Abstract

This paper proposes a method that automatically measures non-invasive blood pressure (BP) based on an auscultatory approach using Korotkoff sounds (K-sounds). There have been methods utilizing K-sounds that were more accurate in general than those using cuff pressure signals only under well-controlled environments, but most were vulnerable to the measurement conditions and to external noise because blood pressure is simply determined based on threshold values in the sound signal. The proposed method enables robust and precise BP measurements by evaluating the probability that each sound pulse is an audible K-sound based on a deep learning using a convolutional neural network (CNN). Instead of classifying sound pulses into two categories, audible K-sounds and others, the proposed CNN model outputs probability values. These values in a Korotkoff cycle are arranged in time order, and the blood pressure is determined. The proposed method was tested with a dataset acquired in practice that occasionally contains considerable noise, which can degrade the performance of the threshold-based methods. The results demonstrate that the proposed method outperforms a previously reported CNN-based classification method using K-sounds. With larger amounts of various types of data, the proposed method can potentially achieve more precise and robust results.

Highlights

  • blood pressure (BP) measurement by the auscultatory method.When the cuff is pressurized above the BP, the artery is collapsed and no blood can flow

  • K-sounds are likely produced by harmonic oscillations of the artery wall, acting as a spring-mass-damper, as it closes and opens with each blood pulse when the cuff pressure is between systolic blood pressure (SBP) and diastolic blood pressure (DBP)

  • When the cuff pressure is lowered to the DBP, blood flows without any obstruction and the Korotkoff sounds disappear

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Summary

Introduction

When the cuff is pressurized above the BP, the artery is collapsed and no blood can flow. When the cuff pressure decreases below the SBP, blood starts to overcome the cuff pressure and flow intermittently. K-sounds are likely produced by harmonic oscillations of the artery wall, acting as a spring-mass-damper, as it closes and opens with each blood pulse when the cuff pressure is between SBP and DBP. When the cuff pressure is lowered to the DBP, blood flows without any obstruction and the Korotkoff sounds disappear. When using this method, an observer listens to the K-sounds using a stethoscope to find the critical cuff pressure values at the moment the K-sounds appear and disappear, which correspond to SBP and DBP, respectively

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