RU2343826C1 - Cardiovascular system evaluator (versions) - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: evaluator contains compressor, air release valve, two obstructive cuffs - brachial and antebrachial, pressure sensor and pulse waves detector with output filters, analog-to-digital converter and control unit connected to PC. Cuffs are fixable on one patient's hand and interconnected through adjustable air valve. According to the first version, brachial cuff is connected with pressure sensor recording constant and variable within Korotkoff's sounds range. The second version implies application of isolated pressure sensor and acoustic detector of Korotkoff's sounds. Antebrachial cuff is pneumatically connected with acoustic detector of Korotkoff's sounds. Control unit contains microprocessor, switchboard and PC interface.

EFFECT: higher accuracy of cardiovascular system evaluation.

13 cl, 9 dwg

Description

The invention relates to medical equipment and can be used to determine the state of the cardiovascular system.

It is known that sufficiently complete information about the state of the cardiovascular system can be obtained from the simultaneous measurement of blood pressure (BP) and pulse wave parameters by the auscultatory method. A routine way to determine the propagation speed of a pulse wave (PWV) is to register, using a sphygmograph, the delay Δt of a peripheral pulse at the beginning of the rise of the curve on the sphygmograms of the carotid and radial arteries. The speed calculation is carried out according to the formula V = L / Δ t, where L is the distance between the sphygmograph sensors, which are installed on the shoulder and the lower third of the forearm. The pneumatic cuff can be installed anywhere (see, for example, Diagnostic and therapeutic equipment, prof. V.S. Mayat, M., Medicine, 1969. S. 243-246). Such measurements make it possible to predict various parameters of the cardiovascular system, for example, to determine the endothelium-dependent vasodilation of arteries by assessing changes in PWV against reactive hyperemia (see, for example, RU 2265391). In this method, the PWR alone is determined by a standard method. Then the brachial artery is squeezed by the cuff of the manometer to measure blood pressure for 3 minutes. The pressure is increased by at least 50 mm Hg. from systolic blood pressure. Immediately after release of air from the cuff of the manometer, the PWV is determined after restoration of blood flow in the artery. It is reported that in the norm there is a significant decrease in PWV, on average, by 21.2%. In patients with coronary heart disease, changes in PWV are significantly less pronounced and amounted to 3.9%; in some patients with coronary heart disease, an increase in PWV is observed.

A large number of technical solutions are described relating to the hardware implementation of devices for recording the parameters of blood pressure and PWR. Domestic studies have shown that registration of blood pressure according to Korotkov’s tones is more accurate in relation to the oscillometric method (Ivanov S.Yu., Livshits NI. Accuracy of blood pressure measurement according to Korotkov’s tones in comparison with the oscillometric method, Bulletin of Arrhythmology, No. 40, 15 / 10/2005 p. 55-58).

Thus, a device is known (EP 0487726, TOMITA MITSUEI, 03.06.1992) for assessing blood flow parameters by registering the leading and trailing edges of the pulse wave and calculating by the formula. The device has one sectioned inflatable cuff connected to an air pump, and computer processing means for recording Korotkov tones. However, this device, despite its apparent simplicity (measuring sections are installed on both sides of the compression section of a single shoulder cuff), is unlikely to provide acceptable accuracy due to the small measuring base L, equal to the width of the cuff, and, in addition, the unproven connection of the PWV with the pressure in the aorta .

In another invention (DE 19960452, RENTSCH WOLFGANG, 01/23/2001) two sets of paired cuffs are installed on the patient's limbs to measure the parameters of the cardiovascular system. Diagnosis of atherosclerotic complications is estimated by the difference in PWV in several zones on the shoulder and upper thigh. The device uses four independent compressors and their control systems, which generally complicates the design, and the need to install the cuff on the thigh is inconvenient when conducting screening studies.

A device is also known (EP 0824009, SHINODA MASAYUKI, 02/18/1998) for determining the state of the cardiovascular system. The device contains the first and second pulse wave sensors, one of which is mounted on the shoulder, and the second on the wrist, which are connected to phase measuring devices. The wrist contact sensor contains a semiconductor chip pressed against the radial artery by means of overpressure created through an elastic diaphragm located in the housing. The case is fastened with a strap. In the diagnosis, a pre-established relationship between the parameters of peripheral blood circulation and the phase shift between the first and second pulse waves synchronized with the patient's heartbeat is used. The disadvantage is the complexity of the design, because two compressors and their control circuits and a complex control and recording circuit are used.

A device for the diagnosis of atherosclerotic changes in arteries (US 6733460 B2 OGURA TOSHIHIKO, 05/11/2004). The device contains four pneumatic channels. Each channel contains a cuff associated with a pressure sensor, a valve and a compressor, a control unit and a computer-based computing device. For diagnostics, a comparison of the amplitudes of pulse waves on the arms and legs is used, since it is known that their amplitude is different for the upper and lower extremities, which, however, requires the elaboration of the criteria for “norm” and “pathology”. In addition, the device uses independent pneumatic systems for each limb with control systems, which is difficult and too cumbersome for screening studies.

A device for measuring hemodynamic parameters is described (RU 2006108107 A, IESh Miklosh, 08.27.2006). Designed to measure hemodynamic characteristics, in particular, aortic size index (Alx) and / or ejection duration (ED) through non-invasive, occlusive blood pressure measurements. The device includes an oscillometric blood pressure meter based on an occlusal cuff - a pressure sensor placed on the brachial artery, as well as blocks that determine the values of hemodynamic parameters, with a high sampling rate of at least 200 samples per cardiac cycle. The arithmetic time block provides the calculation of PWVP based on oscillometric data from the time shift of the main wave and the first reflected wave using the distance between the chest cavity and pubic bone, measured on the patient. The main drawback inherent in this method, like other oscillometric methods, is that the amplitude of the pulse wave depends not only on blood pressure, the characteristics of the vessel and the blood flowing through it, but also on the elastic properties of the soft tissues surrounding the vessel and capable of damping the wave.

The closest analogue is a device for determining the parameters of the cardiovascular system with the registration of blood pressure and PWV (EP 1393670 A2, NARIMATSU et al., 03.03.2004). The device is formed by two channels, similar in technical implementation, contains two cuffs, each of which is connected through controlled valves to individual compressors. In each line, pressure and pulse wave sensors, electric filters to isolate the variable and constant components of the signal, connected through the ADC to the computer, are installed. The disadvantages of this device include the need to place one of the cuffs on the lower leg, which makes it difficult to use during screening, as well as the complexity of the device due to the presence of two compressors and their control systems.

The objective of the invention is to provide a device for determining the parameters of the cardiovascular system with a more rational construction scheme and design, allowing screening using cuffs worn on only one arm of the patient, and not requiring undressing of the patient.

The device for determining the parameters of the cardiovascular system in the first embodiment includes two occlusive cuffs connected by pneumatic lines with a compressor and a pneumatic bleed valve, one of which is a shoulder, pressure and pulse wave sensors with output filters, an analog-to-digital converter, and a control unit connected to a computer. Occlusive cuffs are made with the possibility of fastening on one arm of the patient and are pneumatically connected to each other through a controlled pneumatic valve, and the cuff of smaller width is designed to be placed on the forearm and pneumatically connected to a pulse wave sensor made in the form of a Korotkov tone sensor. The shoulder cuff is connected to a pressure sensor configured to detect constant and variable pressure components in the Korotkov tone range, the control unit contains a microprocessor, a switch, and an interface for communicating with a computer. The control outputs of the microprocessor are connected to the compressor, pneumatic valve actuators and the control input of the switch, the output of which through an analog-to-digital converter is connected to the information input of the microprocessor, the output filters of the sensors are connected to the inputs of the switch, and the compressor and the pneumatic bleed valve are installed in the pneumatic line of the shoulder cuff.

The device may be characterized in that the pressure sensor associated with the shoulder cuff has output filters for extracting constant and variable signals in the range of Korotkov tones of the pressure components.

In the second embodiment, the device has Korotkov’s pressure and tone sensors connected respectively to output filters to separate the constant and variable components of the pressure in the range of Korotkov’s tones.

The device can also be characterized in that it contains means for measuring the distance between the cuffs fixed on the arm, the output of which is connected to the input of the switch.

The device can also be characterized by the fact that the control of the pneumatic valve provides bleeding according to a linear law, and the fact that the output filters contain means for amplifying the output electrical signal.

The device can be characterized by the fact that the control unit is configured to select the modes of single or multiple measurement of blood pressure, blood pressure and pulse wave velocity propagation during the test with hyperemia.

The device can be characterized, in addition, by the fact that the Korotkov tone sensor is an electro-acoustic transducer installed in the housing with a gap on one side of the soundproof membrane sealed in the housing, the second side of which is connected to the pneumatic line.

The technical result of the invention is the expansion of the functionality of the device by increasing the measurement modes of the parameters, the ability to automate measurements, the convenience of screening, as well as increasing the signal-to-noise ratio when receiving Korotkov tones.

The invention is illustrated in the drawings, where Fig. 1 is a block diagram of a first embodiment of a device; figure 2 is a block diagram of a second embodiment; figure 3 - design of sensors;

figure 4 - algorithm of the operation of the control unit;

figure 5 - algorithm of the functioning of the control unit when measuring blood pressure in a routine manner and against a background of hyperemia;

6 is a diagram of the functioning of the control unit with multiple measurement of blood pressure;

Fig.7 - the algorithm of the functioning of the control unit when measuring PWV;

Fig.8 is an external view of the device assembly;

Fig.9 is a view of a display interface for measuring PWV.

The device according to the first embodiment (Fig. 1) comprises a compressor 10 connected by a pneumatic line 12 to a first occlusal cuff 14 intended for installation on the brachial artery. A pressure sensor 18 is installed in the pneumatic line 12, a bleed valve 20 with an electromagnetic actuator 22. The pressure sensor 18 is configured to register a constant and a variable pressure component in the range of Korotkov tones. Through a pneumatic valve 23 with an electromagnetic actuator 24, a pneumatic line 12 is connected via a pneumatic line 25 to a second occlusal cuff 26. The cuff 26 is designed to be mounted on the forearm and has a smaller width than the cuff 14. Both cuffs 14, 26 are designed to be fixed on one, mainly left, arm the patient. In the pneumatic highway 25, a pulse wave sensor 28 is installed, made in the form of a Korotkov tone sensor.

The device is controlled from the control unit 30, which includes a switch 31, to the inputs of which the outputs of the sensor 18 are connected through the output filters 32, 33, and the sensor 28 is connected through the filter 34. The filter 32 emits a constant (slowly changing) component of the signal from the sensor 18 due to pressure in the pneumatic line, and the filters 33, 34 emit only the variable component of the signal (acoustic signal), due to the tones of Korotkov. Filters 32, 33, 34 can be structurally combined with amplifiers of the output electrical signal.

Block 30 includes a microprocessor 35. Its output communication interfaces 351, 352, 353 are connected by buses 36, 37, 38, respectively, to the control inputs of blocks 10, 22, and 24. An interface 354 via bus 39 is connected to the control input of the switch 31.

The output of the switch 31 is connected to the input of an analog-to-digital converter (ADC) 40, the output of which via the bus 42 is connected to the input interface 355 of the microprocessor 35. The interface 356 via bus 44 through the interface 45 of two-way communication is connected to the personal computer PC 50. The interface 357 serves to issue clock signal for the operation of the ADC 40.

To measure the distance of the L base between the centers of the cuffs 14 and 26, a ruler 59 with a scale 60 is used, the information output of which is connected via bus 61 to one of the inputs of the switch 31. It is possible to enter the numerical value of L, measured by a tape measure, using the PC 50 keyboard or execute cuffs on fixed base.

Figure 2 shows a second embodiment of the device with two separate sensors: a sensor 18 of the constant pressure component and acoustic sensors 66, 28 of Korotkov tones installed in the pneumatic lines 12 and 25, respectively. Moreover, to improve the accuracy of measurements, it is advisable to use the same type of sensors 28 and 66 with the same characteristics. The sensors 28 and 66 are connected to the switch 31 through the output filters 33, 34 in the passband of the Korotkov tone signal, and the pressure sensor 18 through the output filter 32 to isolate only the signals of the constant pressure component.

Figure 3 shows the principle of constructive implementation of the sensors 28, 66. The sensor includes a housing 70 with an open neck 72. A soundproofed rubber membrane 74 is sealed in the housing 70, which divides the pneumatic line 12/25 from the measuring cavity 75 of the sensor. A microphone is installed in the cavity 75 under atmospheric pressure — an electro-acoustic transducer 76 that provides reception of Korotkov tones in the frequency band of sound frequencies up to a dozen to hundreds of Hz. This design improves the noise immunity of the sensors.

The device allows measurements in various modes: measuring blood pressure in a routine manner (mode A), measuring blood pressure against hyperemia (mode B), measuring blood pressure multiple times (mode C), measuring PWV (mode D). A block diagram of the algorithm of the functioning of the device as a whole is presented in figure 4, and for these modes in figure 5-7.

Preparation for work includes the following steps.

The operator puts the cuff 14 on the shoulder, and the cuff 26 on the forearm of the same arm of the patient. The distance L between the centers of the cuffs is measured and its value is entered into the PC 50, which activates the device software. The following describes the operation of the patented device separately for each of the modes.

1. Measurement of blood pressure (mode A).

The program controls displayed on the PC 50 display, the blood pressure measurement mode is activated (Fig. 4,5). The required pressure level is set. The measurement of blood pressure is started by clicking on the Start button, after which the Start command is sent to the microprocessor 35. The microprocessor 35 supplies the maximum voltage to the electromagnetic actuators 22 and 24, as a result of which the pneumatic valves 20 and 23 are completely closed. The compressor 10 is supplied with power, it begins to pump the cuff 14.

The microprocessor 35 supplies a control code to the switch 31, as a result of which the switch connects the signal from the output of the pressure sensor 18 to the input of the ADC 40. The microprocessor 35 from the interface 357 supplies the clock to the ADC 40 to digitize the input signal therein.

Codes from the output of the ADC 40 through the input interface 355 enter the microprocessor, then through interfaces 356 and 45 to the PC50. Codes from the output of the ADC, characterizing the pressure D in the cuff 14, are analyzed, compared with a user-specified level of pump Dmax.

When Dmax is reached, the PC50 receives a command to stop pumping and the microprocessor 35 turns off the compressor 10. Next, the microprocessor 35 sends control codes to the actuator 22 to open the bleed valve 20, as a result of which bleeding is ensured. The codes characterizing the pressure are continuously supplied to PK50, where they are analyzed according to the inherent control program for pressure relief according to the linear law. PC50 through the microprocessor 35 adjusts the bleed rate so that the bleed is carried out according to a linear law. The latter increases the accuracy of measuring blood pressure with respect to etching according to a nonlinear law, when with a decrease in the value of D the etching rate gradually decreases.

In the process of bleeding, the microprocessor receives codes from the ADC40, characterizing the signals from the output of the sensor 18, and transmits them to the PC50. Against the background of signals characterizing the current pressure D in the cuff 14, there are signals of Korotkov tones characterizing the values of blood pressure. In PC50, the received codes are filtered, the signals of Korotkov tones are allocated from them, which are stored for further processing. A graph of pressure versus time D = f (T) and the type of signal of Korotkov tones are displayed on the PC display (Fig. 9). After reducing the pressure to the minimum level (D = Dmin), the PK50 sends a command to the microprocessor to turn off the compressor 10 and fully open the valve 20, after which it processes the received signals of Korotkov tones.

Signal processing is as follows. Stored signals are digitally filtered to suppress interference. In the received signals, the maxima of the Korotkov tones are sought, the frequency of their repetition is determined to determine the pulse. Next, select the maximum on the envelope and find the points corresponding to systolic blood pressure and diastolic blood pressure. Usually, envelope points corresponding to the level of 0.5 of the maximum value Umax and to the left (Usist) and to the right (Udiast) of the maximum on the envelope are taken as such points. According to the graph of the law of the change in pressure in the cuff stored in the array of numbers in the PC’s memory, the pressure D is read at the points corresponding to the two points found on the first graph. It also measures the time intervals between the highs.

The received data is displayed on the PC display. To illustrate the measurement process, two cursors are also displayed in the form of vertical lines showing the intersection lines of the Korotkov tone graph at the points ADsist and ADdiast, which allows you to visually monitor the progress of measurements.

2. Measurement of blood pressure against hyperemia (mode B).

The measurements are carried out similarly as in mode A (see Fig. 5), with the addition that the measurement of blood pressure is carried out with a delay of 30 to 240 seconds after pumping the cuff 14. The delay time is set by selecting the required position in the PC50 program menu in section "Type of work, Test with hyperemia, sec."

3. Measurement of blood pressure repeatedly (mode C).

The measurements are carried out in the same way as in mode A, with the exception that the measurement of blood pressure is carried out several times in a row (see Fig.6). The number n of measurements is set in the range from 2 to 10. The recommended number m of measurements is three. The interval between measurements is set in the time interval t = 5-60 seconds in the menu item "delay for multiple measurements of blood pressure, sec." Recommended delay time t = 20 sec. At the end of the measurements, a table of results is formed.

4. Measurement of PWV (mode D).

The patient is put on a cuff 14 on the shoulder and a cuff 26 on the forearm of one hand. By the program controls on the PC50 display, the PWV measurement mode is activated. The required level of pressure pumping Dnak is established for the measurement mode of the superconducting liquid crystal and the measurement time. The measurement mode is started by clicking on the Start button, after which the Start command is sent to the microprocessor. After that, the operations described above for mode A are performed in the PC50 and the microprocessor, with the difference that the valve 23 is in the open state until the set pressure level D = Dnak is reached in both cuffs. The pump level is set automatically according to the results of measuring the blood pressure or by the operator using the "Pump" controller, available in the form of a program. Next, the microprocessor 35 sends a command to close the valve 23, and to the switch 31 - commands that provide alternate connection to the input of the ADC40 signals from the outputs of the filters 32, 33 from the sensor 18 (figure 1) or sensors 18, 66 (figure 2), and also signals from the output of the filter 34 from the sensor 28. The valve 23 prevents the penetration of acoustic signals - Korotkov tones from one cuff into another during the measurement, which reduces the distortion of the waveform and improves the accuracy of measurements. Moreover, in the embodiment shown in FIG. 2, ceteris paribus, the signal-to-noise and noise ratio is 2-3 times better than in the embodiment shown in FIG. 1. In the ADC40, the signals are periodically alternately digitized with a clock frequency issued by the microprocessor. Codes from the ADC output go through the 355 interface to the microprocessor, then through the 45 interface to the PC50. The codes of each of the three signals are digitally filtered to suppress noise and stored in the PC memory for the entire specified measurement time. At the same time, the current time Ttek is counted. After the specified time, the measurement Tizm, i.e. when Ttek = Tism, the reception of codes is stopped, a command to open valves 20, 23 is formed, the microprocessor sends control signals to the actuators 24 and 22. During the measurement and recording of signals from sensors 28, 66, acoustic signals are extracted - Korotkov tones arising in both cuffs 14.26 in the form of short pulses (a duration of several tens of milliseconds).

The characteristics of the sensors are selected in such a way that the sensor 18 has a lower passband that lies in the lower frequency region than the sensors 28, 66. As a result, the filter 33 from the sensor 18 produces signals of Korotkov tones with a longer duration - hundreds of milliseconds, which are used for additional synchronization of the processing of signals from sensors 28, 66.

During recording, the signals are displayed in the form of graphs on the PC50 display to monitor the measurement progress. During the first recording, the sensitivity of the amplifiers of the sensor signals is set so that the amplitude of the signals falls within the specified tolerance (1-2 volts at the ADC input). Knobs for adjusting the signal level during the measurement of PWV are placed on the front panel of the control unit 30 (Fig. 8). Next, the measurement of PWV is repeated.

At the end of the recording, signal processing is carried out, which consists in finding the position of the leading edge of the pulse wave pulses in both cuffs, determining the ΔT delay value of these pulses and calculating the value using the formula: СРП = L / ΔТ, where L is the distance between the centers of the cuffs 14 and 26. The signals of the sensors 18 or 18, 66, as well as the sensor 28 are analyzed at intervals when the pulses of the Korotkov tones from the sensor 18 have a positive polarity. Each of the signals is searched for a maximum, levels 0.25 and 0.75 are counted from it. To the left of the maximum on the signals are the points corresponding to the indicated levels. Next, on the line passing through these points, for each signal, the middle between the points is found. The midpoints found in this way on the straight line are the reference points of the position of the leading edge of the Korotkov tone pulses in time. Next, the intervals ΔТ between adjacent pulses of the signals of two sensors are determined for the entire measurement interval. The number of ΔТ values is obtained equal to the number of Korotkov tone signals received during the measurement process. All values obtained are averaged. After calculation, the value of PWV (m / s) is displayed on the PC display (see Fig. 9).

According to the results of the study, a protocol is formed that includes information about the patient and the measured parameters of the cardiovascular system. Automated reporting reduces patient care time.

Studies have shown that the device allows measurements in various modes: measuring blood pressure in a routine manner, measuring blood pressure many times, measuring blood pressure and PWV during a test with hyperemia. The latter also allows an assessment of endothelial dysfunction, which is of great importance in the formation of arterial hypertension. First, the first value of PWV is determined on the segment of the brachial artery - radial artery, then the brachial artery is pinched for 14 minutes with the cuff 14, after which the second value of the PWV is immediately determined. Comparison of the measured values makes it possible to determine the degree of elasticity of the studied arteries. At the same time, with the help of a small cuff 26, the degree of increase in the amplitude of pulse waves is recorded, which is compared with the initial amplitude (before the test with hyperemia).

The table shows the results of comparing the same indicators between a group of healthy volunteers and groups of patients with arterial hypertension (AH) and a group of patients suffering from stable angina pectoris.

Healthy - AH Healthy - Angina pectoris Parameter Wed Art. Wed Art. R Wed Art. Wed Art. R characters off characters off characters off characters off SRPV 7.5 0.3 10,4 2.1 <0.001 7.5 0.3 9.9 0.8 <0.005 Heart rate 70.9 3,1 71.2 12.9 <0.941 70.9 3,1 69.2 2.2 <0.428 GARDEN 119.7 2,3 146.6 15.4 <0.001 119.7 2,3 123.5 4,5 <0.814 DBP 70.6 2,4 88.9 11.6 <0.001 70.6 2,4 74.9 4.0 <0,304 PV 64.5 2.5 57.5 4.8 <0.03 64.5 2.5 54.9 1.8 <0.01 D aorta 3.0 0.1 3,5 0.4 <0.03 3.0 0.1 3,7 0.1 <0.002 FAND 80.2 11.1 38,0 25.1 <0.005 80.2 11.1 43.8 8.4 <0.04

The study of statistical reliability was carried out using the SPSS software package on the Mann-Whitney U-test. When comparing the results of the study by groups, the results were considered reliable, where p <0.05.

As can be seen from the above results, the values of PWV, endothelial function (FEND), aortic diameter (D-aorta), ejection fraction (EF) reflecting the pumping function of the heart were statistically significant in both comparison groups. The last two indicators were determined during echocardiography with the Akuson Sequoia apparatus (USA).

Thus, the results of a study of the pulse wave velocity, endothelial function, systolic and diastolic blood pressure in healthy volunteers, patients with arterial hypertension and angina pectoris using this device show statistically significant differences in the group of healthy people and in the groups of patients, which makes it possible to use the patented device for non-invasive, accurate diagnosis of the state of the cardiovascular system in healthy and patients suffering from cardiovascular disease th.

Measurements are carried out with sufficient accuracy and a minimum dispersion of results in one measurement cycle without removing the patient’s clothing. Automatic measurement of blood pressure and PWV at predetermined time intervals provides monitoring of these indicators in intensive care units, as well as operating rooms, since sudden changes in the values of PWV, blood pressure and heart rate can accompany certain medical effects. In order to timely notify personnel about changes in these parameters, the device can be equipped with alarm equipment.

The implementation of the device can be carried out using the available components of pneumatic, electronics and computer science. As sensitive elements of pressure sensors, electroacoustic transducers can be used, for example, microphones of the НМ1001А, НМО1003А brands manufactured by JL WORLD, operating in the frequency band from 30-50 Hz to 16 KHz, or similar. Atmel is an ATmega8535 chip as a microcontroller, Nissei valves TDS-V05B, and DEC 22155 A compressor ELEC.CO as pneumatic valves.

Electrical filters with amplification of the output signal can be performed using operational amplifiers, for example, type OP177 from Analog Devices. To measure the distance between the cuffs, digital roulettes DIGICON 216-452, Bosch PMB 300L or similar can be used.

Claims (13)

1. Device for determining the parameters of the cardiovascular system, including two occlusal cuffs connected by pneumatic lines with a compressor and a pneumatic bleed valve, one of which is a shoulder, pressure and pulse wave sensors with output filters, an analog-to-digital converter and a control unit connected to a computer, characterized the fact that the occlusal cuffs are made with the possibility of fixing on one arm of the patient and are pneumatically connected to each other through a controlled pneumatic valve, and the cuff is smaller than Irina is designed to be placed on the forearm and pneumatically connected to a pulse wave sensor made in the form of a Korotkov tone sensor, the shoulder cuff is connected to a pressure sensor configured to register a constant and variable pressure component in the Korotkov tone range, the control unit contains a microprocessor, a switch and an interface for communication with a computer, while the control outputs of the microprocessor are connected to the clock input of the analog-to-digital converter, compressor, pneumatic actuators Gentry and switch control input, the output of which via an analog-digital converter connected to the data input of the microprocessor, wherein the output filters of sensors connected to respective data inputs of the switch, and a compressor bleed air valve installed in pnevmomagistrali brachial cuff. 2. The device according to claim 1, characterized in that the pressure sensor associated with the shoulder cuff has output filters for extracting constant and variable signals in the range of Korotkov tones of the pressure components. 3. The device according to claim 1, characterized in that the Korotkov tone sensor is an electro-acoustic transducer installed in the housing with a gap on one side of the soundproof membrane sealed in the housing, the second side of which is connected to the pneumatic line. 4. The device according to claim 1, characterized in that it contains means for measuring the distance between the cuffs fixed on the arm, the output of which is connected to the corresponding information input of the switch. 5. The device according to claim 1, characterized in that the control of the pneumatic valve provides bleeding according to a linear law. 6. The device according to claim 1, characterized in that the output filters contain means for amplifying the output electrical signal. 7. The device according to claim 1, characterized in that the control unit is configured to select the modes of single or multiple measurement of blood pressure, blood pressure and pulse wave propagation velocity during hyperemia tests. 8. A device for determining the parameters of the cardiovascular system, including two occlusal cuffs connected by pneumatic lines with a compressor and a pneumatic bleed valve, one of which is a shoulder, pressure and pulse wave sensors with output filters, an analog-to-digital converter and a control unit connected to a computer, characterized the fact that the occlusal cuffs are made with the possibility of fixing on one arm of the patient and are pneumatically connected to each other through a controlled pneumatic valve, the cuff being smaller than Irina is designed to be placed on the forearm and is pneumatically connected to a pulse wave sensor made in the form of a Korotkov tone sensor, the shoulder cuff is connected to pressure sensors and Korotkov tones connected respectively to output filters to separate the constant and variable components of pressure in the Korotkov tone range, block The control contains a microprocessor, a switch and an interface for communication with a computer, while the control outputs of the microprocessor are connected to a clock input of analog-to-digital a transducer, a compressor, pneumatic valve actuators and a control input of the switch, the output of which is connected through an analog-to-digital converter to the information input of the microprocessor, and the output filters of the sensors are connected to the corresponding information inputs of the switch, and the compressor and the bleed pneumatic valve are installed in the pneumatic line of the shoulder cuff. 9. The device according to claim 8, characterized in that the Korotkov tone sensor is an electro-acoustic transducer installed in the housing with a gap on one side of the soundproof membrane sealed in the housing, the second side of which is connected to the pneumatic line. 10. The device according to claim 8, characterized in that it contains means for measuring the distance between the cuffs fixed on the arm, the output of which is connected to the corresponding information input of the switch. 11. The device according to claim 8, characterized in that the control of the pneumatic valve provides bleeding according to a linear law. 12. The device according to claim 8, characterized in that the output filters contain means for amplifying the output electrical signal. 13. The device according to claim 8, characterized in that the control unit is configured to select the modes of single or multiple blood pressure measurement, blood pressure measurement and pulse wave propagation velocity during hyperemia tests.

Images