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Digital Photoplethysmography for Assessment of Arterial Stiffness: Repeatability and Comparison with Applanation Tonometry
Open accessAbstract
INTRODUCTION: Arterial stiffness is an independent risk factor for cardiovascular morbidity and can be assessed by applanation tonometry by measuring pulse wave velocity (PWV) and augmentation index (AIX) by pressure pulse wave analysis (PWA). As an inexpensive and operator independent alternative, photoelectric plethysmography (PPG) has been introduced with analysis of the digital volume pulse wave (DPA) and its second derivatives of wave reflections. OBJECTIVE: The objective was to investigate the repeatability of arterial stiffness parameters measured by digital pulse wave analysis (DPA) and the associations to applanation tonometry parameters. METHODS AND RESULTS: 112 pregnant and non-pregnant individuals of different ages and genders were examined with SphygmoCor arterial wall tonometry and Meridian DPA finger photoplethysmography. Coefficients of repeatability, Bland-Altman plots, intraclass correlation coefficients and correlations to heart rate (HR) and body height were calculated for DPA variables, and the DPA variables were compared to tonometry variables left ventricular ejection time (LVET), PWV and AIX. No DPA variable showed any systematic measurement error or excellent repeatability, but dicrotic index (DI), dicrotic dilatation index (DDI), cardiac ejection elasticity index (EEI), aging index (AI) and second derivatives of the crude pulse wave curve, b/a and e/a, showed good repeatability. Overall, the correlations to AIX were better than to PWV, with correlations coefficients >0.70 for EEI, AI and b/a. Considering the level of repeatability and the correlations to tonometry, the overall best DPA parameters were EEI, AI and b/a. The two pansystolic time parameters, ejection time compensated (ETc) by DPA and LVET by tonometry, showed a significant but weak correlation. CONCLUSION: For estimation of the LV function, ETc, EEI and b/a are suitable, for large artery stiffness EEI, and for small arteries DI and DDI. The only global parameter, AI, showed a high repeatability and the overall best correlations with AIX and PWV.
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“Over 30 features have been proposed for assessing the stiffness of both the large and small arteries from a single PPG”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [172]
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Method
Flagged first, then by citations
2 of the 53 references couldn’t be matched to a known paper.
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Charlton, P. H., Kyriacou, P. A., Mant, J., Marozas, V., Chowienczyk, P., & Alastruey, J. (2022) · Proceedings of the IEEE · doi:10.1109/jproc.2022.3149785 · Cited by 250
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Metadata
- Authors
- von Wowern, E., Östling, G., Nilsson, P. M., & Olofsson, P.
- Affiliations
- Lund University (SE)
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-08-20
- Volume
- 10
- Issue
- 8
- Pages
- e0135659
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4546304
- OpenAlex
- W1784071036
- Cited by
- 134
- References
- 53
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 9 · 2023: 8 · 2022: 39 · 2021: 19 · 2020: 12 · 2019: 7 · 2018: 13 · 2017: 9 · 2016: 7
- FWCI
- 7.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- Funders
- Lunds Universitet
- Region Skåne
- 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
- arterial stiffness, digital photoplethysmography, applanation tonometry, pulse wave analysis, pulse wave velocity, augmentation index, repeatability, aging index, left ventricular ejection time, pregnancy, cardiovascular risk
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aorta, Arteries, Blood Pressure, Elasticity, Female, Heart Rate, Humans, Male, Manometry, Middle Aged, Pregnancy, Pulse, Risk Factors, Photoplethysmography, Young Adult, Vascular Stiffness, Pulse Wave Analysis
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