a systolic blood pressure which receives pulse transit time of a subject once, calculates an absolute value of a systolic blood pressure, and calculates the absolute value and a trend of change of the systolic blood pressure, in a state of complete absence of prior information that can be calibrated, such as body measurement information, disease information, and demographic characteristics of the subject, and a method therefor.
According to one embodiment of the present invention, a method for calculating a systolic blood pressure includes receiving data regarding pulse transit time (PTT) and a systolic blood pressure (SBP) of a patient group, extracting a correlation between parameters (a, y0) regarding a PTT-SBP (Pulse Transit Time-Systolic Blood Pressure) relationship (SBP=a*PTT−1+y0) by analyzing the data regarding the pulse transit time (PTT) and the systolic blood pressure (SBP), receiving data regarding a first pulse transit time (PTT) and a systolic blood pressure (SBP) of a measurement subject, and acquiring unique parameter values (a, y0) of the measurement subject by applying the correlation between the parameters (a, y0) and the data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject to the PTT-SBP relationship.
The receiving of the data of the patient group may be receiving data regarding pulse transit time (PTT) and a systolic blood pressure (SBP) of a patient undergoing induction of general anesthesia.
The extracting of the correlation between the parameters (a, y0) may include extracting unique parameter values (a, y0) of each patient regarding the PTT-SBP relationship by performing regression analysis of the data regarding the pulse transit time (PTT) and the systolic blood pressure (SBP) of the patient group; and extracting the correlation between the parameters (a, y0) of the PTT-SBP relationship by performing the regression analysis of the extracted unique parameter values (a, y0) of each patient.
In the correlation between the parameters (a, y0), the correlation may be represented by an equation (y0=118.87−3.25a).
The method for calculating a systolic blood pressure may further includes receiving a second pulse transit time (PTT) of the measurement subject, and calculating at least one of an absolute value and a trend of change of the systolic blood pressure (SBP) of the measurement subject by applying the second pulse transit time (PTT) and the unique parameter values (a, y0) of the measurement subject to the PTT-SBP relationship.
According to another embodiment of the present invention, a device for calculating a systolic blood pressure includes a data input unit that receives data regarding pulse transit time (PTT) and a systolic blood pressure (SBP) of a patient group and data regarding pulse transit time (PTT) and a systolic blood pressure (SBP) of a measurement subject, a correlation extraction unit that extracts a correlation between parameters (a, y0) regarding a PTT-SBP (Pulse Transit Time-Systolic Blood Pressure) relationship (SBP=a*PTT−1+y0) by analyzing the data regarding the pulse transit time (PTT) and the systolic blood pressure (SBP) of the patient group, and a unique parameter acquisition unit that acquires unique parameter values (a, y0) of the measurement subject by applying the correlation between the parameters (a, y0) and the data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject to the PTT-SBP relationship.
As such, according to the present invention, only one measurement of a systolic blood pressure (SBP) and pulse transit time (PTT) of a patient makes it possible to acquire the patient's unique parameters (a, y0) regarding a PTT-SBP relationship with a very high level of accuracy, in a state of complete absence of prior information regarding a measurement subject, such as body measurement information, disease information, and demographic characteristics. Therefore, subsequent measurement of the patient's pulse transit time (PTT) alone makes it possible to calculate not only a trend of change of systolic blood pressure (SBP), but also an absolute value of the systolic blood pressure (SBP).
Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings so as to be easily performed by those skilled in the art to which the present invention belongs. The present invention may, however, be embodied in many different forms and should not be limited to the embodiments set forth herein. In order to clearly describe the present invention, parts irrespective of the description are omitted, and like parts are denoted by like reference numerals or symbols throughout the specification.
Throughout the specification, when a portion is referred to as “including” a certain element, it means that the portion can further include another element, without excluding other elements unless described otherwise in particular.
Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings so as to be easily performed by those skilled in the art in the present invention belongs.
First, a device 100 for calculating a systolic blood pressure according to an embodiment of the present invention will be described with reference to
The device 100 for calculating a systolic blood pressure according to the embodiment of the present invention includes a data input unit 110, a correlation extraction unit 120, and a unique parameter acquisition unit 130, and further includes a PTT input unit 140 and a blood pressure calculation unit 150.
Each configuration of the device 100 for calculating a systolic blood pressure will be specifically described. First, the data input unit 110 receives data regarding pulse transit time (PTT) and a systolic blood pressure (SBP) of a patient group Receive. In addition, the data input unit 110 receives data regarding a first pulse transit time (PTT) and the systolic blood pressure (SBP) of a measurement subject.
Here, the patient group includes a group of patients undergoing induction of general anesthesia. In addition, the data input unit 110 may receive measured data through an external measurement instrument and may receive the measured data through a measurement instrument included in the device 100 for a systolic blood pressure.
Next, the correlation extraction unit 120 extracts a correlation between parameters (a, y0) of a PTT-SBP (Pulse Transit Time-Systolic Blood Pressure) relationship. At this time, the PTT-SBP relationship is as follows.
SBP=a×PTT−1+y0 [Equation 1]
Here, SBP means a systolic blood pressure, PTT means pulse transit time, and a and y0 mean parameters of the PTT-SBP relationship.
In order to extract the correlation between the parameters (a, y0) of the PTT-SBP relationship, the correlation extraction unit 120 analyzes data regarding the pulse wave propagation time (PTT) and the systolic blood pressure (SBP) of the patient group received from the data input unit 110, and extracts parameter values of the PTT-SBP relationship corresponding to data of each patient. Thereafter, the correlation extraction unit 120 analyzes the parameter values of the PTT-SBP relational ship corresponding to the extracted data of each patient and extracts the correlation of the PTT-SBP relationship.
At this time, the correlation extraction unit 120 can use a statistical analysis method for analyzing the pulse transit time (PTT) and the systolic blood pressure (SBP) of the patient group and for analyzing the parameter values (a, y0) of the PTT-SBP relationship corresponding to the data of each patient, and the statistical analysis method includes a regression analysis method.
In addition, the unique parameter acquisition unit 130 acquires the unique parameter values (a, y0) of a measurement subject regarding the PTT-SBP relationship. Specifically, the unique parameter acquisition unit 130 acquires the unique parameter values (a, y0) of the measurement subject by applying the correlation between the parameters of the PTT-SBP relationship extracted by the correlation extraction unit 120 and the data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject to the PTT-SBP relationship.
Meanwhile, the pulse transit time (PTT) can be calculated by using an electrocardiogram signal measured from an electrocardiogram measurement sensor and a pulse signal measured from a pulse measurement sensor. Specifically, the pulse transit time (PTT) can be calculated through a difference between time of a peak point of an electrocardiogram signal generated by the same heartbeat and time of a maximum upslope point obtained by differentiating a pulse.
Next, the PTT input unit 140 receives a second pulse transit time (PTT) of a measurement subject. At this time, the PTT input unit 140 can receive the second pulse transit time (PTT) of the measurement subject measured through an external measurement instrument and can receive the second pulse transit time (PTT) of the measurement subject measured through a measurement instrument included in device 100 for calculating a systolic blood pressure.
Next, the blood pressure calculation unit 150 calculates an absolute value of the systolic blood pressure SBP corresponding to the second pulse transit time (PTT) of a measurement subject transmitted from the PTT input unit 140. In addition, the blood pressure calculation unit 150 can calculate a trend of change of the systolic blood pressure (SBP). In order to calculate at least one of the absolute value and the trend of change of the systolic blood pressure (SBP), the blood pressure calculation unit 150 applies the pulse transit time (PTT) of the measurement subject transmitted from the PTT input unit 140 and the unique parameter values (a, y0) of the measurement subject transmitted from the unique parameter acquisition unit 130 to the PTT-SBP relationship.
According to the embodiment of the present invention, the device 100 for calculating a systolic blood pressure can be realized by including the data input unit 110, the unique parameter acquisition unit 130, the PTT input unit 140, and the blood pressure calculation unit 150, and the correlation between the parameters (a, y0) of the PTT-SBP relationship extracted by the correlation extraction unit 120 can be stored in the device 100 for calculating a systolic blood pressure according to the embodiment of the present invention.
In addition, according to another embodiment of the present invention, the device 100 for calculating a systolic blood pressure can be realized by including the PTT input unit 140 and the blood pressure calculation unit 150, and the unique parameter values (a, y0) of the measurement subject acquired by applying the correlation between the parameters (a, y0) of the PTT-SBP relationship extracted by the correlation extraction unit 120 and the data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject that is, the PTT-SBP relationship can be stored in the device 100 for calculating a systolic blood pressure according to the embodiment of the present invention.
Hereinafter, a systolic blood pressure calculating method according to an embodiment of the present invention will be described with reference to
The systolic blood pressure calculating method according to the embodiment of the present invention can be divided into blood pressure calculation preparation steps (S210 to S250) and blood pressure calculation steps (S260, S270). First, the blood pressure calculation preparation step will be specifically described. The blood pressure calculation preparation step is a process of extracting unique parameter values of a measurement subject regarding a PTT-SBP relationship and is to calculate an absolute value and a trend of change of a systolic blood pressure of the measure subject. That is, the device 100 for calculating a systolic blood pressure extracts the unique parameter values of the measurement subject regarding the PTT-SBP relationship through steps S210 to S250.
First, the device 100 for calculating a systolic blood pressure receives data regarding pulse transit time and a systolic blood pressure of a patient group (S210). At this time, the pulse transit time and the systolic blood pressure are measured every heartbeat of each patient, and correspond 1:1. Therefore, the data is calculated and input as a corresponding pair of measurement values from 70 to 90 number of times per minute, depending on a heart rate of a patient.
Next, the device 100 for calculating a systolic blood pressure analyzes data regarding the pulse transit time and the systolic blood pressure of the patient group, and extracts unique parameter values of each patient regarding the PTT-SBP relationship (S220).
Hereinafter, steps of extracting the unique parameter values for each patient regarding the PTT-SBP relationship will be described in detail with reference to
First, as illustrated in
Next, the device 100 for calculating a systolic blood pressure generates a line which is most suitable for points plotted on the two-dimensional coordinate plane having the PTT as the X-axis and the SBP as the Y-axis through a regression analysis, that is, a regression line. A line passing between the points illustrated in
Then, the device 100 for calculating a systolic blood pressure analyzes the regression line and extracts unique parameter values of each patient regarding the PTT-SBP relationship.
Table 1 illustrates results of the regression analysis regarding
As illustrated in Table 1, the parameter (y0) is −73.0075, the parameter (a) is 48.3312, and a correlation coefficient (R) is 0.8774 as results of the regression analysis of the patient, when assuming that the measured values are measured for 10 minutes, the measured data is calculated by the data regarding approximately 700 to 900 pulse wave transit times and systolic blood pressures which vary over a wide range. At this time, the correlation coefficient (R) is a numerical value indicating a degree of fitness of the regression line, and the closer the correlation coefficient is to 1, the higher the degree of fitness of the regression line is. It can be seen that the regression line illustrated in
Next, the device 100 for calculating a systolic blood pressure analyzes the extracted unique parameter values of each patient and extracts a correlation between the parameters of the PTT-SBP relationship (S230). At this time, the unique parameter values of each patient can be analyzed by using the regression analysis.
Hereinafter, steps of extracting the correlation between the parameters of the PTT-SBP relationship according to the embodiment of the present invention will be described with reference to
First, the device 100 for calculating a systolic blood pressure plots the unique parameter values (a, y0) of each patient determined in step S220 on a two-dimensional coordinate plane having a as the X-axis and a y0 as the Y-axis. As illustrated in
Next, the device 100 for calculating a systolic blood pressure generates a line which is most suitable for points plotted on the two-dimensional coordinate plane having a as the X-axis and y0 as the Y-axis, that is, the regression line, among the unique parameter values measured in each patient through a regression analysis. A line passing between the dispersed points illustrated in
Then, the device 100 for calculating a systolic blood pressure analyzes the regression line and extracts the correlation between the parameters of the PTT-SBP relationship.
Table 2 is a table illustrating resulted values generated by performing the regression analysis of the unique parameter values of a patient group using the device 100 for calculating a systolic blood pressure, according to the embodiment of the present invention.
As illustrated in Table 2, a slope (c) is −3.25, a slice (d) of a straight line is 118.87, and the correlation coefficient (R) is 0.9359 as results of the regression analysis of the unique parameter values. At this time, the correlation coefficient (R) is close to 1, and it can be seen that the regression line illustrated in
When the correlation between the parameters is represented by using the above resulted values, the correlation between the parameters (a, y0) represented by Equation (2) is extracted.
y
0=118.87−3.25a [Equation 2]
After the correlation between the parameters (a, y0) is extracted in step S230, the device 100 for calculating a systolic blood pressure receives data regarding the first pulse transit time and the systolic blood pressure of the measurement subject (S240), and acquires the unique parameter values of a measurement subject regarding the PTT-SBP relationship by using the correlation between the parameters (a, y0) and the data regarding the pulse transit time and systolic blood pressure of the measurement subject (S250).
A step of acquiring the unique parameter values of the measurement subject will be specifically described through the embodiment of the present invention. First, the device 100 for calculating a systolic blood pressure applies Equation (2) representing the correlation between the parameters (a, y0) to the PTT-SBP relationship. Then, the device 100 for calculating a systolic blood pressure generates a result represented by Equation (3).
Next, the device 100 for calculating a systolic blood pressure acquires the unique parameter value (a) of the measurement subject by applying the first pulse transit time and the systolic blood pressure of the measurement subject measure once to Equation (3).
In addition, the device 100 for calculating a systolic blood pressure inserts the acquired unique parameter value (a) of the measurement subject into Equation (2) representing the correlation between the parameters of the PTT-SBP relationship, and acquires the unique parameter value y0 of the measurement subject.
For example, it is assumed that the first pulse transit time of the measurement subject is 0.270 [s] and the systolic blood pressure is 120 [mmHg]. Then, the device 100 for calculating a systolic blood pressure applies 0.270 [s] to the PTT and 120 to the SBP for Equation (2) and acquires 2.51 as the value a. In addition, the device 100 for calculating a systolic blood pressure applies the obtained value a which is (2.51) to Equation (1) and acquires 110.71 as the value y0.
Hereinafter, a blood pressure calculation step according to the embodiment of the present invention will be specifically described. First, the blood pressure calculation step is a process of receiving the pulse transit time of the measurement subject after the blood pressure calculation preparation steps (S210 to S250), and of calculating at least one of an absolute value and a trend of change of the systolic blood pressure of the measurement subject corresponding thereto.
After acquiring the unique parameter values of the measurement subject through the step S250 of
For example, it is assumed that the pulse transit time measured in step S260 is 0.270 [s], and a is 2.51 and y0 is 110.71 which are the unique parameter values of the measurement subject extracted in step S250. Then, the device 100 for calculating a systolic blood pressure derives the unique PTT-SBP relationship (SBP=1.50 PTT−1+117.12) of the measurement subject by applying the unique parameter values to the PTT-SBP relationship, and thereafter, calculates a value of 120.00 [mmHg] as an absolute value of the systolic blood pressure by applying 0.270 [s] which is the pulse transit time of the measurement subject measured in step S250 to the unique PTT-SBP relationship (SBP=1.50 PTT−1+117.12) of the measurement subject.
Next, a systolic blood pressure calculating method according to an embodiment of the present invention will be described.
First, the device 100 for calculating a systolic blood pressure receives data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject.
Then, the device 100 for calculating a systolic blood pressure acquires the unique parameter value (a) of the measurement subject by applying the input data regarding the first pulse transit time (PTT) and the systolic blood pressure (SBP) of the measurement subject to the PTT-SBP relationship (SBP=a*PTT−1+y0). At this time, since the correlation between the parameters is y0=118.87−3.25a, the parameter value (a) is acquired by Equation (3)
In addition, the device 100 for calculating a systolic blood pressure receives the second pulse transit time (PTT) of the measurement subject.
Then, at least one of the absolute value and the trend of change of the systolic blood pressure (SBP) of the measurement subject is calculated by applying the second pulse transit time (PTT) and the unique parameter value a of the measurement subject to the PTT-SBP relationship.
In another embodiment of the present invention, the device 100 for calculating a systolic blood pressure receives the second pulse transit time (PTT) of the measurement subject.
In addition, at least one of the absolute value and the trend of change of the systolic blood pressure (SBP) of the measurement subject is calculated by applying the second pulse transit time (PTT) and the unique parameter value a of the measurement subject to the PTT-SBP relationship.
At this time, the unique parameter value (a) of the measurement subject can be stored in the device 100 for calculating a systolic blood pressure according to the present invention.
Meanwhile, the systolic blood pressure calculating method according to the embodiment of the present invention can be implemented in a form of a computer-readable recording medium in which a program for executing the systolic blood pressure calculating method is recorded.
Hereinafter, accuracy of the systolic blood pressure calculated according to the embodiment of the present invention will be described with reference to
(a) to (d) of
The Bland-Altman Plot is a graph illustrating a difference between values obtained by using two measurement methods.
In
The Bland-Altman plot of
Table 3 below illustrates results of the graph illustrated in
As illustrated in Table 3, among the total of 3336 data sets, the number of data sets with an error of ±20 mmHg or less between the systolic blood pressure and the invasive blood pressure measurement value calculated according to the embodiment of the present invention is 3077 which accounts for 92.3% of the total. In addition, the number of data sets with an error of ±15 mmHg or less is 2676 which accounts for 80.3% of the total, and the number of data sets with an error of ±10 mmHg or less is 1959 which accounts for 58.8% of the total.
As described above, it can be seen that a numeric value of the systolic blood pressure calculated according to the embodiment of the present invention is accurately calculated within a small error range in comparison with the invasive blood pressure measurement value.
As described above, according to the embodiment of the present invention, only one measurement of a systolic blood pressure (SBP) and pulse transit time (PTT) of a patient makes it possible to acquire the patient's unique parameters (a, y0) regarding a PTT-SBP relationship with a very high level of accuracy, in a state of complete absence of prior information regarding a measurement subject, such as body measurement information, disease information, and demographic characteristics. Therefore, subsequent measurement of the patient's pulse transit time (PTT) alone makes it possible to calculate not only a trend of change of systolic blood pressure (SBP), but also an absolute value of the systolic blood pressure (SBP). As such, it is not possible for a technology or related art to realize a technology of calculating a unique characteristic coefficient of the patient by one measurement without the body measurement information and specifying an absolute value of the systolic blood pressure based on the unique characteristic coefficient. A first reason is that a method of related art can calculate the unique characteristic coefficient of a patient, only when measurement information on a height, a body weight, an age, an arm circumference, and the like, and an accompanying disease state such as elasticity of a blood vessel or viscosity of blood are known, and a second reason is that it is difficult to apply the method of related art, because, even if the absolute value of the systolic blood pressure is calculated by one measurement, it is not known at all whether or not the characteristic value of the patient previously calculated according to a degree of subsequent change of the blood pressure accurately reflects a subsequent change in the blood pressure.
In addition, since the present invention calculates a trend of change and an absolute value of the systolic blood pressure in a non-invasive manner, not only a burden on a body of the patient is not imposed, but also a continuous measurement can be made for a long time.
In addition, since the present invention can be applied to a device, which is guaranteed to be mobile and portable, such as a wearable device, not only an in-hospital patient but also a person in outdoor activities have an advantage of measuring a blood pressure in real time.
While the present invention is described with reference to exemplary embodiments, the embodiments are merely examples, and it will be understood by those skilled in the art that various modifications and equivalent embodiments can be made. Accordingly, the true scope of the present invention should be determined by the technical idea of the appended claims.
Number | Date | Country | Kind |
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10-2015-0099804 | Jul 2015 | KR | national |
Filing Document | Filing Date | Country | Kind |
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PCT/KR2016/007699 | 7/14/2016 | WO | 00 |