CN112494022A - Method for obtaining coronary artery blood vessel evaluation parameter and storage medium - Google Patents
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- A—HUMAN NECESSITIES
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
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- A—HUMAN NECESSITIES
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Abstract
The application provides a method and a storage medium for acquiring coronary artery blood vessel evaluation parameters. Obtaining aortic pressure PaData; according to the aortic pressure PaExtracting a flat pressure stabilizing force waveform; and acquiring coronary artery blood vessel evaluation parameters according to the stable pressure waveform. The method and the device solve a plurality of key problems in rapid calculation for obtaining the coronary artery blood vessel evaluation parameters by utilizing the position advantage of the aorta on the cardiovascular morphology and extracting the stable aorta pressure waveform, and comprise the steps of improving the calculation speed, reducing manual intervention, ensuring the accuracy and the like.
Description
Technical Field
The invention relates to the technical field of coronary artery medicine, in particular to a method and a storage medium for acquiring coronary artery blood vessel evaluation parameters.
Background
The deposition of lipids and carbohydrates in human blood on the vessel wall will form plaques on the vessel wall, which in turn leads to vessel stenosis; especially, the blood vessel stenosis near the coronary artery of the heart can cause insufficient blood supply of cardiac muscle, induce diseases such as coronary heart disease, angina pectoris and the like, and cause serious threat to the health of human beings. According to statistics, about 1100 million patients with coronary heart disease in China currently have the number of patients treated by cardiovascular interventional surgery increased by more than 10% every year.
Although conventional medical detection means such as coronary angiography CAG and computed tomography CT can display the severity of coronary stenosis of the heart, the ischemia of the coronary cannot be accurately evaluated. In order to improve the accuracy of coronary artery function evaluation, Pijls in 1993 proposes a new index for estimating coronary artery function through pressure measurement, namely Fractional Flow Reserve (FFR), and the FFR becomes the gold standard for coronary artery stenosis function evaluation through long-term basic and clinical research.
The Fractional Flow Reserve (FFR) generally refers to the fractional flow reserve of myocardium, and is defined as the ratio of the maximum blood flow provided by a diseased coronary artery to the maximum blood flow when the coronary artery is completely normal. Namely, the FFR value can be measured and calculated by measuring the pressure at the position of the coronary stenosis and the pressure at the position of the coronary stenosis under the maximal hyperemia state of the coronary artery through a pressure sensor.
In the prior art, methods for obtaining coronary artery blood vessel evaluation parameters generally transmit the parameters from the inside of a blood vessel in a way of a guide wire and a sensor in the process of invasive surgery. The method has a series of problems to be solved, such as low calculation speed, more manual intervention and incapability of ensuring accuracy.
Disclosure of Invention
The invention provides a method for acquiring coronary artery blood vessel evaluation parameters and a storage medium, which are used for solving the problems of low calculation speed, more manual intervention and incapability of ensuring accuracy.
To achieve the above object, in a first aspect, the present application provides a method for obtaining coronary artery blood vessel evaluation parameters, comprising:
obtaining aortic pressure PaData;
according to the aortic pressure PaExtracting a flat pressure stabilizing force waveform;
and acquiring coronary artery blood vessel evaluation parameters according to the stable pressure waveform.
Optionally, the above-mentioned obtaining a coronary vessel evaluation parameter, the obtaining of the aortic pressure PaA method of data, comprising:
the aortic inlet pressure is acquired by a disposable blood pressure sensor.
Optionally, the above-mentioned obtaining a coronary vessel evaluation parameter is based on the aortic pressure PaThe method for extracting the flat pressure waveform comprises the following steps:
defining a plurality of index lists and physiological parameter thresholds;
calculating average pressure according to the index list and the physiological parameter threshold value and the aortic pressure data;
acquiring a pressure average value point according to the average pressure;
dividing a data cycle according to the pressure mean value point, and acquiring a pressure parameter in each heartbeat cycle;
and acquiring a flat pressure stabilizing waveform according to the pressure parameters.
Optionally, in the above-mentioned obtaining the coronary artery blood vessel evaluation parameter, the index lists include: the device comprises a temporary storage list, a mean point index list, a maximum value point index list and a minimum value point index list.
Optionally, the above-mentioned obtaining the coronary artery blood vessel evaluation parameter, the physiological parameter threshold value includes: the number of heart beat cycles C, the range from diastolic pressure to systolic pressure, the minimum pressure amplitude threshold, the fluctuation difference of systolic pressure or diastolic pressure, the heart rate range, the number of pressures NThreshold(s)Upper limit of number of documents, threshold value of cut-off pressure PCutting blockCut-off heart rate threshold HRCutting blockPressure transmission rate threshold VThreshold(s)。
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters, where the method for calculating an average pressure according to the index list and the physiological parameter threshold includes:
obtaining a heartbeat cycle time threshold according to the heart rate threshold;
acquiring a data point number range in one heartbeat cycle according to the heartbeat cycle number C and a pressure transmission rate threshold;
defining a time period according to the data point number range, counting the number of all data points when finishing one time period, and storing all the obtained aortic pressures and the obtained time in the temporary storage list in a one-to-one correspondence manner;
and if the number of the data in the temporary storage list is an integral multiple of the N threshold, is greater than the minimum threshold of the range of the number of the data points and is less than the maximum threshold of the range of the number of the data points, calculating the average value of the arterial pressure in all the temporary storage lists, namely the average pressure.
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters, wherein the calculating the mean pressure according to the index list and the physiological parameter threshold from the aortic pressure data further includes:
if n continuous aorta pressures P in the temporary storage listaAre all less than a cut-off pressure threshold value PCutting blockRemoving the n aortic pressures P from the temporary lista。
Optionally, the method for obtaining a pressure mean value point according to the mean pressure comprises:
setting a mean point index list;
adding a pressure mean value point into the mean value point index list;
generating a pressure mean point curve according to the pressure mean points;
filtering the pressure average point on the pressure average point curve;
and judging whether the number of the pressure mean value points in the mean value point index list meets the requirement of the heartbeat cycle, if not, repeating the claim 7, and adjusting the n until the requirement of the heartbeat cycle is met.
Optionally, in the above method for obtaining coronary artery blood vessel evaluation parameters, the method for adding a pressure mean point into the mean point index list includes:
registering the aortic pressure P in the temporary listaRespectively with the mean pressure
Make a comparison；
If it is not
And is
Then P will beKAdding into the average value point index list, wherein PK、PK+1Respectively representing the Kth and the Kth +1 arterial pressure in the temporary storage list;
if it is not
And is
Then P will beKAnd adding the average value point index into the average value point index list.
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters, the method for filtering the pressure mean point on the pressure mean point curve includes:
according to Dn＝Pn+1-PnIn which P isn、Pn+1Respectively represent the nth and n +1 th aortic pressures in the mean point index list, the DnRepresents Pn+1、PnPressure difference of (d);
according to HRn＝30/(Dn/n) obtaining a heart rate frequency value HR in the nth half heartbeat cyclen；
If HR is highn＜HRCutting blockDeleting the HR from the average point index listnCorresponding mean pressure points;
if it is not
And at PnThe pressure of the last m continuous aorta is all larger than
And is
Deleting P from the mean point index listnThe last m pressure mean value points are continuous.
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters, where the step of determining whether the number of the pressure mean points in the mean point index list meets the requirement of the heartbeat cycle, and if not, repeating the above method, and adjusting n until the requirement of the heartbeat cycle is met includes:
if the number of data in the average point list is NAre all made ofIf the frequency is less than 2C +1, the requirement of the heartbeat cycle is not met, and the method is repeated;
adjusting N to NAre all made of≥2C+1。
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters, and segmenting a data cycle according to the pressure mean value point to obtain a pressure parameter in each heartbeat cycle, includes:
if it is not
Extracting P from the scratch listnMaximum pressure P in the heart cyclemaxAnd said maximum pressure PmaxAt the position SmaxThe said Smax、PmaxAdding the blood pressure data into a diastolic pressure list in a one-to-one correspondence manner;
obtaining P in the diastolic blood pressure listmaxTo obtain the diastolic pressure PShu shu；
If it is not
Extracting P from the scratch listnMinimum pressure P in the heart cycleminAnd said minimum pressure PminAt the position SminThe said Smin、PminAdding the blood pressure into a systolic pressure list in a one-to-one correspondence manner;
obtaining P in the systolic blood pressure listminTo obtain the systolic pressure PHarvesting machine。
Optionally, the above-mentioned coronary artery vessel evaluation parameter is obtained if PShu shuIf the blood pressure is not in the range from the diastolic pressure to the systolic pressure, the temporary list is obtained again.
Optionally, the above-mentioned obtaining a coronary vessel evaluation parameter, if PShu shuA method for retrieving said scratch list if not within a diastolic to systolic pressure range, comprising: and intercepting the first half part of the temporary storage list into the storage list, and if the number of data is greater than the upper limit of the number of the storage list, directly replacing the first half part of the data of the temporary storage list adopting the storage list into the temporary storage list, and emptying the storage list.
Optionally, the method for obtaining coronary artery blood vessel evaluation parameters and obtaining a flattened pressure waveform according to the pressure parameters comprises:
setting the offset as VThreshold(s)A, intercepting a starting point O and an end point E;
and executing the mean value point index list, the diastolic pressure list and the systolic pressure list according to the offset, the starting point O and the ending point E, and outputting the regulated pressure waveform, the diastolic pressure waveform and the systolic pressure waveform.
Optionally, the acquiring the coronary artery blood vessel evaluation parameter further includes: according to the flat pressure waveform and HR 60VThreshold(s)/(NAre all made of/C), obtaining the heart rate HR.
Optionally, the above method for obtaining coronary artery blood vessel evaluation parameters according to the stationary pressure waveform comprises:
acquiring different blood vessel state periods according to the flat pressure stabilizing force waveform, wherein the method comprises the following steps: a pressure interval of maximum hyperemia, a waveform-free pressure interval;
acquiring the average aortic pressure in different vessel state periods;
and acquiring a plurality of coronary artery blood vessel evaluation parameters according to the aorta average pressure of different blood vessel state periods, wherein the coronary artery blood vessel evaluation parameters comprise coronary artery blood flow reserve fraction and instantaneous waveform-free ratio.
Optionally, the above-mentioned obtaining a coronary artery blood vessel evaluation parameter, the coronary artery fractional flow reserve is according to a formula
Is obtained in which
Representing the average pressure distal to the coronary stenosis,
the mean aortic pressure in the maximal hyperemic state is indicated.
Optionally, the above method for acquiring coronary artery blood vessel evaluation parameters comprises:
acquiring a plurality of diastolic phases and systolic phases from the stationary pressure waveform;
acquiring a waveform segment of the diastolic aortic pressure showing a descending trend;
screening and reserving a waveform segment with another peak lower than the diastolic peak on the waveform segment, setting the position of the another peak as a starting point, and selecting a slope maximum point of the waveform segment as the starting point if the waveform segment has no another peak;
the wave trough corresponding to the waveform segment or 1-8ms before the wave trough is taken as a tail point;
the waveform between the starting point and the end point is used as a transient waveform-free period;
according to
Where iFR represents the instantaneous waveform-free ratio,
representing the average pressure distal to the instantaneous coronary stenosis,
to representThe mean aortic pressure during the instantaneous waveform-free period or the mean aortic pressure in the region 3/4 after the instantaneous waveform-free period from the starting point to the ending point.
In a second aspect, the present application provides a computer storage medium, and a computer program, which when executed by a processor, implements the above-described method for obtaining coronary artery vessel evaluation parameters.
The beneficial effects brought by the scheme provided by the embodiment of the application at least comprise:
the method for obtaining the coronary artery vessel evaluation parameters solves several key problems in rapid calculation of obtaining the coronary artery vessel evaluation parameters by utilizing the position advantages of the aorta on the cardiovascular morphology and extracting the stable aorta pressure waveform, and comprises the steps of improving the calculation speed, reducing manual intervention, ensuring accuracy and the like.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the invention and not to limit the invention. In the drawings:
FIG. 1 is a flow chart of a method of obtaining coronary artery vessel evaluation parameters according to the present application;
FIG. 2 is a flow chart of the present application S200;
FIG. 3 is a flow chart of the present application S220;
FIG. 4 is a flow chart of the present application S230;
FIG. 5 is a flow chart of the present application S232;
FIG. 6 is a flow chart of the present application S234;
FIG. 7 is a flow chart of the present application S240;
FIG. 8 is a flow chart of the present application S250;
fig. 9 is a flowchart of the present application S300.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the specific embodiments of the present invention and the accompanying drawings. It is to be understood that the described embodiments are merely exemplary of the invention, and not restrictive of the full scope of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
In the following description, for purposes of explanation, numerous implementation details are set forth in order to provide a thorough understanding of the various embodiments of the present invention. It should be understood, however, that these implementation details are not to be interpreted as limiting the invention. That is, in some embodiments of the invention, such implementation details are not necessary. In addition, some conventional structures and components are shown in simplified schematic form in the drawings.
Example 1:
in order to solve the above problem, as shown in fig. 1, the present application provides a method for obtaining coronary artery blood vessel evaluation parameters, comprising:
s100, acquiring aortic pressure PaData, comprising:
the aortic inlet pressure is acquired by a disposable blood pressure sensor.
S200, as shown in figure 2, according to the aortic pressure PaExtracting a flat regulated pressure waveform comprising:
s210, defining a plurality of index lists and physiological parameter thresholds;
the plurality of index lists includes: the device comprises a temporary storage list, a mean point index list, a maximum value point index list and a minimum value point index list.
The physiological parameter thresholds include: the number of heart beat cycles C, the range from diastolic pressure to systolic pressure, the minimum pressure amplitude threshold, the fluctuation difference of systolic pressure or diastolic pressure, the heart rate range, the number of pressures NThreshold(s)Upper limit of number of documents, threshold value of cut-off pressure PCutting blockCut-off heart rate threshold HRCutting blockPressure transmission rate threshold VThreshold(s)。
S220, as shown in fig. 3, calculating the average pressure according to the index list, the physiological parameter threshold, and the aortic pressure data, including:
s221, obtaining a heartbeat cycle time threshold according to the heart rate threshold;
s222, acquiring a data point number range in one heartbeat cycle according to the heartbeat cycle number C and the pressure transmission rate threshold;
s223, defining a time period according to the range of the number of the data points, counting the number of all the data points when finishing one time period, and storing all the obtained aortic pressures and the obtained time in a temporary storage list in a one-to-one correspondence manner;
if n continuous aortic pressures P in the temporary storage listaAre all less than a cut-off pressure threshold value PCutting blockThen n aortic pressures P are removed from the scratch listaThe calculated amount is reduced, and the running speed is improved.
S224, if the number of the data in the temporary storage list is NThreshold(s)Is greater than the minimum threshold value of the range of the number of data points and is less than the maximum threshold value of the range of the number of data points, the average value of the aortic pressures in all the temporary storage lists is calculated, namely the average pressure.
S230, as shown in fig. 4, obtaining a pressure average value point according to the average pressure, including:
s231, setting a mean point index list;
s232, as shown in fig. 5, adding a pressure mean point to the mean point index list, including:
s2321, the main artery pressure P in the temporary storage list is storedaRespectively and average pressure
Comparing;
s2322, if
And is
Then P will beKAdding into an average value point index list, wherein PK、PK+1Individual watchShowing the K and K +1 aortic pressures in the scratch list;
s2323, if
And is
Then P will beKAnd adding the average value point index into an average value point index list.
S233, generating a pressure mean point curve according to the pressure mean points;
s234, as shown in fig. 6, filtering the pressure mean point on the pressure mean point curve, including:
s2341, according to Dn＝Pn+1-PnIn which P isn、Pn+1Respectively represent the nth and n +1 aortic pressures in the index list of mean points, DnRepresents Pn+1、PnPressure difference of (d);
s2342, according to HRn＝30/(Dn/n) obtaining the heart rate frequency value HR in the nth half heartbeat periodn；
S2343, if HRn＜HRCutting blockThen HR is deleted from the mean index listnCorresponding mean pressure points;
s2344, if
And at PnThe pressure of the last m continuous aorta is all larger than
And is
Then P is removed from the mean point index listnThe last m pressure mean value points are continuous.
S235, judging whether the number of the pressure average value points in the average value point index list meets the requirement of the heartbeat cycle, if not, repeating the method, and adjusting the size of n until the requirement of the heartbeat cycle is met, wherein the method comprises the following steps:
if the number of data in the average point list is NAre all made ofIf the frequency is less than 2C +1, the requirement of the heartbeat cycle is not met, and the method is repeated;
adjusting N to NAre all made of≥2C+1。
S240, as shown in fig. 7, segmenting the data period according to the pressure mean value point, and acquiring the pressure parameter in each heartbeat period, including:
s241, if
Extracting P from scratch listnMaximum pressure P in the heart cyclemaxAnd maximum pressure PmaxAt the position SmaxWill Smax、PmaxAdding the blood pressure data into a diastolic pressure list in a one-to-one correspondence manner;
s242, acquiring P in the diastolic blood pressure listmaxTo obtain the diastolic pressure PShu shu；
If P isShu shuIf the blood pressure is not in the range from the diastolic pressure to the systolic pressure, the temporary list is obtained again, and the method comprises the following steps: and intercepting the first half part of the temporary storage list into the storage list, and if the number of the data is greater than the upper limit of the number of the storage list, directly replacing the first half part of the data of the temporary storage list adopting the storage list into the temporary storage list, and emptying the storage list.
S243, if
Extracting P from scratch listnMinimum pressure P in the heart cycleminAnd a minimum pressure PminAt the position SminWill Smin、PminAdding the blood pressure into a systolic pressure list in a one-to-one correspondence manner;
s244, acquiring P in the systolic blood pressure listminTo obtain the systolic pressure PHarvesting machine。
S250, as shown in fig. 8, obtaining a smooth pressure waveform according to the pressure parameters, including:
s251, setting the offset as VThreshold(s)A, intercepting a starting point O and an end point E;
and S252, executing the mean value point index list, the diastolic pressure list and the systolic pressure list according to the offset, the starting point O and the ending point E, and outputting a smoothing pressure waveform, a diastolic pressure waveform and a systolic pressure waveform.
S300, as shown in fig. 9, obtaining coronary artery blood vessel evaluation parameters according to the flat stabilization pressure waveform, including:
s310, acquiring different blood vessel state periods according to the flat pressure stabilizing waveform, wherein the method comprises the following steps: a pressure interval of maximum hyperemia, a waveform-free pressure interval;
s320, acquiring the average aortic pressure in different vessel state periods;
s330, obtaining a plurality of coronary artery blood vessel evaluation parameters according to the aorta average pressure of different blood vessel state periods, wherein the coronary artery blood vessel evaluation parameters comprise coronary artery blood flow reserve fraction and instantaneous non-waveform ratio;
fractional coronary flow reserve according to the formula
Is obtained in which
Representing the average pressure distal to the coronary stenosis,
the mean aortic pressure in the maximal hyperemic state is indicated.
The method for acquiring the instantaneous waveform-free ratio comprises the following steps:
acquiring a plurality of diastoles and systoles from the stationary pressure waveform;
acquiring a waveform segment of the diastolic aortic pressure showing a descending trend;
screening and reserving a waveform section with another wave crest lower than the diastolic wave crest on the waveform section, setting the position of the other wave crest as a starting point, and selecting a maximum slope point of the waveform section as the starting point if the waveform section has no other wave crest;
the wave trough corresponding to the waveform segment or 1-8ms before the wave trough is taken as a tail point;
taking the waveform between the starting point and the end point as an instantaneous waveform-free period;
according to
Where iFR represents the instantaneous waveform-free ratio,
representing the average pressure distal to the instantaneous coronary stenosis,
the mean aortic pressure in the immediate waveform-free period or in the region 3/4 after the instantaneous waveform-free period from the starting point to the end point.
In one embodiment of the present application, the method further includes: s400, according to the flat pressure waveform and HR 60VThreshold(s)/(NAre all made of/C), obtaining the heart rate HR.
The present application provides a computer storage medium, a computer program being executed by a processor for implementing the above-mentioned method for obtaining coronary artery vessel evaluation parameters.
As will be appreciated by one skilled in the art, aspects of the present invention may be embodied as a system, method or computer program product. Thus, various aspects of the invention may be embodied in the form of: an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.) or an embodiment combining hardware and software aspects that may all generally be referred to herein as a "circuit," module "or" system. Furthermore, in some embodiments, aspects of the invention may also be embodied in the form of a computer program product in one or more computer-readable media having computer-readable program code embodied therein. Implementation of the method and/or system of embodiments of the present invention may involve performing or completing selected tasks manually, automatically, or a combination thereof.
For example, hardware for performing selected tasks according to embodiments of the invention could be implemented as a chip or a circuit. As software, selected tasks according to embodiments of the invention could be implemented as a plurality of software instructions being executed by a computer using any suitable operating system. In an exemplary embodiment of the invention, one or more tasks according to exemplary embodiments of the methods and/or systems as described herein are performed by a data processor, such as a computing platform for executing a plurality of instructions. Optionally, the data processor comprises volatile storage for storing instructions and/or data and/or non-volatile storage for storing instructions and/or data, e.g. a magnetic hard disk and/or a removable medium. Optionally, a network connection is also provided. A display and/or a user input device, such as a keyboard or mouse, is optionally also provided.
Any combination of one or more computer readable media may be utilized. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following:
an electrical connection having one or more wires, a portable computer diskette, a hard disk, a Random Access Memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.
A computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated data signal may take many forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A computer readable signal medium may also be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device.
Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.
For example, computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C + + or the like and conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user's computer and partly on a remote computer or entirely on the remote computer or server. In the case of a remote computer, the remote computer may be connected to the user's computer through any type of network, including a Local Area Network (LAN) or a Wide Area Network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet service provider).
It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the computer program instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.
These computer program instructions may also be stored in a computer-readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer-readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks.
The computer program instructions may also be loaded onto a computer (e.g., a coronary artery analysis system) or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer, other programmable apparatus or other devices provide processes for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.
The above embodiments of the present invention have been described in further detail for the purpose of illustrating the invention, and it should be understood that the above embodiments are only illustrative of the present invention and are not to be construed as limiting the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.
Claims (20)
1. A method of obtaining coronary artery vessel evaluation parameters, comprising:
obtaining aortic pressure PaData;
according to the aortic pressure PaExtracting a flat pressure stabilizing force waveform;
and acquiring coronary artery blood vessel evaluation parameters according to the stable pressure waveform.
2. Acquisition of coronary vessel evaluation parameters according to claim 1, characterized by the fact that the acquisition of aortic pressure PaA method of data, comprising:
the aortic inlet pressure is acquired by a disposable blood pressure sensor.
3. Method for obtaining coronary vessel evaluation parameters according to claim 1, characterized in that said evaluation is based on the aortic pressure PaThe method for extracting the flat pressure waveform comprises the following steps:
defining a plurality of index lists and physiological parameter thresholds;
calculating average pressure according to the index list and the physiological parameter threshold value and the aortic pressure data;
acquiring a pressure average value point according to the average pressure;
dividing a data cycle according to the pressure mean value point, and acquiring a pressure parameter in each heartbeat cycle;
and acquiring a flat pressure stabilizing waveform according to the pressure parameters.
4. The method of obtaining coronary artery vessel evaluation parameters of claim 3, wherein the plurality of index lists comprises: the device comprises a temporary storage list, a mean point index list, a maximum value point index list and a minimum value point index list.
5. The method of obtaining coronary vessel evaluation parameters according to claim 3, wherein the physiological parameter threshold values comprise: the number of heart beat cycles C, the range from diastolic pressure to systolic pressure, the minimum pressure amplitude threshold, the fluctuation difference of systolic pressure or diastolic pressure, the heart rate range, the number of pressures NThreshold(s)Upper limit of number of documents, threshold value of cut-off pressure PCutting blockCut-off heart rate threshold HRCutting blockPressure transmission rate threshold VThreshold(s)。
6. The method of claim 3, wherein the calculating the mean pressure of the aortic pressure data according to the index list and the physiological parameter threshold comprises:
obtaining a heartbeat cycle time threshold according to the heart rate threshold;
acquiring a data point number range in one heartbeat cycle according to the heartbeat cycle number C and a pressure transmission rate threshold;
defining a time period according to the data point number range, counting the number of all data points when finishing one time period, and storing all the obtained aortic pressures and the obtained time in the temporary storage list in a one-to-one correspondence manner;
if the number of the data in the temporary storage list is NThreshold(s)Is greater than the minimum threshold value of the range of the number of data points and is less than the maximum threshold value of the range of the number of data points, the average value of the aortic pressures in all the temporary storage lists is calculated, namely the average pressure.
7. The method of obtaining coronary artery vessel assessment parameters of claim 6, wherein said method of calculating mean pressure from said index list, said physiological parameter threshold, said aortic pressure data further comprises:
if n continuous aorta pressures P in the temporary storage listaAre all less than a cut-off pressure threshold value PCutting blockRemoving the n aortic pressures P from the temporary lista。
8. The method for obtaining coronary artery vessel evaluation parameters according to claim 6, wherein the method for obtaining the pressure mean value point according to the mean pressure comprises:
setting a mean point index list;
adding a pressure mean value point into the mean value point index list;
generating a pressure mean point curve according to the pressure mean points;
filtering the pressure average point on the pressure average point curve;
and judging whether the number of the pressure mean value points in the mean value point index list meets the requirement of the heartbeat cycle, if not, repeating the claim 7, and adjusting the n until the requirement of the heartbeat cycle is met.
9. The method for obtaining coronary artery vessel evaluation parameters according to claim 8, wherein the method for adding pressure mean points into the mean point index list comprises:
registering the aortic pressure P in the temporary listaRespectively with the mean pressure
Comparing;
if it is not
And is
Then P will beKAdding into the average value point index list, wherein PK、PK+1Respectively representing the Kth and the Kth +1 arterial pressure in the temporary storage list;
if it is not
And is
Then P will beKAnd adding the average value point index into the average value point index list.
10. The method for obtaining coronary artery vessel evaluation parameters according to claim 9, wherein the method for filtering the pressure mean points on the pressure mean point curve comprises:
according to Dn＝Pn+1-PnIn which P isn、Pn+1Respectively represent the nth and n +1 th aortic pressures in the mean point index list, the DnRepresents Pn+1、PnPressure difference of (d);
according to HRn＝30/(Dn/n) obtaining a heart rate frequency value HR in the nth half heartbeat cyclen；
If HR is highn＜HRCutting blockDeleting the HR from the average point index listnCorresponding mean pressure points;
if it is not
And at PnThe pressure of the last m continuous aorta is all larger than
And is
Deleting P from the mean point index listnThe last m pressure mean value points are continuous.
11. The method of claim 10, wherein the step of determining whether the number of the pressure mean points in the mean point index list satisfies a requirement of a heartbeat cycle, and if not, repeating the step of claim 6 to adjust n until the requirement of the heartbeat cycle is satisfied comprises:
if the number of data in the average point list is NAre all made ofIf < 2C +1, the heartbeat cycle requirement is not met, and repeating the claim 6;
adjusting N to NAre all made of≥2C+1。
12. The method for obtaining coronary artery blood vessel evaluation parameters according to claim 11, wherein the method for obtaining the pressure parameters in each heartbeat cycle by dividing the data cycle according to the pressure mean value point comprises:
if it is not
Extracting P from the scratch listnMaximum pressure P in the heart cyclemaxAnd said maximum pressure PmaxAt the position SmaxThe said Smax、PmaxAdding the blood pressure data into a diastolic pressure list in a one-to-one correspondence manner;
obtaining P in the diastolic blood pressure listmaxObtaining diastolic pressure Pshu;
if it is not
Extracting P from the scratch listnMinimum pressure P in the heart cycleminAnd said minimum pressure PminAt the position SminThe said Smin、PminAdding the blood pressure into a systolic pressure list in a one-to-one correspondence manner;
obtaining P in the systolic blood pressure listminTo obtain the systolic pressure PHarvesting machine。
13. The method for obtaining coronary artery vessel evaluation parameters of claim 12, wherein if P isShu shuIf the blood pressure is not in the range from the diastolic pressure to the systolic pressure, the temporary list is obtained again.
14. The method for obtaining coronary artery vessel evaluation parameters of claim 13, wherein the if P isShu shuA method for retrieving said scratch list if not within a diastolic to systolic pressure range, comprising: and intercepting the first half part of the temporary storage list into the storage list, and if the number of data is greater than the upper limit of the number of the storage list, directly replacing the first half part of the data of the temporary storage list adopting the storage list into the temporary storage list, and emptying the storage list.
15. The method of deriving coronary artery vessel assessment parameters according to claim 13, wherein said method of deriving a flattened pressure waveform from said pressure parameters comprises:
setting the offset as VThreshold(s)A, intercepting a starting point O and an end point E;
and executing the mean value point index list, the diastolic pressure list and the systolic pressure list according to the offset, the starting point O and the ending point E, and outputting the regulated pressure waveform, the diastolic pressure waveform and the systolic pressure waveform.
16. The method for obtaining coronary artery vessel evaluation parameters of claim 13, further comprising: according to the flat pressure waveform and HR 60VThreshold(s)/(NAre all made of/C), obtaining the heart rate HR.
17. The method of obtaining coronary artery vessel evaluation parameters according to claim 1, wherein the method of obtaining coronary artery vessel evaluation parameters from the flattened pressure waveform comprises:
acquiring different blood vessel state periods according to the flat pressure stabilizing force waveform, wherein the method comprises the following steps: a pressure interval of maximum hyperemia, a waveform-free pressure interval;
acquiring the average aortic pressure in different vessel state periods;
and acquiring a plurality of coronary artery blood vessel evaluation parameters according to the aorta average pressure of different blood vessel state periods, wherein the coronary artery blood vessel evaluation parameters comprise coronary artery blood flow reserve fraction and instantaneous waveform-free ratio.
18. The method for obtaining coronary artery vessel assessment parameters according to claim 17, wherein said coronary artery fractional flow reserve is according to the formula
Is obtained in which
Representing the average pressure distal to the coronary stenosis,
the mean aortic pressure in the maximal hyperemic state is indicated.
19. The method of obtaining coronary artery vessel evaluation parameters of claim 17, wherein the instantaneous waveform-free ratio is obtained by:
acquiring a plurality of diastolic phases and systolic phases from the stationary pressure waveform;
acquiring a waveform segment of the diastolic aortic pressure showing a descending trend;
screening and reserving a waveform segment with another peak lower than the diastolic peak on the waveform segment, setting the position of the another peak as a starting point, and selecting a slope maximum point of the waveform segment as the starting point if the waveform segment has no another peak;
the wave trough corresponding to the waveform segment or 1-8ms before the wave trough is taken as a tail point;
the waveform between the starting point and the end point is used as a transient waveform-free period;
according to
Obtaining a mixture of, in which,
representing the average pressure distal to the instantaneous coronary stenosis,
represents the mean aortic pressure during the instantaneous waveform-free period or the mean aortic pressure in the region 3/4 after the instantaneous waveform-free period from the starting point to the end point.
20. A computer storage medium, wherein a computer program is executed by a processor to implement the method of obtaining coronary artery vessel evaluation parameters according to any one of claims 1 to 19.
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| PCT/CN2020/132568 WO2022110095A1 (en) | 2020-11-26 | 2020-11-30 | Method for acquiring coronary artery vascular evaluation parameters and storage medium |
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