Abstract
To investigate the value of decomposed short-time digital volume pulse (DVP) signals in discerning systemic vascular anomaly in diabetic patients, demographic and anthropometric parameters, serum lipid profile, fasting blood glucose and glycated hemoglobin (HbA1c) levels were obtained from 29 healthy adults (Group 1) and 29 age-matched type 2 diabetes mellitus patients (Group 2). Six-second DVP signals from right index finger acquired through photoplethysmography were decomposed using ensemble empirical mode decomposition. Using one intrinsic mode function (IMF5), stiffness index (SI) and instantaneous energy of maximal energy (fEmax) were obtained. Other indicators of arterial stiffness, including electrocardiogram-pulse wave velocity of foot (ECG-PWVfoot), crest time (CT) and crest time ratio (CTR), were obtained from the testing subjects for comparison. The mean body weight, body mass index, waist circumference, HbA1c and fasting blood sugar levels were higher in Group 2 than those in Group 1, whereas values of systolic and diastolic blood pressure were lower in Group 2 than those in Group 1. SI and fEmax were significantly higher in Group 2 than those in Group 1. Moreover, fEmax was positively associated with HbA1c concentration, CT and SI in Group 2 (p < 0.05) but not in Group 1. When all subjects were considered, fEmax was highly significantly associated with HbA1c and fasting blood sugar levels, and SI (all p < 0.001). After Hilbert-Huang transformation, short-time DVP signals could give significant information on arterial stiffness and vascular anomaly in diabetic patients.
Highlights
Is cardiovascular disease a major killer in the developed world, but it is a non-communicable disease that poses an ever-increasing health threat in the developing countries[1]
Ensemble empirical mode decomposition (EEMD), which is the first component of Hilbert-Huang transformation (HHT), separates acquired physiological signals into a set of distinct physiological information known as intrinsic mode functions (IMFs)[12]
Is the present study the first to apply EEMD in acquiring only six-second detrended digital volume pulse (DVP) signals for assessing arterial stiffness, but it unveiled the clinical significance of Hilbert-Huang spectrum-derived instantaneous energy of maximal energy in differentiating non-diabetic middle-aged and elderly subjects from those with diabetes by showing highly significant positive associations of frequency of maximal energy (fEmax) with key diabetes parameters and stiffness index
Summary
Is cardiovascular disease a major killer in the developed world, but it is a non-communicable disease that poses an ever-increasing health threat in the developing countries[1]. Parameters including pulse wave velocity (PWV)[4], cardio-ankle vascular index (CAVI)[5], and ankle-brachial blood pressure index (ABI)[6] have been validated as non-invasive assessment tools for vascular health. Despite their non-invasiveness, unfavorable factors including the cost of the equipment, the need for technical assistance during measurement, the relatively long time for data acquisition as well as their hospital-based settings hinder their popularity as screening tools. Since conventional Fourier analysis only displays data as sine and cosine functions, it cannot help in the computation of stiffness index (SI) that requires discernible systolic and diastolic digital volume pulse (DVP) waveforms which are often difficult to obtain in subjects with systemic diseases such as diabetes[11]. Established indices of arterial stiffness including SI, electrocardiogram-pulse wave velocity of foot (ECG-PWVfoot)[14], crest time (CT) and crest time ratio (CTR)[11] were acquired from the testing subjects for comparison
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