Cited by 1,206Non-Invasive Vital Sign MonitoringCardiovascular Health and Disease PreventionHeart Rate Variability and Autonomic Control

The DOI matches its Crossref record; 85 of the 88 references it cites were found in a registry or an index.

On the Analysis of Fingertip Photoplethysmogram Signals

Open access
Elgendi, Mohamed·2012·Current Cardiology Reviews

Abstract

Photoplethysmography (PPG) is used to estimate the skin blood flow using infrared light. Researchers from different domains of science have become increasingly interested in PPG because of its advantages as non-invasive, inexpensive, and convenient diagnostic tool. Traditionally, it measures the oxygen saturation, blood pressure, cardiac output, and for assessing autonomic functions. Moreover, PPG is a promising technique for early screening of various atherosclerotic pathologies and could be helpful for regular GP-assessment but a full understanding of the diagnostic value of the different features is still lacking. Recent studies emphasise the potential information embedded in the PPG waveform signal and it deserves further attention for its possible applications beyond pulse oximetry and heart-rate calculation. Therefore, this overview discusses different types of artifact added to PPG signal, characteristic features of PPG waveform, and existing indexes to evaluate for diagnoses. Keywords: Photoplethysmography, acceleration plethysmogram, second derivative plethysmogram, digital volume pulse, ageing, artery, autonomic function, blood pressure, cardiovascular, heart rate, pulse wave analysis, vascular disease

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Integrity signals

Registry

Crossref · 10.2174/157340312801215782

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Figures

Fig. (1) Signal Measurements (a) Original fingertip photoplethysmogram (b) first derivative wave of photoplethysmogram (c) second derivative wave of photoplethysmogram.
Fig. (1) Signal Measurements (a) Original fingertip photoplethysmogram (b) first derivative wave of photoplethysmogram (c) second derivative wave of photoplethysmogram.CC BY · PubMed Central
Fig. (2) Common structure for PPG diagnostic system consists of three or four stages: 1) Preprocessing stage to emphasize the desired waves. 2) Feature extraction stage to detect the desired waves. 3) Calculate an index or a measure using the extracted features for classification and diagnosis.
Fig. (2) Common structure for PPG diagnostic system consists of three or four stages: 1) Preprocessing stage to emphasize the desired waves. 2) Feature extraction stage to detect the desired waves. 3) Calculate an index or a measure using the extracted features for classification and diagnosis.CC BY · PubMed Central
Fig. (3) Power Spectrum of the PPG signal. The spectrum illustrates peaks at the fundamental frequency of 50 Hz as well as the second harmonic at 100 Hz.
Fig. (3) Power Spectrum of the PPG signal. The spectrum illustrates peaks at the fundamental frequency of 50 Hz as well as the second harmonic at 100 Hz.CC BY · PubMed Central
Fig. (4) Powerline and motion artifacts in PPG.
Fig. (4) Powerline and motion artifacts in PPG.CC BY · PubMed Central
Fig. (5) Baseline wandering in PPG.
Fig. (5) Baseline wandering in PPG.CC BY · PubMed Central
Fig. (6) Low Amplitude PPG signals. Generally, the low amplitude PPG signal is most likely related to the automatic gain controller, but it can be caused due to: bad connectivity between fingertip probe and the finger, loss of central blood pressure, or constriction of the arterioles. Detecting the heart beats in low amplitude PPG signals is considered difficult.
Fig. (6) Low Amplitude PPG signals. Generally, the low amplitude PPG signal is most likely related to the automatic gain controller, but it can be caused due to: bad connectivity between fingertip probe and the finger, loss of central blood pressure, or constriction of the arterioles. Detecting the heart beats in low amplitude PPG signals is considered difficult.CC BY · PubMed Central
Fig. (7) Premature Ventricular Contraction. It is clear that detection of heart beats in PPG signals will be challenging with the existence of PVCs.
Fig. (7) Premature Ventricular Contraction. It is clear that detection of heart beats in PPG signals will be challenging with the existence of PVCs.CC BY · PubMed Central
Fig. (8) Artifacts in PPG signals. This PPG sample contains different challenges in analyzing PPG signals: motion artifacts, muscle artifact, arrhythmia, high frequency artifact, and low amplitude.
Fig. (8) Artifacts in PPG signals. This PPG sample contains different challenges in analyzing PPG signals: motion artifacts, muscle artifact, arrhythmia, high frequency artifact, and low amplitude.CC BY · PubMed Central
Fig. (9) A typical waveform of the PPG and its characteristic parameters, whereas the amplitude of the systolic peaks is x while y is the amplitude of the diastolic peak.
Fig. (9) A typical waveform of the PPG and its characteristic parameters, whereas the amplitude of the systolic peaks is x while y is the amplitude of the diastolic peak.CC BY · PubMed Central
Fig. (10) Original fingertip photoplethysmogram. A1 and A2 are the areas under the whole PPG wave separated at the point of inflection. Thus, the inflection point area ration can be calculated as the division of A2 by A1.
Fig. (10) Original fingertip photoplethysmogram. A1 and A2 are the areas under the whole PPG wave separated at the point of inflection. Thus, the inflection point area ration can be calculated as the division of A2 by A1.CC BY · PubMed Central
Fig. (11) Two consecutive PPG waves.
Fig. (11) Two consecutive PPG waves.CC BY · PubMed Central
Fig. (12) Typical waveform of the PPG and its ΔT feature.
Fig. (12) Typical waveform of the PPG and its ΔT feature.CC BY · PubMed Central
Fig. (13) Typical PPG waveforms show the parameters changes with age [62].
Fig. (13) Typical PPG waveforms show the parameters changes with age [62].CC BY · PubMed Central
Fig. (14) Signal Measurements (a) Original fingertip photoplethysmogram (b) first derivative wave of photoplethysmogram
Fig. (14) Signal Measurements (a) Original fingertip photoplethysmogram (b) first derivative wave of photoplethysmogramCC BY · PubMed Central
Fig. (15) Signal Measurements (a) Original fingertip photoplethysmogram (b) second derivative wave of photoplethysmogram.
Fig. (15) Signal Measurements (a) Original fingertip photoplethysmogram (b) second derivative wave of photoplethysmogram.CC BY · PubMed Central
Fig. (16) APG waveforms and types of photoplethysmogram [73]. There are different types of APG waveforms. The first APG waveform A (far left) refers to good circulation, whereas the amplitude of b wave is lower than c wave. The last APG waveform G (far right) refers to distinctively bad circulation, whereas the amplitude of c wave is lower than b wave.
Fig. (16) APG waveforms and types of photoplethysmogram [73]. There are different types of APG waveforms. The first APG waveform A (far left) refers to good circulation, whereas the amplitude of b wave is lower than c wave. The last APG waveform G (far right) refers to distinctively bad circulation, whereas the amplitude of c wave is lower than b wave.CC BY · PubMed Central

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Citations

Cites

Show all 88 references

Research works printed but not linked: 3

  1. [59]Takazawa KTN Fujita M Matsuoka O Saiki T Aikawa M Tamura S Ibukiyama C Assessment of vasocative agents and vascular aging by the second derivative of photoplethysmogram waveform Hypertension 1998 32 365 70 9719069
  2. [80]Elgendi M Jonkman M De Boer F Fred A Filipe J Gamboa h Heart Rate Variability and Acceleration Plethysmogram measured at rest Biomedical Engineering Systems and Technologies: 2011 Springer 266 77
  3. [81]Tokutaka H MY Gonda E Yamamoto M Construction of a General Physical Condition Judgment System Using Acceleration Plethysmogram Pulse-Wave Analysis 2009 Berlin/Heidelberg Springer 5629 307 15

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Metadata

Authors
Elgendi, M.
Affiliations
Charles Darwin University (AU)
Corresponding author
Elgendi, Mohamed
Venue
Current Cardiology Reviews
Published
2012-06-01
Volume
8
Issue
1
Pages
14-25
ISSN
1573-403X (ISSN-L)
OpenAlex
W1981918735
Cited by
1,206
References
88
Citations by year
2026: 120 · 2025: 106 · 2024: 116 · 2023: 109 · 2022: 130 · 2021: 114 · 2020: 118 · 2019: 118 · 2018: 86 · 2017: 65 · 2016: 46 · 2015: 42 · 2014: 24 · 2013: 11 · 2012: 1
FWCI
2.17
Type
journal article
Language
en
Open access
Locations
  • Current Cardiology Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DR-NTU (Nanyang Technological University) (submittedVersion)
Funders
  • Univerzita Karlova v Praze
  • Australian Government
  • Charles Darwin University
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
photoplethysmography, digital volume pulse, aging, autonomic function, blood pressure, heart rate, pulse wave analysis, cardiovascular disease, vascular disease, atherosclerosis screening
MeSH terms
Fingers, Hemodynamics, Humans, Skin, Artifacts, Photoplethysmography, Pulse Wave Analysis

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