WO2001030235A1 - Dispositif de detection de l'arteriosclerose, et procede d'utilisation correspondant - Google Patents

Dispositif de detection de l'arteriosclerose, et procede d'utilisation correspondant Download PDF

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Publication number
WO2001030235A1
WO2001030235A1 PCT/JP2000/007273 JP0007273W WO0130235A1 WO 2001030235 A1 WO2001030235 A1 WO 2001030235A1 JP 0007273 W JP0007273 W JP 0007273W WO 0130235 A1 WO0130235 A1 WO 0130235A1
Authority
WO
WIPO (PCT)
Prior art keywords
fundus
detecting
electrocardiogram signal
vein
arteriosclerosis
Prior art date
Application number
PCT/JP2000/007273
Other languages
English (en)
Japanese (ja)
Inventor
Reiji Kawada
Original Assignee
Bml, Inc.
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
Application filed by Bml, Inc. filed Critical Bml, Inc.
Priority to AU79496/00A priority Critical patent/AU7949600A/en
Publication of WO2001030235A1 publication Critical patent/WO2001030235A1/fr
Priority to US10/137,283 priority patent/US6999812B2/en

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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
    • 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
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle

Definitions

  • the present invention relates to an apparatus for detecting arteriosclerosis and a method for using the same.
  • Cardiovascular disease is a typical disease that is more likely to occur in elderly people and is likely to be directly linked to bedridden life. It is well known that cardiovascular diseases, along with cancer, which will cast the most serious shadows in an aging society, are largely due to arteriosclerosis. In most cases, ischemic heart disease such as angina pectoris and myocardial infarction, and stroke such as cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage are related to arteriosclerosis as a cause.
  • ischemic heart disease such as angina pectoris and myocardial infarction
  • stroke such as cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage are related to arteriosclerosis as a cause.
  • arteriosclerosis develops with aging to some extent, but it is possible to some extent to slow the progress. In other words, according to the state of the artery, it is possible to avoid catastrophic damage by diet, exercise, non-smoking and other lifestyle guidance, drug therapy, and possibly surgery.
  • angiography is the most accurate means of grasping the state of arteries.However, this is the method that should be used for patients with very invasive subjects and imminent cardiovascular disease. It is. In other words, angiography is It may be used to a person who is not observed objective symptoms, regardless of the c angiography not be the detection means of arteriosclerosis, artery, in particular, as a means to grasp the status of cerebrovascular arteries, photographing of the eye bottom photos That is, fundus diagnosis. At the time of photographing the fundus, there is almost no invasion of the subject, and it is considered to be convenient and widely used for medical examination. Nevertheless, fundus diagnosis is not widely used as a means of diagnosing arteriosclerosis.
  • the problem to be solved by the present invention is to provide a simple and sensitive means for detecting arteriosclerosis. Disclosure of the invention
  • the present inventor has considered that the fact that the fundus photograph is taken arbitrarily at any time is one of the causes that hinders the accurate evaluation of the progression of arteriosclerosis.
  • the phase of the diastole and the systole of the heart due to the Widkessel phenomenon differ from one photographing to another, which is indispensable for the above-mentioned criteria of arteriosclerosis determination based on the fundus photograph.
  • the present invention has been completed by noting that it is difficult to accurately measure the diameters of the fundus artery and the fundus vein.
  • the present invention provides an electrocardiogram signal detection means capable of detecting an electrocardiogram signal, an electrocardiogram signal detection means for detecting a specific pattern of the electrocardiogram signal, and a specific electrocardiogram signal detected thereby. It is an invention to provide an arteriosclerosis detection device (hereinafter, also referred to as the detection device of the present invention) provided with a fundus image detection means capable of detecting a fundus image in synchronization with a pattern.
  • the means for detecting the electrocardiogram signal is not particularly limited as long as it can accurately detect the electrocardiogram signal.
  • the means for detecting the electrocardiogram signal is derived by attaching an electrode sensor composed of a piezoelectric element to the chest or other body part of the subject. Means that can detect an electrocardiogram signal.
  • a mechanism provided by an existing electrocardiograph can be used as a means for detecting an electrocardiogram signal.
  • the electrocardiogram signal sensing means is means for sensing the detected electrocardiogram signal, extracting a specific pattern signal as an electric signal from the sensed electrocardiogram signal, and transmitting it to the fundus image detecting means.
  • the specific pattern signal may be subjected to a process suitable for use in the fundus image detecting means, for example, an amplification process, if necessary.
  • an electrocardiogram signal sensing means for example, an output terminal that detects only a specific electrocardiogram signal such as an R wave of an existing electrocardiograph and transmits the signal to the outside can be used.c
  • the specific electrocardiogram signal is an electrocardiogram.
  • the signal is not particularly limited as long as it is a signal that can be grasped as the above established pattern, and any of the P, Q, R, S or T wave patterns can be selected. from stage to discharge toward the body butter - that the force 5 to select the R-wave is down signal 'it is preferable and practical.
  • a lead method for obtaining an electrocardiogram signal from the subject is not particularly limited, and can be selected from so-called “standard 12 lead” and the like.
  • the criterion for selecting the lead method is preferably the type of the specific ECG signal to be selected. In other words, force detecting specific ECG signal?, It is good preferable to select an easy induction way possible.
  • lead II, lead I, lead L, or the like which detects a potential difference between the left hand and the right hand of the subject.
  • the fundus image detecting means is a means capable of detecting the fundus image in synchronization with a specific pattern of an electrocardiogram signal such as an R wave detected by the electrocardiogram signal detecting means.
  • synchronizing means that the fundus image detecting means responds to a specific pattern of an electrocardiogram signal at a fixed timing. For example, when an R wave is selected as a specific pattern of an electrocardiogram signal, a method of detecting a fundus image at a certain time from any time point in the R wave, for example, a rising time point. Activating the stage. This timing is kept constant and is shorter than the timing when the same pattern of the electrocardiogram signal occurs again (for example, in the case of an R wave, the time when the next R wave occurs). If so, there is no particular limitation.
  • the fundus blood vessels As described above, by detecting the fundus image in synchronization with the specific pattern of the electrocardiogram, information on the fundus blood vessels, specifically, the blood vessel diameter indispensable for obtaining an index for arteriosclerosis in the present invention is obtained. Information can be obtained accurately. That is, as described above, it was difficult to accurately evaluate the fundus vascular diameter, which changes in response to the expansion and contraction of the heart, in the fundus photograph taken arbitrarily at any time, due to the Widkessel phenomenon. However, if the fundus image is detected in synchronization with a specific pattern on the electrocardiogram, it is possible to obtain a fundus blood vessel image at a certain pulsation timing, and it is possible to accurately evaluate the fundus blood vessel diameter. Become.
  • a camera having a mechanism capable of photographing the fundus typically, a so-called fundus camera: an analog camera or a digital camera may be used
  • the shutter is set so as to be synchronized with a specific pattern of the electrocardiogram signal.
  • the arteriosclerosis of the subject can be detected.
  • the specific means of this association is not particularly limited, but the information on the fundus blood vessel diameter is particularly effective information for detecting the arteriosclerosis of the subject.
  • the information about the fundus blood vessel diameter is used as a conventional criterion for arteriosclerosis, such as the aforementioned conditions of the 1969 Ministry of Education Hypertension Research Group, K-W Classification, Seheie Classification, etc. In this case, the arteriosclerosis of the subject can be detected.
  • the present inventor has reported that a fundus artery and a fundus vein (in the present invention, the “fundus artery” means “retinal artery” in medical terms, and “fundus vein” means “retinal vein” in medical terms.
  • the degree of stenosis of the fundus vein in the vicinity of the intersection can be a very useful index that can be associated with the development of arteriosclerosis.
  • the detection device of the present invention which can obtain a fundus blood vessel image at a certain pulsation timing, is very useful for obtaining this index.
  • the degree of the stenosis of the fundus vein can also be detected by directly observing the fundus image obtained by the detection device of the present invention visually.
  • the above-described fundus image detecting means may be provided with a fundus vein stenosis detecting means capable of detecting the fundus vein stenosis, and this process may be automated.
  • a means for detecting the stenosis of the fundus vein for example, a means for detecting the above-mentioned fundus image data converted into electronic information by being captured by a scanner or the like is programmed.
  • Software for example, means for detecting the intersection of the fundus vein and the fundus artery and means for grasping and calculating the degree of stenosis of the fundus vein near the intersection or Z or the like).
  • the present inventor has found that the ratio of the original outer diameter of the fundus vein to the outer diameter of the fundus vein near the intersection of the fundus artery and the fundus vein (hereinafter also referred to as the V ratio) is defined as the fundus vein showing arteriosclerosis. It was found to be extremely useful as an index of stenosis in the vicinity of the crossing point. Specifically, the V ratio is calculated as follows.
  • FIG. 1 is a schematic diagram of a fundus vein and a fundus vein in which stenosis of the fundus vein is observed, wherein the fundus vein 20 crosses the lower side of the fundus artery 10, and in the vicinity of the crossover part 30, The intima of the fundus artery 10 is hardened (not shown), and stenosis near the crossing portion 30 of the fundus vein 20 is recognized by the pulling force due to the hardening.
  • FIG. 4 is a schematic diagram showing a case where the stiffness of the intima of the fundus artery 11 spreads in a direction slightly displaced from the intersection 31 (hardened portions: 11 1 and 11 2). 21 shows that the fundus vein 2 1 is displaced near the intersection 31 as a result of the pulling force acting alternately in the vicinity of the intersection 31 in c. Therefore, it is necessary to slightly correct the V ratio (V 1 ZV 2) described above.
  • a vector line (2 1 1) force connecting the center of the left and right outer diameters of the fundus vein 21 with the fundus artery 11 interposed at the intersection 31 1 is the outer diameter of the fundus vein 2 1
  • a correction value obtained by subtracting 0.1 from the value of the above-mentioned V ratio is used as the V ratio to be used for detecting arteriosclerosis.
  • the outer diameter is more than 1.0 times the outer diameter of the fundus vein 21, the correction value obtained by subtracting 0.2 from the above-mentioned V ratio is used as the atherosclerosis.
  • the average value of the V ratio at a plurality of (about three) intersections of the fundus artery and the fundus vein at least one nipple diameter away from the nipple is calculated, and this is used as the V ratio of the subject. It can be used as a detection index of arteriosclerosis.
  • Standardization information obtained by standardizing the degree of stenosis of the fundus vein near the intersection of the fundus artery and the fundus vein, determined by the V ratio, etc., according to the ages of a plurality of subjects; It is also possible to detect the degree of arterial aging (vascular age) of each subject by associating it with the degree of stenosis in each subject.
  • FIG. 1 is a schematic diagram of the fundus artery and vein, where the stenosis of the fundus vein is observed, and Fig. 2 shows that the stiffness of the intima of the fundus artery is slightly shifted from the intersection.
  • FIG. 3 is a schematic diagram showing a case where the detection device is expanded in the horizontal direction.
  • FIG. 3 is a block diagram showing a configuration of the detection device of the present invention.
  • FIG. 3 is a block diagram showing a configuration of the detection device of the present invention.
  • the detection device 40 of the present invention includes an electrocardiogram signal detection section 41, an electrocardiogram signal detection section 42, and a fundus image detection section 43.
  • the electrocardiogram signal detecting section 41 is composed of an electrode sensor 411 and an amplifying section 412.
  • the sensing unit 42 includes a waveform analysis processing unit 421 and an output unit 422.
  • the fundus image detection unit 43 includes an input unit 431, a waveform signal sensing and transmission unit 4332, a shutter mechanism 4333, an imaging unit 4334, a photoelectric conversion unit 4353, and an output unit. It consists of 4 3 6 and analysis section 4 3 7.
  • the electrode sensor 411 is a mechanism that is made of, for example, a piezoelectric element, is attached to the chest or other body part of the subject, and detects the derived electrocardiogram signal.
  • the amplifying unit 412 is a mechanism for amplifying the electrocardiogram signal detected by the electrode sensor 411.
  • the waveform analysis processing section 4 21 is a mechanism for performing a pulse wave selection processing required in the present invention on the electrocardiogram signal amplified in the amplification section 4 12.
  • a pulse wave signal for the R wave is used at a specific timing as a signal to the shutter mechanism 433 described later
  • a specific timing in the R wave (for example, after a certain time from the rising of the R wave) ) Is a mechanism that performs specific selection processing.
  • the waveform analysis processing unit 4 21 can be provided with a selective amplification unit such as a filter amplifier for specifically amplifying a pulse wave signal at a specific timing of a specific electrocardiogram signal.
  • an AZD conversion mechanism for digitizing the electrocardiogram signal (analog signal) selectively amplified by the selective amplification means can be provided in the waveform analysis processing unit.
  • the output unit 422 is a mechanism (for example, an output terminal or the like) for outputting the electrocardiogram signal selectively amplified by the waveform analysis processing unit 421 to the fundus image detection unit 43. It is.
  • the input unit 431 is provided with a mechanism for inputting the selectively amplified electrocardiogram signal output from the output unit 4222 to the detecting unit (for example, an input terminal or the like). ).
  • the waveform signal sensing / transmitting section 432 is a mechanism that detects the electrocardiogram signal input from the input section 431 and transmits it to the shutter mechanism 433 as an appropriate ON / OFF signal.
  • the shutter mechanism 433 senses the ON signal of the ONZOFF signal (eg, a pulse signal corresponding to a specific electrocardiogram signal), activates the imaging unit 434, and outputs the same “OFF” signal (described above).
  • the imaging unit 434 operates only at timing synchronized with a specific electrocardiogram signal, and can image the fundus of the subject.
  • the imaging unit 433 includes a mechanism for imaging the fundus of the subject, such as an eyepiece, a light source, an alignment mechanism, and an angle-of-view adjustment mechanism, which are provided in a normal fundus optics. Of course, they are provided as necessary.
  • the optical information of the fundus image captured in synchronization with the specific electrocardiogram signal in the imaging unit 434 is converted into electrical information in the photoelectric conversion unit 435 (even analog information is digital information.
  • the electrical information is output at the output unit 436 (for example, a monitor image or a printer image), and the fundus image at the time of imaging is provided to the measurer.
  • the information on the fundus image can be converted into more useful information.
  • the useful information includes, for example, the above-mentioned V ratio of the subject and the age of the blood vessel.
  • the analysis unit 437 includes appropriate software, for example, software for selecting an appropriate intersection between a fundus artery and a fundus vein, software for calculating a V ratio from the intersection, and the V Software for calculating the vascular age from the ratio can be used.
  • the electrocardiogram signal detected from the subject in the electrocardiogram signal detection unit 41 is converted into a specific pulse wave such as an R wave by the electrocardiogram signal detection unit 42.
  • the electric signal based on this specific timing is synchronized with the fundus image detecting means.
  • the Widkessel phenomenon It is possible to obtain a stable fundus image that is not affected by the fundus image detection unit 43.
  • Information related to arteriosclerosis of the subject can be obtained from information obtained from the stable fundus image and subjected to appropriate arithmetic processing as needed.
  • a simple and sensitive means for detecting arteriosclerosis is provided.

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

Abstract

L'invention concerne un dispositif de détection de l'artériosclérose comprenant des moyens permettant de détecter un signal électrocardiographique, des moyens permettant de reconnaître une configuration spécifique du signal électrocardiographique, et des moyens permettant de détecter une image du fond de l'oeil synchronisée avec la configuration spécifique reconnue du signal de l'électrocardiogramme. Ledit dispositif permet une détection simple et précise de l'artériosclérose.
PCT/JP2000/007273 1999-10-22 2000-10-19 Dispositif de detection de l'arteriosclerose, et procede d'utilisation correspondant WO2001030235A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU79496/00A AU7949600A (en) 1999-10-22 2000-10-19 A device for detecting arteriosclerosis, and method of use thereof
US10/137,283 US6999812B2 (en) 1999-10-22 2002-05-03 Arteriosclerosis detection system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP30156599 1999-10-22
JP11/301565 1999-10-22

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US10111101 A-371-Of-International 2000-10-19
US10/137,283 Continuation-In-Part US6999812B2 (en) 1999-10-22 2002-05-03 Arteriosclerosis detection system

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004004556A1 (fr) * 2002-07-03 2004-01-15 Bml, Inc. Systeme pour detecter l'emission d'une onde d'impulsion
JP2005274783A (ja) * 2004-03-23 2005-10-06 Olympus Corp 顕微鏡画像撮影装置
JP2008079682A (ja) * 2006-09-26 2008-04-10 Gifu Univ 画像解析装置及び画像解析プログラム
JPWO2007132865A1 (ja) * 2006-05-16 2009-09-24 株式会社網膜情報診断研究所 血管老化の検出システム
WO2009148067A1 (fr) * 2008-06-04 2009-12-10 株式会社 網膜情報診断研究所 Système de diagnostic d'informations rétiniennes
CN115457038A (zh) * 2022-11-11 2022-12-09 北京鹰瞳科技发展股份有限公司 分级预测模型的训练方法、分级预测的方法及相关产品

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH02274220A (ja) * 1989-04-17 1990-11-08 Kowa Co 眼科診断装置
JPH05261068A (ja) * 1992-03-19 1993-10-12 Topcon Corp 眼科装置
JPH08322805A (ja) * 1995-06-06 1996-12-10 Motoharu Hasegawa 診断結果レポート作成装置および方法
JPH1079034A (ja) * 1996-09-03 1998-03-24 Nippon Telegr & Teleph Corp <Ntt> 血管計測方法

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH02274220A (ja) * 1989-04-17 1990-11-08 Kowa Co 眼科診断装置
JPH05261068A (ja) * 1992-03-19 1993-10-12 Topcon Corp 眼科装置
JPH08322805A (ja) * 1995-06-06 1996-12-10 Motoharu Hasegawa 診断結果レポート作成装置および方法
JPH1079034A (ja) * 1996-09-03 1998-03-24 Nippon Telegr & Teleph Corp <Ntt> 血管計測方法

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004004556A1 (fr) * 2002-07-03 2004-01-15 Bml, Inc. Systeme pour detecter l'emission d'une onde d'impulsion
JP2005274783A (ja) * 2004-03-23 2005-10-06 Olympus Corp 顕微鏡画像撮影装置
JP4689967B2 (ja) * 2004-03-23 2011-06-01 オリンパス株式会社 顕微鏡画像撮影装置
JPWO2007132865A1 (ja) * 2006-05-16 2009-09-24 株式会社網膜情報診断研究所 血管老化の検出システム
JP5535477B2 (ja) * 2006-05-16 2014-07-02 株式会社網膜情報診断研究所 血管老化の検出システム
JP2008079682A (ja) * 2006-09-26 2008-04-10 Gifu Univ 画像解析装置及び画像解析プログラム
WO2009148067A1 (fr) * 2008-06-04 2009-12-10 株式会社 網膜情報診断研究所 Système de diagnostic d'informations rétiniennes
CN115457038A (zh) * 2022-11-11 2022-12-09 北京鹰瞳科技发展股份有限公司 分级预测模型的训练方法、分级预测的方法及相关产品
CN115457038B (zh) * 2022-11-11 2023-08-22 北京鹰瞳科技发展股份有限公司 分级预测模型的训练方法、分级预测的方法及相关产品

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