학술논문

Lower Limb Pulse Rise Time as a Marker of Peripheral Arterial Disease
Document Type
Periodical
Source
IEEE Transactions on Biomedical Engineering IEEE Trans. Biomed. Eng. Biomedical Engineering, IEEE Transactions on. 66(9):2596-2603 Sep, 2019
Subject
Bioengineering
Computing and Processing
Components, Circuits, Devices and Systems
Communication, Networking and Broadcast Technologies
Biomedical measurement
Diseases
Indexes
Surgery
Arteries
Hospitals
Semiconductor device measurement
Atherosclerosis
photoplethysmography
peripheral arterial disease
pulse rise time
pulse wave measurements
Language
ISSN
0018-9294
1558-2531
Abstract
Objective: The aim of the study was to show if pulse rise times (PRTs) extracted from photoplethysmographic (PPG) pulse waves (PWs) have an association with peripheral arterial disease (PAD) or its endovascular treatment, percutanoeus transluminal angioplasty (PTA) of the superficial femoral artery. Methods: Lower and upper limb PPG PWs were recorded and analyzed from 24 patients who suffered from PAD. The measurements were conducted before and after the treatment, and one month later by using transmission-mode PPG-probes placed in the index finger and second toe. Ankle-to-brachial pressure index and toe pressures were used as references in clinical patient measurements. PRTs, i.e., the time from the foot point to the peak point of the PW, were extracted from the PWs and compared bilaterally. The results from the PAD patients were also compared with 31 same-aged and 34 younger control subjects. Results: Statistically significant differences were found between the pretreatment PRTs of the treated limb of the PAD patients and the same-aged control subjects ($p< 10^{-9}$, Mann–Whitney U-test). The changes in the PRT of the treated lower limb were observed immediately after the PTA ($p< 0.001$, Student's t -test), and after one month ($p< 0.0005$), whereas the PRTs of the non-treated lower limb and upper limb did not indicate changes between different examinations. Conclusion: Results show that a PRT greater than 240 ms indicates PAD-lesions in the lower limb. Significance: This proof-of-concept study suggests that the PRT could be an effective and easy-to-use indicator for PAD and monitoring the effectiveness of its treatment.