Diurnal cardio-respiratory changes in ambulatory individuals deciphered using a multi-parameter wearable device

Nachman, Dean; Eisenkraft, Arik; Kolben, Yotam; Carmon, Erez; Hazan, Esther; Goldstein, Nir; Ben Ishay, Arik; Hershkovitz, Mor; Fons, Meir; Merin, Roei; Amir, Offer; Asleh, Rabea; Gepner, Yftach

doi:10.1177/20552076231218885

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…The monitoring devices used in this study ( Figure 1 ) utilize a unique reflective PPG technology, in which part of the transmitted light is reflected from the tissue and detected by a photodiode detector positioned near the light source transmitter. The sensor’s high temporal and quantitative resolution allows it to capture changes in tissue reflectance, from which it derives measurements of several hemodynamic parameters using Pulse Wave Transit Time (PWTT) combined with Pulse Wave Analysis (PWA) [ 12 , 13 , 14 , 15 , 16 , 17 ]. The device requires a single trimonthly calibration of the HR and BP baseline using an FDA-cleared cuff-based device.…”

Section: Methodsmentioning

confidence: 99%

Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension

Kolben,

Gork,

Peled

et al. 2024

Biomedicines

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Intradialytic hypotension (IDH) is a severe complication of hemodialysis (HD) with a significant impact on morbidity and mortality. In this study, we used a wearable device for the continuous monitoring of hemodynamic vitals to detect hemodynamic changes during HD and attempted to identify IDH. End-stage kidney disease patients were continuously monitored 15 min before starting the session and until 15 min after completion of the session, measuring heart rate (HR), noninvasive cuffless systolic and diastolic blood pressure (SBP and DBP), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR). Data were analyzed retrospectively and included comparing BP measured by the wearable devices (recorded continuously every 5 s) and the cuff-based devices. A total of 98 dialysis sessions were included in the final analysis, and IDH was identified in 22 sessions (22.5%). Both SBP and DBP were highly correlated (r > 0.62, p < 0.001 for all) between the wearable device and the cuff-based measurements. Based on the continuous monitoring, patients with IDH had earlier and more profound reductions in SBP and DBP during the HD treatment. In addition, nearly all of the advanced vitals differed between groups. Further studies should be conducted in order to fully understand the potential of noninvasive advanced continuous monitoring in the prediction and prevention of IDH events.

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Section: Methodsmentioning

confidence: 99%

Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension

Kolben,

Gork,

Peled

et al. 2024

Biomedicines

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Wearable cuffless blood pressure tracking: when will they be good enough?

Schutte

2024

J Hum Hypertens

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Wearable health monitoring is a multibillion-dollar industry. But the holy grail is probably getting it right for blood pressure monitoring without a cuff, because raised blood pressure is very common and the leading cause of death in the world. Many have tried and failed, but industry is persisting: numerous cuffless wearable blood pressure devices are on the market, several technologies have been developed, hundreds of patents are registered every year, and some devices already have regulatory approval. However, to convince the die-hard blood pressure critic is a different ball game. To understand the challenges of currently accepted methods and cuffless devices, I performed a 24-h blood pressure monitoring self-test, including measurements when awake, asleep and watching an intense match of the Rugby World Cup final, with the purpose to demonstrate the challenges and opportunities we face. Blood pressure was monitored using five different devices simultaneously: validated left and right arm cuff blood pressure, and three cuffless wearable devices (wrist-band, chest patch and a ring). Whilst none of these devices proved to be perfect in capturing a physiologically challenging measure, namely blood pressure, it emphasised that our current practice of a single blood pressure measurement in clinical practice should be revisited. It further begs the question of when cuffless measurements will be good enough to incorporate in clinical decision-making.

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Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension

Kario,

Williams,

Tomitani

et al. 2024

Journal of Hypertension

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Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management. However, conventional home and ambulatory BP monitoring devices use the upper-arm cuff oscillometric method and only provide intermittent BP readings under static conditions or in a limited number of situations. New innovations include technologies for BP estimation based on processing of sensor signals supported by artificial intelligence tools, technologies for remote monitoring, reporting and storage of BP data, and technologies for BP data interpretation and patient interaction designed to improve hypertension management (“digital therapeutics”). The number and volume of data relating to new devices/technologies is increasing rapidly and will continue to grow. This International Society of Hypertension position paper describes the new devices/technologies, presents evidence relating to new BP measurement techniques and related indices, highlights standard for the validation of new devices/technologies, discusses the reliability and utility of novel BP monitoring devices, the association of these metrics with clinical outcomes, and the use of digital therapeutics. It also highlights the challenges and evidence gaps that need to be overcome before these new technologies can be considered as a user-friendly and accurate source of novel BP data to inform clinical hypertension management strategies.

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Diurnal cardio-respiratory changes in ambulatory individuals deciphered using a multi-parameter wearable device

Cited by 3 publications

References 34 publications

Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension

Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension

Wearable cuffless blood pressure tracking: when will they be good enough?

Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension

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