从前颈接触光体积描记术中提取颈静脉搏动。,Scientific Reports

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从前颈接触光体积描记术中提取颈静脉搏动。
Scientific Reports ( IF 3.8 ) Pub Date : 2020-02-26 , DOI: 10.1038/s41598-020-60317-7
Irene García-López ₁ , Esther Rodriguez-Villegas ₁

Affiliation

颈静脉脉冲（JVP）是用于在心血管疾病（CVD）诊断中检测右心房和中心静脉压（CVP）异常的参考生理信号。侵入性中心静脉导管插入术一直是可靠地提取它的金标准方法。然而，由于其带来的所有风险，最近出现了利用远距离照相机和激光的新型非侵入性方法来测量颈外静脉和颈内静脉的JVP。但是，这些远程选项将患者限制在成像系统前非常特定的身体位置，因此不足以进行长期监控。在这项研究中，我们首次证明，反射光体积描记法（PPG）可以替代方式以接触方式从颈前静脉提取JVP。记录了来自20名健康参与者的颈部JVP-PPG信号，以及参考ECG和动脉手指PPG信号，以进行验证。颈内静脉的B型超声成像也证明了该方法的有效性。结果表明，有可能识别新信号中的特征a，c，v压力波，并确定其与确定的心脏生理学一致的心动周期。小波相干值（接近1和相移±180°）证实了颈部接触JVP-PPG脉冲与动脉手指PPG负相关。每个受试者的平均JVP波形显示典型的JVP脉冲轮廓，但在队列的一半中，除了在c波之后出现的未知“ u”波的奇异点之外。

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Extracting the Jugular Venous Pulse from Anterior Neck Contact Photoplethysmography.

The jugular venous pulse (JVP) is the reference physiological signal used to detect right atrial and central venous pressure (CVP) abnormalities in cardio-vascular diseases (CVDs) diagnosis. Invasive central venous line catheterization has always been the gold standard method to extract it reliably. However, due to all the risks it entails, novel non-invasive approaches, exploiting distance cameras and lasers, have recently arisen to measure the JVP at the external and internal jugular veins. These remote options however, constraint patients to very specific body positions in front of the imaging system, making it inadequate for long term monitoring. In this study, we demonstrate, for the first time, that reflectance photoplethysmography (PPG) can be an alternative for extracting the JVP from the anterior jugular veins, in a contact manner. Neck JVP-PPG signals were recorded from 20 healthy participants, together with reference ECG and arterial finger PPG signals for validation. B-mode ultrasound imaging of the internal jugular vein also proved the validity of the proposed method. The results show that is possible to identify the characteristic a, c, v pressure waves in the novel signals, and confirm their cardiac-cycle timings in consistency with established cardiac physiology. Wavelet coherence values (close to 1 and phase shifts of ±180°) corroborated that neck contact JVP-PPG pulses were negatively correlated with arterial finger PPG. Average JVP waveforms for each subject showed typical JVP pulses contours except for the singularity of an unknown "u" wave occurring after the c wave, in half of the cohort. This work is of great significance for the future of CVDs diagnosis, as it has the potential to reduce the risks associated with conventional catheterization and enable continuous non-invasive point-of-care monitoring of CVP, without restricting patients to limited postures.

更新日期：2020-02-26

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