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Non Invasive measurement of Blood Pressure (BP) has well-established utility in screening, clinical diagnosis and patient follow-up for a variety of critical disease conditions. Traditional methods of measurement such as auscultation and oscillometry, use a cuff and require expert medical personnel and hence not readily amenable to the field or home settings. Majority of cuffless BP monitoring technologies are based on tonometry, Pulse Contour Analysis (PCA) and Pulse Wave Velocity (PWV) principles. Reliable tonometry measurements require expertise, whereas PCA and PWV based techniques suffer from both subject-specific and/or population-specific calibration issues and are hence limited to home or well-being applications and yet to attain widespread acceptance. Hence, there is a strong need for the development of easy to use, reliable, cuffless techniques for measurement of BP, that do not require patient-specific or population-specific calibration, which can potentially be used in clinical, field, 24-hours ambulatory monitoring and even in home-care scenarios.

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Healthcare Technology Innovation Centre (HTIC) of IIT Madras has developed and tested a novel method for calibration-free, cuffless BP in controlled laboratory settings. The work was done as part of the project titled “Arterial compliance probe for cuffless BP measurement” under the Indo-US Grand Challenge Initiative – Affordable BP Measurement Technologies for Low Resource Settings, funded by Science and Engineering Research Board (SERB), DST, Government of India and administered in India by Indo-US Science and Technology Forum (IUSSTF). This method is based on local PWV and real-time evaluation of arterial wall dynamics through HTIC’s proprietary ARTSENS® technology, thus eliminating the need for any calibration coefficients. Following the development of a set of mathematical models for BP computation, the design of custom multi-modal arterial compliance probes, and development of essential electronics experimental hardware, a proof of principle of the proposed method has been demonstrated. Extensive validation of the developed prototypes in clinical and field settings are in progress.  

Publications & Patents:

Journals articles

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  1. P. M. Nabeel, V. Raj Kiran, J. Joseph, V. V Abhidev, and M. Sivaprakasam, “Local pulse wave velocity: theory, methods, advancements, and clinical applications,” IEEE Reviews in Biomedical Engineering, 2019, DOI: 10.1109/RBME.2019.2931587

  2. P. M. Nabeel, J. Joseph, S. Karthik, M. Sivaprakasam, and M. Chenniappan, “Bi-modal arterial compliance probe for calibration-free cuffless blood pressure estimation,” IEEE Transactions on Biomedical Engineering, vol. 65, no. 11, pp. 2392–2404, 2018. (Invited Article)

  3. P. M. Nabeel, S. Karthik, J. Joseph, and M. Sivaprakasam, “Arterial blood pressure estimation from local pulse wave velocity using dual-element photoplethysmograph probe,” IEEE Transactions on Instrumentation and Measurement, vol. 67, no. 6, pp. 1399–1408, 2018.

  4. J. Joseph, P. M. Nabeel, M. I. Shah, and M. Sivaprakasam, “Arterial compliance probe for cuffless evaluation of carotid pulse pressure,” PLoS One, vol. 13, no. 8, p. e0202480, 2018.

  5. P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Single-source PPG-based local pulse wave velocity measurement: a potential cuffless blood pressure estimation technique,” Physiological Measurements, vol. 38, no. 12, pp. 2122–2140, 2017.

  6. P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “A magnetic plethysmograph probe for local pulse wave velocity measurement,” IEEE Transactions on Biomedical Circuits and Systems, vol. 11, no. 5, pp. 1065–1076, 2017.

  7. R. Arathy, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Accelerometric patch probe for cuffless blood pressure evaluation from carotid local pulse wave velocity: design, development, and in-vivo experimental study,” Biomedical Physics and Engineering Express, vol. 5, no. 4, pp. 045010, 2019.

  8. J. Joseph, V. Raj Kiran, M I. Shah, P. M. Nabeel, and M. Sivaprakasam, “ARTSENS Pen – portable easy-to-use device for carotid stiffness evaluation: technology validation and clinical-utility assessment,” Scientific Reports, 2019, under review.

  9. Joseph, S. Rao, R. Venkatachalam, M. I. Shah, P. M. Nabeel, and P. Kaur, “Increased stiffness of the carotid artery is associated with a higher risk of metabolic syndrome: Observations from a community-level study using ARTSENS®,” 2019, under review.

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Conference proceedings

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  1. P. M. Nabeel, C. Vinay, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Deep learning for blood pressure estimation: an approach using local measure of arterial dual diameter waveforms,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Istanbul, Turkey, 2019, pp. 1-6.

  2. V. Raj Kiran, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Methodological and measurement concerns of local pulse wave velocity assessment,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Istanbul, Turkey, 2019, pp. 1-6.

  3. M. Rahul, P. M. Nabeel, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Cuffless evaluation of arterial pressure waveform using flexible force sensor: a proof of principle,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Istanbul, Turkey, 2019, pp. 1-6.

  4. V. Raj Kiran, V. V. Abhidev, P. M. Nabeel, J. Joseph, M. Sivaprakasam, and M. I. Shah, “Arterial stiffness in elastic and muscular arteries: measurement using ARTSENS pen,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Istanbul, Turkey, 2019, pp. 1-6.

  5. V. Raj Kiran, J. Joseph, P. M. Nabeel, F. Hanna, M. Sivaprakasam, and M. I. Shah, “Analytic phase based approach for arterial diameter evaluation using A-mode ultrasound frames,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Istanbul, Turkey, 2019, pp. 1-6.

  6. P. Ramakrishna, P. M. Nabeel, and M. Sivaprakasam, “Novel geometric representation for one-dimensional model of arterial blood pulse wave propagation,” in 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany, 2019, pp. 506-509.

  7. V. Raj Kiran, P. M. Nabeel, J. Joseph, F. Hanna, and M. Sivaprakasam, “Multimodal image-free ultrasound technique for evaluation of arterial viscoelastic properties: a feasibility study,” in 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany, 2019, pp. 5034-5037.

  8. R. Arathy, P. M. Nabeel, J. Joseph, V. V. Abhidev, and M. Sivaprakasam, “Continuous assessment of carotid diameter using an accelerometer patch probe for ambulatory arterial stiffness monitoring,” in 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany, 2019, pp. 5038-5041.

  9. J. Joseph, V. Raj Kiran, P. M. Nabeel, and M. Sivaprakasam, “Image-free ultrasound technique for calibration-free cuffless blood pressure measurement,” in 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany, 2019, p.1.

  10. P. M. Nabeel, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Local evaluation of variation in pulse wave velocity over the cardiac cycle using single-element ultrasound transducer,” in 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2018, pp. 4560–4563.

  11. P. M. Nabeel, S. Venkatramanan, J. Joseph, and M. Sivaprakasam, “Hemodynamic interventions for inducing blood pressure variation in laboratory settings,” in 13th Russian-German Conference on Biomedical Engineering (RGC), Aachen, Germany, 2018, pp. 104–107.

  12. P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Variation in local pulse wave velocity over the cardiac cycle: in-vivo validation using dual-MPG arterial compliance probe,” in 13th Russian-German Conference on Biomedical Engineering (RGC), Aachen, Germany, 2018, pp. 100–103.

  13. P. M. Nabeel, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Non-invasive assessment of local pulse wave velocity as function of arterial pressure,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rome, Italy, 2018, pp. 1–6.

  14. P. M. Nabeel, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Local pulse wave velocity and cuffless blood pressure assessment using ARTSENS,” in 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Seogwipo, 2018, p. 1.

  15. V. Raj Kiran, P. M. Nabeel, J. Joseph, S. Venkatramanan, M. I. Shah, and M. Sivaprakasam, “An in-vivo study on intra-day variations in vascular stiffness using ARTSENS Pen,” in 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2018, pp. 4575–4578.

  16. R. Arathy, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Carotid local pulse wave velocity measurement using dual element accelerometric patch probe,” in 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2018, pp. 4571–4574.

  17. V. Raj Kiran, P. M. Nabeel, J. Joseph, M. I. Shah, and M. Sivaprakasam, “Measurement of arterial Young’s elastic modulus using ARTSENS Pen,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rome, Italy, 2018, pp. 1–6.

  18. V. Raj Kiran, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Evaluation of Local Pulse Wave Velocity using an Image Free Ultrasound Technique,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rome, Italy, 2018, pp. 1–6.

  19. R. Arathy, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Vascular Wall Stiffness Indices Detection Using an Accelerometer-Based System,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rome, Italy, 2018, pp. 1–6.

  20. V. Raj Kiran, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Non-invasive assessment of arterial incremental elastic modulus variations within a cardiac cycle,” in 13th Russian-German Conference on Biomedical Engineering (RGC), Aachen, Germany, 2018, pp. 108–111.

  21. J. Joseph, P. M. Nabeel, M. I. Shah, V. Raj Kiran and M. Sivaprakasam, “Live demonstration of ARTSENS® Pen-an image-free ultrasound device for automated evaluation of vascular stiffness,” IEEE Sensors, New Delhi, India, 2018, pp. 1-1.

  22. P. M. Nabeel, S. Karthik, J. Joseph, M. Chenniappan, and M. Sivaprakasam, “Cuffless blood pressure measurement using ultrasound and dual photoplethysmograph transducer,” in 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Seogwipo, 2017, p. 1.

  23. P. M. Nabeel, S. Karthik, J. Joseph, and M. Sivaprakasam, “Experimental validation of dual PPG local pulse wave velocity probe,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rochester, 2017, pp. 408–413.

  24. P. M. Nabeel, S. Karthik, J. Joseph, and M. Sivaprakasam, “Measurement of carotid blood pressure and local pulse wave velocity changes during cuff induced hyperemia,” in 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Seogwipo, 2017, pp. 1700–1703.

  25. V. Raj Kiran, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Brachial artery stiffness estimation using ARTSENS,” in 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Seogwipo, 2017, pp. 262–265.

  26. R. Arathy, P. M. Nabeel, J. Joseph, M. Sivaprakasam, and V. Awasthi, “An accelerometer probe for local pulse wave velocity measurement,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Rochester, MN, 2017, pp. 1–6.

  27. P. M. Nabeel, J. Joseph, V. Awasthi, and M. Sivaprakasam, “Single source photoplethysmograph transducer for local pulse wave velocity measurement,” in 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, 2016, pp. 4256–4259.

  28. J. Joseph, P. M. Nabeel, and M. Sivaprakasam, “Cuffless evaluation of pulse pressure with arterial compliance probe,” in 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, 2016, p. 1.

  29. 29.  J. Joseph, P. M. Nabeel, M. I. Shah, and M. Sivaprakasam, “Arterial compliance probe for calibration free pulse pressure measurement,” in IEEE International Symposium on Medical Measurements and Applications (MeMeA), Benevento, 2016, pp. 1–6.

  30. 30.  P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Arterial compliance probe for local blood pulse wave velocity measurement,” in 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Milan, 2015, pp. 5712–5715.

  31. J. Joseph, P. M. Nabeel, and M. Sivaprakasam, “A calibration free method for cuff less evaluation of pulse pressure,” in 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Milan, 2015, p. 1.

  32. P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Magnetic plethysmograph transducers for local blood pulse wave velocity measurement,” in 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Chicago, IL, 2014, pp. 1953–1956.

  33. P. M. Nabeel, V. Raj Kiran, J. Joseph, and M. Sivaprakasam, “Determination of incremental local pulse wave velocity using arterial diameter waveform: mathematical modeling and practical implementation,” in IEEE International Conference in Computing in Cardiology (CinC), Singapore, 2019, in press.

  34. V. Raj Kiran, P. M. Nabeel, J. Joseph, and M. Sivaprakasam, “Incorporating arterial viscoelastic modelling for the assessment of changes in pulse wave velocity within a cardiac cycle using Bramwell-Hill equation,” in IEEE International Conference in Computing in Cardiology (CinC), Singapore, 2019, in press.

  35. R. Arathy, P. M. Nabeel, J. Joseph, V. V. Abhidev, and M. Sivaprakasam, “Evaluation of arterial diameter by mathematical transformation of APG for ambulatory stiffness evaluation,” in IEEE International Conference in Computing in Cardiology (CinC), Singapore, 2019, in press.

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Patents

  1. P. M. Nabeel, J. Joseph, M. Sivaprakasam, and Raj Kiran, “Method and system for calibration-free cuff-less evaluation of blood pressure using multi-modal ultrasound probe,” Application number: TEMP/E-1/22670/2018-CHE (Filed on: 07/06/2018).

  2. J. Joseph, M. Sivaprakasam, and P. M. Nabeel, “Method and system for cuff-less blood pressure (BP) measurement of a subject,” U.S. Patent US20170156706 A1, Jun. 2017.

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Grants and research awards

  1. Indo-US Grand Challenge Initiative [Phase I] – Affordable blood pressure technologies for low resource settings, A joint NIH USA and SERB-DST India funding program. Project: Arterial compliance probe for cuff-less blood pressure measurement, Duration: 2014 – 2015.

  2. Indo-US Grand Challenge Initiative [Phase II] – Affordable blood pressure technologies for low resource settings, A joint NIH USA and SERB-DST India funding program. Project: Arterial compliance probe for cuff-less blood pressure measurement, Duration: 2016 – 2017.

  3. Best paper presentation award at the 2018 Russian German Conference in Aachen Germany, for the paper titled “Variation in local pulse wave velocity over the cardiac cycle: in-vivo validation using dual-MPG arterial compliance probe”.

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Web news coverages

  1. Featured Article of IEEE Transactions on Biomedical Engineering (2018, Oct. 20). Bi-Modal Arterial Compliance Probe for Calibration-Free Cuffless Blood Pressure Estimation [Online].                                                                              Available: https://tbme.embs.org/2018/10/20/bi-modal-arterial-compliance-probe-for-calibration-free-cuffless-blood-pressure-estimation/

  2. Medicalphysicsweb (IOP Publishing). (2017, Oct. 13). Magnetic field fluctuations detect arterial pulse [Online].Available: http://medicalphysicsweb.org/cws/article/research/70197

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