Pulse-wave velocity assessments derived from a simple photoplethysmography device: Agreement with a referent device

Gabriel Zieff; Keeron Stone; Craig Paterson; Simon Fryer; Jake Diana; Jade Blackwell; Michelle L Meyer; Lee Stoner

doi:10.3389/fcvm.2023.1108219

Pulse-wave velocity assessments derived from a simple photoplethysmography device: Agreement with a referent device

Front Cardiovasc Med. 2023 Feb 7:10:1108219. doi: 10.3389/fcvm.2023.1108219. eCollection 2023.

Authors

Gabriel Zieff¹, Keeron Stone², Craig Paterson^{1

2}, Simon Fryer², Jake Diana¹, Jade Blackwell^{1

3}, Michelle L Meyer⁴, Lee Stoner¹

Affiliations

¹ Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
² School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom.
³ Department of Physiology, The University of Arizona, Tucson, AZ, United States.
⁴ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Abstract

Objective: Pulse-wave velocity (PWV), a common measure of arterial stiffness, can be measured continuously and across multiple body sites using photoplethysmography (PPG). The objective was to determine whether a simple photoplethysmography PPG PWV method agrees with a referent device.

Approach: Photoplethysmography heart-finger PWV (hfPWV) and heart-toe PWV (htPWV) were compared to oscillometric carotid-wrist PWV (cwPWV) and carotid-ankle PWV (caPWV) referent measurements, respectively. In 30 adults (24.6 ± 4.8 years, body mass index 25.2 ± 5.9 kg/m², 18 female), three measurements were made: two supine baseline measurements (Base 1, Base 2) and one measurement (Tilt) 5 min after a modified head-up tilt test (mHUTT). Overall agreement and repeated measures agreement (change in PPG PWV from Base to Tilt vs. change in referent PWV from Base to Tilt) were calculated using linear mixed models. Agreement estimates were expressed as intra-class correlation coefficients (ICC).

Main results: For hfPWV there was strong overall agreement (ICC: 0.77, 95%CI: 0.67-0.85), but negligible and non-significant repeated measures agreement (ICC: 0.10, 95%CI: -0.18 to 0.36). For htPWV, there was moderate overall agreement (ICC:0.50, 95%CI: 0.31-0.65) and strong repeated measures agreement (ICC: 0.81, 95%CI: 0.69-0.89).

Significance: Photoplethysmography can continuously measure PWV at multiple arterial segments with moderate-strong overall agreement. While further work with upper-limb PPG PWV is needed, PPG can adequately capture acute changes in lower-limb PWV.

Keywords: arterial stiffness; oscillometry; photoplethysmography; repeatability; tilt-testing; validity.