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）是评估心脏泵功能的良好定量指数。为了广泛促进EMAX的临床应用，必须需要一种新的方法来获得无高侵入性测量的EMAX。这项研究的目的是开发一种临床方法，用于估计emax低进入的情况，而无需对参数优化方法（POM）和作者提出的线性弹性方法（LEM）进行任何心脏负载。由于POM和LEM需要左心压（LVP）和主动脉流（AOF），因此我们还开发了一种技术来估计这些信号。首先，我们开发的系统可以根据两种ARX估算LVP（自回归外抗）模型：从径向动脉压（RDP）到主动脉压（AOP）和从AOP到LVP的系统模型；在心脏导管测试中，可以使用LVP，AOP和RDP来识别这些ARX模型。 LVP和AOP是侵入性测量值，但RDP是通过Tonometrics压力传感器无创测量的。一旦确定了这些模型，即使在先前的心脏导管测试之后，也可以通过使用RDP完全无创地估计LVP。总系统已在个人计算机单元中完成，以便使用RDP的离线数据和主动脉流量的多普勒图像估算EMAX。输入模块已添加到系统中，以将系统应用于实际临床用途。

项目成果

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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。

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。

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。

A.Tanaka: "In Vivo Test of Pressure Head and Flow Rate Estimation in a Continuous-Flow Artificial Heart"Artificial Organs. (in press).

A.Tanaka：“连续流动人工心脏中压头和流速估计的体内测试”人工器官。

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