Potential for health screening using long-term cardiovascular parameters measured by finger volume-oscillometry: pilot comparative evaluation in regular and sleep-deprived activities.

We explored the potential of health screening based on the long-term measurement of cardiovascular parameters using the finger volume-oscillometric technique. An automated instrument made simultaneous measurements of key cardiovascular parameters, including blood pressure, pulse pressure, heart rate, normalized pulse volume as an index of α-adrenalin-mediated sympathetic activity, and finger arterial elasticity. These were derived from finger photo-plethysmographic signals during application of cuff pressure. To assess the feasibility of achieving a screening function, measurements were made in ten healthy volunteers during 10 days of day-to-day living (normal condition), and carried out several times at a fixed time every day. During successive 10-day measurements, a 30-hour period of total sleep deprivation was introduced as a physiological challenge (abnormal condition). A linear discriminant analysis of the data was conducted to determine whether these two conditions could be discriminated. Periodic data collection was performed rapidly and easily, and the %-correct classifications of normal and abnormal conditions were 78.2% and 77.5%, respectively. This ability of the method to discriminate between regular and sleep-deprived activities demonstrates its potential for healthcare screening during day-to-day living. Further investigations using larger age and gender groups of subjects including patients with cardiovascular diseases under real-life situations are required.

A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation.

Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.

[Development of a handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method].

A handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method is developed. In this system, the inconvenient and discomfort due to cuff occlusion of the biological segment for BP measurement is improved by developing a new device using a local pressurization method, the stability for the physiological information detection is improved by developing a new detecting system, and the noise during detection using the system is greatly reduced by using a newly developed nozzle-flapper type electro-pneumatic converter. Also, for electrical admittance cardiography to estimate CO, the applicability of a two-compartment coaxial cylindrical model and the optimal position of a spot-electrode array that is used to replace the conventional band-electrode are discussed in this research. Experimental result shows that the monitoring system should satisfy non-invasive BP and CO measurement on beat by beat, and the comfort of measurement is significantly improved.

Experimental and numerical study on optimal spot-electrodes arrays in transthoracic electrical impedance cardiography.

Transthoracic electrical impedance (or admittance) cardiography is a simple technique for the non-invasive and continuous monitoring of stroke volume or cardiac output by detecting the electrical impedance of a thorax which is roughly assumed to be a two-compartment coaxial cylindrical model composed of the aorta and its surrounding thoracic tissues. A tetra-polar band-electrodes method by Kubicek et al. has been widely used for the detection of the electrical impedance. However, this band-electrodes attachment makes a subject troublesome. Replacement of the band- to a spot-electrodes array is therefore highly required for practical use. In our previous reports, we have confirmed that a thorax is nearly assumed as an electrical cylinder model when a pair of current injection spot-electrodes are placed far from the thorax like a placement of the forehead - left medial knee or the mastoid process - lower right abdomen, and that the changes in current distributions associated with cardiac blood ejection are roughly homogeneous around the medial line of the thorax. The present study concerns with determination of an optimal spot-electrodes array for voltage pick-up through the detailed measurements of pulsatile components of the thoracic impedance along the medial line of the thorax using an 11x2 channels impedance mapping system. Additionally, we have investigated the influence of blood volume change in the heart itself by a finite element method.

Assessment of slow-breathing relaxation technique in acute stressful tasks using a multipurpose non-invasive beat-by-beat cardiovascular monitoring system.

Recently, several studies revealed that daily slow-breathing exercise lowered blood pressure and increased baroreflex sensitivity. With this interesting finding, we have been contemplating to design a compact breath-controllable device for relaxation to stress reaction during daily living for home as well as ambulatory use, as a final goal, towards reduction of cognitive hemodynamic disorders, hypertension, and acute stress-induced hemodynamic disorders. The present study thereby describes, as a first step, to design a prototype system combining a compact multipurpose non-invasive beat-by-beat cardiovascular monitor developed previously with a wrist-type vibrator to make a respiration rhythm, and to assess an effect of slow-breathing relaxation on the cardiovascular hemodynamics in response to acute stressful conditions. The cardiovascular hemodynamic monitor can measure beat-by-beat systolic (SBP), mean (MBP) and diastolic (DBP) pressure in a finger based on the volume-compensation method, cardiac output (CO) by the electrical admittance method and the other hemodynamic-related parameters (e.g., total peripheral resistance (TPR=MBP/CO), heart rate (HR), respiratory rate, pulse wave velocity, etc.). The wrist-type vibrator can give various breathing rhythms quietly to a subject using a small vibration motor. The stressful tasks loaded to healthy volunteers (3 males, 23-34 yrs.) in the experiments were cold pressor and arithmetic ones as a representative of daily passive and active coping tasks, respectively, under conditions with (respiratory rate of 6 1/min) and without breath control.. The results showed that the slow-breathing technique could have a significant effect on improvement of the hemodynamic changes following the acute stressful tasks, especially in the passive coping task.

An optimal spot-electrodes array for electrical impedance cardiography through determination of impedance mapping of a regional area along the medial line on the thorax.

Electrical impedance or admittance cardiography is a simple method for non-invasive, continuous measurement the stroke volume and cardiac output. For the electrical impedance cardiography, the band-electrodes array proposed by Kubicek et al has been widely used, and various spot-electrodes array have been experimented in search of a less uncomfortable and equally reliable electrodes array that is easier to attach. From the uniformity of current distribution on the thorax, we have reinvestigated focusing on the measurement of contour maps of static and pulsatile components of a regional area along the medial line on the frontal part of the thorax. Consequently, the appropriate electrodes locations for current injection were determined as the back of an ear and on the lower abdomen, while those for voltage pick-up was on the medial portion at the level of clavicle and on the portion above the xiphisternum. Preliminary comparison experiments between the cardiac output values obtained by the electrical impedance cardiography and by a pulse dye-densitometry showed a fairy good agreement.

Assessment of stress-induced hemodynamic responses using multipurpose non-invasive continuous cardiovascular monitoring system.

In order to develop a simple and reliable assessment method of the stress induced psychosomatic and hemodynamic responses against various stress situations, especially for evaluating of the effectiveness of stress reduction methods, a multipurpose non-invasive continuous cardiovascular monitoring system was developed. The monitoring system could measure beat-by-beat finger blood pressure (SBP, MBP, DBP based on the volume-compensation method), cardiac output (CO, electrical admittance method), total peripheral resistance (TPR=MBP/CO), and the other hemodynamic related parameters (e.g. RR-interval, respiratory rate, pulse wave velocity, etc.). As controlled stress conditions, the human subjects would be exposed to the various stresses such as flash video display, electrical stimulation and so on. In this study, after 5 minutes resting, the stress induced hemodynamic responses were measured during 10-min presentation of floating vertical stripes image using 5 healthy subjects. The image presentation was discontinued when the subject gave his/her self-assessment due to considerable discomfort. The results showed that although BP increased during the presentation in all the subjects, there observed two types of cardiovascular responses; one is a type of increase in CO (or of almost unchanging or decrease in TRP), and the other of increase in TPR. These results strongly suggested that the detection of the change in TPR might be an important factor for the evaluation of stress conditions. Further investigations would be required for the reasons why these two types were observed in the same stressful condition.