EP1294277A2 - Diagnostic d'etats pathologiques par controle du tonus arteriel peripherique - Google Patents

Diagnostic d'etats pathologiques par controle du tonus arteriel peripherique

Info

Publication number
EP1294277A2
EP1294277A2 EP00937145A EP00937145A EP1294277A2 EP 1294277 A2 EP1294277 A2 EP 1294277A2 EP 00937145 A EP00937145 A EP 00937145A EP 00937145 A EP00937145 A EP 00937145A EP 1294277 A2 EP1294277 A2 EP 1294277A2
Authority
EP
European Patent Office
Prior art keywords
peripheral arterial
digit
arterial tone
pressure
tone
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.)
Withdrawn
Application number
EP00937145A
Other languages
German (de)
English (en)
Other versions
EP1294277A4 (fr
Inventor
Daniel A. Goor
Robert P. Schnall
Jacob Sheffy
Peretz Lavie
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Itamar Medical CM 1997 Ltd
Original Assignee
Itamar Medical CM 1997 Ltd
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from US09/324,529 external-priority patent/US6322515B1/en
Application filed by Itamar Medical CM 1997 Ltd filed Critical Itamar Medical CM 1997 Ltd
Publication of EP1294277A2 publication Critical patent/EP1294277A2/fr
Publication of EP1294277A4 publication Critical patent/EP1294277A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • 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

Definitions

  • the present invention relates to the method and apparatus of PCT Application No. PCT/IL97/00249, filed July 23, 1997, International Publication No. WO 98/04182, published 5 February 1998, hereby incorporated by reference as if fully set forth herein, for the non-invasive detection and monitoring of a physiological state or medical condition by monitoring peripheral arterial tone (PAT). More specifically, the present invention relates to monitoring changes in the peripheral arterial tone in reaction to such state or condition, particularly those related to cardiopulmonary distress and blood pressure in order to detect or monitor the physiological state or medical condition of the patient In several additional aspects over and above those described in PCT/IL97/00249.
  • PCT/IL97/00249 describes a method and apparatus for the detection and monitoring of various physiological states and medical conditions by detecting hemodynamic events in a body extremity of the patient.
  • Several particular applications generally related to cardiopulmonary distress and blood pressure were described, namely: detecting myocardial ischemia; sleep staging; detecting sleep apnea syndrome; and continuously monitoring blood pressure.
  • the present application describes several additional applications, particularly in connection with the detection of additional sleep disordered breathing conditions and endothelial dysfunction (ED); the detection of coronary artery disease by mental stress tests; and other applications.
  • ED endothelial dysfunction
  • UARS UARS
  • UARS UARS
  • UARS frequent apneas and hypopneas do not actually occur, but the condition nevertheless results in frequent arousals and sleep fragmentation.
  • UARS could also cause similar cardiac sequelae as OSAS, perhaps due to high levels of airway resistance.
  • the diagnosis of UARS is much more difficult due to the condition's more subtle symptomatology.
  • Endothelial dysfunction is an important vascular disturbance related to risk factors for coronary artery disease. Following is a brief description of ED.
  • Vasoactive agents which influence the tonic state of arterial smooth muscle can arise from within the single cell inner lining layer of the vessel known as the endothelium, or from sites external to this blood vessel wall layer.
  • Vasoactive factors derived beyond the vessel wall include catecholamines from nerve endings serving VSM such as norepinephrine, or circulating factors such as vasopressin and epinephrine, and factors derived from circulating elements such as serotonin from circulating platelets.
  • a group of vasoactive factors can also be derived from the endothelium. These factors can produce either an increase in the level of tonic activity of the blood vessels' VSM (vasoconstriction) or a decrease in the level of VSM tonic activity (vasodilation).
  • endothelial dysfunction refers to an impairment of the ability of endothelial cell layer to produce an appropriate vasodilatory response.
  • An example of this is the vasodilatory response of coronary arteries to acetylcholine (Ach), occurring in healthy vessels as opposed to a paradoxical vasoconstrictory response to Ach in vessels with ED.
  • Ludmer PL Ludmer PL
  • endothelium mediated vasodilation which is important in regulating vascular tone is the vasodilatory response mediated by endothelium in response to increases in shear stress due to increased blood flow velocity within arteries.
  • This mechanism can, for example, modulate neurogenically induced vasconstriction to better achieve homeostatic function.
  • one current diagnostic method for detecting ED is a Brachial Artery Flow Response Duplex Test.
  • This test involves inflating a blood pressure cuff above the patient's elbow to a predetermined pressure (e.g., 300 mm Hg) so as to stop blood flow to the arm below the cuff for a predetermined period of time (e.g., 4 minutes).
  • a doppler flow rate probe and an echo doppler are used to measure relative changes in flow velocity and brachial artery caliber, respectively, prior to application and upon release of the occluding pressure.
  • the results following release of the pressure cuff are compared to the pre occlusion state. If there is a sufficient increase in artery caliber then the patient is considered to have normal endothelial function.
  • the above described diagnostic method has several disadvantages. For example, it requires expensive apparatus and specialized personnel, and it suffers from a lack of accuracy and poor inter and intra-observer reproducibility. Of course, the method is also very uncomfortable to the subject since the pressure cuff is very tight around the subject's arm and blood flow must be stopped for a relatively long time, e.g., 4 minutes.
  • Mental Stress Testing is also very uncomfortable to the subject since the pressure cuff is very tight around the subject's arm and blood flow must be stopped for a relatively long time, e.g., 4 minutes.
  • the mental arithmetic test is one of several methods which have been used to elicit mental stress for the purpose of diagnosing myocardial ischemia. Other tests include public speaking and the revealing of embarrassing personal details and the like. Irrespective of the mode of inducing the mental stress, the present state of the art methods for evaluating the cardiovascular effects of the stress requires a radio-nuclear method for measuring the resultant changes in cardiac function. Because of this dependency on highly expensive apparatus and skilled support staff, this mode of stress testing is of limited usefulness and accessibility.
  • Another very important aspect of detecting mental stress induced myocardial ischemia relates to so called “silent” myocardial ischemia, in which there are no pain symptoms and to "totally silent” ischemia, in which there is no pain symptoms and no ECG changes. It has been shown that a very large percentage, between 33% and 50% of heart patients may have these silent varieties of myocardial ischemia. (Kurata C. Tawarahara K, Sakata K, Taguchi T, Fukumoto Y, Kobayashi A, et al., "Electrocardiographically and
  • VEST Ambulatory Left Ventricular Function Monitor
  • Standard exercise testing with ECG could fail to diagnose such patients.
  • the PAT due to its high sensitivity could facilitate an accurate diagnosis in such cases without having to rely on the costly and poorly available radio-nuclear tests.
  • An object of the present invention is to provide a method and apparatus for non-invasively determining a number of physiological conditions particularly in connection with the detection of certain sleep disordered breathing conditions, ED, and coronary artery disease by mental stress tests.
  • Another object of the present invention is to adapt the method and apparatus of PCT/IL97/00249 for use in the above additional applications.
  • a method for non-invasively determining the physiological condition of endothelial dysfunction (ED), hypopnea, or upper airway resistance syndrome (UARS), sympathetic nervous system reactivity, or reactivity to a pharmalogical agent, in an individual comprising: monitoring peripheral arterial tone of the individual 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.
  • ED endothelial dysfunction
  • UARS upper airway resistance syndrome
  • a method for non-invasively determining the existance of a coronary artery disease in an individual comprising: subjecting the individual to a mental stress test; monitoring peripheral arterial tone of the individual using an external sensor; detecting a change in the peripheral arterial tone; and determining the existance of a coronary artery disease when a specific change in the peripheral arterial tone has been detected.
  • the monitoring comprises viewing a peripheral arterial tone signal wave
  • the specific change is an early attenuation of the peripheral arterial tone signal wave during exercise and/or a slow amplitude increase of the peripheral arterial tone signal wave during recovery.
  • an apparatus for non-invasively determining the physiological condition of endothelial dysfunction (ED), hypopnea, or upper airway resistance syndrome (UARS) in an individual comprising: a probe to be applied to a digit of the individual, the probe sensing the peripheral arterial tone of the digit and outputting signals indicative of the peripheral arterial tone; and a processor receiving the signals output from the probe and either: (a) providing an output indicating changes in the peripheral arterial tone from which the physiological condition can be determined; or (b) determining the physiological condition from changes in the peripheral arterial tone and providing an output indicating the physiological condition.
  • ED endothelial dysfunction
  • UARS upper airway resistance syndrome
  • apparatus for non-invasively determining stress-induced coronary artery disease in an individual comprising: a probe to be applied to a digit of the individual during a mental stress test of the individual, the probe sensing the peripheral arterial tone of the digit and outputting signals indicative of the peripheral arterial tone; and a processor receiving the signals output from the probe and either; (a) providing an output indicating changes in the peripheral arterial tone from which the presence of a stress-induced coronary artery disease can be determined; or (b) determining the presence of a stress-induced coronary artery disease from changes in the peripheral arterial tone and providing an output indicating the physiological state.
  • Fig. 1 illustrates one form of apparatus, as described in PCT/IL97/00249 (Fig. 9), that may be used for the additional applications according to the present invention
  • Fig. 2 illustrates another finger probe, including an optical sensor, which may be used in the apparatus of Fig. 1;
  • Fig. 3 is a table for comparing the results of detecting endothelial dysfunction using the present invention and a conventional brachial artery flow response duplex test;
  • Fig. 4 is a comparison of the waveform of peripheral arterial tone for a normal subject and a subject having endothelial dysfunction
  • Fig. 5 shows a comparison between a positive PAT response to mental stress shown as attenuation of the signal amplitude during the stress period (above), and a negative PAT response (below).
  • the finger probe 2 comprises a thimble-shaped end cap 30 and a pressure cuff 40 connected to a pneumatic system, generally designated 80, which is in turn connected to a processing system, generally designated 90.
  • the pneumatic system 80 includes a pressure source 10 connected to a pneumatic tubing system, generally designated 85.
  • the tubing system includes tubes 7a and 44a, which deliver the pressure from the pressure source to the finger probe 2, and electronic solenoid valves 12 and 46, which can be controlled by the processor 23 to be described later.
  • the pneumatic system 80 further includes a pressure transducer 13 for monitoring the pressure applied by source 10, and a differential pressure transducer 14 measuring the difference between the variable pressure in the finger probe chambers and the constant pressure existing between valves 12 and 46.
  • the pneumatic tubing 85 may be further provided with reservoirs
  • the processing system 90 includes an A/D converter 22, a processor 23, and a monitoring device, generally indicated as monitor 24 and alarm 25.
  • the processing system is responsible for controlling the operation source 10 and solenoids of valves 12 and 46, and also processes the detected signals to provide a decipherable output.
  • valves 12 and 46 are first open and the chambers 5 and 43 of the finger probe are evacuated to allow the patient to insert a finger into the probe. Then, the pressure is raised to a pressure which is sufficient to unload the arterial walls and to prevent venous pooling.
  • the pressure applied by source 10 is measured by a pressure transducer 13 upstream of valves 12 and 46. In the preferred embodiment, the pressure in the pneumatic compartments is automatically raised to 70 mm Hg.
  • valves 12 and 46 are closed, so that the pressure in the right chamber of pressure differential transducer 14 is kept constant.
  • the pressure on the left chamber of transducer 14 varies depending on the pressure inside chamber 5 of the finger probe 2.
  • no calibration of the inventive device is necessary, since the measurement is comparative with the patient's own baseline results observed during the test.
  • the A/D converter 22 shown in Fig. 1 receives the analog outputs of pressure transducers 13 and 14, and converts them into digital form before introducing them into a CPU processor 23.
  • the processor 23 processes the measured finger volume (or optical density) changes to produce output 24a of the volume measurements, and/or an output 24b of the changes in the volume measurements with respect to time. Either one or both measurements can be displayed on the monitor 24.
  • an alarm 25 (e.g., audio or visual) may be actuated if this predetermined drop in measured volume occurs, to immediately alert the attendants.
  • a high pass filter 28 is provided to filter the output of the transducer 14 and improve the signal to noise ration.
  • the finger probe include an annular pressure cuff 40 coaxial with and contiguous to the end cap 30, on the proximal (heart) side of the device.
  • the main purpose of the pressure cuff is to extend the boundary of the constant pressure field beyond the borders of the sensing probe, so as to avoid edge effects.
  • Chamber 43 of the pressure cuff is also filled with a pressurized gas via a port 44; however, solenoid valve 46 isolates conduit 44 from transducer 14.
  • Cuff 40 thus extends the static pressure field for a distance in the proximal (heart) direction from the site of measurement of the finger volume changes accompanying blood pressure waves.
  • the annular pressure cuff 40 acts as a tourniquet which, together with the pressure field produced in the thimble-shaped end cap 30, prevents venous pooling in the distal end (particularly the most distal phalange) of the finger. It also substantially prevents uncontrolled venous back flow; and further, it partially unloads the wall tension of, but does not occlude, the arteries in the distal end of the finger when the finger is at heart level. While the pressure in the pressure cuff may differ from that in the sensing chambers 35, 36, it should not exceed it.
  • Fig. 2 illustrates an apparatus similar to that of Fig. 1 except that changes in the optical density are directly measured to provide a measurement of the changes in the finger accompanying the blood pressure waves.
  • the same reference numerals are used for corresponding parts as in Fig. 1.
  • chamber 5 is pressurized to a fixed predetermined value, as described above with respect to Fig. 1.
  • the tubular diaphragm 4 defining chamber 5 is provided on one side with a light source 100, and on the opposite side with a light receiver 101, such that pulsatile blood volume changes in the finger received within the tubular diaphragm 4 will be detected as changes in optical density by the light receiver 101.
  • This information is fed via conductors 102 to an amplifier circuit 103 where it is amplified and filtered, and then fed to the A/D converter 22 for processing by the processor 23 as described above.
  • the measurement site namely the location of the light source 100 and light receiver 101, is considerably inward of the open end of the rigid casing 3 of the probe 2 which applies the static pressure field uniformly around the outer end of the finger, and therefore the annular pressure cuff (40, Fig. 1) need not be included for this purpose.
  • the annular pressure cuff (corresponding to pressure cuff 40 in Fig. 1, may also be used in the system illustrated in Fig. 2.
  • the finger probe 2 as described above and more fully in PCT/IL97/00249, could be used to house a pulse oximeter for measuring the oxygen saturation of blood.
  • conventional pulse-oximeter sensors could be included in the probe housing and would produce a better measurement of the oxygen saturation of the blood (Sa ⁇ 2 ) because of the stable environment provided by the static pressure field.
  • the generation of a compliance curve of the measured arterial blood vessels could be made by inducing and monitoring transmural pressure changes within the blood vessels. This could be done by changing the applied external pressure generated within the probe, and measuring the corresponding volumes and other volume correlated features of such arterial blood vessels and then plotting such measured values together with hydrostatic pressure changes. This would allow calibration to be performed without restricting a patient's movement. Transmural pressure changes may also be elicited by combined external pressure changes and induced hydrostatic pressure changes. The analysis of the compliance curve whether derived from external pressure changes alone, or from induced hydrostatic pressure changes alone, or from combined hydrostatic pressure changes and external pressure changes, is in all other respects identical to that already described.
  • PCT/IL97/00249 While most of the description in PCT/IL97/00249 focuses on detecting myocardial ischemia, it describes other applications of the method and apparatus, including the use for monitoring various sleeping conditions of a subject, particularly the rapid eye movement (REM) sleep stage and sleep apnea syndrome (SAS) as well as nocturnal myocardial ischemia.
  • REM rapid eye movement
  • SAS sleep apnea syndrome
  • REM Rapid Eye Movement stage sleep
  • REM sleep is a vital tool for diagnosing sleep disorders and numerous other conditions.
  • altered control of breathing occurs with greatly reduced chemosensitivity resulting in highly irregular breathing patterns and the greatest declines in blood oxygen saturation.
  • REM latency Changes in REM latency have been reported in a plethora of affective illnesses including endogenous depression, schizophrenia, anxiety disorders, obsessive-compulsive disorders, eating disorders as well as in narcolepsy, alcoholism, Alzheimer's disease and impotence. REM latency is important not only in the diagnosis of these conditions but also in therapy and follow up since it is a sensitive indicator of the patient's condition.
  • REM detection with the PAT could be an extremely useful adjunct to existing ambulatory monitoring systems, since it yields important information with a minimum of patient instrumentation in a highly cost effective manner. It could be used to provide intensive, long term, follow up in the patient's own home, which would be a logistic impossibility in the sleep lab setting. It could be readily used in combination with oxygen saturation monitoring and ambulatory apnea screening function already described for PAT. It eliminates the need for subjective operator evaluation of sleep studies and the dependency on the specialized and expensive instruments needed for laboratory based sleep staging, such as EEG, EOG and EMG measurements.
  • the peripheral arterial tone was found to be an accurate detector of endothelial dysfunction (as demonstrated in the table in Fig. 3), when a characteristic response pattern was observed during a standardized exercise test procedure as shown in Fig. 4.
  • the normal subject shows no decrease in amplitude of the PAT signal as the exercise progresses, whereas the ED subject shows a clear decline in the signal.
  • BAD brachial artery duplex test
  • 20 were also found by the PAT to be negative responders. Of eight patients responding positively to the BAD test, 7 also had a positive PAT response.
  • a high degree of agreement (87% accuracy) was shown between the PAT and the BAD test.
  • the PAT sensor itself to stop blood flow to the finger for a predetermined period of time instead of stopping blood flow to the arm as in the brachial artery duplex test already described. Following removal of the finger blood flow occlusion, it is possible to record the response in finger pulsatile volume using the PAT sensor in its normal manner. In this way, the endothelium mediated response and the vasodilatory response can be tested without requiring the more extensive occlusion of blood flow to the hand and forearm as practiced today.
  • the probe of the present invention for measuring changes in arterial tone could be used in connection with conventional mental stress testing to predict coronary artery disease.
  • a positive PAT response to mental stress shown as attenuation of the signal amplitude during the stress period (above, and a negative PAT response (below) are given in Fig. 5 where the beginning and end of the stress periods are indicated by 1 and 3, respectively.
  • sympathetic nervous system hyperresponsivity may itself be an important clinical entity which the PAT is well suited to monitor.
  • State of the art measurement of sympathetic nervous system activity is by way of direct intra-neural measurement of the peroneal nerve. This is an invasive procedure which is uncomfortable and carries the risk of injuring the patient.
  • the time-course of autonomic nervous system activity or reactivity can be monitored using the PAT.
  • Such monitoring may incorporate the provocation of sympathetic nervous system reactivity via standardized tests known to the art, such as the cold pressor response, postural changes, inspiratory gasp, mental arithmetic, and so on. Normal limits of reactivity may be defined based on population studies.
  • the time-course of sympathetic nervous system changes during the passive tilting of patients can also be monitored using the PAT.
  • the PAT signal could be monitored during pharmacological stress testing for diagnostic purposes or for pharmacologically eliciting sympathetic nervous responses, as well as for monitoring/evaluating the effects of pharmacological agents on the peripheral arterial tone.
  • the monitoring of the PAT signal amplitude may also be used in the practice of polygraph testing, wherein the monitored parameter is related to sympathetic nervous system reactivity as it pertains to altered level of subject anxiety in response to examiner input.
  • the monitoring of the PAT signal amplitude may also be used in the practice of biofeedback, wherein the monitored parameter is related to sympathetic nervous system reactivity and the therapeutic goal is to train a patient to self regulate the level of sympathetic nervous system reactivity.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biophysics (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Physiology (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

L'invention se rapporte à un procédé et à un appareil permettant de déterminer de manière non invasive un état physiologique de dysfonctionnement endothélial (ED), d'hypopnée ou de syndrome de résistance des voies respiratoires supérieures (UARS). Ledit procédé consiste à contrôler la tonicité artérielle périphérique, à déceler un changement de cette tonicité artérielle périphérique et à déterminer l'état physiologique lorsqu'un changement spécifique de tonicité artérielle périphérique a été décelé.
EP00937145A 1999-06-02 2000-05-29 Diagnostic d'etats pathologiques par controle du tonus arteriel peripherique Withdrawn EP1294277A4 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US324529 1999-06-02
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
PCT/IL2000/000307 WO2000074551A2 (fr) 1999-06-02 2000-05-29 Diagnostic d'etats pathologiques par controle du tonus arteriel peripherique

Publications (2)

Publication Number Publication Date
EP1294277A2 true EP1294277A2 (fr) 2003-03-26
EP1294277A4 EP1294277A4 (fr) 2005-02-09

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EP00937145A Withdrawn EP1294277A4 (fr) 1999-06-02 2000-05-29 Diagnostic d'etats pathologiques par controle du tonus arteriel peripherique

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EP (1) EP1294277A4 (fr)
JP (1) JP2003527149A (fr)
KR (1) KR100674584B1 (fr)
CN (1) CN100376202C (fr)
AU (1) AU768097B2 (fr)
CA (1) CA2375470C (fr)
NZ (1) NZ515591A (fr)
WO (1) WO2000074551A2 (fr)

Families Citing this family (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9468378B2 (en) 1997-01-27 2016-10-18 Lawrence A. Lynn Airway instability detection system and method
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
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
AU2001237695B2 (en) 2000-03-02 2004-11-04 Itamar Medical Ltd. Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system
JP4049671B2 (ja) * 2000-10-23 2008-02-20 イタマール メディカル リミテッド 患者の内皮活性を非侵襲的に評価する装置
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 (ko) * 2003-11-12 2006-04-24 이화여자대학교 산학협력단 혈관 수축력 측정을 위한 혈관 고정장치
US7668579B2 (en) 2006-02-10 2010-02-23 Lynn Lawrence A System and method for the detection of physiologic response to stimulation
RU2309668C1 (ru) 2006-02-20 2007-11-10 Александр Сергеевич Парфенов Способ неинвазивного определения функции эндотелия и устройство для его осуществления
KR100894632B1 (ko) * 2006-10-25 2009-04-24 연세대학교 산학협력단 원격 건강관리를 위한 변좌 일체형 생체신호 획득 장치
CA2722773C (fr) 2008-05-07 2015-07-21 Lawrence A. Lynn Moteur de recherche de modele d'echec medical
RU2468356C2 (ru) * 2008-07-30 2012-11-27 Пиньоло С.П.А. Диодное лазерное устройство для неинвазивного измерения гликемии
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 (pl) 2011-05-31 2017-09-29 Politechnika Łódzka Sposób okreslania parametrów dooceny funkcji sródbłonka naczyniowego
US10842395B2 (en) 2011-11-24 2020-11-24 Itamar Medical Ltd. Apparatus for monitoring arterial pulse waves in diagnosing various medical conditions
CN104042195A (zh) * 2014-05-04 2014-09-17 上海中嘉衡泰医疗科技有限公司 血管内皮功能分析系统和方法
EP3073400B1 (fr) 2015-03-25 2022-05-04 Tata Consultancy Services Limited Système et procédé permettant de déterminer le stress psychologique d'une personne
US10617302B2 (en) 2016-07-07 2020-04-14 Masimo Corporation Wearable pulse oximeter and respiration monitor
ES2952524T3 (es) * 2016-11-15 2023-11-02 Boehringer Ingelheim Vetmedica Gmbh Método para predecir un patógeno respiratorio específico
AU2019257648A1 (en) * 2018-04-23 2020-11-12 Loma Linda University Computer-supported intraneural facilitation for vascular changes
CN109316177A (zh) * 2018-11-02 2019-02-12 杜玲娟 一种用于外周动脉疾病血管狭窄程度的评估装置及方法

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998004182A2 (fr) * 1996-07-30 1998-02-05 Itamar Medical (C.M) 1997 Ltd. Procede et appareil de detection non invasive d'etats pathologiques par controle du tonus arteriel peripherique

Family Cites Families (10)

* Cited by examiner, † Cited by third party
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
DE3612532A1 (de) * 1985-04-12 1986-10-23 Omron Tateisi Electronics Co., Kyoto Elektronisches blutdruckmessgeraet
CA1311016C (fr) * 1985-06-03 1992-12-01 Kevin M. Mcintyre Dispositif d'evaluation des performances mecaniques du coeur
JPS62500425A (ja) * 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 個人の血圧に関連した波形情報を得るための技術
JPS6323645A (ja) * 1986-05-27 1988-01-30 住友電気工業株式会社 反射加温型オキシメ−タ
US4836219A (en) 1987-07-08 1989-06-06 President & Fellows Of Harvard College Electronic sleep monitor headgear
EP0465345B1 (fr) * 1990-07-03 1996-05-08 Ueda Electronic Works Limited Appareil pour mesurer la tension artérielle
IL100080A (en) 1991-11-19 1994-12-29 Sleep Disorders Diagnostic And A presentation system for determining a person's sleep stages
US5365924A (en) * 1992-07-31 1994-11-22 Frederick Erdman Association Method and apparatus for non-invasive cardiovascular diagnosis
JPH06319707A (ja) * 1993-05-13 1994-11-22 Omron Corp 電子血圧計

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998004182A2 (fr) * 1996-07-30 1998-02-05 Itamar Medical (C.M) 1997 Ltd. Procede et appareil de detection non invasive d'etats pathologiques par controle du tonus arteriel peripherique

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO0074551A2 *

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CN100376202C (zh) 2008-03-26
WO2000074551A2 (fr) 2000-12-14
KR20030012788A (ko) 2003-02-12
KR100674584B1 (ko) 2007-01-26
WO2000074551A3 (fr) 2003-01-30
NZ515591A (en) 2004-05-28
CA2375470A1 (fr) 2000-12-14
CN1424889A (zh) 2003-06-18
CA2375470C (fr) 2010-04-13
EP1294277A4 (fr) 2005-02-09
AU768097B2 (en) 2003-12-04
JP2003527149A (ja) 2003-09-16
AU5242900A (en) 2000-12-28

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