心臟是人體中非常重要的器官，負責供應全身所需的血液運送，但由於現代人飲食及生活習慣的改變，心臟疾病在三十年來之死亡率持續成長，並多年來皆位居國人十大死因第二。心臟疾病以冠狀動脈心臟病(coronary artery disease, CAD)最為常見。其檢查價格昂貴、耗時又具侵入性，若能以便宜、快速且非侵入式的檢測方式有效地評估冠狀動脈狹窄的癥狀，則有助於冠狀動脈疾病之早期偵測及治療。
本研究使用生理訊號放大器(Electrocardiography, ECG)、血壓波形感測器(Blood Pressure Waveform, BPW)、雷射都卜勒血流儀(Laser Doppler Flowmetry, LDF)來偵測人體循環之心臟端、動脈至末梢循環之血管血流特性，藉以分析冠狀動脈狹窄疾病之生理上的變異。冠狀動脈狹窄疾病之受測者為接受心導管手術檢查之患者(M0)，並將其檢查結果分做兩類，為須裝置支架之A組與不須裝置支架之B組，與正常人之C組相比。此外，將A組(M0)與裝置支架後三到五個月內量測之數據(M2)來進行探討，並針對其橈動脈與合谷穴所量測之血壓血流訊號分別做時域、頻域上的分析。
實驗結果表示A、B組相比於C組在部分參數上有顯著或接近顯著的差異，代表BPW與LDF在此一疾病與正常人之間的血管血流特性變異上具有良好的解析能力。且在M0與M2間比較也能觀察到些許參數上的差異，可成為治療冠狀動脈狹窄疾病之成效評估。
本實驗所採用之儀器皆為非侵入式、操作簡易、危險性低、具有穩定生理訊號表現，可自行量測及設備成本較低，在臨床應用上可節省人力資源及醫療成本。

Heart is a very important organ that supply all needed blood in human body. However, due to diet and lifestyle change in the modern time, heart disease mortality has risen in the past three decades, and has remained the second of the 10 leading causes of death over recent years. Coronary artery disease is the most common of all the heart disease. The inspections are expensive, time-consuming and intrusive. If assess coronary artery stenosis symptoms effectively at a cheap, quick and non-invasive detection methods, it can provide early detection and treatment of coronary artery disease.
In this study, we used Electrocardiography(ECG), Blood Pressure Waveform(BPW), and Laser Doppler Flowmetry(LDF) to detect blood flow characteristics of cardiac, arteries to vascular peripheral circulation, in order to analyze the induced physiological variation of coronary artery disease. Subjects prior to cardiac catheterization were measured as the M0, and were divided to two types of results; for the group A , they must be fitted with stent and for the group B who do not need the stent, compared to group C composed of normal subjects. In addition, data for three to five months after M0 (M2) were also measured, including blood pressure of radial artery and the blood flow of Hoku, by performing analysis in time and frequency domain.
The results indicate group A, B compared with group C have significant or nearly significant differences in some parameters. Some parameters were also noted to be different between the M0 and M2; it may become the treatment effectiveness evaluation of disease.
The system used in this experiment have advantages, such as non-invasive measurement, simple measurement, low risk, stable physiological signal performance, low cost, and may thus save human resources and health care costs in clinical applications.

1. 行政院衛生福利部-103年國人死因統計結果, http://www.mohw.gov.tw/news/531349778.
2. 曾岐元, 病理學. 匯華圖書出版有限公司, 2001: p. 252-266.
3. Kim, L.K., et al., Impact of metabolic syndrome on the progression of coronary calcium and of coronary artery disease assessed by repeated cardiac computed tomography scans. Cardiovasc Diabetol, 2016. 15(1): p. 92.
4. Villa, A.D., et al., Coronary artery anomalies overview: The normal and the abnormal. World J Radiol, 2016. 8(6): p. 537-55.
5. Lanter, B.B. and D.G. Davies, Propionibacterium acnes Recovered from Atherosclerotic Human Carotid Arteries Undergoes Biofilm Dispersion and Releases Lipolytic and Proteolytic Enzymes in Response to Norepinephrine Challenge In Vitro. Infection and Immunity, 2015. 83(10): p. 3960-3971.
6. Lazaro, V.L., 2014 PHA Clinical Practice Guidelines for the Diagnosis and Management of Patients with Coronary Heart Disease. ASEAN Heart Journal : Official Journal of the ASEAN Federation of Cardiology, 2016. 24: p. 3.
7. 遠東醫訊, http://www.fepc.com.tw/magazine/09609/09609_%E5%86%A0%E7%8B%80%E5%8B%95%E8%84%88%E9%9B%BB%E8%85%A6%E6%96%B7%E5%B1%A4%E9%80%A0%E5%BD%B1.htm?sno=84.
8. Vijayalakshmi, I., Cardiac Catheterization and Imaging (From Pediatrics to Geriatrics). JP Medical Ltd: p. 47.
9. Hasdai, D., et al., Coronary endothelial dysfunction in humans is associated with myocardial perfusion defects. Circulation, 1997. 96(10): p. 3390-5.
10. Stefanadis, C., et al., Aortic distensibility abnormalities in coronary artery disease. Am J Cardiol, 1987. 59(15): p. 1300-4.
11. Chen, C.T., et al., Using a blood pressure harmonic variability index to monitor the cerebral blood flow condition in stroke patients. Biorheology, 2011. 48(3-4): p. 219-28.
12. W.R.Milnor, Hemodynamics,2nd ed ed. Baltimore: Williams & Wilkins, 1989.
13. Hsu, T.L., et al., Organ-specific ligation-induced changes in harmonic components of the pulse spectrum and regional vasoconstrictor selectivity in Wistar rats. Exp Physiol, 2006. 91(1): p. 163-70.
14. Jones, R.J., Heart disease: A textbook of cardiovascular medicine. JAMA, 1980. 244(22): p. 2565-2565.
15. Sato, H., et al., A population-based study of arterial stiffness index in relation to cardiovascular risk factors. J Atheroscler Thromb, 2005. 12(3): p. 175-80.
16. Weber, T., et al., Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation, 2004. 109(2): p. 184-9.
17. Nichols, W.W., Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens, 2005. 18(1 Pt 2): p. 3S-10S.
18. Safar, M.E., B.I. Levy, and H. Struijker-Boudier, Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation, 2003. 107(22): p. 2864-9.
19. Nichols, W.W., et al., Effects of age on ventricular-vascular coupling. Am J Cardiol, 1985. 55(9): p. 1179-84.
20. Kotecha, D., et al., Radial artery pulse wave analysis for non-invasive assessment of coronary artery disease. Int J Cardiol, 2013. 167(3): p. 917-24.
21. Weber, T., et al., Pulse waveform characteristics predict cardiovascular events and mortality in patients undergoing coronary angiography. J Hypertens, 2010. 28(4): p. 797-805.
22. Esen, F., G.S. Aydin, and H. Esen, Detrended fluctuation analysis of laser Doppler flowmetry time series. Microvasc Res, 2009. 78(3): p. 314-8.
23. Hsiu, H., C.L. Hsu, and M.Y. Jan, Relations between beat-to-beat microcirculatory blood flow and variations therein. Photomed Laser Surg, 2010. 28(6): p. 785-92.
24. 范晉祥, 結合血壓波形諧波及血流脈波分析評估早期中風之血管血流特性. 碩士論文,國立台灣科技大學,台北, 2014.
25. Hsiu, H., et al., Complexity analysis of beat-to-beat skin-surface laser-Doppler signals in diabetic subjects. Microvasc Res, 2014. 93: p. 9-13.
26. Hsiu, H., et al., Differences in the skin-surface laser Doppler signals between polycystic ovary syndrome and normal subjects. Microcirculation, 2014. 21(2): p. 124-30.
27. Hsu, C.L., et al., Characteristics of harmonic indexes of the arterial blood pressure waveform in polycystic ovary syndrome. Blood Press Monit, 2014. 19(4): p. 226-32.
28. 林家緯, 循環功能整合評估系統應用於代謝症候群之初步研究. 碩士論文,國立台灣科技大學,台北, 2013.
29. Signal, U.t.E., http://a-fib.com/treatments-for-atrial-fibrillation/diagnostic-tests/the-ekg-signal/.
30. 神農氏, http://www.shen-nong.com/chi/exam/exam_diagnostic_palpation.html.
31. 主要動脈示意圖, http://www.zjemw.com/knowledge/ShowKnowledge.asp?DocID=Y2006M02D02H21m57s52.
32. 張念中, 什麼是冠狀動脈硬化？如何做早期診斷？. T&D飛訊第114期,國家文官學院.
33. Richman, J.S. and J.R. Moorman, Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol, 2000. 278(6): p. H2039-49.
34. Lu, W.A., et al., Pulse spectrum analysis of hospital patients with possible liver problems. Am J Chin Med, 1996. 24(3-4): p. 315-20.
35. Bernardi, L., et al., Relationship between phasic changes in human skin blood flow and autonomic tone. Microvasc Res, 1989. 37(1): p. 16-27.
36. Souza, E.G., et al., Impairment of systemic microvascular endothelial and smooth muscle function in individuals with early-onset coronary artery disease: studies with laser speckle contrast imaging. Coron Artery Dis, 2014. 25(1): p. 23-8.
37. Agarwal, S.C., et al., Laser Doppler assessment of dermal circulatory changes in people with coronary artery disease. Microvasc Res, 2012. 84(1): p. 55-9.
38. Strain, W.D., et al., Attenuated systemic microvascular function in men with coronary artery disease is associated with angina but not explained by atherosclerosis. Microcirculation, 2013. 20(7): p. 670-7.