A survey on signals and systems in ambulatory blood pressure monitoring using pulse transit time

Blood pressure monitoring based on pulse transit or arrival time has been the focus of much research in order to design ambulatory blood pressure monitors. The accuracy of these monitors is limited by several challenges, such as acquisition and processing of physiological signals as well as changes in vascular tone and the pre-ejection period. In this work, a literature survey covering recent developments is presented in order to identify gaps in the literature. The findings of the literature are classified according to three aspects. These are the calibration of pulse transit/arrival times to blood pressure, acquisition and processing of physiological signals and finally, the design of fully integrated blood pressure measurement systems. Alternative technologies as well as locations for the measurement of the pulse wave signal should be investigated in order to improve the accuracy during calibration. Furthermore, the integration and validation of monitoring systems needs to be improved in current ambulatory blood pressure monitors.

[1]  P. Boutouyrie,et al.  Assessment of pulse wave velocity , 2008 .

[2]  M. Sokolow,et al.  Relationship Between Level of Blood Pressure Measured Casually and by Portable Recorders and Severity of Complications in Essential Hypertension , 1966, Circulation.

[3]  Guanqun Zhang,et al.  Assessing the challenges of a pulse wave velocity based blood pressure measurement in surgical patients , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[4]  C.C.Y. Poon,et al.  A novel parameter from PPG dicrotic notch for estimation of systolic blood pressure using pulse transit time , 2008, 2008 5th International Summer School and Symposium on Medical Devices and Biosensors.

[5]  SeongHwan Cho,et al.  A pulse transit time measurement method based on electrocardiography and bioimpedance , 2009, 2009 IEEE Biomedical Circuits and Systems Conference.

[6]  Jin-Chen Hsu,et al.  Real-Time Portable Physiological Signal Detection Powered by Thin Acoustic Sensors , 2012, 2012 7th International Microsystems, Packaging, Assembly and Circuits Technology Conference (IMPACT).

[7]  Robert P Patterson,et al.  Impedance cardiography: What is the source of the signal? , 2010 .

[8]  Julien Penders,et al.  Robust beat detector for ambulatory cardiac monitoring , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[9]  Carmen C. Y. Poon,et al.  Wearable Intelligent Systems for E-Health , 2011, J. Comput. Sci. Eng..

[10]  Carotid and radial pulse feature analysis with EMFi sensor , 2012 .

[11]  Jukka Vanhala,et al.  Design and Implementation of a Portable Long-Term Physiological Signal Recorder , 2010, IEEE Transactions on Information Technology in Biomedicine.

[12]  Carmen C. Y. Poon,et al.  The beat-to-beat relationship between pulse transit time and systolic blood pressure , 2008, 2008 International Conference on Information Technology and Applications in Biomedicine.

[13]  Tor Sverre Lande,et al.  Detecting changes in the human heartbeat with on-body radar , 2013, 2013 IEEE Radar Conference (RadarCon13).

[14]  Jianchu Yao,et al.  A Short Study to Assess the Potential of Independent Component Analysis for Motion Artifact Separation in Wearable Pulse Oximeter Signals , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[15]  Carmen C. Y. Poon,et al.  An Evaluation of the Cuffless Blood Pressure Estimation Based on Pulse Transit Time Technique: a Half Year Study on Normotensive Subjects , 2009, Cardiovascular engineering.

[16]  Andreas Patzak,et al.  Continuous blood pressure measurement using pulse transit time , 2013, Somnologie - Schlafforschung und Schlafmedizin.

[17]  O. Chételat,et al.  Parametric estimation of pulse arrival time: a robust approach to pulse wave velocity , 2009, Physiological measurement.

[18]  V. Kolesnikov,et al.  Variable impedance cardiography waveforms: how to evaluate the preejection period more accurately , 2012 .

[19]  L. G. Sison,et al.  Adaptive noise cancelling of motion artifact in stress ECG signals using accelerometer , 2002, Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology.

[20]  Yong Xu,et al.  An ultra-sensitive wearable accelerometer for continuous heart and lung sound monitoring , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[21]  Gianfranco Parati,et al.  Validation of the Somnotouch-NIBP noninvasive continuous blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010 , 2015, Blood pressure monitoring.

[22]  R. Kirkpatrick,et al.  Ambulatory Blood Pressure Monitoring , 1993, The Journal of the American Board of Family Medicine.

[23]  B. T. Engel,et al.  Portable blood pressure recorder. Accuracy and preliminary use in evaluating intradaily variations in pressure. , 1962, American heart journal.

[24]  Shuming Ye,et al.  An Adjusted Method of Photoplethysmography Detection in Poor Perfusion , 2011, 2011 5th International Conference on Bioinformatics and Biomedical Engineering.

[25]  T. L. Rusch,et al.  Signal processing methods for pulse oximetry , 1996, Comput. Biol. Medicine.

[26]  Carmen C. Y. Poon,et al.  An Armband Wearable Device for Overnight and Cuff-Less Blood Pressure Measurement , 2014, IEEE Transactions on Biomedical Engineering.

[27]  Gilwon Yoon,et al.  Non-constrained Blood Pressure Monitoring Using ECG and PPG for Personal Healthcare , 2009, Journal of Medical Systems.

[28]  Francis Eng Hock Tay,et al.  A Long-term Wearable Vital Signs Monitoring System using BSN , 2008, 2008 11th EUROMICRO Conference on Digital System Design Architectures, Methods and Tools.

[29]  Guy D. Dumont,et al.  Continuous noninvasive blood pressure measurement by pulse transit time , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[30]  A. Hill,et al.  VELOCITY OF TRANSMISSION OF THE PULSE-WAVE: AND ELASTICITY OF ARTERIES , 1922 .

[31]  Yuan-Ting Zhang,et al.  Wearable Medical Systems for p-Health , 2008, IEEE Reviews in Biomedical Engineering.

[32]  Giorgio Parisi,et al.  Multi-point accelerometric detection and principal component analysis of heart sounds , 2014, IWBBIO.

[33]  Ramakrishna Mukkamala,et al.  Improved pulse transit time estimation by system identification analysis of proximal and distal arterial waveforms. , 2011, American journal of physiology. Heart and circulatory physiology.

[34]  M. Nogawa,et al.  A novel hybrid reflectance pulse oximeter sensor with improved linearity and general applicability to various portions of the body , 1998, Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering Towards the Year 2000 and Beyond (Cat. No.98CH36286).

[35]  M. Mathie,et al.  of the 23 rd Annual EMBS International Conference , October 25-28 , Istanbul , Turkey A SYSTEM FOR MONITORING POSTURE AND PHYSICAL ACTIVITY USING ACCELEROMETERS , 2004 .

[36]  P. Obrist,et al.  Pulse transit time: relationship to blood pressure and myocardial performance. , 1979, Psychophysiology.

[37]  S. E. Schmidt,et al.  The chest is a significant collector of ambient noise in heart sound recordings , 2012, 2012 Computing in Cardiology.

[38]  Fangmin Sun,et al.  A Wearable Multi-parameter Physiological System , 2014 .

[39]  Abbas K. Abbas,et al.  Phonocardiography Signal Processing , 2009, Phonocardiography Signal Processing.

[40]  Yuan-Ting Zhang,et al.  Cuffless and noninvasive estimation of blood pressure based on a wavelet transform approach , 2003, IEEE EMBS Asian-Pacific Conference on Biomedical Engineering, 2003..

[41]  Paulo Carvalho,et al.  Robust Characteristic Points for ICG - Definition and Comparative Analysis , 2011, BIOSIGNALS.

[42]  J. Fahrenberg,et al.  Methodological guidelines for impedance cardiography. , 1990, Psychophysiology.

[43]  Seulki Lee,et al.  A 3.9 mW 25-Electrode Reconfigured Sensor for Wearable Cardiac Monitoring System , 2011, IEEE Journal of Solid-State Circuits.

[44]  Mirza Mansoor Baig,et al.  A comprehensive survey of wearable and wireless ECG monitoring systems for older adults , 2013, Medical & Biological Engineering & Computing.

[45]  Michael V. Scanlon Acoustic Sensor for Health Status Monitoring , 1998 .

[46]  L. Geddes,et al.  Measurements of Young's Modulus of Elasticity of the Canine Aorta with Ultrasound , 1979 .

[47]  P. Chowienczyk,et al.  Contour analysis of the photoplethysmographic pulse measured at the finger , 2006, Journal of hypertension.

[48]  G. Panfili,et al.  A wearable device for continuous monitoring of heart mechanical function based on Impedance CardioGraphy , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[49]  Sebastian Zaunseder,et al.  A mobile system for precise wireless pulse transit time (PTT) monitoring , 2011, MobileHealth '11.

[50]  Young Bae Jun,et al.  Further Results on Derivations of Ranked Bigroupoids , 2012, J. Appl. Math..

[51]  Kejia Li,et al.  A Wireless Reflectance Pulse Oximeter With Digital Baseline Control for Unfiltered Photoplethysmograms , 2012, IEEE Transactions on Biomedical Circuits and Systems.

[52]  C. M. Adkins,et al.  Pulse Decomposition Analysis of the digital arterial pulse during hemorrhage simulation , 2011, Nonlinear biomedical physics.

[53]  Steve Warren,et al.  Two-Stage Approach for Detection and Reduction of Motion Artifacts in Photoplethysmographic Data , 2010, IEEE Transactions on Biomedical Engineering.

[54]  H. Asada,et al.  Adaptive hydrostatic blood pressure calibration: Development of a wearable, autonomous pulse wave velocity blood pressure monitor , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[55]  Jong Yong Abdiel Foo,et al.  Pulse transit time as an indirect marker for variations in cardiovascular related reactivity. , 2006, Technology and health care : official journal of the European Society for Engineering and Medicine.

[56]  Weidong Wang,et al.  Motion artifact removal from photoplethysmographic signals by combining temporally constrained independent component analysis and adaptive filter , 2014, Biomedical engineering online.

[57]  Alan Murray,et al.  Effects of external pressure on arteries distal to the cuff during sphygmomanometry , 2005, IEEE Transactions on Biomedical Engineering.

[58]  Devin B. McCombie,et al.  Motion based adaptive calibration of pulse transit time measurements to arterial blood pressure for an autonomous, wearable blood pressure monitor , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[59]  Rui Pedro Paiva,et al.  Assessing Systolic Time-Intervals from Heart Sound: A Feasibility Study , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[60]  Julien Penders,et al.  Early results on wrist based heart rate monitoring using mechanical transducers , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[61]  J. Muehlsteff,et al.  Continuous cuff-less blood pressure monitoring based on the pulse arrival time approach: The impact of posture , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[62]  C. Ahlstrom,et al.  Noninvasive investigation of blood pressure changes using the pulse wave transit time: a novel approach in the monitoring of hemodialysis patients , 2005, Journal of Artificial Organs.

[63]  M. Toda,et al.  Contact-Type Vibration Sensors Using Curved Clamped PVDF Film , 2006, IEEE Sensors Journal.

[64]  Yuan-ting Zhang,et al.  A novel method for assessing arterial stiffness by a hydrostatic approach , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[65]  K. Thanushkodi,et al.  Wavelet based pulse rate and Blood pressure estimation system from ECG and PPG signals , 2011, 2011 International Conference on Computer, Communication and Electrical Technology (ICCCET).

[66]  Jong Yong Abdiel Foo Use of Independent Component Analysis to Reduce Motion Artifact in Pulse Transit Time Measurement , 2008, IEEE Signal Processing Letters.

[67]  Yan Chen,et al.  Continuous and Noninvasive Blood Pressure Measurement: A Novel Modeling Methodology of the Relationship Between Blood Pressure and Pulse Wave Velocity , 2009, Annals of Biomedical Engineering.

[68]  P. M. Nabeel,et al.  Magnetic plethysmograph transducers for local blood pulse wave velocity measurement , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[69]  Claudio Sartori,et al.  Noninvasive and Nonocclusive Blood Pressure Estimation Via a Chest Sensor , 2013, IEEE Transactions on Biomedical Engineering.

[70]  Y.T. Zhang,et al.  Continuous and long-term arterial blood pressure monitoring by using h-Shirt , 2008, 2008 International Conference on Information Technology and Applications in Biomedicine.

[71]  Hirokazu Tanaka,et al.  Blood pressure estimation from pulse wave velocity measured on the chest , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[72]  O. Casas,et al.  Determination of heart rate using a high-resolution temperature measurement , 2006, IEEE Sensors Journal.

[73]  H.H. Asada,et al.  Noise Cancellation Model Validation for Reduced Motion Artifact Wearable PPG Sensors Using MEMS Accelerometers , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[74]  Youngil Kim,et al.  Design of filter to reject motion artifact of pulse oximetry , 2004, Comput. Stand. Interfaces.

[75]  F. Mee,et al.  Accuracy of the Novacor DIASYS 200 determined by the British Hypertension Society protocol. , 1991, Journal of hypertension.

[76]  P. C. Pandey,et al.  Automatic detection of characteristic points in impedance cardiogram , 2011, 2011 Computing in Cardiology.

[77]  Qiao Zhang,et al.  Noninvasive cuffless blood pressure estimation using pulse transit time and Hilbert-Huang transform , 2013, Comput. Electr. Eng..

[78]  Teh-Ho Tao,et al.  An Ultrawideband Radar Based Pulse Sensor for Arterial Stiffness Measurement , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[79]  Rui Pedro Paiva,et al.  Beat-to-beat systolic time-interval measurement from heart sounds and ECG , 2012, Physiological measurement.

[80]  K. Kawecka-Jaszcz,et al.  Comparison of aortic pulse wave velocity measured by three techniques: Complior, SphygmoCor and Arteriograph , 2008, Journal of hypertension.

[81]  J. Muehlsteff,et al.  Wireless Body Sensor Network for Continuous Cuff-less Blood Pressure Monitoring , 2006, 2006 3rd IEEE/EMBS International Summer School on Medical Devices and Biosensors.

[82]  E. Ertugrul Karsak,et al.  An Integrated Approach Based on 2-Tuple Fuzzy Representation and QFD for Supplier Selection , 2014 .

[83]  George R. Wodicka,et al.  Design, construction, and evaluation of a bioacoustic transducer testing (BATT) system for respiratory sounds , 2006, IEEE Transactions on Biomedical Engineering.

[84]  Emma Pickwell-MacPherson,et al.  The effects of pre-ejection period on post-exercise systolic blood pressure estimation using the pulse arrival time technique , 2010, European Journal of Applied Physiology.

[85]  Federico S. Cattivelli,et al.  Noninvasive Cuffless Estimation of Blood Pressure from Pulse Arrival Time and Heart Rate with Adaptive Calibration , 2009, 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks.

[86]  J. McFetridge-Durdle,et al.  Ambulatory Impedance Cardiography: A Systematic Review , 2006, Nursing research.

[87]  Changyun Wen,et al.  Continuous and Noninvasive Measurement of Systolic and Diastolic Blood Pressure by One Mathematical Model with the Same Model Parameters and Two Separate Pulse Wave Velocities , 2011, Annals of Biomedical Engineering.

[88]  Amir Haghighat,et al.  Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education , 2005 .

[89]  Stephen James Wilson,et al.  A computational system to optimise noise rejection in photoplethysmography signals during motion or poor perfusion states , 2006, Medical and Biological Engineering and Computing.

[90]  Y.T. Zhang,et al.  A model-based calibration method for noninvasive and cuffless measurement of arterial blood pressure , 2006, 2006 IEEE Biomedical Circuits and Systems Conference.

[91]  J. Stradling,et al.  Value of beat-to-beat blood pressure changes, detected by pulse transit time, in the management of the obstructive sleep apnoea/hypopnoea syndrome. , 1998, The European respiratory journal.

[92]  M Zamir,et al.  Mechanical events within the arterial wall under the forces of pulsatile flow: a review. , 2011, Journal of the mechanical behavior of biomedical materials.

[93]  Refet Firat Yazicioglu,et al.  A Low-power and Compact-sized Wearable Bio-impedance Monitor with Wireless Connectivity , 2013 .

[94]  G. Reboldi,et al.  Clinical utility of ambulatory blood pressure monitoring in the management of hypertension , 2014, Expert review of cardiovascular therapy.

[95]  J McLaughlin,et al.  Piezoelectric sensor determination of arterial pulse wave velocity. , 2003, Physiological measurement.

[96]  F.E.H. Tay,et al.  An integrated wrist-worn routine monitoring system for the elderly using BSN , 2008, 2008 5th International Summer School and Symposium on Medical Devices and Biosensors.

[97]  Olivier Chételat,et al.  Chest Pulse-Wave Velocity: A Novel Approach to Assess Arterial Stiffness , 2011, IEEE Transactions on Biomedical Engineering.

[98]  H. Harry Asada,et al.  Wearable, Cuff-less PPG-Based Blood Pressure Monitor with Novel Height Sensor , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[99]  Y.T. Zhang,et al.  Continuous and noninvasive estimation of arterial blood pressure using a photoplethysmographic approach , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[100]  Mark Butlin,et al.  Arterial blood pressure measurement and pulse wave analysis—their role in enhancing cardiovascular assessment , 2010, Physiological measurement.

[101]  Mehrdad Nourani,et al.  A Motion-Tolerant Adaptive Algorithm for Wearable Photoplethysmographic Biosensors , 2014, IEEE Journal of Biomedical and Health Informatics.

[102]  X. Zhang,et al.  The Cuffless Arterial Blood Pressure Estimation based on the Timing- Characteristics of Second Heart Sound , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[103]  Mohanasankar Sivaprakasam,et al.  Local Pulse Wave Velocity estimation using Magnetic Plethysmograph , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[104]  N. Stergiopulos,et al.  Comprar Snapshots Of Hemodynamics. An Aid For Clinical Research And Graduate Education | Nico Westerhof | 9781441963628 | Springer , 2010 .

[105]  Jeong-Whan Lee,et al.  Magneto-Plethysmographic Sensor for Peripheral Blood Flow Velocity , 2014, IEEE Sensors Journal.

[106]  Yuan-Ting Zhang,et al.  Theoretical Study on the Effect of Sensor Contact Force on Pulse Transit Time , 2007, IEEE Transactions on Biomedical Engineering.

[107]  H. Harry Asada,et al.  Artifact-resistant power-efficient design of finger-ring plethysmographic sensors , 2001, IEEE Transactions on Biomedical Engineering.

[108]  Jong Yong Abdiel Foo Development of a temperature-controlled miniature enclosure for monitoring poor perfusion photoplethysmographic signals. , 2007, Physiological measurement.

[109]  Edward J. Ciaccio,et al.  Tonometric Arterial Pulse Sensor With Noise Cancellation , 2008, IEEE Transactions on Biomedical Engineering.

[110]  Jong-Hoon Ahn,et al.  A Linear Transformation Approach for Estimating Pulse Arrival Time , 2012, J. Appl. Math..

[111]  S. Erdine,et al.  ESH-ESC Guidelines for the Management of Hypertension , 2006, Herz Kardiovaskuläre Erkrankungen.

[112]  A. Sherwood,et al.  Hemodynamics of blood pressure responses during active and passive coping. , 1990, Psychophysiology.

[113]  C.C.Y. Poon,et al.  A Health-Shirt using e-Textile Materials for the Continuous and Cuffless Monitoring of Arterial Blood Pressure , 2006, 2006 3rd IEEE/EMBS International Summer School on Medical Devices and Biosensors.

[114]  R. Payne,et al.  Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure. , 2006, Journal of applied physiology.

[115]  Westgate Road,et al.  Photoplethysmography and its application in clinical physiological measurement , 2007 .

[116]  Refet Firat Yazicioglu,et al.  A 160 $\mu{\rm A}$ Biopotential Acquisition IC With Fully Integrated IA and Motion Artifact Suppression , 2012, IEEE Transactions on Biomedical Circuits and Systems.

[117]  Alberto Avolio,et al.  Determination of Aortic Pulse Wave Velocity From Waveform Decomposition of the Central Aortic Pressure Pulse , 2008, Hypertension.

[118]  H.H. Asada,et al.  Low Variance Adaptive Filter for Cancelling Motion Artifact in Wearable Photoplethysmogram Sensor Signals , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[119]  J. Carroll,et al.  Determination of pulse wave velocities with computerized algorithms. , 1991, American heart journal.

[120]  E. O’Brien,et al.  The British Hypertension Society protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems. , 1990, Journal of hypertension.

[121]  Carmen C. Y. Poon,et al.  Modeling of Pulse Transit Time under the Effects of Hydrostatic Pressure for Cuffless Blood Pressure Measurements , 2006, 2006 3rd IEEE/EMBS International Summer School on Medical Devices and Biosensors.

[122]  Carmen C. Y. Poon,et al.  Cuff-less and Noninvasive Measurements of Arterial Blood Pressure by Pulse Transit Time , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[123]  V. C. Padaki,et al.  Smart Vest: wearable multi-parameter remote physiological monitoring system. , 2008, Medical engineering & physics.

[124]  John Semmlow,et al.  Acoustic detection of coronary artery disease. , 2007, Annual review of biomedical engineering.

[125]  J. Muehlsteff,et al.  Comparison of systolic time interval measurement modalities for portable devices , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[126]  L A Geddes,et al.  Pulse transit time as an indicator of arterial blood pressure. , 1981, Psychophysiology.

[127]  Tomás Ward,et al.  Artifact Removal in Physiological Signals—Practices and Possibilities , 2012, IEEE Transactions on Information Technology in Biomedicine.

[128]  Yuan-ting Zhang,et al.  Reduction of motion artifact in pulse oximetry by smoothed pseudo Wigner-Ville distribution , 2005, Journal of NeuroEngineering and Rehabilitation.

[129]  A. Patzak,et al.  Continuous blood pressure measurement by using the pulse transit time: comparison to a cuff-based method , 2011, European Journal of Applied Physiology.

[130]  Jun Tan,et al.  A 0.7-V 17.4-µW 3-lead wireless ECG SoC , 2012, 2012 IEEE Biomedical Circuits and Systems Conference (BioCAS).

[131]  Joseph D. Bronzino,et al.  The Biomedical Engineering Handbook , 1995 .

[132]  D. M. Cooper,et al.  Motion artefact reduction of the photoplethysmographic signal in pulse transit time measurement , 2004, Australasian Physics & Engineering Sciences in Medicine.

[133]  Yuan-ting Zhang,et al.  The effect of local mild cold exposure on pulse transit time , 2006, Physiological measurement.

[134]  Yuan-Ting Zhang,et al.  Relations Between the Timing of the Second Heart Sound and Aortic Blood Pressure , 2008, IEEE Transactions on Biomedical Engineering.

[135]  Refet Firat Yazicioglu,et al.  Motion artifact reduction in ambulatory ECG monitoring: an integrated system approach , 2011, Wireless Health.

[136]  João Cardoso,et al.  Piezoelectric probe for pressure waveform estimation in flexible tubes and its application to the cardiovascular system , 2011 .

[137]  A. Guyton,et al.  Textbook of Medical Physiology , 1961 .

[138]  H. Harry Asada,et al.  Cuffless Blood Pressure Monitoring Using Hydrostatic Pressure Changes , 2008, IEEE Transactions on Biomedical Engineering.

[139]  SeongHwan Cho,et al.  An integrated pulse wave velocity sensor using Bio-impedance and noise-shaped body channel communication , 2013, 2013 Symposium on VLSI Circuits.

[140]  Sang-Suk Lee,et al.  Measurement of Blood Pressure Using an Arterial Pulsimeter Equipped with a Hall Device , 2011, Sensors.

[141]  A. Dominiczak,et al.  2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) , 2007, European heart journal.

[142]  SeongHwan Cho,et al.  A bio-impedance measurement system for portable monitoring of heart rate and pulse wave velocity using small body area , 2009, 2009 IEEE International Symposium on Circuits and Systems.

[143]  Nam-Gyun Kim,et al.  Continuous Blood Pressure Monitoring using Pulse Wave Transit Time , 2005 .

[144]  G. Berntson,et al.  Where to B in dZ/dt. , 2007, Psychophysiology.

[145]  L. G. Sison,et al.  Characterization and adaptive filtering of motion artifacts in pulse oximetry using accelerometers , 2002, Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology.

[146]  Tianshuang Qiu,et al.  Noise and Disturbance Reduction for Heart Sounds in Cycle-Frequency Domain Based on Nonlinear Time Scaling , 2010, IEEE Transactions on Biomedical Engineering.

[147]  S. M. Debbal,et al.  Computerized heart sounds analysis , 2008, Comput. Biol. Medicine.

[148]  Darrin J. Young,et al.  Skin-Coupled Personal Wearable Ambulatory Pulse Wave Velocity Monitoring System Using Microelectromechanical Sensors , 2014, IEEE Sensors Journal.

[149]  W. Nichols McDonald's Blood Flow in Arteries , 1996 .

[150]  René van Lien,et al.  Estimated preejection period (PEP) based on the detection of the R-wave and dZ/dt-min peaks does not adequately reflect the actual PEP across a wide range of laboratory and ambulatory conditions. , 2013, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[151]  Jordi Calabia,et al.  Doppler ultrasound in the measurement of pulse wave velocity: agreement with the Complior method , 2011, Cardiovascular ultrasound.

[152]  P. Erne,et al.  Assessment of Systolic and Diastolic Function in Asymptomatic Subjects Using Ambulatory Monitoring With Acoustic Cardiography , 2011, Clinical cardiology.

[153]  Peter R. Smith,et al.  A new method for pulse oximetry possessing inherent insensitivity to artifact , 2001, IEEE Transactions on Biomedical Engineering.

[154]  T. Togawa,et al.  Continuous estimation of systolic blood pressure using the pulse arrival time and intermittent calibration , 2000, Medical and Biological Engineering and Computing.

[155]  X. Aubert,et al.  Cuffless Estimation of Systolic Blood Pressure for Short Effort Bicycle Tests: The Prominent Role of the Pre-Ejection Period , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.