Quantitative comparison of photoplethysmographic waveform characteristics: Effect of measurement site
Open accessAbstract
Introduction: Photoplethysmography (PPG) has been widely used to assess cardiovascular function. However, few studies have comprehensively investigated the effect of measurement site on PPG waveform characteristics. This study aimed to provide a quantitative comparison on this. Methods: 36 healthy subjects participated in this study. For each subject, PPG signals were sequentially recorded for one minute from six different body sites (finger, wrist under (anatomically volar), wrist upper (dorsal), arm, earlobe, and forehead) under both normal and deep breathing patterns. For each body site under a certain breathing pattern, the mean amplitude was firstly derived from recorded PPG waveform which was then normalized to derive several waveform characteristics including the pulse peak time (Tp), dicrotic notch time (Tn), and the reflection index (RI). The effects of breathing pattern and measurement site on the waveform characteristics were finally investigated by the analysis of variance (ANOVA) with post-hoc multiple comparisons. Results: Under both breathing patterns, the PPG measurements from the finger achieved the highest percentage of analysable waveforms for extracting waveform characteristics. There were significant effects of breathing pattern on Tn and RI (larger Tn and smaller RI with deep breathing on average, both p<0.03). The effects of measurement site on mean amplitude, Tp, Tn, and RI were significant (all p<0.001). The key results were that, under both breathing patterns, the mean amplitude from finger PPG was significantly larger and its Tp and RI were significantly smaller than those from the other five sites (all p < 0.001, except p=0.04 for the Tp of ‘wrist under’), and Tn was only significantly larger than that from the earlobe (both p < 0.05). Conclusion: This study has quantitatively confirmed the effect of PPG measurement site on PPG waveform characteristics (including mean amplitude, Tp, Tn, and RI), providing scientific evidence for a better understanding the PPG waveform variations between different body sites.
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Hartmann et al. determined that there is no statistically significant change in PPG amplitude as a function of age.
“Another study by Hartmann et al. determined that there is no statistically significant change in PPG amplitude as a function of age; however, this work featured 36 individuals ranging in age from only 33 to 58.”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [95]
Dicrotic notch duration at the finger was not significantly different from measurements under the wrist and forehead, but was different from the earlobe, arm, and wrist.
“Dicrotic notch duration at the finger was not significantly different from measurements under the wrist and forehead, but was different from the earlobe, arm, and wrist.”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [95]
Locations on the head and finger provide the greatest PPG amplitude.
“Overall, it has been found that locations on the head and finger provide the greatest PPG amplitude [95,145].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [95]
The finger yielded a significant peak point position, meaning a shorter systolic rising edge (p < 0.001 for all sites except under the wrist, which had p = 0.04).
“The finger yielded a significant peak point position, meaning a shorter systolic rising edge (p < 0.001 for all sites except under the wrist, which had p = 0.04).”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [95]
The finger was shown to have a significantly lower (p < 0.001) reflection index.
“Finally, the finger was shown to have a significantly lower (p < 0.001) reflection index.”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [95]
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Self-citation
- Authors
- Hartmann, V., Liu, H., Chen, F., Qiu, Q., Hughes, S., & Zheng, D.
- Affiliations
- Anglia Ruskin University (GB)
- Southern University of Science and Technology (CN)
- Corresponding author
- Chen, Fei
- Zheng, Dingchang
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2019-03-05
- Volume
- 10
- Pages
- 198-198
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC6412091
- OpenAlex
- W2919598938
- Cited by
- 173
- References
- 28
- Citations by year
- 2026: 18 · 2025: 31 · 2024: 28 · 2023: 17 · 2022: 35 · 2021: 28 · 2020: 13 · 2019: 3
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Anglia Ruskin Research Online (Anglia Ruskin University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by-nc-nd)
- Funders
- Newton Fund
- National Natural Science Foundation of China
- 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, reflection index, mean amplitude, finger PPG, deep breathing, cardiovascular function
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