Assessment of vasoactive agents and vascular aging by the second derivative of photoplethysmogram waveform
Abstract
To evaluate the clinical application of the second derivative of the fingertip photoplethysmogram waveform, we performed drug administration studies (study 1) and epidemiological studies (study 2). In study 1, ascending aortic pressure was recorded simultaneously with the fingertip photoplethysmogram and its second derivative in 39 patients with a mean+/-SD age of 54+/-11 years. The augmentation index was defined as the ratio of the height of the late systolic peak to that of the early systolic peak in the pulse. The second derivative consists of an a, b, c, and d wave in systole and an e wave in diastole. Ascending aortic pressure increased after injection of 2.5 microg angiotensin from 126/74 to 160/91 mm Hg and decreased after 0.3 mg sublingual nitroglycerin to 111/73 mm Hg. The d/a, the ratio of the height of the d wave to that of the a wave, decreased after angiotensin from -0.40+/-0.13 to -0.62+/-0.19 and increased after nitroglycerin to -0.25+/-0.12 (P<0.001 and P<0.001, respectively). The negative d/a increased with increases in plethysmographic and ascending aortic augmentation indices (r=0.79, P<0.001, and r=0.80, P<0.001, respectively). The negative d/a reflects the late systolic pressure augmentation in the ascending aorta and may be useful for noninvasive evaluation of the effects of vasoactive agents. In study 2, the second derivative of the plethysmogram waveform was measured in a total of 600 subjects (50 men and 50 women in each decade from the 3rd to the 8th) in our health assessment center. The b/a ratio increased with age, and c/a, d/a, and e/a ratios decreased with age. Thus, the second derivative aging index was defined as b-c-d-e/a. The second derivative wave aging index (y) increased with age (x) (r=0.80, P<0.001, y=0.023x-1.515). The second derivative aging index was higher in 126 subjects with any history of diabetes mellitus, hypertension, hypercholesterolemia, and ischemic heart disease than in age-matched subjects without such a history (-0.06+/-0.36 versus -0.22+/-0.41, P<0.01). Women had a higher aging index than men (P<0.01). The b-c-d-e/a ratio may be useful for evaluation of vascular aging and for screening of arteriosclerotic disease.
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The ratio b/a has been found to correlate positively to age, while c/a, d/a and e/a have all been correlated negatively to age.
“The ratio b/a has been found to correlate positively to age, while c/a, d/a and e/a have all been correlated negatively to age [29,59].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [29]
e/a decreases as age increases.
“| e/a | Decrease | Takazawa et al., 1998 Elgendi et al., 2012 | [29,59] |”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [29]
d/a decreases as age increases.
“| d/a | Decrease | Takazawa et al., 1998 Elgendi et al., 2012 | [29,59] |”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [29]
c/a decreases as age increases.
“| c/a | Decrease | Takazawa et al., 1998 Elgendi et al., 2012 | [29,59] |”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [29]
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- Authors
- Takazawa, K., Tanaka, N., Fujita, M., Matsuoka, O., Saiki, T., Aikawa, M., Tamura, S., & Ibukiyama, C.
- Affiliations
- Tokyo Medical University (JP)
- Venue
- Hypertension
- Published
- 1998-08
- Volume
- 32
- Issue
- 2
- Pages
- 365-370
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2016300113
- Cited by
- 589
- References
- 16
- Citations by year
- 2026: 39 · 2025: 44 · 2024: 32 · 2023: 34 · 2022: 46 · 2021: 37 · 2020: 20 · 2019: 34 · 2018: 31 · 2017: 27 · 2016: 29 · 2015: 24 · 2014: 20 · 2013: 22 · 2012: 19
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- photoplethysmogram, vascular aging, vasoactive drugs, angiotensin II, nitroglycerin, augmentation index, aortic pressure, pulse wave analysis, aging index, noninvasive hemodynamic assessment, drug efficacy evaluation, B/A ratio
- MeSH terms
- Aged, Aging, Angiotensin II, Aorta, Blood Pressure, Female, Nitroglycerin, Humans, Male, Middle Aged, Vasoconstriction, Vasoconstrictor Agents, Vasodilator Agents, Photoplethysmography
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