Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients

AbstractHeart rate variability (HRV) utilizes the electrocardiogram (ECG) and has been widely studied as a non-invasive indicator of cardiac autonomic activity. Pulse rate variability (PRV) utilizes photoplethysmography (PPG) and recently has been used as a surrogate for HRV. Several studies have found that PRV is not entirely valid as an estimation of HRV and that several physiological factors, including the pulse transit time (PTT) and blood pressure (BP) changes, may affect PRV differently than HRV. This study aimed to assess the relationship between PRV and HRV under different BP states: hypotension, normotension, and hypertension. Using the MIMIC III database, 5 min segments of PPG and ECG signals were used to extract PRV and HRV, respectively. Several time-domain, frequency-domain, and nonlinear indices were obtained from these signals. Bland–Altman analysis, correlation analysis, and Friedman rank sum tests were used to compare HRV and PRV in each state, and PRV and HRV indices were compared among BP states using Kruskal–Wallis tests. The findings indicated that there were differences between PRV and HRV, especially in short-term and nonlinear indices, and although PRV and HRV were altered in a similar manner when there was a change in BP, PRV seemed to be more sensitive to these changes.

Download Full-text

Relationship between Ischemic Stroke and Pulse Rate Variability as a Surrogate of Heart Rate Variability

Brain Sciences ◽

10.3390/brainsci9070162 ◽

2019 ◽

Vol 9 (7) ◽

pp. 162 ◽

Cited By ~ 3

Author(s):

Ajay K. Verma ◽

Parshuram N. Aarotale ◽

Parastoo Dehkordi ◽

Jau-Shin Lou ◽

Kouhyar Tavakolian

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Ischemic Stroke ◽

Arterial Stiffness ◽

Pulse Rate ◽

Stroke Survivors ◽

Pulse Rate Variability ◽

Autonomic Cardiovascular Control ◽

Autonomic Reflex

Autonomic reflex ascertains cardiovascular homeostasis during standing. Impaired autonomic reflex could lead to dizziness and falls while standing; this is prevalent in stroke survivors. Pulse rate variability (PRV) has been utilized in the literature in lieu of heart rate variability (HRV) for ambulatory and portable monitoring of autonomic reflex predominantly in young, healthy individuals. Here, we compared the PRV with gold standard HRV for monitoring autonomic reflex in ischemic stroke survivors. Continuous blood pressure and electrocardiography were acquired from ischemic stroke survivors (64 ± 1 years) and age-matched controls (65 ± 2 years) during a 10-minute sit-to-stand test. Beat-by-beat heart period (represented by RR and peak-to-peak (PP) intervals), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse arrival time (PAT), an indicator of arterial stiffness, were derived. Time and frequency domain HRV (from RR intervals) and PRV (from PP intervals) metrics were extracted. PAT was lower (248 ± 7 ms vs. 270 ± 8 ms, p < 0.05) suggesting higher arterial stiffness in stroke survivors compared to controls during standing. Further, compared to controls, the agreement between HRV and PRV was impaired in stroke survivors while standing. The study outcomes suggest that caution should be exercised when considering PRV as a surrogate of HRV for monitoring autonomic cardiovascular control while standing in stroke survivors.

Download Full-text

Comment on ‘pulse rate variability in cardiovascular health: a review on its applications and relationship with heart rate variability’

Physiological Measurement ◽

10.1088/1361-6579/ac1dec ◽

2021 ◽

Vol 42 (9) ◽

pp. 098001

Author(s):

Jacquelin Peck ◽

Michael J Wishon ◽

Harrison Wittels ◽

Hector Davila ◽

S Howard Wittels ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Pulse Rate ◽

Cardiovascular Health ◽

Pulse Rate Variability

Download Full-text

Non-Invasive Cuffless Blood Pressure Monitoring System

Computational Tools and Techniques for Biomedical Signal Processing - Advances in Bioinformatics and Biomedical Engineering ◽

10.4018/978-1-5225-0660-7.ch008 ◽

2017 ◽

pp. 174-194

Author(s):

Harinderjit Singh ◽

Dilip Kumar

Keyword(s):

Blood Pressure ◽

Blood Pressure Monitoring ◽

Pulse Transit Time ◽

The Body ◽

Peak Time ◽

Non Invasive ◽

Inflatable Cuff ◽

Measuring Devices ◽

Cuffless Blood Pressure ◽

Electrocardiogram Ecg

These days most of the Blood Pressure (BP) measuring devices are having inflatable cuff that is needed to be occluded on the patient's arm for measuring blood pressure. This technique is not suitable in cases where continuous measurement of BP is required. Therefore, this work is aimed at designing of non-invasive and continuously monitors the blood pressure by using Pulse Transit Time (PTT) technique. For taking out PTT both of the signals are extracted from the body of the patient with the help of bio sensors i.e. Electrocardiogram (ECG) sensor and Photoplethysmogram (PPG) sensor. PTT was measured by taking the peak to peak time difference of ECG signal and PPG signal and this PTT is indirectly correlated with blood pressure, based on which Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) is calculated.

Download Full-text