Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: A review from VascAgeNet

The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular ageing, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarises research into assessing vascular age from the PPG. Three categories of approaches are described: (i) those which use a single PPG signal (based on pulse wave analysis); (ii) those which use multiple PPG signals (such as pulse transit time measurement); and (iii) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realise the full potential of photoplethysmography for assessing vascular age.

Development of Continuous Blood Pressure Measurement System Using Photoplethysmograph and Pulse Transit Time

It is not only a problem for old age anyone. So, blood pressure is the one provides importance information with vital signs about cardiovascular health using oscillometric method. Unfortunately, this method required inflation and following deflation of the cuff. This method only gives instantaneous blood pressure and continuous measurement is not available. It is not available to the patients that required long term monitoring. To overcome this problem, the development of Continuous Non-Invasive Blood Pressure (NIBP) algorithm based on Pulse Transit Time (PTT) using two channel Photoplethysmograph (PPG) is proposed in this study. PPG is a non-invasive device for detecting blood volume changes can be affected by various physiological factors, analysis of the PPG signal can provide sufficient information on the human health condition; more specifically their cardio-vascular related performance. Literatures show that the PTT has linear relationship with blood pressure. Nevertheless, the determination of the model structure, order and real-time implementation to offer a continuous measurement of the PTT still remains challenging tasks in this area. PTT can be as index to monitor cardiovascular disease. In this project, dynamic model based on pulse transit time will be proposed to continuously monitor blood pressure by using PPG signals. Different kind of resolutions in microcontroller combined with PPG sensor will be used as well. MATLAB software is also been applied for PTT calculation based on two PPG sensors. PPG is method for detect blood volume changes with optical source transmitter send from one end and received the signal from another by receiver through body tissue as medium. MATLAB functions as Digital Signal Processing (DSP) for signals received in computer. Linear Regression technique and Fung's algorithm are applied to obtain the best fit line for all the points in order to systolic and diastolic blood pressure measurement. The results showed that the algorithm based on pulse transit time has been developed for the assessment of blood pressure and justify patient’ condition with 86.34% and 88.20% accuracy. Finally, this technique is a simple, user friendly and operator independent PPG system suitable for long term and wearable blood pressure monitor.

Determination of aortic pulse transit time based on waveform decomposition of radial pressure wave

Carotid-femoral pulse transit time (cfPTT) is a widely accepted measure of central arterial stiffness. The cfPTT is commonly calculated from two synchronized pressure waves. However, measurement of synchronized pressure waves is technically challenging. In this paper, a method of decomposing the radial pressure wave is proposed for estimating cfPTT. From the radial pressure wave alone, the pressure wave can be decomposed into forward and backward waves by fitting a double triangular flow wave. The first zero point of the second derivative of the radial pressure wave and the peak of the dicrotic segment of radial pressure wave are used as the peaks of the fitted double triangular flow wave. The correlation coefficient between the measured wave and the estimated forward and backward waves based on the decomposition of the radial pressure wave was 0.98 and 0.75, respectively. Then from the backward wave, cfPTT can be estimated. Because it has been verified that the time lag estimation based on of backward wave has strong correlation with the measured cfPTT. The corresponding regression function between the time lag estimation of backward wave and measured cfPTT is y = 0.96x + 5.50 (r = 0.77; p < 0.001). The estimated cfPTT using radial pressure wave decomposition based on the proposed double triangular flow wave is more accurate and convenient than the decomposition of the aortic pressure wave based on the triangular flow wave. The significance of this study is that arterial stiffness can be directly estimated from a noninvasively measured radial pressure wave.