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Publication Number
US-11324405-B2
Publication Date
2022-05-10
Expiration Date
Abstract
Method and systems provide for reliable, convenient, and cost-effective personalized assessment of hemodynamic status in the ambulatory heart failure patient. The method and apparatus use pulse contour analysis of data obtained through observation of the patient for determination of hemodynamic status, and for determination of day-to-day changes in hemodynamic status. Observational assessment of the patient includes monitoring during activities of daily living including sleeping, sitting and standing. These activities create changes in venous return that are used to evaluate cardiac function or changes in cardiac function. The method and system infer body position by using position and motion information obtained by the system. Changes in cardiac function over time or due to changes in body pose are evaluated for the assessment of hemodynamic status, with a focus on changes resulting from fluid overload.
Core Innovation
The invention relates to noninvasive ambulatory heart failure and hemodynamic monitoring that infers volume status from wearable pulse contour analysis. It measures a first pulse contour and a second pulse contour from different cardiac cycles and derives left ventricular output metrics from temporal relationships between features within each pulse contour.
The approach determines a measure of variation between the left ventricular output metrics and assesses volume status from that variation. The monitoring is positioned as assessing positional cardiac-function variability as an indicator of congestion or fluid overload, and it observes hemodynamic changes associated with body-position or pose changes during activities of daily living, including sleep, sitting, and standing.
The system includes multiple configurations for ambulatory use, including wearable devices such as a watch, ring, and waist belt, and it also mentions vision-based body position sensing. Optional communication to clinicians is described as enabling proactive management intended to avoid hospital admissions, and the document further discusses deriving metrics such as LVET and LVETI from the pulse contour and tracking their changes.
Claims Coverage
The document includes two independent claims that cover both a method and an apparatus. Each independent claim relies on measuring first and second pulse contours from different cardiac cycles using a noninvasive wearable sensor, deriving left ventricular output metrics from temporal relationships within each pulse contour, determining a measure of variation between the metrics, and assessing volume status from that variation.
Assessing volume status from variation in pulse-derived left ventricular output metrics
Measuring a first pulse contour and a second pulse contour from different cardiac cycles using a noninvasive wearable sensor; determining a first metric of left ventricular output from the first pulse contour and a second metric of left ventricular output from the second pulse contour based on temporal relationships between features within each pulse contour; determining a measure of variation between the first and second metrics; assessing volume status from the measure of variation.
Volume status assessment apparatus using pulse contour variation between cardiac cycles
Providing an apparatus with a noninvasive sensor configured to measure a pulse contour, and a measurement control system configured to measure a first pulse contour and a second pulse contour from different cardiac cycles; providing an analysis system configured to determine a first metric of left ventricular output from the first pulse contour and a second metric of left ventricular output from the second pulse contour based on temporal relationships between features within each pulse contour; determining a measure of variation between the first metric and the second metric; assessing volume status from the measure of variation.
Across the independent claims, the core coverage is the use of noninvasive wearable pulse contour measurements from different cardiac cycles to compute temporal-feature-based left ventricular output metrics, followed by assessing volume status from variation between the two metrics.
Stated Advantages
Personalize cardiac function assessment using wearable PPG pulse contour analysis.
Quantify day-to-day or time-dependent hemodynamic congestion and fluid overload from inferred volume status.
Provide robustness over days for detecting positional and time-dependent changes.
Enable proactive management intended to avoid hospital admissions.
Documented Applications
Observational monitoring during activities of daily living, including sleep, sitting, and standing.
Monitoring and quantifying positional and time-dependent hemodynamic congestion as an indicator of congestion/fluid overload.
Ambulatory heart failure/hemodynamic status monitoring using wearable sensor configurations and optional clinician communication to support proactive management intended to avoid hospital admissions.
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