Photoplethysmography Analysis of Artery Properties in Patients with Cardiovascular Diseases

In this study arterial parameters of healthy subjects were compared to those of patients with cardiovascular diseases. The photoplethysmography (PPG) measurements of blood volume pulsations have been performed. Using a novel algorithm for analysis of simultaneously measured ear and finger PPG signals, arterial parameters were evaluated in representative groups of healthy subjects and patients with cardiovascular diseases. Digital volume pulse (DVP), pulse cycle duration (T), augmentation index (AIx), reflection index (RI) and transit time of reflected wave (RTT) were evaluated in every heartbeat cycle. Correlations between the AIx and RI, T and RTT, AIx and standard deviation of AIx, RTT an…

Assessment of conduit artery vasomotion using photoplethysmography

Vasomotion is a spontaneous oscillation of vascular tone. The phenomenon has been observed in small arterioles and capillaries as well as in the large conduit arteries. The layer of smooth muscle cells that surrounds a blood vessel can spontaneously and periodically change its tension and thereby the arterial wall stiffness also changes. As the understanding of the phenomenon is still rather obscure, researchers would benefit from a low-cost and reliable investigation technique such as photoplethysmography (PPG). PPG is an optical blood pulsation measurement technique that can offer substantial information about the arterial stiffness. The aims of this pilot study were to evaluate the usefu…

Wearable photoplethysmography device prototype for wireless cardiovascular monitoring

The aim of the study was to develop a prototype system of the smart garment for real time telemetric monitoring of human cardiovascular activity. Two types of photoplethysmography (PPG) sensors for low noise and artefact free signal recording from various sites of the human body that were suitable for integration into smart textile were investigated. The reflectance sensors with single and multiple photodiodes based on "pulse-duration-based signal conversion" signal acquisition principle were designed and evaluated. The technical parameters of the system were measured both on bench and in vivo. Overall, both types of PPG sensors showed acceptable signal quality SNR 86.56±3.00 dB, dynamic ra…

Two-stage multi-Gaussian fitting of conduit artery photoplethysmography waveform during induced unilateral hemodynamic events.

Photoplethysmography (PPG) is an optical technique with high diagnostic potential, yet clinical applications remain underdeveloped. Standardization of signal recording and quantification of waveform are essential prerequisites for broader clinical use. The aim of this study was to utilize a two-stage multi-Gaussian fitting technique in order to examine the parameters of conduit artery PPG waveform recorded during increasing the unilateral regional vascular resistance (RVR). This study was conducted on 14 young and healthy volunteers; various external compressions (ECs) were performed by inflating a tight cuff at 0, 40, 80, and 200 mmHg, while registering femoral PPG (wavelength 880 nm), dia…

Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study.

Background Conduit arteries, especially the aorta, play a major role in ensuring efficient cardiac function and optimal microvascular flow due to their viscoelastic properties. Studies in animals and on isolated arteries show that acute systemic inflammation can cause aortic stiffening which affects hemodynamic efficiency. Carotid-femoral pulse wave velocity, a measure of aortic stiffness, may be useful as a bedside investigational method in patients with early sepsis admitted to intensive care, as circulatory changes can lead to multiple organ failure and increased mortality. This study aims to investigate arterial stiffness in early sepsis and its association with clinical outcomes. Metho…

Effect of probe contact pressure on the photoplethysmographic assessment of conduit artery stiffness

Currently, photoplethysmography (PPG) is a frequently studied optical blood pulsation detection tech- nique among biophotonic and biomedical researchers due to the fact that it shows high potential for estimating the arterial stiffness (AS). The extraction of diagnostically useful information requires standardized measurement pro- cedure with good repeatability. However, the effects of a crucially important factor—the optimal contact pressure (CP) of the probe—are often ignored. Also, CP values are not reported to evaluate those effects. It is hypothesized that AS estimated from PPG pulse wave 2nd derivative parameter b∕a is strongly inconsistent when recorded at nonoptimal probe CP. Our pi…

The assessment of gingivitis using remote photoplethysmography

Gum disease caused by bacterial infection, systemic conditions or neurogenic inflammation remains a prevalent and important concern of public health in both, developing and developed countries, potentially causing tooth loss if left untreated. Therefore, a simple, cost-effective, and contactless diagnostic tool is needed in dentistry. The present study aims to develop and investigate the feasibility of a motion artefact-free, miniature imaging photoplethysmography system which is dedicated for assessment of gingivitis in the dental office. The device comprised of a sub-miniature monochromatic camera equipped with miniature lens, 4-LED ring illuminator, cross polarizers and bandpass optical …

Remote photoplethysmography for skin perfusion monitoring using narrowband illumination

The purpose of this study was to determine potential of remote photoplethysmography for skin perfusion monitoring, using 540 nm narrowband and 530 nm broadband illuminations. The alterations of cutaneous circulation were produced by topical skin heating protocol. The setup comprises of 530 nm LED light source and two identical cameras operated simultaneously: one equipped with narrowband optical filter (CWL=540nm), and another without filter. Results demonstrate the typical heating test response curve- comprising first peak, nadir and plato phase, which were significantly different in narrowband and broadband illumination. It was concluded that selection of optimal light source parameters i…

Evaluation of nitroglycerin effect on remote photoplethysmogram waveform acquired at green and near infra-red illumination

Assessment of skin microcirculation provides diagnostically valuable information during the early stages of pathologies. The simple, cost-effective and intrusive alternative to existing circulation assessment methods is remote photoplethysmography (rPPG). The objective of the present pilot study was to reveal an effect on sublingual administration of 1 mg nitroglycerin on systemic hemodynamic parameters and rPPG waveforms, at 810 nm and 530nm illumination. The protocol comprised 3 minutes of baseline recording, 15 minutes recording of NTG effect, 2 minutes of arterial occlusion and the following 3 min reactive hyperemia. Two PPG signals were acquired from glabrous skin of the middle finger …

Photoplethysmography system for blood pulsation detection in unloaded artery conditions

Photoplethysmography (PPG) is an optical method of blood pulsation recording and has been extensively studied for decades. Recently PPG is widely used in the medical equipment for patient monitoring and in laboratories for research and physiological studies. In spite of the technological progress in the field of medical equipment, there are no generally accepted standards for clinical PPG measurements up to date. One of the most important factors affecting PPG waveform is the contact pressure between tissue and PPG probe. The aim of the current study was to develop and evaluate a system for software-assisted PPG signal acquisition from the unloaded artery. Novel PPG waveform derived Optimal…

Association between elastic and muscular artery stiffness and organ dysfunction in patients with early severe sepsis

Sepsis is characterised by massive inflammatory response, which can affect vascular function. As part of vascular dysfunction large arteries can be affected. To what extent changes in large artery function contribute to organ dysfunction in sepsis is not well studied.

Imaging photoplethysmography for evaluation of cutaneous sensory nerve fiber function

Peripheral neuropathy refers to peripheral nervous system dysfunction which affects up to 2% of the world's population. This condition is caused by damage to the small nerve fibers, hence its assessment is still challenging due to the lack of simple, non-invasive and objective diagnostic techniques. The present study aimed to develop and evaluate a simple, objective and non-invasive technique for assessment of small cutaneous sensory nerve fiber function. Our approach is based on utilization of imaging photoplethysmography and local skin heating. The effectiveness of the method was evaluated on young, healthy volunteers (n = 14) after 10 minutes of 45-degree local skin heating, while record…

Remote Photoplethysmography for Evaluation of Cutaneous Sensory Nerve Fiber Function

About 2% of the world’s population suffers from small nerve fiber dysfunction, neuropathy, which can result in severe pain. This condition is caused by damage to the small nerve fibers and its assessment is challenging, due to the lack of simple and objective diagnostic techniques. The present study aimed to develop a contactless photoplethysmography system using simple instrumentation, for objective and non-invasive assessment of small cutaneous sensory nerve fiber function. The approach is based on the use of contactless photoplethysmography for the characterization of skin flowmotions and topical heating evoked vasomotor responses. The feasibility of the technique was evaluated on volunt…

Reliability of Hemodynamic Parameters Measured by a Novel Photoplethysmography Device

Three channel photoplethysmography (PPG) signal pulse wave studies of the leg’s conduit arteries during rest conditions were performed. The obtained data of each channel showed similar values, proving arterial PPG as a reliable and repeatable method to assess arterial waveform parameters. A validation experiment was carried out by acquiring signals from three identical IR PPG sensors, which were placed on different sites over the leg’s conduit arteries during rest conditions. Coefficients of variation (CV) were calculated at a 95% confidence interval by comparing results of each subject during multiple attempts. This data processing leads us to certain criteria of improvements in our method…

Multimodal Device for Real-Time Monitoring of Skin Oxygen Saturation and Microcirculation Function

The present study introduces a recently developed compact hybrid device for real-time monitoring of skin oxygen saturation and temperature distribution. The prototype involves a snapshot hyperspectral camera, multi-wavelength illuminator, thermal camera, and built-in computer with custom-developed software. To validate this device in-vivo we performed upper arm vascular occlusion on eight healthy volunteers. Palm skin oxygen saturation maps were analyzed in real-time using k-means segmentation algorithm and two-layer optical diffuse model. The prototype system demonstrated a satisfying performance of skin hyperspectral measurements in the spectral range of 507&ndash

Multi-spectral photoplethysmography biosensor

A photoplethysmography (PPG) signal can provide very useful information about a subject's hemodynamic status in a hospital or home environment. A newly developed portable multi-spectral photoplethysmography device has been used for studies of 11 healthy subjects. The developed optical fiber biosensor comprises one multi-wavelength laser diode (405nm, 660nm and 780nm) and a single photodiode with multi-channel signal output processing and built in Li-ion accumulator; special software was created for visualization and measuring of the MS-PPG signals. ARM7TDMI-S LPC2148, NXP (founded by Philips) 32 bit processor with clock frequency of 60 MHz performs measurement and analysis of the signal.

Impact of increased mean arterial pressure on skin microcirculatory oxygenation in vasopressor-requiring septic patients: an interventional study

Abstract Background Heterogeneity of microvascular blood flow leading to tissue hypoxia is a common finding in patients with septic shock. It may be related to suboptimal systemic perfusion pressure and lead to organ failure. Mapping of skin microcirculatory oxygen saturation and relative hemoglobin concentration using hyperspectral imaging allows to identify heterogeneity of perfusion and perform targeted measurement of oxygenation. We hypothesized that increasing mean arterial pressure would result in improved oxygenation in areas of the skin with most microvascular blood pooling. Methods We included adult patients admitted to the intensive care unit within the previous 24 h with sepsis a…

Usability of photoplethysmography method in estimation of conduit artery stiffness

Three channel photoplethysmography (PPG) signal waveform studies of leg conduit arteries during a provocative occlusion test were performed. PPG waveform second derivative amplitude ratio and arterial pulse wave velocity values showed significant correlations with ultrasound (US) reference method of local and regional arterial stiffness (AS), showing the ability to use PPG for AS change quantitative assessment.

Snapshot hyperspectral system for noninvasive skin blood oxygen saturation monitoring

The present study introduces recently developed compact hyperspectral snapshot system (device and software) for skin oxygen saturation monitoring. This prototype device involves compact snapshot hyperspectral camera, multi-wavelength illuminator, optical filter and crossed polarizers. The device was validated using reference color samples and and in-vivo during finger arterial occlusion tests. The prototype system demonstrated good performance of skin hyperspectral measurements in spectral range of 500-630nm. The results confirmed reliability of developed system for in-vivo assessment of skin blood oxygen saturation.

Hyperspectral evaluation of skin blood oxygen saturation at baseline and during arterial occlusion

Skin capillary blood oxygen saturation is a clinically important diagnostic parameter, which provides valuable information for timely treatment of pathological conditions e.g. sepsis, hypoxemia or decompression illness. Hyperspectral imaging is non-invasive optical techniques with high clinical potential, however its use for skin blood oxygen saturation detection is still challenging, therefore in the present study, a method for in-vivo manipulation of skin oxygen saturation was developed, and reliability of the method evaluated by means of hyperspectral imaging in detection of oxygen saturation. In order to produce alterations of skin capillary blood parameters and oxygen saturation, the p…

Remote photoplethysmography for assessment of oral mucosa

The present study is devoted to the assessment of oral mucosa perfusion using remote photoplethysmography (rPPG) technique. The alterations of mucosal perfusion were evoked by regional infiltration anesthesia containing adrenaline. Simple rPPG setup comprising white LED light source, video camera and narrowband optical filter (CWL=540nm), are able to detect subtle microcirculation changes in gingiva. Results demonstrate substantial decrease of rPPG waveform amplitude and subsequently perfusion index in affected gingiva region, following administration of anesthetics. The present study emphasizes clinical advantages of remote photoplethysmography and perfusion index mapping as a simple and c…

Assessment of age-related skin changes using hyperspectral polarization imaging

Abstract We report a development of hyperspectral polarization imaging approach for assessment of age-related skin changes. The degree of residual polarization is used as a quantitative marker of the age-related pathological malformations. The developed approach in frame of express analysis of the degree of residual polarization in each pixel of the image are shown.

A photoplethysmography device for multipurpose blood circulatory system assessment

A novel method for photoplethysmography (PPG) signal detection has been proposed and implemented in a three channel prototype device. The current design is simple, low cost and does not require sophisticated analogue circuits. The prototype was evaluated by physiological measurements and recorded PPG signals from conduit arteries of human subject.

Multispectral Photophletysmography for Evaluation of Cutaneous Flowmotions

Human skin may reflect health conditions. Important and possibly diagnostically potent components of microcirculation are slow flow oscillations-flowmotions, however there is a lack of studies in this field. The present pilot study was devoted to evaluation of multispectral imaging photoplethysmography in determination of different components of flowmotions. Eight subjects were enrolled for the study. During resting conditions video was captured from dorsal aspect of hand at seven different wavelength and flowmotion analysis performed. Results indicate that at the resting conditions neurogenic component along with endothelial are dominant regardless of wavelength, while myogenic has the low…

Additional file 1: of Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study

Table S1. Results of Cox regression analysis of the association between pulse wave velocity and length of survival. (DOCX 15 kb)

Microcirculation and mean arterial pressure: friends or foes?—reply

The analysis of blood flow changes under local anesthetic input using non-contact technique

In this work photoplethysmography imaging (PPGI) technique was used to obtain blood flow changes in human skin under regional anesthesia (RA). PPGI was evaluated from video taken by video camera for 26 patients 2 minutes before and immediately after RA, using custom developed software. Results showed that blood flow obtained by PPGI increases immediately after RA effect and the amplitude of PPGI showed correlation with temperature changes in human skin (r=0.8±0.14, p<0.0001). We found that PPGI technique can be usable for non-contact monitoring of quality of RA.

Aortic stiffness in patients with early sepsis

Acute and chronic systemic inflammatory conditions are associated with aortic stiffening. Carotid-femoral pulse wave velocity (PWV), a marker of aortic stiffness, increases in patients with inflammatory diseases and independently correlates to levels of C-reactive protein (CRP). The effects of massive inflammatory response in early sepsis on mechanical properties of the aorta have not been investigated. The objective of the current study was to prospectively assess aortic stiffness in patients with early severe sepsis and septic shock and relate it to inflammatory and haemodynamic variables and outcome.

Maģistrālo artēriju fotopletizmogrāfija un tās pielietojumi hemodinamiskā stāvokļa raksturošanai

Elektroniskā versija nesatur pielikumus

Novel hybrid technology for early diagnostics of sepsis

Sepsis is a potentially fatal disease with mortality rate as high as 50% in patients with septic shock; mortality rate can increase by 7.6% per hour if appropriate treatment is not started. Internationally accepted guidelines for diagnosis of sepsis rely on vital sign monitoring and laboratory tests in order to recognize organ failure. This pilot study aims to explore the potential of hyperspectral and thermal imaging techniques to identify and quantify early alterations in skin oxygenation and perfusion induced by sepsis. The study comprises both physiological model experiments on healthy volunteers in a laboratory environment, as well as screening case series of patients with septic shock…

Additional file 1: of Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study

Table S1. Results of Cox regression analysis of the association between pulse wave velocity and length of survival. (DOCX 15 kb)

Imaging photoplethysmography for assessment of chronic pain patients

In present pilot study application of multi-spectral imaging photoplethysmography for assessment of chronic pain patients during topical skin heating test was proposed. Photoplethysmography signal was recorded at 420nm, 530nm and 810nm illumination from the skin and corresponding perfusion indexes and perfusion maps were calculated. The novel parameter-PPGflare index was introduced and compared in neuropathic patients and healthy volunteers. Preliminary results suggest that neuropathic patients exhibited significantly lower PPGflare index, and that local heating substantially change PPG waveform at heat exposed skin region. Present study emphasizes advantages of imaging photoplethysmography…

Polarization-sensitive hyperspectral imaging of human skin: From system design to clinical validation (Conference Presentation)

We present the development and validation of a new approach for quantitative functional imaging of human skin based on the machine learning technique for the analysis of the hyperspectral skin images. The considered skin parameters include blood volume fraction, blood oxygenation, melanin content, and the epidermal layer thickness. Additionally, the degree of residual polarization of the reflected light has been analyzed. The validity of the approach has been confirmed by the initial preclinical tests with the tissue-mimicking phantoms, functional in-vivo skin tests, and pilot clinical study of type II diabetic patients. The proposed technique has great potential to be implemented in clinic…

Asinsrites pulsāciju biosignālu optiskie mērījumi un to analīze

Darbā veikti divi savstarpēji saistīti pētījumi ar mērķi pilnveidot asinsrites optiskās diagnostikas metodes, reģistrējot un analizējot fotopletizmogrāfisko (PPG) signālu laika un formas.parametrus. Izstrādāta metodika un veikti klīniskie mērījumi statistiski nozīmīgā (128 personas) kardiovaskulāro slimību pacientu un veselu personu (20 personas) grupās, katrā sirdsdarbības ciklā nosakot pulsa cikla ilgumu, pulsa viļņa izplatīšanās un atstarotā viļņa aizkaves laikus, augmentācijas indeksu un refleksijas indeksu. Analizējot šo parametru korelācijas, parādīta iespēja pēc PPG signālu formām atšķirt slimu un veselas personu grupas. Veikti pirmie pētījumi, lai novērtētu asins tilpuma plūsmas iet…