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Statistical Analysis of the Consistency of HRV Analysis Using BCG or Pulse Wave Signals
Huiying Cui1, Zhongyi Wang1, Bin Yu2
1College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, China.
Insights
Ballistocardiography (BCG) shows good agreement with electrocardiography (ECG) for heart rate variability (HRV) analysis in measures like Mean and SDNN. However, other HRV indices demonstrate poorer agreement, suggesting limitations for BCG in certain applications.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Signal Processing
Background:
- Ballistocardiography (BCG) offers non-contact, unobtrusive physiological signal acquisition.
- Its validity as an alternative to traditional Heart Rate Variability (HRV) analysis using electrocardiography (ECG) requires further establishment.
- Previous studies have yielded inconsistent findings regarding BCG's accuracy in HRV assessment.
Purpose of the Study:
- To comprehensively evaluate the validity of BCG signals for HRV analysis by comparing them against gold-standard ECG R-R intervals.
- To assess the agreement of various HRV indices derived from BCG (J-J intervals) and ECG (R-R intervals).
- To compare BCG-derived HRV indices with those derived from Pulse Wave (PW) signals.
Main Methods:
- Fifty healthy subjects (26.2 ± 5.5 years) participated in the study.
- Statistical analyses included Coefficients of Variation (CV), Lin’s Concordance Correlation Coefficient (LCCC), and Bland-Altman analysis (BA ratio).
- Consistency was assessed between BCG J-J intervals and ECG R-R intervals, and also between PW P-P intervals and ECG R-R intervals.
Main Results:
- Measures like Mean and SDNN showed good agreement between BCG and ECG (CV diff < 2%, LCCC > 0.99, BA ratio < 0.1).
- pNN50 demonstrated moderate agreement (CV diff < 5%, LCCC > 0.95, BA ratio < 0.2).
- RMSSD, HF, and LF/HF indices exhibited poor agreement (CV diff ≥ 5% or LCCC ≤ 0.95 or BA ratio ≥ 0.2). BCG and PW performance was similar, except for pNN50.
Conclusions:
- BCG is a valid alternative to ECG for specific HRV indices (Mean, SDNN, LF) due to good agreement.
- Its utility for other indices (pNN50, RMSSD, HF, LF/HF) is limited, requiring further investigation.
- BCG shows comparable performance to Pulse Wave analysis for most HRV indices.
Abstract:
Ballistocardiography (BCG) is considered a good alternative to HRV analysis with its non-contact and unobtrusive acquisition characteristics. However, consensus about its validity has not yet been established. In this study, 50 healthy subjects (26.2 ± 5.5 years old, 22 females, 28 males) were invited. Comprehensive statistical analysis, including Coefficients of Variation (CV), Lin’s Concordance Correlation Coefficient (LCCC), and Bland-Altman analysis (BA ratio), were utilized to analyze the consistency of BCG and ECG signals in HRV analysis. If the methods gave different answers, the worst case was taken as the result. Measures of consistency such as Mean, SDNN, LF gave good agreement (the absolute value of CV difference < 2%, LCCC > 0.99, BA ratio < 0.1) between J-J (BCG) and R-R intervals (ECG). pNN50 showed moderate agreement (the absolute value of CV difference < 5%, LCCC > 0.95, BA ratio < 0.2), while RMSSD, HF, LF/HF indicated poor agreement (the absolute value of CV difference ≥ 5% or LCCC ≤ 0.95 or BA ratio ≥ 0.2). Additionally, the R-R intervals were compared with P-P intervals extracted from the pulse wave (PW). Except for pNN50, which exhibited poor agreement in this comparison, the performances of the HRV indices estimated from the PW and the BCG signals were similar.
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