Abstract
The accurate measurement of the arterial pulse wave is beneficial to clinical health assessment and is important for the effective diagnosis of many types of cardiovascular disease. A variety of sensors have been developed for the non-invasive detection of these waves, but the type of sensor has an impact on the measurement results. Therefore, it is necessary to compare and analyze the signals obtained under a range of conditions using various pulse sensors to aid in making an informed choice of the appropriate type. From the available types we have selected four: a piezoresistive strain gauge sensor (PESG) and a piezoelectric Millar tonometer (the former with the ability to measure contact force), a circular film acceleration sensor, and an optical reflection sensor. Pulse wave signals were recorded from the left radial, carotid, femoral, and digital arteries of 60 subjects using these four sensors. Their performance was evaluated by analyzing their susceptibilities to external factors (contact force, measuring site, and ambient light intensity) and by comparing their stability and reproducibility. Under medium contact force, the peak-to-peak amplitude of the signals was higher than that at high and low force levels and the variability of signal waveform was small. The optical sensor was susceptible to ambient light. Analysis of the intra-class correlation coefficients (ICCs) of the pulse wave parameters showed that the tonometer and accelerometer had good stability (ICC > 0.80), and the PESG and optical sensor had moderate stability (0.46 < ICC < 0.86). Intra-observer analysis showed that the tonometer and accelerometer had good reproducibility (ICC > 0.75) and the PESG and optical sensor had moderate reproducibility (0.42 < ICC < 0.91). Inter-observer analysis demonstrated that the accelerometer had good reproducibility (ICC > 0.85) and the three other sensors had moderate reproducibility (0.52 < ICC < 0.96). We conclude that the type of sensor and measurement site affect pulse wave characteristics and the careful selection of appropriate sensor and measurement site are required according to the research and clinical need. Moreover, the influence of external factors such as contact pressure and ambient light should be fully taken into account.
Highlights
The arterial pulse wave contains much physiological and pathological information and its accurate measurement can improve the diagnosis of cardiovascular disease (Ma et al, 2013; Papaioannou et al, 2016), a major public health problem worldwide (Yang et al, 2016)
The Effect of Contact Force on the Pulse Wave As shown in Figure 2, for each sensor type, when the contact force was increased from light to medium, the peak-to-peak amplitude of the signal increased
The above results show that firstly, the effect of contact pressure, measuring site, and ambient light on the pulse wave should be considered when carrying out measurements on patients
Summary
The arterial pulse wave contains much physiological and pathological information and its accurate measurement can improve the diagnosis of cardiovascular disease (Ma et al, 2013; Papaioannou et al, 2016), a major public health problem worldwide (Yang et al, 2016). Many types of sensors have been developed for the non-invasive detection of pulse waves (Schafer and Vagedes, 2013; Meidert et al, 2014; Stea et al, 2014; Boutry et al, 2015; Kamshilin et al, 2016). Many other types of sensors have been developed and used in a clinical setting. These include piezoresistive and piezoelectric devices as well as photoelectric sensors. Murphy et al (2011) proposed a piezoelectric sensor based on polyvinyl difluoride (PVDF) for the measurement of pulse wave velocity (PWV) in hypertensive patients. Lovinsky (2006) presented an optical pulse sensor system to monitor arterial oxygen saturation and Loukogeorgakis et al (2002) proposed a new method for measuring PWV using reflectance photoplethysmography. These include piezoresistive and piezoelectric devices as well as photoelectric sensors. Chen et al (2016) presented an ultra-flexible strain sensor for the long-term measurement of pulse waves. Murphy et al (2011) proposed a piezoelectric sensor based on polyvinyl difluoride (PVDF) for the measurement of pulse wave velocity (PWV) in hypertensive patients. Clemente et al (2010) designed a piezo-film-based measurement method to reconstruct the blood pressure waveform. Lovinsky (2006) presented an optical pulse sensor system to monitor arterial oxygen saturation and Loukogeorgakis et al (2002) proposed a new method for measuring PWV using reflectance photoplethysmography. Li et al (2018) used photoplethysmography to investigate the changes of arterial waveform characteristics in pregnant women
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