Estimation of aortic stiffness by finger photoplethysmography using enhanced pulse wave analysis and machine learningShow others and affiliations
2024 (English)In: Frontiers in Cardiovascular Medicine, E-ISSN 2297-055X, Vol. 11, article id 1350726Article in journal (Refereed) Published
Abstract [en]
Introduction: Aortic stiffness plays a critical role in the evolution of cardiovascular diseases, but the assessment requires specialized equipment. Photoplethysmography (PPG) and single-lead electrocardiogram (ECG) are readily available in healthcare and wearable devices. We studied whether a brief PPG registration, alone or in combination with single-lead ECG, could be used to reliably estimate aortic stiffness. Methods: A proof-of-concept study with simultaneous high-resolution index finger recordings of infrared PPG, single-lead ECG, and finger blood pressure (Finapres) was performed in 33 participants [median age 44 (range 21–66) years, 19 men] and repeated within 2 weeks. Carotid–femoral pulse wave velocity (cfPWV; two-site tonometry with SphygmoCor) was used as a reference. A brachial single-cuff oscillometric device assessed aortic pulse wave velocity (aoPWV; Arteriograph) for further comparisons. We extracted 136 established PPG waveform features and engineered 13 new with improved coupling to the finger blood pressure curve. Height-normalized pulse arrival time (NPAT) was derived using ECG. Machine learning methods were used to develop prediction models. Results: The best PPG-based models predicted cfPWV and aoPWV well (root-mean-square errors of 0.70 and 0.52 m/s, respectively), with minor improvements by adding NPAT. Repeatability and agreement were on par with the reference equipment. A new PPG feature, an amplitude ratio from the early phase of the waveform, was most important in modelling, showing strong correlations with cfPWV and aoPWV (r = −0.81 and −0.75, respectively, both P < 0.001). Conclusion: Using new features and machine learning methods, a brief finger PPG registration can estimate aortic stiffness without requiring additional information on age, anthropometry, or blood pressure. Repeatability and agreement were comparable to those obtained using non-invasive reference equipment. Provided further validation, this readily available simple method could improve cardiovascular risk evaluation, treatment, and prognosis.
Place, publisher, year, edition, pages
Frontiers Media SA , 2024. Vol. 11, article id 1350726
Keywords [en]
arterial stiffness, machine learning, photoplethysmography, prediction models, pulse wave analysis, pulse wave velocity wearables, vascular ageing
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:kth:diva-344935DOI: 10.3389/fcvm.2024.1350726ISI: 001189887100001Scopus ID: 2-s2.0-85188422487OAI: oai:DiVA.org:kth-344935DiVA, id: diva2:1848561
Note
QC 20240404
2024-04-032024-04-032025-02-10Bibliographically approved