Chest Wearable Apparatus for Cuffless Continuous Blood Pressure Measurements Based on PPG and PCG Signals

This paper describes an integrated chest wearable apparatus for continuous blood pressure (BP) measurements exploiting the heart-rate (HR) and the pulse arrival time (PAT) in a modified Moens-Korteweg model. The device embeds a miniaturized gas pressure sensor to record the phonocardiogram (PCG) of the heart sounds, a LED-photodiode pair to detect the photoplethysmogram (PPG) of the blood flow wave, a mu-controller, a wireless communication module and the power supply. With the proposed device no active participation would be required from human subjects for BP measurements, since the HR and the PAT are continuously extracted from the PCG and PPG signals. Dedicated signal processing algorithms were developed and implemented off-line to extract both HR and PAT. A subject-specific calibration protocol of the BP modelwas designed and implemented. The calibration and validation of the apparatus were performed on a cohort of 20 healthy subjects. A GIMA ABPM pressure Holter was chosen as reference device, and 8 measurements points, evenly distributed over a 10-minute interval, were used for model calibration for each subject. The range of DBP and SBP measurements were 52-85 mmHg and 90-141 mmHg, respectively. The results from Bland-Altman analysis showed that the mean +/- 1.96SD for the estimated diastolic, systolic, and mean BP with the proposed method against reference were 0.01 +/- 7.55, 1.47 +/- 3.76, 0.74 +/- 4.38 mmHg, respectively. The corresponding mean absolute differences (MAD) were 3.06, 1.83, and 1.80 mmHg. These results demonstrates that the acquisition apparatus is able to continuously estimate the BP with an accuracy comparable to traditional cuff-based devices.