Sympathetically induced spontaneous fluctuations of the photoplethysmographic signal

Khanokh, Boris; Slovik, Youval; Landau, David; Nitzan, Meir

doi:10.1007/bf02351014

Cited by 41 publications

(27 citation statements)

References 25 publications

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“…After the examination, the stored data was digitally analyzed for detecting the minimum of each PPG pulse 14 in the right hand. No PPG pulses appeared in the left hand ͑distal to the cuff͒ for cuff pressure above systolic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Respiration-induced changes in tissue blood volume distal to occluded artery, measured by photoplethysmography

2006

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Abstract. Photoplethysmography ͑PPG͒ measures the cardiac-induced fluctuations and other changes in tissue blood volume by light transmission measurement. In the current study, light transmission was simultaneously measured in the two index fingers of healthy subjects, while the brachial artery in the left arm was occluded by a pressure cuff, so that no PPG signal appeared in the left finger. Correlated respiratory-induced changes in the PPG baseline in the right hand and in the light transmission in the left hand were found, indicating respiratory-induced blood volume changes in the finger distal to the occluded artery. The blood volume changes under the PPG probe distal to the occluded artery are interpreted as transition of blood volume from small arteries into big veins, mediated by the sympathetic nervous system. BackgroundThe origin of the respiratory-induced high-frequency ͑HF͒ fluctuations in arterial blood pressure was attributed either to direct mechanical effect of respiratory-induced thoracic pressure changes on the arteries or to sympathetic or parasympathetic tone oscillations.1-4 The latter can be either direct, through central coupling of respiratory drive to the autonomic nervous system, or modulated by the baroreceptors.Respiratory-induced fluctuations have also been shown in the peripheral hemodynamics. Deep inspiration demonstrated lower skin blood flow due to higher sympathetic activity. 5-7The photoplethysmographic ͑PPG͒ signal is also modulated by respiration. The PPG photodetector output, which is proportional to light transmission through the tissue, oscillates in the heart cycle rate due to the cardiac-induced increase in the tissue blood volume during systole. The PPG baseline, which is inversely related to tissue blood volume has shown respiratory HF fluctuations [8][9][10][11] and significantly decreased after deep inspiratory gasp. 12The respiratory-induced changes in PPG baseline can originate from arterial blood pressure changes caused mechanically by thoracic pressure changes and passively transmitted from the large arteries to the small arteries 9 or from peripheral sympathetic activity oscillations.11 In the following we present PPG examinations, demonstrating respirationinduced changes in tissue blood volume in a finger distal to occluded artery under a pressure cuff. These tissue blood volume changes cannot be directly originated from hemodynamic changes in the body proximal to the pressure cuff. Materials and Methods SubjectsTransmission PPG was simultaneously measured in the right and left index fingers of 10 nonsmoker male subjects aged 21-63 years. The subjects were normotensive ͑of blood pressure not higher than 140/ 90 mmHg͒, and had no known cardiovascular or neurological disease. During the examination the subjects sat comfortably, with their hands laid on the table, at about heart level. After a rest period of 5 min the subjects were asked to breathe with a period of 10-15 s, and PPG measurement started. After 2 min, the cuff pressure was raised to above systolic bl...

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Section: Discussionmentioning

confidence: 99%

Respiration-induced changes in tissue blood volume distal to occluded artery, measured by photoplethysmography

2006

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“…Since the PPG waveform is a measure of the peripheral blood volume, its variability consists of the fluctuations in the tissue blood volume (baseline), which includes the venous and the capillary blood, and in the arterial pulse volume (amplitude) [1,11]. In addition, the variability in the pulse wave further includes contribution from the forward pulse wave and the reflected pulse waves.…”

Section: Methodsmentioning

confidence: 99%

Extraction of photoplethysmographic waveform variability by lowpass filtering

Grace

Middleton

Lovell³

et al. 2005

2005 IEEE Engineering in Medicine and Biology 27th Annual Conference

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Cardiovascular variability is known to provide useful physiological information about autonomic function and peripheral vascular tone. Previous studies have used systolic values (peaks) or diastolic values (troughs) in the photoplethysmographic signal (PPG) to represent the variability in the finger pulse waveform. However, the feature detection process is error prone and often requires manual correction which is time consuming. The current study has proposed the lowpass filtering method as an alternative means to extract the variability signal. The similarities between the lowpass filtered spectrum and the spectra produced by other representation methods were assessed quantitatively via the computation of normalized cross-correlations. Results showed that the lowpass filtered signal produced a variability spectrum which was nearly identical to that of the pulse waveform mean value (correlation = 0.996), and was highly correlated with the trough and the peak variability spectra (correlation > 0.9). Compared with feature extraction methods, the lowpass filtering method is much simpler and computationally efficient to implement. In addition, the lowpass filtering method can be applied in conjunction with signal decomposition techniques such as principal component analysis (PCA) to better quantify sympathetic change.

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“…The very low-frequency (VLF) fluctuations in BL and AM were also examined in the time domain, which is advantageous over power spectrum analysis because of the non-periodic pattern of the VLF fluctuation curves (KHANOKH et al, 2004, NITZAN et al, 2001. For healthy subjects, a high right-left coefficient of correlation was found for the BL and AM VLF fluctuation curves, both for fingers and toes, owing to their central origin.…”

Section: Introductionmentioning

confidence: 99%

“…In the aforementioned study (KHANOKH et al, 2004), several parameters related to the VLF fluctuations were examined, such as the right-left correlation coefficient for BL or AM in fingers or in toes, the BL-AM correlation coefficient and standaxd deviation of the fluctuations, divided by their mean. Whereas the latter two parameters exhibited significant reduction with subject's age, the right-left BL or AM correlation coefficients only slightly depended on age.…”

Section: Introductionmentioning

confidence: 99%

Right-left correlation of the sympathetically induced fluctuations of photoplethysmographic signal in diabetic and non-diabetic subjects

Buchs

Slovik

Rapoport

et al. 2005

Med. Biol. Eng. Comput.

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Photoplethysmography (PPG) records the cardiac-induced changes in tissue blood volume by light-transmission measurements. The baseline and amplitude of the PPG signal show very low-frequency (VLF) spontaneous fluctuations, which are mediated by the sympathetic nervous system, and high correlation between right and left extremities of healthy subjects. As sympathetic neuropathy is one of the diabetic complications, the right-left correlation of the PPG fluctuations was examined in diabetic patients. The PPG signal was simultaneously measured in the two index fingers and the two second toes of 35 diabetic patients and 33 non-diabetic subjects. For each PPG pulse, the baseline and amplitude were determined, and the right-left correlation coefficients of the VLF fluctuations in the baseline and amplitude were derived. The VLF fluctuations in the baseline showed high right-left correlation, both for fingers (0.93 +/- 0.05) and toes (0.93 +/- 0.06), for the non-diabetic subjects, and significantly lower correlation (0.78 +/- 0.22 and 0.84 +/- 0.17, respectively) for the diabetic patients. Similar results were obtained for the amplitude VLF fluctuations. The right-left correlation coefficients for diabetic patients decreased with the disease duration for the toe baseline and toe amplitude fluctuations and correlated with heart rate response to deep breathing for the finger baseline and toe amplitude fluctuations. The right-left correlation coefficients of the PPG fluctuations provide a simple and convenient means for assessing the adequacy of the sympathetic nervous system function.

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Sympathetically induced spontaneous fluctuations of the photoplethysmographic signal

Cited by 41 publications

References 25 publications

Respiration-induced changes in tissue blood volume distal to occluded artery, measured by photoplethysmography

Respiration-induced changes in tissue blood volume distal to occluded artery, measured by photoplethysmography

Extraction of photoplethysmographic waveform variability by lowpass filtering

Right-left correlation of the sympathetically induced fluctuations of photoplethysmographic signal in diabetic and non-diabetic subjects

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