Conduit Artery Photoplethysmography and its Applications in the Assessment of Hemodynamic Condition

Elektroniskā versija nesatur pielikumusPromocijas darbā ir izstrādāta maģistrālo artēriju fotopletizmogrāfijas (APPG) metode hemodinamisko parametru novērtējumam. Pretstatot referentām metodēm, demonstrēta iespēja iegūt arteriālo elasticitāti raksturojošus parametrus, izmantojot APPG signāla formas analīzi (atvasinājuma un signāla formas aproksimācijas parametri) un ar APPG iegūtu pulsa izplatīšanās ātrumu unilaterālā gultnē. Izstrādāta APPG reģistrācijas standartizācija, mērījuma laikā nodrošinot optimālo sensora piespiedienu. Šis paņēmiens validēts ārējās ietekmes (sensora piespiediens) un hemodinamisko stāvokļu (perifērā vaskulārā pretestība) izmaiņās femorālā APPG signālā, identificējot būtiskākos faktorus APPG pielietojumos. Veikta APPG validācija asinsrites fizioloģijas un preklīniskā pētījumā demonstrējot APPG potenciālu pētniecībā un diagnostikā. Izstrādāts pulsa formas parametrizācijas paņēmiens, saistot fizioloģiskās un aproksimācijas modeļa komponentes. Atslēgas vārdi: maģistrālā artērija, fotopletizmogrāfija, arteriālā elasticitāte, metodes standartizācija, pulsa formas kvantifikācija, vazomocija, sepseThe doctoral thesis features the development of a conduit artery photoplethysmography technique (APPG) for the evaluation of hemodynamic parameters. Contrasting referent methods, the work demonstrates the possibility to receive parameters characterizing the arterial stiffness by means of APPG waveform analysis (derivation and waveform approximation parameters) and APPG obtained pulse wave velocity in a unilateral vascular bed. In this work APPG standardization technique was developed providing optimal probe contact pressure conditions. It was validated by altering the external factors (probe contact pressure) and hemodynamic conditions (peripheral vascular resistance) on the femoral APPG waveform identifying the key factors in APPG applications. The APPG validation in blood circulation physiology and a pre-clinical trial was performed demonstrating APPG potential in the extension of applications. An arterial waveform parameterization was developed relating the physiological wave to approximation model components. Keywords: conduit artery, photoplethysmography, arterial stiffness, method standardization, waveform parametrization, vasomotion, sepsi

Remote Assessment of the Cardiovascular Function Using Camera-Based Photoplethysmography

Camera-based photoplethysmography (cbPPG) is a novel measurement technique that allows the continuous monitoring of vital signs by using common video cameras. In the last decade, the technology has attracted a lot of attention as it is easy to set up, operates remotely, and offers new diagnostic opportunities. Despite the growing interest, cbPPG is not completely established yet and is still primarily the object of research. There are a variety of reasons for this lack of development including that reliable and autonomous hardware setups are missing, that robust processing algorithms are needed, that application fields are still limited, and that it is not completely understood which physiological factors impact the captured signal. In this thesis, these issues will be addressed. A new and innovative measuring system for cbPPG was developed. In the course of three large studies conducted in clinical and non-clinical environments, the system’s great flexibility, autonomy, user-friendliness, and integrability could be successfully proven. Furthermore, it was investigated what value optical polarization filtration adds to cbPPG. The results show that a perpendicular filter setting can significantly enhance the signal quality. In addition, the performed analyses were used to draw conclusions about the origin of cbPPG signals: Blood volume changes are most likely the defining element for the signal's modulation. Besides the hardware-related topics, the software topic was addressed. A new method for the selection of regions of interest (ROIs) in cbPPG videos was developed. Choosing valid ROIs is one of the most important steps in the processing chain of cbPPG software. The new method has the advantage of being fully automated, more independent, and universally applicable. Moreover, it suppresses ballistocardiographic artifacts by utilizing a level-set-based approach. The suitability of the ROI selection method was demonstrated on a large and challenging data set. In the last part of the work, a potentially new application field for cbPPG was explored. It was investigated how cbPPG can be used to assess autonomic reactions of the nervous system at the cutaneous vasculature. The results show that changes in the vasomotor tone, i.e. vasodilation and vasoconstriction, reflect in the pulsation strength of cbPPG signals. These characteristics also shed more light on the origin problem. Similar to the polarization analyses, they support the classic blood volume theory. In conclusion, this thesis tackles relevant issues regarding the application of cbPPG. The proposed solutions pave the way for cbPPG to become an established and widely accepted technology

Novel Methods for Weak Physiological Parameters Monitoring.

M.S. Thesis. University of Hawaiʻi at Mānoa 2017

The 2023 wearable photoplethysmography roadmap

Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology

Clinical evaluation of a new optical fibre method of measuring oxygen saturation using photoplethysmograph signals reflected from internal tissues

MD (Res)Traditional methods of measuring oxygen saturation, e.g. pulse oximetry, depend on an adequate peripheral circulation and have a 20–30 second lag time before readings are obtained. This was a series of evaluations of novel optical probes, designed to measure oxygen saturation using fibreoptic technology directly from internal organs including the brain, oesophagus and organs with splanchnic circulations. A series of pilot studies were proposed and research ethics approval obtained to carry out studies in humans, under general anaesthesia, using these probes. Innovative reflectance probes were designed specifically for each of the four applications, so as to obtain potentially useful signals needed for signal processing, analysis and evaluation. Signals were successfully obtained from the brain, oesophagus and splanchnic region in almost all of the patients recruited. Good quality photoplethysmograph signals were recorded and these were translated into clinically meaningful values of oxygen saturation comparable to traditional methods of pulse oximetry. Overall, the signals were prone to movement artefacts as well as occasional interference from surgical diathermy and other sources. Nonetheless, the probes could prove to be a useful alternative to conventional external transmittance pulse oximetry methods as well as providing useful information regarding regional perfusion and oxygenation. The success of these pilot studies will form the basis of more research in the area and further development of such probes on the medical engineering front

Validity of resting heart rate derived from contact-based smartphone photoplethysmography compared with electrocardiography:a scoping review and checklist for optimal acquisition and reporting

Background: With the rise of smartphone ownership and increasing evidence to support the suitability of smartphone usage in healthcare, the light source and smartphone camera could be utilized to perform photoplethysmography (PPG) for the assessment of vital signs, such as heart rate (HR). However, until rigorous validity assessment has been conducted, PPG will have limited use in clinical settings.Objective: We aimed to conduct a scoping review assessing the validity of resting heart rate (RHR) acquisition from PPG utilizing contact-based smartphone devices. Our four specific objectives of this scoping review were to (1) conduct a systematic search of the published literature concerning contact-based smartphone device-derived PPG, (2) map study characteristics and methodologies, (3) identify if methodological and technological advancements have been made, and (4) provide recommendations for the advancement of the investigative area.Methods: ScienceDirect, PubMed and SPORTDiscus were searched for relevant studies between January 1st, 2007, and November 6th, 2022. Filters were applied to ensure only literature written in English were included. Reference lists of included studies were manually searched for additional eligible studies.Results: In total 10 articles were included. Articles varied in terms of methodology including study characteristics, index measurement characteristics, criterion measurement characteristics, and experimental procedure. Additionally, there were variations in reporting details including primary outcome measure and measure of validity. However, all studies reached the same conclusion, with agreement ranging between good to very strong and correlations ranging from r = .98 to 1.Conclusions: Smartphone applications measuring RHR derived from contact-based smartphone PPG appear to agree with gold standard electrocardiography (ECG) in healthy subjects. However, agreement was established under highly controlled conditions. Future research could investigate their validity and consider effective approaches that transfer these methods from laboratory conditions into the “real-world”, in both healthy and clinical populations

Camera-Based Remote Photoplethysmography for Estimation of Heart Rate using Single Board Computers

The objective of this project was to develop a wireless, noncontact monitoring system that measures multiple physiological parameters in human faces from a distance using a camera. Compared to traditional sensors, this monitoring system does not use wires or adhesives, providing a safer, more user-friendly application. The goal of the monitoring systems was to estimate heart rate (HR). The current practices of measuring HR involve collecting electrocardiogram (ECG) signals from adhesive electrodes placed on various parts of the body and using a pulse oximeter (PO) typically placed on the ear lobe or finger. We were able to successfully create 2 monitoring systems and compare their results to the PO. Both monitoring systems are low-cost at less than $200. Neither system has been shown to exist in literature thus making them novel implementations. After analysis, we found the estimated HR from one of the systems to be not significantly different from the PO readings. In conclusion, we were able to estimate HR from a distance using a camera-based system which can have many useful applications, potentially in the Neonatal ICU and in other home health settings

Instant Stress: Detection of Perceived Mental Stress Through Smartphone Photoplethysmography and Thermal Imaging

Background: A smartphone is a promising tool for daily cardiovascular measurement and mental stress monitoring. A smartphone camera-based PhotoPlethysmoGraphy (PPG) and a low-cost thermal camera can be used to create cheap, convenient and mobile monitoring systems. However, to ensure reliable monitoring results, a person has to remain still for several minutes while a measurement is being taken. This is very cumbersome and makes its use in real-life mobile situations quite impractical. // Objective: We propose a system which combines PPG and thermography with the aim of improving cardiovascular signal quality and capturing stress responses quickly. // Methods: Using a smartphone camera with a low cost thermal camera added on, we built a novel system which continuously and reliably measures two different types of cardiovascular events: i) blood volume pulse and ii) vasoconstriction/dilation-induced temperature changes of the nose tip. 17 healthy participants, involved in a series of stress-inducing mental workload tasks, measured their physiological responses to stressors over a short window of time (20 seconds) immediately after each task. Participants reported their level of perceived mental stress using a 10-cm Visual Analogue Scale (VAS). We used normalized K-means clustering to reduce interpersonal differences in the self-reported ratings. For the instant stress inference task, we built novel low-level feature sets representing variability of cardiovascular patterns. We then used the automatic feature learning capability of artificial Neural Networks (NN) to improve the mapping between the extracted set of features and the self-reported ratings. We compared our proposed method with existing hand-engineered features-based machine learning methods. // Results: First, we found that the measured PPG signals presented high quality cardiac cyclic information (relative power Signal Quality Index, pSQI: M=0.755, SD=0.068). We also found that the measured thermal changes of the nose tip presented high quality breathing cyclic information and filtering helped extract vasoconstriction/dilation-induced patterns with fewer respiratory effects (respiratory pSQI: from M=0.714 to M=0.157). Second, we found low correlations between the self-reported stress scores and the existing metrics of the two cardiovascular signals (i.e. heart rate variability and thermal directionality metrics) from short measurements, suggesting they were not very dependent upon one another. Third, we tested the performance of the instant perceived stress inference method. The proposed method achieved significantly higher accuracies than existing pre-crafted features based-methods. In addition, the 17-fold Leave-One-Subject-Out (LOSO) cross-validation results showed that combination of both modalities produced higher accuracy in comparison with the use of PPG or thermal imaging only (PPG+Thermal: 78.33%; PPG: 68.53%; Thermal: 58.82%). The multimodal results are comparable to the state-of-the-art automatic stress recognition methods that require long term measurements (usually, at least a period of 2 minutes is required for an accuracy of around 80% from LOSO). Lastly, we explored effects of different widely-used data labeling strategies on the sensitivity of our inference methods. Our results showed the need for separation of and normalization between individual data. // Conclusions: Results demonstrate the feasibility of using smartphone-based imaging for instant mental stress recognition. Given that this approach does not need long-term measurements requiring attention and reduced mobility, we believe it is more suitable for mobile mental healthcare solutions in the wild