基於多尺度、數值、形態學應用於心搏率與混雜因素之估算血壓量測系統

1. 基於多尺度、數值、形態學應用於心搏率與混雜因素之估算血壓量測系統基於多尺度、數值、形態學應用於心搏率與混雜因素之估算血壓量測系統 Multiscale mathematics morphology applied to heart rate and blood pressure estimates confounding measurement system Adviser: Huang Ji-Jer Presenter:SyuHao-Yi Date:2013/10/02

2. OUTLINE • Introduction • Brief introduction • ECG, PPG background and principles • Research on motivation and purpose • Paper Review • Materials and Methods • PPG sensor • Analog circuits • Digital filtering • Digital Circuits • GUI • Regression analysis and estimation of blood pressure

3. OUTLINE • Results and Discussion • Analog circuit analysis and measurement • Digital filtering assessment and actual measurements • Digital filtering results built on firmware • Auto gain control experiment • Single and multiple regression analysis • Conclusions and Future Work

4. INTRODUCTION • 1.INTRODUCTION • Brief introduction • Health promotion and fertility decline in developing countries faced the problem of an aging population

5. INTRODUCTION • 1.INTRODUCTION • Brief introduction • An international reach 7% of the population aged 65 is an aging , 14% called for aged, 20% called for super-aged 出處:行政院經濟建設委員會人力規劃處101年7月23日

6. INTRODUCTION • 1.INTRODUCTION • Brief introduction • Growing population, chronic diseases and functional disorders are increasing, except for medical services ,the home care services have been our needs

7. INTRODUCTION • 1.INTRODUCTION • ECG, PPG background and principles • The source of the human heart beat is an electrical pulse generated by a cluster of cells within the heart called the sinoatrial (SA) node Photo Source : TEXAS INSTRUMENTS -EKG-Based Heart-Rate Monitor Implementation on the LaunchPad Using MSP430G2xx

8. INTRODUCTION • 1.INTRODUCTION • ECG, PPG background and principles • The electrocardiogram (ECG) or elektrokardiogramm (EKG) is a medical standard for testing the human heart for defects and diseases • The typical amplitude of the R wave component of the ECG signal is approximately 1 mV Photo Source : TEXAS INSTRUMENTS -EKG-Based Heart-Rate Monitor Implementation on the LaunchPad Using MSP430G2xx

9. INTRODUCTION • 1.INTRODUCTION • ECG, PPG background and principles • A photoplethysmograph (PPG) the use of light source to measure the blood volume change of the blood vessel • Each ECG signal cycle corresponds to a PPG signal Photo Source : Biocom technologies

10. INTRODUCTION • 1.INTRODUCTION • ECG, PPG background and principles • PPG is often using a pulse oximeter which illuminates the skin and measures changes in light absorption Photo Source :Heart-Rate Monitoring Control System Using Photoplethysmography (PPG) by Wesley Nguyen and Ryan Horjus

11. INTRODUCTION • 1.INTRODUCTION • ECG, PPG background and principles • The change in volume caused by the pressure pulse is detected by illuminating the skin with the light from a Light Emitting Diode (LED) and then measuring the amount of light either transmitted or reflected to a photodiode Photo Source : Photoplethysmography (PPG) system by Geert Langereis Heart-Rate Monitoring Control System Using Photoplethysmography (PPG) by Wesley Nguyen and Ryan Horjus

12. 1.INTRODUCTION • Research on motivation and purpose • Capture ECG PPG signal characteristics of the systolic and diastolic blood pressure Using 3M filter and analysis of systolic and diastolic blood contains Obtain ECG to be Removed Baseline Wander Using IIR Filter The Circuits of Amp. Gain Offset and ADC • ECG • PPG • Pressure

13. 2.PAPER REVIEW PAPER REVIEW1 • Effect of confounding factors on blood pressure estimation using pulse arrival time • This article has been downloaded from IOPscience. Please scroll down to see the full text article. 2008 Physiol. Meas. 29 615 (http://iopscience.iop.org/0967-3334/29/5/007) Jung Soo Kim, KoKeun Kim, Hyun Jae Baek and KwangSuk Park

14. 2.PAPER REVIEW • Enhancing the estimation of blood pressure using pulse arrival time and two confounding factors • This article has been downloaded from IOPscience. Please scroll down to see the full text article.2010 Physiol. Meas. 31 145 (http://iopscience.iop.org/0967-3334/31/2/002) Hyun Jae Baek, Ko Keun Kim, Jung Soo Kim, Boreom Lee and KwangSuk Park

15. 2.PAPER REVIEW • Methods • Selected parameters for BP estimation using multiple-regression analysis were heart rate, pulse arrival time and arterial stiffness index (TDB)

16. 2.PAPER REVIEW Correlation coefficients of SBP and DBP with the HR or RR interval. HR shows aslightly higher correlation with both SBP and DBP than with the RR interval.

17. 2.PAPER REVIEW • Results • Experiments for parameter selection and evaluation of the results were performed using ten male subjects with an average age of 28 years (25–32 years) Correlation between BP and BP estimating parameters for patient A

18. 2.PAPER REVIEW • Results (BP = a + b∗PAT + c∗HR + d∗TDB) (BP = a + b∗PAT + c∗HR + d∗TDB)

19. 2.PAPER REVIEW • Methods • Clinical data from dental anesthesia • Data from unconstrained biological signal measurement systems • Application on a toilet seat • Application in a vehicle • Application at a computer

20. 2.PAPER REVIEW • Results

21. 2.PAPER REVIEW2 PAPER REVIEW2 2.PAPER REVIEW • Results

22. 2.PAPER REVIEW 2.PAPER REVIEW2 • Results Performance enhancement for BP estimation by inclusion of confounding factors in clinical data under dental anesthesia. Performance enhancement for BP estimation by inclusion of confounding factors in the unconstrained data.

23. 3.Materials and Methods • PPG sensor • Reflective Optical Sensor with Transistor Output • The CNY70 is a reflective sensor that includes an infrared emitter and phototransistor in a leaded package which blocks visible light. • Detector type: phototransistor • • Dimensions (L x W x H in mm): 7 x 7 x 6 • • Peak operating distance: < 0.5 mm • Typical output current under test: IC = 1 mA • • Emitter wavelength: 950 nm • • Daylight blocking filter

24. 3.Materials and Methods • Analog circuits • ECG PPG block diagram of the measurement circuit Gain/Offset MCU( 12bits ADC) Notch Filter Ins-Amp HP Filter LP Filter AGC ECG block diagram GUI MCU( 12bits ADC) PPG Signal Gain /Offset GUI LP Filter PPG block diagram

25. 3.Materials and Methods • Analog circuits • Auto Gain Control Block Diagram G0 G1 G2 G3 G4 G5 G6 G7 A0 A1 A2 A3 A4 A5 A6 A7 74HC374 AGC Analog Signal G2 G1 G0 G3 G6 G5 G4 G7 4051 Offset 4051 Gain MSP430 DSP

26. 3.Materials and Methods G2 G1 G0 G3 4051 Rm 0 1 2 3 4 5 6 7 ………… Vf OP R47 OP R47 Voffset Vin Differential Amplifier Offset circuit Schematic diagram

27. Auto Gain Control(AGC)

28. 3.Materials and Methods G6 G5 G4 G7 4051 Rg 0 1 2 3 4 5 6 7 ………… OP Output OP Voffset inverting amplifier inverting amplifier Gain circuit Schematic diagram

29. 3.Materials and Methods

30. 3.Materials and Methods • Digital filtering • Type Cascade form and Direct form Butterworth design a five order low-pass filter five order high-pass filter and notch filter • High-pass cut-off frequency (fc) of 0.5Hz to eliminate baseline drift • 60Hz stop-band filter (Notch) to filter out noise in utility power

31. 3.Materials and Methods • Digital filtering • Filter system transfer function

32. 3.Materials and Methods • Digital filtering • Direct form structure diagram

33. 3.Materials and Methods • Digital filtering • Cascade form • Signal processing sub-process calculates its output into the relationship

34. 3.Materials and Methods • Digital filtering • Cascade form structure diagram

35. 3.Materials and Methods • Digital filtering • Multi-scale Mathematical Morphology (3M filter), based on set operations, provides a way to analyze signals using nonlinear signal processing operators that incorporate the geometry information of the signal

36. 3.Materials and Methods • Digital filtering • The shape information of the signal is extracted by using a structure element to operate on the signal, such operators serve two purposes, i.e. extracting the useful signal and removing the artifacts

37. 3.Materials and Methods • Digital filtering • 3M Filter related equations

38. 3.Materials and Methods • Digital filtering • In this stage, the 3M filter used to eliminate baseline drift and reduce interference noises (motion artifacts, muscle contraction)

39. 3.Materials and Methods • Digital Circuits • BP estimates System Architecture MSP430F5438A Physiological signal GUI、 Analysis A/D 12bit DSP UART AGC AGC DSP

40. 3.Materials and Methods • Digital Circuits • Firmware Flowchart

41. 3.Materials and Methods • GUI • National Instruments/LabWindow CVI 9.0

42. 3.Materials and Methods • Regression analysis and estimation of blood pressure • By the measuring system via the electrode captured ECG waveform, and LED and light sensor captured PPG waveform, the waveform conducted over two zero point and peak detection, could be obtained for HR, Pulse arrival time-PAT and TDB three different time parameters. Then the standard blood pressure measurements were obtained with systolic and diastolic blood pressure, as shown conducting analysis

43. 3.Materials and Methods • Regression analysis and estimation of blood pressure • ECG waveform and LED and light sensor PPG waveforms captured

44. 4.Results and Discussion • Analog circuit analysis and measurement • ECG Second-order high-pass circuit

45. 3.Materials and Methods • Analog circuits • PSpice circuit simulation frequency response

46. 4.Results and Discussion • Analog circuit analysis and measurement • ECG Actual measuring high-pass circuit Bode

47. 4.Results and Discussion • Analog circuit analysis and measurement • ECG Second-order low-pass circuit

48. 3.Materials and Methods • Analog circuits • PSpice circuit simulation frequency response

49. 4.Results and Discussion • Analog circuit analysis and measurement • ECG Actual measuring low-pass circuit Bode

50. 4.Results and Discussion • Analog circuit analysis and measurement • ECG Notch filter circuit