TY - JOUR
T1 - Quantifying changes in size of arrhythmic photoplethysmography waveforms during a Valsalva maneuver for assessing cardiac filling pressure
AU - Silber, Harry A.
AU - Win, Theingi Tiffany
AU - Monti, Jennifer
AU - Galiatsatos, Panagis
N1 - Publisher Copyright:
© 2020 Institute of Physics and Engineering in Medicine
PY - 2020/10
Y1 - 2020/10
N2 - Objective: We previously showed that the change in amplitude of a finger photoplethysmography waveform during the Valsalva maneuver reflects cardiac filling pressure. However, the automated determination of peaks and valleys to calculate amplitude is limited in significant arrhythmias such as atrial fibrillation and premature ventricular complexes, which are common in heart failure. The purpose of this study was to assess the change in size of the waveform by calculating the change in root mean square (RMS) of the signal, thereby utilizing the entire cardiac cycle, and to compare it to change in size of peak-to-valley amplitude. Approach: We compared the two approaches in signals obtained from participants of a prior study who were tested prior to a clinically indicated cardiac catheterization. Correlation between the two methods was assessed in cases without, and then with, significant arrhythmias including atrial fibrillation or premature ventricular complexes. Main results: Calculations from the two methods of peak-valley amplitude and RMS were highly correlated with each other in signals without (0.99, p < 0.0001, n = 252) and with significant arrhythmias (0.90, p < 0.0001, n = 34). Significance: RMS analysis of photoplethysmography signal size during the Valsalva maneuver is highly correlated with the method of analyzing changes in peak-valley amplitude, but does not rely on identifying peaks and valleys. The RMS method may be a more robust automated method of assessing cardiac filling pressure in patients with significant arrhythmias.
AB - Objective: We previously showed that the change in amplitude of a finger photoplethysmography waveform during the Valsalva maneuver reflects cardiac filling pressure. However, the automated determination of peaks and valleys to calculate amplitude is limited in significant arrhythmias such as atrial fibrillation and premature ventricular complexes, which are common in heart failure. The purpose of this study was to assess the change in size of the waveform by calculating the change in root mean square (RMS) of the signal, thereby utilizing the entire cardiac cycle, and to compare it to change in size of peak-to-valley amplitude. Approach: We compared the two approaches in signals obtained from participants of a prior study who were tested prior to a clinically indicated cardiac catheterization. Correlation between the two methods was assessed in cases without, and then with, significant arrhythmias including atrial fibrillation or premature ventricular complexes. Main results: Calculations from the two methods of peak-valley amplitude and RMS were highly correlated with each other in signals without (0.99, p < 0.0001, n = 252) and with significant arrhythmias (0.90, p < 0.0001, n = 34). Significance: RMS analysis of photoplethysmography signal size during the Valsalva maneuver is highly correlated with the method of analyzing changes in peak-valley amplitude, but does not rely on identifying peaks and valleys. The RMS method may be a more robust automated method of assessing cardiac filling pressure in patients with significant arrhythmias.
KW - Cardiac filling pressure
KW - Photoplethysmography
KW - Root-mean-square
KW - Valsalva maneuver
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U2 - 10.1088/1361-6579/abb790
DO - 10.1088/1361-6579/abb790
M3 - Article
C2 - 33164916
AN - SCOPUS:85095972745
SN - 0967-3334
VL - 41
JO - Physiological Measurement
JF - Physiological Measurement
IS - 10
M1 - 105004
ER -