Non-invasive measurement of Valsalva-induced hemodynamic changes on a bathroom scale ballistocardiograph

Unobtrusive and compact methods for monitoring time varying hemodynamic trends can allow physicians to monitor heart failure of outpatients at home. In this paper, the ballistocardiogram (BCG), measured on a modified commercial bathroom scale, is proposed as a viable option for this important need. The BCG measures the reaction force of the body to cardiac ejection of blood and is a non-invasive tool for evaluating cardiovascular function. The Valsalva maneuver was used to modulate the hemodynamics in a well documented manner, and BCG signals were acquired from 15 subjects. The electrocardiogram (ECG) was simultaneously obtained to measure the electrical to mechanical delay in ventricular contraction: the interval from the ECG R-wave peak to the BCG J-wave peak. This interval, called the RJ interval, decreased for all subjects following the release of intrathoracic strain compared to the resting value, suggesting that it is inversely correlated to cardiac contractility. The power spectrum magnitude of the BCGs showed that the high frequency content increased after release, also consistent with increased contractility (faster ejection). Additionally, J-wave amplitudes increased following release, suggesting that it is correlated to stroke volume. Since RJ interval computation required the ECG, BCG J-wave rise time was proposed as an alternative for evaluating cardiac contractility. The correlation between this rise time and RJ interval was high (R² = 0.78).