Background Introduction of telemonitoring systems to patient care which provide extensive information about the cardiovascular status of the patient is a promising direction to reduce cardiovascular morbidity and mortality. Our team has developed a telemedical system which is based on the photoplethysmographic detection of the digital arterial pulse wave. The system incorporates a cloud-based automated algorithm which analyses the pulse contour to provide 15 scientifically established parameters for versatile characterization of cardiovascular function. The aim of the current study was to assess the variability of the measurements to test the applicability of the tool before clinical use. We assessed the repeatability of the measurements by detecting stable artificial signals, and also test-retest variability by repeatedly examining the pulse contours of healthy individuals under standardized conditions. Results Most contour parameters (stiffness index, reflection index, left ventricular ejection time index and mean interbeat intervals) are measured with high repeatability (coefficients of variation (CV) < 1% for each parameter), and exhibit acceptable intrapersonal fluctuations (CVs < 10%). However, some parameters derived from the second derivative of the pulse wave seem to be more variable (aging index, d/a ratio). This is explained by the typical alterations of the pulse wave under specific circumstances, which cause the flattening or complete disappearance of c and d inflections on the second derivative. Conclusion Our measurements proved that our telemonitoring system detects and analyses digital pulse contours with high accuracy and highlighted that second derivative parameters should be interpreted cautiously. We recommend the evaluation of these parameters only in those measurements where c and d points are detected reliably. Pulse contour parameters are stable in healthy individuals under standardized conditions, which allows detection of subtle abnormal alterations by the remote surveillance system.

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