Effects of Percutaneous Transluminal Angioplasty of Superficial Femoral Artery on Photoplethysmographic Pulse Transit Times
We analyze the changes in upper and lower limb pulse transit times (PTT) caused by peripheral artery disease (PAD) and its treatment with percutaneous transluminal angioplasty (PTA) of the superficial femoral artery. PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finge...
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creator | Peltokangas, Mikko Suominen, Velipekka Vakhitov, Damir Korhonen, Janne Verho, Jarmo Mattila, Ville M. Romsi, Pekka Lekkala, Jukka Vehkaoja, Antti Oksala, Niku |
description | We analyze the changes in upper and lower limb pulse transit times (PTT) caused by peripheral artery disease (PAD) and its treatment with percutaneous transluminal angioplasty (PTA) of the superficial femoral artery. PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finger and 2nd toes. PTTs were defined between the R-peaks of the ECG and different reference points of the PPG: foot and peak points, maxima of 1st and 2nd derivative, and by means of intersecting tangents method. Also the PTTs between the toe and finger pulses were analyzed. Our sample consists of 24 subjects examined before and after the PTA and in 1-month follow-up visit. Also 28 older than 65 years controls having normal ankle-to-brachial pressure index (ABI) and no history in cardiovascular diseases as well as 21 younger subjects were examined. The differences between the groups and pre- and post-treatment phases were analyzed by means of non-parametric statistical tests. The changes in the PTTs of upper limb and non-treated lower limb were negligible. The agreement with the reference values, ABI and toe pressures, was studied by kappa-analysis, resulting in kappa-values of 0.33-0.91. Differences in PTTs were found between pre-treatment state of the treated limb, post-treatment state and the follow-up visit, as well as between the pre-treatment state and controls. If patients' age and systolic blood pressure were taken into consideration, the method of lower limb PTT calculation from the peak point turns out feasible in finding the markers of PAD and monitoring post-treatment vascular remodellation. |
doi_str_mv | 10.1109/JBHI.2018.2851388 |
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PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finger and 2nd toes. PTTs were defined between the R-peaks of the ECG and different reference points of the PPG: foot and peak points, maxima of 1st and 2nd derivative, and by means of intersecting tangents method. Also the PTTs between the toe and finger pulses were analyzed. Our sample consists of 24 subjects examined before and after the PTA and in 1-month follow-up visit. Also 28 older than 65 years controls having normal ankle-to-brachial pressure index (ABI) and no history in cardiovascular diseases as well as 21 younger subjects were examined. The differences between the groups and pre- and post-treatment phases were analyzed by means of non-parametric statistical tests. The changes in the PTTs of upper limb and non-treated lower limb were negligible. The agreement with the reference values, ABI and toe pressures, was studied by kappa-analysis, resulting in kappa-values of 0.33-0.91. Differences in PTTs were found between pre-treatment state of the treated limb, post-treatment state and the follow-up visit, as well as between the pre-treatment state and controls. If patients' age and systolic blood pressure were taken into consideration, the method of lower limb PTT calculation from the peak point turns out feasible in finding the markers of PAD and monitoring post-treatment vascular remodellation.</description><identifier>ISSN: 2168-2194</identifier><identifier>EISSN: 2168-2208</identifier><identifier>DOI: 10.1109/JBHI.2018.2851388</identifier><identifier>PMID: 29994622</identifier><identifier>CODEN: IJBHA9</identifier><language>eng</language><publisher>United States: IEEE</publisher><subject>Adult ; Aged ; Angioplasty ; Ankle ; Arteries ; Atherosclerosis ; Blood pressure ; Cardiovascular diseases ; Electrocardiography ; Female ; Femoral artery ; Femoral Artery - surgery ; Femur ; Fingers - blood supply ; Fingers - physiology ; Foot ; Heart diseases ; Hospitals ; Humans ; Indexes ; Male ; Medical treatment ; Middle Aged ; Peripheral Arterial Disease - surgery ; Peripheral artery disease ; Photoplethysmography ; Photoplethysmography - methods ; Photoplethysmography - statistics & numerical data ; Pulse Wave Analysis - methods ; Pulse Wave Analysis - statistics & numerical data ; Pulse wave measurements ; Signal Processing, Computer-Assisted ; Statistical analysis ; Statistical tests ; Surgery ; Tangents ; Toes - blood supply ; Toes - physiology ; Transit time ; Vascular diseases</subject><ispartof>IEEE journal of biomedical and health informatics, 2019-05, Vol.23 (3), p.1058-1065</ispartof><rights>Copyright The Institute of Electrical and Electronics Engineers, Inc. (IEEE) 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-23de3261f43c57b81417430d08066c9e6f7b221e9d0e3ebfea61e9133f37bd533</citedby><cites>FETCH-LOGICAL-c392t-23de3261f43c57b81417430d08066c9e6f7b221e9d0e3ebfea61e9133f37bd533</cites><orcidid>0000-0003-3721-3467 ; 0000-0002-6624-0926 ; 0000-0001-5336-3719</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://ieeexplore.ieee.org/document/8399495$$EHTML$$P50$$Gieee$$H</linktohtml><link.rule.ids>314,776,780,792,27901,27902,54733</link.rule.ids><linktorsrc>$$Uhttps://ieeexplore.ieee.org/document/8399495$$EView_record_in_IEEE$$FView_record_in_$$GIEEE</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29994622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peltokangas, Mikko</creatorcontrib><creatorcontrib>Suominen, Velipekka</creatorcontrib><creatorcontrib>Vakhitov, Damir</creatorcontrib><creatorcontrib>Korhonen, Janne</creatorcontrib><creatorcontrib>Verho, Jarmo</creatorcontrib><creatorcontrib>Mattila, Ville M.</creatorcontrib><creatorcontrib>Romsi, Pekka</creatorcontrib><creatorcontrib>Lekkala, Jukka</creatorcontrib><creatorcontrib>Vehkaoja, Antti</creatorcontrib><creatorcontrib>Oksala, Niku</creatorcontrib><title>Effects of Percutaneous Transluminal Angioplasty of Superficial Femoral Artery on Photoplethysmographic Pulse Transit Times</title><title>IEEE journal of biomedical and health informatics</title><addtitle>JBHI</addtitle><addtitle>IEEE J Biomed Health Inform</addtitle><description>We analyze the changes in upper and lower limb pulse transit times (PTT) caused by peripheral artery disease (PAD) and its treatment with percutaneous transluminal angioplasty (PTA) of the superficial femoral artery. PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finger and 2nd toes. PTTs were defined between the R-peaks of the ECG and different reference points of the PPG: foot and peak points, maxima of 1st and 2nd derivative, and by means of intersecting tangents method. Also the PTTs between the toe and finger pulses were analyzed. Our sample consists of 24 subjects examined before and after the PTA and in 1-month follow-up visit. Also 28 older than 65 years controls having normal ankle-to-brachial pressure index (ABI) and no history in cardiovascular diseases as well as 21 younger subjects were examined. The differences between the groups and pre- and post-treatment phases were analyzed by means of non-parametric statistical tests. The changes in the PTTs of upper limb and non-treated lower limb were negligible. The agreement with the reference values, ABI and toe pressures, was studied by kappa-analysis, resulting in kappa-values of 0.33-0.91. Differences in PTTs were found between pre-treatment state of the treated limb, post-treatment state and the follow-up visit, as well as between the pre-treatment state and controls. If patients' age and systolic blood pressure were taken into consideration, the method of lower limb PTT calculation from the peak point turns out feasible in finding the markers of PAD and monitoring post-treatment vascular remodellation.</description><subject>Adult</subject><subject>Aged</subject><subject>Angioplasty</subject><subject>Ankle</subject><subject>Arteries</subject><subject>Atherosclerosis</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Femoral artery</subject><subject>Femoral Artery - surgery</subject><subject>Femur</subject><subject>Fingers - blood supply</subject><subject>Fingers - physiology</subject><subject>Foot</subject><subject>Heart diseases</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Indexes</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Peripheral Arterial Disease - surgery</subject><subject>Peripheral artery disease</subject><subject>Photoplethysmography</subject><subject>Photoplethysmography - methods</subject><subject>Photoplethysmography - statistics & numerical data</subject><subject>Pulse Wave Analysis - methods</subject><subject>Pulse Wave Analysis - statistics & numerical data</subject><subject>Pulse wave measurements</subject><subject>Signal Processing, Computer-Assisted</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Surgery</subject><subject>Tangents</subject><subject>Toes - blood supply</subject><subject>Toes - physiology</subject><subject>Transit time</subject><subject>Vascular diseases</subject><issn>2168-2194</issn><issn>2168-2208</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RIE</sourceid><sourceid>EIF</sourceid><recordid>eNpdkU9r3DAQxUVpacI2H6AUiqGXXHYjabyydExC_hLIQrZnY8ujrIJtOZJ8WPLlI-NNDtFF0rzfPKF5hPxmdMUYVWf3F7d3K06ZXHG5ZiDlN3LMmZBLzqn8_nFmKj8iJyG80LRkKinxkxxxpVQuOD8mb1fGoI4hcybboNdjrHp0Y8i2vupDO3a2r9rsvH-2bmirEPcT-DQO6I3VNknX2Dk_IT6iT2qfbXYuJhjjbh869-yrYWd1thnbgLOrjdnWdhh-kR-mStWTw74g_6-vtpe3y4fHm7vL84elBsXjkkODwAUzOeh1UUuWsyIH2lBJhdAKhSlqzhmqhiJgbbAS6cIADBR1swZYkNPZd_DudcQQy84GjW07f7XkVEgAqdIUF-TfF_TFjT6NIFFprqDWIItEsZnS3oXg0ZSDt13l9yWj5RROOYVTTuGUh3BSz9-D81h32Hx2fESRgD8zYBHxU5aQ5PTqO4H-lCA</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Peltokangas, Mikko</creator><creator>Suominen, Velipekka</creator><creator>Vakhitov, Damir</creator><creator>Korhonen, Janne</creator><creator>Verho, Jarmo</creator><creator>Mattila, Ville M.</creator><creator>Romsi, Pekka</creator><creator>Lekkala, Jukka</creator><creator>Vehkaoja, Antti</creator><creator>Oksala, Niku</creator><general>IEEE</general><general>The Institute of Electrical and Electronics Engineers, Inc. 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Academic</collection><jtitle>IEEE journal of biomedical and health informatics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Peltokangas, Mikko</au><au>Suominen, Velipekka</au><au>Vakhitov, Damir</au><au>Korhonen, Janne</au><au>Verho, Jarmo</au><au>Mattila, Ville M.</au><au>Romsi, Pekka</au><au>Lekkala, Jukka</au><au>Vehkaoja, Antti</au><au>Oksala, Niku</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Percutaneous Transluminal Angioplasty of Superficial Femoral Artery on Photoplethysmographic Pulse Transit Times</atitle><jtitle>IEEE journal of biomedical and health informatics</jtitle><stitle>JBHI</stitle><addtitle>IEEE J Biomed Health Inform</addtitle><date>2019-05</date><risdate>2019</risdate><volume>23</volume><issue>3</issue><spage>1058</spage><epage>1065</epage><pages>1058-1065</pages><issn>2168-2194</issn><eissn>2168-2208</eissn><coden>IJBHA9</coden><abstract>We analyze the changes in upper and lower limb pulse transit times (PTT) caused by peripheral artery disease (PAD) and its treatment with percutaneous transluminal angioplasty (PTA) of the superficial femoral artery. PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finger and 2nd toes. PTTs were defined between the R-peaks of the ECG and different reference points of the PPG: foot and peak points, maxima of 1st and 2nd derivative, and by means of intersecting tangents method. Also the PTTs between the toe and finger pulses were analyzed. Our sample consists of 24 subjects examined before and after the PTA and in 1-month follow-up visit. Also 28 older than 65 years controls having normal ankle-to-brachial pressure index (ABI) and no history in cardiovascular diseases as well as 21 younger subjects were examined. The differences between the groups and pre- and post-treatment phases were analyzed by means of non-parametric statistical tests. The changes in the PTTs of upper limb and non-treated lower limb were negligible. The agreement with the reference values, ABI and toe pressures, was studied by kappa-analysis, resulting in kappa-values of 0.33-0.91. Differences in PTTs were found between pre-treatment state of the treated limb, post-treatment state and the follow-up visit, as well as between the pre-treatment state and controls. If patients' age and systolic blood pressure were taken into consideration, the method of lower limb PTT calculation from the peak point turns out feasible in finding the markers of PAD and monitoring post-treatment vascular remodellation.</abstract><cop>United States</cop><pub>IEEE</pub><pmid>29994622</pmid><doi>10.1109/JBHI.2018.2851388</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3721-3467</orcidid><orcidid>https://orcid.org/0000-0002-6624-0926</orcidid><orcidid>https://orcid.org/0000-0001-5336-3719</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Angioplasty Ankle Arteries Atherosclerosis Blood pressure Cardiovascular diseases Electrocardiography Female Femoral artery Femoral Artery - surgery Femur Fingers - blood supply Fingers - physiology Foot Heart diseases Hospitals Humans Indexes Male Medical treatment Middle Aged Peripheral Arterial Disease - surgery Peripheral artery disease Photoplethysmography Photoplethysmography - methods Photoplethysmography - statistics & numerical data Pulse Wave Analysis - methods Pulse Wave Analysis - statistics & numerical data Pulse wave measurements Signal Processing, Computer-Assisted Statistical analysis Statistical tests Surgery Tangents Toes - blood supply Toes - physiology Transit time Vascular diseases |
title | Effects of Percutaneous Transluminal Angioplasty of Superficial Femoral Artery on Photoplethysmographic Pulse Transit Times |
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