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Girish VV, V RK, M NP, Sivaprakasam M, Joseph J. Wearable Ambulatory Accelerometer System for Estimating Arterial Stiffness: A Pilot Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083056 DOI: 10.1109/embc40787.2023.10340560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Given the gap between the crucial role of measuring arterial stiffness in cardiovascular disease prevention and the lack of a technology for frequent/continuous measurement to assess it without an operator, we have developed a wearable accelerometer-based system. It estimates local stiffness metrics (Ep, β, and AC) by employing a one-point patient-specific calibration on the features of acceleration plethysmogram (APG) signal. An in-vivo study on 12 subjects was conducted (a) to select suitable ones from the host features on which the calibration could be applied and (b) to assess the feasibility of reliably estimating the stiffness metrics post-exercise when calibrated prior. The acquired APG signals were found to be reliable (SNR > 38 dB) and repeatable (CoV < 10 %). By examining a correlation matrix, it was found that (a-b)/(a"-b") is a potential feature of consideration for calibration against the stiffness. Due to exercise intervention, the local stiffness metrics have physiologically perturbed by a significant amount (p < 0.05), as observed from the reference measurements. Estimated Ep was found to have statistically significant and strong correlation (r = 0.761, p < 0.05) with actual Ep value, whereas statistically significant and moderate correlation were found with estimated β (r = 0.682, p < 0.05) and estimated AC (r = 0.615, p < 0.05) with their respective actual measures. The system demonstrated its ability to estimate post-exercise stiffness metrics using the baseline calibration, even when subject to significant physiological changes.Clinical Relevance- This study reveals the potential of the developed wearable system to be used for continuous stiffness estimation even in the presence of hemodynamic perturbations.
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Almarshad MA, Islam MS, Al-Ahmadi S, BaHammam AS. Diagnostic Features and Potential Applications of PPG Signal in Healthcare: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10030547. [PMID: 35327025 PMCID: PMC8950880 DOI: 10.3390/healthcare10030547] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
Recent research indicates that Photoplethysmography (PPG) signals carry more information than oxygen saturation level (SpO2) and can be utilized for affordable, fast, and noninvasive healthcare applications. All these encourage the researchers to estimate its feasibility as an alternative to many expansive, time-wasting, and invasive methods. This systematic review discusses the current literature on diagnostic features of PPG signal and their applications that might present a potential venue to be adapted into many health and fitness aspects of human life. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020. To this aim, papers from 1981 to date are reviewed and categorized in terms of the healthcare application domain. Along with consolidated research areas, recent topics that are growing in popularity are also discovered. We also highlight the potential impact of using PPG signals on an individual’s quality of life and public health. The state-of-the-art studies suggest that in the years to come PPG wearables will become pervasive in many fields of medical practices, and the main domains include cardiology, respiratory, neurology, and fitness. Main operation challenges, including performance and robustness obstacles, are identified.
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Affiliation(s)
- Malak Abdullah Almarshad
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
- Computer Science Department, College of Computer and Information Sciences, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia
- Correspondence:
| | - Md Saiful Islam
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
| | - Saad Al-Ahmadi
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
| | - Ahmed S. BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia;
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Md Lazin Md Lazim MR, Aminuddin A, Chellappan K, Ugusman A, Hamid AA, Wan Ahmad WAN, Mohamad MSF. Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072591. [PMID: 32290168 PMCID: PMC7177218 DOI: 10.3390/ijerph17072591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 11/18/2022]
Abstract
Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers.
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Affiliation(s)
- Md Rizman Md Lazin Md Lazim
- Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia; (A.A.); (A.U.); (A.A.H.)
| | - Amilia Aminuddin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia; (A.A.); (A.U.); (A.A.H.)
| | - Kalaivani Chellappan
- Centre of Advance Electronic & Communication Engineering (PAKET), Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- Correspondence: ; Tel.: +603-8911-8374
| | - Azizah Ugusman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia; (A.A.); (A.U.); (A.A.H.)
| | - Adila A Hamid
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia; (A.A.); (A.U.); (A.A.H.)
| | - Wan Amir Nizam Wan Ahmad
- Biomedicine Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Mohd Shawal Faizal Mohamad
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia;
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Zhang Y, Jiang Z, Qi L, Xu L, Sun X, Chu X, Liu Y, Zhang T, Greenwald SE. Evaluation of Cardiorespiratory Function During Cardiopulmonary Exercise Testing in Untreated Hypertensive and Healthy Subjects. Front Physiol 2018; 9:1590. [PMID: 30487751 PMCID: PMC6246679 DOI: 10.3389/fphys.2018.01590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 10/23/2018] [Indexed: 01/10/2023] Open
Abstract
Objective: This study aimed to compare differences in cardiorespiratory function between untreated hypertensive subjects (UHS) and healthy subjects (HS) during cardiopulmonary exercise testing (CPET). Additionally, it also aimed to explore the potential mechanisms of different exercise responses in cardiorespiratory function before, during and after CPET. Methods: Thirty subjects (15 UHS and 15 HS) were enrolled. Photoplethysmography (PPG), respiratory signal, and ECG were simultaneously collected while subjects were performing CPET. Fiducial points (a, b, c, d, e) were extracted from the second derivative of the PPG (SDPPG), and the ratios b/a, c/a, d/a, e/a, and (b-c-d-e)/a (named Aging Index, AGI) were calculated as markers of systolic and diastolic function. Additionally, respiratory rate was calculated and analyzed. Results:Before CPET, there were no significant differences in b/a, d/a, and AGI between two groups. However, after CPET, b/a (-0.9 ± 0.19 vs. -1.06 ± 0.19, p-value = 0.03) and AGI (-0.49 ± 0.75 vs. -1.15 ± 0.59, p-value = 0.011) of the UHS group were significantly higher than those of the HS. The d/a (-0.32 ± 0.24 vs. -0.14 ± 0.17, p-value = 0.024), and c/a (-0.33 ± 0.26 vs. -0.07 ± 0.19, p-value = 0.004) were significantly lower in UHS than those in HS. In contrast, before CPET, e/a (0.22 ± 0.11 vs. 0.32 ± 0.09, p-value = 0.007) in UHS was significantly lower than that in HS, while after CPET there was no significant difference between the two groups in this variable. In addition, during CPET, AGI (p-value = 0.003), and respiratory rate (p-value = 0.000) in UHS were significantly higher in comparison with before CPET. Conclusions: Different exercise responses showed the differences of cardiorespiratory function between UHS and HS. These differences not only can highlight the CV risk of UHS, but also can predict the appearance of arterial stiffness in UHS. Additionally, during CPET, significant differences in AGI, autonomic nervous function and respiratory activity assessed by respiratory rate were found between the two groups in comparison with before CPET.
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Affiliation(s)
- Yahui Zhang
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang City, China
| | - Zhihao Jiang
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang City, China
| | - Lin Qi
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang City, China
| | - Lisheng Xu
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang City, China
| | - Xingguo Sun
- Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Beijing, China
| | - Xinmei Chu
- Beijing Haidian Hospital, Peking University Third Hospital Haidian Campus, Beijing, China
| | - Yanling Liu
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Tianjing Zhang
- Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Beijing, China
| | - Stephen E Greenwald
- Blizard Institute, Barts, The London School of Medicine, Dentistry, Queen Mary University of London, London, United Kingdom
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Abstract
Photoplethysmogram (PPG) signals collected using a pulse oximeter are increasingly being used for screening and diagnosis purposes. Because of the non-invasive, cost-effective, and easy-to-use nature of the pulse oximeter, clinicians and biomedical engineers are investigating how PPG signals can help in the management of many medical conditions, especially for global health application. The study of PPG signal analysis is relatively new compared to research in electrocardiogram signals, for instance; however, we anticipate that in the near future blood pressure, cardiac output, and other clinical parameters will be measured from wearable devices that collect PPG signals, based on the signal’s vast potential. This article attempts to organize and standardize the names of PPG waveforms to ensure consistent terminologies, thereby helping the rapid developments in this research area, decreasing the disconnect within and among different disciplines, and increasing the number of features generated from PPG waveforms.
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Clinical significance of an elevated ankle-brachial index differs depending on the amount of appendicular muscle mass: the J-SHIPP and Nagahama studies. Hypertens Res 2018; 41:354-362. [DOI: 10.1038/s41440-018-0020-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/09/2017] [Accepted: 09/27/2017] [Indexed: 12/19/2022]
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Miyashita H. The time is ripe to reevaluate the second derivative of the digital photoplethysmogram (SDPTG), originating in Japan, as an important tool for cardiovascular risk and central hemodynamic assessment. Hypertens Res 2017; 40:429-431. [DOI: 10.1038/hr.2016.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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