Enhancing the pulse contour analysis-based arterial stiffness estimation using a novel photoplethysmographic parameter.

In this paper, we propose a novel method for enhancing pulse contour analysis-based arterial stiffness estimation using a simple and low-complexity photoplethysmographic parameter (P2Ocd). The method first eliminates baseline wanders in the digital volume pulse (DVP) by applying a simple morphological filter. The filtered DVP signal is then transformed into a slope sum function signal to simplify the pulse peak detection process by enhancing the upslope of the DVP signal while suppressing its downslope. An adaptive thresholding scheme is applied to detect pulse peaks from the transformed signal. Pulse onsets are then identified as the minimum values between consecutive pulse peaks. The P2Ocd is finally calculated by dividing the time interval between the pulse peak and the pulse onset by the pulse length. In order to assess the agreement of the P2Ocd with an established technique, brachial-ankle pulse wave velocity, we performed Bland-Altman and correlation analyses. Furthermore, we evaluated the P2Ocd-based arterial stiffness estimation in terms of prediction accuracy (% error rate) and repeatability (coefficient of variation). The results show that the proposed measurement agrees well with the established technique and shows a high repeatability; it also has a better predictive accuracy than that of conventional methods. In addition, we show that the proposed parameter further improves the predictive accuracy by combining it with age. The proposed method is therefore highly applicable to small ubiquitous healthcare applications.