Non-Contact Blood Pressure Monitoring Using Radar Signals: A Dual-Stage Deep Learning Network

Emerging radar sensing technology is revolutionizing cardiovascular monitoring by eliminating direct skin contact. This approach captures vital signs through electromagnetic wave reflections, enabling contactless blood pressure (BP) tracking while maintaining user comfort and privacy. We present a hierarchical neural framework that synergizes spatial and temporal feature learning for radar-driven, contactless BP monitoring. By employing advanced preprocessing techniques, the system captures subtle chest wall vibrations and their second-order derivatives, feeding dual-channel inputs into a hierarchical neural network. Specifically, Stage 1 deploys convolutional depth-adjustable lightweight residual blocks to extract spatial features from micro-motion characteristics, while Stage 2 employs a transformer architecture to establish correlations between these spatial features and BP periodic dynamic variations. Drawing on the intrinsic link between systolic (SBP) and diastolic (DBP) blood pressures, early estimates from Stage 2 are used to expand the feature set for the second-stage network, boosting its predictive power. Validation achieved clinically acceptable errors (SBP: -1.09 ± 5.15 mmHg, DBP: -0.26 ± 4.35 mmHg). Notably, this high degree of accuracy, combined with the ability to estimate BP at 2 s intervals, closely approximates real-time, beat-to-beat monitoring, representing a pivotal breakthrough in non-contact BP monitoring.

Accurate Cardiac Duration Detection for Remote Blood Pressure Estimation Using mm-Wave Doppler Radar

This study introduces a radar-based model for estimating blood pressure (BP) in a touch-free manner. The model accurately detects cardiac activity, allowing for contactless and continuous BP monitoring. Cardiac motions are considered crucial components for estimating blood pressure. Unfortunately, because these movements are extremely subtle and can be readily obscured by breathing and background noise, accurately detecting these motions with a radar system remains challenging. Our approach to radar-based blood pressure monitoring in this research primarily focuses on cardiac feature extraction. Initially, an integrated-spectrum waveform is implemented. The method is derived from the short-time Fourier transform (STFT) and has the ability to capture and maintain minute cardiac activities. The integrated spectrum concentrates on energy changes brought about by short and high-frequency vibrations, in contrast to the pulse-wave signals used in previous works. Hence, the interference caused by respiration, random noise, and heart contractile activity can be effectively eliminated. Additionally, we present two approaches for estimating cardiac characteristics. These methods involve the application of a hidden semi-Markov model (HSMM) and a U-net model to extract features from the integrated spectrum. In our approach, the accuracy of extracted cardiac features is highlighted by the notable decreases in the root mean square error (RMSE) for the estimated interbeat intervals (IBIs), systolic time, and diastolic time, which were reduced by 87.5%, 88.7%, and 73.1%. We reached a comparable prediction accuracy even while our subject was breathing normally, despite previous studies requiring the subject to hold their breath. The diastolic BP (DBP) error of our model is 3.98±5.81 mmHg (mean absolute difference ± standard deviation), and the systolic BP (SBP) error is 6.52±7.51 mmHg.

Non-Contact Stable Arterial Pulse Measurement Using mmWave Array Radar

Pulse signals can serve as important indicators of one's cardiovascular condition. However, capturing signals with stable morphology using radar under varying measurement periods remains a significant challenge. This paper reports a non-contact arterial pulse measurement method based on mmWave radar, with stable signals achieved through a range-angle focusing algorithm. A total of six subjects participated in the experiment, and the results showed that, under different measurement times, the pulse morphology of the same body part for each subject had good consistency, reaching a correlation of over 0.84, and four selected pulse signs remained stable. This is a quantitative assessment revealing a high correlation in pulse morphology measured by radar over different periods. In addition, the influence of array size and measurement distance was analyzed, providing a reference of array selection for research work with different requirements. This work offers an effective reference framework for long-term pulse measurement using radar technology.

Recommendations for evaluating photoplethysmography-based algorithms for blood pressure assessment

Photoplethysmography (PPG) is a non-invasive optical technique that measures changes in blood volume in the microvascular tissue bed of the body. While it shows potential as a clinical tool for blood pressure (BP) assessment and hypertension management, several sources of error can affect its performance. One such source is the PPG-based algorithm, which can lead to measurement bias and inaccuracy. Here, we review seven widely used measures to assess PPG-based algorithm performance and recommend implementing standardized error evaluation steps in their development. This standardization can reduce bias and improve the reliability and accuracy of PPG-based BP estimation, leading to better health outcomes for patients managing hypertension.

Recent Advances in Materials, Devices and Algorithms Toward Wearable Continuous Blood Pressure Monitoring

Continuous blood pressure (BP) tracking provides valuable insights into the health condition and functionality of the heart, arteries, and overall circulatory system of humans. The rapid development in flexible and wearable electronics has significantly accelerated the advancement of wearable BP monitoring technologies. However, several persistent challenges, including limited sensing capabilities and stability of flexible sensors, poor interfacial stability between sensors and skin, and low accuracy in BP estimation, have hindered the progress in wearable BP monitoring. To address these challenges, comprehensive innovations in materials design, device development, system optimization, and modeling have been pursued to improve the overall performance of wearable BP monitoring systems. In this review, we highlight the latest advancements in flexible and wearable systems toward continuous noninvasive BP tracking with a primary focus on materials development, device design, system integration, and theoretical algorithms. Existing challenges, potential solutions, and further research directions are also discussed to provide theoretical and technical guidance for the development of future wearable systems in continuous ambulatory BP measurement with enhanced sensing capability, robustness, and long-term accuracy.

Meta-Analysis of Pulse Transition Features in Non-Invasive Blood Pressure Estimation Systems: Bridging Physiology and Engineering Perspectives

The pulse transition features (PTFs), including pulse arrival time (PAT) and pulse transition time (PTT), hold significant importance in estimating non-invasive blood pressure (NIBP). However, the literature showcases considerable variations in terms of PTFs' correlation with blood pressure (BP), accuracy in NIBP estimation, and the comprehension of the relationship between PTFs and BP. This inconsistency is exemplified by the wide-ranging correlations reported across studies investigating the same feature. Furthermore, investigations comparing PAT and PTT have yielded conflicting outcomes. Additionally, PTFs have been derived from various bio-signals, capturing distinct characteristic points like the pulse's foot and peak. To address these inconsistencies, this study meticulously reviews a selection of such research endeavors while aligning them with the biological intricacies of blood pressure and the human cardiovascular system (CVS). Each study underwent evaluation, considering the specific signal acquisition locale and the corresponding recording procedure. Moreover, a comprehensive meta-analysis was conducted, yielding multiple conclusions that could significantly enhance the design and accuracy of NIBP systems. Grounded in these dual aspects, the study systematically examines PTFs in correlation with the specific study conditions and the underlying factors influencing the CVS. This approach serves as a valuable resource for researchers aiming to optimize the design of BP recording experiments, bio-signal acquisition systems, and the fine-tuning of feature engineering methodologies, ultimately advancing PTF-based NIBP estimation.

Reconstruction of central arterial pressure waveform based on CBi-SAN network from radial pressure waveform

The central arterial pressure (CAP) is an important physiological indicator of the human cardiovascular system which represents one of the greatest threats to human health. Accurate non-invasive detection and reconstruction of CAP waveforms are crucial for the reliable treatment of cardiovascular system diseases. However, the traditional methods are reconstructed with relatively low accuracy, and some deep learning neural network models also have difficulty in extracting features, as a result, these methods have potential for further advancement. In this study, we proposed a novel model (CBi-SAN) to implement an end-to-end relationship from radial artery pressure (RAP) waveform to CAP waveform, which consisted of the convolutional neural network (CNN), the bidirectional long-short-time memory network (BiLSTM), and the self-attention mechanism to improve the performance of CAP reconstruction. The data on invasive measurements of CAP and RAP waveform were used in 62 patients before and after medication to develop and validate the performance of CBi-SAN model for reconstructing CAP waveform. We compared it with traditional methods and deep learning models in mean absolute error (MAE), root mean square error (RMSE), and Spearman correlation coefficient (SCC). Study results indicated the CBi-SAN model performed great performance on CAP waveform reconstruction (MAE: 2.23 ± 0.11 mmHg, RMSE: 2.21 ± 0.07 mmHg), concurrently, the best reconstruction effect was obtained in the central artery systolic pressure (CASP) and the central artery diastolic pressure(CADP) (RMSECASP: 2.94 ± 0.48 mmHg, RMSECADP: 1.96 ± 0.06 mmHg). These results implied the performance of the CAP reconstruction based on CBi-SAN model was superior to the existing methods, hopped to be effectively applied to clinical practice in the future.

Continuous Non-Invasive Blood Pressure Measurement Using 60 GHz-Radar-A Feasibility Study

Blood pressure monitoring is of paramount importance in the assessment of a human's cardiovascular health. The state-of-the-art method remains the usage of an upper-arm cuff sphygmomanometer. However, this device suffers from severe limitations-it only provides a static blood pressure value pair, is incapable of capturing blood pressure variations over time, is inaccurate, and causes discomfort upon use. This work presents a radar-based approach that utilizes the movement of the skin due to artery pulsation to extract pressure waves. From those waves, a set of 21 features was collected and used-together with the calibration parameters of age, gender, height, and weight-as input for a neural network-based regression model. After collecting data from 55 subjects from radar and a blood pressure reference device, we trained 126 networks to analyze the developed approach's predictive power. As a result, a very shallow network with just two hidden layers produced a systolic error of 9.2±8.3 mmHg (mean error ± standard deviation) and a diastolic error of 7.7±5.7 mmHg. While the trained model did not reach the requirements of the AAMI and BHS blood pressure measuring standards, optimizing network performance was not the goal of the proposed work. Still, the approach has displayed great potential in capturing blood pressure variation with the proposed features. The presented approach therefore shows great potential to be incorporated into wearable devices for continuous blood pressure monitoring for home use or screening applications, after improving this approach even further.

Dynamic Microwave Imaging of the Cardiovascular System Using Ultra-Wideband Radar-on-Chip Devices

OBJECTIVE

Microwave imaging has been investigated for medical applications such as stroke and breast imaging. Current systems typically rely on bench-top equipment to scan at a variety of antenna positions. For dynamic imaging of moving structures, such as the cardiovascular system, much higher imaging speeds are required than what has thus far been reported. Recent innovations in radar-on-chip technology allow for simultaneous high speed data collection at multiple antenna positions at a fraction of the cost of conventional microwave equipment, in a small and potentially portable system. The objective of the current work is to provide proof of concept of dynamic microwave imaging in the body, using radar-on-chip technology.

METHODS

Arrays of body-coupled antennas were used with nine simultaneously operated coherent ultra-wideband radar chips. Data were collected from the chest and thigh of a volunteer, with the objective of imaging the femoral artery and beating heart. In addition, data were collected from a phantom to validate system performance. Video data were constructed using beamforming.

RESULTS

The location of the femoral artery could successfully be resolved, and a distinct arterial pulse wave was discernable. Cardiac activity was imaged at locations corresponding to the heart, but image quality was insufficient to identify individual anatomical structures. Static and differential imaging of the femur bone proved unsuccessful.

CONCLUSION

Using radar chip technology and an imaging approach, cardiovascular activity was detected in the body, demonstrating first steps towards biomedical dynamic microwave imaging. The current portable and modular system design was found unsuitable for static in-body imaging.

SIGNIFICANCE

This first proof of concept demonstrates that radar-on-chip could enable cardiovascular imaging in a low-cost, small and portable system. Such a system could make medical imaging more accessible, particularly in ambulatory or long-term monitoring settings.

Cuff-less and continuous blood pressure measurement based on pulse transit time from carotid and toe photoplethysmograms

Blood pressure (BP) is a vital health parameter that varies throughout the day. As a single reading of high BP may not indicate hypertension, continuous monitoring of BP is usually recommended by medical doctors to confirm the diagnosis of hypertension. In the last few decades, researchers have investigated cuff-less and continuous BP measurements based on pulse transit time (PTT). The main purpose of this research is to develop an autoregressive (ARX) system identification (SI)-based PTT calculation model using two PPG signals acquired from carotid and toe. The signals were recorded from 65 subjects with an age range between 20 and 60 years. The results of the study have been validated in two stages. The first validation comprised the estimated BP from PTT using SI compared to the measured BP using the cuff-based method for all subjects. The results of the estimated BP using the proposed method compared to the measured BP obtained using the standard BP cuff measurement method are highly correlated to both systolic blood pressure (R² = 0.8132) and diastolic blood pressure (R² = 0.8357). The second validation consisted of comparing PTT values using system identification to the results of the PTT derived from the ECG-PPG method. The results showed that both methods are highly correlated (R² = 0.7808), and there is no significant difference between them (p < 0.05) with a slightly better PTT estimation related to DBP in the proposed method. Our results have proven that the PTT obtained from the carotid PPG and toe PPG using the system identification approach yielded SBP and DBP estimations that are consistent with the values of the conventional BP cuff method. The newly proposed method has the advantage of being cuff-less and able to provide continuous BP measurements.

Characterization of the Analog Device Inc (ADI) MAX30009 Bioimpedance Analog Front End Chip

An increasing number of novel wearable health monitors utilize Bioimpedance (BioZ) to deliver meaningful health insights. Several integrated circuit BioZ chips have emerged to measure BioZ within the space constraints of wearable applications. One new integrated circuit BioZ chip, the MAX30009 Bioimpedance Analog Front End (AFE), has never been characterized. This paper aims to provide an initial characterization of the MAX30009. The AFE's performance was evaluated through a series of tests exploring the chip's accuracy, precision, and performance in the presence of realistic RC contact impedance circuits. The experiments found the AFE can achieve a standard deviation of 0.067 ohms and 0.033 degrees for a 100-ohm resistor and 0.0575 ohms and 0.249 degrees for a 227 nF capacitor at 50 kHz. Ultimately, a Bland-Altman analysis suggests that over the frequency range of 1 kHz - 340 kHz, the MAX30009 is interchangeable with a reference Zurich Instruments Impedance Analyzer. Clinical Relevance-The MAX30009 Bioimpedance chip is demonstrated to be interchangeable with a Zurich Instruments impedance analyzer over the range of 1 kHz - 340 kHz.

A Hardware-based Lightweight ANN for Real-time Wearable Blood Pressure Estimation

Blood pressure (BP) is an important indicator of the state of cardiovascular health. BP estimation is an essential method to prevent the occurrence of hypertension. Currently, there is a strong focus on low power design for a wearable BP estimation device. This paper proposes a lightweight artificial neural network (ANN) for BP estimation and implements it on an ultra-low-power application-specific integrated circuit (ASIC). On the test set, the mean absolute error (MAE) and standard deviation (SD) of the estimated systolic BP and diastolic BP are 2.47 ± 3.48 mmHg and 1.45 ± 1.88 mmHg. Besides, in the case of 8-bit quantization, the MAE ± SD of the estimated systolic BP and diastolic BP are 12.41 ± 5.32 mmHg and 6.29 ± 3.03 mmHg respectively. The regression result R² of overall SBP and DBP is 0.9702. This ASIC whose power is 19.72 µW is validated via the 0.18 µm CMOS process, occupying an area of 730 µmx 730 µm.

Cuffless and Touchless Measurement of Blood Pressure from Ballistocardiogram Based on a Body Weight Scale

Currently, in terms of reducing the infection risk of the COVID-19 virus spreading all over the world, the development of touchless blood pressure (BP) measurement has potential benefits. The pulse transit time (PTT) has a high relation with BP, which can be measured by electrocardiogram (ECG) and photoplethysmogram (PPG). The ballistocardiogram (BCG) reflects the mechanical vibration (or displacement) caused by the heart contraction/relaxation (or heart beating), which can be measured from multiple degrees of the body. The goal of this study is to develop a cuffless and touchless BP-measurement method based on a commercial weight scale combined with a PPG sensor when measuring body weight. The proposed method was that the PTTBCG-PPGT was extracted from the BCG signal measured by a weight scale, and the PPG signal was measured from the PPG probe placed at the toe. Four PTT models were used to estimate BP. The reference method was the PTTECG-PPGF extracted from the ECG signal and PPG signal measured from the PPG probe placed at the finger. The standard BP was measured by an electronic blood pressure monitor. Twenty subjects were recruited in this study. By the proposed method, the root-mean-square error (ERMS) of estimated systolic blood pressure (SBP) and diastolic blood pressure (DBP) are 6.7 ± 1.60 mmHg and 4.8 ± 1.47 mmHg, respectively. The correlation coefficients, r2, of the proposed model for the SBP and DBP are 0.606 ± 0.142 and 0.284 ± 0.166, respectively. The results show that the proposed method can serve for cuffless and touchless BP measurement.

Measurement of pulse transit time using ultra-wideband radar

BACKGROUND: The pulse transit time is an important factor that can be used to estimate the blood pressure indirectly. In many studies, pressures in the artery near and far from the heart are measured or the electrocardiogram and photoplethysmography are used to calculate the pulse transit time. In other words, the so-called contact measurements have been mainly used in these studies. OBJECTIVE: In this paper, a new method based on radar technology to measure the pulse transit time in a non-contact manner is proposed. METHODS: Radar pulses were simultaneously emitted to the chest and the wrist, and the reflected pulses were accumulated. Heartbeats were extracted by performing principal component analysis on each time series belonging to the accumulated pulses. Then, the matched heartbeat pairs were found among the heartbeats obtained from the chest and wrist and the time delay between them, i.e. the pulse transit time, was obtained. RESULTS: By comparing the pulse transit times obtained by the proposed method with those obtained by conventional methods, it is confirmed that the proposed method using the radar can be used to obtain the pulse transit time in a non-contact manner.

Recent Development of Non-Contact Multi-Target Vital Sign Detection and Location Tracking Based on Metamaterial Leaky Wave Antennas

Microwave radar sensors have been developed for non-contact monitoring of the health condition and location of targets, which will cause minimal discomfort and eliminate sanitation issues, especially in a pandemic situation. To this end, several radar sensor architectures and algorithms have been proposed to detect multiple targets at different locations. Traditionally, beamforming techniques incorporating phase shifters or mechanical rotors are utilized, which is relatively complex and costly. On the other hand, metamaterial (MTM) leaky wave antennas (LWAs) have a unique property of launching waves of different spectral components in different directions. This feature can be utilized to detect multiple targets at different locations to obtain their healthcare and location information accurately, without complex structure and high cost. To this end, this paper reviews the recent development of MTM LWA-based radar sensor architectures for vital sign detection and location tracking. The experimental results demonstrate the effectiveness of MTM vital sign radar compared with different radar sensor architectures.

A new radio-frequency acoustic method for remote study of liquids

In the present work, a novel study method of conductive liquids has been proposed. It is based on a discovered phenomenon of radiofrequency anisotropy of electrolyte solution, which arises in response to mechanical excitation of the solution. The phenomenon was observed during the development of a radiofrequency polarimetric contactless cardiograph. The electric field vector rotates after its transition through the pericardial region due to the acceleration changes of blood. Numerous in vitro experiments with monochromatic and impulse acoustic waves always induced the polarization rotation of the RF wave passing through an electrolyte solution. The response obtained from the solutions on acoustic excitation of the Heaviside function form demonstrates the effect of a solution “memory”. The dynamics of this process resembles the spin glasses magnetization. We hypothesized that there was a magnetic moment change within the solution, and the possible reason for it is an appearance of electromagnetic impulse caused by the same acoustic excitation. In a further experiment, we really captured a suspected electrical potential. Given that, we can declare at least three new physical effects never observed before for an electrolyte solution. The study method itself may provide broad options for remote measurement of the electrolyte solution parameters.

Chest-based Real-Time Pulse and Respiration Monitoring Based on Bio-Impedance

Pulse wave and respiration are two important vital signals in diagnosing and treating diseases. In this paper, we investigated a Bio-impedance (BImp) based respiration and pulse wave monitoring system. The BImp signal is successfully extracted from a wearable device placed on the shoulder. Using the rate calculation algorithm, heart rate (HR), and respiration rate (RR) values are extracted accurately. The data is collected during different steps of breathing including slow, fast, deep, hold, and normal from 10 volunteers. The accuracy of HR results is compared to that of extracted from PPG with considering ECG based HR as reference. The extracted RR values are investigated against TCo₂ sensor's output. The estimation of both RR and HR extracted from the BImp signal has higher accuracy compared to the other methods.

Conventional pulse transit times as markers of blood pressure changes in humans

Pulse transit time (PTT) represents a potential approach for cuff-less blood pressure (BP) monitoring. Conventionally, PTT is determined by (1) measuring (a) ECG and ear, finger, or toe PPG waveforms or (b) two of these PPG waveforms and (2) detecting the time delay between the waveforms. The conventional PTTs (cPTTs) were compared in terms of correlation with BP in humans. Thirty-two volunteers [50% female; 52 (17) (mean (SD)) years; 25% hypertensive] were studied. The four waveforms and manual cuff BP were recorded before and after slow breathing, mental arithmetic, cold pressor, and sublingual nitroglycerin. Six cPTTs were detected as the time delays between the ECG R-wave and ear PPG foot, R-wave and finger PPG foot [finger pulse arrival time (PAT)], R-wave and toe PPG foot (toe PAT), ear and finger PPG feet, ear and toe PPG feet, and finger and toe PPG feet. These time delays were also detected via PPG peaks. The best correlation by a substantial extent was between toe PAT via the PPG foot and systolic BP [- 0.63 ± 0.05 (mean ± SE); p < 0.001 via one-way ANOVA]. Toe PAT is superior to other cPTTs including the popular finger PAT as a marker of changes in BP and systolic BP in particular.

Measurement, Analysis and Interpretation of Pressure/Flow Waves in Blood Vessels

The optimal performance of the cardiovascular system, as well as the break-down of this performance with disease, both involve complex biomechanical interactions between the heart, conduit vascular networks and microvascular beds. ‘Wave analysis’ refers to a group of techniques that provide valuable insight into these interactions by scrutinizing the shape of blood pressure and flow/velocity waveforms. The aim of this review paper is to provide a comprehensive introduction to wave analysis, with a focus on key concepts and practical application rather than mathematical derivations. We begin with an overview of invasive and non-invasive measurement techniques that can be used to obtain the signals required for wave analysis. We then review the most widely used wave analysis techniques—pulse wave analysis, wave separation and wave intensity analysis—and associated methods for estimating local wave speed or characteristic impedance that are required for decomposing waveforms into forward and backward wave components. This is followed by a discussion of the biomechanical phenomena that generate waves and the processes that modulate wave amplitude, both of which are critical for interpreting measured wave patterns. Finally, we provide a brief update on several emerging techniques/concepts in the wave analysis field, namely wave potential and the reservoir-excess pressure approach.

Non-Contact Blood Pressure Measurement Scheme Using Doppler Radar

A continuous cuffless non-contact blood pressure (BP) measurement scheme using Doppler radar is proposed. This non-contact BP estimation scheme uses the periods in which the heart beats and periods in which the heart contracts. These periods are obtained using Doppler radar signals. Diastolic BP (DBP) was estimated using the period in which the heart contracts. Pulse pressure (PP) was estimated using one period in which the heart beats and one period in which the heart contracts. Systolic BP (SBP) was obtained by the sum of the estimated DBP and PP. The correlation of the estimated BP and the BP acquired by the BP monitor was calculated. The correlation coefficients were 0.79 for SBP, 0.88 for DBP, and 0.81 for PP. The BP was successfully measured in a contactless manner.

Spectral Parametrization of PPG, IPG and pAT Pulse Waves for Continuous Noninvasive Blood Pressure Estimation

Recent technological advances are enabling the sector of wearables to rapidly expand. An increasingly big emphasis is placed on introducing continuous monitoring of biosignals such as heart rate, SpO2 and ECG. Extrapolating from the current trend of making clinical signals available to the general public, arterial blood pressure is a realistic and useful next step. Its robust, non-obtrusive, continuous acquisition is of great interest and importance, especially in clinical settings. Using a body sensor network, we acquire photoplethysmography, bioimpedance and pulse applanation tonometry signals synchronously at the periphery. The pulse waves are decomposed into spectral amplitude and phase. The values thereof are then used as features for blood pressure estimation. We apply a polynomial regression method and evaluate performance employing leave one out cross validation. A single initial parameter calibration is applied for the entire measurement. Our results with noisy datasets exhibit acceptable tracking of mean arterial pressure, with a baseline error of 0.62 mmHg, absolute error of 4.6 mmHg and standard deviation of 5.3 mmHg. Spectral phase information mostly outperforms amplitude information. Optically, electrically and electro-mechanically derived signals perform similarly, but best compliance and quality is achieved for electrical bioimpedance. We conclude that using a single, peripherally acquired plethysmographic waveform for blood pressure tracking is feasible, offering increased placement flexibility and compliance at the cost of reduced accuracy.

Wearable Millimeter-Wave Device for Contactless Measurement of Arterial Pulses

Wearable monitors for measuring vital signs such as blood pressure will greatly impact the medical field. This work presents a millimeter-wave, radar-based system for performing accurate measurements of arterial pulse waveforms without contacting the region that is pulsing. Electromagnetic and radar-system simulation models are utilized to demonstrate the viability and safety of this approach. This is followed by hardware/software implementation and a study on 12 human subjects. Measured radial arterial waveforms exhibit signal strengths that are well above the noise floor of the system and a morphology that would be expected in an arterial pulse. Finally, comparison of the radar-based signals with a reference tonometer indicates a strong correlation between waveforms, as well as similar spectral signatures. The results observed suggest a millimeter-wave based approach for arterial pulse detection is very promising for future applications in pulse wave analysis and pulse transit time measurement for blood pressure tracking.

Blood Pressure Estimation Using On-body Continuous Wave Radar and Photoplethysmogram in Various Posture and Exercise Conditions

The pulse arrival time (PAT), pre-ejection period (PEP) and pulse transit time (PTT) are calculated using on-body continuous wave radar (CWR), Photoplethysmogram (PPG) and Electrocardiogram (ECG) sensors for wearable continuous systolic blood pressure (SBP) measurements. The CWR and PPG sensors are placed on the sternum and left earlobe respectively. This paper presents a signal processing method based on wavelet transform and adaptive filtering to remove noise from CWR signals. Experimental data are collected from 43 subjects in various static postures and 26 subjects doing 6 different exercise tasks. Two mathematical models are used to calculate SBPs from PTTs/PATs. For 38 subjects participating in posture tasks, the best cumulative error percentage (CEP) is 92.28% and for 21 subjects participating in exercise tasks, the best CEP is 82.61%. The results show the proposed method is promising in estimating SBP using PTT. Additionally, removing PEP from PAT leads to improving results by around 9%. The CWR sensors present a low-power, continuous and potentially wearable system with minimal body contact to monitor aortic valve mechanical activities directly. Results of this study, of wearable radar sensors, demonstrate the potential superiority of CWR-based PEP extraction for various medical monitoring applications, including BP measurement.

Non-invasive continuous blood pressure monitoring systems: current and proposed technology issues and challenges

High blood pressure (BP) or hypertension is the single most crucial adjustable risk factor for cardiovascular diseases (CVDs) and monitoring the arterial blood pressure (ABP) is an efficient way to detect and control the prevalence of the cardiovascular health of patients. Therefore, monitoring the regulation of BP during patients' daily life plays a critical role in the ambulatory setting and the latest mobile health technology. In recent years, many studies have been conducted to explore the feasibility and performance of such techniques in the health care system. The ultimate aim of these studies is to find and develop an alternative to conventional BP monitoring by using cuff-less, easy-to-use, fast, and cost-effective devices for controlling and lowering the physical harm of CVDs to the human body. However, most of the current studies are at the prototype phase and face a range of issues and challenges to meet clinical standards. This review focuses on the description and analysis of the latest continuous and cuff-less methods along with their key challenges and barriers. Particularly, most advanced and standard technologies including pulse transit time (PTT), ultrasound, pulse arrival time (PAT), and machine learning are investigated. The accuracy, portability, and comfort of use of these technologies, and the ability to integrate to the wearable healthcare system are discussed. Finally, the future directions for further study are suggested.

Coherent UWB Radar-on-Chip for In-Body Measurement of Cardiovascular Dynamics

Coherent ultra-wideband (UWB) radar-on-chip technology shows great promise for developing portable and low-cost medical imaging and monitoring devices. Particularly monitoring the mechanical functioning of the cardiovascular system is of interest, due to the ability of radar systems to track sub-mm motion inside the body at a high speed. For imaging applications, UWB radar systems are required, but there are still significant challenges with in-body sensing using low-power microwave equipment and wideband signals. Recently, it was shown for the first time, on a single subject, that the arterial pulse wave can be measured at various locations in the body, using a coherent UWB radar-on-chip technology. This paper provides more substantial evidence, in the form of new measurements and improved methods, to demonstrate that cardiovascular dynamics can be measured using radar-on-chip. Results across four participants were found to be robust and repeatable. Cardiovascular signals were recorded using radar-on-chip systems and electrocardiography (ECG). Through ECG-aligned averaging, the arterial pulse wave could be measured at a number of locations in the body. Pulse arrival time could be determined with high precision, and blood pressure pulse wave propagation through different arteries was demonstrated. In addition, cardiac dynamics were measured from the chest. This paper serves as a first step in developing a portable and low-cost device for long-term monitoring of the cardiovascular system and provides the fundamentals necessary for developing UWB radar-on-chip imaging systems.

Preclinical Evaluation of a Noncontact Simultaneous Monitoring Method for Respiration and Carotid Pulsation Using Impulse-Radio Ultra-Wideband Radar

There has been the possibility for respiration and carotid pulsation to be simultaneously monitored from a distance using impulse-radio ultra-wideband (IR-UWB) radar. Therefore, we investigated the validity of simultaneous respiratory rates (RR), pulse rates (PR) and R-R interval measurement using IR-UWB radar. We included 19 patients with a normal sinus rhythm (NSR) and 14 patients with persistent atrial fibrillation (PeAF). The RR, PR, R-R interval and rhythm were obtained simultaneously from the right carotid artery area in a supine position and under normal breathing conditions using IR-UWB radar. There was excellent agreement between the RR obtained by IR-UWB radar and that manually counted by a physician (intraclass correlation coefficient [ICC] 0.852). In the NSR group, there was excellent agreement between the PR (ICC 0.985), average R-R interval (ICC 0.999), and individual R-R interval (ICC 0.910) measured by IR-UWB radar and electrocardiography. In the PeAF group, PR (ICC 0.930), average R-R interval (ICC 0.957) and individual R-R interval (ICC 0.701) also agreed well between the two methods. These results demonstrate that IR-UWB radar can simultaneously monitor respiration, carotid pulse and heart rhythm with high precision and may thus be utilized as a noncontact continuous vital sign monitoring in clinical practice.

Cuff-Less Methods for Blood Pressure Telemonitoring

Blood pressure telemonitoring (BPT) is a telemedicine strategy that uses a patient's self-measured blood pressure (BP) and transmits this information to healthcare providers, typically over the internet. BPT has been shown to improve BP control compared to usual care without remote monitoring. Traditionally, a cuff-based monitor with data communication capabilities has been used for BPT; however, cuff-based measurements are inconvenient and cause discomfort, which has prevented the widespread use of cuff-based monitors for BPT. The development of new technologies which allow for remote BP monitoring without the use of a cuff may aid in more extensive adoption of BPT. This would enhance patient autonomy while providing physicians with a more complete picture of their patient's BP profile, potentially leading to improved BP control and better long-term clinical outcomes. This mini-review article aims to: (1) describe the fundamentals of current techniques in cuff-less BP measurement; (2) present examples of commercially available cuff-less technologies for BPT; (3) outline challenges with current methodologies; and (4) describe potential future directions in cuff-less BPT development.

Pulse transit time technique for cuffless unobtrusive blood pressure measurement: from theory to algorithm

Cuffless technique holds great promise to measure blood pressure (BP) in an unobtrusive way, improving diagnostics and monitoring of hypertension and its related cardiovascular diseases, and maximizing the independence and participation of individual. Pulse transit time (PTT) has been the most commonly employed techniques for cuffless BP estimation. Many studies have been conducted to explore its feasibility and validate its performance in the clinical settings. However, there is still issues and challenges ahead before its wide application. This review will investigate the understanding and development of the PTT technique in depth, with a focus on the physiological regulation of arterial BP, the relationship between PTT and BP, and the summaries of the PTT-based models for BP estimation.

A Novel Method for Breath Detection via Stepped-Frequency Continuous Wave Ultra-Wideband (SFCW UWB) Radars Based on Operational Bandwidth Segmentation

Human being detection via ultra-wideband (UWB) radars has shown great prospects in many areas, such as biomedicine, military operation, public security, emergency rescue, and so on. When a person stays stationary, the main feature that separates him/her from surroundings is the movement of chest wall due to breath. There have been many algorithms developed for breath detection while using UWB radars. However, those algorithms were almost based on a basic scheme that focused on processing in the time dimension of UWB data. They did not utilize the benefits from the wide operational bandwidth of UWB radars to show potential superiority over those narrowband systems such as a continuous wave (CW) Doppler radar. In this paper, a breath detection method was proposed based on operational bandwidth segmentation. A basic theoretical model was firstly introduced, indicating that characteristics of breath signals contained in UWB echoes were consistent among the operational frequencies, while those of clutters were not. So, the method divided a set of UWB echo data into a number of subsets, each of which corresponded to a sub-band within the operational bandwidth of the UWB radar. Thus information about the operational frequency is provided for subsequent processing. With the aid of the information, a breath enhancement algorithm was developed mainly by averaging the segmented UWB data along the operational frequency. The algorithm's performance was verified by data measured by a stepped-frequency CW (SFCW) UWB radar. The experimental results showed that the algorithm performed better than that without the segmentation. They also showed its feasibility for fast detection of breath based on a short duration of data. Moreover, the method's potential for target identification and impulse-radio (IR) UWB radar was investigated. In summary, the method provides a new processing scheme for UWB radars when they are used for breath detection. With this scheme, the UWB radars have a benefit of greater flexibility in data processing over those narrowband radars, and thus will perform more effectively and efficiently in practical applications.

Comment on 'New photoplethysmogram indicators for improving cuffless and continuous blood pressure estimation accuracy'

OBJECTIVE

A recent study investigated the potential utility of new photoplethysmogram (PPG) indicators to improve cuffless continuous blood pressure (BP) measurement.

APPROACH

In this Comment we provide additional discussion of the physiology underlying PPG- and pulse arrival time (PAT)-based BP measurement. We also discuss validation of these measurements.

MAIN RESULTS

Changes in PPG features and PAT can occur independently of BP. Any study validating BP measurement based on PPG features or PAT should include a variety of calibration independent physiological challenges affecting BP.

SIGNIFICANCE

PPG/PAT-based BP measurement has been investigated extensively as an alternative to cuff-based BP measurement. We feel the inherent physiological confounding in PPG/PAT-based measurement makes it unlikely that it will be of clinical value.

A Novel Non-contact Heart Rate Monitor Using Impulse-Radio Ultra-Wideband (IR-UWB) Radar Technology

We discovered that impulse-radio ultra-wideband (IR-UWB) radar could recognize cardiac motions in a non-contact fashion. Therefore, we measured the heart rate (HR) and rhythms using an IR-UWB radar sensor and evaluated the validity and reliability of the measurements in comparison to electrocardiography. The heart beats were measured in 6 healthy volunteers (18 samples) with normal sinus rhythm (NSR) and 16 patients (36 samples) with atrial fibrillation (AF) using both an IR-UWB radar sensor and electrocardiography simultaneously. The participants hold their breath for 20 seconds during the data acquisition. In subjects with NSR, there was excellent agreement of HR (intraclass correlation coefficient [ICC] 0.856), average R-R interval (ICC 0.997) and individual R-R intervals between the two methods (ICC 0.803). In subjects with AF, HR (ICC 0.871) and average R-R interval (ICC 0.925) from the radar sensor also agreed well with those from electrocardiography, though there was a small disagreement in the individual R-R intervals between the two methods (ICC 0.697). The rhythms computed by the signal-processing algorithm showed good agreement between the two methods (Cohen's Kappa 0.922). The IR-UWB radar sensor is precise and accurate for assessing HR and rhythms in a non-contact fashion.

Monitoring the Relative Blood Pressure Using a Hydraulic Bed Sensor System

We propose a nonwearable hydraulic bed sensor system that is placed underneath the mattress to estimate the relative systolic blood pressure of a subject, which only differs from the actual blood pressure by a scaling and an offset factor. Two types of features are proposed to obtain the relative blood pressure, one based on the strength and the other on the morphology of the bed sensor ballistocardiogram pulses. The relative blood pressure is related to the actual by a scale and an offset factor that can be obtained through calibration. The proposed system is able to extract the relative blood pressure more accurately with a less sophisticated sensor system compared to those from the literature. We tested the system using a dataset collected from 48 subjects right after active exercises. Comparison with the ground truth obtained from the blood pressure cuff validates the promising performance of the proposed system, where the mean correlation between the estimate and the ground truth is near to 90% for the strength feature and 83% for the morphology feature.

Developing a Wireless, High Precision and Processing Speed Pulse Monitoring Headset Using Photoplethysmography

In this paper, thorough improvement of pulse monitoring and analysis equipment with a headset structure is presented. In order to study the most suitable infrared wavelength for the acquisition of the pulse wave at the earlobe, Monte Carlo simulation was adapted. Both high frequency noise and baseline drift, generated in the signal acquisition process, are considered. To further optimize the system design and improve accuracy, for the sensor's dimensional drift, the corresponding compensation was carried on in the software. This paper introduced nonlinear quantization, especially in terms of very weak pulse signal, in the time domain analysis process. A quick extraction method named table look-up combing with interpolation was utilized to obtain frequency domain information whose processing speed can be increased by about 30 times compared with fast Fourier transformation setting the sampling point as 300. The results demonstrated the sensor's excellent performance in pulse signal acquisition whose maximum residual is less than 0.004 mV. The test on a random sample of 300 people indicates that the system had high correlation with reference, validating the system accuracy is extremely high. Overall, this paper provides a practical pulse monitoring and analysis system with high precision and processing speed that can be widely applied in the field of health management or medical measurement.

Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Predictions on Maximum Calibration Period and Acceptable Error Limits

OBJECTIVE

Pulse transit time (PTT) is being widely pursued for ubiquitous blood pressure (BP) monitoring. PTT-based systems may require periodic cuff calibrations but can still be useful for hypertension screening by affording numerous out-of-clinic measurements that can be averaged. The objective was to predict the maximum calibration period that would not compromise accuracy and acceptable error limits in light of measurement averaging for PTT-based systems.

METHODS

Well-known mathematical models and vast BP data were leveraged. Models relating PTT, age, and gender to BP were employed to determine the maximum time period for the PTT-BP calibration curve to change by <1 mmHg over physiological BP ranges for each age and gender. A model of within-person BP variability was employed to establish the screening accuracy of the conventional cuff-based approach. These models were integrated to investigate the screening accuracy of the average of numerous measurements of a PTT-based system in relation to the accuracy of its individual measurements.

RESULTS

The maximum calibration period was about 1 year for a 30 year old and declined linearly to about 6 months for a 70 year old. A PTT-based system with a precision error of >12 mmHg for systolic BP could achieve the screening accuracy of the cuff-based approach via measurement averaging.

CONCLUSION

This theoretical study indicates that PTT-based BP monitoring is viable even with periodic calibration and seemingly high measurement errors.

SIGNIFICANCE

The predictions may help guide the implementation, evaluation, and application of PTT-based BP monitoring systems in practice.