Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

A smart cushion for real-time heart rate monitoring

10.1109/BioCAS.2012.64185122012 IEEE Biomedical Circuits and Systems Conference: Intelligent Biomedical Electronics and Systems for Better Life and Better Environment, BioCAS 2012 - Conference Publications53-5

Cardiac-induced localized thoracic motion detected by a fiber optic sensing scheme

The cardiovascular health of the human population is a major concern for medical clinicians, with cardiovascular diseases responsible for 48% of all deaths worldwide, according to the World Health Organization. The development of new diagnostic tools that are practicable and economical to scrutinize the cardiovascular health of humans is a major driver for clinicians. We offer a new technique to obtain seismocardiographic signals up to 54 Hz covering both ballistocardiography (below 20 Hz) and audible heart sounds (20 Hz upward), using a system based on curvature sensors formed from fiber optic long period gratings. This system can visualize the real-time three-dimensional (3-D) mechanical motion of the heart by using the data from the sensing array in conjunction with a bespoke 3-D shape reconstruction algorithm. Visualization is demonstrated by adhering three to four sensors on the outside of the thorax and in close proximity to the apex of the heart; the sensing scheme revealed a complex motion of the heart wall next to the apex region of the heart. The detection scheme is low-cost, portable, easily operated and has the potential for ambulatory applications

A NOVEL BCG SENSOR-ARRAY FOR UNOBTRUSIVE CARDIAC MONITORING

Unobtrusive heart rate monitoring is a popular research topic in biomedical engineering. The reason is that convential methods, e.g. the clinical gold standard electrocardiography, require conductive contact to the human body. Other methods such as ballistocardiography try to record these vital signs without electrodes that are attached to the body. So far, these systems cannot replace routine procedures. Most systems have some drawbacks that cannot be compensated, such as aging of the sensor materials or movement artifacts. In addition, the signal form differs greatly from an ECG, which is an electrical signal. The ballistocardiogram has a mechanical source, which makes it harder to evaluate. We have developed a new sensor array made of near-IR-LEDs to record BCGs. IR-sensors do not age in relevant time scales. Analog filtering was neccesary, because the signal amplitude was very small. The digitized data was then processed by various algorithms to extract beat-to-beat or breath-to-breath intervals. The redundancy of multiple BCG channels was used to provide a robust estimation of beat-to-beat intervals and heart rate. We installed the system beneath a mattress topper of a hospital bed, but any other bed would have been sufficient. The validation of this measurement system shows that it is well suited for BCG recordings. The use of multiple channels has proven to be superior to relying on a single BCG channel

Assessment of trends in the cardiovascular system from time interval measurements using physiological signals obtained at the limbs

Cardiovascular diseases are an increasing source of concern in modern societies due to their increasing prevalence and high impact on the lives of many people. Monitoring cardiovascular parameters in ambulatory scenarios is an emerging approach that can provide better medical access to patients while decreasing the costs associated to the treatment of these diseases. This work analyzes systems and methods to measure time intervals between the electrocardiogram (ECG), impedance plethysmogram (IPG), and the ballistocardiogram (BCG), which can be obtained at the limbs in ambulatory scenarios using simple and cost-effective systems, to assess cardiovascular intervals of interest, such as the pulse arrival time (PAT), pulse transit time (PTT), or the pre-ejection period (PEP). The first section of this thesis analyzes the impact of the signal acquisition system on the uncertainty in timing measurements in order to establish the design specifications for systems intended for that purpose. The minimal requirements found are not very demanding yet some common signal acquisition systems do not fulfill all of them while other capabilities typically found in signal acquisition systems could be downgraded without worsening the timing uncertainty. This section is also devoted to the design of systems intended for timing measurements in ambulatory scenarios according to the specifications previously established. The systems presented have evolved from the current state-of-the-art and are designed for adequate performance in timing measurements with a minimal number of active components. The second section is focused on the measurement of time intervals from the IPG measured from limb to limb, which is a signal that until now has only been used to monitor heart rate. A model to estimate the contributions to the time events in the measured waveform of the different body segments along the current path from geometrical properties of the large arteries is proposed, and the simulation under blood pressure changes suggests that the signal is sensitive to changes in proximal sites of the current path rather than in distal sites. Experimental results show that the PAT to the hand-to-hand IPG, which is obtained from a novel four-electrode handheld system, is correlated to changes in the PEP whereas the PAT to the foot-to-foot IPG shows good performance in assessing changes in the femoral PAT. Therefore, limb-to-limb IPG measurements significantly increase the number of time intervals of interest that can be measured at the limbs since the signals deliver information from proximal sites complementary to that of other measurements typically performed at distal sites. The next section is devoted to the measurement of time intervals that involve different waves of the BCG obtained in a standing platform and whose origin is still under discussion. From the relative timing of other physiological signals, it is hypothesized that the IJ interval of the BCG is sensitive to variations in the PTT. Experimental results show that the BCG I wave is a better surrogate of the cardiac ejection time than the widely-used J wave, which is also supported by the good correlation found between the IJ interval and the aortic PTT. Finally, the novel time interval from the BCG I wave to the foot of the IPG measured between feet, which can be obtained from the same bathroom scale than the BCG, shows good performance in assessing the aortic PAT. The results presented reinforce the role of the BCG as a tool for ambulatory monitoring since the main time intervals targeted in this thesis can be obtained from the timing of its waves. Even though the methods described were tested in a small group of subjects, the results presented in this work show the feasibility and potential of several time interval measurements between the proposed signals that can be performed in ambulatory scenarios, provided the systems intended for that purpose fulfill some minimal design requirements.Les malalties cardiovasculars són una tema de preocupació creixent en societats modernes, degut a l’augment de la seva prevalença i l'elevat impacte en les vides dels pacients que les sofreixen. La mesura i monitoratge de paràmetres cardiovasculars en entorns ambulatoris és una pràctica emergent que facilita l’accés als serveis mèdics i permet reduir dràsticament els costos associats al tractament d'aquestes malalties. En aquest treball s’analitzen sistemes i mètodes per la mesura d’intervals temporals entre l’electrocardiograma (ECG), el pletismograma d’impedància (IPG) i el balistocardiograma (BCG), que es poden obtenir de les extremitats i en entorns ambulatoris a partir de sistemes de baix cost, per tal d’avaluar intervals cardiovasculars d’interès com el pulse arrival time (PAT), pulse transit time (PTT) o el pre-ejection period (PEP). En la primera secció d'aquesta tesi s’analitza l’impacte del sistema d’adquisició del senyal en la incertesa de mesures temporals, per tal d’establir els requeriments mínims que s’han de complir en entorns ambulatoris. Tot i que els valors obtinguts de l’anàlisi no són especialment exigents, alguns no són assolits en diversos sistemes habitualment utilitzats mentre que altres solen estar sobredimensionats i es podrien degradar sense augmentar la incertesa en mesures temporals. Aquesta secció també inclou el disseny i proposta de sistemes per la mesura d’intervals en entorns ambulatoris d’acord amb les especificacions anteriorment establertes, a partir de l’estat de l’art i amb l’objectiu de garantir un correcte funcionament en entorns ambulatoris amb un nombre mínim d’elements actius per reduir el cost i el consum. La segona secció es centra en la mesura d’intervals temporals a partir de l’IPG mesurat entre extremitats, que fins al moment només s’ha fet servir per mesurar el ritme cardíac. Es proposa un model per estimar la contribució de cada segment arterial per on circula el corrent a la forma d’ona obtinguda a partir de la geometria i propietats físiques de les artèries, i les simulacions suggereixen que la senyal entre extremitats és més sensible a canvis en arteries proximals que en distals. Els resultats experimentals mostren que el PAT al hand-to-hand IPG, obtingut a partir d’un innovador sistema handheld de quatre elèctrodes, està fortament correlacionat amb els canvis de PEP, mentre que el PAT al foot-to-foot IPG està correlat amb els canvis en PAT femoral. Conseqüentment, l’ILG entre extremitats augmenta de manera significativa els intervals d’interès que es poden obtenir en extremitats degut a que proporciona informació complementària a les mesures que habitualment s’hi realitzen. La tercera secció està dedicada a la mesura d’intervals que inclouen les ones del BCG vertical obtingut en plataformes, de les que encara se’n discuteix l’origen. A partir de la posició temporal relativa respecte altres ones fisiològiques, s’hipostatitza que l’interval IJ del BCG es sensible a variacions del PTT. Els resultats experimentals mostren que la ona I del BCG és un millor indicador de l’ejecció cardíaca que el pic J, tot i que aquest és el més utilitzat habitualment, degut a la bona correlació entre l’interval IJ i el PTT aòrtic. Finalment, es presenta un mètode alternatiu per la mesura del PTT aòrtic a partir de l’interval entre el pic I del BCG i el peu del foot-to-foot IPG, que es pot obtenir de la mateixa plataforma que el BCG i incrementa la robustesa de la mesura. Els resultats presentats reforcen el paper del BCG com a en mesures en entorns ambulatoris, ja que els principals intervals objectiu d’aquesta tesi es poden obtenir a partir de les seves ones. Tot i que els mètodes descrits han estat provats en grups petits de subjectes saludables, els resultats mostren la viabilitat i el potencial de diversos intervals temporals entre les senyals proposades que poden ésser realitzats en entorns ambulatoris, sempre que els sistemes emprats compleixin els requisits mínims de disseny.Postprint (published version

Cardiac induced localised motion of the human torso detected by a long period grating fibre optic sensing scheme

Cardiovascular health of the human population is a major concern for medical clinicians, with cardiovascular diseases responsible for 48% of all deaths worldwide, according to the World Health Organisation. Therefore the development of new practicable and economical diagnostic tools to scrutinise the cardiovascular health of humans is a major driver for clinicians. We offer a new technique to obtain seismocardiographic signals covering both ballistocardiography (below 20Hz) and audible heart sounds (20Hz upwards). The detection scheme is based upon an array of curvature/displacement sensors using fibre optic long period gratings interrogated using a variation of the derivative spectroscopy interrogation technique. © 2014 SPIE

Automatic heart rate detection from FBG sensors using sensor fusion and enhanced empirical mode decomposition

International audienceCardiovascular diseases are the world's top leading causes of death. Real time monitoring of patients who have cardiovascular abnormalities can provide comprehensive and preventative health care. We investigate the role of the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) and sensor fusion for automatic heart rate detection from a mat with embedded Fiber Bragg Grating (FBG) sensor arrays. The fusion process is performed in the time domain by averaging the readings of the sensors for each sensor array. Subsequently, the CEEMDAN is applied to obtain the interbeat intervals. Experiments are performed with 10 human subjects (males and females) lying on two different positions on a bed for a period of 20 minutes. The overall system performance is assessed against the reference ECG signals. The average and standard deviation of the mean relative absolute error are 0.049, 0.019 and 0.047, 0.038 for fused and best sensors respectively. Sensor fusion together with CEEMDAN proved to be robust against motion artifacts caused by body movements

A Novel Broadband Forcecardiography Sensor for Simultaneous Monitoring of Respiration, Infrasonic Cardiac Vibrations and Heart Sounds

The precordial mechanical vibrations generated by cardiac contractions have a rich frequency spectrum. While the lowest frequencies can be palpated, the higher infrasonic frequencies are usually captured by the seismocardiogram (SCG) signal and the audible ones correspond to heart sounds. Forcecardiography (FCG) is a non-invasive technique that measures these vibrations via force sensing resistors (FSR). This study presents a new piezoelectric sensor able to record all heart vibrations simultaneously, as well as a respiration signal. The new sensor was compared to the FSR-based one to assess its suitability for FCG. An electrocardiogram (ECG) lead and a signal from an electro-resistive respiration band (ERB) were synchronously acquired as references on six healthy volunteers (4 males, 2 females) at rest. The raw signals from the piezoelectric and the FSR-based sensors turned out to be very similar. The raw signals were divided into four components: Forcerespirogram (FRG), Low-Frequency FCG (LF-FCG), High-Frequency FCG (HF-FCG) and heart sounds (HS-FCG). A beat-by-beat comparison of FCG and ECG signals was carried out by means of regression, correlation and Bland–Altman analyses, and similarly for respiration signals (FRG and ERB). The results showed that the infrasonic FCG components are strongly related to the cardiac cycle (R2 > 0.999, null bias and Limits of Agreement (LoA) of ± 4.9 ms for HF-FCG; R2 > 0.99, null bias and LoA of ± 26.9 ms for LF-FCG) and the FRG inter-breath intervals are consistent with ERB ones (R2 > 0.99, non-significant bias and LoA of ± 0.46 s). Furthermore, the piezoelectric sensor was tested against an accelerometer and an electronic stethoscope: synchronous acquisitions were performed to quantify the similarity between the signals. ECG-triggered ensemble averages (synchronized with R-peaks) of HF-FCG and SCG showed a correlation greater than 0.81, while those of HS-FCG and PCG scored a correlation greater than 0.85. The piezoelectric sensor demonstrated superior performances as compared to the FSR, providing more accurate, beat-by-beat measurements. This is the first time that a single piezoelectric sensor demonstrated the ability to simultaneously capture respiration, heart sounds, an SCG-like signal (i.e., HF-FCG) and the LF-FCG signal, which may provide information on ventricular emptying and filling events. According to these preliminary results the novel piezoelectric FCG sensor stands as a promising device for accurate, unobtrusive, long-term monitoring of cardiorespiratory functions and paves the way for a wide range of potential applications, both in the research and clinical fields. However, these results should be confirmed by further analyses on a larger cohort of subjects, possibly including also pathological patients