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A Novel Approach to Cardiac Health Assessment Using a Redesign of the Brachial Cuff Device


Tamborini, Alessio (2023) A Novel Approach to Cardiac Health Assessment Using a Redesign of the Brachial Cuff Device. Dissertation (Ph.D.), California Institute of Technology. doi:10.7907/rp22-me93.


Current diagnostic methodologies in cardiology face large tradeoffs between procedure invasiveness and diagnostic reliability, ultimately requiring individuals to undergo cardiac catheterization for accurate diagnosis. Given the current societal burden of cardiovascular disease, there is a need for translational medical devices that bridge the accuracy gap between invasive and non-invasive measurements in the assessment of heart health. This thesis focuses on the development and validation of a high-resolution cuff-based system for assessment of central cardiovascular health.

Traditional pressure cuffs suffer low signal resolution when applied to non-invasive pulse waveform acquisition. In the first section of this thesis, we develop a cuff-based device with a pneumatic filter for high fidelity pulse waveform acquisition. This work discusses the design and functionality of the cuff-device, and investigates the repeatability of the cuff-based measurement. Furthermore, the derived mathematical model of the pneumatic filter is shown to have an equivalent behavior to an electrical low-pass filter inclusive of a time constant and a frequency response curve.

The accuracy and reliability of the pulse waveform features from the cuff-device are evaluated with human study data. Firstly, an IRB study is performed at Caltech on a young and healthy population showing that the cuff-device data lies within a narrow distribution indicative of the healthy nature of the population. Secondly, data from a clinical trial collecting simultaneous invasive catheter, cuff, and ECG is analyzed. The first analysis compared waveform parameters from the cuff in sSBP hold pressure with simultaneous aortic catheter, showing strong correlations between the two measurement modalities for both magnitude and fluctuations thereof.

Lastly, this work investigated the relationship between cuff-based parameters and left ventricular functions. We introduced a cuff-based method for extraction of the pressure-sound waveform, a pressure based surrogate of heart sounds. The results from this analysis showed that the pressure-sound features correlate with the strength of the left ventricular isovolumetric contraction and relaxation. Other important results from this work demonstrated the correlations between the heart-lung interactions in the left ventricle and cuff parameters: breathing fluctuations proportionally affect LV pressures and cuff sSBP waveform parameters. Overall these results support the accuracy and reliability of a cuff-based device for central cardiovascular health assessments.

Item Type:Thesis (Dissertation (Ph.D.))
Subject Keywords:Cardiovascular Diagnostics, Pulse Wave Analysis, Non-invasive Pulse Waveform
Degree Grantor:California Institute of Technology
Division:Engineering and Applied Science
Major Option:Medical Engineering
Thesis Availability:Public (worldwide access)
Research Advisor(s):
  • Gharib, Morteza
Thesis Committee:
  • Tai, Yu-Chong (chair)
  • Gharib, Morteza
  • Gao, Wei
  • Dabiri, John O.
Defense Date:24 May 2023
Funding AgencyGrant Number
Andrew and Peggy Cherng Department of Medical Engineering FellowshipUNSPECIFIED
Gakenheimer FellowshipUNSPECIFIED
Record Number:CaltechTHESIS:06012023-001712615
Persistent URL:
Tamborini, Alessio0000-0001-7651-3505
Default Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:15252
Deposited By: Alessio Tamborini
Deposited On:05 Jun 2023 18:02
Last Modified:12 Jun 2023 19:31

Thesis Files

[img] PDF (Redacted thesis. Chapters 3, 5, 6, 7 excluded) - Final Version
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