Carotid and Jugular Classification in ARTSENS

Abstract

Over past few years our group has been working on the development of a low-cost device, ARTSENS, for measurement of local arterial stiffness (AS) of the common carotid artery (CCA). This uses a single element ultrasound transducer to obtain A-mode frames from the CCA. It is designed to be fully automatic in its operation such that, a general medical practitioner can use the device without any prior knowledge of ultrasound modality. Placement of the probe over CCA and identification of echo positions corresponding to its two walls are critical steps in the process of measurement of AS. We had reported an algorithm to locate the CCA walls based on their characteristic motion. Unfortunately, in supine position, the internal jugular vein (IJV) expands in the carotid triangle and pulsates in a manner that confounds the existing algorithm and leads to wrong measurements of the AS. Jugular venous pulse (JVP), on its own right, is a very important physiological signal for diagnosis of morbidities of the right side of the heart and there is a lack of noninvasive methods for its accurate estimation. We integrated an ECG device to the existing hardware of ARTSENS and developed a method based on physiology of the vessels, which now enable us to segregate the CCA pulse (CCP) and the JVP. False identification rate is less than 4%. To retain the capabilities of ARTSENS to operate without ECG, we designed another method where the classification can be achieved without an ECG, albeit errors are a bit higher. These improvements enable ARTSENS to perform automatic measurement of AS even in the supine position and make it a unique and handy tool to perform JVP analysis.

Assessment of Non-Contact Measurement Using a Microwave Sensor to Jugular Venous Pulse Monitoring

“…A recent study has reported that the JVP waveform contains important prognostic information regarding heart failure [1,21]. We expect that use of the proposed method in acquisition of accurate JVP waveform information will contribute to the diagnosis of such pathologies.…”

Effects of body positions on arterial stiffness as assessed by pulse wave velocity

“…Because the Vicorder uses a neck pressure pad placed over the carotid area, interference of the jugular vein on the arterial signal is known to be present [20]. Accordingly, the manufacturer's instructions recommend the measurements to be done in the upper body tilted position (at ∼30°).…”

Clinical Applicability of Assessment of Jugular Flow over the Individual Cardiac Cycle Compared with Current Ultrasound Methodology

“…The a, c and v waves are well visible in the CSA time diagram, as well the P, Q, R, S and T waves in the ECG. The CSA time diagram actually corresponds with the well known JVP diagram (Sisini et al, 2015;Sahani et al, 2015). The relationship between the ECG and CSA time diagram (JVP waves) is the following: the R wave is just after the a wave and before the c wave.…”