Potential value of electrocardiogram and photoplethysmogram for non-invasive blood pressure estimation during exercise

Blood pressure (BP) monitoring is required to ensure safety of home-based exercise in seniors. Pulse transit time (PTT) defined as the time it takes a pulse wave to travel between two arterial sites is considered to be inversely proportional to BP. Different approaches have been described to calculate PTT using photoplethysmogram (PPG) and electrocardiogram (ECG) however it is not clear which approach produces better BP estimates. The purpose of this study was to compare potential value of different approaches for calculating PTT and other derivatives of PPG and ECG described in the literature for assessing BP during exercise. Three calibration points were collected from five study participants at different levels of exertion on three different days. A high precision automated BP monitor was used to obtain reference BP. A correlation matrix between PPG/ECG derivatives and the reference BP values was analyzed. Based on the bivariate correlation analysis, PPG/ECG derivatives that demonstrated the most prominent association with reference BP were identified. The results of the study confirmed the value of individualized calibration for BP estimation using PTT and identified optimal means to derive it from PPG and ECG.

[1]  M A Schalekamp,et al.  Comparison of Finapres non-invasive beat-to-beat finger blood pressure with intrabrachial artery pressure during and after bicycle ergometry. , 1989, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[2]  Joseph Finkelstein,et al.  Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[3]  In Cheol Jeong,et al.  Introducing a practical approach for non-invasive blood pressure monitoring during home-based telerehabilitation exercise program , 2013, 2013 IEEE Point-of-Care Healthcare Technologies (PHT).

[4]  Michael Böhm,et al.  Relationship between pulse transit time and blood pressure is impaired in patients with chronic heart failure , 2010, Clinical Research in Cardiology.

[5]  D Shapiro,et al.  Pulse transit time and blood pressure: an intensive analysis. , 1983, Psychophysiology.

[6]  Mohamed Elgendi.  Standard Terminologies for Photoplethysmogram Signals , 2012, Current cardiology reviews.

[7]  Biju Cherian,et al.  Review: Endurance exercise and resistance training in cardiovascular disease , 2008, Therapeutic advances in cardiovascular disease.

[8]  John Anthony,et al.  Accuracy Assessment of the Dinamap ProCare 400 in Pregnancy and Preeclampsia , 2010, Hypertension in pregnancy.

[9]  Jeffrey Wood,et al.  Impact of physical telerehabilitation on functional outcomes in seniors with mobility limitations , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[10]  J. Naschitz,et al.  Pulse Transit Time by R-Wave-Gated Infrared Photoplethysmography: Review of the Literature and Personal Experience , 2004, Journal of Clinical Monitoring and Computing.

[11]  J. Moon,et al.  Validation study of the Dinamap ProCare 200 upper arm blood pressure monitor in children and adolescents , 2011, Korean journal of pediatrics.

[12]  Westgate Road,et al.  Photoplethysmography and its application in clinical physiological measurement , 2007 .

[13]  H. Asada,et al.  Utility of the Photoplethysmogram in Circulatory Monitoring , 2008, Anesthesiology.

[14]  Carmen C. Y. Poon,et al.  An Evaluation of the Cuffless Blood Pressure Estimation Based on Pulse Transit Time Technique: a Half Year Study on Normotensive Subjects , 2009, Cardiovascular engineering.

[15]  Satomi Suzuki,et al.  Cuffless and non-invasive Systolic Blood Pressure estimation for aged class by using a Photoplethysmograph , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.