Patent Application
20210145298
Embodiments of the present invention relate to methods, apparatuses, computer programs and systems for calculating a pulse wave velocity of a subject. In particular, they relate to calculating the pulse wave velocity of the subject in an unobtrusive manner.
In the human circulation system, the heart pumps blood around the vasculature (arteries and veins) of a subject.
The heart pumps rhythmically, intermittently pumping a volume of blood into the arteries of the vasculature. The arteries are elastic tubes and as the volume of blood is passed along the branching network of arteries, the arteries distend increasing their volume. This increase in volume is referred to as an arterial pulse or simply a pulse. The speed at which this pulse moves along the arterial system, the pulse wave velocity, depends in part upon the systolic pressure generated by a ventricular contraction of the heart and the elastic properties of the arteries.
The pulse wave velocity is therefore a clinical indication related to the health of a subject's circulation system. It is dependent upon the systolic blood pressure generated by ventricular contraction and also the health of the vasculature.
The pulse wave velocity is determined by dividing the in-vivo distance from the heart to a particular pulse point of the vasculature of the subject by the time difference between detecting the heart's ventricular output and detecting the arterial pulse at the pulse point. The ventricular output may, for example, be detected by attaching electrocardiogram electrodes to the subject and the arterial pulse may be detected by detecting the change in arterial volume produced by the passing arterial pulse wave (plethysmography). The distance between the heart and the particular pulse point for the subject may, for example, be determined from a look-up table based upon the subject's height. It will be appreciated from the foregoing that it is important that a standard pulse point is used for the measurement of the arterial pulse signal so that the distance used is correct. It is therefore necessary to constrain the relationship between the subject and the sensors used. Typically the sensors are attached to the body of the subject at specific positions.
It would be desirable to be able to measure pulse wave velocity of a subject differently.
According to various, but not necessarily all, embodiments of the invention there is provided a method comprising:
According to various, but not necessarily all, embodiments of the invention there is provided a computer program that when run by a processor enables the processor to estimate an in-vivo distance, from a heart to a first one of a plurality of sensors in dependence upon a determined unconstrained body position of the subject, wherein the distance causes a time difference, dependent upon a pulse wave velocity, between detecting a heart-related signal and detecting a vascular signal at the first one of a plurality of distributed sensors.
According to various, but not necessarily all, embodiments of the invention there is provided a system comprising: means for detecting a heart-related signal; means for detecting a vasculature signal at a first one of a plurality of distributed sensors; means for determining a time difference between detecting the heart-related signal and detecting the vasculature signal; means for automatically estimating an in-vivo distance from the heart of the subject to the first one of the plurality of sensors in dependence upon a determined unconstrained body position of the subject; and means for calculating a pulse wave velocity using the determined time difference and the estimated in-vivo distance.
According to various, but not necessarily all, embodiments of the invention there is provided an apparatus comprising:
According to various, but not necessarily all, embodiments of the invention there is provided a system comprising:
According to various, but not necessarily all, embodiments of the invention there is provided examples as claimed in the appended claims.
For a better understanding of various examples that are useful for understanding the detailed description, reference will now be made by way of example only to the accompanying drawings in which:
In the examples described below, methods, apparatuses, computer programs and systems are described which may be used to measure a pulse wave velocity of a subject, for example a human subject. The pulse wave velocity is measured without a requirement to constrain the position of the subject relative to the sensors used or to constrain the position of the sensors used relative to the subject. The subject has an unconstrained body position relative to the sensors used. The subject may therefore be unaware that the measurement is in progress.
In some but not necessarily all examples, the sensors are not attached to the subject's body nor does the subject have to adopt a particular constrained body position relative to the sensors.
At block 102, the method 100 comprises detecting a heart-related signal of a subject.
At block 104, the method 100 comprises detecting a vasculature signal of the subject at a first one of a plurality of distributed sensors.
At block 106, the method 100 comprises determining a time difference between detecting the heart-related signal and detecting the vasculature signal.
At block 108, the method 100 comprises using a controller to automatically estimate an in-vivo distance from the heart of the subject to the first one of the plurality of sensors in dependence upon a determined unconstrained body position of the subject.
At block 110, the method 100 comprises calculating a pulse wave velocity by dividing the estimate of the in-vivo distance from the heart of the subject to the first one of the plurality of sensors by the time difference between detecting the heart-related signal and detecting the vasculature signal.
It should be appreciated that the first one of the plurality of distributed sensors that detects the vasculature signal of the subject may be any one of the plurality of distributed sensors. The identity of the first one of the plurality of distributed sensors will change with the changing body position of the subject.
The blocks 104, 108 may therefore alternatively be described as detecting a vasculature signal of the subject at any one of the plurality of distributed sensors and using a controller to automatically estimate an in-vivo distance from the heart of the subject to the sensor used to detect the vasculature signal, in dependence upon a determined unconstrained body position of the subject.
The heart-related signal of a subject may relate to any phase of the heart cycle. In some but not necessarily all examples it may be a signal produced by or as a consequence of ventricular contraction.
The vasculature signal of the subject may be a signal produced by an arterial pulse wave. In some but not necessarily all examples it may be a signal dependent upon a change in arterial volume.
The sensors 202 comprise one or more sensors for detecting the heart-related signal, a plurality of distributed sensors for detecting a vasculature signal and sensors for determining a subject's body position (posture).
The plurality of sensors are spatially distributed over an area or volume such that a vasculature signal can be detected, at different ones of the plurality of sensors, as the subject changes posture.
A controller 204 is configured to receive sensing data from the sensors 202. In some examples, the controller 204 is configured to perform the whole of the method 100 including the detection of the heart-related signal (block 102) and the detection of the vasculature signal (block 104) from the data provided by the sensors 202. In other examples, the sensors 202 themselves may detect the heart-related signal and the vasculature signal and provide timing information to the controller 204 such that it can perform the block 106 of the method 100.
The controller 204 is configured to estimate an in-vivo distance D from a heart of the subject to a first one of a plurality of sensors 202. The distance causes a time difference T between detecting a heart-related signal and detecting a vasculature signal at the first one of a plurality of distributed sensors.
In some but not necessarily all examples, the in-vivo distance D is determined from the unconstrained posture of the subject. The distance D may be determined with body posture image recognition algorithms or by matching an entry in a database to detected posture sensor data. The database may comprise a plurality of entries each associating different reference posture sensor data p to different distances D(p). Querying the database with the detected posture sensor data p′ returns the distance D(p′). In some but not necessarily all examples the database may return the distance D(p″) where p″ is the reference posture sensor data that is most similar to the detected posture sensor data p′. Similarity may be determined in different ways, for example, pattern matching, principal component analysis, neural networks, hidden Markov models or other approaches may be used.
In some but not necessarily all examples, the database may be stored remotely and offered as a centralized service to multiple users simultaneously. In other examples, the database may be stored locally at the controller 204.
In some but not necessarily all examples, the controller 204 is configured to calculate a pulse wave velocity using the determined time difference T and the estimated in-vivo distance D. If the heart-related signal relates to ventricular output then the distance D is divided by the time T. If the heart-related signal relates to a different phase of the cardiac cycle, the time T may be adjusted and the pulse wave velocity determined by dividing the distance D by the adjusted time T′.
In some examples, the controller 204 may perform all of the blocks 102, 104, 106, 108, 110 of
In some, but not necessarily all examples, the sensors 202 may, in addition, comprise electrocardiogram sensors for example capacitive electrocardiogram sensors. These may be used for accurately monitoring the cycle of a human heart and may be used to detect the heart-related signal during normal use or during a calibration phase.
In some, but not necessarily all examples, the sensors 202 may, in addition, comprise sensors measuring the mechanical ventricular contraction, for example, Ballistocardiogram (BCG) or seism cardiogram (SCG) sensors.
Referring back to
For example, at block 112, the method 100 may comprise a control step such as controlling the storage of the pulse wave velocity as a continuous record over time and/or sending the calculated pulse wave velocity to a remote location for storage or processing and/or performing a further calculation in relation to the pulse wave velocity and/or in relation to the calculated pulse wave velocity or in relation to the further calculation based upon the pulse wave velocity, generating a warning or an alert.
It may, for example, be possible to use the pulse wave velocity to calculate an indicator of arterial stiffness. A theoretical model based on the Moens-Korteweg equation relates the ratio of the square of the pulse wave velocity v to the Young's modulus E of arterial stiffness to a constant c: v2=c·E.
It is therefore possible to obtain and store an indicator of arterial stiffness for a subject and also to monitor and store changing arterial stiffness over time for a subject.
It is also possible to convert the calculated pulse wave velocity to a systolic blood pressure estimate. This conversion may be based upon a theoretical model which, in turn, is based upon the Moens-Korteweg equation.
P=αloge{b/[(d/v−c)2−1]}
This equation relates the systolic blood pressure P to the calculated pulse wave velocity v using the empirically-determined constants a, b, c, d. The constants a, b, c, d may, for example, be determined using a calibration process in which both systolic blood pressure and the pulse wave velocity are measured. The systolic blood pressure may, for example be measured using a standard occlusion method and the pulse wave velocity may be measured separately as described above.
It is therefore possible to obtain and store an indicator of systolic blood pressure for a subject and also to monitor and store changing systolic blood pressure over time for a subject.
Implementation of the controller 204 may be as controller circuitry. The controller 204 may be implemented in hardware alone, have certain aspects in software including firmware alone or can be a combination of hardware and software (including firmware).
As illustrated in
The processor 206 is configured to read from and write to the memory 208. The processor 206 may also comprise an output interface via which data and/or commands are output by the processor 206 and an input interface via which data and/or commands are input to the processor 206.
The memory 208 stores a computer program 210 comprising computer program instructions (computer program code) that controls the operation of the controller 204 when loaded into the processor 206. The computer program instructions, of the computer program 210, provide the logic and routines that enables the apparatus to perform the methods illustrated in
The apparatus 204 therefore comprises:
The computer program 210 may arrive at the controller 204 via any suitable delivery mechanism. The delivery mechanism may be, for example, a non-transitory computer-readable storage medium, a computer program product, a memory device, a record medium such as a compact disc read-only memory (CD-ROM) or digital versatile disc (DVD), an article of manufacture that tangibly embodies the computer program 210. The delivery mechanism may be a signal configured to reliably transfer the computer program 210. The controller may propagate or transmit the computer program 210 as a computer data signal.
Although the memory 208 is illustrated as a single component/circuitry it may be implemented as one or more separate components/circuitry some or all of which may be integrated/removable and/or may provide permanent/semi-permanent/dynamic/cached storage.
Although the processor 206 is illustrated as a single component/circuitry it may be implemented as one or more separate components/circuitry some or all of which may be integrated/removable. The processor 206 may be a single core or multi-core processor.
References to ‘computer-readable storage medium’, ‘computer program product’, ‘tangibly embodied computer program’ etc. or a ‘controller’, ‘computer’, ‘processor’ etc. should be understood to encompass not only computers having different architectures such as single/multi-processor architectures and sequential (Von Neumann)/parallel architectures but also specialized circuits such as field-programmable gate arrays (FPGA), application specific circuits (ASIC), signal processing devices and other processing circuitry. References to computer program, instructions, code etc. should be understood to encompass software for a programmable processor or firmware such as, for example, the programmable content of a hardware device whether instructions for a processor, or configuration settings for a fixed-function device, gate array or programmable logic device etc.
As used in this application, the term ‘circuitry’ refers to all of the following:
This definition of ‘circuitry’ applies to all uses of this term in this application, including in any claims. As a further example, as used in this application, the term “circuitry” would also cover an implementation of merely a processor (or multiple processors) or portion of a processor and its (or their) accompanying software and/or firmware. The term “circuitry” would also cover, for example and if applicable to the particular claim element, a baseband integrated circuit or applications processor integrated circuit for a mobile phone or a similar integrated circuit in a server, a cellular network device, or other network device.
The sensors 220, 222, 224 may, in some examples, be independent, different sensors and in some examples one or more of the sensors may be the same sensor that performs two or more functions.
The sensors 220, 222, 224 may, in some examples, be unconstrained sensors that do not have to be in a particular spatial relationship to the subject to perform the function described. Thus the heart-related signal, the vasculature signal and the posture may be determined for different arbitrary postures of the subject.
The one or more sensors 220 for sensing the heart-related signal may, for example, comprise movement sensors, force sensors, electrical voltage sensors, impedance (or conductivity) sensors, pressure sensors and/or audio sensors.
A movement sensor may be used to detect the movement of the subject's heart. Such a sensor may be described as a ballistocardiography sensor as it detects the body movement arising from the blood flow in arteries or as a seismocardiography sensor as it detects the chest wall movement arising from the heart movement. Such sensors may be implemented using, for example, an accelerometer sensor or a gyroscope sensor.
A force or pressure sensor may be used to detect a ventricular contraction of the subject's heart. Such a sensor may be described as a ballistocardiography sensor as it detects the force or pressure arising from body movement or as seismocardiography sensor as it detects the force or pressure arising from chest wall movement arising from the heart movement. Such sensors may be implemented using, for example, a piezoelectric sensor, an electromechanical film sensor, a strain gauge sensor, a piezoresistive sensor, a capacitive sensor or a fluid pressure sensor.
An electrical voltage sensor may be used to detect the electrical signal generated by cardiac cycle. Such a sensor may be described as an electrocardiography sensor as it detects the electrical signal generated by the subject's heart muscles. Such sensors may be implemented using, for example, resistive and/or capacitive coupling to the user's body.
An impedance (or conductivity) sensor may be used to detect the impedance change generated by cardiac cycle. Such a sensor may be described as an impedancecardiography sensor as it detects the impedance change generated by increased fluid i.e. blood volume in the measurement area. Such sensors may be implemented using, for example, resistive and/or capacitive coupling to the user's body.
An audio sensor, for example a microphone, may be configured to detect audio arising from the heart cycle of the subject. Such a sensor may be described as a phonocardiography sensor.
The plurality of distributed sensors 222 are configured to sense a vasculature signal, for example an arterial pulse, of the subject at different locations such that as the posture of the subject changes it remains possible to sense a vasculature signal at one of the plurality of distributed sensors 222. The plurality of distributed sensors 222 may for example be contact sensors configured for impedance plethysmography, force sensors, pressure sensors and/or audio sensors.
The posture sensors 224 are configured to determine a posture of the subject. The posture of the subject may change because the body position of the subject is unconstrained for determination of the pulse wave velocity. The determination of the subject's posture may, for example, be determined by using spatially distributed pressure sensors, spatially distributed force sensors, spatially distributed impedance sensors, spatially distributed capacitance sensors, spatially distributed inductance sensors or by using a visual sensor and computer vision analysis or reflected structured light analysis to determine the position of the subject's limbs. The visual sensor may operate in the visible spectrum or the infrared spectrum for example.
One or more of the different sensors described may be used to detect the heart-related signal, the vasculature signal at different positions and the subject's posture.
Pressure, force and/or conductivity sensors may be re-used for determining the subject's posture and for determining one or more circulatory signals (the heart-related signal and/or the vasculature signal).
The apparatus 240 is configured such that the sensors 202 are proximal to the subject when the subject is using the apparatus 240. The apparatus 240 may, for example, be furniture, furnishings or clothes that are proximal to the subject. As such, it is not therefore necessary to attach sensors 202, 222 to the subject and there is the possibility of relative movement between the sensors 202, 222 and the subject. There is no requirement to constrain movement of the sensors 202, 222 relative to the subject nor to constrain movement of the subject relative to the sensors 202, 222.
In the illustrated example, the apparatus 240 is a bed or a mattress in which the sensors 202, 222 are embedded. In alternative examples the apparatus 240 may be a sheet for a mattress in which the sensors 202, 222 are embedded.
It is possible to embed the sensors 202, 222 within a sheet or a mattress by using conductive stripes and/or electrical yarn. It is for example possible to create the plurality of distributed sensors 222 as electrical contact sensors suitable for impedance plethysmography.
The blocks illustrated in
Where a structural feature has been described, it may be replaced by means for performing one or more of the functions of the structural feature whether that function or those functions are explicitly or implicitly described.
The recording of data may comprise only temporary recording, or it may comprise permanent recording or it may comprise both temporary recording and permanent recording. Temporary recording implies the recording of data temporarily. This may, for example, occur during sensing, occur at a dynamic memory, occur at a buffer such as a circular buffer, a register, a cache or similar. Permanent recording implies that the data is in the form of an addressable data structure that is retrievable from an addressable memory space and can therefore be stored and retrieved until deleted or over-written, although long-term storage may or may not occur. The use of the term ‘store’, ‘storage’ etc. in relation to data relates to permanent recording of the data.
As used here ‘module’ refers to a unit or apparatus that excludes certain parts/components that would be added by an end manufacturer or a user. The controller 204 may be a module.
The term ‘comprise’ is used in this document with an inclusive not an exclusive meaning. That is any reference to X comprising Y indicates that X may comprise only one Y or may comprise more than one Y. If it is intended to use ‘comprise’ with an exclusive meaning then it will be made clear in the context by referring to “comprising only one.” or by using “consisting”.
In this brief description, reference has been made to various examples. The description of features or functions in relation to an example indicates that those features or functions are present in that example. The use of the term ‘example’ or ‘for example’ or ‘may’ in the text denotes, whether explicitly stated or not, that such features or functions are present in at least the described example, whether described as an example or not, and that they can be, but are not necessarily, present in some of or all other examples. Thus ‘example’, ‘for example’ or ‘may’ refers to a particular instance in a class of examples. A property of the instance can be a property of only that instance or a property of the class or a property of a sub-class of the class that includes some but not all of the instances in the class. It is therefore implicitly disclosed that a feature described with reference to one example but not with reference to another example, can where possible be used in that other example but does not necessarily have to be used in that other example.
Although embodiments of the present invention have been described in the preceding paragraphs with reference to various examples, it should be appreciated that modifications to the examples given can be made without departing from the scope of the invention as claimed.
Features described in the preceding description may be used in combinations other than the combinations explicitly described.
Although functions have been described with reference to certain features, those functions may be performable by other features whether described or not.
Although features have been described with reference to certain embodiments, those features may also be present in other embodiments whether described or not.
Whilst endeavoring in the foregoing specification to draw attention to those features of the invention believed to be of particular importance it should be understood that the Applicant claims protection in respect of any patentable feature or combination of features hereinbefore referred to and/or shown in the drawings whether or not particular emphasis has been placed thereon.
| Number | Date | Country | Kind |
|---|---|---|---|
| 17179202.1 | Jun 2017 | EP | regional |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/FI2018/050451 | 6/13/2018 | WO | 00 |
