Sharif Digital Repository

Flow mediated dilation (FMD) is a non-invasive method for endothelial function assessment providing an index extracted from ultrasonic B-mode images. Although utilized in the research community, the difficulty of its application and high cost of ultrasonic devices prevent it from being widely used in clinical settings. In this study we show that substituting the ultrasonic device with more easily handled and low cost photoplethysmography and electrocardiography is possible. We introduce new indices based on the photoplethysmogram (PPG) and electrocardiogram (ECG) and show that they are correlated with the ultrasound-based FMD Index. To this end, a conventional ultrasound FMD test was carried... 

Non-invasive measurement of flow-mediated dilation (FMD) in the brachial artery for assessing endothelial function is costly and operator-dependent, limiting its application to research cases. In this paper, an approach based on a physiological model between normalized central blood pressure and finger photoplethysmogram is presented. Baseline model parameters are estimated using a genetic algorithm in 30 subjects consisting of ten normal blood pressure (BP), ten high-BP and ten elderly volunteers. Beat-to-beat fitness values after reactive hyperaemia are calculated using baseline (before cuff occlusion) data. Results show that stimulus-induced changes are fairly described with a first order... 

Flow mediated dilation (FMD) measurement using ultrasound imaging (FMD-US) has been established as a standard method for assessing the endothelial function. Recently, a less skilled-operator demanding method has been proposed based on the photoplethysmogram (PPG) changes during reactive hyperemia. It was shown that the amplitude of the PPG pulse (FMD-PPG) changed in a quite similar manner to that of the artery diameter in the method of the FMD-US i.e. increases following releasing the cuff and then gradually returns to baseline. In this study PPG changes following reactive hyperaemia were modelled using time-varying passive electrical elements (R, L and C). The output of the electric analog... 

Endothelial dysfunction assessment has received considerable attention due to its potential in early screening of cardiovascular diseases. Since the seminal work by Celermajer in flow-mediated dilation (FMD) based on B-mode ultrasound measurement of the brachial artery dilation following limb ischemia, many attempts have been made toward applying this method to clinical, non-invasive endothelial dysfunction assessment. One major obstacle toward achieving this objective has been the relative high cost of the required setup and skilled manpower. Such limitations have prompted the investigation of other non-invasively accessible signals such as the photoplethysmogram (PPG) in relation to FMD.... 

Dyslipidemia is considered to be one of the main heart risk factors, affecting the endothelial vascular function, which can be non-invasively investigated by ultrasound flow-mediated dilation (US-FMD). However, US-FMD comes at a high-cost and is operator-dependent. In this paper, the effect of dyslipidemia on the photoplethysmogram (PPG) signal recorded from collateral index fingers is investigated following a previous study where it was shown that results similar to that of US-FMD can be replicated by the PPG. Two groups, consisting of 30 healthy subjects free from any risk factors and 30 subjects who have only dyslipidemia as risk factor were respectively considered. The percent change in... 

Noninvasive measurement of brachial artery (BA) flow mediated dilation (FMD), commonly measured by high resolution ultrasonography, has provided a non-invasive means for the evaluation of endothelial function. Recently, another technique based on finger photopletysmogram (PPG) analysis has been proposed by the authors. In this paper, simultaneous measurement of BA FMD and PPG signals data from 86 human subjects (43 healthy and 43 risk) is analyzed and a statistical model is proposed to estimate the BA FMD based on PPG signals, the BA diameter at baseline as well as other demographics factors such as age and gender. Linear regression by multivariate analysis was conducted to obtain the... 

Flow-mediated dilation measurement in the brachial artery using ultrasound imaging (FMD-US) is a common noninvasive procedure for endothelial function evaluation in the peripheral arteries. As FMD-US is operator-dependent and involves onerous equipment, its use has been mostly confined to research settings. In this paper, we propose to use the more accessible finger photoplethysmogram signal in conjunction with the FMD test (FMD-PPG) as a surrogate method. To this end, a tube-load physiological model of the upper arterial path in the arm is developed. Signals acquired from young and elderly subjects (N=20) are then investigated using model parameter estimation by the genetic algorithm. Our... 

Atherosclerosis is a major cause of coronary artery disease leading to morbidity and mortality worldwide. Currently, coronary angiography is considered to be the most accurate technique to diagnose coronary artery disease (CAD). However, this technique is an invasive and expensive procedure with risks of serious complications. Since the symptoms of CAD are not noticed until advanced stages of the disease, early and effective diagnosis of CAD is considered a pertinent measure. In this paper, a non-invasive optical signal, the finger photoplethysmogram (PPG) obtained before and after reactive hyperemia is investigated to discriminate between subjects with different CAD conditions. To this end,...