TRANSLATING PHOTOPLETHYSMOGRAPHIC PERIPHERAL PULSEWAVE ANALYSIS: BRIDGING THEORY TO CLINICAL PRACTICE FOR THE UTILIZATION OF A REMOTE PATIENT MONITORING SYSTEM
Kulin Dániel
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
SE Elméleti Orvostudományi Központ, Beznák Aladár terem
2026-02-11 14:00:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Dr. Miklós Zsuzsanna
Dr. Horváth Tamás
Dr. Szabó Gergely
Dr. Zsembery Ákos
Dr. Hricisák István
Dr. Barta Imre
Photoplethysmography (PPG)-based pulse contour analysis provides a non-invasive approach for studying peripheral hemodynamics and pulse wave morphology.
This thesis investigated the physiological behavior, stability, and interpretability of selected digital arterial volume pulse (DVP) parameters derived from peripheral PPG recordings, using a custom-built high-resolution research system (SCN4ALL).
Study 1 assessed the technical and short-term physiological stability of PPG-derived pulse wave parameters under standardized conditions. Artificial signal testing demonstrated excellent repeatability (CV < 1%), indicating minimal device- and algorithm-related measurement error. In human test-retest measurements, key parameters - including stiffness index, reflection index, left ventricular ejection time index, mean interbeat interval, and b/a - showed low intrapersonal variability (CV < 10%), supporting their robustness in healthy subjects. Second-derivative-based parameters were more variable due to limited c-d point detectability; therefore, a c-d point detection ratio was introduced as a quality control metric. Parallel finger recordings showed strong within-subject agreement (ICC > 0.80), indicating that most variability reflects interindividual differences rather than measurement location effects.
Study 2 investigated how PPG-based parameters reflect central cardiac function by comparing them with echocardiographic measurements in 37 healthy subjects. PPG-derived ejection time showed highest correlation with echocardiographic values (r = 0.648, p < 0.001), despite a consistent overestimation (+95 ms). Twelve additional PPG features showed moderate and significant correlations - both previously published PPG parameters and markers defined by our research group - (r > 0.4, p < 0.05) with key echocardiographic indices, including left ventricular dimensions, stroke volume, global longitudinal strain, aortic root diameter, ventricular filling pressure (E/e’ lat), and atrial contraction (MV-A).
Overall, the results contribute to a more detailed physiological interpretation of peripheral pulse wave morphology and highlight which PPG-derived parameters provide stable and interpretable information under standardized conditions in healthy individuals. These findings establish a physiological basis for future hypothesis-driven studies investigating specific cardiovascular conditions and well-defined clinical questions.
