Advances in Cuffless Continuous Blood Pressure Monitoring Technology Based on PPG Signals

Objective To review the progress of research on photoplethysmography- (PPG-) based cuffless continuous blood pressure monitoring technologies and prospect the challenges that need to be addressed in the future. Methods Using Web of Science and PubMed as search engines, the literature on cuffless continuous blood pressure studies using PPG signals in the recent five years were searched. Results Based on the retrieved literature, this paper describes the available open datasets, commonly used signal preprocessing methods, and model evaluation criteria. Early researches employed multisite PPG signals to calculate pulse wave velocity or time and predicted blood pressure by a simple linear equation. Later, extensive researches were dedicated to mine the features of PPG signals related to blood pressure and regressed blood pressure by machine learning models. Most recently, many researches have emerged to experiment with complex deep learning models for blood pressure prediction with the raw PPG signal as input. Conclusion This paper summarized the methods in the retrieved literature, provided insight into the artificial intelligence algorithms employed in the literature, and concluded with a discussion of the challenges and opportunities for the development of cuffless continuous blood pressure monitoring technologies.

[1]  S. Pechprasarn,et al.  Cuff-Less Blood Pressure Prediction from ECG and PPG Signals Using Fourier Transformation and Amplitude Randomization Preprocessing for Context Aggregation Network Training , 2022, Biosensors.

[2]  T. Niiranen,et al.  Interrelations Between High Blood Pressure, Organ Damage, and Cardiovascular Disease: No More Room for Doubt. , 2022, Hypertension.

[3]  G. Guidoboni,et al.  Towards Robust Blood Pressure Estimation From Pulse Wave Velocity Measured by Photoplethysmography Sensors , 2022, IEEE Sensors Journal.

[4]  Reza Baradaran Kazemzadeh,et al.  A Novel Clustering-Based Algorithm for Continuous and Noninvasive Cuff-Less Blood Pressure Estimation , 2021, Journal of healthcare engineering.

[5]  Sujit Dey,et al.  Personalized Blood Pressure Estimation Using Photoplethysmography: A Transfer Learning Approach , 2021, IEEE Journal of Biomedical and Health Informatics.

[6]  Assim Boukhayma,et al.  Continuous PPG-Based Blood Pressure Monitoring Using Multi-Linear Regression , 2020, IEEE Journal of Biomedical and Health Informatics.

[7]  M. Kaur,et al.  Blood Pressure and Heart Rate Measurements Using Photoplethysmography with Modified LRCN , 2022, Computers, Materials & Continua.

[8]  Yeou-Jiunn Chen,et al.  Attention Mechanism-Based Convolutional Long Short-Term Memory Neural Networks to Electrocardiogram-Based Blood Pressure Estimation , 2021, Applied Sciences.

[9]  Sayan Sarkar,et al.  Introduction of Boosting Algorithms in Continuous Non-Invasive Cuff-less Blood Pressure Estimation using Pulse Arrival Time , 2021, 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[10]  Assim Boukhayma,et al.  Photoplethysmography Based Blood Pressure Monitoring Using the Senbiosys Ring , 2021, 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[11]  Panayiotis A. Kyriacou,et al.  Recurrent Neural Network Models for Blood Pressure Monitoring Using PPG Morphological Features , 2021, 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[12]  Wei He,et al.  A Continuous Blood Pressure Estimation Method Using Photoplethysmography by GRNN-Based Model , 2021, Sensors.

[13]  Frédéric Bousefsaf,et al.  iPPG 2 cPPG: Reconstructing contact from imaging photoplethysmographic signals using U-Net architectures , 2021, Comput. Biol. Medicine.

[14]  Mirco Fuchs,et al.  Assessment of Non-Invasive Blood Pressure Prediction from PPG and rPPG Signals Using Deep Learning , 2021, Sensors.

[15]  G. Cirrincione,et al.  A Comparison of Deep Learning Techniques for Arterial Blood Pressure Prediction , 2021, Cognitive Computation.

[16]  Gretchen A. Stevens,et al.  Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants , 2021, The Lancet.

[17]  Marco Levorato,et al.  A Deep Learning Approach to Predict Blood Pressure from PPG Signals , 2021, 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[18]  Hanlin Mou,et al.  CNN-LSTM Prediction Method for Blood Pressure Based on Pulse Wave , 2021, Electronics.

[19]  M. Ezzati,et al.  Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension , 2021, Nature Reviews Cardiology.

[20]  Stephanie B. Baker,et al.  A hybrid neural network for continuous and non-invasive estimation of blood pressure from raw electrocardiogram and photoplethysmogram waveforms , 2021, Comput. Methods Programs Biomed..

[21]  K. Maher,et al.  Comparison of Invasive and Oscillometric Blood Pressure Measurement in Obese and non-Obese Children. , 2021, American journal of hypertension.

[22]  Edith Grall-Maës,et al.  Blood Pressure Morphology Assessment from Photoplethysmogram and Demographic Information Using Deep Learning with Attention Mechanism , 2021, Sensors.

[23]  Sunwoong Choi,et al.  An Estimation Method of Continuous Non-Invasive Arterial Blood Pressure Waveform Using Photoplethysmography: A U-Net Architecture-Based Approach , 2021, Sensors.

[24]  Chadi El Hajj,et al.  Deep learning models for cuffless blood pressure monitoring from PPG signals using attention mechanism , 2021, Biomed. Signal Process. Control..

[25]  T. Ward,et al.  Estimation of Continuous Blood Pressure from PPG via a Federated Learning Approach , 2021, Sensors.

[26]  Meng Rong,et al.  A Blood Pressure Prediction Method Based on Imaging Photoplethysmography in combination with Machine Learning , 2021, Biomed. Signal Process. Control..

[27]  Frédéric Bousefsaf,et al.  Remote estimation of pulse wave features related to arterial stiffness and blood pressure using a camera , 2021, Biomed. Signal Process. Control..

[28]  Panayiotis A. Kyriacou,et al.  Cuffless blood pressure estimation from PPG signals and its derivatives using deep learning models , 2021, Biomed. Signal Process. Control..

[29]  Jianwei Shuai,et al.  Cuffless blood pressure estimation based on composite neural network and graphics information , 2021, Biomed. Signal Process. Control..

[30]  Xi Huang,et al.  Calibration-free Blood Pressure Assessment Using An Integrated Deep Learning Method , 2020, 2020 IEEE International Conference on Bioinformatics and Biomedicine (BIBM).

[31]  Kemal Polat,et al.  A non-invasive continuous cuffless blood pressure estimation using dynamic Recurrent Neural Networks , 2020 .

[32]  D. Demarchi,et al.  A Random Tree Based Algorithm for Blood Pressure Estimation , 2020, 2020 IEEE MTT-S International Microwave Biomedical Conference (IMBioC).

[33]  Hae-Young Lee,et al.  Validation of a wearable cuff-less wristwatch-type blood pressure monitoring device , 2020, Scientific Reports.

[34]  Yung-Hui Li,et al.  Real-Time Cuffless Continuous Blood Pressure Estimation Using Deep Learning Model , 2020, Sensors.

[35]  Fen Miao,et al.  Continuous Blood Pressure Estimation From Electrocardiogram and Photoplethysmogram During Arrhythmias , 2020, Frontiers in Physiology.

[36]  Amit Acharyya,et al.  PP-Net: A Deep Learning Framework for PPG-Based Blood Pressure and Heart Rate Estimation , 2020, IEEE Sensors Journal.

[37]  Abhishek Chakraborty,et al.  PPG-BASED AUTOMATED ESTIMATION OF BLOOD PRESSURE USING PATIENT-SPECIFIC NEURAL NETWORK MODELING , 2020 .

[38]  S. Sengupta,et al.  The use of multi-site photoplethysmography (PPG) as a screening tool for coronary arterial disease and atherosclerosis , 2020, Physiological measurement.

[39]  Panayiotis A. Kyriacou,et al.  Cuffless and Continuous Blood Pressure Estimation From PPG Signals Using Recurrent Neural Networks , 2020, 2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[40]  Jiann-Shing Shieh,et al.  Genetic Deep Convolutional Autoencoder Applied for Generative Continuous Arterial Blood Pressure via Photoplethysmography , 2020, Sensors.

[41]  V. Jeya Maria Jose,et al.  Investigation on the effect of Womersley number, ECG and PPG features for cuff less blood pressure estimation using machine learning , 2020, Biomed. Signal Process. Control..

[42]  Sung-Hyoun Cho,et al.  Blood Pressure Estimation Algorithm Based on Photoplethysmography Pulse Analyses , 2020, Applied Sciences.

[43]  Mohammad Monir Uddin,et al.  Estimating Blood Pressure from the Photoplethysmogram Signal and Demographic Features Using Machine Learning Techniques , 2020, Sensors.

[44]  Mohammad Hassan Moradi,et al.  A multistage deep neural network model for blood pressure estimation using photoplethysmogram signals , 2020, Comput. Biol. Medicine.

[45]  Ivan Martinovic,et al.  Seeing Red: PPG Biometrics Using Smartphone Cameras , 2020, 2020 IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (CVPRW).

[46]  M. M. Ahmadi,et al.  Blood Pressure Estimation Using Photoplethysmogram Signal and Its Morphological Features , 2020, IEEE Sensors Journal.

[47]  D. Eytan,et al.  Estimation and Tracking of Blood Pressure Using Routinely Acquired Photoplethysmographic Signals and Deep Neural Networks , 2020, Critical Care Explorations.

[48]  Haipeng Liu,et al.  Cuffless Blood Pressure Estimation Using Single Channel Photoplethysmography: A Two-Step Method , 2020, IEEE Access.

[49]  U. Rajendra Acharya,et al.  A computational intelligence tool for the detection of hypertension using empirical mode decomposition , 2020, Comput. Biol. Medicine.

[50]  S. Morgan,et al.  Blood pressure estimation with complexity features from electrocardiogram and photoplethysmogram signals , 2020 .

[51]  Kalamullah Ramli,et al.  Noninvasive Classification of Blood Pressure Based on Photoplethysmography Signals Using Bidirectional Long Short-Term Memory and Time-Frequency Analysis , 2020, IEEE Access.

[52]  Behnam Askarian,et al.  Cuff-Less Blood Pressure Monitoring System Using Smartphones , 2020, IEEE Access.

[53]  Luca Mainardi,et al.  Chest Wearable Apparatus for Cuffless Continuous Blood Pressure Measurements Based on PPG and PCG Signals , 2020, IEEE Access.

[54]  Jiyong Jang,et al.  End-to-End Blood Pressure Prediction via Fully Convolutional Networks , 2019, IEEE Access.

[55]  Charith Chitraranjan,et al.  A Robust Neural Network-Based Method to Estimate Arterial Blood Pressure Using Photoplethysmography. , 2019, 2019 IEEE 19th International Conference on Bioinformatics and Bioengineering (BIBE).

[56]  Mitja Lustrek,et al.  Blood Pressure Estimation from Photoplethysmogram Using a Spectro-Temporal Deep Neural Network , 2019, Sensors.

[57]  Youn Ho Kim,et al.  The Potential of Wearable Limb Ballistocardiogram in Blood Pressure Monitoring via Pulse Transit Time , 2019, Scientific reports.

[58]  Haiyan Wu,et al.  A Non-Invasive Continuous Blood Pressure Estimation Approach Based on Machine Learning , 2019, Sensors.

[59]  Guy Carrault,et al.  A New Wearable Device for Blood Pressure Estimation Using Photoplethysmogram , 2019, Sensors.

[60]  Iman Sharifi,et al.  A novel dynamical approach in continuous cuffless blood pressure estimation based on ECG and PPG signals , 2019, Artif. Intell. Medicine.

[61]  Roozbeh Jafari,et al.  Noninvasive Cuffless Blood Pressure Estimation Using Pulse Transit Time and Impedance Plethysmography , 2019, IEEE Transactions on Biomedical Engineering.

[62]  Ahmadreza Attarpour,et al.  Cuff-less continuous measurement of blood pressure using wrist and fingertip photo-plethysmograms: Evaluation and feature analysis , 2019, Biomed. Signal Process. Control..

[63]  Md. Kamrul Hasan,et al.  Cuffless blood pressure estimation from electrocardiogram and photoplethysmogram using waveform based ANN-LSTM network , 2018, Biomed. Signal Process. Control..

[64]  D. Zheng,et al.  Blood Pressure Estimation Using Photoplethysmography Only: Comparison between Different Machine Learning Approaches , 2018, Journal of healthcare engineering.

[65]  Mitja Lustrek,et al.  Blood Pressure Estimation with a Wristband Optical Sensor , 2018, UbiComp/ISWC Adjunct.

[66]  Aman Gaurav,et al.  InstaBP: Cuff-less Blood Pressure Monitoring on Smartphone using Single PPG Sensor , 2018, 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[67]  Mark Butlin,et al.  Sensitivity of Video-Based Pulse Arrival Time to Dynamic Blood Pressure Changes , 2018, 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[68]  J. Lau,et al.  Poor emotional responsiveness in clinical hypertension: Reduced accuracy in the labelling and matching of emotional faces amongst individuals with hypertension and prehypertension , 2018, Psychology & health.

[69]  K. Asayama,et al.  Diurnal blood pressure changes , 2018, Hypertension Research.

[70]  Yadan Zhang,et al.  Non-invasive continuous blood pressure measurement based on mean impact value method, BP neural network, and genetic algorithm , 2018, Technology and health care : official journal of the European Society for Engineering and Medicine.

[71]  Ying Xing,et al.  A Novel Neural Network Model for Blood Pressure Estimation Using Photoplethesmography without Electrocardiogram , 2018, Journal of healthcare engineering.

[72]  Mohamed Elgendi,et al.  Descriptor : A new , short-recorded photoplethysmogram dataset for blood pressure monitoring in China , 2018 .

[73]  Lei Zhang,et al.  Development of a new characteristic parameter – waveform index of finger blood volume pulse , 2016 .

[74]  Peter Szolovits,et al.  MIMIC-III, a freely accessible critical care database , 2016, Scientific Data.

[75]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[76]  Hoda Mohammadzade,et al.  Cuff-less high-accuracy calibration-free blood pressure estimation using pulse transit time , 2015, 2015 IEEE International Symposium on Circuits and Systems (ISCAS).

[77]  Mohd. Alauddin Mohd. Ali,et al.  The Analysis of PPG Morphology: Investigating the Effects of Aging on Arterial Compliance , 2012 .

[78]  Matthias Görges,et al.  University of Queensland Vital Signs Dataset: Development of an Accessible Repository of Anesthesia Patient Monitoring Data for Research , 2012, Anesthesia and analgesia.

[79]  M. Elgendi On the Analysis of Fingertip Photoplethysmogram Signals , 2012, Current cardiology reviews.

[80]  R. Rubinshtein,et al.  Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. , 2010, European heart journal.

[81]  Kirk H. Shelley,et al.  The relationship between the photoplethysmographic waveform and systemic vascular resistance , 2007, Journal of Clinical Monitoring and Computing.

[82]  Shinobu Tanaka,et al.  Accuracy Assessment of a Noninvasive Device for Monitoring Beat-by-Beat Blood Pressure in the Radial Artery Using the Volume-Compensation Method , 2007, IEEE Transactions on Biomedical Engineering.

[83]  John Allen Photoplethysmography and its application in clinical physiological measurement , 2007, Physiological measurement.

[84]  Gilwon Yoon,et al.  Nonconstrained Blood Pressure Measurement by Photoplethysmography , 2006 .

[85]  Leo Breiman,et al.  Random Forests , 2001, Machine Learning.

[86]  Y.T. Zhang,et al.  Continuous and noninvasive estimation of arterial blood pressure using a photoplethysmographic approach , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[87]  K. Takazawa,et al.  Assessment of vasoactive agents and vascular aging by the second derivative of photoplethysmogram waveform. , 1998, Hypertension.

[88]  W. B. Murray,et al.  The peripheral pulse wave: Information overlooked , 1996, Journal of clinical monitoring.

[89]  Petrov,et al.  Blood pressure by Korotkoff's auscultatory method: end of an era or bright future?. , 1996, Blood pressure monitoring.

[90]  S N Hunyor,et al.  Quantitative photoplethysmography: Lambert-Beer law or inverse function incorporating light scatter. , 1993, Journal of biomedical engineering.

[91]  A Sapiński,et al.  [Theoretic principles of arterial blood pressure determination using the sphygmo-oscillography method]. , 1986, Kardiologia polska.

[92]  T. Young III. An essay on the cohesion of fluids , 1805, Philosophical Transactions of the Royal Society of London.