Non-invasive biosensors to detect cardiovascular changes in heart failure

 描述(申请人提供)：心力衰竭(HF)是当今社会面临的最大挑战之一，每年夺走数十万美国人的生命，每年花费超过300亿美元的医疗保险。这项研究的最终目标是创建一种不引人注目的可穿戴系统，用于在自然环境中持续监测心力衰竭患者，自动评估他们经历恶化的风险，并向照顾者和患者本身提供反馈。支持这些努力的中心创新是拟议的对日常生活中经历的压力源(例如，行走、爬楼梯)的血液动力学反应的测量。这种血流动力学反应的测量将通过可穿戴式心肺功能图(BCG)实现。这项研究提出了以下四个具体目标：(1)阐明可穿戴式心搏图(BCG)信号产生的潜在机制；(2)开发新的预测分析算法，用于在家中测量心力衰竭患者的BCG信号；(3)设计和实现可穿戴式传感系统，用于估计心输出量(CO)、血压(BP)和来自流动受试者的间接量热；(4)在心肺负荷测试期间对健康和心力衰竭患者评估可穿戴式传感系统，并在家中为少数患者试验新系统。第一个目标将为更好地理解可穿戴BCG信号-一种测量身体振动对心跳的响应-奠定坚实的基础，并将为传感器的位置和模式提供信息，以优化感知。此外，对这款可穿戴原型的评估将包括可用性测试，以评估对实际挑战(例如运动伪影、设备摩擦衣服)的舒适性和健壮性，并将根据结果对设计进行改进和改进。虽然我们预计可穿戴设备将提供最佳解决方案，但通过更成熟的、现有的基于规模的系统，项目风险得到了缓解。这个项目的成功完成最终可以减少与心力衰竭相关的住院率，从而既提高美国老年人的生活质量，又降低整体医疗成本。

 DESCRIPTION (provided by applicant): Heart failure (HF) is one of the most major challenges faced by society today, claiming hundreds of thousands of American lives each year and costing more than 30 billion Medicare dollars annually. The ultimate goal of this research is to create an unobtrusive wearable system for continuously monitoring HF patients in naturalistic settings, automatically assessing their risk of experiencing an exacerbation, and providing feedback to caregivers and the patients themselves. The central innovation that will support these efforts is the proposed measurement of hemodynamic responses to stressors experienced in normal activities of daily living (e.g., walking, climbing stairs). The measurement of such hemodynamic responses will be enabled by wearable ballistocardiography (BCG). The following four specific aims are proposed for the research: (1) to elucidate the underlying mechanisms involved in the genesis of wearable ballistocardiogram (BCG) signals; (2) to develop novel predictive analytics algorithms for BCG signals measured from HF patients at home; (3) to design and implement a wearable sensing system for estimating cardiac output (CO), blood pressure (BP), and indirect calorimetry from ambulant subjects; and (4) to evaluate the wearable sensing system with healthy and HF patients during cardiopulmonary stress testing, and to pilot the new system at home for a small population of patients. The first aim will build a strong foundation for better understanding the wearable BCG signal - a measurement of body vibrations in response to the heartbeat - and will inform the placement and modality of the sensor for optimizing the sensing. Furthermore, the evaluation of this wearable prototype will include usability testing to assess comfort and robustness to practical challenges (e.g., motion artifacts, the device rubbing on clothing), and based on the results the design will be refined and improved. While we anticipate that the wearable will provide the best solution, the project risk is mitigated through the more mature, existing scale- based system. Successful completion of this project could ultimately reduce HF related hospitalizations, and thus both improve quality of life for elderly Americans, and reduce overall healthcare costs.