Cuffless Non-invasive Blood Pressure Measurement Using CNN-LSTM Model: A Correlation Study
Main Article Content
Abstract
Cardiovascular disease is a major concern for people all around the world and still remains as the main cause of death worldwide. Blood pressure has been identified as the most important risk factor. Having the ability to acquire continuous monitoring on this biological parameter plays a significant role in reducing the risk of getting cardiac disease. Many studies conducted utilize two biosignals and features manually extracted from signals as input to the model. However, these methods increase the computational complexity in the pre-processing stage as it involves signal synchronization, and the model performance is highly dependent on the selection of features. The main objective of this study is to build a hybrid convolutional neural network combined with Long-Short Term Memory (CNN-LSTM) model to estimate blood pressure from PPG signals, which eliminates the need for manual feature extraction. Correlation study is performed to evaluate the performance of the model, and it gives a direct visualization of the model’s performance in percentage. This research compared the correlation performance between MIMIC-II dataset, UKM dataset, and PPG-BP dataset using the CNN-LSTM model to estimate blood pressure from PPG signals. The results show that the UKM dataset performs the best, having the highest overall correlation at 0.53 for systolic blood pressure, and 0.29 for diastolic blood pressure. The model trained with this dataset is suitable to estimate systolic blood pressure ranging from 141 to 150mmHg, and diastolic blood pressure ranging 81 to 90 mmHg. In conclusion, among the three datasets, UKM dataset is the most suitable dataset to be used as the input of the CNN-LSTM model to perform cuffless blood pressure measurement with PPG signals.
(Manuscript received: 16 March 2023 | Accepted: 27 July 2023 | Published: 30 September 2023)
Article Details
References
WHO. (2021). Cardiovascular diseases (CVDs). Retrieved from https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). (accessed on 28 January 2022)
Department of Statistics Malaysia (DOSM). (2021). Statistics on Causes of Death, Malaysia. Retrieved from https://www.dosm.gov.my/v1/index.php. (accessed on 28 January 2022)
Wu, C. Y., Hu, H. Y., Chou, Y. J., Huang, N., Chou, Y. C., & Li, C. P. (2015). High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults. Medicine 94(47):e2160.
Fuchs, F. D., & Whelton, P. K. 2020. High Blood Pressure and Cardiovascular Disease. Hypertension 75(2): 285–292.
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). (2022). Disease and Stroke. Retrieved from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/heart-disease-stroke.htm. (accessed on 29 January 2022)
Meidert, A. S., & Saugel, B. (2018). Techniques for Non-Invasive Monitoring of Arterial Blood Pressure. Frontiers in Medicine 4.
Forouzanfar, Mohamad & Dajani, Hilmi & Groza, Voicu & Bolic, Miodrag & Rajan, Sreeraman. (2015). Oscillometric Blood Pressure Estimation: Past, Present, and Future. IEEE reviews in biomedical engineering.
Finnegan, E., Christian Montoya Villarroel, M., Davidson, S., Jorge, J., Harford, M., & Tarassenko, L. (2020). Comparing Trends in Blood Pressure Computed from the Arterial Line and Sphygmomanometer in the ICU. 2020 Computing in Cardiology Conference (CinC).
Leblanc, M. V., Auclair, A., Leclerc, J., Bussières, J., Agharazii, M., Hould, F. S., Marceau, S., Brassard, P., Godbout, C., Grenier, A., Cloutier, L., & Poirier, P. (2018). Blood Pressure Measurement in Severely Obese Patients: Validation of the Forearm Approach in Different Arm Positions. American Journal of Hypertension 32(2): 175–185.
Ceglowski, P., Lehane, K., Chow, C., Pelecanos, A., Tognolini, A., & Eley, V. (2020). Arm Dimensions of Patients with Obesity and Their Experiences with Blood Pressure Measurement: An Observational Study. Obesity 28(4): 718–723.
Parry Fung, Dumont, G., Ries, C., Mott, C., & Ansermino, M. (2004). Continuous noninvasive blood pressure measurement by pulse transit time. The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.
Sola, J., & Delgado-Gonzalo, R. (2019). The Handbook of Cuffless Blood Pressure Monitoring. Springer. Retrieved from https://link. springer. com/book/10, 1007, 978-3.
El-Hajj, C., & Kyriacou, P. (2021). Deep learning models for cuffless blood pressure monitoring from PPG signals using attention mechanism. Biomedical Signal Processing and Control, 65: 102301.
Vallius, S. (2019). Time synchronization of signal data in multiparameter measurement system. Theseus.
Samria, R., Jain, R., Jha, A., Saini, S., & Chowdhury, S. R. (2014). Noninvasive cuff’less estimation of blood pressure using Photoplethysmography without electrocardiograph measurement. 2014 IEEE REGION 10 SYMPOSIUM.
Chan, K., Hung, K., & Zhang, Y. (2001). Noninvasive and cuffless measurements of blood pressure for telemedicine. 2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society.
Kachuee, M., Kiani, M. M., Mohammadzade, H., & Shabany, M. (2017). Cuffless Blood Pressure Estimation Algorithms for Continuous Health-Care Monitoring. IEEE Transactions on Biomedical Engineering, 64(4), 859–869.
Zhang, Y., & Feng, Z. (2017). A SVM Method for Continuous Blood Pressure Estimation from a PPG Signal. Proceedings of the 9th International Conference on Machine Learning and Computing.
Shobitha, S., Amita, P. M., Krupa, B. N., & Beng, G. K. (2017). Cuffless blood pressure prediction from PPG using relevance vector machine. 2017 International Conference on Electrical, Electronics, Communication, Computer, and Optimization Techniques (ICEECCOT).
Kurylyak, Y., Lamonaca, F., & Grimaldi, D. (2013). A Neural Network-based method for continuous blood pressure estimation from a PPG signal. 2013 IEEE International Instrumentation and Measurement Technology Conference (I2MTC).
Slapnicar, G., Mlakar, N., & Lustrek, M. (2019). Blood Pressure Estimation from Photoplethysmogram Using a Spectro-Temporal Deep Neural Network. Sensors 19(15): 3420.
Su, P., Ding, X.-R., Zhang, Y.-T., Liu, J., Miao, F., & Zhao, N. (2018). Long-term blood pressure prediction with deep recurrent neural networks. 2018 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).
Yang, S., Zhang, Y., Cho, S. Y., Correia, R., & Morgan, S. P. (2021). Non-invasive cuff-less blood pressure estimation using a hybrid deep learning model. Optical and Quantum Electronics 53(2).
Evdochim, L., Zhdanov, A. E., Dobrescu, L., & Dobrescu, D. (2022). Data Analytics of BP-PPG Dataset: Noninvasive Blood Pressure Assessment by Using Photoplethysmography Fiducial Points. 2022 International Conference on Business Analytics for Technology and Security (ICBATS).
Saeed, M., Villarroel, M., Reisner, A. T., Clifford, G., Lehman, L. W., Moody, G., Heldt, T., Kyaw, T. H., Moody, B., & Mark, R. G. (2011). Multiparameter Intelligent Monitoring in Intensive Care II: A public-access intensive care unit database*. Critical Care Medicine, 39(5), 952–960.
Thambiraj, G., Gandhi, U., Mangalanathan, U., Jose, V. J. M., & Anand, M. (2020). Investigation on the effect of Womersley number, ECG and PPG features for cuff less blood pressure estimation using machine learning. Biomedical Signal Processing and Control 60: 101942.
Liang, Y., Chen, Z., Liu, G., & Elgendi, M. (2018). A new, short-recorded photoplethysmogram dataset for blood pressure monitoring in China. Scientific Data 5(1).
Pribil, J., Pribilova, A., & Frollo, I. (2020). Comparative Measurement of the PPG Signal on Different Human Body Positions by Sensors Working in Reflexive and Transmission Modes. Proceedings of 7th International Electronic Conference on Sensors and Applications.
Hertzman AB. (1937). Photoelectric plethysmography of the nasal septum in man.
Zhao, D., Sun, Y., Wan, S., & Wang, F. (2017). SFST: A robust framework for heart rate monitoring from photoplethysmography signals during physical activities. Biomedical Signal Processing and Control, 33, 316–324.
Chowdhury, M. H., Shuzan, M. N. I., Chowdhury, M. E., Mahbub, Z. B., Uddin, M. M., Khandakar, A., & Reaz, M. B. I. (2020). Estimating Blood Pressure from the Photoplethysmogram Signal and Demographic Features Using Machine Learning Techniques. Sensors 20(11): 3127.
Oh, C., Han, S., & Jeong, J. (2020). Time-Series Data Augmentation based on Interpolation. Procedia Computer Science, 175, 64–71.
KR, A., & M, B. (2019). Heart rate estimation from photoplethysmography signal for wearable health monitoring devices. Biomedical Signal Processing and Control, 50, 1–9.
Biswas, D., Everson, L., Liu, M., Panwar, M., Verhoef, B. E., Patki, S., Kim, C. H., Acharyya, A., van Hoof, C., Konijnenburg, M., & van Helleputte, N. (2019). CorNET: Deep Learning Framework for PPG-Based Heart Rate Estimation and Biometric Identification in Ambulant Environment. IEEE Transactions on Biomedical Circuits and Systems, 13(2), 282–291.
Panwar, M., Biswas, D., Bajaj, H., Jobges, M., Turk, R., Maharatna, K., & Acharyya, A. (2019). Rehab-Net: Deep Learning Framework for Arm Movement Classification Using Wearable Sensors for Stroke Rehabilitation. IEEE Transactions on Biomedical Engineering, 66(11), 3026–3037.
Spuler, M., Sarasola-Sanz, A., Birbaumer, N., Rosenstiel, W., & Ramos-Murguialday, A. (2015). Comparing metrics to evaluate performance of regression methods for decoding of neural signals. 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).
Botchkarev, A. (2019). A New Typology Design of Performance Metrics to Measure Errors in Machine Learning Regression Algorithms. Interdisciplinary Journal of Information, Knowledge, and Management, 14, 045–076.