WO2024070507A1

WO2024070507A1 - Medical monitoring device

Info

Publication number: WO2024070507A1
Application number: PCT/JP2023/032145
Authority: WO
Inventors: 貴之内田; 知紀八田
Original assignee: テルモ株式会社
Priority date: 2022-09-26
Filing date: 2023-09-01
Publication date: 2024-04-04

Abstract

This non-invasive medical monitoring device is provided with a harness, a first sensor and a second sensor. The harness is configured so as to be attached to at least any one of a chest front face and a chest back face of a user. The first sensor is disposed on the user-side surface of the harness in at least one of the chest front face and the chest back face of the user, and can acquire vibration information about the body surface of the user. The second sensor is arranged on a surface of the harness which is opposite to the user-side surface, and acquires biological information that is different from the vibration information about the body surface of the user.

Description

Medical Monitoring Devices

This disclosure relates to a medical monitoring device.

Chronic diseases such as heart failure run the risk of worsening even after a patient is discharged from the hospital, so it is important to detect deterioration by continuously measuring multiple vital signs non-invasively. Vital signs that can be measured non-invasively include heart sounds, electrocardiograms, and pulse waveforms, and it is desirable to combine these multiple pieces of vital signs. It is desirable for appropriate measurement of vital signs to be performed by the patient alone, without the need for complex settings. For this reason, methods have been proposed for measuring a patient's vital signs by placing sensors that measure vital signs on a belt or clothing worn by the patient (see, for example, Patent Documents 1 to 4).

JP 2020-089502 A JP 2018-121928 A US Patent Application Publication No. 2018/0325407 International Publication No. WO 2018/047814

In conventional technology, to measure an electrocardiogram, electrodes attached to a belt or clothing were placed in direct contact (close contact) with the patient's skin. For this reason, with conventional technology, it was necessary to remove the clothing in order to measure vital signs. Furthermore, measurements of vital signs using conventional technology did not always include measurement of heart sound waveforms, which is an important measurement item for understanding hemodynamics. Since the accuracy of measuring heart sounds is easily affected by minute changes in the measurement conditions, it is necessary to adjust the measurement position and the pressure with which the sensor presses against the patient's measurement site. However, with conventional technology, there was no mechanism for making the necessary adjustments even when measuring heart sounds. For these reasons, it was either time-consuming or difficult for patients to measure multiple pieces of vital signs at home.

Therefore, the purpose of this disclosure, which has been made with these points in mind, is to provide a medical monitoring device that is easier to use when a user measures multiple pieces of vital signs at home.

The present invention is (1) a non-invasive medical monitoring device comprising a harness configured to be worn on at least one of the front and back sides of a user's chest, a first sensor disposed on the user's side of the harness on at least one of the front and back sides of the chest and capable of acquiring vibration information of the user's body surface, and a second sensor disposed on the opposite side of the harness to the user's side and acquiring biometric information different from the vibration information of the user's body surface.

(2) In the medical monitoring device of (1) above, it is preferable that the vibration information of the body surface is at least one of heart sounds and apical pulsation.

(3) It is preferable that the medical monitoring device of (1) or (2) above further includes a pressure adjustment mechanism that adjusts the pressure with which the first sensor presses against the body surface so that the pressure is appropriate for the first sensor to acquire the vibration information of the body surface.

(4) In the medical monitoring device described in any of (1) to (3) above, it is preferable that the harness includes a shoulder belt portion that is placed on the shoulder of the user and a chest belt portion that at least partially covers the front or back of the user's chest.

(5) In the medical monitoring device described in any one of (1) to (4) above, it is preferable that the second sensor includes a pulse wave sensor that can be measured by the user touching it with at least one hand.

(6) In the medical monitoring device described in any of (1) to (5) above, it is preferable that the second sensor includes electrodes that are arranged at two positions that the user can touch with each hand, and that can be measured by touching the electrodes with both hands without overlapping.

(7) In the medical monitoring device described in any one of (1) to (6) above, it is preferable that the harness further includes a waist belt portion that at least partially covers the abdomen of the user.

(8) In the medical monitoring device described in any of (1) to (7) above, it is preferable that the harness has a position adjustment mechanism that can adjust the position of the first sensor.

(9) It is preferable that the medical monitoring device described in any of (1) to (8) above further includes a control unit that calculates parameters related to the cardiac function of the user based on the waveforms output by the first sensor and the second sensor.

The present invention (10) is a non-invasive medical monitoring device comprising a harness configured to be worn on at least one of the front and back sides of a user's chest, a first sensor disposed on the user's side of the harness on at least one of the front and back sides of the user's chest and capable of acquiring vibration information of the user's body surface, and a pressure adjustment mechanism that adjusts the pressure with which the first sensor presses against the body surface so that the pressure is appropriate for the first sensor to acquire the vibration information of the body surface.

(11) In the medical monitoring device of (10) above, it is preferable that the vibration information of the body surface is at least one of heart sounds and apical pulsation.

(12) It is preferable that the medical monitoring device described in (10) or (11) above further comprises a second sensor provided on the side of the harness opposite the side of the user, which acquires biological information different from the vibration information of the body surface of the user.

(13) In the medical monitoring device described in any of (10) to (12) above, it is preferable that the harness includes a shoulder belt portion that is placed on the shoulder of the user, and a chest belt portion that at least partially covers the front or back of the user's chest.

(14) In the medical monitoring device described in (12) above, it is preferable that the second sensor includes a pulse wave sensor that can be measured by the user touching it with at least one hand.

(15) In any of the medical monitoring devices described in (12) above, it is preferable that the second sensor includes electrodes that are arranged at two positions that the user can touch with each hand, and that can be measured by touching the electrodes with both hands without overlapping.

(16) In the medical monitoring device described in any one of (10) to (15) above, it is preferable that the harness further includes a waist belt portion that at least partially covers the abdomen of the user.

(17) In the medical monitoring device described in any of (10) to (16) above, it is preferable that the harness has a position adjustment mechanism that can adjust the position of the first sensor.

(18) It is preferable that the medical monitoring device described in (12), (14) or (15) above further includes a control unit that calculates parameters related to the cardiac function of the user based on the waveforms output by the first sensor and the second sensor.

(19) It is preferable that the medical monitoring device described in any one of (1) to (9), (12), (14), (15) or (18) above is configured to be capable of acquiring the plurality of pieces of biometric information using the first sensor and the second sensor while the user is wearing clothing around the user's chest.

(20) It is preferable that the medical monitoring device described in any of (1) to (19) above further comprises a third sensor that is disposed on the user's side of the harness on at least one of the front and back sides of the chest of the user and that acquires biological information different from the vibration information of the body surface of the user.

This disclosure makes it possible to improve the ease of use of the device when a user measures multiple pieces of biometric information at home.

1 is a block diagram showing a schematic configuration of a medical monitoring device according to an embodiment. 2 is a diagram showing a first example of the biometric information acquisition unit of FIG. 1 in a state where it is worn by a user; 3 is a diagram of the biometric information acquisition unit in FIG. 2 as viewed from behind the user. FIG. 2 is a view of the chest belt portion of FIG. 1 as seen from the user's side. 5 is a cross-sectional view of the chest belt portion of FIG. 4 taken along line AA. 1 is a diagram illustrating an example of the placement of a heart sound sensor on a body when measuring biological information. FIG. FIG. 13 is a diagram showing another example of the arrangement of sensors on the chest belt portion, as viewed from the side opposite to the user's side; FIG. 13 is a diagram showing a second example of the biometric information acquisition unit when worn by a user. FIG. 13 is a diagram showing a third example of a biometric information acquisition unit in a state where it is worn by a user. 10 is a diagram of the biometric information acquisition unit in FIG. 9 as viewed from behind the user. FIG. 13 is a diagram showing a fourth example of a biometric information acquisition unit in a state where it is worn by a user. 12 is a diagram of the biometric information acquisition unit in FIG. 11 as viewed from behind the user. 11A and 11B are diagrams illustrating an example of a harness position adjustment mechanism. 13A and 13B are diagrams illustrating another example of a harness position adjustment mechanism. FIG. 1 is a diagram showing the overall procedure for monitoring a user's biological information using a medical monitoring device. FIG. 13 is a diagram showing a flow of processing performed by a user at home using a medical monitoring device. FIG. 13 is a top view showing an example of an arrangement of sensors including a third sensor in the chest belt portion.

Below, an embodiment of the present disclosure will be described with reference to the drawings. The drawings used in the following description are schematic. The shapes and proportions in the drawings do not necessarily correspond to the real thing.

(Overall configuration of medical monitoring device)
As shown in Fig. 1, a medical monitoring device 1 according to an embodiment of the present disclosure includes a bioinformation acquisition unit 10, an information processing unit 20, and a display unit 21. The bioinformation acquisition unit 10, the information processing unit 20, and the display unit 21 may each be configured by independent hardware that can communicate with each other. Furthermore, each function of the bioinformation acquisition unit 10, the information processing unit 20, and the display unit 21 may be implemented in a single piece of hardware, or may be distributed and arranged in an arbitrary form by two or more pieces of hardware.

The biometric information acquisition unit 10 is attached to the body of the user who uses the medical monitoring device 1, and acquires the user's biometric information in a non-invasive manner. Therefore, the medical monitoring device 1 is a non-invasive measurement device. The biometric information acquired by the biometric information acquisition unit 10 includes heart sounds, an electrocardiogram, and a pulse waveform. Therefore, the biometric information acquisition unit 10 includes a heart sound sensor 11, an electrocardiogram sensor 12, and a pulse wave sensor 13. In the following, "user" refers to a patient who has their biometric information measured at home.

The heart sound sensor 11 is the first sensor that is positioned facing the user's heart (the user's side), which is the part where heart sounds are acquired, and acquires the user's heart sounds. The heart sound sensor 11 is a sensor that detects sounds including heart sounds. The heart sound sensor 11 converts sounds including heart sounds into electrical signals, for example. The heart sound sensor 11 can be adopted from among various sensors such as a capacitor type microphone that detects changes in electrostatic capacitance between a diaphragm (vibration plate) and a back plate (electrode), a piezoelectric type microphone that uses a piezoelectric element, and an electrodynamic type microphone that combines a permanent magnet and a coil. The heart sound sensor 11 can output the detected heart sounds to the information processing unit 20. The heart sound sensor 11 can also acquire heart sounds even over thin clothing.

The electrocardiogram sensor 12 is a second sensor provided on the surface opposite to the user's side, and acquires the user's electrocardiogram. The electrocardiogram sensor 12 is an electrode capable of measuring the potential difference between two different parts of the user's skin. The two different parts are, for example, the user's hands. The electrocardiogram sensor 12 may include an impedance sensor capable of measuring the impedance between the electrode and two different parts of the user's skin. The impedance sensor may grasp the breathing state and detect the breathing rate from the impedance change between the electrodes. The electrocardiogram sensor 12 has two electrodes 12a (see FIG. 2) arranged in positions where the user can touch them with one of both hands. The user can measure the electrocardiogram by touching the two electrodes 12a with different hands so that the hands do not overlap. The waveform of the electrocardiogram measured by the electrocardiogram sensor 12 indicates the electrical activity of the user's heart.

The pulse wave sensor 13 detects pulse waves, which are changes in the user's intra-arterial pressure. The pulse wave sensor 13 can be used as a second sensor in place of or in addition to the electrocardiogram sensor 12. The pulse wave sensor 13 includes a photoplethysmograph (PPG: Photo Plethysmography) and a pulse wave sensor 13 using a piezoelectric element. The photoplethysmograph irradiates the detection target area with light and measures changes in the volume of blood vessels based on changes in the amount of light transmitted or reflected. The pulse wave sensor 13 using a piezoelectric element measures minute vibrations of the blood vessel walls as pressure changes. The pulse wave sensor 13 can measure at various positions on the body. In addition, the pulse wave sensor 13 using a piezoelectric element can measure the pulse waveform even over thin clothing, so it may be installed on the surface facing the user. In addition, the pulse wave sensor 13 may be placed on the side opposite the user, so that the user can measure the pulse waveform by touching it with at least one hand.

The second sensor may be a sensor other than the electrocardiogram sensor 12 and the pulse wave sensor 13. The second sensor is preferably a sensor that can be touched with the hand and can obtain biometric information from the hand. Such a sensor allows the user to measure biometric information while still wearing clothes.

The bioinformation acquisition unit 10 may further include a pressure adjustment mechanism 15. The pressure adjustment mechanism 15 adjusts the pressure with which the heart sound sensor 11 presses against the surface of the user's body. The waveform of the heart sound sensor 11 is likely to change due to changes in the pressure with which the heart sound sensor 11 presses against the surface of the user's body (hereinafter referred to as "pressure" as appropriate). The pressure adjustment mechanism 15 is controlled so that the heart sound sensor 11 can measure heart sounds well. The structure of the pressure adjustment mechanism 15 will be described further below.

The information processing unit 20 is a computer that controls the entire medical monitoring device 1 and performs various information processing. The information processing unit 20 may be, for example, a dedicated computer used in the medical monitoring device 1, or a general-purpose computer. If it is a general-purpose computer, the information processing unit 20 may be, for example, a tablet terminal, a smartphone, a notebook PC (Personal Computer), a desktop PC, a workstation, or the like. The functions of the information processing unit 20 may be distributed across multiple devices rather than being located in a single device.

The information processing unit 20 executes various processes based on the bio-information acquired by the bio-information acquisition unit 10. The information processing unit 20 controls the pressure adjustment mechanism 15 of the bio-information acquisition unit 10. The information processing unit 20 measures or estimates parameters related to cardiac function based on the bio-information acquired by the bio-information acquisition unit 10. The information processing unit 20 can measure or estimate parameters related to cardiac function by combining multiple pieces of bio-information acquired by the bio-information acquisition unit 10. Parameters related to cardiac function may include, for example, cardiac index (CI), or valvular disease, or ejection fraction (EF: ejection fraction) such as left ejection fraction (LEF: left ejection fraction) and right ejection fraction (REF: right ejection fraction), or PEP (Preejection Period), or ET (Ejection Time) such as LVET (Left Ventricular Ejection Time) and RVET (Right Ventricular Ejection Time), or STI (Systolic Time Interval). Furthermore, the parameters related to cardiac function are blood parameters related to cardiac function, and blood parameters related to cardiac function include, for example, brain natriuretic peptide (BNP), NT-proBNP, oxygen saturation, and pulmonary-systemic blood flow ratio.

Furthermore, the parameters relating to cardiac function are parameters indicating intracardiac hemodynamics, and may include cardiac output (CO), intracardiac pressure, and intracardiac vascular pressure. More specifically, intracardiac pressure refers to the systolic pressure, diastolic pressure, and mean pressure of each part of the heart. Intracardiac pressure includes, for example, left heart pressure, right heart pressure, and left ventricular pressure waveform, right ventricular pressure waveform, and left ventricular end-diastolic pressure (LVEDP), left atrial pressure (LAP), left ventricular pressure (LVP), pulmonary artery end-diastolic pressure (PAP), and other parameters. The intracardiac pressure may include pulmonary artery end diastolic pressure (PAEDP) or pulmonary artery diastolic pressure (PADP), right atrial pressure (RAP), and right ventricular pressure (RVP). More specifically, the intracardiac pressure is the pressure or mean pressure of blood vessels near the heart. Examples of cardiovascular pressure include, but are not limited to, central venous pressure (CVP), pulmonary arterial pressure (PAP), and pulmonary wedge pressure (PWP). Pulmonary arterial wedge pressure is also called PAWP (pulmonary arterial wedge pressure), PCWP (pulmonary capillary wedge pressure), or PAOP (pulmonary artery occlusion pressure).

The information processing unit 20 includes a control unit 22, a memory unit 23, and an output unit 24.

The control unit 22 includes at least one processor, at least one dedicated circuit, or a combination of these. The processor is a general-purpose processor such as a CPU (Central Processing Unit), or a dedicated processor specialized for a specific process. The control unit 22 executes processes related to the operation of the information processing unit 20 while controlling each part of the information processing unit 20. The control unit 22 may execute processes according to a program stored in the memory unit 23. The configuration of the control unit 22 will be described further below.

The memory unit 23 is, for example, but not limited to, a semiconductor memory, a magnetic memory, or an optical memory. The memory unit 23 may function, for example, as a main memory device, an auxiliary memory device, or a cache memory. The memory unit 23 stores any information used in the operation of the medical monitoring device 1. For example, the memory unit 23 may sequentially store system programs, application programs, and information acquired by each sensor. The memory unit 23 stores a reference waveform used for measurement by the heart sound sensor 11.

The output unit 24 includes one or more output interfaces that output information to notify the user. The output unit 24 may include a communication interface for communicating with an external server 25.

The display unit 21 is a display device that displays various information processed by the information processing unit 20. The display unit 21 may be a dedicated display device or a display of a PC or the like. The display unit 21 may also use the display screen of a smartphone.

The information processing unit 20 is further configured to be able to transmit the estimated cardiac function parameters to an external server 25 via a communication line. The external server 35 is, for example, a server at a hospital used by a user performing measurements at home, or a dedicated server for the medical monitoring device 1 located in the cloud. The information stored in the external server 25 can be used to assist medical professionals such as doctors in checking the user's condition and, if necessary, intervening by changing the prescription, etc.

(Configuration Example 1 of Biometric Information Acquisition Unit)
An example of the configuration of the biometric information acquisition unit 10 will be described with reference to Figs. 2 and 3. The heart sound sensor 11, the electrode 12a of the electrocardiogram sensor 12, and the pulse wave sensor 13 of the biometric information acquisition unit 10 are arranged on a harness 16 worn by the user. For example, the heart sound sensor 11 and the pulse wave sensor 13 are arranged on the user's side, and the electrode 12a of the electrocardiogram sensor is provided on the opposite side to the user's side. The harness 16 fixes the heart sound sensor 11, the electrode 12a of the electrocardiogram sensor 12, and the pulse wave sensor 13 to the user's body 30. The harness 16 is composed of a plurality of flat, elongated, strip-like parts. The harness 16 includes a shoulder belt portion 16a and a chest belt portion 16b. When worn by the user, the shoulder belt portion 16a is hung on the left and right shoulders of the user and passes between the left and right shoulders and armpits. The shoulder belt portion 16a connects the left shoulder and left armpit and the right shoulder and right armpit in front of the user, and crosses between the left shoulder and right armpit and the right shoulder and left armpit in the back of the user. The harness 16 may include a fastener for fastening to the user's body. The fastener may include a fastening metal fitting, a buckle, etc.

The harness 16 is worn to cover at least one of the front and back of the user's chest. In the example of FIG. 2, the harness 16 includes a chest belt portion 16b worn on the front of the user's chest. The chest belt portion 16b has a heart sound sensor 11 and a pulse wave sensor 13 arranged on the surface facing the user. The heart sound sensor 11 is a first sensor capable of acquiring vibration information of the user's chest surface. More specifically, the user's chest surface is the skin surface of the chest of the user's body 30 when the user is not wearing clothes, or the clothing surface of the chest of the user's body 30 when the user is wearing clothes. The first heart sensor may be not only the heart sound sensor 11, but also a sensor that detects the apical beat (beat acquired from the tip of the heart). Two electrodes 12a of the electrocardiogram sensor 12 and a measurement start button 14 are provided on the surface of the chest belt portion 16b opposite to the user's side. In addition to heart sounds and apical pulsation, the heart sound sensor 11 may also acquire lung sounds (breath sounds, accessory murmurs, etc.) and other vibration information from within the body (intestinal peristalsis sounds, vascular murmurs, etc.) as vibration information.

FIG. 4 is a view of the chest belt portion 16b as seen from the side of the user's body 30. FIG. 5 is a cross-sectional view of the chest belt portion 16b of FIG. 4 taken along the line A-A. In this example, the heart sound sensor 11 and the pulse wave sensor 13 are integrally configured, or are arranged side by side on the same plane. In this case, the pulse wave sensor 13 may be a sensor using a piezoelectric element that can be used even when the user is wearing clothes. The heart sound sensor 11 and the pulse wave sensor 13 may be configured to be pressed against the surface of the user's body by the pressure adjustment mechanism 15. As an example, the pressure adjustment mechanism 15 includes a housing portion 15a, a movable member 15b, a biasing portion 15c, an air tube 15d, a control valve 15e, and a pump P. The air tube 15d and the pump P are outside the housing portion 15a, but are omitted in FIG. 2 and FIG. 4.

The housing 15a houses the movable member 15b and the biasing member 15c. The housing 15a has an opening on the side facing the user's body 30. The movable member 15b, which has the heart sound sensor 11 and pulse wave sensor 13 fixed to its end, can advance or retreat through this opening.

The movable member 15b is, for example, a cylindrical member with one bottom surface being the surface on which the heart sound sensor 11 and pulse wave sensor 13 are arranged. When worn by the user, the movable member 15b has a flange portion 15f with a flat surface that contacts the biasing portion 15c on the side opposite the user's body 30.

The biasing portion 15c can bias the flange portion 15f toward the user's body 30 with an adjustable force. For example, the biasing portion 15c can be a balloon with elasticity that can expand and contract by introducing air into the interior and expelling air from the interior.

The pressure adjustment mechanism 15 includes an air tube 15d that communicates with the inside of the biasing part 15c, which is a balloon, a control valve 15e located midway through the air tube 15d, and a pump P that sends air to the air tube 15d or expels air from the air tube 15d. The control part 22 of the information processing part 20 can control the control valve 15e and the pump P.

With the above-mentioned configuration, the pressure adjustment mechanism 15 can adjust the amount of air in the balloon by supplying air to the inside of the balloon, which is the biasing part 15c, or exhausting air from the inside of the balloon, in response to a control signal from the control part 22. This adjusts the biasing force of the biasing part 15c against the movable member 15b, and adjusts the pressure with which the heart sound sensor 11 presses against the heart sound acquisition part of the user's body 30. In other words, the pump P, air tube 15d, and control valve 15e are used to adjust the pressure of the heart sound sensor 11.

The pressure adjustment mechanism 15 may include a pressure sensor 15g that measures the pressure of the heart sound sensor 11. The pressure sensor 15g may be disposed on the surface of the movable member 15b on which the heart sound sensor 11 is provided. The pressure adjustment mechanism 15 may include a spring 15h for retracting the movable member 15b into the housing part 15a when no biasing force is applied by the biasing part 15c. The spring 15h is provided in the housing part 15a and biases the surface of the flange part 15f facing the user's body 30 toward the opposite side of the user's body 30. The pressure sensor 15g and the spring 15h are not essential components.

The pressure adjustment mechanism 15 is not limited to the configuration shown in FIG. 5. For example, the pressure adjustment mechanism 15 may have a configuration including a motor and a movable member that advances and retreats as the motor rotates. In this case, the pressure with which the heart sound sensor 11 presses against the user's body 30 can be adjusted by electrically controlling the motor, without introducing air from outside the housing 15a as shown in FIG. 5. Also, a rubber bag such as that used in blood pressure measurement can be used as the pressure adjustment mechanism 15 to press the heart sound sensor 11 against the user.

The pressure adjustment mechanism 15 may be incorporated into a bag- or pocket-shaped portion of the chest belt portion 16b. Alternatively, the chest belt portion 16b may be divided into two portions with the pressure adjustment mechanism 15 in between, and the ends of each portion may be fixed to the left and right ends of the housing portion 15a of the pressure adjustment mechanism 15 as seen from the user. The housing portion 15a does not need to be a hard material as long as it can press the heart sound sensor 11 against the user's body 30.

The heart sound sensor 11 is positioned toward the heart 31 of the user's body 30 as shown in FIG. 6. The heart sound sensor 11 is positioned at a position determined in advance by a doctor.

When taking measurements using the bioinformation acquisition unit 10, the user attaches the harness 16 to the body 30 and operates the measurement start button 14 while touching the left and right electrodes 12a of the electrocardiogram sensor 12 with each hand, respectively. This starts the measurement, and the heart sounds, electrocardiogram, and pulse waveform are measured simultaneously or sequentially. For heart sounds, the pressure adjustment mechanism 15 adjusts the pressure with which the heart sound sensor 11 presses against the user's body 30 so that it is appropriate for acquiring heart sounds.

In the above configuration example, the heart sound sensor 11 and the pulse wave sensor 13 are arranged on the same surface of the movable member 15b, but the arrangement of the heart sound sensor 11, the electrocardiogram sensor 12, and the pulse wave sensor 13 is not limited to this. The heart sound sensor 11 and the pulse wave sensor 13 may be arranged in different positions as shown in FIG. 7. In the example of FIG. 7, the pulse wave sensor 13 is arranged on the outside of the left and right electrodes 12a, but the pulse wave sensor 13 may be arranged on the inside of the left and right electrodes 12a. In FIG. 7, two pulse wave sensors 13 are shown, but there may be only one pulse wave sensor 13. The pulse wave sensor 13 may be provided on the side opposite to the user, and a photoelectric volume pulse wave meter may be used. When performing measurement, the user touches the left and right electrodes 12a with the fingers of the left and right hands, respectively, and touches both or either of the pulse wave sensors 13 with the fingers of the hand. The fingers touching the electrodes 12a and the fingers touching the pulse wave sensor 13 may be different fingers. This allows you to measure the electrocardiogram and pulse waveform from your fingers.

(Configuration Example 2 of Biometric Information Acquisition Unit)
With reference to FIG. 8, a configuration example of the bioinformation acquiring unit 10A will be described. The bioinformation acquiring unit 10A differs from the bioinformation acquiring unit 10 shown in FIG. 2 and FIG. 3 in the arrangement of the heart sound sensor 11, the electrocardiogram sensor 12, and the pulse wave sensor 13. In the bioinformation acquiring unit 10A, the two electrodes 12a of the electrocardiogram sensor 12 are arranged on the left and right shoulder belt parts 16a, respectively. In addition, the measurement start button 14 is arranged near one of the electrodes 12a. During measurement, the user can touch the left electrode 12a with the left hand and the right electrode 12a with the right hand. In this configuration, the electrode 12a of the electrocardiogram sensor 12 and the heart sound sensor 11 are separated, so that the possibility that the sound generated when the user touches the electrode 12a becomes noise and is detected by the heart sound sensor 11 can be reduced. In addition, in this configuration, the two electrodes 12a are separated compared to the arrangement of the electrodes 12a in the configuration example 1, so that the possibility that the left and right hands will come into contact with each other is low. For this reason, it is expected that more accurate measurement can be performed.

(Configuration Example 3 of Biometric Information Acquisition Unit)
9 and 10, a further example of the configuration of a bioinformation acquisition unit 10B in which the heart sound sensor 11, electrocardiogram sensor 12, and pulse wave sensor 13 are arranged differently will be described. In the bioinformation acquisition unit 10B, the chest belt portion 16b of the harness 16 is absent, and the pulse wave sensor 13 is arranged on the shoulder belt portion 16a together with the electrode 12a of the electrocardiogram sensor 12. In addition, in the bioinformation acquisition unit 10B, as shown in Fig. 10, the heart sound sensor 11 is provided at a position where the shoulder belt portion 16a crosses on the back side of the user when the bioinformation acquisition unit 10B is worn. In this way, it is possible to acquire heart sounds from the back side of the user.

In this way, the heart sound sensor 11 may be placed on the user's side, at least on either the front or back of the user's chest, of the harness 16. The harness 16 can also be configured to have a chest belt portion 16b on the back side of the user in order to measure heart sounds on the back of the user's chest. The chest belt portion 16b is placed so as to at least partially cover the front or back of the chest.

(Configuration Example 4 of Biometric Information Acquisition Unit)
11 and 12, a further example of the configuration of the bioinformation acquisition unit 10C will be described. The bioinformation acquisition unit 10C shown in FIG. 11 and FIG. 12 is different from the above-mentioned examples 1 to 3, and includes, in addition to the shoulder belt portion 16a and the chest belt portion 16b, a waist belt portion 16c that at least partially covers the abdomen of the user and is fixed to the waist. The heart sound sensor 11 is disposed in the chest belt portion 16b. The electrodes 12a of the electrocardiogram sensor 12 and the pulse wave sensor 13 are disposed in the left and right shoulder belt portions 16a. Furthermore, the ends of the shoulder belt portions 16a that are farther from the shoulders are fixed to the waist belt portions 16c on both the front and back sides of the user. This makes it possible to fix the harness 16 to the user's body 30 more accurately.

(Adjusting the position of the heart sound sensor)
The waveform of the heart sound detected is likely to change depending on the position where the heart sound sensor 11 is attached. It is necessary that the heart sound sensor 11 can be adjusted to an appropriate position for each user by a doctor, nurse, etc. For this reason, the harness 16 is provided with a position adjustment mechanism. For example, as shown in FIG. 13, the chest belt part 16b where the heart sound sensor 11 is placed on the side of the user's body 30 may be position adjustable in the vertical direction (up and down direction of the user) on the surface of the user's body. The position adjustment mechanism may include, for example, a hook-and-loop fastener and a clip for fixing the chest belt part 16b of the harness 16 at an appropriate position relative to the shoulder belt part 16a. The shoulder belt part 16a may have a scale 17a indicating the vertical position of the chest belt part 16b.

Furthermore, for example, as shown in FIG. 14, the position where the heart sound sensor 11 is placed on the chest belt portion 16b may be adjustable in the horizontal direction (left and right direction of the user) on the surface of the user's body. For example, the chest belt portion 16b of the harness 16 may be configured so that the lengths of the left and right portions sandwiching the heart sound sensor 11 are adjustable. Further, for example, the heart sound sensor 11 may be configured so that it can slide and be fixed along the chest belt portion 16b. The chest belt portion 16b may have a scale 17b that indicates the horizontal position of the heart sound sensor 11. The mechanism for adjusting the position of the heart sound sensor 11 in the horizontal direction is included in the position adjustment mechanism. The position adjustment mechanism may simultaneously include the configurations shown in FIG. 13 and FIG. 14.

Once the positions of the sensors, including the heart sound sensor 11, are set with respect to the harness 16, the next time the user wears the harness, each sensor will be positioned in the same position as set with respect to the user's body 30. To stabilize the position of the harness 16 when worn, weights or the like may be attached to predetermined parts of the harness 16.

(Configuration of the control unit)
The control unit 22 of the information processing unit 20 will be further described with reference to Fig. 1. The control unit 22 includes functional blocks of a waveform processing unit 22a, a pressure determination unit 22b, and a hemodynamics calculation unit 22c. The processing of each functional block may be executed by the same processor or may be executed by multiple different processors.

The waveform processing unit 22a performs processing such as filtering and noise removal on the measurement signals acquired by the heart sound sensor 11, the electrocardiogram sensor 12, and the pulse wave sensor 13. Furthermore, the waveform processing unit 22a recognizes upwardly convex and downwardly convex parts in the waveform, and recognizes characteristic parts of each waveform. For example, in the case of a measurement signal from the heart sound sensor 11, the waveform processing unit 22a detects the first sound and the second sound, etc. In addition, in the case of a measurement signal from the electrocardiogram sensor 12, the waveform processing unit 22a detects waveforms such as the Q wave, the R wave, and the S wave. Furthermore, the waveform processing unit 22a may perform processing such as differentiating the measurement signal from the pulse wave sensor 13 twice to calculate the waveform shape of an accelerated pulse wave. The waveform processing unit 22a passes the waveform of the detected heart sound signal (phonocardiogram) to the pressure determination unit 22b.

The pressure determination unit 22b is configured to determine an increase or decrease in pressure on the heart sound sensor 11 based on the waveform of the heart sound signal detected by the heart sound sensor 11 and processed by the waveform processing unit 22a. The pressure determination unit 22b controls the pressure adjustment mechanism 15 so as to bring the heart sound signal obtained from the heart sound sensor 11 closer to the shape of a reference waveform of the heart sound waveform stored in advance in the storage unit 23.

For example, if the amplitude of the heart sound signal is smaller than the amplitude of the heart sound waveform stored in the memory unit 23, the pressure determination unit 22b controls the pressure adjustment mechanism 15 to slightly increase or decrease the pressure on the heart sound sensor 11, and acquires the amplitude of the heart sound signal from the waveform processing unit 22a. In the case of the pressure control mechanism of Figure 5, for example, the increase or decrease in pressure can be achieved by controlling the pump P and control valve 15e. The pressure determination unit 22b changes the pressure on the heart sound sensor 11 in a direction that increases the amplitude of the heart sound signal, based on the increase or decrease in the amplitude of the heart sound signal acquired after adjusting the pressure. For example, if increasing the pressure on the heart sound sensor 11 increases the amplitude of the heart sound signal, the waveform processing unit 22a tracks the change in the amplitude of the heart sound signal while gradually increasing the pressure on the heart sound sensor 11. When the pressure determination unit 22b determines that the amplitude of the heart sound signal has peaked or that a predetermined threshold value based on the amplitude of a reference waveform of the heart sound waveform previously stored in the storage unit 23 has been exceeded, the pressure determination unit 22b fixes the pressure on the heart sound sensor 11 and performs measurement.

The pressure determination unit 22b may control the pressure based on the overall similarity between the two waveforms, rather than comparing the amplitude of the heart sound signal measured by the heart sound sensor 11 with the amplitude of the reference waveform stored in the memory unit 23. The pressure determination unit 22b controls the pressure adjustment mechanism 15 so that the similarity is maximized. The similarity between the two waveforms can be calculated using a known method.

If the pressure adjustment mechanism 15 has a pressure sensor 15g, the control unit 22 may acquire the pressure detected by the pressure sensor 15g and use it to control the pressure. In this case, the information processing unit 20 may pre-store an optimal pressure in the memory unit 23, and the pressure determination unit 22b may control the pressure adjustment mechanism 15 so that the pressure detected by the pressure sensor 15g approaches the optimal pressure. The memory unit 23 may store an alternative parameter for achieving the optimal pressure instead of the optimal pressure, for example a setting value of the pump or control valve of the pressure adjustment mechanism 15.

In the above description, the pressure determination unit 22b controls the pressure of the heart sound sensor based on the waveform of the heart sound signal processed by the waveform processing unit 22a. However, the information processing unit 20 can also control the bioinformation acquisition unit 10 in a manner other than this to obtain an appropriate waveform of the heart sound signal. For example, the control unit 22 of the information processing unit 20 can control the pressure adjustment mechanism 15 to gradually increase the pressure from a low pressure while continuously monitoring the heart sound waveform, and measure the heart sound signal when an appropriate waveform appears. The control unit 22 can determine whether the heart sound waveform is an appropriate waveform by determining the similarity to a reference waveform stored in the memory unit 23, for example. In this case, adjustment of the pressure by the pressure determination unit 22b is not necessary.

The hemodynamics calculation unit 22c acquires the heart sound signal obtained from the heart sound sensor 11 after the pressure has been adjusted by the pressure determination unit 22b, together with the measurement signals of the electrocardiogram and/or pulse waveform, from the waveform processing unit 22a. The hemodynamics calculation unit 22c combines the measurement data of the heart sound with the measurement data of the electrocardiogram and/or pulse waveform to measure parameters related to cardiac function. The parameters related to cardiac function may include STIs such as PEP or LVET, as described above. The hemodynamics calculation unit 22c may store the measurement results in the memory unit 23.

The hemodynamics calculation unit 22c may estimate parameters indicating intracardiac hemodynamics by machine learning by inputting the measurement data of the heart sounds, electrocardiogram, and pulse waveform as explanatory variables into a learned model previously stored in the memory unit 23. As described above, the parameters indicating intracardiac hemodynamics may include intracardiac pressures such as left ventricular end-diastolic pressure, pulmonary artery pressure, and pulmonary artery wedge pressure. The parameters indicating intracardiac hemodynamics are included in the parameters related to cardiac function.

The control unit 22 may store the parameters related to cardiac function calculated and estimated by the hemodynamics calculation unit 22c in the memory unit 23 and/or display them on the display unit 21. The control unit 22 may further transmit the parameters related to cardiac function to an external server 25.

(Flow for using medical monitoring devices at home)
Next, a procedure for performing a measurement at home using the medical monitoring device 1 having the pressure adjustment mechanism 15 will be described with reference to FIG.

First, the doctor in charge of the user decides to remotely monitor the user using the medical monitoring device 1 (step S101).

Next, at the medical institution, a doctor or nurse puts the biometric information acquisition unit 10 on the user and adjusts the positions of the chest belt portion 16b of the harness 16, as well as the heart sound sensor 11, the electrocardiogram sensor 12, and the pulse wave sensor 13 (step S102). The doctor or nurse may adjust the entire harness 16 so that it is fixed to the user's body 30. The doctor or nurse adjusts the position of the heart sound sensor 11 so that an optimal heart sound signal is obtained.

The doctor or nurse stores the heart sound signal acquired after the adjustments of step S102 as a reference waveform in the memory unit 23 of the information processing unit 20 or another storage medium (step S103). If the information processing unit 20 is located remotely, the reference waveform may be transmitted to and stored in the memory unit 23 of the information processing unit 20 by any method.

Next, the user performs measurements at home using the biometric information acquisition unit 10 that has been adjusted at the medical institution (step S104). The user may perform measurements of biometric information at a set time each day. The measurement process of step S104 is described below with reference to FIG. 16.

First, the user at home puts on the harness 16 of the biometric information acquisition unit 10 on the body 30 (S201). At this time, the user does not need to remove his/her clothes. The medical monitoring device 1 can acquire biometric information even if the user is clothed.

The user operates the measurement start button 14 while wearing the harness 16. This starts the measurement (step S202). Each of the subsequent steps S202 to S209 is a process executed by the control unit 22 of the information processing unit 20.

The electrocardiogram sensor 12 and pulse wave sensor 13 can continue to acquire measurement data continuously from the start of measurement. The electrodes 12a of the electrocardiogram sensor 12 are provided on the side of the harness 16 opposite the side facing the user's body surface, and the user can measure their electrocardiogram by touching one of the two electrodes 12a with one of both hands and the other hand to the other of the two electrodes 12a. Therefore, the user can measure their electrocardiogram while still wearing their clothes.

When the pulse wave sensor 13 is attached to the surface of the user's body of the harness 16 as shown in Figure 4, a sensor using a piezoelectric element is used, making it possible to measure even while the user is wearing clothes. Furthermore, when the pulse wave sensor 13 is attached to the surface of the harness 16 opposite to the surface facing the user's body as shown in Figure 7, the pulse wave sensor 13 is configured as a photoelectric volume pulse wave meter and obtains a pulse wave signal from the user's finger, making it possible to measure even while the user is wearing clothes.

The pressure determination unit 22b of the control unit 22 controls the pressure adjustment mechanism 15 to increase the pressure of the heart sound sensor 11 to the initial pressure value previously stored in the memory unit 23 (step S203). Note that step S203 is not essential. For example, the control unit 22 may start with the pressure that the heart sound sensor 11 applies to the user's body surface when the harness 16 is attached, and gradually increase the pressure.

The control unit 22 acquires a heart sound signal from the heart sound sensor 11 (step S204). The acquired heart sound signal is subjected to filtering, noise removal, and other processing in the waveform processing unit 22a.

The pressure determination unit 22b of the control unit 22 determines the degree of similarity between the waveform of the heart sound signal obtained from the heart sound sensor 11 and the reference waveform of the heart sound waveform stored in the memory unit 23 (step S205). A publicly known method can be used to evaluate the degree of similarity of the waveforms.

If the waveform obtained from the heart sound sensor 11 is not similar to the reference waveform (step S205: No), the pressure determination unit 22b recognizes the acquisition state of the heart sound based on the acquired heart sound signal (step S206). The acquisition state of the heart sound includes a state in which the amplitude of the heart sound signal is smaller or larger than the reference waveform by a predetermined percentage or more, or the shape of the waveform of the heart sound signal is significantly different from that of the reference waveform. The pressure determination unit 22b may control the pressure adjustment mechanism 15 to change the pressure of the heart sound sensor 11 in order to determine whether to adjust the pressure to increase or decrease.

Based on the recognition result in step S206, the pressure determination unit 22b automatically controls the pressure adjustment mechanism 15 to increase or decrease the pressure on the heart sound sensor 11 (step S207). The pressure determination unit 22b again acquires the heart sound signal from the heart sound sensor 11 (step S203) and determines whether the waveform of the heart sound signal is similar to the reference waveform (step S205). The pressure determination unit 22b repeats the processes of steps S204 to S207 unless it is determined that the heart sound signal is similar to the reference waveform (step S205: No).

If it is determined in step S205 that the heart sound signal is similar to the reference waveform (step S205: Yes), the hemodynamics calculation unit 22c acquires signals obtained by processing the signals from the heart sound sensor 11, the electrocardiogram sensor 12, and the pulse wave sensor 13 in the waveform processing unit 22a. Based on these signals, the hemodynamics calculation unit 22c calculates or estimates parameters related to cardiac function (step S208).

The control unit 22 stores the parameters related to cardiac function calculated or estimated by the hemodynamics calculation unit 22c in the memory unit 23, and causes the output unit 24 to display them on the display unit 21 (step S209).

Returning to FIG. 15, the control unit 22 of the information processing unit 20 transmits the parameters related to cardiac function obtained as the measurement results to the external server 25 via the output unit 24 (step S105).

Doctors and/or nurses at the medical institution can remotely monitor the user's measurement result data stored on the external server 25 (step S106).

The doctor and/or nurse can change the treatment or prescription based on changes in the parameters related to the user's cardiac function. The doctor and/or nurse can communicate the changes to the user at home via a communication line (step S107).

The procedure for performing measurements at home using a medical monitoring device 1 having a pressure adjustment mechanism 15 has been described with reference to Figures 15 and 16, but the medical monitoring device can also be configured without a pressure adjustment mechanism 15. In that case, step S103 in Figure 15 and steps S203 to S207 in Figure 16 are not executed.

As described above, the medical monitoring device 1 disclosed herein can improve the ease of use of the device when a user measures multiple pieces of biological information at home. This allows doctors and/or nurses to remotely monitor the user's condition, such as heart failure. The medical monitoring device 1 disclosed herein can calculate or estimate parameters related to cardiac function by combining multiple pieces of biological information including heart sounds, electrocardiograms, and pulse waveforms, allowing doctors at medical institutions to respond quickly when there is a change in a parameter related to cardiac function.

In addition, the user can measure heart sounds, electrocardiograms, and pulse waveforms at home in a non-invasive manner, which places less strain on the user's body 30. Furthermore, by fixing each sensor to the harness 16, multiple pieces of vital signs can be easily measured simultaneously in parallel simply by wearing the harness 16. Furthermore, the electrodes 12a of the electrocardiogram sensor 12 are provided on the side of the harness 16 opposite the user's side, and the user can measure by touching them with their hands, so the user can measure vital signs while wearing their clothes.

Furthermore, in the medical monitoring device 1 of the present disclosure, the heart sound sensor 11 is provided with a pressure adjustment mechanism 15 that adjusts the pressure of the heart sound sensor 11 against the user's body 30, and this is controlled by the control unit 22 based on the heart sound signal from the heart sound sensor 11. Therefore, the medical monitoring device 1 is able to measure heart sounds by optimizing the pressure of the heart sound sensor 11, which requires delicate adjustment. In addition, the harness 16 of the medical monitoring device 1 has a position adjustment mechanism that can adjust the position of the heart sound sensor 11, so that a doctor or the like can set the heart sound sensor 11, whose position needs to be adjusted for each user, to an appropriate position. This allows heart sounds to be measured in the same position every time.

(Third Sensor Arrangement Example)
In each of the above embodiments, the electrode 12a of the electrocardiogram sensor 12 was provided on the surface of the harness 16 opposite to the side of the body 30 of the user. The bioinformation acquisition unit 10 may be provided with an electrode 18 of a third sensor that is arranged on at least one of the front and back chest of the user of the harness 16 on the side of the user's body 30 and acquires bioinformation different from the vibration information of the user's body surface. The third sensor is, for example, an electrocardiogram sensor. FIG. 17 shows an example of the arrangement of each sensor (including electrodes) when the electrode 18 of the third sensor is added on the chest belt part 16b of the configuration example 1 of the bioinformation acquisition unit 10 shown in FIG. 2. The pressure adjustment mechanism 15 is shown in a simplified form. In addition to the electrode 12a arranged at a position that can be touched by hand, the electrode 18 is also provided on the surface side of the user's body, so that if the user is not wearing clothes, the user can continuously monitor without touching the electrode 12a with his or her hand. The electrode 18 of the third sensor can be provided at any position on the harness 16 as long as it is on the surface side of the body. In this case, since it is necessary to touch the skin, it is assumed that the measurement is performed without wearing clothes. There may be a button that allows the user to select whether to use electrodes on the body surface or electrodes that can be touched by the hand, depending on whether the user is wearing clothes or not.

Although the embodiments of the present disclosure have been described based on the drawings and examples, it should be noted that those skilled in the art can easily make various modifications or corrections based on the present disclosure. Therefore, it should be noted that these modifications or corrections are included in the scope of the present disclosure. For example, the shape and arrangement of each component of the medical monitoring device shown in each embodiment are merely examples. In addition, for example, the functions included in each component or each step can be rearranged so as not to cause logical contradictions, and multiple components or steps can be combined into one or divided. Although the embodiments of the present disclosure have been described mainly with respect to the device, the embodiments of the present disclosure can also be realized as a method including steps executed by each component of the device. The embodiments of the present disclosure can also be realized as a method, a program executed by a processor provided in the device, or a non-transitory computer-readable medium having a program recorded thereon. It should be understood that these are also included in the scope of the present disclosure.

1

Medical monitoring device

10, 10A, 10B, 10C Biometric information acquisition unit 11 Heart sound sensor (first sensor)
12 electrocardiogram sensor (second sensor)
12a Electrode 13 Pulse wave sensor (second sensor)
DESCRIPTION OF SYMBOLS 14 Measurement start button 15 Pressure adjustment mechanism 15a Housing 15b Movable member

15c Pressing section

15d Air tube

15e Control valve 15f Collar

15g Pressure sensor 15h Spring 16 Harness 16a Shoulder belt section 16b Chest belt section 16c Waist belt section 17a, b Scale 18 Electrode (third sensor) 20 Information processing section 21 Display section 22 Control section 22a Waveform processing section 22b Pressure determination section 22c Hemodynamics calculation section 23 Memory section 24 Output section 25 External server 30 Body 31 Heart

Claims

1. A non-invasive medical monitoring device, comprising:
A harness configured to be worn on at least one of a front chest and a back chest of a user;
a first sensor that is disposed on a side of the user at least on one of the front and back sides of the chest of the user of the harness and that is capable of acquiring vibration information of a body surface of the user;
a second sensor provided on the side of the harness opposite the user's side and configured to acquire biometric information different from the vibration information of the user's body surface.
The medical monitoring device according to claim 1, wherein the vibration information of the body surface is at least one of heart sounds and apical pulsation.
The medical monitoring device of claim 1 further comprises a pressure adjustment mechanism that adjusts the pressure with which the first sensor presses against the body surface so that the pressure is appropriate for the first sensor to acquire the vibration information of the body surface.
The medical monitoring device according to claim 1, wherein the harness comprises a shoulder belt portion that is placed on the shoulders of the user and a chest belt portion that at least partially covers the front or back of the user's chest.
The medical monitoring device of claim 1, wherein the second sensor includes a pulse wave sensor that can be measured by the user touching it with at least one hand.
The medical monitoring device according to claim 1, wherein the second sensor includes electrodes that are arranged at two positions that the user can touch with each hand, and that can be measured by touching the electrodes with both hands without overlapping.
The medical monitoring device of claim 1, wherein the harness further comprises a waist belt portion that at least partially covers the abdomen of the user.
The medical monitoring device of claim 1, wherein the harness has a position adjustment mechanism that can adjust the position of the first sensor.
The medical monitoring device according to claim 1, further comprising a control unit that calculates a parameter related to the cardiac function of the user based on the waveforms output by the first sensor and the second sensor.
1. A non-invasive medical monitoring device, comprising:
A harness configured to be worn on at least one of a front chest and a back chest of a user;
a first sensor that is disposed on a side of the user at least on one of the front and back sides of the chest of the user of the harness and that is capable of acquiring vibration information of a body surface of the user;
a pressure adjustment mechanism that adjusts the pressure with which the first sensor presses against the body surface so that the pressure is appropriate for the first sensor to acquire the vibration information of the body surface.
The medical monitoring device according to claim 10, wherein the vibration information of the body surface is at least one of heart sounds and apical pulsation.
The medical monitoring device according to claim 10, further comprising a second sensor provided on the surface of the harness opposite the user's side, for acquiring biological information different from the vibration information of the user's body surface.
The medical monitoring device according to claim 10, wherein the harness comprises a shoulder belt portion that is placed on the shoulders of the user and a chest belt portion that at least partially covers the front or back of the user's chest.
The medical monitoring device of claim 12, wherein the second sensor includes a pulse wave sensor that can be measured by the user touching it with at least one hand.
The medical monitoring device according to claim 12, wherein the second sensor includes electrodes that are arranged at two positions that the user can touch with each hand, and that can be measured by touching the electrodes with both hands without overlapping.
The medical monitoring device of claim 10, wherein the harness further comprises a waist belt portion that at least partially covers the abdomen of the user.
The medical monitoring device of claim 10, wherein the harness has a position adjustment mechanism that can adjust the position of the first sensor.
The medical monitoring device according to claim 12, further comprising a control unit that calculates a parameter related to the cardiac function of the user based on the waveforms output by the first sensor and the second sensor.
The medical monitoring device according to claim 1 or 12, configured to enable acquisition of the plurality of pieces of biometric information by the first sensor and the second sensor while the user is wearing clothing on the user's chest.
The medical monitoring device according to claim 1, further comprising a third sensor arranged on the side of the user of the harness on at least one of the front and back sides of the chest of the user, and acquiring biological information different from the vibration information of the body surface of the user.