Clinicals & Papers
Plethysmography & Pulse Wave Analysis
Heart Rate Variability (HRV)
Accelerated Plethysmography (APG)
& Pulse Wave Velocity (PWV)
Photoplethysmography is a wave signal that indicates pulsation of the chest wall and great arteries followed by the heartbeat. In essence, with eachÂ cardiac cycleÂ the heart pumps blood to the periphery. Even though this pressure pulse is somewhat damped by the time it reaches the skin, it is enough to distend the arteries and arterioles in the subcutaneous tissue.
The Max Pulse uses Accelerated Photoplethysmograph (APG) technology through the use of a simple, easy-to-use, non-invasive, reflected, infrared light (IR) finger sensor that implements light emitting diodes (LEDs) as both light emitter and detector, as well as, pulse-based signal conversion techniques.
The change in volume caused by the pressure pulse is detected by illuminating the skin with the light from a LED and then measuring the amount of light either transmitted or reflected to a photodiode. Each cardiac cycle appears as a peak.
APGâ€™s are used in many medical fields and clinical applications. In fact, it was reported in the Journal of Hypertension in 2007, that a European task force was organized to set guidelines for the management of arterial hypertension. The task force consisted of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). The task force added Pulse Wave Velocity (PWV) as an acceptable marker for arterial stiffness. Learn Moreâ€¦
Although according to many healthcare practitioners, â€śThe ECG based heart rate variability (HRV) measurements has become an important method of assessment of the cardiac autonomic regulation.â€ť1 Plethysmography is gaining substantial credentials as an economical, portable, noninvasive, and complimentary data collection device to the ECG.Â In fact, some say, â€śThe results indicate that PPG (photoplethysmography)Â is as effective as ECGÂ (electrocardiography)Â in measuring the eleven parameters of heart rate variability.â€ť2
Below are additional articles on the use and validity of using Pulse Wave and Plethysmography technologies:
1. Application of heart rate variability in prognosis of patients with diabetes mellitus.
Markuszewski L, Bissinger A. Pol Merkuriusz Lek. 2005 Oct;19(112):548-52. Read abstract...
2. A Measurement of Electrocardiography and Photoplethesmography in Obese Children.
C. V. Russoniello, V. Pougtachev, E. Zhirnov and M. T. Mahar.
Applied Psychophysiology and Biofeedback: Volume 35, Issue 3 (2010), Pages 257-259. Read abstract...
3. Guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
Mancia G, De Backer G, Dominiczak A, et al. 2007. J Hypertens. 2007;25:1105-1187. Read abstractâ€¦
4. Noninvasive pulse wave analysis for the early detection of vascular disease.
Cohn J, Finkelstein S, McVeigh G, et al. Hypertension. 1995;26:503-508. Read abstractâ€¦
5. Contour analysis of the photoplethysmographic pulse measured at the finger.
Millasseau SC, Ritter JM, Takazawa K, Chowienczyk PJ. J Hypertens. 2006;24:1449-1456. Read abstractâ€¦
6. Pulse pressure and aortic pulse wave velocity are markers of cardiovascular risk in hypertensive populations.
Asmar R, Rudnichi A, Blacher J, London GM, Safar ME. Am J Hypertens. 2001;14:91-97. Read abstractâ€¦
7. Better management of cardiovascular diseases by pulse wave velocity: combining clinical practice with clinical research using evidence-based medicine.
Khoshdel AR, Carney SL, Nair BR, Gillies A. Clin Med Res. 2007;5:45-52. Read abstractâ€¦
8. Wave reflection in the systemic circulation and its implications in ventricular function.
O'Rourke MF, Kelly RP. J Hypertens. 1993;11:327-337. Read abstractâ€¦
9. Pulse wave analysis and arterial stiffness.
Wilkinson IB, Cockcroft JR, Webb DJ. J Cardiovasc Pharmacol. 1998;32:S33-S37. Read abstractâ€¦
10. Pulse wave velocity and the second derivative of the finger photoplethysmogram in treated hypertensive patients: their relationship and associating factors.
Hashimoto J, Chonan K, Aoki Y, et al. J Hypertens. 2002;20:2415-2422. Read abstractâ€¦
11. The peripheral pulse wave: information overlooked.
Murray WB, Foster PA. J Clin Monit. 1996;12:365-377. Read abstractâ€¦
12. Photoelectric plethysmography - some fundamental aspects of the reflection and transmission method.
Nijboer JA, Dorlas JC, Mahieu HF. Clin Phys Physiol Meas. 1981;2:205-215. Read abstractâ€¦
13. Frequency analysis of the peripheral pulse wave detected in the finger with the photoplethysmograph.
Sherebrin MH, Sherebrin RZ. IEEE Trans Biomed Eng. 1990;37:313-317. Read abstractâ€¦
14. Arterial stiffness: clinical relevance, measurement and treatment.
Izzo JL Jr, Shykoff BE. Rev Cardiovasc Med. 2001; 2:29-34,37-40. Read abstractâ€¦
15. Determination of age-related increases in large artery stiffness by digital pulse contour analysis.
Millasseau SC, Kelly RP, Ritter JM, Chowienczyk PJ. Clin Sci (Lond). 2002;103:371-377. Read abstractâ€¦
16. Waveform analysis of peripheral pulse wave detected in the fingertip with photoplethysmograph.
Hlimonenko I, Meigas K, Vahisalu R. Measure Sci Rev. 2003;3:49-52. Read abstractâ€¦
17. Photo-electric plethysmography as a monitoring device in anaesthesia.
Dorlas JC, Nijboer JA. Br J Anaesth. 1985;57:524-530. Read abstractâ€¦
18. An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man.
Karamanoglu M, O'Rourke MF, Avolio AP, Kelly RP. Eur Heart J. 1993;14:160-167. Read abstractâ€¦
19. A photoelectric plethysmograph for the measurement of cutaneous blood flow.
Challoner AV, Ramsay CA. Phys Med Biol. 1974;19:317-328. Read abstractâ€¦
20. Annual progression of coronary calcification in trials of preventative therapies: a systematic review.
McCullough PA, Chinnaiyan KM. Arch Intern Med. 2009;169:2064-2070. Read abstractâ€¦
21. Repeatability of peripheral pulse measurements on ears, fingers and toes using photoelectric plethysmography.
Jago JR, Murray A. Clin Phys Physiol Measure. 1988;9:319-329. Read abstractâ€¦
22. Noninvasive determination of age related changes in the human arterial pulse.
Kelly RP, Hayward C, Avolio A, O'Rourke M. Circulation. 1989;80:1652-1659. Read abstractâ€¦
23. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients.
Blacher J, Asmar R, Djane S, London GM, Safar ME. Hypertension. 1999;33:1111-1117. Read abstractâ€¦
24. Impact of aortic stiffness on survival in end-stage renal disease.
Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Circulation. 1999;99:2434-2439. Read abstractâ€¦
25. A double take on serial measurement of coronary artery calcification.
O'Malley P. Arch Intern Med. 2009;169:2051-2052. Read abstractâ€¦
26. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients.
Laurent S, Boutouyrie P, Asmar R, et al. Hypertension. 2001;37:1236-1241. Read abstractâ€¦
27. Studies of the arterial pulse wave and its modification in the presence of human arteriosclerosis.
Lax H, Feinberg AW, Cohen BM. J Chronic Dis. 1956;3:618-631. Read abstractâ€¦