Concatenated Convolutional Neural Network Model for Cuffless Blood Pressure Estimation Using Fuzzy Recurrence Properties of PPG Signals

Due to the importance of continuous monitoring of blood pressure (BP) in controlling hypertension, the topic of cuffless blood pressure (BP) estimation has been widely studied in recent years. A most important approach is to explore the nonlinear mapping between the recorded peripheral signals and the BP values which is usually conducted by deep neural networks. Because of the sequence-based pseudo periodic nature of peripheral signals such as photoplethysmogram (PPG), a proper estimation model needed to be equipped with the 1-dimensional (1-D) and recurrent layers. This, in turn, limits the usage of 2-dimensional (2-D) layers adopted in convolutional neural networks (CNN) for embedding spatial information in the model. In this study, considering the advantage of chaotic approaches, the recurrence characterization of peripheral signals was taken into account by a visual 2-D representation of PPG in phase space through fuzzy recurrence plot (FRP). FRP not only provides a beneficial framework for capturing the spatial properties of input signals but also creates a reliable approach for embedding the pseudo periodic properties to the neural models without using recurrent layers. Moreover, this study proposes a novel deep neural network architecture that combines the morphological features extracted simultaneously from two upgraded 1-D and 2-D CNNs capturing the temporal and spatial dependencies of PPGs in systolic and diastolic BP estimation. The model has been fed with the 1-D PPG sequences and the corresponding 2-D FRPs from two separate routes. The performance of the proposed framework was examined on the well-known public dataset, namely, Multi-Parameter Intelligent in Intensive Care II. Our scheme is analyzed and compared with the literature in terms of the requirements of the standards set by the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). The proposed model met the AAMI requirements, and it achieved a grade of A as stated by the BHS standard. In addition, its mean absolute errors (MAE) and standard deviation for both systolic and diastolic blood pressure estimations were considerably low, 3.05±5.26 mmHg and 1.58±2.6 mmHg, in turn.

Cuff-Less Blood Pressure Estimation from Electrocardiogram and Photoplethysmography Based on VGG19-LSTM Network

In recent years, studies have found that the hierarchical neural network with LSTM network has higher accuracy than another feature engineering. Therefore, this paper first tries to build a multi-stage blood pressure estimation model through VGG19 and LSTM network. Based on the time node of the R wave peak in the QRS waveform in ECG, VGG19 is used to extract various higher-dimensional and rich life characteristics in the PPG signal segment by heartbeat as the unit and focus on processing the dynamics of SBP and DBP Correlation, finally use the LSTM model to extract the time dependence of the vital signs. Results: Experiments show that compared with similar multi-stage models, this model has higher accuracy. The performance of this method meets the Advancement of Medical Instrumentation (AAMI) standard and reaches the A level of the British Hypertension Society (BHS) standard. The average error and standard deviation of the estimated value of SBP were 1.7350 4.9606 mmHg, and the average error and standard deviation of the estimated value of DBP were 0.7839 2.7700 mmHg, respectively.

A Continuous Blood Pressure Estimation Method Using Photoplethysmography by GRNN-Based Model

Compared with diastolic blood pressure (DBP) and systolic blood pressure (SBP), the blood pressure (BP) waveform contains richer physiological information that can be used for disease diagnosis. However, most models based on photoplethysmogram (PPG) signals can only estimate SBP and DBP and are susceptible to noise signals. We focus on estimating the BP waveform rather than discrete BP values. We propose a model based on a generalized regression neural network to estimate the BP waveform, SBP and DBP. This model takes the raw PPG signal as input and BP waveform as output. The SBP and DBP are extracted from the estimated BP waveform. In addition, the model contains encoders and decoders, and their role is to be responsible for the conversion between the time domain and frequency domain of the waveform. The prediction results of our model show that the mean absolute error is 3.96 ± 5.36 mmHg for SBP and 2.39 ± 3.28 mmHg for DBP, the root mean square error is 5.54 for SBP and 3.45 for DBP. These results fulfill the Association for the Advancement of Medical Instrumentation (AAMI) standard and obtain grade A according to the British Hypertension Society (BHS) standard. The results show that the proposed model can effectively estimate the BP waveform only using the raw PPG signal.

A Novel Machine Learning-Based Systolic Blood Pressure Predicting Model

Blood pressure (BP) is a vital biomedical feature for diagnosing hypertension and cardiovascular diseases. Traditionally, it is measured by cuff-based equipment, e.g., sphygmomanometer; the measurement is discontinued and uncomfortable. A cuff-less method based on different signals, electrocardiogram (ECG) and photoplethysmography (PPG), is proposed recently. However, this method is costly and inconvenient due to the collections of multisensors. In this paper, a novel machine learning-based systolic blood pressure (SBP) predicting model is proposed. The model was evaluated by clinical and lifestyle features (gender, marital status, smoking status, age, weight, etc.). Different machine learning algorithms and different percentage of training, validation, and testing were evaluated to optimize the model accuracy. Results were validated to increase the accuracy and robustness of the model. The performance of our model met both the level of grade A (British Hypertension Society (BHS) standard) and the American National Standard from the Association for the Advancement of Medical Instrumentation (AAMI) for SBP estimation.

Continuous Blood Pressure Estimation Using Exclusively Photopletysmography by LSTM-Based Signal-to-Signal Translation

Monitoring continuous BP signal is an important issue, because blood pressure (BP) varies over days, minutes, or even seconds for short-term cases. Most of photoplethysmography (PPG)-based BP estimation methods are susceptible to noise and only provides systolic blood pressure (SBP) and diastolic blood pressure (DBP) prediction. Here, instead of estimating a discrete value, we focus on different perspectives to estimate the whole waveform of BP. We propose a novel deep learning model to learn how to perform signal-to-signal translation from PPG to arterial blood pressure (ABP). Furthermore, using a raw PPG signal only as the input, the output of the proposed model is a continuous ABP signal. Based on the translated ABP signal, we extract the SBP and DBP values accordingly to ease the comparative evaluation. Our prediction results achieve average absolute error under 5 mmHg, with 70% confidence for SBP and 95% confidence for DBP without complex feature engineering. These results fulfill the standard from Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS) with grade A. From the results, we believe that our model is applicable and potentially boosts the accuracy of an effective signal-to-signal continuous blood pressure estimation.

A clinical set-up for noninvasive blood pressure monitoring using two photoplethysmograms and based on convolutional neural networks

Blood pressure is a reliable indicator of many cardiac arrhythmias and rheological problems. This study proposes a clinical set-up using conventional monitoring systems to estimate systolic and diastolic blood pressures continuously based on two photoplethysmogram signals (PPG) taken from the earlobe and toe. Several amendments were applied to conventional clinical monitoring devices to construct our project plan. We used two monitors to acquire two PPGs, one ECG, and invasive blood pressure as the reference to evaluate the estimation accuracy. One of the most critical requirements was the synchronization of the acquired signals that was accomplished by using ECG as the time reference. Following data acquisition and preparation procedures, the performance of each PPG signal alone and together was investigated using deep convolutional neural networks. The proposed architecture was evaluated on 32 records acquired from 14 patients after cardiovascular surgery. The results showed a better performance for toe PPG in comparison with earlobe PPG. Moreover, they indicated the algorithm accuracy improves if both signals are applied together to the network. According to the British Hypertension Society standards, the results achieved grade A for both blood pressure measurements. The mean and standard deviation of estimation errors were +0.3 ± 4.9 and +0.1 ± 3.2 mmHg for systolic and diastolic BPs, respectively. Since the method is based on conventional monitoring equipment and provides a high estimation consistency, it can be considered as a possible alternative for inconvenient invasive BP monitoring in clinical environments.

An Estimation Method of Continuous Non-Invasive Arterial Blood Pressure Waveform Using Photoplethysmography: A U-Net Architecture-Based Approach

Blood pressure (BP) monitoring has significant importance in the treatment of hypertension and different cardiovascular health diseases. As photoplethysmogram (PPG) signals can be recorded non-invasively, research has been highly conducted to measure BP using PPG recently. In this paper, we propose a U-net deep learning architecture that uses fingertip PPG signal as input to estimate arterial BP (ABP) waveform non-invasively. From this waveform, we have also measured systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). The proposed method was evaluated on a subset of 100 subjects from two publicly available databases: MIMIC and MIMIC-III. The predicted ABP waveforms correlated highly with the reference waveforms and we have obtained an average Pearson’s correlation coefficient of 0.993. The mean absolute error is 3.68 ± 4.42 mmHg for SBP, 1.97 ± 2.92 mmHg for DBP, and 2.17 ± 3.06 mmHg for MAP which satisfy the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) standard and obtain grade A according to the British Hypertension Society (BHS) standard. The results show that the proposed method is an efficient process to estimate ABP waveform directly using fingertip PPG.

An Adaptive Weight Learning-Based Multitask Deep Network for Continuous Blood Pressure Estimation Using Electrocardiogram Signals

Estimating blood pressure via combination analysis with electrocardiogram and photoplethysmography signals has attracted growing interest in continuous monitoring patients’ health conditions. However, most wearable/portal monitoring devices generally acquire only one kind of physiological signals due to the consideration of energy cost, device weight and size, etc. In this study, a novel adaptive weight learning-based multitask deep learning framework based on single lead electrocardiogram signals is proposed for continuous blood pressure estimation. Specifically, the proposed method utilizes a 2-layer bidirectional long short-term memory network as the sharing layer, followed by three identical architectures of 2-layer fully connected networks for task-specific blood pressure estimation. To learn the importance of task-specific losses automatically, an adaptive weight learning scheme based on the trend of validation loss is proposed. Extensive experiment results on Physionet Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) II waveform database demonstrate that the proposed method using electrocardiogram signals obtains estimating performance of 0.12±10.83 mmHg, 0.13±5.90 mmHg, and 0.08±6.47 mmHg for systolic blood pressure, diastolic blood pressure, and mean arterial pressure, respectively. It can meet the requirements of the British Hypertension Society standard and US Association of Advancement of Medical Instrumentation standard with a considerable margin. Combined with a wearable/portal electrocardiogram device, the proposed model can be deployed to a healthcare system to provide a long-term continuous blood pressure monitoring service, which would help to reduce the incidence of malignant complications to hypertension.