CN100376202C - Diagnosing medical conditions by monitoring peripheral arterial tone - Google Patents
Diagnosing medical conditions by monitoring peripheral arterial tone Download PDFInfo
- Publication number
- CN100376202C CN100376202C CNB008083215A CN00808321A CN100376202C CN 100376202 C CN100376202 C CN 100376202C CN B008083215 A CNB008083215 A CN B008083215A CN 00808321 A CN00808321 A CN 00808321A CN 100376202 C CN100376202 C CN 100376202C
- Authority
- CN
- China
- Prior art keywords
- peripheral arterial
- pressure
- output
- finger
- measure
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6825—Hand
- A61B5/6826—Finger
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1073—Measuring volume, e.g. of limbs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
- A61B5/414—Evaluating particular organs or parts of the immune or lymphatic systems
- A61B5/416—Evaluating particular organs or parts of the immune or lymphatic systems the spleen
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/683—Means for maintaining contact with the body
- A61B5/6838—Clamps or clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
- A61B5/4035—Evaluating the autonomic nervous system
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Vascular Medicine (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Immunology (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
A method for non-invasively determining the physiological condition of endothelial dysfunction (ED), hypopnea, or upper airway resistance syndrome (UARS) by: monitoring peripheral arterial tone using an external sensor; detecting a change in the peripheral arterial tone; and determining the physiological condition when a specific change in the peripheral arterial tone has been detected.
Description
Background of invention
The present invention relates to come the method and apparatus of non-invasive detection and monitoring physiological status or physical state by monitoring peripheral tremulous pulse tone (PAT), this method and apparatus be documented in proposed on July 23rd, 1 997, application number is that (this application is open on February 5th, 1998 in the PCT application of PCT/I L97/00249, international publication number is W098/04182), the list of references as this paper whereby this application is all proposed.More particularly, the present invention relates to monitor the variation of the peripheral arterial tone in particular state or situation reaction, the variation of especially poverty-stricken and blood pressure about cardiopulmonary, thus can the several others outside content described in the PCT/IL97/00249 detect or monitoring patient's physiological status or physical state.
Description of related art
As mentioned above, PCT/IL97/00249 has put down in writing and has a kind ofly detected and the method and apparatus of monitoring different physiological statuss and physical state by the hematodinamics situation that detects the patient body extremity.Described several concrete application in this application, these use general poverty-stricken relevant with blood pressure with cardiopulmonary, detect myocardial ischemia that is:; Sleep period; Detect sleep apnea syndrome; And continuous monitoring blood pressure.
The present patent application has been described several other application, relates in particular to the detection of additional sleep disordered breath state and endothelial dysfunction (ED); Utilize the stress experiment to detect coronary artery disease; And other application.
Sleep disordered breathing
Except causing breathing the Obstructive Sleep Apnea that obviously stops (as described in as a reference the PCT/I L97/00249 herein), in the medical science works, also has the disorderly breath state of putative additional obstructive sleep.These additional situations comprise hypopnea and last trachea impedance synthesis disease (UARS) respectively.Though these situations do not relate to the total blockage of trachea, yet they are relevant with the healthy result of great passiveness.In UARS, in fact frequent asphyxia and hypopnea can not take place, but this situation but can cause the frequent division that wakes up and sleep.UARS also can cause the similar heart sequela with OSAS, and this may cause owing to high-caliber trachea impedance.Because the symptom of UARS is sharp more, therefore the diagnosis to this disease is quite difficult (referring to Guilleminault C, StoohsR, Clark A, Cetel M and Maistros P, " A Cause of ExcessiveDaytime Sleepiness.The Upper Airway Resistance Syndrome. ", Chest 104:781-787 (1993)).
The detection of endothelial dysfunction (ED)
Endothelial dysfunction (ED) is a kind of great angiopathy disease relevant with the risk factor of coronary artery disease.It below is concise and to the point description to ED.
The blood vessel function agent that influences the strong state of arterial smooth muscle (VSM) results from the individual cells inner liner (being called endothelium) of blood vessel, perhaps results from the outside, position of this blood vessel parietal layer.The blood vessel function factor that is derived from outside the blood vessel wall comprises from the catecholamines of teleneuron as VSM (for example norepinephrine), or repetition factor for example vassopressin and epinephrine, and the factor that is derived from circulating component (for example coming the hematoblastic 5-hydroxy tryptamine of self-loopa).One group of blood vessel function factor also can be derived from endothelium.These factors can strengthen the strong activity level (vasoconstriction) of blood vessel V SM, also can reduce the strong activity level (vasodilation) of VSM.
The meaning of term " endothelial dysfunction " is that endothelial layer produces the ability of suitable vasodilation reaction and can not repair.An example like this is the vasodilation reaction of coronary artery to acetylcholine (Ach), this reaction comes across in the healthy blood vessel, and in contrast be, in having the blood vessel of ED, produce reverse vasoconstriction reaction (referring to Ludmer PL, Selwyn AP, Shook TL, et al., " Paradoxical VasoconstrictionInduced by Acetylcholine in Atherosclerotic CoronaryArteries ", N.Engl.J.Med.315:1046 (1986)).
Transmitting vasodilative another example at the endothelium that plays an important role aspect the adjusting blood vessel tone is, for responding the shear stress that increases owing to blood flow speed in the tremulous pulse, and react (referring to Kuo L by the vasodilation that endothelium transmits, Day is MJ, Chilian WM, " Endothelium-Dependent Flow Induced Dilation of IsolatedCoronary Arterioles ", Am J Physiol 259; H1063 (1990)).This mechanism for example can in and the vasoconstriction brought out of neuron so that obtain homeostatic function better.
The diagnostic method that is used to detect ED at present can not be suitable for the use of routine clinical preferably.
As an illustration, a kind of diagnostic method that is used to detect ED at present is the test of brachial artery stream reaction double.This test comprises: make the blood pressure cuff on patient's elbow expand into a predetermined pressure (for example 300mm Hg), so that make blood flow stop one section preset time (for example 4 minutes) on the arm under the blood pressure cuff.Applying before the occlusion pressure and when discharging occlusion pressure, measuring the relative variation of flow velocity and brachial artery caliber respectively with Doppler's flow velocity probe and doppler echo instrument then.With the result of release pressure cover and blocked state before compare subsequently.If the tremulous pulse caliber increases enough greatly, think that so patient has normal endothelial function.
Above-described diagnostic method has several point defects.For example, need expensive equipment and professional and technical personnel, and lack accuracy, observer's self poor repeatability.Certainly, because pressure sleeve very tight and blood flow around the receptor arm must stop the quite a long time (for example 4 minutes), so this method also is very uncomfortable for receptor.
The stress test
It is to be used to one of several method that causes stress already for diagnosis of myocardial ischemia that spirit is calculated test.Other test comprises the announcement and the similar test of public speech and poverty-stricken individual character details.Ignore the mode that causes stress, the As-Is of these technical methods that is used to assess the cardiovascular effect of pressure is, need be used to measure the radiometric method of the final variation of cardiac function.Owing to depend on very expensive equipment and technical support personnel, therefore the usability and the accessibility of this pressure test mode are restricted.
The stress test is even more important, because this test shows, the back one-tenth that is caused the heart patient of myocardial ischemia by stress causes death and non-deadly heart accident rate significantly raises, thereby the stress test has important prognosis effect (referring to Jain D aspect the concrete evaluation high risk patient, Burg M, Soufer R, Zaret BL, " PrognosticImplications of Mental Stress Induced Silent Left VentricularDysfunction in Patients with Stable Angina Pectoris ", AM JCardiol.73:31-35 (1995); And Jiang W, Babyak M, Krantz DS, Waugh RA, Coleman RE, Hanson MM et al., " Mental Stress InducedMyocardial Ischemia and Cardiac Events ", JAMA 275:1651-1656 (1996)).The responsiveness that the vasoconstrictive initiation of finger and sympathetic nervous system are strong excessively in sensitive individual being carried out the process of stress test is relevant, and the latter is associated with the pathogeny and the accelerated development of cardiovascular disease (referring to Rozanski A, Blumenthal JA, and Kaplan J, " Impact of Psychological Factors on thePathogenesis of Cardiovascular Disease and Implications forTherapy ", Circulation 2192-2217 (1999)).
Another the extremely important aspect that detects the myocardial ischemia that stress causes is, relates to so-called " asymptomatic " myocardial ischemia, promptly do not have pain symptom and is " asymptomatic fully " ischemia, just both do not had pain symptom also not have ECG to change.Showed already, the heart patient that very big ratio is 33-50% has these asymptomatic various myocardial ischemia diseases (referring to Kurata C.Tawarahara K, Sakata K, Taguchi T, Fukumoto Y, Kobayashi A, et al., " Electrocardiographically andSymptomatically Silent Myocardial Ischemia During ExerciseTesting ", Japanese Circulation Journal 55; 825-834, (1991); And Ishibashi M, Yasuda T, Tamaki N and Strauss HW, " Evaluationof Symptomatic vs. Silent Myocardial I schemia Using theAmbulatory Left Ventricular Function Monitor (VEST) ", Isr.J.Med Sci.25:532-538 (1989)).
Carry out ECG standard exercise test and can not diagnose such patient.Therefore PAT is easy to diagnose accurately under these situations, and does not rely on radioactive test expensive, the usability difference owing to its higher sensitivity.
Purpose of the invention and overview
An object of the present invention is to provide a kind of method and apparatus that is used for the many physiological statuss of non-invasive mensuration, these physiological statuss especially with the detection of some sleep disordered breathing state and ED and relevant with stress test diagnosis coronary artery disease.
Another object of the present invention is to make the method and apparatus of PCT/IL97/00249 be applicable to above-mentioned other extra application.
According to one aspect of the present invention, a kind of non-invasive method of measuring the physiological status of individual following disease is provided: promptly endothelial dysfunction (ED), hypopnea or go up trachea impedance synthesis disease (UARS), sympathetic nervous system is reactive or to the reactivity of pharmaceutical preparation, this method comprises: utilize the individual peripheral arterial tone of external sensor monitoring; Detect the variation of peripheral arterial tone; And when the special variation that detects the peripheral arterial tone, measure this physiological status.
According to another aspect of the present invention, the method for the existence of coronary artery disease in a kind of non-invasive mensuration individuality is provided, this method comprises: make individuality carry out the stress test; Utilize the individual peripheral arterial tone of external sensor monitoring; Detect the variation of peripheral arterial tone; And the existence of when detecting special variation of peripheral arterial tone, measuring coronary artery disease.
According to other characteristic in the described preferred embodiment, monitoring comprises: observe peripheral arterial tone signal ripple, this specific change is the early stage decay of peripheral arterial tone signal ripple in the exercise process, and/or the slow amplification of peripheral arterial tone signal ripple in the recovery process.
According to another aspect of the present invention, provide a kind of non-invasive device of measuring the physiological status of individual following disease: i.e. endothelial dysfunction (ED), hypopnea or go up trachea impedance synthesis disease (UARS), this device comprises: one is applied to individual finger or the probe on the toes, the signal of the peripheral arterial tone of this probe finger sensing or toes and this peripheral arterial tone of output expression; And a processor, this processor receive from the signal of probe output and or: (a) provide the output of an expression peripheral arterial tonal variations, and can measure physiological status by output of this expression peripheral arterial tonal variations; Or (b) measure physiological status by the variation of peripheral arterial tone and the output of this physiological status of expression is provided.In one embodiment of the invention, this device comprises that also is used to measure the equipment that patient is in sleep state or is in wakefulness.In another embodiment of the invention, described to be used to measure the equipment that patient is in sleep state or is in wakefulness be an actigraph (actigraph).
According to one side more of the present invention, a kind of device that is used for the coronary artery disease of non-invasive mensuration individuality pressure initiation is provided, this device comprises: be applied to individual finger or the probe on the toes in the stress process of the test of individuality, the signal of the peripheral arterial tone of this probe finger sensing or toes and this peripheral arterial tone of output expression; And processor, this processor receive from the signal of probe output and or: (a) provide the output of an expression peripheral arterial tonal variations, and can measure the existence of the coronary artery disease that pressure causes by the output of this expression peripheral arterial tonal variations; Or (b) measure the existence of the coronary artery disease that pressure causes by the variation of peripheral arterial tone and the output of this physiological status of expression is provided.In one embodiment of the invention, this device also comprises a pulse oximeter that is used to measure the oxygen saturation of arterial blood.In another embodiment of the invention, described pulse oximeter is accommodated in the described probe.
By following description, other characteristic of the present invention and advantage will become apparent.
Brief description of the drawings
Herein with reference to the accompanying drawings, only present invention is described by example, wherein:
Shown in Fig. 1 is that this device can be used for according to other additional application of the present invention as a kind of form of device as described in the PCT/IL97/00249 (Fig. 9);
Shown in Fig. 2 is another finger probe, and this probe comprises an optical pickocff and can be used in the device of Fig. 1;
Fig. 3 is a form, and the result that this form will utilize the present invention to detect endothelial dysfunction compares with utilizing the cacergastic result of conventional brachial artery stream reaction double test detection;
Shown in Fig. 4 is the figure that the peripheral arterial tone waveform of normal receptor and the peripheral arterial tone waveform with receptor of endothelial dysfunction are compared; And
Fig. 5 is the comparison figure between the positive PAT reaction to stress represented with the form of signal amplitude decay during pressure (above) react with negative PAT (below).
The description of preferred embodiment
(corresponding to Fig. 9 of PCT/IL97/00249) as shown in Figure 1, finger probe 2 comprises sleeve-shaped end cap 30 and links to each other with baric systerm the pressure sleeve 40 of (generally representing with numeral 80), and baric systerm links to each other with processing system (generally representing with numeral 90).Baric systerm 80 comprises the pressure source 10 that links to each other with pneumatic tube system (generally representing with numeral 85).The carrier pipe system comprises carrier pipe 7a and 44a, and by the electromagnetic valve 12 and 46 of processor 23 control of the following stated, wherein carrier pipe will flow to finger probe 2 from the pressure of pressure source.
Baric systerm 80 also comprises: pressure transducer 13, this pressure transducer are used for monitoring by pressure source 10 applied pressures; And differential pressure pick-up 14, the difference between the constant voltage that exists between the variable pressure in this differential pressure pick-up mensuration finger probe chamber and valve 12 and 46.Optional is that pneumatic tube system 85 also can be furnished with bin 47,48 and 49.
In order to finish diagnostic procedure, at first open valve 12 and 46 and empty-handedly refer to probe chamber 5 and 43 side by side, so that will being pointed, patient inserts probe.Then, pressure is elevated to certain pressure, this pressure is enough to unload arterial wall and prevents venous congestion.Utilize the pressure transducer 13 of valve 12 and 46 upstreams to measure by pressure source 10 applied pressures.In the preferred embodiment, the pressure in the pressure chamber is elevated to 70mm Hg automatically.
At this moment, shut off valve 12 and 46 is so that make the pressure in the right ventricle of differential pressure pickup 14 keep constant.On the other hand, the pressure in the left chamber of pick off 14 changes according to the pressure in the chamber 5 of finger probe 2.It should be noted that in order to detect peripheral blood vessel and shrink that needn't proofread and correct device of the present invention, this is because this mensuration can compare with viewed patient's in the process of the test oneself baseline result.
For the result who obtains, the hands that needs relative fixed to be tried.In different exercise pressure test processes, by hands being clamped in a stable position and avoiding excessively moving of hands can realize this point usually.
The variation of the experimenter's finger plethysmogram that causes owing to the arteriotony impulse wave can make chamber 5 expand or shrink, and makes that air pressure in the chamber 5 is corresponding to be reduced or increase.Chamber 5 links to each other with pneumatic tube system 85 by its opening 7 and carrier pipe 7a.Yet owing to valve 12 is closed, so the variation of pressure only influences the left chamber of differential pressure pick-up 14.Differential pressure pick-up 14 detects these pressure variations and provides with these pressure and changes corresponding output.
A/D converter 22 shown in Figure 1 receives the simulation output of pressure transducer 13 and 14, and converts thereof into digital form before CPU processor 23 is introduced in these outputs.Processor 23 is handled the finger plethysmogram of being measured (or optical density) and is changed, thereby produces the output 24a of volume determination value, and/or the output 24b that changes of the volume determination value corresponding with the time.Measured value one or the two can be presented on the monitor 24.
If shown output 24 shows tested volumetrical variation and surpasses predetermined cut-off point, represent that then peripheral blood vessel shrinks, and the observer of observed monitor 24 is seen immediately.Optionally be, then can lift siren 25 (for example audio frequency or video), so that report to the police to the staff immediately if occur this predetermined point in the tested volume.
It is general and tremulous pulse pollex volume-variation is proportional to run through the peak of signal amplitude, and will shrink and reduce along with peripheral blood vessel.Therefore, when the system of Fig. 1 is used to detect peripheral blood vessel and shrinks, as opposite with the absolute value of pressure, the observer will be interested in the relative variation of the amplitude that runs through peak value.As a result, in the preferred embodiment, provide a high power filter 28, be used for the output of filtered sensor 14 and improve the noise signal volume.
Preferably, finger probe comprises: near (heart) side of device, coaxial and overlap 40 near the annular pressure of end cap 30 with end cap 30.The main purpose of this pressure sleeve is, the boundary of constant voltage field is stretched over outside the border of sensor probe, thereby avoided border effect.The chamber 43 of pressure sleeve also has been full of Compressed Gas by opening 44; Yet electromagnetic valve 46 makes pipeline 44 separate with pick off 14.So there is the place of a segment distance at the mensuration position that the finger plethysmogram that cover 40 makes static-pressure field be stretched over and be attended by the blood pressure ripple on nearly (heart) direction changes.Annular pressure cover 40 plays tourniquet, the pressure field that it produces in sleeve-shaped end cap 30, the distal end that prevents to point (especially tip phalanges) generation venous congestion.It has also avoided venous return out of control basically; And when finger was in heart level, this pressure sleeve had partly unloaded the arterial wall tension force of finger distal end, but does not but make its obturation.Although the pressure of pressure sleeve can with the pressure difference in the sensing chamber 35,36, the former should not surpass the latter.
Fig. 2 shows with Fig. 1 and similarly installs, and has just directly measured the variation of optical density, so that the measured value of the finger plethysmogram variation that is attended by the blood pressure ripple is provided.For easy to understand, use with Fig. 1 in identical reference number represent corresponding parts.
So, in device shown in Figure 2, make chamber 5 be pressurized to a fixed predetermined value (as the description of above relevant Fig. 1).Yet, in this case, the tubular type diaphragm 4 that limits chamber 5 is configured in the example with light source 100, and opposition side has optical receiver 101, will be detected by optical receiver 101 thereby the volumetrical variation of finger pollex blood that receives in the tubular type diaphragm 4 is taken as the variation of optical density.This information is presented to amplifying circuit 103 by lead 102, and is exaggerated and filters at this, is fed to A/D converter 22 then again, so that handle (as mentioned above) by processor 23.
In layout shown in Figure 2, measure the position, promptly the position of light source 100 and optical receiver 101 is very importantly in the inside of rigidity shell 3 openings of probe 2, thereby can apply the static pressure field of force equably around the finger outer end, therefore need not for this purpose the annular pressure cover (40, Fig. 1).Yet, if desired light source and light collector are located adjacent to the opening of the rigidity shell of probe 2, also this annular pressure cover (corresponding to the pressure sleeve among Fig. 1 40) can be used for system shown in Figure 2.
Other details of this device and different modification thereof, and the method for utilizing the different physical states of this device diagnosis all is documented in, and (this application is open on February 5th, 1998 among the above-mentioned PCT/IL97/00249, international publication number is WO98/04182), the list of references as this paper this application is all proposed herein.
As mentioned above and among the PCT/IL97/00249 more fully describe, finger probe 2 can be used for holding pulse oximeter, the latter is used to measure the oxygen saturation of blood.In this was used, conventional pulse oximeter sensor was included in the housing of this probe, and can preferably measure the oxygen saturation (SaO of blood
2), this is because the static pressure field of force provides stable environment.
As the alternative blood pressure bearing calibration of method described in a kind of PCT/IL97/00249, can produce tested arterial vascular compliance curve by bringing out and monitoring endovascular transmural pressure variation.Can this curve of following making: change the external pressure that adds that is produced in the probe, and measure these arterial vascular corresponding volumes and other characteristic relevant, make these measured values and hydraulic pressure change curve then with volume.This correction can be implemented need not to limit under patient's the active situation.Also can obtain transmural pressure by the hydraulic pressure variation merging that external pressure is changed and brought out changes.Analyze obeying curve is only to be derived from external pressure to change, and still only is derived from the hydraulic pressure that is brought out and changes, still be derived from hydraulic pressure and change the summation that changes with external pressure, this analysis all others with described identical.
Although the major part among the PCT/IL97/00249 is described and is all concentrated in the detection of myocardial ischemia, but it has also described other application of this method and apparatus, comprise the different sleep states that are used to monitor receptor, especially fast eye move (REM) Sleep stages and sleep apnea syndrome (SAS) and night myocardial ischemia.
Sleep stages, particularly REM (eye moves fast) stage sleep is an important tool of diagnosing sleep disordered and many other states.In the REM sleep, the variable control of breathing makes chemosensitivity reduce greatly, and the latter causes the very irregular and blood oxygen saturation decline maximum of respiratory graphics.
The preclinical variation of REM had been reported in the emotion disease already too much, also be reported in these diseases of narcolepsy, alcoholism, Alzheimer and sexual impotence, and the emotion disease comprises endogenous type depression, schizophrenia, anxiety disorder, obsessive idea and conduct disorder, eating disorder.REM incubation period is important in the diagnosis of these states not only, and treatment and after to renew also be important, this is because it is the sensitive indicators of patient condition.
The REM stage sleep and the decay of PAT signal between have very strong getting in touch.Compare with the previous non-REM phase, this decay is the decay of an essence amplitude.The Three Represents example of expression PAT signal and magnetic time course has been shown among Figure 21 of PCT/IL97/00249.Importantly, notice that the decay of PAT amplitude is triggered by the REM sleep, but as if with one to carry out the cycle relevant, it is synchronous with sleep cycle in such a way that this carries out the cycle, that is, the minimum point in this cycle is slept with REM and is conformed to.
The current state of the technical method that is used to identify that the REM stage sleeps is, many somnolences, and its needs expensive device, considerable patient's testing equipment and professional and technical personnel.A kind of REM detector of simplification is people's such as Hobson US4, and in 836,219 disclosed " medicated cap at night (nightcap) ", this device depends on two communication channels that detect the REM sleep; Health moves with eyes and moves.Yet this method needs a large amount of testing equipments, and these equipment are uncomfortable for patient and impair sleep.Another patent equipment (US5 of Lavie, 280,791) has used heart rate change method.Yet this method need require signal analysis and not resemble the PAT method reliable.
Utilize PAT to detect REM, it is exceedingly useful being accompanied by existing mobile monitoring system, this be since its with the higher cost efficient manner, utilize minimum patient's testing equipment to produce important information.It is used in the support that provides powerful, long-term, follow-up in the patient own home, and these logically are impossible in sleep laboratory.It is easy to be used in combination with oxygen saturation monitoring and mobile asphyxia screening function (describing for PAT).This method need not subjective operator and assesses the sleep study result, and does not rely on special, expensive testing equipment, and these equipment for based on breadboard Sleep stages for example the mensuration of EEG, EOG and EMG be essential.
The detailed description of other additional application
Detect the operating process of endothelial dysfunction
Except the many application described in the PCT/IL97/00249, find that also peripheral arterial tone (PAT) is the accurate detection agent (as confirming in the table of Fig. 3) of endothelial dysfunction, at this moment take exercise in the process of the test and observe characteristic reaction figure (as shown in Figure 4) in standard.Normal receptor shows that the amplitude of PAT signal does not reduce when exercise is carried out, and ED receptor shows signal has descended significantly.In this research, in 23 receptors that are regarded as the ED feminine gender that detect with brachial artery stream reaction double test (BAD), detect with PAT, find that it also is negative reaction person that 20 receptors are arranged.Show among male 8 patients in the BAD test, have 7 also to be the PAT positive reaction.So, between PAT and BAD test, demonstrate concordance (87% accuracy rate) highly.
By before 4 minutes the coronary occlusion process, among and afterwards, the PAT pick off is applied to the finger tip of occlusion site, can carry out ED and detect test.Can measure the degree (with respect to the level before inaccessible) that pollex blood volume increases along with the releasing of obturation with PAT, and according to the degree that changes, diagnosis has or not ED.
Also can utilize the PAT pick off itself to make blood flow be parked in finger the preceding paragraph preset time, rather than the test of brachial artery stream reaction double is parked on the arm blood flow like that as has been described.Cancellation finger blood flow obturation can utilize the PAT pick off with the volumetrical reaction of its normal mode record finger pollex subsequently.In this mode, can test reaction and vasodilation reaction that endothelium transmits, blood flow is more inaccessible (puts into practice as present) on hands and forearm and need not to make.
The stress test
In the stress test, the inventor has found that some individualities show as vasoconstriction, and this vasoconstriction can keep during pressure for a long time; Other individuality shows as has early stage vasoconstriction tendency, has disappeared and this tendency is very fast; Other individuality shows as does not almost have vasoconstrictive tendency.
When one group of receptor with coronary artery disease was accepted the stress test, the inventor found to have the receptor that prolongs the vasoconstriction reaction and have relatively poor cardiac performance according to the dirty imaging organon of present core.
Therefore determine that the probe that is used to measure the tremulous pulse tone of the present invention can be used in combination with conventional stress test, so that the prediction coronary artery disease.
In a series of test, utilize PAT and Duo Bo door radioactivity ventriculography (MUGA) organon that 18 male are carried out the stress test simultaneously, it is found that, in presenting 9 patients of positive MUGA result, have 8 also to present positive PAT result, and 6 negative MUGA responders also are PAT negative reaction persons.It is indefinite that two patients are arranged.In remaining two kinds of situation, a patient presents positive MUGA reaction and negative PAT reaction, and a patient presents negative MUGA reaction and positive PAT reaction.PAT compares with MUGA, and its total accuracy rate is 87%.Fig. 5 provided during pressure to stress show as the signal amplitude decay positive PAT reaction (above), and the example of negative PAT reaction (following), wherein 1 and 3 beginning and the end that indicate the pressure phase respectively.
Sleep disordered breathing
In having 42 patients of Obstructive Sleep Apnea, the inventor finds, can clearly see the instantaneous decay that the PAT signal is very dark and the tachycardia of periodic property normally in each asphyxia situation.Between the total asphyxia-hypopnea mark of standard (129.5 ± 22.4 (meansigma methods ± SEM)) and instantaneous vasoconstriction and tachycardia situation (121.2 ± 19.4 (R-.92, p is less than .0001)), find to have good concordance.
Additional application
1) autonomic nervous system is active or reactive
Recently, there has been data to think that autonomic nervous activity or the reactive portion that plays act in the pathogeny of CAD.This hint, autonomic nervous system activity or reactivity itself can be important clinical parameters.
The ability of PAT detection reaction sexual intercourse sense neural activity obtains in bringing out property myocardial ischemia process and in the stress process of the test confirming.The responsiveness that sympathetic nervous system is strong excessively is associated (referring to Roz anski A with the pathogeny and the accelerated development of cardiovascular disease, Blumenthal JA, and Kaplan J, " Impact of Psychological Factorson the Pathogenesis of Cardiovascular Disease andImplications for Therapy ", Circulation 2192-2217 (1999)).
Therefore, the responsiveness itself that sympathetic nervous system is strong excessively just can be the sick kind of important clinical, and PAT is well suited for this disease kind of monitoring.The active technical measurement state of sympathetic nervous system is, by means of directly interior neural mensuration of fibular nerve.This is an invasive process, be uncomfortable and have the injury patient danger.
2) use PAT monitoring autonomic nervous system activity or reactive;
Utilize the active or reactive time course of PAT monitoring autonomic nervous system.This monitoring can be incorporated the reactive excitation of sympathetic nervous system into by standard test method well known in the art, for example cold booster reaction, posture change, air-breathingly breathe, spirit calculates or the like.Can be according to the limit normal of colony's organon defined reaction.
Can utilize the time course that sympathetic nervous system changes in PAT monitoring patient's the passive tilt process.
In addition, can monitor the PAT signal in pharmacology pressure test process, this test is used for diagnostic purpose, perhaps is used for drawing the sympathetic nerve reaction on pharmacology, and is used to monitor/assess the action effect of medicament to the peripheral arterial tone.
3) resemble assessment and biofeedback therapy more;
In the practice that resembles test, can also utilize the monitoring of PAT signal amplitude, wherein when monitored parameter response examiner's input and when changing the anxiety level of receptor, this monitored parameter is relevant with the sympathetic nervous system reactivity more.
Also can utilize the monitoring of PAT signal amplitude in the biofeedback practice, wherein monitored parameter is relevant with the sympathetic nervous system reactivity, and therapeutic goal is the level of reactivity that training patient oneself regulates sympathetic nervous system.
Though invention has been described and show with regard to its preferred embodiment and experimental program, but will be understood by those skilled in the art that, can change form and details in the appending claims restricted portion, these changes do not break away from marrow of the present invention and scope.
Claims (24)
1. method that average information is provided non-invasively, this average information can be used for measuring following physiological status in the individuality with other physiological state information: promptly endothelial dysfunction, hypopnea, go up trachea impedance synthesis disease, sympathetic nervous system is reactive or to the reactivity of pharmaceutical preparation, this method comprises:
Utilize the individual peripheral arterial tone of external sensor monitoring;
Detect the variation of peripheral arterial tone; And
When the special variation that detects the peripheral arterial tone, measure described physiological status.
2. method that average information is provided non-invasively, this average information can be used for measuring that coronary artery disease exists in the individuality with other physiological state information, this method comprises:
Make individuality accept the stress test;
Utilize the individual peripheral arterial tone of external sensor monitoring;
Detect the variation of peripheral arterial tone; And
When detecting special variation of peripheral arterial tone, measure the existence of coronary artery disease.
3. method as claimed in claim 1 or 2 is characterized in that described monitoring comprises observation peripheral arterial tone signal ripple.
4. method as claimed in claim 3 is characterized in that described special variation is the early stage decay of peripheral arterial tone signal ripple in the exercise process, and/or the slow amplitude of peripheral arterial tone signal ripple increases in the recovery process.
5. the method for claim 1 is characterized in that implementing pressure test, so that obtain hyperemia.
6. the method for claim 1 is characterized in that implementing pressure test, so that it is active or reactive to obtain autonomic nervous system.
7. the method for claim 1 is characterized in that for diagnostic purpose, implements the pharmacology pressure test.
8. the method for claim 1 is characterized in that implementing pressure test, so that obtain the sympathetic nervous system reactivity on pharmacology.
9. the method for claim 1 is characterized in that this physiological status is the reaction of patient to medicament.
10. device that average information is provided non-invasively, this average information can be used for measuring individual following physiological status with other physiological state information: i.e. endothelial dysfunction; The sleep disordered breathing state of hypopnea or last trachea impedance synthesis disease; Autonomic nervous system is active or reactive; Or to the reactivity of medicament, this device comprises:
One is applied to individual finger or the probe on the toes, the signal of the peripheral arterial tone of described probe finger sensing or toes and this peripheral arterial tone of output expression; And
A processor, this processor receive from the signal of described probe output and are designed to provide the output of an expression peripheral arterial tonal variations, and can measure described physiological status by the output of this expression peripheral arterial tonal variations; Perhaps be designed to measure described physiological status and an output of representing described physiological status is provided by the variation of peripheral arterial tone.
11. device as claimed in claim 10 is characterized in that also comprising that is used to measure the equipment that patient is in sleep state or is in wakefulness.
12. device as claimed in claim 11, it is characterized in that being used to measuring the equipment that patient is in sleep state or is in wakefulness is an actigraph.
13. device as claimed in claim 10 is characterized in that by the output that described processor provides it being the time course of peripheral arterial tone signal, observes this output, so that obtain the bio information of autonomic nervous activity or reactive patient's level.
14. device as claimed in claim 10, it is characterized in that by the output that described processor provides it being the time course of peripheral arterial tone signal, observe this output, so that for the therapeutic purposes of biofeedback therapy, provide the information of assert autonomic nervous activity or reactive patient's level to patient.
15. device as claimed in claim 10 is characterized in that this physiological status is the time course state of sympathetic nerve tone in the inclining experiment.
16. device as claimed in claim 15 is characterized in that this physiological status is the state of different sympathetic nerve tones in the inclining experiment.
17. a device that is used for providing average information non-invasively, this average information can be used for being determined at the individual coronary artery disease that is caused by pressure in the stress test with other physiological state information, and this device comprises:
One is applied to individual finger or the probe on the toes, the signal of the peripheral arterial tone of described probe finger sensing or toes and this peripheral arterial tone of output expression; And
A processor, this processor receive from the signal of described probe output and are designed to provide the output of an expression peripheral arterial tonal variations, and can measure the coronary artery disease that is caused by pressure by the output of this expression peripheral arterial tonal variations; Perhaps be designed to measure the coronary artery disease that causes by pressure and an output of representing this physiological status is provided by the variation of peripheral arterial tone.
18., it is characterized in that also comprising a pulse oximeter that is used to measure the oxygen saturation of arterial blood as claim 10 or 17 described devices.
19. device as claimed in claim 18 is characterized in that described pulse oximeter is accommodated in the described probe.
20., it is characterized in that as claim 10 or 17 described devices:
Described probe comprises a pressure applicator, and this pressure applicator comprises:
A tubular holders is used to receive the distal end of the predetermined length of the finger of individual body or toes, and this distal end comprises the sharp distal tip farthest of finger or toes;
An end cap is used to receive the sharp distal tip farthest of finger or toes, thereby avoids the vein blood stasis to amass at sharp distal tip place farthest;
At least one has the pressure sleeve of a film, the structure of this film is arranged so that finger or the toes part before the sharp distal tip farthest that pressure can be applied to finger or toes, thereby described pressure sleeve plays the effect of vein tourniquet, avoids at finger or toes place venous congestion and vein ahead of shock wave taking place;
A pressure source, when being used in receiving described tubular holders static-pressure field is applied to around the distal end of the finger of individual body or toes, wherein this static pressure is enough to have avoided basically at the distal end place of finger or toes advancing of venous congestion and vein shock wave taken place, and part unloading but not inaccessible wherein tremulous pulse; And
A determinator is used to measure the finger of following the blood pressure ripple or the variation at toes distal end place;
And wherein, described processor receive from the signal of described determinator output and or: (a) provide the output of an expression peripheral arterial tonal variations, and can measure physiological status by output of this expression peripheral arterial tonal variations; Or (b) measure physiological status by the variation of peripheral arterial tone and the output of this physiological status of expression is provided.
21. device as claimed in claim 20 is characterized in that described determinator comprises the pulse oximeter of the oxygen saturation that is used to measure arterial blood.
22. device as claimed in claim 21 is characterized in that described pulse oximeter is accommodated in the described device.
23. device as claimed in claim 21 is characterized in that also comprising that is used to measure the equipment that patient is in sleep state or is in wakefulness.
24. device as claimed in claim 10 is characterized in that physiological status is the time course state of sympathetic nerve tone in the body gesture change procedure.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US09/324,529 US6322515B1 (en) | 1996-07-30 | 1999-06-02 | Method and apparatus for the non-invasive detection of medical conditions by monitoring peripheral arterial tone |
| US09/324,529 | 1999-06-02 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1424889A CN1424889A (en) | 2003-06-18 |
| CN100376202C true CN100376202C (en) | 2008-03-26 |
Family
ID=23263994
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB008083215A Expired - Lifetime CN100376202C (en) | 1999-06-02 | 2000-05-29 | Diagnosing medical conditions by monitoring peripheral arterial tone |
Country Status (8)
| Country | Link |
|---|---|
| EP (1) | EP1294277A4 (en) |
| JP (1) | JP2003527149A (en) |
| KR (1) | KR100674584B1 (en) |
| CN (1) | CN100376202C (en) |
| AU (1) | AU768097B2 (en) |
| CA (1) | CA2375470C (en) |
| NZ (1) | NZ515591A (en) |
| WO (1) | WO2000074551A2 (en) |
Families Citing this family (25)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9042952B2 (en) | 1997-01-27 | 2015-05-26 | Lawrence A. Lynn | System and method for automatic detection of a plurality of SPO2 time series pattern types |
| US8932227B2 (en) | 2000-07-28 | 2015-01-13 | Lawrence A. Lynn | System and method for CO2 and oximetry integration |
| US9468378B2 (en) | 1997-01-27 | 2016-10-18 | Lawrence A. Lynn | Airway instability detection system and method |
| US9521971B2 (en) | 1997-07-14 | 2016-12-20 | Lawrence A. Lynn | System and method for automatic detection of a plurality of SPO2 time series pattern types |
| US20070191697A1 (en) | 2006-02-10 | 2007-08-16 | Lynn Lawrence A | System and method for SPO2 instability detection and quantification |
| AU3769501A (en) | 2000-03-02 | 2001-09-12 | Itamar Medical Ltd | Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system |
| WO2002034105A2 (en) * | 2000-10-23 | 2002-05-02 | Itamar Medical Ltd. | Non-invasive endothelial activity evaluation |
| US9053222B2 (en) | 2002-05-17 | 2015-06-09 | Lawrence A. Lynn | Patient safety processor |
| US20070225614A1 (en) | 2004-05-26 | 2007-09-27 | Endothelix, Inc. | Method and apparatus for determining vascular health conditions |
| KR100573645B1 (en) * | 2003-11-12 | 2006-04-24 | 이화여자대학교 산학협력단 | Fixed device of blood vessel for measureing contractile force of blood vessel |
| US7668579B2 (en) | 2006-02-10 | 2010-02-23 | Lynn Lawrence A | System and method for the detection of physiologic response to stimulation |
| RU2309668C1 (en) | 2006-02-20 | 2007-11-10 | Александр Сергеевич Парфенов | Method and device for non-invasive measurement of function of endothelium |
| KR100894632B1 (en) * | 2006-10-25 | 2009-04-24 | 연세대학교 산학협력단 | Bio-signal measurement system unified toilet stool |
| CA2722773C (en) | 2008-05-07 | 2015-07-21 | Lawrence A. Lynn | Medical failure pattern search engine |
| WO2010013264A1 (en) * | 2008-07-30 | 2010-02-04 | Pignolo S.P.A. | Diode laser device for the non-invasive measurement of glycaemia |
| US8057400B2 (en) | 2009-05-12 | 2011-11-15 | Angiologix, Inc. | System and method of measuring changes in arterial volume of a limb segment |
| US9072433B2 (en) | 2011-02-18 | 2015-07-07 | Covidien Lp | Method and apparatus for noninvasive blood pressure measurement using pulse oximetry |
| PL226889B1 (en) | 2011-05-31 | 2017-09-29 | Politechnika Łódzka | Method and system for assessing the endothelial function |
| WO2013076722A1 (en) | 2011-11-24 | 2013-05-30 | Itamar Medical Ltd. | Apparatus for monitoring arterial pulse waves in diagnosing various medical conditions |
| CN104042195A (en) * | 2014-05-04 | 2014-09-17 | 上海中嘉衡泰医疗科技有限公司 | Vascular endothelial function analysis system and method |
| EP3073400B1 (en) | 2015-03-25 | 2022-05-04 | Tata Consultancy Services Limited | System and method for determining psychological stress of a person |
| US10617302B2 (en) | 2016-07-07 | 2020-04-14 | Masimo Corporation | Wearable pulse oximeter and respiration monitor |
| DK3541288T3 (en) * | 2016-11-15 | 2023-09-11 | Boehringer Ingelheim Vetmedica Gmbh | METHOD FOR PREDICTING A SPECIFIC RESPIRATORY PATHOGEN |
| WO2019209754A1 (en) * | 2018-04-23 | 2019-10-31 | Loma Linda University | Computer-supported intraneural facilitation for vascular changes |
| CN109316177A (en) * | 2018-11-02 | 2019-02-12 | 杜玲娟 | A kind of assessment device and method for peripheral arterial disease hemadostewnosis degree |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4030485A (en) * | 1974-11-12 | 1977-06-21 | Glenfield Warner | Method and apparatus for continuously monitoring systolic blood pressure |
| US4862895A (en) * | 1985-04-12 | 1989-09-05 | Omron Tateisi Electronics Co. | Electronic blood pressure meter |
| US4926867A (en) * | 1986-05-27 | 1990-05-22 | Sumitomo Electric Industries, Ltd. | Light-reflecting and heating type oximeter |
| EP0465345A1 (en) * | 1990-07-03 | 1992-01-08 | Ueda Electronic Works Limited | Blood pressure measuring apparatus |
| US5365924A (en) * | 1992-07-31 | 1994-11-22 | Frederick Erdman Association | Method and apparatus for non-invasive cardiovascular diagnosis |
| WO1998004182A2 (en) * | 1996-07-30 | 1998-02-05 | Itamar Medical (C.M) 1997 Ltd. | Diagnosing medical conditions by monitoring arterial tone |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA1311016C (en) * | 1985-06-03 | 1992-12-01 | Kevin M. Mcintyre | Evaluating heart mechanical performance |
| JPS62500425A (en) * | 1985-06-17 | 1987-02-26 | アメリカン ホスピタル サプライ コ−ポレ−シヨン | Technology for obtaining waveform information related to individual blood pressure |
| US4836219A (en) | 1987-07-08 | 1989-06-06 | President & Fellows Of Harvard College | Electronic sleep monitor headgear |
| IL100080A (en) | 1991-11-19 | 1994-12-29 | Sleep Disorders Diagnostic And | Monitor system for determining the sleep stages of a person |
| JPH06319707A (en) * | 1993-05-13 | 1994-11-22 | Omron Corp | Electronic hemomanometer |
-
2000
- 2000-05-29 JP JP2001501092A patent/JP2003527149A/en active Pending
- 2000-05-29 EP EP00937145A patent/EP1294277A4/en not_active Withdrawn
- 2000-05-29 NZ NZ515591A patent/NZ515591A/en not_active IP Right Cessation
- 2000-05-29 CN CNB008083215A patent/CN100376202C/en not_active Expired - Lifetime
- 2000-05-29 AU AU52429/00A patent/AU768097B2/en not_active Expired
- 2000-05-29 WO PCT/IL2000/000307 patent/WO2000074551A2/en active Search and Examination
- 2000-05-29 KR KR1020017015245A patent/KR100674584B1/en active IP Right Grant
- 2000-05-29 CA CA2375470A patent/CA2375470C/en not_active Expired - Lifetime
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4030485A (en) * | 1974-11-12 | 1977-06-21 | Glenfield Warner | Method and apparatus for continuously monitoring systolic blood pressure |
| US4862895A (en) * | 1985-04-12 | 1989-09-05 | Omron Tateisi Electronics Co. | Electronic blood pressure meter |
| US4926867A (en) * | 1986-05-27 | 1990-05-22 | Sumitomo Electric Industries, Ltd. | Light-reflecting and heating type oximeter |
| EP0465345A1 (en) * | 1990-07-03 | 1992-01-08 | Ueda Electronic Works Limited | Blood pressure measuring apparatus |
| US5365924A (en) * | 1992-07-31 | 1994-11-22 | Frederick Erdman Association | Method and apparatus for non-invasive cardiovascular diagnosis |
| WO1998004182A2 (en) * | 1996-07-30 | 1998-02-05 | Itamar Medical (C.M) 1997 Ltd. | Diagnosing medical conditions by monitoring arterial tone |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2003527149A (en) | 2003-09-16 |
| KR20030012788A (en) | 2003-02-12 |
| EP1294277A4 (en) | 2005-02-09 |
| AU768097B2 (en) | 2003-12-04 |
| KR100674584B1 (en) | 2007-01-26 |
| EP1294277A2 (en) | 2003-03-26 |
| WO2000074551A2 (en) | 2000-12-14 |
| CA2375470A1 (en) | 2000-12-14 |
| CN1424889A (en) | 2003-06-18 |
| AU5242900A (en) | 2000-12-28 |
| CA2375470C (en) | 2010-04-13 |
| WO2000074551A3 (en) | 2003-01-30 |
| NZ515591A (en) | 2004-05-28 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN100376202C (en) | Diagnosing medical conditions by monitoring peripheral arterial tone | |
| US6322515B1 (en) | Method and apparatus for the non-invasive detection of medical conditions by monitoring peripheral arterial tone | |
| EP1585424B1 (en) | Apparatus for non-invasively evaluating endothelial activity in a patient | |
| JP3290176B2 (en) | Detection of atherosclerosis in humans | |
| JP7093777B2 (en) | A device for monitoring blood flow and respiratory flow | |
| AU2001237695B2 (en) | Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system | |
| JP2011501678A (en) | Sensors containing substances that generate electrical signals upon stretching | |
| Webster | The physiological measurement handbook | |
| JPH02107228A (en) | Device and method of measuring heart compression wave | |
| AU2001237695A1 (en) | Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system | |
| Allen et al. | The covariation of blood pressure and pulse transit time in hypertensive patients | |
| JP2008307307A (en) | Evaluation method of blood vessel function, and apparatus for the same | |
| Huang et al. | Studying peripheral vascular pulse wave velocity using bio-impedance plethysmography and regression analysis | |
| Meyer-Sabellek et al. | Blood Pressure Measurements: New Techniques in Automatic and in 24-hour Indirect Monitoring | |
| JP5006509B2 (en) | Pulse wave velocity measurement method for measuring pulse wave velocity in a pulse wave velocity measuring device | |
| US20120184824A1 (en) | Method for measuring the local stiffness index of the wall of a conducting artery, and corresponding equipment | |
| Tamura | Blood pressure | |
| Lavoisier et al. | Validation of a continuous penile blood-flow measurement by pulse-volume-plethysmography | |
| Pereira | Methods and instrumentation for non-invasive assessment of the cardiovascular condition | |
| Bieber et al. | Visual detection of short-wave blood pressure fluctuations | |
| Bhullar et al. | From Concept to Cure: The Life and Legacy of Scipione Riva-Rocci | |
| IL151437A (en) | Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system | |
| JP2007244605A (en) | Arteriosclerosis-degree determination apparatus | |
| Jones et al. | NASA contributions to cardiovascular monitoring | |
| Chhangani | REVIEW ON MODERN AND AYURVEDIC ASPECTS OF NADI PARIKSHA |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CX01 | Expiry of patent term |
Granted publication date: 20080326 |
|
| CX01 | Expiry of patent term |