JP5076229B2 - Vascular disease inspection device and bypass vascular diagnosis device - Google Patents

Description

  The present invention relates to a vascular disease inspection device and a bypass vascular diagnosis device that inspect a vascular disease such as an ischemic disease based on a blood flow velocity waveform, a blood pressure waveform, or a blood flow waveform.

  As conventional examination methods for vascular diseases, there are known methods using a pressure sensor invaded into the blood vessel, an ultrasonic Doppler flow rate sensor, a pressure sensor, or the like pressed against the outside of the blood vessel. In a vascular disease, when a blood vessel is occluded, a bypass operation is performed in which the occluded portion is bypassed by grafting (referring to a general blood vessel of a transplanted living body) and blood is supplied to the downstream portion. As an evaluation of the bypass operation, blood pressure, blood flow velocity, and blood flow volume of each part of the human body are measured and examined.

  For example, FIG. 19 is an explanatory diagram of a revascularization evaluation method for bypass surgery in lower limb ischemia. Lower limb ischemia is a symptom in which the arterial pathway leading to the lower limb is blocked. Bypass surgery is performed to bypass this blocked portion with a graft (which refers to the blood vessels of the transplanted body in general) and supply blood to the lower limb. Done. The bypassed blood descends the lower limb 21 by the lower knee artery 23 passing through the lower limb 21 of FIG. By pressing an ultrasonic Doppler velocimeter 29 against the dorsal artery 27 on the foot surface 25 from above the skin, revascularization of the entire lower limb 21 can be evaluated.

  In this case, a segmental blood pressure measurement method is used in which the blood pressure, blood flow rate, and blood flow volume of each part of the human body are measured, examined, and compared. In particular, an ankle / brachial pressure index (API) is used. Method, ABI method (Blood, not Pressure) is known. The API method measures both the blood pressure of the upper arm and the blood pressure of the lower limb, for example, the ankle joint, and the ratio is API (API = ankle blood pressure / arm blood pressure), and this value is used to diagnose the degree of vascular disease. It is. In the ABI method, the ratio of blood flow is similarly ABI. For example, a manchette is wound around the upper arm and ankle joint, the pressure is lowered, the blood flow when the pulsation is heard for the first time is measured, and the ABI value is obtained from the ratio. The blood flow volume of the foot table is obtained by assuming the thickness of the blood vessel to the blood flow velocity obtained by the flow meter 29 pressed against the foot dorsal artery 27. The same applies to the upper arm.

  FIG. 20 is an explanatory diagram of an evaluation method for revascularization flowing through a graft in a bypass operation when there is a disease in a coronary artery that supplies nutrients to the heart. From the ascending aorta 33 of the heart 31, the coronary artery branches, the right coronary artery (commonly abbreviated as RCA) 35, the left anterior descending branch (abbreviated as LAD) 37, the first and second diagonal branches (abbreviated as D) And left-handed branch 41 (abbreviated as CIRC). In the figure, a case where a bypass is provided on the left front descending branch 37 by a graft 43 is shown. In this case, the sensor part of the Doppler type flow meter 45 is attached so as to clip the periphery of the graft 43 itself, and the maximum value of the blood flow flowing through the graft 43 during the operation is evaluated. It should be noted here that in the case of coronary artery bypass surgery, the flow rate can be directly evaluated without assuming the thickness of the graft 43, which is a bypass blood vessel, by clipping the sensor part to the outer periphery of the graft 43 itself. When the operation is completed, the chest is closed again, and there is a special feature that the revascularization cannot be evaluated from the outside.

  In addition to the evaluation of the ABI value and the evaluation other than the coronary artery bypass blood vessel flow rate maximum value, for example, an arterial flow velocity waveform is displayed by frequency analysis display or zero crossing display.

JP 7-308294 A

  By measuring the segmental blood pressure in the above-mentioned lower limb ischemia, particularly the evaluation of the ABI value, and the evaluation of the maximum flow rate value flowing through the bypass coronary artery, the vascular disease and bypass blood vessel can be evaluated and examined. However, the segmental blood pressure measurement method such as the ABI value needs to measure blood flow at a plurality of sites.

  Further, during the operation, the patient immediately after the operation is in a resting state, and the blood flow velocity and blood flow volume are under the blood pressure in the resting state of the operation environment, whereas the revascularization evaluation is performed 10 days after the operation. Is under blood pressure in daily life. Therefore, from clinical cases, for example, the ABI value does not necessarily match the course of vascular reconstruction after bypass surgery. Similarly, the maximum flow rate value flowing through the coronary artery bypass blood vessel does not necessarily coincide with the course of blood vessel reconstruction after the bypass operation.

  Moreover, in order to diagnose a disease from the frequency analysis display result or zero crossing display result of the arterial flow velocity waveform, specialized knowledge and experience are required.

  The present invention has been made to solve such a problem, and by obtaining a characteristic amount of a blood flow velocity waveform, a blood pressure waveform, or a blood flow waveform, an accurate and easy-to-understand examination can be performed. An object of the present invention is to provide a vascular disease inspection device and a bypass vascular diagnosis device that can be associated with revascularization.

  The vascular disease inspection apparatus according to the present invention is based on a blood pressure and blood flow rate waveform signal or a blood pressure and blood flow rate waveform signal output from a measuring device that measures blood pressure and blood flow rate, or blood pressure and blood flow rate. , Using the equivalent constant of blood vessels that define the relationship between blood pressure and blood flow velocity, or the equivalent constant of blood vessels that calculate the equivalent constant of blood vessels that define the relationship between blood pressure and blood flow, Dynamic blood vessel state calculating means for calculating a blood flow rate value or a blood flow amount value in a virtual blood pressure state in which a load is applied to the blood vessel and obtaining a dynamic blood vessel state is provided.

  In the vascular disease inspection apparatus according to the present invention, it is preferable that the equivalent constant calculating means separately obtains the equivalent resistance and equivalent compliance of the blood vessel as the equivalent constant of the blood vessel.

  In addition, the bypass angiography apparatus according to the present invention provides a blood pressure and blood flow rate waveform signal, or a blood pressure and blood flow rate waveform signal, or a blood pressure and blood flow rate waveform signal output from a measuring device that measures blood pressure and blood flow rate. Based on the equivalent constant of the bypass blood vessel that defines the relationship between blood pressure and blood flow velocity, or equivalent constant of the bypass blood vessel that defines the relationship between blood pressure and blood flow, and the equivalent constant of the calculated blood vessel And a dynamic bypass blood vessel state calculating means for calculating a blood flow velocity value or a blood flow value in a virtual blood pressure state in which a load is applied to the bypass blood vessel and obtaining a dynamic bypass blood vessel state. .

  In the bypass vascular disease inspection apparatus according to the present invention, it is preferable that the equivalent constant calculating means separately obtains the equivalent resistance and equivalent compliance of the bypass blood vessel as the equivalent constant of the blood vessel.

  By analyzing a flow velocity waveform or a flow waveform of an artery, it is possible to evaluate peripheral vascular resistance and vascular compliance, which is effective for diagnosis of vascular disease.

  There is a difference between a normal blood flow waveform or blood flow waveform and a patient blood flow waveform or blood flow waveform. Therefore, vascular diseases can be examined and diagnosed based on the equivalent constants of blood vessels obtained from these waveforms.

  Further, by obtaining the blood vessel resistance and compliance separately based on the blood flow velocity and blood pressure waveform signals, a more precise diagnosis based on each of the blood vessel resistance and compliance is possible.

  The vascular disease inspection apparatus and bypass vascular diagnosis apparatus according to the present invention obtains an equivalent constant of a blood vessel from a blood flow velocity waveform or a blood flow waveform, and based on these, a dynamic blood vessel in a virtual blood pressure state when a load is applied to the blood vessel Since the state can be obtained, examination and diagnosis of vascular diseases can be performed accurately.

It is a block block diagram of the vascular disease inspection apparatus which concerns on this invention. It is a graph which shows the blood flow rate waveform before the operation of the patient who has a disease in an artery. It is a graph which shows the blood flow rate waveform immediately after the operation of the patient. It is a graph which shows the blood flow rate waveform one week after the operation of the patient. It is explanatory drawing in the case of calculating | requiring a time constant as a waveform feature-value based on reference embodiment of this invention. It is explanatory drawing in the case of calculating | requiring sharpness as a waveform feature-value based on reference embodiment of this invention. It is a figure which shows the example of the blood flow rate waveform of the blood which flows through the bypass blood vessel of a typical heart coronary artery. It is the figure which defined the inclination in the case of using the inclination of the rising time of a waveform as a feature-value of the blood flow velocity waveform based on reference embodiment of this invention. It is the figure which graphed the result of one case of the change of the normalized ABI value of the prior art, and the normalized inclination which concerns on the reference embodiment of this invention before bypass surgery, immediately after surgery, and after the postoperative day progress. It is the figure which graphed the result of the other case of the change of the ABI value of a prior art, and the normalized inclination which concerns on the reference embodiment of this invention before bypass surgery, immediately after surgery, and after the postoperative day progress. It is the figure which graphed the result of the further another case of the change of the normalized inclination which concerns on the ABI value of a prior art, and the reference embodiment of this invention before bypass surgery, immediately after surgery, and after the postoperative day progress. It is explanatory drawing in the case of defining the normalized inclination which concerns on the reference embodiment of this invention about the blood flow rate waveform of the cardiac coronary artery bypass blood vessel. In the case of bypass operation of the coronary artery, in a case where three bypass grafts were performed, the normalized slope magnitude according to the reference embodiment of the present invention was compared with the maximum value of blood flow. is there. The figure which showed the magnitude | size of the normalization inclination which concerns on the reference embodiment of this invention in the other case which performed bypass graft of three places about the bypass operation of the heart coronary artery compared with the maximum value of the blood flow rate It is. The figure which showed the magnitude | size of the normalization inclination which concerns on the reference embodiment of this invention in the other case which performed bypass graft of three places about the bypass operation of the heart coronary artery compared with the maximum value of the blood flow rate It is. The figure which showed the magnitude | size of the normalization inclination which concerns on the reference embodiment of this invention in the other case which performed bypass graft of three places about the bypass operation of the heart coronary artery compared with the maximum value of the blood flow rate It is. It is a figure which shows the model of the electric circuit equivalent to a systemic circulation system. It is a figure which shows the simple model of the electric circuit equivalent to a systemic circulation system. It is explanatory drawing of the revascularization evaluation method of the bypass operation in lower limb ischemia in a prior art. It is explanatory drawing of the evaluation method of the revascularization which flows in the graft | grafting in a bypass operation when there is a disease in the coronary artery which supplies nutrition to the heart part in a prior art.

  Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

  FIG. 1 is a block diagram of a vascular disease inspection apparatus according to the present invention. The vascular disease inspection apparatus 1 includes an A / D conversion unit 2, a memory unit 3, a waveform analysis unit 4, and an output unit 5. Reference numeral 10 denotes an ultrasonic Doppler blood flow rate measuring device (or blood pressure measuring device). The blood flow rate signal (or blood pressure signal) of the target site measured by the blood flow rate measuring device (or blood pressure measuring device) 10 is supplied to the vascular disease inspection device 1.

  The A / D converter 2 converts the blood flow velocity (or blood pressure) waveform signal into a digital waveform signal. The digital waveform signal is stored in the memory unit 3 in correspondence with the time series. The waveform analysis unit 4 obtains a waveform feature amount based on the digital waveform signal stored in the memory unit 3. The waveform analysis unit 4 includes a CPU or DSP (Digital Signal Processor) and a waveform analysis program. The output unit 5 outputs the feature amount of the waveform obtained by the waveform analysis unit 4. The output unit 5 includes an image display device such as a monitor device. The output unit 5 may be configured to include a printer device for printing out the output of the waveform feature quantity.

  A block diagram of a bypass vascular diagnostic device according to another embodiment of the present invention is also substantially the same, and instead of the blood flow velocity measuring device (or blood pressure measuring device) 10 of FIG. 1, a blood flow measuring device (or blood pressure measuring device). The blood flow volume signal (or blood pressure signal) of the target site measured by these is supplied to the bypass vascular diagnostic apparatus instead of the vascular disease inspection apparatus 1.

  Figures 2 to 4 show patients with lower limb ischemia who performed bypass surgery on the diseased artery, obtained a blood flow rate signal from a Doppler velocimeter that was pressed against the dorsal artery, and showed the state of blood circulation reconstruction. This is the result. FIG. 2 is a graph showing a blood flow velocity waveform before surgery for a patient having a disease in an artery, FIG. 3 is a graph showing a blood flow velocity waveform immediately after surgery for the patient, and FIG. 4 is a week of surgery for the patient. It is a graph which shows the blood flow rate waveform after. In these graphs, the vertical axis represents blood flow velocity and the horizontal axis represents time. The value on the horizontal axis indicates the sampling number when the blood flow rate signal is sampled at a predetermined sampling period.

  From these graphs, it can be seen that the blood flow velocity waveform when the arterial occlusion is advanced rises and falls slowly, and the blood flow velocity waveform after the bypass operation has a sharp rise and fall.

  FIG. 5 is a diagram illustrating an example of feature amount extraction processing in the waveform analysis unit. FIG. 5 shows a case where a time constant is obtained as a waveform feature amount. The waveform analysis unit 4 recognizes a unimodal rapid advance phase based on, for example, the positive peak value, and cuts out each cycle of the blood flow velocity waveform based on each rapid advance phase. The waveform analysis unit 4 obtains the time until the blood flow velocity increases from 0 to a value of about 63% of the peak value, and sets this as the rising time constant. The waveform analysis unit 4 obtains the time until the blood flow velocity drops from the peak value to a value of about 37% of the peak value, and sets this as the falling time constant. The waveform analysis unit 4 obtains a rising time constant and a falling time constant for each period, obtains an average value for each of a plurality of periods, and outputs a rising time constant and a falling time constant. The waveform analysis unit 4 may obtain and output only the rising time constant.

  On the screen of the image display device constituting the output unit 5, a blood flow velocity waveform is displayed, and the rise time constant and the fall time constant are displayed. Thereby, a doctor or the like can determine the degree of vascular disease or the like based on the displayed time constant. This is because the time constant becomes large when there is a disease such as stenosis or occlusion of a blood vessel.

  A threshold value for determining normality and a threshold value for determining the degree of vascular disease are set in advance, and the waveform analysis unit 4 compares the calculated time constant with each threshold value to determine the vascular disease level. The degree may be determined, and the determination result may be displayed on the output unit 5.

  Moreover, you may use a Fourier-transform value, a differential value, or an integral value as a feature-value of a waveform.

  Further, the sharpness may be used as the feature amount of the waveform. FIG. 6 is a diagram illustrating an example of obtaining the sharpness as the waveform feature amount. A period which is 50% of the peak value of the rapid advance phase is obtained, and this is set as a half width. Then, the ratio of the half-value width period to the one-cycle period (half-value width / cycle) is obtained, and the obtained ratio is defined as the sharpness.

  In the above-described reference embodiment, the blood flow velocity waveform is exemplified and the feature amount is obtained. However, the blood pressure waveform or the blood flow feature amount may be obtained.

  FIG. 7 shows an example of a blood flow waveform of blood flowing in a typical coronary artery bypass vessel, bypassing the left internal sternal artery as a graft to the left anterior descending branch (LAD), and a Doppler flow meter in the bypass vessel. The case where the sensor part is clipped and the blood flow amount flowing through the bypass blood vessel is measured is shown. The horizontal axis represents time, and the vertical axis represents blood flow. The horizontal axis represents the sampling number of the measurement sampling period.

  The blood flow waveform flowing through the bypass coronary artery of the heart coronary artery in FIG. 7 is different from the blood flow velocity waveform in the dorsal artery in FIGS. 2 to 4 and peaks of two rapid advance phases are observed in one heartbeat cycle. . This is due to the fact that the heart beat has two periods, diastole and systole. In other words, blood is sent to the general terminal artery corresponding to the diastole, but in the case of the cardiac coronary artery, the myocardium relaxes even in the systole, so that the blood easily flows into the coronary artery, and these two cycles Correspondingly, there are two peaks of rapid advance phase.

  FIG. 8 is a diagram in which a slope is defined when the slope of the rising timing of the waveform is used as the characteristic amount of the blood flow velocity waveform in lower limb ischemia. The lowest point and the highest point of the blood flow velocity are connected by a straight line, and the slope of the straight line is obtained and set as the slope. This slope is a unit of blood flow velocity / time, but if it is converted into voltage / voltage by the blood flow velocity measuring device 10 and further this waveform data is output directly to the output unit 5, the length in the Y-axis direction / X Since it becomes the axial length, if normalization is performed for each of these conversions, the Y-axis direction length and the X-axis direction length of the figure in FIG.

  FIG. 9 to FIG. 11 are graphs showing changes in normalized slope before and after the bypass operation, and after a predetermined day after the operation. In this case, it is shown in comparison with the ABI value.

  For example, in FIG. 9, FIG. 9A shows the change in the ABI value before surgery, immediately after surgery, and 17 days after surgery. FIG. 9B shows the change in normalized slope corresponding to this. In this patient's case, the ABI value was slightly improved by the bypass operation, and the ABI value was improved 17 days after the operation. As for the normalized inclination, a significant improvement is seen by the bypass operation, and the improvement is remarkable at the time when 17 days have passed since the operation.

  In the case of the patient of FIG. 10, the ABI value is zero before the operation, and it has not recovered even immediately after the bypass operation. On the other hand, the normalized slope was improved by bypass surgery, and after 11 days after the operation, the ABI value recovered and the normalized slope was greatly improved.

  In the case of the patient in FIG. 11, the ABI value fell to zero by the bypass operation, but the normalized slope recovered significantly. After 10 days from the operation, the ABI value recovered slightly, but the value before the operation was restored. On the other hand, the normalized slope was further improved significantly.

  In this way, when the changes in the ABI value before and after the bypass operation are three cases of improvement, no change, and decrease, the change in the ABI value does not correspond to the result of revascularization, and the normalized slope is All are markedly improved and are consistent with the results of revascularization.

  Therefore, in bypass surgery for lower limb ischemia, the normalized slope of the dorsal artery blood flow velocity waveform is an effective waveform feature for postoperative vascular reconstruction evaluation, that is, for vascular disease testing equipment. I understand.

  FIG. 12 is an explanatory diagram in the case where the normalized slope is defined for the blood flow waveform of the cardiac coronary artery bypass blood vessel. In this case, since two types of waveforms are obtained according to the two periods of the diastolic phase and systolic phase of one heartbeat, the slope normalized to each of the rising time of the diastolic phase and the rising time of the systolic phase is obtained. Is distinguished from S1 and S2. Further, regarding the maximum value of the blood flow, the maximum values corresponding to the diastole and the systole were distinguished as M1 and M2. In this case, the blood flow was also compared with a normalized amount.

  FIG. 13 to FIG. 16 show the comparison of the normalized slopes S1 and S2 with the maximum blood flow values M1 and M2 in the case of three bypass grafts for the coronary artery bypass surgery. It is shown. The three bypass locations vary depending on the patient, but the right coronary artery (RCA), the left anterior descending branch (LAD), the left circumflex branch (CIRC), the first and second diagonal branches (D), etc. It is.

  For example, in FIG. 13, FIG. 13 (a) is arranged in order from a small value to a large value in order to know the range of the values of the maximum blood flow M1, M2 normalized for three bypass blood vessels. is there. In this case, the minimum value is 0.15 and the maximum value is 0.45. FIG. 13B shows the corresponding normalized slopes arranged in order from the smallest value to the largest value in order to know the range. The minimum value was 0.25 and the maximum value was 2.65.

  In this way, there is no significant difference in normalized maximum blood flow in the three bypass blood vessels. In other words, as long as the normalized maximum blood flow is observed, there is no significant difference in revascularization of the bypass blood vessels. Is evaluated. However, with regard to the normalized slope, it can be seen that there are significant differences in the three bypass vessels.

  The same can be said for FIGS. 14, 15 and 16 showing different cases. In particular, in cardiac coronary artery bypass surgery, the characteristic evaluation of bypass blood vessels is that the chest is closed once the operation is completed, so when using a normalized slope that can evaluate a large difference in blood circulation reconstruction as a feature value, This is a very effective evaluation tool.

  Therefore, it can be understood that the normalized slope of the blood flow waveform of the bypass blood vessel in the coronary artery bypass surgery is an effective waveform feature amount for evaluation of revascularization by the bypass surgery, that is, for the bypass blood vessel diagnostic apparatus.

  FIG. 17 is a diagram showing a model of an electric circuit equivalent to the systemic circulation system. The characteristics of the blood vessel include a resistance R (corresponding to the resistance of the electric circuit) representing the fineness of the blood vessel and a compliance C (corresponding to the capacitance of the electric circuit) representing the softness of the blood vessel. The above-mentioned time constant is obtained as CR, and it is effective for diagnosing disease only by obtaining this time constant, but in order to make a more precise diagnosis, these resistance R and compliance C are used. It is desirable to ask separately. That is, since it is not possible to distinguish between a case where the blood vessel is hard and thick and a case where the blood vessel is soft and thin only by the time constant, it is desirable to distinguish these.

  Since peripheral blood vessels have high resistance, compliance can be ignored and a model of the systemic circulation system can be represented as shown in FIG. Here, Ra is arterial resistance, Ca is arterial compliance, Pa is arterial blood pressure, Rp is peripheral vascular resistance, Rv is venous resistance, Cv is venous compliance, Pv is venous blood pressure, and Ph is cardiac blood pressure.

  FIG. 18 is a diagram showing a simple model of an electric circuit equivalent to the systemic circulation system. The parameter of the vein is hardly changed by physiological factors, and the arterial resistance Ra is small compared to the peripheral vascular resistance Rp and can be ignored. Therefore, as shown in FIG. The model can be made simpler.

（１）
（第二の方法）． 図２〜図４に示すように波形周期には比較的安定している期間があり、この間のコンプライアンスＣは無視できるので、この間の血圧と血流速とを測定して抵抗Ｒを求め、また別途、上述の時定数を求め、これら時定数と抵抗ＲとからコンプライアンスＣを求めることができる。 In order to obtain the resistance R and the compliance C, there are the following two methods.
(First method). Blood pressure (corresponding to voltage) and blood flow velocity (corresponding to current) are measured, and resistance R and compliance C are identified using the least square method or the like. When obtained by the least square method, the model equation of the discrete system is as follows. Using this Equation 1 as a model, the peripheral blood vessel resistance Rp and the blood pressure V (k) and the blood flow velocity i (k) are calculated. Arterial compliance Ca can be determined.

(1)
(Second method). As shown in FIGS. 2 to 4, the waveform period has a relatively stable period, and the compliance C during this period can be ignored. Therefore, the resistance R is obtained by measuring the blood pressure and the blood flow rate during this period, and Separately, the above-mentioned time constant is obtained, and the compliance C can be obtained from these time constant and the resistance R.

  Therefore, in the case of the first method, Equation 1 is used in which the model of the systemic circulation system shown in FIGS. More specifically, the blood pressure and blood flow velocity data measured by sampling are used as discretized data, and the model parameters are identified using the least square method to obtain the equivalent resistance and equivalent compliance, which are the equivalent constants of the blood vessel. In the case of the second method, equivalent resistance and equivalent compliance, which are equivalent constants of blood vessels, are obtained by simultaneously measuring blood pressure during a period in which the blood flow rate is relatively stable.

  The equivalent constant of the blood vessel that defines the relationship between blood pressure and blood flow velocity obtained in this way is a value inherent to the blood vessel, and is the same in both a resting state and a daily life. Using this fact, if the equivalent constant of blood vessels is known, the relationship between blood pressure and blood flow velocity in various living environments of patients can be obtained.

  An apparatus for examining vascular disease according to an embodiment of the present invention uses equivalent constant calculation means for obtaining an equivalent constant that defines the relationship between blood pressure and blood flow rate from blood pressure and blood flow rate data, and the equivalent constant. Since the blood flow velocity value in the virtual blood pressure state in which a load is applied to the blood vessel is calculated and the dynamic blood vessel state calculating means for obtaining the dynamic blood vessel state is provided, the dynamic state of the blood vessel after the bypass operation can be predicted.

  That is, if Ts, Ca, Rp, which are equivalent constants of blood vessels, are given in Equation 1, the blood flow velocity i (k) under the blood pressure can be calculated by inputting an appropriate blood pressure V (k). . During the operation, immediately after the operation, the patient is in a resting state, and the blood flow rate under blood pressure at that time is different from the blood flow rate under blood pressure in daily life after a predetermined day after the operation. Therefore, during the operation, the blood vessel disease inspection apparatus calculates the equivalent constant of the blood vessel in real time, and uses the result to input the blood pressure value in the virtual daily life into the formula (1), and after the operation, The blood flow rate in daily life after the passage of days can be predicted and calculated.

  Similarly, in the bypass angiography apparatus which is a further embodiment of the present invention, an equivalent constant calculating means for obtaining an equivalent constant that defines the relationship between blood pressure and blood flow volume from blood pressure and blood flow data, Using the dynamic blood vessel state calculation means to calculate the blood flow volume value in the virtual blood pressure state with the load applied to the blood vessel and obtain the dynamic blood vessel state, so predict the dynamic state of the bypass blood vessel after bypass surgery it can.

  The vascular disease inspection device and bypass vascular diagnosis device according to the present invention can be used for vascular disease inspection such as ischemic disease, and postoperative diagnosis after bypass surgery as a result.

  DESCRIPTION OF SYMBOLS 1 Vascular disease test | inspection apparatus, 2 A / D conversion part, 3 Memory part, 4 Waveform analysis part, 5 Output part, 10 Blood flow velocity (or blood pressure) measuring device, 21 Lower limb, 23 Inferior knee artery, 25 Foot table, 27 foot Dorsal artery, 29 anemometer, 31 heart, 33 ascending aorta, 35 right coronary artery, 37 left anterior descending branch (LAD), 39 first and second diagonal branches (D), 41 left circumflex branch (CIRC), 43 graft, 45 Flow meter.

Claims (4)

The relationship between blood pressure and blood flow rate is defined based on blood pressure and blood flow rate waveform signals output from blood pressure and blood flow rate, or blood pressure and blood flow rate waveform signals, or blood pressure and blood flow rate waveform signals. An equivalent constant calculating means for calculating an equivalent constant of a blood vessel, or an equivalent constant of a blood vessel defining a relationship between blood pressure and blood flow,
Dynamic blood vessel state calculation means for calculating a blood flow rate value or a blood flow value in a virtual blood pressure state in which a load is applied to the blood vessel using the calculated blood vessel equivalent constant, and obtaining a dynamic blood vessel state;
A vascular disease inspection apparatus comprising: In the vascular disease inspection apparatus according to claim 1,
An equivalent constant computing means obtains an equivalent resistance and equivalent compliance of a blood vessel separately as an equivalent constant of the blood vessel, and a blood vessel disease inspection apparatus characterized by the above. The relationship between blood pressure and blood flow rate is defined based on blood pressure and blood flow rate waveform signals output from blood pressure and blood flow rate, or blood pressure and blood flow rate waveform signals, or blood pressure and blood flow rate waveform signals. An equivalent constant of the bypass blood vessel, or an equivalent constant calculating means for calculating an equivalent constant of the bypass blood vessel that defines the relationship between blood pressure and blood flow,
Using the calculated blood vessel equivalent constant, the blood flow velocity value or the blood flow value value in the virtual blood pressure state in which the bypass blood vessel is loaded is calculated, and the dynamic bypass blood vessel state calculating means for obtaining the dynamic bypass blood vessel state;
A bypass blood vessel diagnostic apparatus comprising: The bypass angiography apparatus according to claim 3,
An equivalent constant computing means obtains an equivalent resistance and an equivalent compliance of a bypass blood vessel separately as an equivalent constant of the blood vessel, and a bypass blood vessel diagnostic apparatus characterized in that

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