Cardiovascular Hemodynamics Processing System (CHAMPS)

摘要/摘要 高血压是心血管疾病发病率和死亡率过高的主要原因，并且仍然是一个重要因素。 这是一个全国性的问题，大约三分之一的成年人患有高血压。血压监测 作为心血管疾病的重要标志物，具有较高的诊断和预后价值。静态BP快照， 通常是在医生就诊期间通过血压计获得的，有文件证明是可靠的 问题，其原因包括白大褂的高血压和糟糕的技术。因此，电子 佩戴在上臂上并设计用于自我测量血压的示波测量装置 (SBPM)已被广泛采用；然而，这些设备也存在测量可靠性差的问题 很少根据特定的指南(例如，在患者坐着时进行测量， 手臂保持与心脏水平，手臂保持静止，不说话或交叉腿部)。感官上的 或基于铜的示波式动态血压监测仪(ABPM)，可在家庭环境中佩戴并提供 24小时内的定期自动测量|最重要的是，在睡眠期间|已经成为 临床标准，据报道提供了更准确和可靠的结果。但是，这些设备仍然需要 患者遵循与SBPM相同的指南，仅进行间歇性测量(例如，每15-30分钟 白天，晚上每隔30-60分钟)，被许多患者发现无礼和不舒服。 建议的心血管血流动力学处理系统(CHAMPS)将是一种可靠、易用、 和舒适的(即，非基于cu的)连续(即，逐跳)动态血压监测仪(CABPM)， 可以全天候运行，甚至在日常生活活动(ADL)中也是如此。这款新的BP监护仪将是 对临床实践的一项重要补充，准确而不引人注目地评估有既往或 疑似高血压，即使在运动过程中也没有不适症状。Champs提供 准确的BP估计，不会限制用户的移动性、身体姿势或手臂抬高。在拟议的SBIR中 第一阶段，Barron Associates寻求通过严格的评估来证明Champs的概念证明 一种新的算法，消除了传统上与脉冲传输时间相关的重复校准的需要 基于(PTT)的系统。Champs逐拍BP估计可以直接使用，也可以通过任意方式求平均 间隔(例如，模仿传统的ABPM)。在I期，Champs收缩压、舒张压和平均动脉压 将比较休息、不同姿势和手臂抬高以及跑步机锻炼时的估计值。 直接通过使用专门设计的临床实验室系统获得的标准血压测量 在心脏应激和运动试验中的应用。Champs BP估计值与标准的比较 每个参与者将在两个50分钟的测试期内获得测量结果，测试间隔为24小时至 证明CHAMPS无需重新校准即可提供准确的BP估计的能力。冠军将全力以赴 需要一种符合人体工程学的、准确、可靠和低成本的cABPM，用于医疗保健和临床研究。 _

Summary/Abstract Hypertension is a leading cause of excess cardiovascular morbidity and mortality, and remains a signi cant national problem, with approximately one third of all adults having high blood pressure (BP). BP monitoring has high diagnostic and prognostic value as an important marker of cardiovascular disease. Static BP snapshots, which are typically obtained via sphygmomanometry during doctor's-oce visits, have documented reliability issues, the causes of which include \white-coat" hypertension and poor technique. As a result, electronic oscillometric devices that are worn on the upper arm and are designed for self blood pressure measurement (SBPM) have seen widespread adoption; however, these devices also su er from poor reliability as measurements are seldom performed according to the speci ed guidelines (e.g., measurements taken with the patient seated, arm cu maintained at heart level, arm cu kept stationary, and no talking or leg crossing). Auscultatory or oscillometric cu -based ambulatory BP monitors (ABPMs) that can be worn in home settings and provide regular automated measurements over 24 h periods|and, most importantly, during sleep|have become the clinical standard, reportedly providing more accurate and reliable results. However, these devices still require the patient to follow the same guidelines as SBPMs, yield intermittent measurements only (e.g., every 15-30 min during the day, every 30-60 min at night), and are found by many patients to be obtrusive and uncomfortable. The proposed Cardiovascular Hemodynamics Processing System (CHAMPS ) will be a reliable, easy-to-use, and comfortable (i.e., non-cu -based) continuous (i.e., beat-to-beat) ambulatory BP monitor (cABPM) that can operate around the clock, even during activities of daily living (ADL). This new class of BP monitor will be an important addition to clinical practice, accurately and unobtrusively assessing individuals with established or suspected hypertension, even during movement and without uncomfortable cu in ations. CHAMPS provides accurate BP estimates without restricting users' mobility, body postures, or arm elevations. In the proposed SBIR Phase I e ort, Barron Associates seeks to demonstrate proof-of-concept for CHAMPS via rigorous evaluation of a new algorithm that obviates the need for repeated calibrations traditionally associated with pulse transit time (PTT)-based systems. CHAMPS beat-to-beat BP estimates may be used directly or averaged over arbitrary intervals (e.g., to mimic conventional ABPMs). In Phase I, CHAMPS systolic, diastolic, and mean arterial BP estimates obtained during rest, di erent postures and arm elevations, and treadmill exercise will be compared directly with criterion BP measurements obtained using a clinical laboratory system speci cally designed for application in cardiac stress and exercise testing. Comparisons between CHAMPS BP estimates and criterion measurements will be obtained in each participant during two 50-min test periods separated by 24-h to demonstrate the ability of CHAMPS to provide accurate BP estimates without recalibration. CHAMPS will ful ll the need for an ergonomic, accurate, reliable, and low-cost cABPM for use in healthcare and clinical research. _