KR102236814B1 - Method, apparatus and program for obtaining information of cardiovascular system using heart sound - Google Patents

Abstract

A method of acquiring cardiovascular system information using heart sound is provided. The method of acquiring cardiovascular system information using the heart sound includes: a computer obtaining measured heart sound data of a specific patient in real time, a computer obtaining at least one measured heart sound processing data using the measured heart sound data, and the computer And generating and providing a real-time change graph of the measured heart sound processing data.

Description

Cardiovascular information acquisition method using heart sound, its device, and its program {METHOD, APPARATUS AND PROGRAM FOR OBTAINING INFORMATION OF CARDIOVASCULAR SYSTEM USING HEART SOUND}

The present invention relates to a method for acquiring cardiovascular information using heart sound, an apparatus for the same, and a program thereof.

Cardiovascular information is information related to the heart or blood vessels, such as stroke volume (SV), systemic vascular resistance (SVR), pulse pressure (PP), and stroke volume variation (SV). SVV) and Systolic Time Variation (STV).

Cardiac output, body vascular resistance, pulse pressure, variance in one cardiac output, and change in systolic time are the most important and basic indicators to determine whether the patient's circulatory function is functioning normally during surgery, but direct measurement is difficult and direct measurement is difficult. In order to obtain information such as cardiac output, body vascular resistance, pulse pressure, variance in one cardiac output, and change in systolic time, measurements should be made by an invasive method.

In order to acquire these information mainly, there are invasive methods or methods of obtaining indirectly, but in the case of invasive methods, it is often difficult to perform during surgery, and methods of obtaining indirectly (e.g., ultrasound measurement method, etc.) In the case of, it is difficult to obtain an accurate value.

Korean Registered Patent Publication No. 10-1306553, 2013.09.09.

The problem to be solved by the present invention is to provide cardiac and blood vessel information to be acquired invasively by using the heart sound of a patient acquired in real time.

In addition, the problem to be solved by the present invention is to provide a tendency toward increasing and decreasing of information on the heart and blood vessels over time, using a non-invasive method.

In addition, the problem to be solved by the present invention is to provide accurate values of heart and blood vessel information using a non-invasive method.

The problems to be solved by the present invention are not limited to the problems mentioned above, and other problems that are not mentioned will be clearly understood by those skilled in the art from the following description.

A method of acquiring cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem includes the steps of: a computer obtaining measured heart sound data of a specific patient in real time, and at least one computer using the measured heart sound data The step of acquiring the measured heart sound processing data and the step of generating and providing a real-time change graph of the measured heart sound processing data by the computer, wherein the real-time change graph of the measured heart sound processing data is a specific cardiovascular information data graph. They have the same tendency to change.

A method of acquiring cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem includes the steps of: a computer obtaining measured heart sound data of a specific patient in real time, and at least one computer using the measured heart sound data Acquiring the measured heart sound processing data in real time, the computer obtaining a scale factor between the measured heart sound processing data and the cardiovascular data value, and the computer specific cardiovascular system based on the measured heart sound processing data and the scale factor The calculation value of the information data is calculated and provided, wherein the cardiovascular information data includes a step of calculating cardiovascular information data, which is data having the same change trend as the specific measured heart sound processing data.

A method of acquiring cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem includes the steps of: a computer obtaining measured heart sound data of a specific patient in real time, and a second computer using the measured heart sound data Acquiring heart sound amplitude or power data in real time, wherein the computer calculates and provides a calculated value of specific body vascular resistance data based on the second heart sound amplitude or power data, wherein the body vascular resistance data is a specific second heart sound amplitude Or a step of calculating cardiac output data information, which is data having the same change trend as the power data.

The measured heart sound processing data is the second maximum amplitude or power of the heart sound, and the cardiovascular information data is Systemic Vascular Resistance (SVR).

The measured heart sound processing data is a systolic period interval (Systolic Time Interval, S1-S2 Interval, STI), and the cardiovascular information data is a stroke volume (SV), pulse pressure (PP), or pulse pressure variation (Pulse Pressure Variation, PPV).

In the step of obtaining the measured heart sound data in real time, the heart and lung sound data including the measured heart sound data are acquired through a heart and lung sound acquisition device inserted to a specific point in the patient's esophagus or airways.

The cardiopulmonary sound acquisition device is a tube formed by extending from a cardiopulmonary sound measurement position in the esophagus or airways to the outside of the body, and is provided at a first end of the tube, and is disposed at the cardiopulmonary sound measurement position to A probe that collects sound, converts the cardiopulmonary sound collected by the probe into an electrical signal, and is connected to a cable at the second end of the tube and a microphone disposed inside the probe, thereby generating an electrical signal corresponding to the heart and lung sound. It includes a connector for transmitting to the cardiovascular information output device.

In the method for obtaining cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem, the computer uses the reference heart sound processing data and invasive measurement data, and the reference heart sound processing data and the invasive measurement data are Further comprising the step of deriving a correlation, wherein the reference heart sound data and the invasive measurement data are obtained at one or more of the same patient and at the same time.

A method for obtaining cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem includes extracting the cardiovascular data of a patient using the correlation and the measured heart sound data derived by the computer. It further includes steps.

The step of deriving the correlation is characterized in that the correlation is derived using a graph.

The step of deriving the correlation may be extracted by a learning algorithm based on the reference heart sound data and the invasive measurement data.

The step of deriving the correlation further includes removing noise, and the step of removing the noise includes: obtaining reference data by the computer, and the reference heart sound data by the computer using a heart sound filter. Acquiring a feature point, the step of matching the reference data from which the feature point is acquired with the reference heart sound data, and when the computer determines that an abnormal section is included in the wave of the reference data, the abnormality And excluding reference heart sound data matching the section as noise.

The step of deriving the correlation further comprises removing noise, wherein the removing of the noise comprises: converting, by the computer, a graph of a temporal image for the correlation into a frequency domain, and the computer If it is determined that the abnormal section is included in the graph on the frequency domain, excluding the section on the time domain matching the abnormal section as noise.

The method for acquiring cardiovascular information using heart sound according to an embodiment of the present invention for solving the above-described problem further comprises the step of generating, by the computer, a matrix for extracting a scale factor, and the matrix for extracting the scale factor The step of generating, wherein the computer obtains the reference heart sound data, obtaining at least one reference heart sound processing data using the reference heart sound data, the computer obtains invasive measurement data, the reference heart sound data and the invasive The measurement data is obtained at one or more of the same patient and at the same time, the invasive measurement data acquisition step, the computer calculating a scale factor between the reference heart sound processing data and the invasive measurement data, the computer with the reference heart sound data Generating a matrix using the reference heart sound processing data, the invasive measurement data, and the scale factor for each physical condition of each patient who has acquired the invasive measurement data, wherein the computer determines the measured heart sound processing data and the cardiovascular data values The step of extracting the scale factor of the liver is characterized in that the scale factor is extracted using the matrix.

The computer includes calculating a scale factor between the reference heart sound processing data and the invasive measurement data, and the reference heart sound processing data, the invasive measurement data, and the reference heart sound processing data for each physical condition of each patient who has obtained the reference heart sound data and the invasive measurement data. The step of generating a matrix using scale coefficients is performed using a learning algorithm, and a matrix using the scale coefficients is provided.

A program for acquiring cardiovascular system information using a heart sound according to another embodiment of the present invention for solving the above-described problem is stored in a recording medium in order to execute any one of the above methods in combination with a computer, which is hardware.

The cardiovascular system information acquisition device using heart sound according to another embodiment of the present invention for solving the above-described problem includes a measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time, using the measured heart sound data. A measurement heart sound processing data acquisition unit that acquires at least one measurement heart sound processing data, and a measurement heart sound processing data change graph providing unit that generates and provides a real-time change graph of the measurement heart sound processing data, The real-time change graph is one having the same trend of change in a specific cardiovascular information data graph.

The cardiovascular system information acquisition device using heart sound according to another embodiment of the present invention for solving the above-described problem includes a measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time, using the measured heart sound data. A measurement heart sound processing data acquisition unit that acquires at least one measurement heart sound processing data in real time, a scale factor calculation unit that calculates a scale factor between the measurement heart sound processing data and a cardiovascular data value, and the measurement heart sound processing data and the scale factor Based on the calculation value of specific cardiovascular information data is calculated and provided, wherein the cardiovascular information data includes a cardiovascular information data calculation unit, which is data having the same change trend as the specific measured heart sound processing data.

Other specific details of the present invention are included in the detailed description and drawings.

According to the present invention, it is possible to acquire a patient's heart sound in real time and use it to obtain a trend and an accurate value of a graph for heart and blood vessel information.

In addition, according to the present invention, cardiac and blood vessel information may be acquired by using the heart sound of a patient, so that cardiac and blood vessel information can be obtained faster than invasive cardiac and blood vessel information.

In addition, according to the present invention, by acquiring heart sound data and invasive measurement data of various patients as a reference, it is possible to generate a matrix regarding a scale factor required to derive accurate values for heart and blood vessel information.

The effects of the present invention are not limited to the effects mentioned above, and other effects not mentioned will be clearly understood by those skilled in the art from the following description.

1 is a view for explaining a method of providing cardiovascular information as a graph using heart sound according to an embodiment of the present invention.
2 is a view for explaining a method of calculating and providing a calculated value for cardiovascular information using heart sound according to an embodiment of the present invention.
3 is a diagram for explaining a method of deriving a correlation between reference heart sound data and invasive measurement data according to the present invention.
4 is a graph for explaining a relationship between a second heart sound amplitude and body vascular resistance as an embodiment of the present invention.
5 is a graph for explaining the relationship between the systolic time interval and cardiac output as an embodiment of the present invention.
6 is a graph for explaining a relationship between a systolic time interval and a pulse pressure as an embodiment of the present invention.
7 is a graph for explaining the relationship between the systolic time variation and the pulse pressure variation as an embodiment of the present invention.
8 is a graph for explaining the relationship between the first heart sound and myocardial contractile force as an embodiment of the present invention.
9 is a diagram illustrating a method of extracting cardiovascular data using correlation and measured heart sound data according to the present invention.
10 and 11 are diagrams for explaining a method of removing noise when deriving a correlation between reference heart sound data and invasive measurement data according to the present invention.
12 is a diagram for explaining a method of generating a matrix for extracting a scale factor according to the present invention.

Advantages and features of the present invention, and a method of achieving them will become apparent with reference to the embodiments described below in detail together with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but may be implemented in a variety of different forms. It is provided to fully inform the skilled person of the scope of the present invention, and the present invention is only defined by the scope of the claims.

The terms used in the present specification are for describing exemplary embodiments and are not intended to limit the present invention. In this specification, the singular form also includes the plural form unless specifically stated in the phrase. As used herein, “comprises” and/or “comprising” do not exclude the presence or addition of one or more other elements other than the mentioned elements. Throughout the specification, the same reference numerals refer to the same elements, and "and/or" includes each and all combinations of one or more of the mentioned elements. Although "first", "second", and the like are used to describe various elements, it goes without saying that these elements are not limited by these terms. These terms are only used to distinguish one component from another component. Therefore, it goes without saying that the first component mentioned below may be the second component within the technical idea of the present invention.

Unless otherwise defined, all terms (including technical and scientific terms) used in the present specification may be used with meanings that can be commonly understood by those of ordinary skill in the art to which the present invention belongs. In addition, terms defined in a commonly used dictionary are not interpreted ideally or excessively unless explicitly defined specifically.

In the present specification, the'measurement heart sound data' is heart sound data derived from the current patient's heart and lung sound signals measured in real time.

In the present specification, the'measured heart sound processing data' is processed data such as calculating or deriving some values from the measured heart sound data.For example, the measured heart sound processing data includes a first heart sound, a second heart sound, and a Phonocardiogram. , PCG), Systolic Time Interval (S1-S2 Interval, STI), the maximum amplitude of the first heart sound, and the maximum amplitude of the second heart sound, and all data that can be derived by processing the measured heart sound data are included. It is not limited to the example.

In the present specification,'cardiovascular information data' is information data of the heart and blood vessels, and is information data of the heart and blood vessels of a current patient that acquires a cardiopulmonary sound signal in real time. For example, the information data of the heart and blood vessels is 1 Stroke Volume (SV), Systemic Vascular Resistance (SVR), Pulse Pressure (PP), Pulse Pressure Variation (PPV), Stroke Volume Variation (SVV), Systolic Time Variation (STV) and myocardial contractility change are included, and all information data related to the heart and blood vessels are included, but are not limited to the above examples.

In the present specification,'cardiopulmonary sound data' is data of a cardiopulmonary sound signal acquired from the left ventricle of a patient.

In the present specification,'reference heart sound data' is heart sound data derived from cardiopulmonary sound signals previously acquired from a plurality of patients in order to derive a correlation between heart sound data and invasive measurement data.

In the present specification, the'reference heart sound processing data' is processed data such as calculating or deriving a partial value from the reference heart sound data. For example, the reference heart sound processing data is a first heart sound (S1), a second heart sound (S2). ), Phonocardiogram (PCG), Systolic Time Interval (S1-S2 Interval, STI), maximum amplitude of the first heart sound, maximum amplitude of the second heart sound, and data that can be derived by processing the measured heart sound data Are all included, and are not limited to the above examples.

The first heart sound is a sound generated when the atrioventricular valve is closed, and the second heart sound is a sound generated when the aorta and pulmonary valves are closed, indicating the end of heart contraction and the start of heart relaxation.

In the present specification,'invasive measurement data' is data previously acquired from a plurality of patients in order to derive a correlation with heart sound data, and is information data of the heart and blood vessels of the plurality of patients. For example, invasive measurement data Is, among data previously acquired from multiple patients, one-time cardiac output (Stroke Volume, SV), Systemic Vascular Resistance (SVR), Pulse Pressure (PP), and Pulse Pressure Variation (PPV). ), Stroke Volume Variation (SVV), Systolic Time Variation (STV), and arterial pressure waveforms, and all information data related to the heart and blood vessels are included, and are not limited to the above examples. .

In the present specification,'reference data' is data for reference in removing noise when deriving a correlation between reference heart sound data and invasive measurement data among data obtained by non-invasive measurement. For example, reference data is , Electrocardiogram and arterial blood pressure (ABP), and reference data that may serve as a reference are all included, and are not limited to the above examples.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is a view for explaining a method of providing cardiovascular information as a graph using heart sound according to an embodiment of the present invention.

Referring to FIG. 1, in the method of acquiring cardiovascular information using heart sound according to an embodiment of the present invention, the step of acquiring measured heart sound data of a specific patient in real time (S110), and measured heart sound processing data using the measured heart sound data It includes obtaining (S130) and generating and providing a real-time change graph of the measured heart sound processing data (S150).

In the step S110 of acquiring the measured heart sound data of a specific patient in real time (S110), the heart and lung sound data including the measured heart sound data is acquired through a heart and lung sound acquisition device inserted to a specific point of the patient's airway.

The cardiopulmonary sound acquisition device includes a tube, a probe, a microphone, and a connector, and the tube is formed by extending from the heart and lung sound measurement position in the esophagus or airways to the outside of the body, and the probe is provided at the first end of the tube and the cardiopulmonary It is placed in the sound measurement position, collects cardiopulmonary sound through the esophagus or airway surface, the microphone converts the cardiopulmonary sound collected from the probe into an electrical signal, is placed inside the probe, and the connector is a cable at the second end of the tube. Is connected to, and transmits an electrical signal corresponding to the cardiopulmonary sound to the cardiovascular information output device.

In step S130 of acquiring measured heart sound processing data using the measured heart sound data, at least one data included in the measured heart sound processing data is acquired.

In the step of generating and providing a real-time change graph of the measured heart sound processing data (S150), the real-time change graph of the measured heart sound processing data is a graph of the measured heart sound processing data, and has the same change trend of the specific cardiovascular information data graph.

In the past, invasive measurement data can be obtained only by invasively inserting a tool (eg, inserting a tool to the heart to determine cardiac output), so it was not possible to grasp the change in data in surgery where it is difficult to invasively insert the tool.

According to the present invention, even if the cardiovascular information data graph is not directly provided, only a real-time change graph of the measured heart sound processing data is provided, thereby providing the same trend of change in the cardiovascular information data to a patient, a doctor, or a user who needs cardiovascular information. can do.

For example, in the case of a drop in blood pressure, a decrease in blood pressure occurs due to a decrease in the total load (total blood volume), a decrease in myocardial contractility, or a body vascular resistance.If the patient's blood pressure decreases during surgery by a medical staff, the cause of the drop in blood pressure It is possible to cope accordingly only when you understand

In this case, as described above, in order to measure the body vascular resistance, the tool must be invasively inserted, but most of the surgery is difficult to invasively insert the tool.

Therefore, according to the present invention, the trend is consistent with the body vascular resistance graph, and as the second heart sound maximum amplitude graph obtained by processing the measured heart sound data is provided, when the value decreases on the second heart sound maximum amplitude graph, the body blood vessel As the resistance decreases, the medical staff can recognize that the patient's blood pressure drop can be appropriately dealt with.

2 is a view for explaining a method of calculating and providing a calculated value of cardiovascular information using heart sound according to an embodiment of the present invention.

Referring to FIG. 2, a method of calculating and providing a calculated value of cardiovascular information according to an embodiment of the present invention includes the step of acquiring measured heart sound data of a specific patient in real time (S210), and measured using measured heart sound data. Acquiring heart sound processing data (S230), calculating a scale factor between the measured heart sound processing data and the cardiovascular data value (S250), and calculating a calculated value of the cardiovascular information data based on the measured heart sound processing data and the scale factor It includes a step (S270) to provide.

The step of acquiring the measured heart sound data of a specific patient in real time (S210) and the step of acquiring measured heart sound processing data using the measured heart sound data (S230) are the same as described above in FIG. 1.

In step S250 of acquiring a scale factor between the measured heart sound processing data and the cardiovascular information data value (S250), a scale factor for calculating the cardiovascular information data value is obtained by using the measured heart sound processing data. The method of obtaining the scale factor is obtained by using a graph or matrix generated based on previously acquired heart sound and invasive data of a plurality of patients. A specific method of obtaining a scale factor using a graph or matrix will be described later.

The step of calculating and providing the calculated value of the cardiovascular information data based on the measured heart sound processing data and the scale factor (S270) is, in an embodiment, a graph of the cardiovascular information data based on the measured heart sound processing data and the scale factor. It is to generate and provide the exact value of each point of the graph as a calculated value of the cardiovascular information data, and in another embodiment, the exact value of the cardiovascular information data is calculated without generating a graph of the cardiovascular information data. To provide.

3 is a diagram for describing a method of deriving a correlation between reference heart sound processing data and invasive measurement data according to the present invention.

Referring to FIG. 3, the method of acquiring cardiovascular information using heart sound according to an embodiment of the present invention includes the step of deriving a correlation between reference heart sound processing data and invasive measurement data (S100), and measuring heart sound data of a specific patient. A real-time acquisition step (S110), a step of obtaining the measured heart sound processing data using the measured heart sound data (S130), and the step of generating and providing a real-time change graph of the measured heart sound processing data (S150).

The step of deriving the correlation between the reference heart sound processing data and the invasive measurement data (S100) is a step prior to the acquisition of the patient's measured heart sound data measured in real time, and the reference heart sound processing data previously obtained from a plurality of other patients And invasive measurement data are used to derive a correlation.

The reference heart sound data and the invasive measurement data are paired as acquired at the same patient and at the same time among a plurality of other patients, and the correlation between the reference heart sound processing data processed from the reference heart sound data and the invasive measurement data To derive.

In addition, in Figure 3, the step of acquiring the measured heart sound data of a specific patient in real time (S110), the step of acquiring the measured heart sound processing data using the measured heart sound data (S130), and a real-time change graph of the measured heart sound processing data are generated and provided. Prior to the step (S150), the step (S100) of deriving the correlation between the reference heart sound processing data and the invasive measurement data is shown to be added, but the step of obtaining the measured heart sound data of a specific patient in real time (S210) , Acquiring measured heart sound processing data using the measured heart sound data (S230), calculating a scale factor between the measured heart sound processing data and the cardiovascular data value (S250), and based on the measured heart sound processing data and the scale factor Before the step (S270) of calculating and providing the calculated value of the relationship information data, the step (S100) of deriving a correlation between the reference heart sound data and the invasive measurement data is added.

Hereinafter, as an example of the correlation between the measured heart sound processing data and the cardiovascular information data, as a method of acquiring cardiovascular information using the heart sound of the present invention, a graph showing the correlation will be described.

4 is a graph for explaining a relationship between a second heart sound amplitude and body vascular resistance as an embodiment of the present invention.

4(a) and 4(b) are exemplary graphs for each of patient 1 and patient 2;

5 is a graph for explaining the relationship between the systolic time interval and cardiac output as an embodiment of the present invention.

5(a) and 5(b) are exemplary graphs for Patient 1 and Patient 2, respectively.

6 is a graph for explaining a relationship between a systolic time interval and a pulse pressure as an embodiment of the present invention.

Figure 6 (a) is a graph for 20 seconds, Figure 6 (b) is a graph for several hours.

7 is a graph for explaining the relationship between the systolic time variation and the pulse pressure variation as an embodiment of the present invention.

7(a) and 7(b) are exemplary graphs for each of patient 1 and patient 2;

8 is a graph for explaining the relationship between the first heart sound and myocardial contractile force as an embodiment of the present invention.

Figure 8 (a) is a graph for 7 hours, Figure 8 (b) is a graph for 11 hours. As the first heart sound and invasive arterial pressure, the change in myocardial contractile force that changes continuously during the operation time during surgery is calculated as the highest point within one heart sound cycle of the waveform obtained by differentiating the arterial pressure waveform, and the difference between the first heart sound and the first heart sound. It is a graph showing the relationship.

Referring to FIG. 4, it can be seen that the trend of the graph between the second heart sound amplitude and the body vascular resistance is similar.

Although various factors contribute to the generation of the second heart sound, it is mainly related to the obstruction of the aortic valve, and the obstruction of the aortic valve is affected by the increase or decrease of the afterload.

Accordingly, it can be seen that the second heart sound amplitude and the form of a graph of the body vascular resistance are similar to each other when the scale value is adjusted, as shown in FIG. 4.

As described above, by using the measured heart sound data to derive second heart sound amplitude data, which is heart sound processing data, and providing only the second heart sound amplitude data graph, the trend of the body vascular resistance graph can be grasped.

The tendency can be recognized as an increase in the second heart sound amplitude and an increase in body vascular resistance, and when the second heart sound amplitude decreases, it may be recognized as a decrease in body vascular resistance.

Therefore, in a situation where it is difficult to acquire body vascular resistance invasively during surgery, it is possible to present a trend of increase or decrease in body vascular resistance by acquiring only cardiopulmonary sound data even if it is not acquired invasively to medical staff who need to understand the trend of increase or decrease in vascular resistance. I can.

Referring to FIG. 5, it can be seen that the trend of the graph between the systolic time interval (S1-S2 Interval, STI) and cardiac output is similar.

Systolic time is approximately governed by the time from immediately after the occlusion of the atrioventricular valve to the closure of the aortic valve. This is because at that point, the ventricle is affected by the under-volume (preload) that must be rescued.

Accordingly, it can be seen that the systolic time interval and the cardiac output are formed similarly to each other when the scale value is adjusted, as shown in FIG. 5.

As described above, by deriving systolic time interval data, which is heart sound processing data, using the measured heart sound data, and providing only the systolic time interval data graph, the trend of the cardiac output graph can be grasped. In addition, if the cardiac output graph is corrected using information such as the heart rate or the time interval between the electrocardiogram and the heart sound, more accurate cardiac output information can be calculated.

As described above in FIG. 4, in a situation where it is difficult to acquire cardiac output invasively during surgery, for medical staff who need to grasp the trend of increase or decrease in cardiac output, even if not acquired invasively, only systolic time interval data is acquired and the index is processed. By calculating, the trend of increase or decrease in cardiac output can be presented.

Referring to FIG. 6, it can be seen that the trend of the graph between the systolic time interval and the pulse pressure is similar.

Pulse pressure represents the difference between systolic blood pressure and diastolic blood pressure, and reflects the delivery of blood rescued by the cardiac cycle to the peripheral pressure. It is known that pulse pressure and cardiac output show a proportional relationship. Therefore, if the change of pulse pressure according to breathing is tracked through the systolic time interval, the variation of pulse pressure according to the breathing can also be tracked through the variation of the systolic time interval.

Accordingly, it can be seen that the systolic time interval and the graph form of the pulse pressure are formed similarly to each other when the scale value is adjusted, as shown in FIG. 6.

As described above, by using the measured heart sound data to derive systolic time interval data, which is heart sound processing data, and providing only systolic time interval data and a graph processed therefrom, the trend of the pulse pressure graph can be grasped.

As described above in FIG. 4, in a situation where it is difficult to obtain pulse pressure invasively during surgery, to medical staff who need to grasp the increase or decrease tendency of pulse pressure, only systolic time interval data is obtained even if not acquired invasively to present the increase/decrease tendency of pulse pressure. Can give.

Referring to FIG. 7, it can be seen that the trend of the graph between the systolic time variation and the pulse pressure variation is similar.

As described above in FIG. 6, if the change in pulse pressure according to respiration is tracked through the systolic time interval, the variation in pulse pressure according to the respiration may also be tracked through the change in systolic time interval.

Accordingly, it can be seen that the graphs of the variation in systolic time and the variation in pulse pressure are formed similarly to each other when the scale value is adjusted, as shown in FIG. 7.

As described above, by using the measured heart sound data to derive systolic time variance data, which is heart sound processing data, and providing only systolic time variance data and a graph processed therefrom, the trend of the pulse pressure variance graph can be grasped.

Referring to FIG. 8, it can be seen that the trend of the graph between the change in myocardial contractile force and the first heart sound is similar.

Specifically, assuming that the maximum value of the arterial pressure waveform change (dP/dt max) is calculated as the highest point within one heart sound period of the waveform obtained by differentiating the arterial pressure waveform, FIG. 8 shows the first heart sound and arterial pressure waveform change. It is a graph showing the relationship between the maximum value (dP/dt max) of, and the first heart sound by calculating the maximum value (dP/dt max) of the change in arterial pressure waveform as a surrogate indicator of the change in myocardial contractility that continuously changes during the operation time. As a result of comparing the graph of the liver, it can be seen that the trend of the graph is similar.

The maximum value (dP/dt max) of the change in arterial pressure waveform is also used as a method of evaluating the change in myocardial contractility after dobutamine administration.

As shown in the graph of FIG. 8, the reason why the trend between the change of myocardial contractile force and the first heart sound is similar is that the myocardial contractile force is the force that the heart contracts to build blood, and is transmitted to the mitral valve at the beginning of contraction. Because. Specifically, since the first heart sound is composed of the sound generated while passing through the left ventricular outflow tract (LVOT) and the closure of the mitral valve, the physiological effect of myocardial contraction is reduced. 1 This is because it is reflected in the heart sound.

In addition, as shown in FIGS. 4 to 8, the second heart sound amplitude and systolic time interval, which are processed data values, rather than the extraction time of the maximum values of the invasively acquired body vascular resistance, cardiac output, pulse pressure, pulse pressure variation, and arterial pressure waveform change. , The data of the systolic time variance and the extraction time of the first heart sound are faster.

The reason is that in the case of invasive extraction of body vascular resistance, cardiac output, and pulse pressure, heat is applied to extract it, diluted in the body, and measurement is possible only after returning to the body, so it takes about 5 minutes or more. do.

On the other hand, in the case of calculating the trend of the graph or the calculated value of the cardiovascular information data using the reference heart sound processing data indirectly, the cardiovascular information data is acquired invasively because there is no process of rotating the body for invasive extraction. It has the effect of being able to check closer to real time faster than doing it.

9 is a diagram illustrating a method of extracting cardiovascular data using correlation and measured heart sound data according to the present invention.

Referring to FIG. 9, the method of acquiring cardiovascular information using heart sound according to the present invention includes the steps of deriving a correlation between reference heart sound processing data and invasive measurement data (S100), and obtaining measured heart sound data of a specific patient in real time ( S110), obtaining the measured heart sound processing data using the measured heart sound data (S130), generating and providing a real-time change graph of the measured heart sound processing data (S150), and the cardiovascular system using the correlation and measured heart sound data And extracting information data (S170).

In the step of extracting cardiovascular information data using correlation and measured heart sound data (S170), as an embodiment, the correlation is derived using a graph.

In another embodiment, the cardiovascular information data is extracted by a learning algorithm based on reference heart sound data and invasive measurement data.

As described above in FIG. 3, in FIG. 9, extracting cardiovascular information data using correlation and measurement heart sound data (S170) is performed, and a step of deriving a correlation between reference heart sound processing data and invasive measurement data ( S100), obtaining measured heart sound data of a specific patient in real time (S110), obtaining measured heart sound processing data using the measured heart sound data (S130), generating and providing a real-time change graph of the measured heart sound processing data Although shown as being added after (S150), the step of deriving the correlation between the reference heart sound processing data and the invasive measurement data (S100) a step of acquiring the measured heart sound data of a specific patient in real time (S210), using the measured heart sound data Acquiring the measured heart sound processing data (S230), calculating a scale factor between the measured heart sound processing data and the cardiovascular data value (S250), and calculating the calculated value of the cardiovascular information data based on the measured heart sound processing data and the scale factor. It includes the addition after the step of calculating and providing (S270).

10 and 11 are diagrams for explaining a method of removing noise when deriving a correlation between reference heart sound processing data and invasive measurement data according to the present invention.

The step of deriving the correlation described above in FIG. 3 further includes the step of removing noise.

Referring to FIG. 10, the step of removing noise includes: acquiring reference data (S310), acquiring feature points of reference heart sound data using a heart sound filter (S330), and reference data obtained by acquiring feature points. Matching with data (S350), and when it is determined that the abnormal section is included in the wave of the reference data, excluding the reference heart sound data matching the abnormal section as noise (S370).

The reference data is data for reference in removing noise when deriving a correlation between the reference heart sound data and the invasive measurement data among data obtained by non-invasive measurement, such as an electrocardiogram, arterial blood pressure, and the like.

The reference data is data capable of grasping an abnormal section in real time. The abnormal section is a section in which noise is generated in the cardiopulmonary sound data by reflecting the patient's movement and posture change, for example during surgery, and since it is difficult to determine the abnormal section using only the reference heart sound data, reference data is used. Thus, by identifying the abnormal section and excluding the matching reference heart sound data section, there is an effect of accurately deriving a correlation between the reference heart sound processing data and the invasive measurement data.

In the step of acquiring the characteristic points of the reference heart sound data using the heart sound filter (S330), the intermittent noise is removed and the respiratory sound is separated, so that the characteristic points of the reference heart sound data required for analysis are clearly identified and obtained.

The heart sound filter includes all filters that can clearly distinguish the characteristic points of the heart sound.

In addition, referring to FIG. 11, in the step of removing the noise, when it is determined that the graph on the time domain for the correlation is converted into the frequency domain (S410) and the graph on the frequency domain determines that an abnormal section is included, And a step (S430) of excluding a section in the time domain matching the abnormal section as noise.

A method of determining that an abnormal section is included in the graph on the frequency domain is determined as an abnormal section when it exceeds a range of a predetermined value within the graph on the frequency domain.

Since it is difficult to determine the abnormal section in the graph in the time domain, it is possible to accurately derive the correlation between the reference heart sound processing data and the invasive measurement data by identifying the abnormal section in the graph in the frequency domain and excluding the section in the matching time domain. There is an effect that can be.

12 is a diagram for explaining a method of generating a matrix for extracting a scale factor according to the present invention.

In the front end of the method for calculating and providing the calculated cardiovascular information using the heart sound described above in FIG. 2, a matrix for calculating a scale factor using reference heart sound data and invasive data acquired using a plurality of patients previously It further comprises the step of generating.

Referring to FIG. 12, a method of generating a matrix for extracting a scale factor includes acquiring reference heart sound data, acquiring reference heart sound processing data using the reference heart sound data (S510), and acquiring invasive data (S530). ), calculating a scale factor between the reference heart sound processing data and the invasive measurement data (S550), and generating a matrix using the reference heart sound processing data, the invasive measurement data, and the scale factor (S570).

In the step of acquiring reference heart sound data and obtaining reference heart sound processing data using the reference heart sound data (S510), the reference heart sound data is heart sound data previously acquired from a plurality of patients, and the reference heart sound processing data is the reference heart sound data. It is processed data such as calculating or deriving some values from.

The reference heart sound data and the invasive measurement data are paired as acquired at the same patient and at the same time among a plurality of other patients, and the scale factor of the reference heart sound processing data processed from the reference heart sound data and the invasive measurement data To derive.

It was confirmed in FIGS. 4 to 6 that the trend of the graph between the reference heart sound processing data and the invasive measurement data coincide.

Accordingly, in the step of calculating a scale factor between the reference heart sound processing data and the invasive measurement data (S550), the scale factor between the reference heart sound processing data and the invasive measurement data acquired at the same patient and the same time among at least one of the plurality of other patients is calculated. It is obtained by calculating.

In step S570 of generating a matrix using the reference heart sound processing data, the invasive measurement data, and the scale factor (S570), a matrix is generated by using the reference heart sound processing data, invasive measurement data, and scale factors for each physical condition of a plurality of patients.

By creating a matrix using reference heart sound processing data, invasive measurement data, and scale factor for each physical condition of a plurality of patients, in calculating the calculated value of the cardiovascular information data using only the patient's measured heart sound data, the patient's It is possible to obtain a scale factor that matches the body condition and heart sound data. In addition, in this case, not only the scale factor is obtained, but also invasive measurement data can be obtained.

Therefore, in the front end of the method for calculating and providing the calculated value of cardiovascular information using the heart sound described above in FIG. 2, the calculation of the scale factor is performed using the reference heart sound data and invasive data previously acquired using a plurality of patients. The method further comprises generating a matrix for processing, and obtaining a scale factor between the measured heart sound processing data and the cardiovascular data value (S250) is characterized in that the scale factor is obtained using the generated matrix.

Thereafter, in the step of calculating and providing the calculated value of the cardiovascular information data based on the measured heart sound processing data and the scale factor (S270), the initial measured heart sound data obtained from the patient is used to compare with the reference heart sound data on the matrix to provide accurate Calculate and provide the calculated value.

In one embodiment, by acquiring a certain section of measured heart sound data, by acquiring only one accurate calculated value of the matched cardiovascular information data using the reference heart sound data matched with the section and the matched body condition of the patient, the cardiovascular system is continuously All calculated values of information data can be obtained.

In addition, the step of calculating the scale factor between the reference heart sound processing data and the invasive measurement data (S550) is calculated using a learning algorithm, and generating a matrix using the reference heart sound processing data, the invasive measurement data, and the scale factor (S570). In addition, by generating using a learning algorithm, a matrix using a scale factor can be provided to a user.

An apparatus for acquiring cardiovascular information using heart sound according to another embodiment of the present invention, a measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time, acquires at least one measured heart sound processing data using the measured heart sound data It includes a measurement heart sound processing data acquisition unit and a measurement heart sound processing data change graph providing unit that generates and provides a real-time change graph of the measurement heart sound processing data, and the real-time change graph of the measurement heart sound processing data is a specific cardiovascular information data graph Has the same tendency to change.

According to another embodiment of the present invention, an apparatus for acquiring cardiovascular information using heart sound, a measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time, uses the measured heart sound data to convert at least one measured heart sound processing data in real time. Acquired, measured heart sound processing data acquisition unit, a scale factor calculation unit that calculates a scale factor between the measured heart sound processing data and the cardiovascular data value, and a calculated value of specific cardiovascular information data based on the measured heart sound processing data and the scale factor However, the cardiovascular system information data includes a cardiovascular system information data calculation unit, which is data having the same change trend as the specific measured heart sound processing data.

The apparatus for obtaining cardiovascular information according to the present invention has the same configuration as the method for obtaining cardiovascular information described above with reference to FIGS. 1 to 12.

The steps of a method or algorithm described in connection with an embodiment of the present invention may be implemented directly in hardware, implemented as a software module executed by hardware, or a combination thereof. Software modules include Random Access Memory (RAM), Read Only Memory (ROM), Erasable Programmable ROM (EPROM), Electrically Erasable Programmable ROM (EEPROM), Flash Memory, hard disk, removable disk, CD-ROM, or It may reside on any type of computer-readable recording medium well known in the art to which the present invention pertains.

In the above, embodiments of the present invention have been described with reference to the accompanying drawings, but those of ordinary skill in the art to which the present invention pertains can be implemented in other specific forms without changing the technical spirit or essential features. You will be able to understand. Therefore, the embodiments described above are illustrative in all respects, and should be understood as non-limiting.

Claims (19)

Deriving, by the computer, a correlation between the reference heart sound processing data and the invasive measurement data;
Obtaining, by the computer, measured heart sound data of a specific patient in real time;
Obtaining, by the computer, at least one measured heart sound processing data by using the measured heart sound data;
Generating and providing, by the computer, a real-time change graph of the measured heart sound processing data; And
And extracting, by the computer, cardiovascular information data of the patient using the correlation and the measured heart sound data,
The reference heart sound processing data and the invasive measurement data form a pair as one or more previously acquired at the same patient and at the same time,
The real-time change graph of the measured heart sound processing data has the same change trend as the change graph of the cardiovascular information data,
A method of acquiring cardiovascular information using heart sound. Deriving, by the computer, a correlation between the reference heart sound processing data and the invasive measurement data;
Obtaining, by the computer, measured heart sound data of a specific patient in real time;
Obtaining, by a computer, at least one measured heart sound processing data in real time by using the measured heart sound data;
Extracting, by the computer, cardiovascular information data of the patient using the correlation and the measured heart sound data;
Extracting, by the computer, a scale factor between the measured heart sound processing data and the value of the cardiovascular information data; And
The computer calculates and provides a calculated value of the specific cardiovascular information data based on the measured heart sound processing data and the scale factor, wherein the cardiovascular information data is data having the same change tendency as the specific measured heart sound processing data, Including the step of calculating cardiovascular information data,
The reference heart sound processing data and the invasive measurement data form a pair as one or more previously acquired at the same patient and at the same time,
A method of acquiring cardiovascular information using heart sound. delete The method according to claim 1 or 2,
The measured heart sound processing data is the second heart sound maximum amplitude or power,
The cardiovascular information data is Systemic Vascular Resistance (SVR),
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The measured heart sound processing data is a systolic period interval (Systolic Time Interval, S1-S2 Interval, STI),
The cardiovascular information data is a cardiac output (Stroke Volume, SV), a pulse pressure (PP), or a pulse pressure variation (PPV),
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The measured heart sound processing data is the first heart sound maximum amplitude or power,
The cardiovascular information data is a change in myocardial contractility,
The change in myocardial contractile force is calculated as the highest point in one cardiac cycle of the waveform obtained by differentiating the arterial pressure waveform,
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The step of obtaining the measured heart sound data in real time,
Acquired using cardiopulmonary sound data including the measured heart sound data through a cardiopulmonary sound acquisition device inserted to a specific point in the patient's esophagus or airway,
A method of acquiring cardiovascular information using heart sound. The method of claim 7,
The cardiopulmonary sound acquisition device,
A tube formed to extend outside the body from a location for measuring heart and lung sounds in the esophagus or airways;
A probe provided at the first end of the tube and disposed at the cardiopulmonary sound measurement position to collect cardiopulmonary sound through the esophagus or airway surface;
A microphone disposed inside the probe for converting the cardiopulmonary sound collected by the probe into an electrical signal;
It is connected to the cable at the second end of the tube, comprising a connector for transmitting an electrical signal corresponding to the cardiopulmonary sound to the cardiovascular information output device,
A method of acquiring cardiovascular information using heart sound. delete delete The method according to claim 1 or 2,
The step of deriving the correlation,
Characterized in that the correlation is derived using a graph,
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The step of deriving the correlation,
It characterized in that it is extracted by a learning algorithm based on the reference heart sound processing data and invasive measurement data,
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The step of deriving the correlation,
Further comprising the step of removing the noise,
The step of removing the noise,
Obtaining, by the computer, reference data;
Obtaining, by the computer, a feature point of the reference heart sound data using a heart sound filter;
Matching the reference data obtained by the computer with the reference heart sound data obtained by obtaining a feature point; And
When the computer determines that the abnormal section is included in the wave of the reference data, excluding reference heart sound data matching the abnormal section as noise,
A method of acquiring cardiovascular information using heart sound. The method according to claim 1 or 2,
The step of deriving the correlation,
Further comprising the step of removing the noise,
The step of removing the noise,
Converting, by the computer, the graph in the time domain of the correlation into the frequency domain; And
When the computer determines that the abnormal section is included in the graph on the frequency domain, excluding a section in the time domain matching the abnormal section as noise,
A method of acquiring cardiovascular information using heart sound. The method of claim 2,
The computer generating a matrix for extracting the scale factor,
Generating a matrix for extracting the scale factor comprises:
Obtaining, by the computer, reference heart sound data, and obtaining at least one reference heart sound processing data using the reference heart sound data;
The computer obtaining invasive measurement data, wherein the reference heart sound data and the invasive measurement data are obtained at one or more of the same patient and at the same time;
Calculating, by the computer, a scale factor between the reference heart sound processing data and the invasive measurement data;
Generating, by the computer, a matrix using the reference heart sound processing data, the invasive measurement data, and the calculated scale factor for each physical condition of each patient for which the reference heart sound data and the invasive measurement data are acquired,
The step of extracting, by the computer, a scale factor between the measured heart sound processing data and the cardiovascular information data value,
Characterized in that to extract the scale factor using the matrix,
A method of acquiring cardiovascular information using heart sound. The method of claim 15,
The computer,
Obtaining a scale factor between the reference heart sound processing data and the invasive measurement data; And
Generating a matrix using the reference heart sound processing data, the invasive measurement data, and the scale factor for each physical condition of each patient who has acquired the reference heart sound data and the invasive measurement data,
Performed using a learning algorithm, characterized in that to provide a matrix using the scale factor,
A method of acquiring cardiovascular information using heart sound. A program for acquiring cardiovascular system information using heart sounds stored in a recording medium in order to execute the method of any one of claims 1, 2, 15 and 16 in combination with a computer as hardware. A measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time;
A heart sound processing data acquisition unit for acquiring at least one measured heart sound processing data by using the measured heart sound data; And
A measurement heart sound processing data change graph providing unit for generating and providing a real-time change graph of the measured heart sound processing data,
The real-time change graph of the measured heart sound processing data has the same change trend as the change graph of the cardiovascular information data,
The cardiovascular information data,
A correlation between reference heart sound processing data and invasive measurement data paired as one or more of the same patient and previously acquired at the same time; And
Data extracted using the measured heart sound data,
Cardiovascular system information acquisition device using heart sound. A measured heart sound data acquisition unit that acquires measured heart sound data of a specific patient in real time;
A measured heart sound processing data acquisition unit for acquiring at least one measured heart sound processing data in real time by using the measured heart sound data;
A scale factor calculator configured to calculate a scale factor between the measured heart sound processing data and cardiovascular information data values; And
Calculating and providing a calculated value of cardiovascular information data based on the measured heart sound processing data and the scale factor, wherein the cardiovascular information data is data having the same change trend as the specific measured heart sound processing data, which is cardiovascular information data calculation Includes wealth,
The cardiovascular information data,
A correlation between reference heart sound processing data and invasive measurement data paired as one or more of the same patient and previously acquired at the same time; And
Data extracted using the measured heart sound data,
Cardiovascular system information acquisition device using heart sound.

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