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On the Analysis of Fingertip Photoplethysmogram Signals
Open accessAbstract
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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![Fig. (13) Typical PPG waveforms show the parameters changes with age [62].](/paper-figures/8ee5a57901c347579a7a5160e4be1526/on-the-analysis-of-fingertip-photoplethysmogram-signals-figure-13.jpg)


![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.](/paper-figures/54ec3ef6e18e4116ad4a30b26f4dd445/on-the-analysis-of-fingertip-photoplethysmogram-signals-figure-16.jpg)
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In the citing paper
“| 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 [59]
In the citing paper
“The shape of a clean PPG signal is closely related to the blood pulse wave of the human body25”
From Data quality evaluation in wearable monitoring (2022) · cites this paper as [25]
In the citing paper
“In this case, the pulsatile component of the PPG can be of the order of 1 mV in amplitude [55] although lower amplitudes can be caused by technical factors, such as inappropriate gain control, or physiological factors, such as vasoconstriction [9].”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [9]
In the citing paper
“In particular, obesity can lead to changes in skin thickness, blood flow, and oxygen saturation. This affects the optical properties of skin in addition to the distance light has to travel to reach a target vessel or vessels [48,59,60].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [59]
In the citing paper
“While, to the authors’ knowledge, publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited, we will explore works which suggest that there would be a substantial effect [56,59,60,61,62,63,64,65,66,67,68,69,70].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [59]
In the citing paper
“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 [59]
In the citing paper
“| 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 [59]
In the citing paper
“| 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 [59]
In the citing paper
“Furthermore, PPG can be used to index heart rate variability (HRV), blood pressure, oxygen saturation, and cardiac output24, but as of yet have not be widely rolled out in consumer-use devices and therefore data collection other than HR will not be discussed further.”
From Guidelines for wrist-worn consumer wearable assessment of heart rate in biobehavioral research (2020) · cites this paper as [24]
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Metadata
- Authors
- Elgendi, M.
- Affiliations
- Charles Darwin University (AU)
- Corresponding author
- Elgendi, Mohamed
- ORCID
- Elgendi, Mohamed
- Venue
- Current Cardiology Reviews
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2012-06-01
- Volume
- 8
- Issue
- 1
- Pages
- 14-25
- ISSN
- 1573-403X (ISSN-L)
- PMC
- PMC3394104
- 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
- bronze
- doi.org
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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