CN118490976B - Cardiac output estimation method and device based on right ventricular catheter pump - Google Patents
Cardiac output estimation method and device based on right ventricular catheter pump Download PDFInfo
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- 230000002861 ventricular Effects 0.000 title claims abstract description 92
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- 230000008878 coupling Effects 0.000 claims description 48
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- 230000036772 blood pressure Effects 0.000 claims description 39
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- 238000004364 calculation method Methods 0.000 claims description 7
- 238000003062 neural network model Methods 0.000 claims description 6
- 239000008280 blood Substances 0.000 description 22
- 210000004369 blood Anatomy 0.000 description 22
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- 210000001147 pulmonary artery Anatomy 0.000 description 11
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- 230000035487 diastolic blood pressure Effects 0.000 description 4
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- 230000035488 systolic blood pressure Effects 0.000 description 4
- 230000009471 action Effects 0.000 description 3
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- 210000005241 right ventricle Anatomy 0.000 description 3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/13—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
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- A—HUMAN NECESSITIES
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
- A61M60/523—Regulation using real-time patient data using blood flow data, e.g. from blood flow transducers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
- A61M60/531—Regulation using real-time patient data using blood pressure data, e.g. from blood pressure sensors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/70—General characteristics of the apparatus with testing or calibration facilities
- A61M2205/702—General characteristics of the apparatus with testing or calibration facilities automatically during use
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Abstract
The embodiment of the application provides a cardiac output estimation method and device based on a right ventricular catheter pump, and relates to the technical field of medical equipment, wherein the method comprises the following steps: determining a target pressure signal of a current cardiac cycle of a target area where a bleeding port of the right ventricular catheter pump is located, and obtaining a current heart rate of a target heart; estimating the cardiac output of the coupled system based on the target pressure signal and the current heart rate as a baseline cardiac output; obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of a target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of a target region; based on the target state parameter, a deviation amount of the reference cardiac output is calculated, the reference cardiac output is adjusted according to the deviation amount, and the adjusted reference cardiac output is determined as an actual cardiac output of the coupled system. By applying the scheme provided by the embodiment, accurate estimation of cardiac output can be realized.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to a cardiac output estimation method and device based on a right ventricular catheter pump.
Background
A right ventricular catheter pump is a device that provides support or auxiliary function for a right heart failure patient, for assisting the heart in pumping blood.
After implantation of the right ventricular catheter pump, the heart pumps blood in parallel with the right ventricular catheter pump, and cardiac output refers to the overall pumped blood flow of the coupling system to which the heart and right ventricular catheter pump are coupled. The cardiac output can be used for accurately evaluating the current cardiac performance and timely adjusting the operation parameters of the right ventricular catheter pump. Based on this, a cardiac output estimation scheme is needed.
Disclosure of Invention
The embodiment of the application aims to provide a cardiac output estimation method and device based on a right ventricular catheter pump, so as to accurately estimate cardiac output. The specific technical scheme is as follows:
In a first aspect, an embodiment of the present application provides a method for estimating cardiac output based on a right ventricular catheter pump, the method comprising:
Determining a target pressure signal of a current cardiac cycle of a target area where a bleeding port of a right ventricular catheter pump is located, and obtaining a current heart rate of a target heart, wherein the target heart is a heart implanted by the right ventricular catheter pump;
Estimating the cardiac output of a coupling system as a reference cardiac output based on the target pressure signal and the current heart rate, wherein the coupling system is a system in which the right ventricular catheter pump is coupled with a target heart;
Obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of the target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of the target region based on a fitting result;
calculating a deviation amount of a reference cardiac output based on the target state parameter, adjusting the reference cardiac output according to the deviation amount, and determining the adjusted reference cardiac output as an actual cardiac output of the coupling system.
In one embodiment of the present application, the calculating the deviation amount of the reference cardiac output based on the target state parameter includes:
obtaining a static parameter representing inherent characteristics of a blood vessel, and calculating a target elastic parameter representing the elastic performance of the blood vessel of a target region based on the static parameter and the duration of a current cardiac cycle;
An amount of deviation of the reference cardiac output is determined based on the target state parameter and a target elastic parameter.
In one embodiment of the present application, estimating the cardiac output of the coupling system based on the target pressure signal and the current heart rate includes:
Determining a first pressure signal and a second pressure signal in the target pressure signal based on signal feature points of the target pressure signal, wherein the first pressure signal represents a blood pressure signal of a systolic phase in the current cardiac cycle, and the second pressure signal represents a blood pressure signal of a diastolic phase in the current cardiac cycle;
Calculating a change characteristic value representing the change condition of the signal amplitude between the first pressure signal and the second pressure signal;
And determining the cardiac output of the change characteristic value corresponding to the current heart rate as the cardiac output of the coupling system.
In one embodiment of the present application, the fitting the current and the signal characteristic value, and determining the target state parameter characterizing the vascular response state of the target area based on the fitting result, includes:
Inputting the signal characteristic value and the current into a pre-trained state parameter prediction model to obtain parameters output by the state parameter prediction model, wherein the parameters are used as target state parameters for representing the vascular response state of the target region;
Wherein, the state parameter prediction model is: the method comprises the steps of taking a sample blood pressure signal characteristic value and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model to obtain a model for estimating the blood vessel response state parameters, wherein the sample blood pressure signal characteristic value is a characteristic value of a blood pressure signal of a preset cardiac cycle of the sample area, and the sample current is a current value of the preset cardiac cycle of the sample right ventricular catheter pump.
In a second aspect, an embodiment of the present application provides a cardiac output estimation device based on a right ventricular catheter pump, the device comprising:
The information acquisition module is used for determining a target pressure signal of a current cardiac cycle of a target area where a bleeding port of the right ventricular catheter pump is located and acquiring a current heart rate of a target heart, wherein the target heart is a heart implanted by the right ventricular catheter pump;
The reference value estimation module is used for estimating the cardiac output of a coupling system based on the target pressure signal and the current heart rate, and the coupling system is used as a reference cardiac output, wherein the coupling system is a system in which the right ventricular catheter pump is coupled with a target heart;
The parameter determining module is used for obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining the signal characteristic value of the target pressure signal, fitting the current and the signal characteristic value, and determining the target state parameter representing the vascular response state of the target region based on the fitting result;
And the cardiac output estimation module is used for calculating the deviation amount of the reference cardiac output based on the target state parameter, adjusting the reference cardiac output according to the deviation amount, and determining the adjusted reference cardiac output as the actual cardiac output of the coupling system.
In one embodiment of the present application, the cardiac output estimation module includes:
a parameter calculation sub-module, configured to obtain a static parameter that characterizes an intrinsic property of a blood vessel, and calculate a target elastic parameter that characterizes an elastic property of the blood vessel of the target region based on the static parameter and a duration of a current cardiac cycle;
a deviation determination sub-module for determining a deviation amount of the reference cardiac output based on the target state parameter and a target elastic parameter.
In one embodiment of the present application, the reference value estimation module includes:
A signal determination submodule, configured to determine a first pressure signal and a second pressure signal in the target pressure signal based on signal feature points of the target pressure signal, where the first pressure signal represents a blood pressure signal of a systolic phase in the current cardiac cycle, and the second pressure signal represents a blood pressure signal of a diastolic phase in the current cardiac cycle;
the characteristic calculation sub-module is used for calculating a change characteristic value representing the change condition of the signal amplitude between the first pressure signal and the second pressure signal;
and the reference value estimation sub-module is used for determining the cardiac output quantity of the change characteristic value corresponding to the current heart rate as the cardiac output quantity of the coupling system.
In one embodiment of the present application, the parameter determining module is specifically configured to input a signal characteristic value and a current into a pre-trained state parameter prediction model, to obtain a parameter output by the state parameter prediction model, as a target state parameter representing a vascular response state of the target region; wherein, the state parameter prediction model is: the method comprises the steps of taking a sample blood pressure signal characteristic value and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model to obtain a model for estimating the blood vessel response state parameters, wherein the sample blood pressure signal characteristic value is a characteristic value of a blood pressure signal of a preset cardiac cycle of the sample area, and the sample current is a current value of the preset cardiac cycle of the sample right ventricular catheter pump.
In a third aspect, an embodiment of the present application provides a controller, including a processor, a communication interface, a memory, and a communication bus, where the processor, the communication interface, and the memory complete communication with each other through the communication bus;
a memory for storing a computer program;
And a processor, configured to implement the method steps described in the first aspect when executing the program stored in the memory.
In a fourth aspect, embodiments of the present application provide a computer-readable storage medium having stored therein a computer program which, when executed by a processor, implements the method steps of the first aspect described above.
From the above, it can be seen that, by applying the scheme provided by the embodiment of the present application, on one hand, the reference cardiac output is obtained based on the target pressure signal and the current heart rate estimation, and the pumping blood flow of the coupling system has an association relationship with the pressure and the heart rate of the target area; on the other hand, since the state parameter based on the vascular response state is used to calculate the deviation amount of the reference cardiac output, and just because the vascular dynamic response state affects the pumping blood flow of the coupling system, the deviation amount of the reference cardiac output can be accurately calculated by using the state parameter; in summary, by adopting the scheme provided by the embodiment, the reference cardiac output can be accurately adjusted, so that the adjusted reference cardiac output is close to the actual cardiac output, and the accuracy of cardiac output estimation is improved.
Furthermore, the target state parameter is obtained by fitting the signal characteristic value of the current and the pressure signal of the current cardiac cycle of the right ventricular catheter pump, the current reflects the current running parameter of the right ventricular catheter pump, and the signal characteristic value reflects the current physiological condition of the target heart, so that the two angles of the running of the right ventricular catheter pump and the current physiological condition of the target heart are combined, the determined target state parameter can more accurately reflect the actual response state of the blood vessel of the target region under the current coupling system, and the accuracy of the cardiac output estimation is further improved.
Of course, it is not necessary for any one product or method of practicing the application to achieve all of the advantages set forth above at the same time.
Drawings
In order to more clearly illustrate the embodiments of the application or the technical solutions in the prior art, the drawings used in the embodiments or the description of the prior art will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the application, and other embodiments may be obtained according to these drawings to those skilled in the art.
FIG. 1 is a schematic diagram of a right ventricular catheter pump according to an embodiment of the present application;
FIG. 2 is a flow chart of a first method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application;
FIG. 3 is a flow chart of a second method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application;
FIG. 4 is a flowchart of a third method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application;
fig. 5 is a schematic structural diagram of a cardiac output estimating device based on a right ventricular catheter pump according to an embodiment of the present application.
Detailed Description
The following description of the embodiments of the present application will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present application, but not all embodiments. Based on the embodiments of the present application, all other embodiments obtained by the person skilled in the art based on the present application are included in the scope of protection of the present application.
Before the embodiment of the application is described, an application scene of the embodiment of the application is first described.
The embodiment of the application is applied to a right ventricle catheter pump system, which comprises a right ventricle catheter pump and a controller, wherein the right ventricle catheter pump is used for accelerating and pumping lower vena cava blood into pulmonary arteries, and the controller is used for detecting, controlling and the like.
The structure of the right ventricular catheter pump is shown in fig. 1, and the right ventricular catheter pump comprises a driving assembly 101, a pumping assembly 102, a blood inlet 103 and a blood outlet 104.
After the right ventricular catheter pump is implanted into the heart, the blood inlet is positioned in the inferior vena cava and the bleeding port is positioned in the pulmonary artery.
The driving component drives the pumping component to rotate at a high speed, and the blood is accelerated to be pushed from the blood inlet to the bleeding outlet until the pulmonary artery based on the high-speed rotation of the pumping component, so that the auxiliary heart blood pumping function is realized.
The following describes embodiments of the present application in detail. Referring to fig. 2, fig. 2 is a flowchart of a first method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application, where the method includes the following steps S201 to S204.
Step S201: and determining a target pressure signal of the current cardiac cycle of the target area where the right ventricular catheter pump bleeding port is located, and obtaining the current heart rate of the target heart.
The target region is a pulmonary artery region because the right ventricular catheter pump port is located at the pulmonary artery.
The target pressure signal characterizes the blood pressure condition of the current cardiac cycle of the target region, and since the target region is a pulmonary artery region, the target pressure signal may characterize a pulmonary artery pressure signal.
In the first embodiment, the target pressure signal may be stored in a memory, and the blood pressure signal of the current cardiac cycle of the target region is read from the memory as the target pressure signal when this step is performed.
When determining the target pressure signal, in a second embodiment, a pressure sensor is integrated at the blood inlet of the right ventricular catheter pump, the pressure sensor collects the pressure signal of the blood inlet region, obtains the pressure signal of the current cardiac cycle of the blood inlet region, and determines the target pressure difference corresponding to the current according to the corresponding relation between the preset current and the pressure difference, which is the pressure difference between the blood inlet region and the blood inlet region, and calculates the sum value of the target pressure difference and the pressure signal of the current cardiac cycle of the blood inlet region as the target pressure signal.
The target heart is a heart implanted by a right ventricular catheter pump. The current heart rate may be read from the memory.
Step S202: based on the target pressure signal and the current heart rate, the cardiac output of the coupled system is estimated as a baseline cardiac output.
The coupling system is a system for coupling the right ventricular catheter pump with the target heart. The reference cardiac output is understood to be the output that the coupling system can reach in the case of the current target pressure signal and the current heart rate.
In one embodiment, when estimating the reference cardiac output, a fitting relationship between the pressure signal, the heart rate and the cardiac output of a unit cardiac cycle of the bleeding port region may be pre-constructed, and according to the fitting relationship, the target pressure signal and the current heart rate are fitted, and the fitting result represents the cardiac output, so as to obtain the reference cardiac output of the coupling system.
Other ways of estimating the reference cardiac output may be found in the corresponding embodiment of fig. 5, which is not described in detail herein.
Step S203: obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of a target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of the target region based on the fitting result.
The target state parameter is parameter information for characterizing a vascular response state of the target region. The blood vessel is influenced by the complex structure and performance of the blood vessel, and the state of the vascular system in the processes of bearing blood, transporting blood and the like is a response state. The target state parameters may include response time parameters, response rate parameters, etc. of the vascular response state.
The signal characteristic value is used for reflecting signal characteristic information of the target pressure signal, for example, the signal characteristic value can be a characteristic value such as a maximum value, a pressure change rate, a pressure change amplitude and the like in the target pressure signal.
In the first embodiment, when determining the target state parameter, the fitting equation may be pre-constructed according to a preset fitting equation, where the fitting equation is used to characterize a fitting relationship between a pulmonary artery blood pressure feature value, current information and a vascular response state, and the signal feature value and the current are brought into the fitting equation to obtain a fitting result, and the state parameter of the vascular response state is obtained through the fitting result.
In the second embodiment, when determining the target state parameter, the signal characteristic value and the current signal may be input into a state parameter prediction model trained in advance, so as to obtain the parameter output by the state parameter prediction model, which is used as the target state parameter representing the vascular response state of the target region.
The state parameter prediction model is as follows: the method comprises the steps of taking a characteristic value of a sample blood pressure signal and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model, and estimating a model of the blood vessel response state parameters.
The characteristic value of the sample blood pressure signal is the characteristic value of a blood pressure signal of a preset cardiac cycle of a sample area, and the sample current is the current value of the preset cardiac cycle of the sample right ventricular catheter pump.
In the training process of adopting the plurality of training samples, the state parameter prediction model learns the fitting relation among the pulmonary artery blood pressure signal value, the current and the state parameter, so that when the model is actually applied, the current received signal characteristic value and the current can be fitted based on the learned fitting relation, and the target state parameter of the vascular response state can be predicted based on the fitting result.
Because the state parameter prediction model learns fitting relations among the characteristic values of the pulmonary artery blood pressure signals, the current information and the state parameters, the state parameter prediction model can be used for accurately predicting the target state parameters of the vascular response state.
Step S204: based on the target state parameter, a deviation amount of the reference cardiac output is calculated, the reference cardiac output is adjusted according to the deviation amount, and the adjusted reference cardiac output is determined as an actual cardiac output of the coupled system.
The target state parameter is a vascular response state representing the target area, and when the blood vessel actually conveys blood, the vascular response state is affected, so that corresponding deviation of cardiac output occurs under the conditions of target pressure and current heart rate. Therefore, the reference cardiac output is adjusted using the target state parameter, so that the adjusted reference cardiac output can be made close to the actual cardiac output.
In calculating the deviation amount, in one embodiment, the deviation amount corresponding to the target state parameter may be determined as the deviation amount of the reference cardiac output according to the correspondence between the preset state parameter and the deviation amount.
Other embodiments for calculating the deviation amounts can be found in the examples corresponding to fig. 3, which will not be described in detail herein.
In adjusting the reference cardiac output, a sum between the deviation amount and the reference cardiac output may be calculated as the adjusted reference cardiac output.
From the above, it can be seen that, by applying the solution provided in this embodiment, on one hand, the reference cardiac output is obtained based on the target pressure signal and the current heart rate estimate, and the pumped blood flow of the coupling system has a correlation with the pressure and the heart rate of the target area; on the other hand, since the state parameter based on the vascular response state is used to calculate the deviation amount of the reference cardiac output, and just because the vascular dynamic response state affects the pumping blood flow of the coupling system, the deviation amount of the reference cardiac output can be accurately calculated by using the state parameter; in summary, by adopting the scheme provided by the embodiment, the reference cardiac output can be accurately adjusted, so that the adjusted reference cardiac output is close to the actual cardiac output, and the accuracy of cardiac output estimation is improved.
Furthermore, the target state parameter is obtained by fitting the signal characteristic value of the current and the pressure signal of the current cardiac cycle of the right ventricular catheter pump, the current reflects the current running parameter of the right ventricular catheter pump, and the signal characteristic value reflects the current physiological condition of the target heart, so that the two angles of the running of the right ventricular catheter pump and the current physiological condition of the target heart are combined, the determined target state parameter can more accurately reflect the actual response state of the blood vessel of the target region under the current coupling system, and the accuracy of the cardiac output estimation is further improved.
In the foregoing embodiment corresponding to fig. 2, the calculation of the deviation amount in the mentioned manner may be performed according to the following steps S304-S305. Based on this, referring to fig. 3, fig. 3 is a flowchart of a third method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application, where the method includes the following steps S301 to S305.
Step S301: and determining a target pressure signal of the current cardiac cycle of the target area where the right ventricular catheter pump bleeding port is located, and obtaining the current heart rate of the target heart.
The target heart is a heart implanted by a right ventricular catheter pump.
Step S302: based on the target pressure signal and the current heart rate, the cardiac output of the coupled system is estimated as a baseline cardiac output.
The coupling system is a system for coupling the right ventricular catheter pump with the target heart.
Step S303: obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of a target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of the target region based on the fitting result.
The steps S301 to S303 are the same as the steps S201 to S203, and are not described herein.
Step S304: a static parameter characterizing the intrinsic properties of the blood vessel is obtained, and a target elastic parameter characterizing the elastic properties of the blood vessel of the target region is calculated based on the static parameter and the duration of the current cardiac cycle.
The above-described static parameters are used to characterize the intrinsic properties of the blood vessel, including the cross-sectional area of the blood vessel, the length of the blood vessel, the density of the blood vessel, etc. The static parameters may be detected in advance, and the static parameters stored in the memory may be read when this step is performed.
The elastic performance of the blood vessel is influenced by the inherent characteristics of the blood vessel and the duration of the current cardiac cycle, and when calculating the target elastic parameter, the target elastic parameter can be calculated according to the following expression:
；
Wherein B represents a target elastic parameter, K represents a static parameter, and T represents a current cardiac cycle duration.
Step S305: and determining the deviation amount of the reference cardiac output based on the target state parameter and the target elastic parameter, adjusting the reference cardiac output according to the deviation amount, and determining the adjusted reference cardiac output as the actual cardiac output of the coupling system.
In calculating the deviation amount, in the first embodiment, the deviation amounts corresponding to the target state parameter and the target elastic parameter may be determined as the deviation amount of the reference cardiac output.
In this embodiment, a correspondence relationship among the state parameter, the elastic parameter, and the deviation amount may be previously established, and the deviation amount corresponding to the target state parameter and the target elastic parameter may be determined as the deviation amount of the reference cardiac output according to the correspondence relationship.
In calculating the deviation amount, in the second embodiment, a target countermeasure parameter that characterizes the countermeasure performance of the blood vessel of the target region may be calculated based on the state parameter and the elasticity parameter; and determining a target elasticity parameter, a target countermeasure parameter and a target state parameter, and calculating the deviation amount of the reference cardiac output.
The target challenge parameter is used to characterize the challenge performance of the blood vessels in the target area. In the process of carrying blood by the blood vessel, the blood vessel can generate a certain resistance to the blood, and the resistance can lead to the antagonistic performance of the blood vessel.
In this embodiment, when calculating the countermeasure parameter, a ratio between the state parameter and the elastic parameter may be calculated, and the calculated ratio is determined as the target countermeasure parameter.
After the target countermeasure parameter is determined, when the deviation amount is calculated, the deviation amounts corresponding to the target elastic parameter, the target countermeasure parameter, and the target state parameter may be determined as the deviation amount of the reference cardiac output. Specifically, the correspondence between the elastic parameter, the countermeasure parameter, the state parameter, and the deviation amount may be previously constructed, and the deviation amount corresponding to the target elastic parameter, the target countermeasure parameter, and the target state parameter may be determined as the deviation amount of the reference cardiac output according to the correspondence.
As is apparent from the above, in the present embodiment, when determining the deviation amount, in addition to the target state parameter, the target elastic parameter is combined, and since the target elastic parameter is the elastic property of the blood vessel representing the target region and the elastic property of the blood vessel affects the pumping performance of the coupling system in which the heart is coupled with the right ventricular catheter pump, the deviation amount can be determined more accurately by combining the target state parameter and the target elastic parameter, thereby improving the accuracy of the cardiac output estimation.
In the above-described embodiment corresponding to fig. 2, the estimation of the reference cardiac output may be performed according to the following steps S402-S404, in addition to the estimation of the reference cardiac output in the mentioned manner. Based on this, referring to fig. 4, fig. 4 is a flowchart of a third method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application, where the method includes the following steps S401 to S406.
Step S401: and determining a target pressure signal of the current cardiac cycle of the target area where the right ventricular catheter pump bleeding port is located, and obtaining the current heart rate of the target heart.
The target heart is a heart implanted by a right ventricular catheter pump.
The step S401 is the same as the step S201, and will not be described again.
Step S402: the first pressure signal and the second pressure signal in the target pressure signal are determined based on the signal feature points of the target pressure signal.
The first pressure signal is indicative of a systolic blood pressure signal in a current cardiac cycle, and the second pressure signal is indicative of a diastolic blood pressure signal in the current cardiac cycle.
When the first pressure signal and the second pressure signal are determined, a dicrotic notch point of the target blood pressure signal can be identified, the dicrotic notch point represents a demarcation point between the systolic phase and the diastolic phase of the current cardiac cycle, the blood pressure signal between the starting time of the current cardiac cycle and the dicrotic notch point is used as the blood pressure signal of the systolic phase, namely the first pressure signal, and the blood pressure signal between the dicrotic notch point and the ending time of the current cardiac cycle is used as the blood pressure signal of the diastolic phase, namely the second pressure signal.
Step S403: a variation characteristic value representing a variation in signal amplitude between the first pressure signal and the second pressure signal is calculated.
The change characteristic value is used for reflecting the signal change condition between the first pressure signal and the second pressure signal, and the first pressure signal is a systolic blood pressure signal, the second pressure signal is a diastolic blood pressure signal, and the signal change between the first pressure signal and the second pressure signal is used for representing the blood pressure fluctuation condition between the systolic phase and the diastolic phase.
In calculating the variation characteristic value, in the first embodiment, a first signal value representing the systolic pressure in the first pressure signal may be determined, and a second signal value representing the diastolic pressure in the second pressure signal may be determined, and a difference between the first signal value and the second signal value may be calculated as the variation characteristic value.
In this embodiment, when determining the first signal value and the second signal value, the maximum pressure value in the first pressure signal may be determined as a first signal value indicative of the systolic pressure and the minimum pressure value in the second pressure signal may be determined as a second signal value indicative of the diastolic pressure.
In the second embodiment, when calculating the variation characteristic value, it is also possible to calculate the average value of the first pressure signal and the average value of the second pressure signal, and calculate the difference between the two average values as the variation characteristic value.
Step S404: and determining the cardiac output of which the change characteristic value corresponds to the current heart rate as the cardiac output of the coupling system.
When determining the cardiac output, a mapping relation between a preset change characteristic value and the cardiac output can be pre-established, and the cardiac output corresponding to the calculated change characteristic value and the current cardiac output can be determined as the cardiac output of the coupling system according to the mapping relation.
Step S405: obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of a target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of the target region based on the fitting result.
Step S406: based on the target state parameter, a deviation amount of the reference cardiac output is calculated, the reference cardiac output is adjusted according to the deviation amount, and the adjusted reference cardiac output is determined as an actual cardiac output of the coupled system.
The steps S405 to S406 are the same as the steps S203 to S204, and are not described here again.
From the above, it can be seen that, since the reference cardiac output is calculated based on the change characteristic value and the current heart rate, the change characteristic value is determined based on the change condition of the amplitude of the blood pressure signal between the systolic phase and the diastolic phase of the current cardiac cycle, and since the blood pressure signals of the systolic phase and the diastolic phase in one cardiac cycle can reflect the blood information pumped by the coupling system, the reference cardiac output can be accurately determined based on the change characteristic value and the current heart rate.
Corresponding to the method for estimating the cardiac output based on the right ventricular catheter pump, the embodiment of the application also provides a device for estimating the cardiac output based on the right ventricular catheter pump.
Referring to fig. 5, fig. 5 is a schematic structural diagram of a cardiac output estimating device based on a right ventricular catheter pump according to an embodiment of the present application, where the device includes the following 501-504:
An information obtaining module 501, configured to determine a target pressure signal of a current cardiac cycle of a target area where a bleeding port of a right ventricular catheter pump is located, and obtain a current heart rate of a target heart, where the target heart is a heart in which the right ventricular catheter pump is implanted;
A benchmark value estimating module 502, configured to estimate, based on the target pressure signal and the current heart rate, a cardiac output of a coupling system as a benchmark cardiac output, where the coupling system is a system in which the right ventricular catheter pump is coupled to a target heart;
A parameter determining module 503, configured to obtain a current of a current cardiac cycle of the right ventricular catheter pump, determine a signal feature value of the target pressure signal, fit the current and the signal feature value, and determine a target state parameter representing a vascular response state of the target region based on a fitting result;
A cardiac output estimation module 504, configured to calculate a deviation amount of a reference cardiac output based on the target state parameter, adjust the reference cardiac output according to the deviation amount, and determine the adjusted reference cardiac output as an actual cardiac output of the coupling system.
From the above, it can be seen that, by applying the solution provided in this embodiment, on one hand, the reference cardiac output is obtained based on the target pressure signal and the current heart rate estimate, and the pumped blood flow of the coupling system has a correlation with the pressure and the heart rate of the target area; on the other hand, since the state parameter based on the vascular response state is used to calculate the deviation amount of the reference cardiac output, and just because the vascular dynamic response state affects the pumping blood flow of the coupling system, the deviation amount of the reference cardiac output can be accurately calculated by using the state parameter; in summary, by adopting the scheme provided by the embodiment, the reference cardiac output can be accurately adjusted, so that the adjusted reference cardiac output is close to the actual cardiac output, and the accuracy of cardiac output estimation is improved.
Furthermore, the target state parameter is obtained by fitting the signal characteristic value of the current and the pressure signal of the current cardiac cycle of the right ventricular catheter pump, the current reflects the current running parameter of the right ventricular catheter pump, and the signal characteristic value reflects the current physiological condition of the target heart, so that the two angles of the running of the right ventricular catheter pump and the current physiological condition of the target heart are combined, the determined target state parameter can more accurately reflect the actual response state of the blood vessel of the target region under the current coupling system, and the accuracy of the cardiac output estimation is further improved.
In one embodiment of the present application, the cardiac output estimation module 504 includes:
a parameter calculation sub-module, configured to obtain a static parameter that characterizes an intrinsic property of a blood vessel, and calculate a target elastic parameter that characterizes an elastic property of the blood vessel of the target region based on the static parameter and a duration of a current cardiac cycle;
a deviation determination sub-module for determining a deviation amount of the reference cardiac output based on the target state parameter and a target elastic parameter.
As is apparent from the above, in the present embodiment, when determining the deviation amount, in addition to the target state parameter, the target elastic parameter is combined, and since the target elastic parameter is the elastic property of the blood vessel representing the target region and the elastic property of the blood vessel affects the pumping performance of the coupling system in which the heart is coupled with the right ventricular catheter pump, the deviation amount can be determined more accurately by combining the target state parameter and the target elastic parameter, thereby improving the accuracy of the cardiac output estimation.
In one embodiment of the present application, the reference value estimation module 502 includes:
A signal determination submodule, configured to determine a first pressure signal and a second pressure signal in the target pressure signal based on signal feature points of the target pressure signal, where the first pressure signal represents a blood pressure signal of a systolic phase in the current cardiac cycle, and the second pressure signal represents a blood pressure signal of a diastolic phase in the current cardiac cycle;
the characteristic calculation sub-module is used for calculating a change characteristic value representing the change condition of the signal amplitude between the first pressure signal and the second pressure signal;
and the reference value estimation sub-module is used for determining the cardiac output quantity of the change characteristic value corresponding to the current heart rate as the cardiac output quantity of the coupling system.
From the above, it can be seen that, since the reference cardiac output is calculated based on the change characteristic value and the current heart rate, the change characteristic value is determined based on the change condition of the amplitude of the blood pressure signal between the systolic phase and the diastolic phase of the current cardiac cycle, and since the blood pressure signals of the systolic phase and the diastolic phase of one cardiac cycle can reflect the blood information to be pumped by the heart, the reference cardiac output can be accurately determined based on the change characteristic value and the current heart rate.
In one embodiment of the present application, the parameter determining module 503 is specifically configured to input a signal characteristic value and a current into a pre-trained state parameter prediction model to obtain a parameter output by the state parameter prediction model, where the parameter is used as a target state parameter representing a vascular response state of the target area; wherein, the state parameter prediction model is: the method comprises the steps of taking a sample blood pressure signal characteristic value and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model to obtain a model for estimating the blood vessel response state parameters, wherein the sample blood pressure signal characteristic value is a characteristic value of a blood pressure signal of a preset cardiac cycle of the sample area, and the sample current is a current value of the preset cardiac cycle of the sample right ventricular catheter pump.
Because the state parameter prediction model learns fitting relations among the characteristic values of the pulmonary artery blood pressure signals, the current information and the state parameters, the state parameter prediction model can be used for accurately predicting the target state parameters of the vascular response state.
Corresponding to the method for estimating the cardiac output based on the right ventricular catheter pump, the embodiment of the application also provides a controller, which comprises a processor, a communication interface, a memory and a communication bus, wherein the processor, the communication interface and the memory are communicated with each other through the communication bus; a memory for storing a computer program; and the processor is used for realizing the functions of the functional modules of the system when executing the programs stored in the memory.
The communication bus mentioned by the controller may be a peripheral component interconnect standard (PERIPHERAL COMPONENT INTERCONNECT, PCI) bus or an extended industry standard architecture (Extended Industry Standard Architecture, EISA) bus, etc. The communication bus may be classified as an address bus, a data bus, a control bus, or the like. For ease of illustration, the figures are shown with only one bold line, but not with only one bus or one type of bus.
The communication interface is used for communication between the controller and other devices.
The Memory may include random access Memory (Random Access Memory, RAM) or may include Non-Volatile Memory (NVM), such as at least one disk Memory. Optionally, the memory may also be at least one memory device located remotely from the aforementioned processor.
The processor may be a general-purpose processor, including a central processing unit (Central Processing Unit, CPU), a network processor (Network Processor, NP), etc.; but may also be a digital signal Processor (DIGITAL SIGNAL Processor, DSP), application SPECIFIC INTEGRATED Circuit (ASIC), field-Programmable gate array (Field-Programmable GATE ARRAY, FPGA) or other Programmable logic device, discrete gate or transistor logic device, discrete hardware components.
In yet another embodiment of the present application, a computer readable storage medium is provided, in which a computer program is stored, which when executed by a processor, implements a method for estimating cardiac output based on a right ventricular catheter pump according to an embodiment of the present application.
In yet another embodiment of the present application, a computer program product comprising instructions which, when run on a computer, cause the computer to perform the method for estimating cardiac output based on a right ventricular catheter pump provided by an embodiment of the present application is also provided.
From the above, it can be seen that, by applying the solution provided in this embodiment, on one hand, the reference cardiac output is obtained based on the target pressure signal and the current heart rate estimate, and the pumped blood flow of the coupling system has a correlation with the pressure and the heart rate of the target area; on the other hand, since the state parameter based on the vascular response state is used to calculate the deviation amount of the reference cardiac output, and just because the vascular dynamic response state affects the pumping blood flow of the coupling system, the deviation amount of the reference cardiac output can be accurately calculated by using the state parameter; in summary, by adopting the scheme provided by the embodiment, the reference cardiac output can be accurately adjusted, so that the adjusted reference cardiac output is close to the actual cardiac output, and the accuracy of cardiac output estimation is improved.
Furthermore, the target state parameter is obtained by fitting the signal characteristic value of the current and the pressure signal of the current cardiac cycle of the right ventricular catheter pump, the current reflects the current running parameter of the right ventricular catheter pump, and the signal characteristic value reflects the current physiological condition of the target heart, so that the two angles of the running of the right ventricular catheter pump and the current physiological condition of the target heart are combined, the determined target state parameter can more accurately reflect the actual response state of the blood vessel of the target region under the current coupling system, and the accuracy of the cardiac output estimation is further improved.
In the above embodiments, it may be implemented in whole or in part by software, hardware, firmware, or any combination thereof. When implemented in software, may be implemented in whole or in part in the form of a computer program product. The computer program product includes one or more computer instructions. When loaded and executed on a computer, produces a flow or function in accordance with embodiments of the present application, in whole or in part. The computer may be a general purpose computer, a special purpose computer, a computer network, or other programmable apparatus. The computer instructions may be stored in or transmitted from one computer-readable storage medium to another, for example, by wired (e.g., coaxial cable, optical fiber, digital Subscriber Line (DSL)), or wireless (e.g., infrared, wireless, microwave, etc.). The computer readable storage medium may be any available medium that can be accessed by a computer or a data storage device such as a server, data center, etc. that contains an integration of one or more available media. The usable medium may be a magnetic medium (e.g., floppy disk, hard disk, tape), an optical medium (e.g., DVD), or a semiconductor medium (e.g., solid state disk Solid STATE DISK (SSD)), etc.
It is noted that relational terms such as first and second, and the like are used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Moreover, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising one … …" does not exclude the presence of other like elements in a process, method, article, or apparatus that comprises the element.
In this specification, each embodiment is described in a related manner, and identical and similar parts of each embodiment are all referred to each other, and each embodiment mainly describes differences from other embodiments. In particular, for apparatus, controller, computer readable storage medium embodiments, since they are substantially similar to method embodiments, the description is relatively simple, with reference to portions of the method embodiments being relevant.
The foregoing description is only of the preferred embodiments of the present application and is not intended to limit the scope of the present application. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application are included in the protection scope of the present application.
Claims (10)
1. A method of estimating cardiac output based on a right ventricular catheter pump, the method comprising:
Determining a target pressure signal of a current cardiac cycle of a target area where a bleeding port of a right ventricular catheter pump is located, and obtaining a current heart rate of a target heart, wherein the target heart is a heart implanted by the right ventricular catheter pump;
Estimating the cardiac output of a coupling system as a reference cardiac output based on the target pressure signal and the current heart rate, wherein the coupling system is a system in which the right ventricular catheter pump is coupled with a target heart;
Obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining a signal characteristic value of the target pressure signal, fitting the current and the signal characteristic value, and determining a target state parameter representing the vascular response state of the target region based on a fitting result;
Calculating a deviation amount of a reference cardiac output based on the target state parameter, adjusting the reference cardiac output according to the deviation amount, and determining the adjusted reference cardiac output as an actual cardiac output of the coupling system.
2. The method of claim 1, wherein the calculating the deviation amount of the reference cardiac output based on the target state parameter comprises:
obtaining a static parameter representing inherent characteristics of a blood vessel, and calculating a target elastic parameter representing the elastic performance of the blood vessel of a target region based on the static parameter and the duration of a current cardiac cycle;
An amount of deviation of the reference cardiac output is determined based on the target state parameter and a target elastic parameter.
3. The method according to claim 1 or 2, wherein estimating the cardiac output of the coupled system based on the target pressure signal and the current heart rate comprises:
Determining a first pressure signal and a second pressure signal in the target pressure signal based on signal feature points of the target pressure signal, wherein the first pressure signal represents a blood pressure signal of a systolic phase in the current cardiac cycle, and the second pressure signal represents a blood pressure signal of a diastolic phase in the current cardiac cycle;
Calculating a change characteristic value representing the change condition of the signal amplitude between the first pressure signal and the second pressure signal;
And determining the cardiac output of the change characteristic value corresponding to the current heart rate as the cardiac output of the coupling system.
4. The method according to claim 1 or 2, wherein said fitting the current and signal characteristic values, and determining a target state parameter characterizing a vascular response state of the target region based on a fitting result, comprises:
Inputting the signal characteristic value and the current into a pre-trained state parameter prediction model to obtain parameters output by the state parameter prediction model, wherein the parameters are used as target state parameters for representing the vascular response state of the target region;
Wherein, the state parameter prediction model is: the method comprises the steps of taking a sample blood pressure signal characteristic value and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model to obtain a model for estimating the blood vessel response state parameters, wherein the sample blood pressure signal characteristic value is a characteristic value of a blood pressure signal of a preset cardiac cycle of the sample area, and the sample current is a current value of the preset cardiac cycle of the sample right ventricular catheter pump.
5. A right ventricular catheter pump-based cardiac output estimation device, the device comprising:
The information acquisition module is used for determining a target pressure signal of a current cardiac cycle of a target area where a bleeding port of the right ventricular catheter pump is located and acquiring a current heart rate of a target heart, wherein the target heart is a heart implanted by the right ventricular catheter pump;
The reference value estimation module is used for estimating the cardiac output of a coupling system based on the target pressure signal and the current heart rate, and the coupling system is used as a reference cardiac output, wherein the coupling system is a system in which the right ventricular catheter pump is coupled with a target heart;
The parameter determining module is used for obtaining the current of the current cardiac cycle of the right ventricular catheter pump, determining the signal characteristic value of the target pressure signal, fitting the current and the signal characteristic value, and determining the target state parameter representing the vascular response state of the target region based on the fitting result;
And the cardiac output estimation module is used for calculating the deviation amount of the reference cardiac output based on the target state parameter, adjusting the reference cardiac output according to the deviation amount and determining the adjusted reference cardiac output as the actual cardiac output of the coupling system.
6. The apparatus of claim 5, wherein the cardiac output estimation module comprises:
a parameter calculation sub-module, configured to obtain a static parameter that characterizes an intrinsic property of a blood vessel, and calculate a target elastic parameter that characterizes an elastic property of the blood vessel of the target region based on the static parameter and a duration of a current cardiac cycle;
a deviation determination sub-module for determining a deviation amount of the reference cardiac output based on the target state parameter and a target elastic parameter.
7. The apparatus of claim 5 or 6, wherein the reference value estimation module comprises:
A signal determination submodule, configured to determine a first pressure signal and a second pressure signal in the target pressure signal based on signal feature points of the target pressure signal, where the first pressure signal represents a blood pressure signal of a systolic phase in the current cardiac cycle, and the second pressure signal represents a blood pressure signal of a diastolic phase in the current cardiac cycle;
the characteristic calculation sub-module is used for calculating a change characteristic value representing the change condition of the signal amplitude between the first pressure signal and the second pressure signal;
and the reference value estimation sub-module is used for determining the cardiac output quantity of the change characteristic value corresponding to the current heart rate as the cardiac output quantity of the coupling system.
8. The device according to claim 5 or 6, wherein the parameter determining module is specifically configured to input a signal eigenvalue and a current into a pre-trained state parameter prediction model, to obtain parameters output by the state parameter prediction model, as target state parameters representing a vascular response state of the target region; wherein, the state parameter prediction model is: the method comprises the steps of taking a sample blood pressure signal characteristic value and a sample current as training samples, taking actual state parameters of a blood vessel response state of a sample area where a bleeding port of a sample right ventricular catheter pump is located as training references, training an initial neural network model to obtain a model for estimating the blood vessel response state parameters, wherein the sample blood pressure signal characteristic value is a characteristic value of a blood pressure signal of a preset cardiac cycle of the sample area, and the sample current is a current value of the preset cardiac cycle of the sample right ventricular catheter pump.
9. A controller, characterized in that the controller comprises a processor, a communication interface, a memory and a communication bus, wherein the processor, the communication interface and the memory are communicated with each other through the communication bus;
a memory for storing a computer program;
A processor for implementing the method steps of any one of claims 1-4 when executing a program stored on a memory.
10. A computer-readable storage medium, characterized in that the computer-readable storage medium has stored therein a computer program which, when executed by a processor, implements the method steps of any of claims 1-4.
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| US20060167361A1 (en) * | 2005-01-27 | 2006-07-27 | Bennett Tommy D | Method and apparatus for continuous pulse contour cardiac output |
| EP2346392A1 (en) * | 2008-08-26 | 2011-07-27 | Cardiac Pacemakers, Inc. | Cardiac output estimation using pulmonary artery pressure |
| US8591423B2 (en) * | 2008-10-10 | 2013-11-26 | Cardiac Pacemakers, Inc. | Systems and methods for determining cardiac output using pulmonary artery pressure measurements |
| CN101983732B (en) * | 2010-11-19 | 2012-07-25 | 北京工业大学 | Blood pump control device based on physiological parameters |
| AU2017326989B2 (en) * | 2016-09-19 | 2023-03-16 | Abiomed, Inc. | Cardiovascular assist system that quantifies heart function and facilitates heart recovery |
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| US20220257921A1 (en) * | 2018-06-19 | 2022-08-18 | Abiomed, Inc. | Systems and methods for determining cardiac performance |
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