The Association Between Bending Photoplethysmography Waveform Area Index and Congestive Heart Failure

Congestive heart failure (CHF) is closely associated with a decrease in cardiac output, and photoplethysmography (PPG) parameters can experimentally assess cardiac output. It is unclear whether there is an association between the change of bending photoplethysmography waveform area index (BPWAI) due to postural changes and CHF.

We enrolled patients with suspected CHF. Patients completed physical examination, echocardiography, and pro-brain natriuretic peptide (NT-proBNP) test during their visit, and finger-end PPG waveform area was measured in the sitting and bending positions using PPG. We then used logistic regression to analyze the association between BPWAI and CHF, and the receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the event risk association strength.

A total of 523 patients with suspected CHF were included in this study, of whom 291 (55.6%) had a final diagnosis of CHF. The association between BPWAI and CHF decreased 0.45-fold for per 1 standard deviation increase in BPWAI (OR: 0.55 [95% CI, 0.44-0.68]). The AUC for BPWAI associated with CHF was 0.736 (95% CI, 0.689-0.782), with a corresponding sensitivity of 67.4% and specificity of 71.5%, and a cut-off value of 0.85 for the diagnosis of CHF.

When patients bend over, their PPG waveform area decreases, which is closely associated with patients with CHF. BPWAI is significantly associated with CHF and may serve as a potential associated indicator for CHF.