Dual-channel photoplethysmography to monitor local changes in vascular stiffness

Monitoring arterial distensibility changes is important to understand the cardiovascular status of patient. Pulse transit time (PTT), which is an inverse equivalent of pulse wave velocity (PWV), has shown its potential in such studies. However, its methodological approach in using an electrocardiogram and a peripheral photoplethysmography (PPG) is limited due to the inclusion of pre-ejection period (PEP) in its computation. Previous studies have suggested the using the transit time difference between two peripheral measuring sites (PTT-D) instead. However, it requires two medical instruments and may not be efficient in terms of equipment utility, especially in prolonged clinical studies.

Postural changes are known to cause complex haemodynamics adaptation and thereby affecting transit time measurements. A customised dual-channel PPG system based on discrete electronic devices was constructed to evaluate against conventional peripheral-based PTT. 10 healthy adults (7 male; mean age 27.0 yr) were recruited to assess the differences observed in PTT and PTT-D during two postural change test activities.

PTT-D derived from the customised PPG system registered 43.3+/- 5.6 ms and - 31.1+/- 3.8 ms relative changes for the two regulated activities while conventional PTT recorded 43.6+/- 10.3 ms and -31.0+/-m 6.5 ms respectively. The former may have similar results but have significantly lower variance (< 0.05).

Findings herein suggest that PTT-D derived from the customised PPG system shows potential. It can be used as an alternative to conventional peripheral-based PTT and possibly as a direct assessment of arterial distensibility or PWV variations as it does not include PEP in its time-related computations.