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Published on: April 17, 2020
Noninvasive Determination of Blood Pressure by Heart Sound Analysis Compared With Intra-Arterial Monitoring in
Gaurav Kapur1, Lingguang Chen2, Yong Xu3
1Department of Pediatrics, Children's Hospital of Michigan/Wayne State University, Detroit, MI.
Objectives:
To develop a novel device to predict systolic and diastolic blood pressure based on measured heart sound signals and evaluate its accuracy in comparison to intra-arterial blood pressure readings.
Study Design:
Prospective, observational pilot study.
Setting:
PICU.
Patients:
Critically ill children (0-18 yr) undergoing continuous blood pressure monitoring via radial artery intra-arterial catheters were enrolled in the study after informed consent. The study included medical, cardiac, and surgical PICU patients.
Interventions:
Along with intra-arterial blood pressure, patient's heart sounds were recorded simultaneously by a highly sensitive sensor taped to the chest. Additional hardware included a data acquisition unit and laptop computer. Subsequently, advanced signal processing technologies were used to minimize random interfering signals and extract and separate S1 and S2 signals. A computerized model was then developed using artificial neural network systems to estimate blood pressure from the extracted heart sound analysis.
Measurements And Main Outcomes:
We found a statistically significant correlation for systolic (r = 0.964; R = 0.928) and diastolic (r = 0.935; R = 0.868) blood pressure readings (n = 491) estimated by the novel heart-sound signal-based method and those recorded by intra-arterial catheters. The mean difference of the individually paired determinations of the blood pressure between the heart-sound-based method and intra-arterial catheters was 0.6 ± 7 mm Hg for systolic blood pressure and -0.06 ± 5 mm Hg for diastolic blood pressure, which was within the recommended range of 5 ± 8 mm Hg for any new blood pressure devices.
Conclusions:
Our findings provide proof of concept that the heart-sound signal-based method can provide accurate, noninvasive blood pressure monitoring.
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