Development of Noninvasive Estimation system of Maximum Ventricular Elastance Emax for Clinical Application

临床应用最大心室弹性Emax无创估计系统的开发

• 批准号: 14580807
• 负责人: YOSHIZAWA Makoto
• 金额: $ 2.37万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14580807/
• 关键词: Emax; estimation of cardiac function; aortic flow; cardiac catheter test; radial arterial pressure; linear elastance method; parameter optimization method; ARX model; 心機能; 定常流ポンプ; 非侵襲的推定; 最大エラスタンス; 左心室圧; トノメトリ法

The maximum ventricular elastance (Emax) is a good quantitative index for evaluating cardiac pump function. To extensively promote clinical application of Emax, it is necessary to need a new method for obtaining Emax without high invasive measurements. The purpose of this research was to develop a clinical method for estimating Emax low-invasively without any cardiac load on the of the parameter optimization method (POM) and the linear elastance method (LEM) that has been proposed by the authors. Because the POM and LEM need left ventricular pressure (LVP) and aortic flow (AoF), we have also developed a technique to estimate these signals in the following.First, the system we have developed can estimate LVP on the basis of two ARX (autoregressive exogeneous) models : the system model from radial arterial pressure (RdP) to aortic pressure (AoP) and the system model from AoP to LVP, respectively ; In a cardiac catheterization test, these ARX models can be identified by using LVP, AoP and RdP. LVP and AoP are invasive measurements but RdP is measured noninvasively by a tonometric pressure sensor. Once these models are identified, it is guessed that LVP can be estimated fully noninvasively by using RdP even after the previous cardiac catheterization test.Secondly, the developed system can estimate AoF by automatically extracting the contour of Doppler echocardiography during the ejection period.Finally, the total system has been completed in a personal computer unit so as to estimate Emax on the basis of the POM using the off-line data of RdP and the Doppler image of aortic flow rate. An input module has been added to the system to apply the system to real clinical use.

最大心室弹性（Emax）是评价心脏泵功能的较好的定量指标。为了更广泛地推广Emax的临床应用，需要一种新的无创测量Emax的方法。本研究的目的是开发一种临床方法来估计Emax的低侵入性无任何心脏负荷的参数优化方法（POM）和线性弹性方法（LEM）的作者已经提出的。由于POM和LEM需要左心室压力（LVP）和主动脉流量（AoF），因此我们还开发了以下技术来估计这些信号：首先，我们开发的系统可以在两个ARX的基础上估计LVP（自回归外生）模型：分别为从桡动脉压（RdP）到主动脉压（AoP）的系统模型和从AoP到LVP的系统模型;在心导管检查中，这些ARX模型可以通过使用LVP、AoP和RdP来识别。LVP和AoP是有创测量，但RdP是通过眼压传感器无创测量的。一旦识别出这些模型，就可以推测，即使在先前的心导管检查之后，也可以通过使用RdP完全无创地估计LVP。其次，所开发的系统可以通过自动提取射血期多普勒超声心动图的轮廓来估计AoF。最后，整个系统已经在个人计算机单元中完成，以便使用off-RdP线数据和主动脉血流速度多普勒图像。系统中增加了一个输入模块，以将系统应用于真实的临床使用。

项目成果

T.Yambe, M.Yoshizawa, A.Tanaka, K.Abe, R.Taira, K.Tabayashi, H.Takeda, S.Nitta: "Effect of PDE inhibitor on complex dynamics in cardiac function (in Japanese)"Jap.J.Appl.Physiology. Vol.32. 235-239 (2002)

T.Yambe、M.Yoshizawa、A.Tanaka、K.Abe、R.Taira、K.Tabayashi、H.Takeda、S.Nitta：“PDE 抑制剂对心脏功能复杂动态的影响（日语）”Jap。

Tomoyuki Yambe: "Artificial baroreflex system makes deterministic chaos"Japanese J.Applied Physiology. 33. 169-174 (2003)

Tomoyuki Yambe：“人工压力反射系统造成确定性混乱”日本应用生理学杂志。

Y.Saijo: "Development of an ultra-portable echo device connected to USB port"Ultrasonics. (in press). (2004)

Y.Saijo：“开发连接到 USB 端口的超便携式回声设备”超声波。

M.Yoshizawa: "Sensor-less estimation of pressure head and flow of a continuous-flow artificial heart based on input power and rotational speed"ASAIO Journal. 48. 443-448 (2002)

M.Yoshizawa：“基于输入功率和转速对连续流人工心脏的压头和流量进行无传感器估计”ASAIO 期刊。

Tomoyuki Yambe, Mune-ichi, Shibata, Makoto Yoshizawa, Yusuke Abe, Kou Imachi, Akira Takana, Ken-ichi Abe, Hidetoshi Matsuki, Shigenao Maruyama, Toshiyuki Takagi, Yun Lun, Tausku Yamaguchi, Shin-ichi Nitta: "Artificial baroreflex system makes deterministic

Tomoyuki Yambe、Mune-ichi、Shibata、Makoto Yoshizawa、Yusuke Abe、Kou Imachi、Akira Takana、Ken-ichi Abe、Hidetoshi Matsuki、Shigenao Maruyama、Toshiyuki Takagi、Yun Lun、Tausku Yamaguchi、Shin-ichi Nitta：“人工压力反射系统