UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Non-Invasive Detection of Mechanical Alternans Utilizing Photoplethysmography

Besleaga, T; Badiani, S; Lloyd, G; Toschi, N; Canichella, A; Demosthenous, A; Lambiase, PD; (2018) Non-Invasive Detection of Mechanical Alternans Utilizing Photoplethysmography. IEEE Journal of Biomedical and Health Informatics 10.1109/JBHI.2018.2882550. (In press). Green open access

[img]
Preview
Text
Besleaga FINAL VERSION.pdf - Accepted version

Download (1MB) | Preview

Abstract

Background and Significance: Mechanical alternans (MA) is a biomarker associated with mortality and life-threatening arrhythmias in heart failure patients. Despite showing prognostic value, its use is limited by the requirement of measuring continuous blood pressure (BP), which is costly and impractical. Objective: To develop and test, for the first time, non-invasive MA surrogates based on photoplethysmography (PPG). Methods: Continuous BP and PPG were recorded during clinical procedures and tests in 35 patients. MA was induced either by ventricular pacing (Group A, N=19) or exercise (Group B, N=16). MA was categorized as sustained or intermittent if MA episodes were observed in at least 20 or between 12 to 20 consecutive beats, respectively. Eight features characterizing pulse morphology were derived from the PPG and MA surrogates were evaluated. Results: Sustained alternans was observed in 9 patients (47%) from Group A, whereas intermittent alternans was observed in 13 patients (68%) from Group A and in 10 patients (63%) from Group B. The PPG-based MA surrogate showing the highest accuracy, V'M, was based on the maximum of the first derivative of the PPG pulse. It detected both sustained and intermittent MA with 100% sensitivity and 100% specificity in Group A and intermittent MA with 100% sensitivity and 83% specificity in Group B. Furthermore, the magnitudes of MA and its PPG-based surrogate were linearly correlated (R 2 =0.83, p<0.001). Conclusion: MA can be accurately identified non-invasively through PPG analysis. This may have important clinical implications for risk stratification and remote monitoring.

Type: Article
Title: Non-Invasive Detection of Mechanical Alternans Utilizing Photoplethysmography
Open access status: An open access version is available from UCL Discovery
DOI: 10.1109/JBHI.2018.2882550
Publisher version: https://doi.org/10.1109/JBHI.2018.2882550
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Blood pressure, Biomedical monitoring, Heart, Monitoring, Fingers, Informatics, Photoplethysmography
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Electronic and Electrical Eng
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10062242
Downloads since deposit
117Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item