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from Arterial Blood Pressure Signals

Dandu Sriram Raju, M. Sabarimalai Manikandan and Barathram.Ramkumar

School of Electrical Sciences

Indian Institute of Technology Bhubaneswar

Bhubaneswar, Odisha-751013, India.

Email:{sriram.iitbbs, msm.sabari, and barathram24}@gmail.com

for determining time-location of systolic peak in arterial blood

pressure (ABP) signals. The method consists of four major

steps: Gaussian derivative filtering, nonlinear peak amplification,

Gaussian derivative based peak finding scheme, and peak position

adjustment procedure. The method is tested and validated using

the standard MIT-BIH Polysomnographic database containing a

wide range of ABP signals, artifacts and high-frequency noises.

Our results demonstrate that the proposed method can achieve

better peak detection performance while maintaining very small

detection error rates for both clean and noisy ABP signals.

The method achieves an average sensitivity of 99.89% and

positive predictivity of 99.59% on test ABP datasets consisting

of 67,125 beats. Unlike other existing methods, our method is

quite straightforward and simple in the sense that it does not

use search-back algorithms with secondary thresholds.

I. I NTRODUCTION

Arterial blood pressure (ABP) signal contains vital clinical

information about the cardiovascular system, including heart

rate, systolic and diastolic arterial pressures. These clinical

information are widely used to assess properties of the arterial

vessel wall [1]-[6]. Furthermore, the morphological characteristics of an ABP waveform are closely related with the

hemodynamic behaviors of blood circulation [3]. The ABP

signal consists of a systolic peak, dichrotic notch, and dichrotic

peak. The onset and steep upstroke points reflect the aortic

valve opening for blood ejection. The systolic peak of the

ABP waveform indicates the integrated behaviors of cardiac

blood ejection and arterial wave reflection. The dicrotic notch

indicates the closure of aortic valve [3]. The detection of

those pressure components is essential for assessing different

abnormal functions of structural components of heart [4][6]. Thus, an automatic detection method has become very

important tools for pulse oximetry, cardiac arrhythmia detection, and pulse contour analysis [6]. There are numerous

current and potential applications for pressure components

detection methods. Although many detection methods have

been reported for ECG signals [7], [8], there are only a few

methods to detect essential peaks in ABP signals [6].

In [11], X. Liu and J. Liu (2012) presented a method

for detecting the systolic peak of the atrial blood pressure

signals. The method consists of four components: a low-pass

filter to reduce high-frequency noise, a slope sum function

(SSF) to enhance the morphological up-slope features of the

TS14SPSAA02 355

ABP signal, modified mean shift algorithm to detect local

maxima and peak position calibration strategy to find true

peak of the ABP signals. The standard MIT-BIH database was

used for validation. In [3], B. N. Li et al. (2010) presented

an automatic delineator for characterizing the fiducial points

(namely, onsets, systolic peaks and dichrotic notches) of

arterial blood pressure waveforms. The delineation method

is based on the critical point detection in the derivative of

filtered ABP waveform that detects systolic peaks by using

zero-crossing points after the maximal inflection in waveform

derivative. The amplitude and interval thresholds are used in

the detection process. The delineator had an average error rate

1.14%, sensitivity 99.43% and positive predictivity 99.45%. In

[1], W. Zong et al. (2003) presented an open-source algorithm

to detect onset of arterial blood pressure pulses. The method

is based on a windowed and weighted slope sum function to

extract the onsets of ABP waveforms, and claimed its accuracy

99.31% on 368,364 beats with reference to ECG reference

and annotations and 96.41% on 39,848 beats with reference

to manual annotation.

In [13], Z. T. Beattie presented an algorithm to detect

pressure peak beats in ABP, intracranial pressure (ICP), and

pulse oximetry (SpO2) signals. The beat detection algorithm

includes decimation process, 10th order high pass elliptical filter, 6th order autoregressive model, spectral density estimator,

peak detection algorithm and decision logic. The algorithm

had an average sensitivity of 99.6% 0.27 and an average

positive predictivity of 98.6% 1.1. In [6], Mateo Aboy et al.

(2005) designed an automatic detection algorithm for pressure

signals that locates the first peak following each heart beat.

This is called the percussion peak in intracranial pressure,

the systolic peak in ABP and the pulse oximetry (SpO2)

signals. The proposed algorithm incorporates a filter bank with

variable cutoff frequencies, spectral estimates of the heart rate,

rank-order nonlinear filters, and decision logic and achieved

a sensitivity of 99.36% and positive predictivity of 98.43%.

In [15], F. Scholkmann et al. (2012) presented a new method

for automatic detection of peaks in noisy periodic and quasiperiodic signals. The method is based on the calculation and

analysis of the local maxima scalogram, a matrix comprising

the scale-dependent occurrences of local maxima.

Most existing detection methods use similar decision rule

41

The proposed detection method consists of four major steps:

Gaussian derivative filtering, nonlinear peak amplification,

Gaussian derivative based peak finding scheme, and peak

position adjustment procedure. In the first stage, the ABP

signal is preprocessed for suppressing the baseline drifts and

enhancing the high-slope portions of ABP signals. The filtered

signal is obtained by convolution of the ABP signal with Gaussian derivative function. In the second stage, nonlinear signal

processing performs high-frequency noise suppression and

further amplifies the magnitude of the high-slope components

in the filtered signal. In the third stage, the signal envelope

from the nonlinear signal processing stage is processed to find

approximate locations of systolic peaks. The locations of local

peaks are automatically determined by processing the positive

zero-crossing points of the output waveform obtained from the

convolution of the signal envelope with Gaussian derivative

kernel. Finally, the detected locations of candidate peaks are

used as guides to find true time-locations of systolic peaks in

the ABP signal.

100point Gaussian

Kernel

1

0.8

0.6

0.4

0.2

(a)

20

various noises and artifacts including baseline drift, amplitude modulation with respiration, power-line interference and

instrument noise [6]. To suppress noises and artifacts, many

40

60

80

100

0.1

0.05

ZeroCrossing Point

0

0.05

(b)

0.1

20

40

60

Sample Number

80

100

Fig. 1. (a) The 100-point Gaussian kernel window with spread = 6.25,

and (b) The Gaussian derivative kernel.

wavelets, empirical mode decomposition, adaptive filters and

filter banks have been used in the processing stage [1], [3], [6],

[10]. In this work, the first stage of the proposed preprocessor

employs a Gaussian derivative filter to remove baseline wander

and eliminates high-frequency noise. The output of this filter

contains only high-slope portions. The second preprocessing

stage employs a squarer and an adaptive energy-thresholding

rule for further attenuating other low-amplitude components

and enhancing the high-slope systolic peak portions of the

ABP waveform. The third Shannon energy computation stage

further magnifies the magnitude of a low-amplitude peak. The

smoothing filter provides smooth signal envelope, wherein

the smoothing filtering is determined from refractory period.

The preprocessing stage finally provides a signal envelope

containing smooth local peaks that correspond to the systolic

peaks contained in the ABP signal. Thus, the resulting smooth

signal envelope is further processed to find time-locations of

true systolic peaks in ABP signals.

1) Gaussian Derivative Filtering: The Gaussian derivative

filter is designed to emphasize high-slope systolic peak portions of the ABP waveform. The length and spread of the

Gaussian pulse kernel is determined empirically in such that it

can simultaneously emphasize the high-slope peak portion and

suppress the baseline wander and high-frequency noise. Thus,

the proposed preprocessing can reduce the computational load

as compared to most existing methods which use a set of

digital filters and derivatives. The M 1 coefficients vector

of a Gaussian kernel g[m] are computed as

M 2

1 (m 2 )

2

A. Preprocessing Stages

TS14SPSAA02 355

1.2

Gaussian Derivative

Kernel

thresholds for locating onset and peaks of the ABP waveforms. Many of the methods used in QRS detection that take

advantage of the impulsive shape of the QRS complex that do

not work well on pressure signals. In practise, ABP signals

are often contaminated by various noises and artifacts. Under

this scenario, most of these semi-automatic methods had a

large number of false positive and negative detections [6].

Furthermore, the morphology of the ABP waveform can vary

in response to different pathologic or physiologic stresses.

Therefore, reliable and accurate detection method is essential

for cardiac health monitoring applications.

In this paper, we propose an automatic peak detection

method based on Gaussian derivative filters and Shannon

energy envelogram. The method is much less sensitive to

parameter choices than conventional methods. The produces a

very robust and accurate detection performance on both clean

and noisy ABP signals. The key feature in our method is a

Gaussian derivative filtering to enhance the high-slope of APB

signal and to suppress baseline artifacts, a nonlinear signal processing to suppress the high-frequency noises and emphasize

magnitude of the low systolic peaks and a straightforward and

simple peak finding scheme to automatically determine timelocation of systolic peaks contained in the ABP signal.

The rest of this paper is organized as follows. Section

II describes the proposed systolic peak detection algorithm.

Section III provides the experimental results for a wide variety

of ABP signals from the standard MIT-BIH Polysomnographic

database. Finally, conclusions are drawn in Section IV.

g[m] = e 2

m = 1, 2, 3, ........, M

(1)

the width spread (or standard deviation) of the Gaussian

kernel. The width of the Gaussian kernel is directly related

42

Amplitude

(a)

Amplitude

(b)

0

1

10

12

14

10

12

14

Thresholded

Energy

Shannon

Energy (SE)

Energy

0.8

0.6

0.4

0.2

(e)

Smooth SE

Envelope

0.5

(d)

(f)

0.5

(c)

magnitude of the components of the systolic peaks. In this

work, adaptive thresholding is applied on the energy envelope

in order to remove the low-amplitudes of other components of

the ABP signal. The adaptive thresholding rule is defined as

0, e[n] <

(5)

eth [n] =

e[n], e[n] >

0.5

0

1

0.8

0.6

0.4

0.2

10

12

14

10

12

14

10

12

14

10

12

14

thresholding process, the energy values e[n] smaller than the

threshold parameter are set to zero and other values are

retained. Here, the adaptive-threshold parameter for each

ABP segment is computed as

N

N

1

1

=

(e[n] e )2 and e =

e[n].

N n=1

N n=1

0.3

0.2

0.1

0

0.2

0.15

0.1

0.05

0

8

Time (second)

(a) Original ABP signal. (b) Output of the Gaussian derivative filtering stage.

(c) Output of the squaring operation stage. (d) Output adaptive thresholding

stage. (e) Output of Shannon energy computation stage. (f) Output of the

smoothing filtering stage.

pulse width. Then, Gaussian derivative kernel is computed as

h[m] = g[m + 1] g[m]

m = 1, 2, 3, ......., M 1 (2)

in Fig. 1(a) and the corresponding Gaussian derivative function

is shown in Fig. 1(b). The filtered signal is obtained by taking

the convolution of the input ABP signal x[n] and Gaussian

derivative function h[n]. The filtered signal d[n] is computed

as

x[k] h[n k].

(3)

d[n] =

k=

the figure, it is observed that the Gaussian derivative filtering

approach can effectively remove the baseline wander and highfrequency noise contained in the input ABP signal. The filtered

signal has maximum magnitude around systolic peak regions

in the input ABP signal. To simplify the peak detection task,

the bipolar filtered signal is first converted into unipolar signal

before applying peak detection logic.

2) Squaring and Adaptive thresholding: The filtered signal

d[n] is first squared to obtain a positive-valued signal and then

adaptive thresholding is performed on the energy (or squarer)

values e[n]. The energy is computed as

e[n] = d2 [n].

(4)

2(c). The squaring operation further reduces the magnitude

TS14SPSAA02 355

ABP segment is 10 s. The output of the adaptive thresholding

stage is shown in Fig. 2(d). By comparing Figs. 2 (c) and

(d), we can observe that the thresholding process effectively

eliminates spurious noise spikes and tend to reduce the number

of false positive detections for noisy ABP signals.

3) Shannon energy computation and Smoothing: Since

squarer may bury the peaks of low-amplitude systolic peak

under the high-amplitude ones, we thus use Shannon energy

transformation which results in small deviations between the

successive R peaks. The effectiveness of this nonlinear transformation was well studied in the previous published work [7].

To compute Shannon energy, the thresholded energy signal

eth [n] is first normalized as

eth [n] =

eth [n]

maxN

n=1 (|eth [n]|)

(6)

computed as

(7)

s[n] =

e2th [n] log e2th [n].

The output of the Shannon energy stage is shown in Fig.

2(e). The multiple peaks in the Shannon energy envelope

may increase number of false positive detections. Therefore,

the envelope smoothing process is implemented in this work.

The Shannon energy values are smoothed using a linear zerophase filtering with a rectangular impulse response, h(k) of

length L. The smoothing filter is designed to provide smoothed

peaked-waves around systolic peak portions and to smooth

out the multiple peaks. The smoothness depends on the filter

length L, which is found empirically. In this work, window

length of 100 ms is chosen that is less than refractory period

of 300 ms, during which no new ABP pulse is found [1].

The envelope smoothing process can reduce number of false

positive detections. The output of the smoothing filter is shown

in Fig. 2(f). It can seen clearly that the locations of candidate

systolic peaks in the smooth Shannon energy envelope s[n]

correspond to approximate locations of the systolic peaks in

the ABP signal shown in Fig. 2(a). Therefore, in this proposed

method, those candidate peaks are first detected and then used

43

(e)

(f)

(g)

Convolution

Output

Output

Preprocessor

10

15

10

15

0

1.5

1

0.5

0

0

0.3

10

15

10

15

10

15

10

15

10

15

0

0.1

Output ZC

Detector

(d)

0.1

Output of

Peak Finder

(c)

0

0

0.2

0.15

0.1

0.05

Approximate

Location

(b)

1

0.5

Final Output

(a)

Original

0.2

0.1

1

0.5

0

1

0.5

0

Fig. 3. Illustrates the outputs of different stages of the peak finding scheme.

(a) Original ABP signal. (b) Output of the preprocessing stage. (c) Output

of the convolution of smooth signal envelope and Gaussian derivative kernel.

(d) Detected negative zerocrossing points. (e) Output of peak finding stage.

(f) Detected approximate locations of peaks. (g) Detected peaks using peak

adjustment procedure.

ABP signal.

B. Peak Finding Logic and Peak Location Adjustment Rule

The peak-finding scheme employs the peak-finding logic

used in our previous work [8]. We study the performance

of peak-finding logic which uses Gaussian derivative kernel

to locate the peaks contained in the smooth Shannon energy

envelope. The 101-point Gaussian kernel with spread = 12.5

is shown in Fig. 1(a) and the its first order Gaussian derivative

is shown in Fig. 1(b). By referring figures, we can observe

that the Gaussian kernel is symmetric about M

2 + 1 and

its first-order Gaussian derivative is an antisymmetric. The

odd order derivatives are odd functions (antisymmetric around

zero). Fig. 1(a) clearly shows that the Gaussian kernel function

has peak at m = M

2 + 1. Fig. 1(b) shows that the slope of

Gaussian derivative is positive and negative for 1 m M

2

+

1

M,

respectively

and

also

its

slope

is

and M

2

zero at m = M

,

where

denotes

the

floor

function.

By

2

using this property of Gaussian kernel, the peaks of the signal

envelope are located by finding convolution of the smooth

signal envelope s[n] and the Gaussian derivative d[n]. The

convolution between these two signals is computed as

z[n] =

(8)

k=

the smooth signal envelope shown in Fig. 3(b). By referring

TS14SPSAA02 355

has both positive and negative zero-crossings because of the

anti-symmetric nature of the Gaussian derivative kernel [8].

Fig. 3(c) clearly demonstrate that the negative zero-crossing

points correspond to the locations of the local peaks (or local

maxima) of the smmoth Shannon energy envelope s[n] shown

in Fig. 3(b). Therefore, the negative zero-crossing points are

detected and used as guides to find locations of true systolic

peaks in the original ABP signal shown in Fig. 3(a). The

negative zero-crossing points are detected by checking the sign

of the convolution output z[n] at time t(n) and t(n + 1). The

output of the negative zero-crossing point finder is shown in

Fig. 3(d). By comparing Figs. 3(d) and (e), it can be observed

that the peak-finding technique accurately finds time-locations

of candidate peaks contained in the smooth signal envelope.

The output shown in Fig. 3(f) demonstrate that the detected

time-locations are slightly shifted from the locations of true

systolic peaks of the input ABP signal. Therefore, the final

peak location adjustment procedure is used to correct the errors

of peak position shift. Firstly, a ABP segment centered around

a detected location (p[m] w2 ) is extracted from the original

ABP signal. Secondly, a simple algorithm finds a location of

maximum peak in the extracted ABP segment. Then, it stores

the new time-locations of real systolic peaks. This correction

procedure is repeated for all the detected locations p[m]. The

window size is 30 samples. The output of the peak location

adjustment stage is shown in Fig. 3(g). The experimental

results clearly show that the time-locations of systolic peaks

are accurately detected regardless of varying amplitudes and

morphologies of APB waveforms.

III. R ESULTS AND D ISCUSSION

The standard MIT-BIH Polysomnographic database

(http://www.physionet.org/physiobank/database/slpdb/)

is

used for testing and validating the performance of the

proposed detection method. The database contains 18

ABP recordings of variable duration [1]. By following the

guidelines given by the Association for the Advancement of

Medical Instrumentation (AAMI), two benchmark parameters

are used to assess the detection performance: sensitivity

and positive predictivity [16]. Sensitivity (Se) and positive

predictivity (+P) are defined as

TP

100 %

TP + FN

TP

Positive Predictivity (+P) =

100 %

TP + FP

Sensitivity (Se) =

(9)

(10)

quantitative results: true positive (TP) when a systolic peak

is correctly detected, false negative (FN) when a systolic is

not detected, and false positive (FP) when an noise peak is

detected as systolic peak. By using these quantitative results,

we also calculate the detection error rate (DER) and overall

44

TABLE I

P ERFORMANCE OF THE PROPOSED DETECTION METHOD IN FINDING

TIME - LOCATIONS OF SYSTOLIC PEAKS IN ABP SIGNAL .

Amplitude

1

0.5

0

0

10

15

20

Output of Preprocessor

25

30

10

15

20

Output of Peak Finding Logic

25

30

10

15

20

25

Detected Peaks from PeakLocation Adjustment Stage

30

Negative

Zerocrossings

Smooth Signal

Envelope

0.2

0.15

0.1

0.05

0.1

0

0.1

Detected Peaks

1.5

ABP signal

Detected Peaks

Manual Annotations

1

0.5

0

0

10

15

Time (second)

20

25

30

Amplitude

polysomnographic database. (a) ABP segment from the record SLP/slp02. (b)

Output of the preprocessing stage. (c) Output of the peak-finding logic. (d)

Output of peak adjustment stage. Performance evaluation with respect to both

manual annotations (black asterisk) and systolic peaks detected (red circle)

by the proposed method. The test ABP signal includes baseline wander and

variable peak interval.

ABP

TP

FN

FP

DER

Se

+P Accuracy

Record (peaks) (peaks) (peaks) (%)

(%)

(%)

(%)

slp01a

3332

0

0

0

100

100

100

slp01b

3150

3

27

0.95 99.90 99.15

99.06

slp02a

4653

0

6

0.13 100.00 99.87

99.87

slp02b

3937

0

5

0.13 100.00 99.87

99.87

slp03

3339

0

8

0.24 100.00 99.76

99.76

slp04

4118

0

11

0.27 100.00 99.73

99.73

slp14

3178

0

14

0.44 100.00 99.56

99.56

slp16

4325

0

11

0.25 100.00 99.75

99.75

slp32

3467

0

17

0.49 100.00 99.51

99.51

slp37

4377

0

11

0.25 100.00 99.75

99.75

slp41

3486

67

75

4.07 98.11 97.89

96.09

slp45

3854

0

12

0.31 100.00 99.69

99.69

slp48

3598

0

8

0.22 100.00 99.78

99.78

slp59

3811

0

11

0.29 100.00 99.71

99.71

slp60

3730

0

15

0.40 100.00 99.60

99.60

slp61

3728

0

10

0.27 100.00 99.73

99.73

slp66

3477

0

14

0.40 100.00 99.60

99.60

slp67x

3495

0

9

0.26 100.00 99.74

99.74

Overall 67055

70

264

0.52 99.89 99.59

99.49

0.5

0

detection accuracy as

10

15

Output of Preprocessor

20

25

10

15

Output of Peak Finding Logic

20

25

10

15

Output of PeakLocation Adjustment Stage

20

25

Negative

Zerocrossing

the detection parameters of those algorithms are not provided

for reproducing their experimental results reported in the previously works. Therefore, we compare the detection accuracy

of the proposed method with expert manual annotations of

ABP signals provided in the standard database for algorithm

validation. First, we used the proposed method to annotate

the systolic peaks of the ABP signals. Then, the detected

systolic peaks are manually inspected for each of test ABP

signal. By comparing the manual annotations and methodbased annotations, we find a number of true positives, a

number of false negatives, and a number of false positives

for each ABP signal. The detection results of the proposed

method are summarized in Table I for all 18 recordings.

From the results shown in the table, we can observe that the

proposed detection method achieves an average sensitivity of

99.89%, a positive predictivity of 99.59% and DER of 0.52%.

From the detection results shown in Figs. 4-6, we can see

that the the proposed method has excellent performance in

detecting systolic peaks contained in the ABP signal including

baseline wanders, time-varying peak intervals and different

ABP morphologies.

Our method consists of several stages. Most stages are

computationally efficient enough to implement in a nearly real-

Detected Peaks

FP + FN

100 %. (11)

TP

TP

100 %. (12)

Accuracy (Acc) =

(TP + FP + FN)

Smooth Signal

Envelope

TS14SPSAA02 355

0.3

0.2

0.1

0

0.1

0

0.1

1.5

ABP signal

Detected Peaks

Manual Annotations

1

0.5

0

0

10

15

20

25

Time (second)

polysomnographic database. (a) ABP segment from the record SLP/slp04. (b)

Output of the preprocessing stage. (c) Output of the peak-finding logic. (d)

Output of peak adjustment stage. Performance evaluation with respect to both

manual annotations (black asterisk) and systolic peaks detected (red circle) by

the proposed method. The test ABP signal includes long pause and different

ABP morphologies.

time block processing architecture. The proposed peak detection method is implemented using MATLAB programming.

The maximum and minimum computation time for the block

with duration of 10 s are 0.8580 s and 1.061 s, respectively that

is less than test block duration. The computational efficiency

can be further improved if we implement detection method

using C/C++ programming. In future directions, we study

45

Amplitude

0.5

Smooth Signal

Envelope

Negative

Zerocrossing

R EFERENCES

10

15

Output of Preprocessor

20

25

10

15

Output of Peak Finding Logic

20

25

10

15

Output of PeakLocation Adjustment Stage

20

25

0.2

0.15

0.1

0.05

0.1

0

0.1

Detected

Peaks

1.5

ABP signal

Detected Peaks

Manual Annotations

1

0.5

0

10

15

20

25

Time (second)

polysomnographic database. (a) ABP segment from the record SLP/slp06. (b)

Output of the preprocessing stage. (c) Output of the peak-finding logic. (d)

Output of peak adjustment stage. Performance evaluation with respect to both

manual annotations (black asterisk) and systolic peaks detected (red circle)

by the proposed method.

hardware.

IV. C ONCLUSION

This paper presents an automatic detection method for

determining time-locations of systolic peaks contained in the

ABP signal. The proposed method comprises the Gaussian

derivative filtering to simultaneously emphasize high-slope

systolic peak portion and removes baseline wanders and

high-frequency noise. The non-linear peak amplification stage

magnifies the medium-amplitude systolic peaks and further

suppresses amplitude of low-frequency artifacts. The Gaussian

derivative kernel based peak finding scheme automatically

finds locations of peaks contained in the smooth signal envelope. The proposed detection method is tested and validated

using the standard MIT-BIH Polysomnographic database. The

method achieves an average sensitivity of 99.89% and positive

predictivity of 99.59% on test ABP datasets consisting of

67,125 beats. Our results show that this method is effective

in detecting the systolic peak in continuous blood pressure

signals including different ABP morphologies and various

kinds of artifices and noise. Unlike previous peak detection

methods, the proposed method is quite straightforward and

simple in the sense that it does not use search-back algorithms

with secondary thresholds. Thus, the proposed method can

be suitable for many cardiac health monitoring applications

including pulse oximetry, cardiac arrhythmia detection, and

cardiac output monitoring devices.

TS14SPSAA02 355

detect onset of arterial blood pressure pulses, Computers in Cardiology,

2003 , pp. 259-262, Sept. 2003.

[2] M. A. Navakatikyan, C. J. Barrett, G. A. Head, J. H. Ricketts, S. C.

Malpas, A real-time algorithm for the quantification of blood pressure

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