METHOD AND APPARATUS FOR MEASURING FUNCTIONALITY OF A PERIODICALLY CHANGING SYSTEM

Abstract: A diagnostic, and monitoring device (4) is disclosed to determine functionality of the cardio-circulatory system, generate performance diagrams, and to measure cardio-circulatory functionality on the performance scale. The diagnostic monitoring device further identifies zones of criticalities on the performance scale used as reference to diagnose myocardial fitness, myocardial impairment, hyper, hypo-systolic dysfunctional, hypo-diastolic dysfunctional, dysfunctional pre-loads, after loads, critical illness, the trends to diagnose cardio-circulatory compliance, failure, outcome, and fitness. The method, and device have utility to design, monitor therapies for differential treatment of myocardial impairment, dysfunctions, rehabilitation, conditioning exercises, evaluate the efficacy of drugs, and to predict outcome of interventions.

Description: METHOD AND APPARATUS FOR MEASURING FUNCTIONALITY OF A PERIODICALLY CHANGING SYSTEM CROSS REFERENCE TO RELATED APPLICATION This application is a continuation-in-part of Application 08/984,956, filed December 4, 1997. 1. Field of the Invention: The present invention relates to the functionality of a system periodically changing in time and, more specifically, to a method and apparatus for establishing a performance scale for determining functionality of the system on the performance scale. 2. Description of Prior Art: For the cardiocirculatory system functionality is usually inferred by relating maximal or minimal values of the periodically changing hemodynamic parameters during one cycle to an empirically derived surrogate range of normalcy. The empiricism associated with the surrogate range of normalcy provides for ambiguous patient diagnosis . Absent is a cardiocirculatory performance scale descriptive of the functionality of the cardiocirculatory system to measure objectively and quantitatively human performance. Disclosed in U. S. Patent 5,370, 122 is a method to establish the synergy of several hemodynamic parameters from which to deduce functionality. Also, U. S. Patent 5,810,011 discloses a method to measure the synergy of several different parameters to deduce functionality for display in a single reference frame. Both disclosures fail to describe functionality with specificity on a performance scale. It is therefore an object of the present invention to provide a cardiocirculatory performance scale for hemodynamic parameters to measure human performance on said scale and to display functionality in a PD. It is a further objective of the present invention to identify basal units on the performance scale for hemodynamic parameters to allow measurements of hemodynamic parameters in basal units for display in a PD. It is still another object of the present invention to determine zones of criticalities for sustenance of life, myocardial impairment, myocardial fitness, normofunctionalities , dysfunctionalities, preload, and afterload from the human performance scale for diagnosis of cardiocirculatory compliance and failure, for progress and/or regress, and for design and monitoring therapeutic interventions . SUMMARY OF THE PRESENT INVENTION According to the present invention, there is provided a diagnostic device and method for diagnosis of the functionality of the cardiocirculatory system of an individual, measured on a performance scale, and displayed in a performance diagram, PD, said scale and PD to be used for diagnosis of myocardial impairment, myocardial fitness, dysfunctions, critical illness, preload, afterload, cardiocirculatory compliance, failure, progress and/or regress, and outcome. The device includes the combination of sensors responsive to electromechanical physiological parameters of an individual, collectively referred to as A, at an initial time t 1( denoted, A x and at a subsequent time t 2 , denoted A 2 , means to transmit A to a computer for computing the magnitudes of A at various times, the difference of the magnitudes of A at various times, the ratio of the change of A at various times in relation to the magnitude of A at an initial time, and the time trend of the computed parameters . The computer further includes sensors responsive to pre-selected magnitudes of A which are fractions or multiples determined from a standard signal A under standard conditions to serve as basal unit on a cardiocirculatory performance scale and to establish zones of criticalities . Still further, the computer includes means for comparing the measured signal A with its standard to produce a signal A* which expresses signal A in basal units for display on the cardiocirculatory performance scale for determining functionality, said functionality comprising myocardial efficiency, myocardial impairment, dysfunctions, preload, afterload, cardiocirculatory compliance, progress and/or regress, outcome, and failure, where said diagnosis is derived by reference to the zones of criticalities and the time trend of the computed parameters . The device further provides means for selecting therapeutic interventions, depending on the attainment of zones of criticalities, displays and monitors for recording progress or regress by departing or attaining the zones of criticalities, recording means, audible and visible warning means activated upon the establishment of pre-selected values to warn of criticalities, and modems for transmission to a central storage facility. BRIEF DESCRIPTION OF THE DRAWINGS The present invention will be more fully understood when the following detailed description is read in conjunction with the accompanying drawings in which: FIG. 1 illustrates the time sequence of electromechanical physiological parameters A, said parameters A to include electrocardiographic signals, ECG, arterial pressure, left ventricular pressure, atrial pressure, jugular pressure, carotid pressure, radial pressure, pulmonary artery pressure, right ventricular pressure, and ventricular volume, collectively referred to as signals A, in the instant invention during the time of one heart beat; FIG. 2 illustrates a PD used to determine functionality of the cardiocirculatory system and to diagnose myocardial impairment, myocardial fitness, dysfunctions, preload, afterload, critical illness, cardiocirculatory compliance, failure, Progress and/or regress, and outcome; FIG. 3 shows a block diagram of the apparatus to practice the instant invention; FIG. 4 illustrates the utility of the present invention to determine cardiocirculatory functionality and to diagnose myocardial impairment, fitness, dysfunction, preload, afterload, critical illness, cardiocirculatory compliance, failure, progress and/or regress, and outcome of a patient; FIG. 5 demonstrates the utility of the present invention to diagnose cardiocirculatory fitness; FIG. 6 illustrates the utility of the relation of separation of subsequent measurements to assure accurate trend determination for progress and/or regress diagnosis. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to FIG. 1, there are displayed electromechanical physiological signals A as a function of time. The magnitudes of the electromechanical signals at a specific time describe the state of the system at that time but not functionality. Sustenance of life, for example, reflects functionality. For life to be sustained a minimal difference of A at two different times is needed. To determine functionality of the cardiocirculatory system the difference of A at two different times, AA, is derived as AA = A x - A 2 (1) Expending the right side of equation (1) by the ratio of A^ -, . yields Ai AA = (Ai - A 2 ) * = EF(A) * A x (2) where EF (A) is the ejection fraction of A. EF(A) = (A x - A 2 ) / A x (3) Electromechanical physiological parameters change with body surface area, BSA, and age. Further, the instantaneous demand placed upon the cardiocirculatory system is not only met by the magnitude of AA but also by the adjustment of the time of one heart beat, RR, (R to R interval in the electrocardiogram) during which AA is expended. To standardize with respect to BSA and to convert a per- beat event into a per-unit time event equations (1) and (2) are divided by BSA and RR to yield AA* = A x * - A 2 * (4) AA* = EF(A) * A x * (5) where AA* = AA / BSA * RR, A x * = A-_ / BSA * RR, and A 2 * = A 2 / BSA * RR. To establish a cardiocirculatory performance scale a basal AA* , denoted AA* basal , is required, which has assigned a basal unit, 1 BU. AA* basal = 1 BU. In general, basal units are derived as a fraction of a constant property. For example, the original basal unit of measuring a length is one meter, which is derived as a fraction of the constant property of the earth circumference around the equator. The magnitude of AA* expended by subjects of the 20 to 30 years age group in resting condition is a constant property as the growth process is completed and age-related dysfunctions are still absent. It is, therefore, used to serve as basal unit on the cardiocirculatory performance scale. To determine the basal value, AA* basal , needed to sustain life, hemodynamic values for subjects of the age group of 20 to 30 years measured in supine position under resting conditions are inserted into equation (4) . To convert electromechanical physiological parameters AA, measured in conventional units into the same parameters measured in basal units AA is divided by BSA, RR, and AA* basal , according to AA(conventional units) AA*(BU) = (6) BSA(m 2 ) * RR(sec) * AA* basal (conventional units) Further, a basal value of EF(A), denoted EF(A) basal , is derived from equation (3) by insertion of hemodynamic parameters for subjects of the 20 to 30 years age group. Subsequent substitution of EF(A) basal into equation (5) yields A^ asa i as AA* basal / EF(A) basal or 1 / EF(A) basal . Additionally, A 2 * basal is derived from equation (4) as A 2 * basal = x bas al ~ A basal = A λ basal - 1. Referring now to FIG. 2, there is shown a performance diagram, PD, according to the teachings of the instant invention. A computer computes AA* , A x *, A 2 *, and EF (A) from the functionality equations (3), (4), and (5) and plots AA* , A x *, and A 2 * on a lower scale versus time and EF (A) on an upper scale also versus time . The upper plot shows the efficiency with which A λ * of the lower plot is converted to AA*, according to equation (5) . The lower plot illustrates the manner in which a specific AA* is derived in a transition from A * to A 2 *, according to equation (4) . Basal values EF(A), A,.*^.^, AA* basal , and A 2 * basal are added to the PD of FIG. 2 as horizontal lines. The basal values indicate normo-functionality. The horizontal lines divide EF(A), A lt * , AA*, and A 2 * into two zones: one above and one below the basal lines. A ι * > j basa! and A 2 * > A 2 * basal denote the zones above the basal values and indicate systolic hyper-dysfunctionality and diastolic hyper- dysfunctionality. Conversely, A x * < A 1 * basal and A 2 * < A 2 * basal denote the zones below the basal values and indicate systolic hypo- dysfunctionality and diastolic hypo-dysfunctionality. By definition, EF(A) describes the efficiency of the cardiocirculatory system. EF(A) < EF(A) basal denotes th zone below the basal lines and indicates inefficient operation or myocardial impairment. EF(A) > EF(A) basal denotes the zone above the basal line and indicates efficient operation or absence of myocardial impairment. AA* basal is the basal difference the cardiocirculatory system must maintain to sustain life, otherwise death will result. Basal values are derived from a group of healthy subjects of 20 to 30 years of age measured in supine position under resting conditions. One basal unit (BU) is assigned to AA* basal or AA* basal = 1 BU. A patient is critically ill with death imminent in the zone AA* < AA* basal or AA* < 1 BU. Here, AA* necessary to sustain life is not maintained. As a corollary, AA* > AA* basal is mandatory to sustain life. All values EF(A), j_* , AA* , A 2 * are expressed in BUs for use in the PD. Basal values, according to the instant invention, serve to define the zones of critical illness, myocardial impairment, hypo-dysfunctionality, hyper-dysfunctionality, and normo-functionality. Expressing these parameters in terms of BUs permits a quantitative determination of the intensity of hyper- dysfunctionality, hypo-dysfunctionality, myocardial impairment, and critical illness. Attainment of basal values indicates a compliant system. Normo-functional systems and hyper-dysfunctional system without myocardial impairment are compliant systems, denoted c. s. in the PD of FIG. 2. The zones of normo-functionality and hyper- dysfunctionality in the PD are therefore zones absent of the danger of death. Conversely, failure to attain the basal values indicates a failing system, denoted f. s. in the PD of FIG. 2. Myocardial impaired, hypo-dysfunctional and critical ill systems are failing systems . The zones of myocardial impairment and hypo- dysfunctionality in the PD as precursors to critical illness and death are danger zones . By measuring performance on the cardiocirculatory performance scale the instant invention teaches the assessment of general age related diseases and the specific dysfunctions unrelated to age. Furthermore, the instant invention diagnoses the evolution of the pathological state from normo- functionality to hyper-dysfunctionality, to hypo-dysfunctionality, to myocardial impairment, to critical illness and death. A summary of the conditions for normo-functionality, hyper-dysfunctionality, myocardial impairment, hypo-dysfunctionality, and critical illness is provided in Table 1. TABLE 1 zone of critical illness (failing system) ; AA* < AA* basal zone of hypo-dysfunctionality (failing system) : AA* > AA* basal and A- * < A λ * basal and/or A 2 * < A 2 * basal zone of myocardial impairment (failing system) ; AA* > AA* basal and EF (A) < EF (A) basal zone of hyper-dysfunctionality (compliant system) ; AA* > AA* basal and Ai* > A ! *,,.,, ! and A 2 * > A 2 * basal and EF (A) > EF (A) basal zone of normo-functionality (compliant system) ; AA* = AA* basal and Ai* = An a s ai and A 2 * = A 2 * basal and EF (A) = EF (A) basal The PD, measured at rest, permits the determination of progress and/or regress and, thus, outcome from trend measurements. Trends departing from the basal lines indicate regress and trends approaching basal lines indicate progress. The PD, not measured at rest, reflects the stress of physical activities. The concomitant changes of EF(A), A x *, AA*, and A 2 * of the compliant cardiocirculatory system of an exercising subject are a measure of physical fitness. To establish a trend for determination of progress and/or regress successive measurements must be truly different from each other. All measurements are afflicted with an unavoidable error. The true value of the measurement is never known only that it falls within the error range. For two measurements to be truly different the error ranges cannot overlap otherwise both measurements may fall into the overlap region where they would not be different from each other. The embodiment, as shown in FIG. 3 illustrates the teachings of the instant. Accordingly, sensors 2 are placed on a subject 1 to detect signals representative of electromechanical physiological signals A to include but not limited to ventricular and atrial volumes, cross-sectional ventricular and atrial areas, ventricular, arterial, central venous, jugular, radial, pulmonary artery, carotid, and atrial pressures, electrical signals, echocardiographic signals, time signals for one heart cycle, and heart rate which are transmitted on multi-line wire 3 to computer 4. Such sensors 2 may include catheters, ultra-sound equipment, pressure transducers, blood pressure cuffs, electrodes, and echocardiographic sensors as required for differential assessment of the left or right heart electromechanical physiological parameters. Additional input representative of patient information including weight, height, body surface area, pre-selected time intervals, and pre-selected basal electromechanical physiological parameters values is provided from a keyboard 5 to computer 4 on line 6. Computer 4 is programmed to process the incoming signals on line 6 to establish a basal value for AA* basal as basal unit for the cardiocirculatory functionality scale and to establish basal values EF(A) basal , A 1 * bMal and A 2 * basal for further establishing boundary zones of criticality. Computer 4 is also programmed to process the incoming signals on line 3, to determine their magnitudes and to convert them into multiples of the basal unit for use on the cardiocirculatory performance scale. Further, computer 4 generates a performance diagram, establishes zones of criticality and determines myocardial impairment, myocardial fitness, hyper- and hypo- systolic and diastolic dysfunctionality, and critical illness by reference to the zones of criticality. Additionally, computer 4 determines suitable values of EF(A), AA* , A x *, and A 2 * to establish a trend for diagnosis of compliance and failure of the cardiocirculatory system. All parameters, representative of said functionality, are transmitted by line 8 to a monitor 9 which is comprised of a display 10, audible and visual alarms 11 to warn of emergencies if preset values of the parameters are attained, and indicators 12 to display diagnosis of myocardial impairment, hyper- and hypo- dysfunctionality, critical illness, compliance, failure, progress, regress, outcome, and physical fitness from the attainment of specific magnitudes of the electromechanical physiological variables, measured on the cardiocirculatory performance scale by reference to the zones of criticalities . The signals displayed by display 10 and the audio and visual alarms 11 and the signals displayed by indicator 12 are transmitted on line 14 to a printer 13 for producing hard copies and on line 16 to a modem 15 for transmission over telephone lines to central storage. A memory 17 in the computer 4 serves as storage of all information and data. Referring now to FIG. 4, there is shown a PD generated by computer 4 of FIG. 3 from data published by Bonignore et.al. in an article entitled, Obstructive sleep apneas, in Respiratory Critical Care Medicine 1994;149:155-159, prior to, during and after termination of a sleep apnea. Here the electromechanical physiological parameter AA* is the pulmonary artery pulse pressure, PP*, A t * is the systolic pulmonary artery pressure SBP* , and A 2 * is the diastolic pulmonary artery pressure, DBP* all measured in basal units and displayed versus time at successive heart beats, according to the instant invention, said PD showing alternating hyper-dysfunctionality, H, myocardial impairment, M, systolic hypo- dysfunctionality, S, diastolic hypo-dysfunctionality, D, and critical illness, C, during the apneic period. According to the instant invention, an alarm is triggered upon the attainment of the danger zones of myocardial impairment and hypo-dysfunctionality. A different sound may be triggered upon the attainment of the zone of critical illness, thus, providing an instant warning of imminent death. Referring now to FIG. 5, there is shown a PD generated by computer 4 of FIG. 3 from data published by R. A. Wolthuis et . al . in an article entitled, The response of heal thy men to treadmill exercise, Circulation 1977;55:153-157. Here the electromechanical parameter AA* is the arterial pulse pressure, A x * is the systolic arterial blood pressure, and A 2 * is the diastolic arterial blood pressure. The PD of FIG. 5 examines subjects of the three age groups of 26 years, 47 years and 60 years performing a graduated exercise test, GXT. According to the instant invention, the PD reveals diminishing efficiency of the cardiocirculatory system with increasing age. It permits assessment of cardiocirculatory performance, design and monitoring of rehabilitation and conditioning exercise programs . Referring now to FIG. 6, there is shown the relationship of separation for two measurements from each other which is a requirement for trend determination from which to diagnose progress and/or regress. All measurements are afflicted with errors. The true value of a measurement is never known, only that it lies within the error range of the measurement. Placing two measurements 1 and m 2 and their respective error ranges ± e : and ± e m 2 on a number line reveals the two measurements to be truly different when the error ranges of both measurements do not overlap. Otherwise both measurements m x and m 2 may fall into the overlapping region where they would not be different from each other. The condition for two measurements to be different can be expressed by the relationship of separation where |m x - m 2 | is the absolute value of the difference of m x and m 2 . Computer 4 in FIG. 3 selects measurements for trend determination to diagnose cardiocirculatory compliance and failure from all measurements satisfying the relationship of separation. In other embodiments of the present invention other electromechanical physiological parameters including but not limited to the electromechanical physiological variables noted in FIG. 1 include ventricular and atrial volumes, cross-sectional ventricular and atrial areas, ventricular, arterial, central venous, jugular, radial, pulmonary artery, wedge, carotid and atrial pressures, electrical, and echocardiographic signals, volumes of inspired and expired gases, and, additionally, combinations of these parameters, including but not limited to ventricular, atrial, aortic energies, and work, together with other constant physiological parameters to serve as basal units, said parameters to be used to determine functionality from which to select therapeutic interventions and to monitor progress, and to evaluate drugs. While the present invention has been described in connection with the preferred embodiments of the various figures, it is to be understood that other similar embodiments may be used or modifications and additions may be made to the described embodiment for performing the same functions of the present invention without deviating therefrom. Therefore, the present invention should not be limited to any single embodiment, but rather construed in breadth and scope in accordance with the recitation of the appended claims.

Claims: CLAIMS I claim: 1. A cardiac diagnostic device and method for establishing cardiocirculatory functionality of an individual, said device including the combination of: means for measuring physiological parameters of such subject; means responsive to the measurement of physiological parameters for deriving cardiocirculatory functionality; means for deriving a cardiocirculatory performance scale; means for measuring cardiocirculatory functionality on the performance scale; means for establishing zones of criticality on the performance scale; means for display of cardiocirculatory functionality in a performance diagram; means to diagnose normo-functionality, hyper- dysfunctionality, myocardial fitness, myocardial impairment, hypo-dysfunctionality, and critical illness on the cardiocirculatory performance scale by reference to the zones of criticality; and means to diagnose cardiocirculatory compliance and failure from trend measurements to determine outcome. 2. The cardiac diagnostic device according to claim 1 wherein said measurements of physiological parameters include any and all electromechanical physiological parameters; 3. The cardiac diagnostic device according to claim 1 wherein said means for deriving said cardiocirculatory performance scale includes a computer for establishing basal units, for said cardiocirculatory performance scale from inputs of multiples of constant physiological parameters via a keyboard, said basal units further establishing zones of criticalities. 4. The cardiac diagnostic device according to claim 1 wherein said means for establishing cardiocirculatory functionality includes a computer for determining cardiocirculatory functionality from the functionality equations AA* = EF(A) * A x * AA* = A x * - A 2 * wherein AA*, A,,*, and A 2 * equal AA, A lf and A 2 referenced to time, body surface area and basal AA* and wherein A x is an electromechanical parameter measured at time t 1; A 2 is an electromechanical parameter measured at time t 2 , and AA is the difference of A-- , and A 2 . 5. The cardiac diagnostic device according to claim 4 wherein said computer measures cardiocirculatory functionality on the performance scale in multiples of basal units for display in a performance diagram, and further establishes a trend of said functionality. 6. The cardiac diagnostic device according to claim 5 wherein said computer diagnoses myocardial fitness, myocardial impairment, hyper-systolic, hyper-diastolic, hypo-systolic, hypo- diastolic dysfunctionality, normo-functionality, preload, afterload, critical illness, cardiocirculatory compliance, and failure by comparison of EF(A), AA* , A * , A 2 *, with the zones of criticalities and their time trend; wherein EF(A) greater than the basal value establishes the zone of myocardial fitness; wherein EF(A) less than the basal value establishes the zone of myocardial impairment; wherein A x * greater than the basal value establishes the zone of hyper-systolic dysfunctionality, excessive preloads and compliance; wherein A,_* less than the basal value establishes the zone of hypo-systolic dysfunctionality, depressed preloads and failure; wherein A 2 * greater than the basal value establishes the zone of hyper-diastolic functionality, excessive afterloads, and compliance; wherein A 2 * less than the basal value establishes the zone of hypo-diastolic dysfunctionality, depressed afterloads, and failure; wherein AA* less than the basal value establishes a zone of critical illness; wherein A z * , AA* , and A 2 * equal to their respective basal values establishes normo-functionality; wherein trends of EF(A), A x *, AA* , and A 2 * approaching basal values denotes progress; wherein trends of EF(A), A z * , AA* , and A 2 * departing from the basal values denotes failure; 7. The cardiac diagnostic device according to claim 3 wherein said computer is programmed to subject the measurements of all physiological measurements A and their derivatives to the test of separation, according to the relationship l m ι ~ 2 | > e m x + e m 2 to establish trends for progress and regress determinations. 8. The cardiac diagnostic device according to claim 6 to design and monitor patient-specific therapies for improvement of myocardial fitness and treatment of myocardial impairment, for treatment of hyper- and hypo- systolic and diastolic dysfunctionality, hypo- and hyper- preloads and afterloads, critical illness, for maintenance of cardiocirculatory compliance, and effectuating cardiocirculatory failure. 9. The cardiac diagnostic device according to claim 6 to diagnose cardiocirculatory fitness and to design and monitor patient-specific rehabilitation and subject-specific conditioning programs . 10. The cardiac diagnostic device of claim 6 wherein said computer evaluates the efficacy of drugs to effectuate patients in the zones of criticalities and cardiocirculatory failure. 11. The cardiac diagnostic device of claim 1 wherein said sensors include catheters, pressure transducers, pressure cuffs, electrodes, or echocardiographic sensors. 12. The cardiac diagnostic device according to claim 1 wherein said measurements derived by said sensors correspond to any electromechanical physiological parameter, including ventricular volumes; ventricular and atrial cross-sectional areas; ventricular, arterial, central venous, pulmonary artery, wedge, carotid, atrial, jugular, and radial pressures, inspired and expired volume of gases, electrocardiographic and echocardiographic signals, time for completion of one heart beat, heart rate, pre-selected times, and combinations thereof. 13. The cardiac diagnostic device according to claim 1 for determining outcome by reference to functionality, cardiocirculatory compliance and cardiocirculatory failure. 14. A method of diagnosing cardiac functionality of an individual, said method including the steps of: measuring electromechanical physiological parameters A of said individual at an initial time t l t denoted A x , and at a subsequent time t 2 , denoted A 2 , establishing a cardiocirculatory performance scale and further establishing basal units of said performance scale by referencing basal constant data of A to a pre-selected basal time of one heart beat and body surface area, establishing zones of criticalities on the cardiocirculatory performance scale by reference to the basal units of said scale, establishing cardiocirculatory functionality from functionality equations AA* = EF(A) * Ai AA* = A x * - A 2 * EF(A) = (A x - A 2 ) / A x wherein AA* , A x *, and A 2 * equal AA, A 1; and A 2 referenced to time body surface area, and basal AA* and wherein A λ , is an electromechanical parameter measured at time t 1; A 2 is an electromechanical parameter measured at time t 2 , and AA is the difference of A x and A 2 . establishing trends for the parameters computed by the functionality equations for display in a performance diagram; subjecting the measurements of all physiological parameters and their derivations to the test of separation according to the relationship measuring electromechanical physiological signals on the cardiocirculatory performance scale by referencing the measured signals with respect to time, body surface area and the basal units; diagnosing normo-functionality, myocardial fitness, myocardial impairment, hyper-systolic dysfunctionality, hyper- diastolic dysfunctionality, hypo-systolic dysfunctionality, hypo- diastolic dysfunctionality, preload, afterload, and critical illness by reference to the zones of criticalities, and diagnosing cardiocirculatory compliance and cardiocirculatory failure from the trend of the parameters computed from the functionality equations . 15. The method of claim 14 including the steps of design and monitoring of patient-specific rehabilitation programs for treatment of dysfunctionalities, myocardial impairment, critical illness, and effectuating cardiocirculatory compliance and cardiocirculatory failure. 16. The method of claim 14 including the steps of design and monitoring subject-specific conditioning programs. 17. The method of claim 14 including the steps of evaluating the efficacy of drugs by reference to the zones of criticalities and the trend of the parameters computed from the functionality equations . 18. The method of claim 14 including the steps of determining outcome of an intervention by reference to functionality and the time trends thereof. 19. The method of claim 14 wherein said step of measuring includes all electromechanical signals deriving signals corresponding ventricular volumes, ventricular and atrial cross- sectional areas, ventricular, arterial, central venous, pulmonary artery, carotid, atrial, jugular, and radial pressures, inspired and expired volumes of gases, electrocardiographic, and echocardiographic signals, time for completion of one heart beat, pre-selected times, and combinations thereof. 20. The method of claim 14 wherein said step of measuring includes catheters, pressure transducers, pressure cuffs, electrodes, and echocardiographic sensors.

Inventors: KUNIG SABINE VIVIAN, KUNIG, SABINE, VIVIAN
Applicants: KUNIG SABINE VIVIAN, KUNIG, SABINE, VIVIAN
Application year: 1998
Main classification: A61B5
IPC codes: A61B5