Cuffless Continuous Estimation of Relative Mean Arterial Pressure Using Unrestrained and Noncontact Ballistocardiogram and Electrocardiogram: Evaluation in Short Time In-bed Experiments

Abstract

To facilitate capturing the characteristic variations of blood pressure (BP) such as BP surges during the nocturnal period, the in-bed continuous daily measurement of BP may be useful. In this study, we proposed and evaluated a method for cuffless continuous estimation of relative mean arterial pressure (MAP) using capacitive ballistocardiogram (cBCG) and electrocardiogram (cECG) measured using an unrestrained and noncontact method. We adapted a well-known equation for calculating MAP, which is equal to the product of cardiac output and peripheral vascular resistance. We then derived an estimation formula for the relative MAP using the J–K amplitude from the cBCG, heart rate from the cECG, and pulse beat arrival time calculated from the cBCG and cECG. To determine the coefficients for the estimation formula, we measured the MAP of a subject with a commercial device and used the least squares method. To obtain input data for the estimation formula, the cBCG from the heel of the right leg and cECG from the back of the subject were measured simultaneously with capacitively coupled electrodes placed under a bed sheet. The total length of the input data was 80 s for each Valsalva test (VT), and the Valsalva maneuver was used to increase BP during measurement. The data for each VT was separated into a training segment (Tr) and a test segment (Te). To evaluate the proposed estimation method, the following indices were calculated for each VT in 7 subjects: (1) correlation coefficient (CC) between estimated and reference MAP values, (2) confidence interval (CI), and (3) root mean square error (RMSE). For the Tr, average CC was 0.93 ± 0.06, average CI was 2.96 ± 1.29 mmHg, and average RMSE was 0.75 ± 0.33 mmHg. Furthermore, average RMSE for the Te was 2.49 ± 2.22 mmHg. These results indicate that the continuous cuffless method proposed in this study can be used for estimating relative MAP over a short time period. As the subjects in this study were all men in their early twenties, further validation in diverse subjects is required for broad application of the proposed method.