Preclinical, Multi-Aspect Assessment of the Reliability of a Photoplethysmography-Based Telemonitoring System to Track Cardiovascular Status

Dániel Kulin,Konrád István Lucz,Flóra Antali,Dina Wafa,Dániel Sándor Veres,Zsuzsanna Miklós,Sándor Kulin

doi:10.3390/app10227977

Dániel Kulin, Konrád István Lucz + Show 5 more

Open Access

https://doi.org/10.3390/app10227977

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Journal: Applied sciences	Publication Date: Nov 10, 2020
Citations: 5	License type: CC BY 4.0

Affiliation: Semmelweis University

Abstract

Telemonitoring systems equipped with photoplethysmography-based contour analysis of the digital arterial volume pulse (DVP) can be optimal tools for remote monitoring of cardiovascular patients; however, the method is known to be sensitive to errors. We aimed to show that DVP analysis is a reliable method to track cardiovascular status. We used our proprietary SCN4ALL telemedicine system and analyzed nine parameters derived from the DVP and its second derivative (SDDVP). First, we assessed the repeatability of system measurements by detecting artificial signals. Then test–retest reliability of human measurements was evaluated in healthy individuals under standardized conditions. The SCN4ALL system analyzed each parameter with high accuracy (coefficients of variation (CVs) < 1%). Test–retest reliability of most parameters (stiffness index, reflection index, left ventricular ejection time index, b/a, heart rate) was satisfactory (CVs < 10%) in healthy individuals. However, aging index and d/a ratio derived from the SDDVP were more variable. Photoplethysmography-based pulse contour analysis is a reliable method to monitor cardiovascular status if measurements are performed with a system of high accuracy. Our results highlighted that SDDVP parameters can be interpreted with limitations due to (patho)physiological variations of the DVP. We recommend the evaluation of these parameters only in measurements where all inflections of SDDVP are detected reliably.

Highlights

Despite the enormous effort invested in research and development of new treatments to break the dominance of cardiovascular diseases in morbidity and mortality statistics, they are still among the leading causes of death [1,2]
Before addressing our main goal, i.e., that of assessing the reliability of human digital arterial volume pulse (DVP) measurements in general, we determined the repeatability of measurements made by our telemedicine system
The results showed that the measurement was stable: the confidence intervals (CIs) were very close to the mean of the five measurements, and the coefficient of variation was below 1% for each calculated variable

Summary

Introduction

Despite the enormous effort invested in research and development of new treatments to break the dominance of cardiovascular diseases in morbidity and mortality statistics, they are still among the leading causes of death [1,2]. A potential breakthrough could be achieved by launching extensive home surveillance programs that allow close follow-up of cardiovascular patients. Development of a cardiovascular telemonitoring system requires the incorporation of a cardiovascular measurement that is noninvasive, easy-to-use for the patient, convenient, timesaving, Appl. Sci. 2020, 10, 7977 and not least provides clinically relevant information about the current cardiovascular status of the patient. The detection and analysis of digital arterial volume pulse (DVP) recorded by the photoplethysmographic (PPG) method is a perfect option as it fits all these requirements. The DVP tracks the changes of vessel diameter and blood volume in the arteries which occur due to arterial pulsation [3,4], and its shape is identical to the digital arterial pulse wave

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