Effect of increasing heart rate on finger photoplethysmography fitness index (PPGF) in subjects with implanted cardiac pacemakers

Abstract

Finger photoplethysmography (PPG) is a noninvasive method that measures blood volume changes in the finger. The PPG fitness index (PPGF) has been proposed as an index of vascular risk and vascular aging. The objectives of the study were to determine the effects of heart rate (HR) on the PPGF and to determine whether PPGF is influenced by blood pressure (BP) changes. Twenty subjects (78±8 years, 3 female) with permanent cardiac pacemakers or cardioverter defibrillators were prospectively recruited. HR was changed by pacing, in a random order from 60 to 100 bpm and in 10 bpm increments. At each paced HR, the PPGF was derived from a finger photoplethysmogram. Cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) were derived from the finger arterial pressure waveform. Brachial blood pressure (BP) was measured by the oscillometric method. This study found that as HR was increased from 60 to 100 bpm, brachial diastolic BP, brachial mean BP and CO were significantly increased (p<0.01), whilst the PPGF and SV were significantly decreased (p<0.001). The effects of HR on the PPGF were influenced by BP, with a decreasing HR effect on the PPGF that resulted from a higher BP. In conclusion, HR was a significant confounder for PPGF and it must be taken into account in analyses of PPGF, when there are large changes or differences in the HR. The magnitude of this effect was BP dependent.

The Association between Inflammation and Pulse Wave Velocity in Dyslipidemia: An Evidence-Based Review

“…There are other inflammatory mediators that can be assessed such as IL-6 and TNF- α . On the other hand, there are other available methods to assess arterial stiffness such as augmentation index and finger photoplethysmography fitness index (PPGF) [ 55 – 57 ]. However, in this review, we only focus on cfPWV and baPWV since both methods have been found to be associated with future CVD as mentioned earlier [ 9 , 12 ].…”

“…Mediators of Inflammation [55][56][57]. However, in this review, we only focus on cfPWV and baPWV since both methods have been found to be associated with future CVD as mentioned earlier [9,12].…”

The effects of pedometer-based exercise on central and peripheral vascular functions among young sedentary men with CVD risk factors

“…The PPGF index was derived from an AC component of the PPG morphological changes and compared with a 19-year-old healthy reference (gender-specific) who was identified from the population. The details of the formula could be found in the previous study ( Aminuddin et al, 2018 ).…”

“…PPG measures blood volume changes in the peripheral arterial bed via optical techniques in accordance with the contraction and relaxation of the heart. PPG values are affected by several parameters, such as arterial stiffness, resistance, pressure, and blood viscosity ( Aminuddin et al, 2018 ). There are several PPG indexes that have been introduced for the assessment of vascular function, such as stiffness index, reflection index, aging index, and second derivative of PPG ( Allen, 2007 ).…”

Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review

“…The effects of HR towards PPG markers are still inconclusive. Because PPG markers had an association with arterial stiffness, it is speculated that HR may affect PPG markers [45]. The variation of the HR may influence the result of vascular markers and affect cardiovascular risk.…”