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J. Clin. Med. 2018, 7(10), 316; https://doi.org/10.3390/jcm7100316

Can Photoplethysmography Replace Arterial Blood Pressure in the Assessment of Blood Pressure?

1
School of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
2
Center for Research and Advanced Studies (Cinvestav), Monterrey’s Unit, Apodaca N. L. 66600, México
3
Nuffield Department of Surgical Sciences, University of Oxford, Oxford 450456, UK
4
School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5005, Australia
5
Centre for Biomedical Engineering, The University of Adelaide, Adelaide, SA 5005, Australia
6
Faculty of Medicine, University of British Columbia, Vancouver, BC V1Y 1T3, Canada
7
BC Children’s & Women’s Hospital, Vancouver, BC V6H 3N1, Canada
*
Author to whom correspondence should be addressed.
Received: 28 August 2018 / Revised: 19 September 2018 / Accepted: 28 September 2018 / Published: 30 September 2018
(This article belongs to the Section Vascular Medicine)
Full-Text   |   PDF [1178 KB, uploaded 30 September 2018]   |  

Abstract

Arterial Blood Pressure (ABP) and photoplethysmography (PPG) are both useful techniques to monitor cardiovascular status. Though ABP monitoring is more widely employed, this procedure of signal acquisition whether done invasively or non-invasively may cause inconvenience and discomfort to the patients. PPG, however, is simple, noninvasive, and can be used for continuous measurement. This paper focuses on analyzing the similarities in time and frequency domains between ABP and PPG signals for normotensive, prehypertensive and hypertensive subjects and the feasibility of the classification of subjects considering the results of the analysis performed. From a database with 120 records of ABP and PPG, each 120 s in length, the records where separated into epochs taking into account 10 heartbeats, and the following statistical measures were performed: Correlation (r), Coherence (COH), Partial Coherence (pCOH), Partial Directed Coherence (PDC), Directed Transfer Function (DTF), Full Frequency Directed Transfer Function (ffDTF) and Direct Directed Transfer Function (dDTF). The correlation coefficient was r > 0.9 on average for all groups, indicating a strong morphology similarity. For COH and pCOH, coherence (linear correlation in frequency domain) was found with significance (p < 0.01) in differentiating between normotensive and hypertensive subjects using PPG signals. For the dataset at hand, only two synchrony measures are able to convincingly distinguish hypertensive subjects from normotensive control subjects, i.e., ffDTF and dDTF. From PDC, DTF, ffDTF, and dDTF, a consistent, a strong significant causality from ABP→PPG was found. When all synchrony measures were combined, an 87.5 % accuracy was achieved to detect hypertension using a Neural Network classifier, suggesting that PPG holds most informative features that exist in ABP. View Full-Text
Keywords: pulse morphology; pulse oximeter; blood pressure monitoring; pulse arrival time; global health; digital medicine; wearable devices pulse morphology; pulse oximeter; blood pressure monitoring; pulse arrival time; global health; digital medicine; wearable devices
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Martínez, G.; Howard, N.; Abbott, D.; Lim, K.; Ward, R.; Elgendi, M. Can Photoplethysmography Replace Arterial Blood Pressure in the Assessment of Blood Pressure? J. Clin. Med. 2018, 7, 316.

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