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首页> 外文期刊>International Journal of General Medicine >The spectral analysis of photoplethysmography to evaluate an independent cardiovascular risk factor
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The spectral analysis of photoplethysmography to evaluate an independent cardiovascular risk factor

机译：光体积描记术的光谱分析以评估独立的心血管危险因素

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Background: In this study, we evaluate homeostatic markers correlated to autonomic nervous and endothelial functions in a population of coronary artery disease (CAD) patients versus a control group. Since CAD is the highest risk marker for sudden cardiac death, the study objective is to determine whether an independent cardiovascular risk score based on these markers can be used alongside known conventional cardiovascular risk markers to strengthen the understanding of a patient's vascular state.Materials and methods: Sixty-five subjects (13 women) with a mean age of 62.9 years (range 40–80 years) who were diagnosed with CAD using coronary angiography (group 1) and seventy-two subjects (29 women) with a mean age of 45.1 years (range 18–85 years) who claimed they were healthy (group 2) were included in the study. These subjects underwent examination with the TM-Oxi and SudoPath systems at IPC Heart Care Centers in Mumbai, India. The TM-Oxi system takes measurements from a blood pressure device and a pulse oximeter. The SudoPath measures galvanic skin response to assess the sudomotor pathway function. Spectral analysis of the photoplethysmograph (PTG) waveform and electrochemical galvanic skin response allow the TM-Oxi and SudoPath systems to calculate several homeostatic markers, such as the PTG index (PTGi), PTG very low frequency index (PTGVLFi), and PTG ratio (PTGr). The focus of this study was to evaluate these markers (PTGi, PTGVLFi, and PTGr) in CAD patients against a control group, and to calculate an independent cardiovascular risk factor score: the PTG cardiovascular disease risk score (PTG CVD), calculated solely from these markers. We compared PTGi, PTGVLFi, PTGr, and PTG CVD scores between the CAD patient group and the healthy control group. Statistical analyses were performed using receiver operating characteristic curves to determine the specificity and sensitivity of the markers to detect CAD at optimal cutoff values for PTGi, PTGVLFi, PTGr, and PTG CVD. In addition, correlation analyses between these markers and conventional autonomic nervous system and endothelial function markers were performed to understand the possible underlying physiological sources of the differences observed in marker values between CAD patients and healthy control patients. Additionally, t-tests were performed between two subgroups of the CAD patient group to determine whether diabetic or coronary artery bypass grafting (CABG) patients have significantly different PTGi marker values.Results: Each spectral analysis PTG marker yielded a high specificity and sensitivity to detect CAD. Most notably, the PTG CVD score had a sensitivity of 82.5% and specificity of 96.8%, at a cutoff of 2, when used to detect CAD (P=0.0001; area under the receiver operating characteristic curve =0.967). The PTG spectral analysis markers were well-correlated to other autonomic nervous system and endothelial function markers. CAD diabetic patients (n=27) had a lower PTGi value compared with the CAD non-diabetic patients (n=38): and patients that underwent CABG (n=18) had a higher PTGi value compared with the CAD without CABG surgery patients (n=47).Conclusion: The spectral analysis of the photoplethysmography method is noninvasive, fast, operator-independent, and cost-effective, as only an oximeter and galvanic skin response device are required in order to assess in a single testing the autonomic nervous system and endothelial function. The spectral analysis techniques used on the photoplethysmogram, as outlined in this study, could be useful when used alongside conventional known cardiovascular disease risk markers.
机译：背景：在这项研究中，我们评估了与对照组相比在冠心病（CAD）患者人群中与自主神经和内皮功能相关的稳态指标。由于CAD是导致心脏猝死的最高风险标志物，因此本研究的目的是确定是否可以将基于这些标志物的独立心血管疾病危险评分与已知的常规心血管疾病危险标志物一起使用，以加深对患者血管状态的了解。 ：65例平均年龄为62.9岁（40-80岁）的受试者（13名女性）通过冠状动脉造影被诊断为CAD（第1组），而72例受试者（29名女性）的平均年龄为45.1声称自己健康的年龄（18-85岁）（第2组）纳入研究。这些受试者在印度孟买的IPC心脏保健中心接受了TM-Oxi和SudoPath系统的检查。 TM-Oxi系统从血压仪和脉搏血氧仪进行测量。 SudoPath测量皮肤电反应以评估sudomotor通路功能。光电容积描记器（PTG）波形的光谱分析和电化学电流皮肤响应使TM-Oxi和SudoPath系统可以计算几种稳态标记，例如PTG指数（PTGi），PTG极低频指数（PTGVLFi）和PTG比率（ PTGr）。这项研究的重点是针对对照组评估CAD患者中的这些标志物（PTGi，PTGVLFi和PTGr），并计算独立的心血管危险因素评分：PTG心血管疾病危险评分（PTG CVD），仅根据这些标记。我们比较了CAD患者组和健康对照组之间的PTGi，PTGVLFi，PTGr和PTG CVD评分。使用接收器工作特征曲线进行统计分析，以确定标记物的特异性和敏感性，以在PTGi，PTGVLFi，PTGr和PTG CVD的最佳临界值下检测CAD。另外，进行了这些标记物与常规自主神经系统和内皮功能标记物之间的相关性分析，以了解在CAD患者和健康对照患者之间观察到的标记物值差异的可能的潜在生理来源。此外，在CAD患者组的两个亚组之间进行了t检验，以确定糖尿病或冠状动脉搭桥术（CABG）患者的PTGi标记值是否存在显着差异。结果：每种光谱分析PTG标记均具有很高的特异性和检测敏感性CAD。最值得注意的是，当用于检测CAD时，PTG CVD评分的敏感度为82.5％，特异性为96.8％（截止值为2）（P = 0.0001;接收器工作特性曲线下的面积= 0.967）。 PTG光谱分析标记与其他自主神经系统和内皮功能标记密切相关。与没有糖尿病的CAD患者相比，CAD糖尿病患者（n = 27）的PTGi值较低：与没有CABG手术的CAD患者相比，接受CABG的患者（n = 18）的PTGi值较高。 （n = 47）。结论：光体积描记法的光谱分析是无创，快速，独立于操作者且具有成本效益的，因为仅需使用血氧饱和度计和皮肤电反应仪即可在一次测试中评估自主神经神经系统和内皮功能。如本研究所述，在光电容积描记图上使用的光谱分析技术与常规的已知心血管疾病风险标记物一起使用时可能会很有用。

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