Analysis of Pulse Wave Morphology Measured by Photoplethysmography During Arm Position Changes

Anatoly V. Skripal orcid (Login required)
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Dmitry G. Verkhov orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Sergey Y. Dobdin orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Andrey A. Sagaidachnyi orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Andrey D. Usanov orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Andrey V. Antonov orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation

Elena S. Olenko orcid
Saratov National Research State University named after N.G. Chernyshevsky, Russian Federation




DOI: 10.18287/JBPE25.11.020310

Abstract

Numerous studies underscore the importance of analyzing pulse wave morphology via photoplethysmography (PPG) as an accessible method for investigating localized vascular responses. Contemporary approaches to modeling pulse wave morphology are based on the assumption that the dicrotic wave arises from reflections at vascular bifurcations and other vascular inhomogeneities. An alternative perspective posits that normal blood circulation is sustained through smooth muscle tone. To validate this hypothesis, we analyzed pulse wave morphology during arm position changes, which are associated with alterations in arterial tone within the vascular system. This study substantiates the feasibility of evaluating vascular resistance changes through dicrotic wave curvature during arm repositioning, measurable via the slope angle of the PPG signal at this segment. Furthermore, it is shown that the venulo-arteriolar reflex triggered by arm position changes leads to ambiguous dynamics in pulse wave amplitude variations. The presence or absence of the venulo-arteriolar reflex impacts pulse wave amplitude but does not affect dicrotic wave curvature, which is exclusively governed by changes in arteriolar smooth muscle tone.

Keywords

pulse wave morphology; photoplethysmography; diastolic wave; dicrotic wave; venulo-arteriolar reflex; vascular resistance

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References


1. J. Allen, “Photoplethysmography and its application in clinical physiological measurement,” Physiological measurement 28(3), R1 (2007).

2. S. R. Alty, N. Angarita-Jaimes, S. C. Millasseau, and P. J. Chowienczyk, “Predicting arterial stiffness from the digital volume pulse waveform,” IEEE Transactions on Biomedical Engineering 54(12), 2268–2275 (2007).

3. M. F. O’Rourke, D. E. Gallagher, “Pulse wave analysis,” Journal of Hypertension. Supplement: Official Journal of the International Society of Hypertension 14(5), S147–S157 (1996).

4. C. S. Hayward, M. Kraidly, C. M. Webb, and P. Collins, “Assessment of endothelial function using peripheral waveform analysis: a clinical application,” Journal of the American College of Cardiology 40(3), 521–528 (2002).

5. U. Rubins, A. Grabovskis, J. Grube, and I. Kukulis, “Photoplethysmography analysis of artery properties in patients with cardiovascular diseases,” in 14th Nordic-Baltic Conference on Biomedical Engineering and Medical Physics, A. Katashev, Y. Dekhtyar, and J. Spigulis (Eds.), Springer Berlin Heidelberg, 20, 319–322 (2008).

6. C. Lee, H. Sik Shin, and M. Lee, “Relations between ac-dc components and optical path length in photoplethysmography,” Journal of Biomedical Optics, 16(7), 077012 (2011).

7. I. Yu. Volkov, A. A. Sagaidachnyi, and A. V. Fomin, “Photoplethysmographic imaging of hemodynamics and two-dimensional oximetry,” Optics and Spectroscopy 130(7), 452–469 (2022).

8. S. C. Millasseau, R. P. Kelly, J. M. Ritter, and P. J. Chowienczyk, “Determination of age-related increases in large artery stiffness by digital pulse contour analysis,” Clinical Science 103(4), 371–377 (2002).

9. G. Angius, D. Barcellona, E. Cauli, L. Meloni, and L. Raffo, “Myocardial infarction and antiphospholipid syndrome: a first study on finger PPG waveforms effects,” in 2012 Computing in Cardiology, IEEE, 517–520 (2012).

10. M. Elgendi, “On the analysis of fingertip photoplethysmogram signals,” Current Cardiology Reviews, 8(1), 14–25 (2012).

11. A. C. Guyton, J. E. Hall, Medical Physiology, Logosphera, Russia (2008). ISBN: 978-5-9865701-3-6. [in Russian].

12. D. Morman, L. Heller, Cardiovascular physiology (translated from English), 4th Ed., Peter Publishing House, Saint Petersburg (2000). ISBN: 5-314-00164-0. [in Russian].

13. A. Kubarko, V. Pereverzev and A. Semenovich, Normal physiology, High School, Minsk (2014). ISBN: 978-985-06-2339-3. [in Russian].

14. W. J. Zwiebel, J. S. Pellerito, Introduction to Vascular Ultrasonography, Elsevier Saunders, Philadelphia (2005).

15. V. G. Lelyuk, S. E. Lelyuk. Cerebral circulation and arterial pressure, Nastoyashcheie Vremia, Moscow (2004). [in Russian].

16. S. V. Ivanov, A. N. Ryabikov, and S. K. Malyutina, “Aterial stiffness and pulse wave reflection in association with arterial hypertension,” Bulletin of Siberian Branch of Russian Academy of Medical Sciences 28(3), 9–12 (2008). [in Russian].

17. L. I. Kalakutskiy, A. A. Fedotov, “Diagnostics of endothelial dysfunction by the method of contour analysis of pulse wave,” Izvestiya Yuzhnogo Federal’nogo Universiteta. Tekhnicheskie nauki 98(9), 93–98 (2009). [in Russian].

18. C. M. McEniery, Yasmin, I. R. Hall, A. Qasem, I. B. Wilkinson, and J. R. Cockcroft, “Normal Vascular Aging: Differential Effects on Wave Reflection and Aortic Pulse Wave Velocity,” Journal of the American College of Cardiology 46(9), 1753–1760 (2005).

19. Q. Yousef, M. B. I. Reaz, and M. A. M. Ali, “The analysis of PPG morphology: investigating the effects of aging on arterial compliance,” Measurement Science Review 12(6), 266 (2012).

20. M. Hickey, J. P. Phillips, and P. A. Kyriacou, “Investigation of peripheral photoplethysmographic morphology changes induced during a hand-elevation study,” Journal of Clinical Monitoring and Computing 30(5), 727–736 (2016).

21. M. Ye. Bondarenko, N. N. Kizilova, “Pulse Wave Reflections in Asymmetrically Branching Arterial Networks,” Russian Journal of Biomechanics (4), 52–62 (2002).

22. A. V. Skripal, D. G. Verkhov, F. Al-Badri, K. V. Mashkov, A. D. Usanov, A. A. Sagaidachnyi, and V. A. Klochkov, “The appearance of the venuloarteriolar reflex during measurements microcirculation of blood by laser Doppler flowmetry caused by a change in the position of the hand,” Izvestiya of Saratov University. Physics 25(1), 53–66 (2025).

23. G. Wang, M. Atef, and Y. Lian, “Towards a continuous non-invasive cuffless blood pressure monitoring system using PPG: Systems and circuits review,” IEEE Circuits and Systems Magazine 18(3), 6–26 (2018).

24. M. Nitzan, Z. Ovadia-Blechman, “Physical and physiological interpretations of the PPG signal,” Chapter 9 in Photoplethysmography, J. Allen, P. Kyriacou (Eds.), Elsevier, 319–340 (2022).

25. J. Park, H. S. Seok, S. S. Kim, and H. Shin, “Photoplethysmogram analysis and applications: an integrative review,” Frontiers in physiology 12, 808451 (2022).

26. I. Korhonen, A. Yli-Hankala, “Photoplethysmography and nociception” Acta Anaesthesiologica Scandinavica 53(8), 975–985 (2009).

27. B. Estanol-Vidal, F. Gutierrez-Manjarrez, R. Martinez-Memije, H. Senties-Madrid, M. J. Berenguer-Sanchez, L. Magana-Zamora, G. Delgado-Garcia, and E. Chiquete-Anaya, “The two faces of venoarteriolar reflex: cutaneous vasodilatation and vasoconstriction to raise and to lower the arm,” Revista de Neurología 62(9), 403–407 (2016).

28. E. M. Rozhnov, I. D. Zhuchkov, and G. V. Krasnikov, “Influence of vascular changes on signals of peripheral blood flow in various position of the arm,” Izvestiya Tula State University. Natural Science 4, 152–163 (2020). [in Russian].

29. Z. Ovadia-Blechman, A. Gritzman, M. Shuvi, B. Gavish, V. Aharonson, and N. Rabin, “The response of peripheral microcirculation to gravity-induced changes,” Clinical Biomechanics 57, 19–25 (2018).

30. An. V. Skripal, A.-B. Farkad, K. V. Mashkov, A. D. Usanov, and A. P. Averyanov, “Laser flowmetry of microcirculation of the finger depending on the external temperature and the limb position,” Regional Blood Circulation and Microcirculation 22(4), 35–41 (2023). [in Russian].

31. Q. Y. Lee, G. S. Chan, S. J. Redmond, P. M. Middleton, E. Steel, P. Malouf, C. Critoph, G. Flynn, E. O’Lone, and N. H. Lovell, “Multivariate classification of systemic vascular resistance using photoplethysmography,” Physiological Measurement 32(8), 1117 (2011).

32. A. Wang, L. Yang, C. Liu, J. Cui, Y. Li, X. Yang, S. Zhang, and D. Zheng, “Athletic Differences in the Characteristics of the Photoplethysmographic Pulse Shape: Effect of Maximal Oxygen Uptake and Maximal Muscular Voluntary Contraction,” BioMed Research International 2015(1), 752570 (2015).

33. A. Burkert, A. Scholze, and M. Tepel, “Noninvasive continuous monitoring of digital pulse waves during hemodialysis,” Asaio Journal 52(2), 174–179 (2006).

34. I. S. Zaletov, A. A. Sagaidachnyi, A. V. Skripal, V. A. Klochkov, D. I. Mayskov, and A. V. Fomin, “Interrelation between pulse wave forms in the peripheral arteries registered by methods of impedance rheography and ultrasonic dopplerography,” Izvestiya of Saratov University. Physics 23(1), 24–36 (2023). [in Russian].

35. A. V. Skripal, A. V. Fomin, A. S. Bakhmetyev, N. B. Brilenok, A. A. Sagaidachnyi, S. Y. Dobdin, and A. S. Tikhonova, “Diagnostics of arterial vessels of athletes using Doppler ultrasound measurement,” Izvestiya of Saratov University. Physics 22(2), 141–148 (2022).

36. D. G. Verkhov, F. Al-Badri, A. A. Sagaidachny, S. Y. Dobdin, A. D. Usanov, and A. V. Skripal, “Determination of vascular resistance by the form of the pulse pressure wave,” in All-Russian School-Seminar on Computer Diagnostic Methods in Biology and Medicine – 2024, Saratov, 28–30 (2024).

37. E. E. Ladozhskaya-Gapeenko, K. N. Khrapov, “Possibilities of Laser-Doppler Flowmetry in assessment of functional state of microcirculation,” Regional Blood Circulation and Microcirculation 19(3), 39–45 (2020). [in Russian].

38. M. Midttun, P. Sejrsen, “Blood flow rate in arteriovenous anastomoses and capillaries in thumb, first toe, ear lobe, and nose,” Clinical Physiology 16(3), 275–289 (1996).

39. L. Monteiro Rodrigues, C. Rocha, S. Andrade, T. Granja, and J. Gregório, “The acute adaptation of skin microcirculatory perfusion in vivo does not involve a local response but rather a centrally mediated adaptive reflex,” Frontiers in Physiology 14, 1177583 (2023).

40. Y. Hu, A. Hu, and S. Song, “Comparative study of photoplethysmographic waveforms with application of antihypertensive medication in hypertensive patients,” Annals of Noninvasive Electrocardiology 27(3), e12941 (2022).




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