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STUDYINGTHEBLOODFLOWSIGNALUSINGPHOTOPLETHYSMOGRAPHY
AlekseevV.A.,HamdanS.,YuranS.I.

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Thereareseveralmethodsforstudyingcardiovascularsystem,asultrasound,impedanceplethysmography,electrocardiographandphotoplethysmography,inthis
studywedevelopedmethodphotoplethysmography,thatithasasmallvalium,itiseasytobuildandtheoutputsignaldoesnteffectinthegravitation.The
photoplethysmography(PPG)hasusedforhartratemeterandoximetry.PPGhasdevelopedtobeusedforearlycardiovasculardiagnostics.
Asensorunitfornoninvasivedetectionandanalysisofthepulsatingbloodflowwaveformsbymeansofthereflectivesingleperiodphotoplethysmography(SPPPG)
techniquehasbeendesignedandclinicallytested.ThesensorisoperatedjointlywithanystandardPC,byconnectingthesensorheadtotheADcardandusinga
separateharddiscwiththesignalprocessingsoftwareallcircuitsarefeededbythePCpowersupply.Afterprocessing,normalizedshapeofthemeanSPPPGsignal
anditsparametersarecalculatedanddisplayedthemeasurement/processingtimedoesnotexceed2minutes.TheclinicallydetectedSPPPGsignalshapesand
correspondingparametersarepresentedanddiscussed.Thepreliminaryresultsconfirmgoodpotentialofthissensingapproachforfastandpatientfriendlyearly
cardiovasculardiagnostics.
1.INTRODUCTION
Photoplethysmography(PPG)isanoninvasivemethodforstudiesofthebloodvolumepulsationsbydetectionandtemporalanalysisofthetissuescatteredabsorbed
opticalradiation.Bloodpumpingandtransportatdifferentbodylocationsfingertip,earlobe,forehead,forearm,etc.aremonitoredwithsimpleandconvenientPPG
contactsensors.
Whenthetissueisilluminatedbyvisibleornearinfraredradiation,heartbeatperiodchangesinthetransmittedandscatteredopticalsignallevelscanberecordedby
meansofthephotoplethysmographic(PPG)sensors[1](seeFig.1).ThePPGsignalsareoriginatedbyabsorptionofopticalradiationbythepulsatingbloodvolume,
thereforetheycontainclinicallyvaluableinformationonthebloodpumpingandtransportconditionsinlivingbody.

Fig.1.PlacementofopticalDevices
AnumberoftransmissiontypefingerandearlobePPGdevicesformonitoringofheartbeatrateandtissuebloodsupplyhavebeendesignedandroutinelyused.
AdvanceddesignsofthebackscatteringorreflectiontypePPGsensors[2]areofincreasedinteresttoday,mainlythankstothetheirclinicallymoreconvenientone
touchoperationmode.However,thereflectedPPGsignalsareweakerandthereforemorenoisy,thanthetransmittedones.
FullandclearclinicalinterpretationofallcomponentsofthePPGsignalsisstillproblematic.Qualitatively,onecanassumethattheinitialpartofthedetectedheartbeat
signal(raisingfrontandsystolicpeak)mainlyreflectstheheartconditionandactivity,whilethefollowingpartofapulseisgenerallydeterminedbyelasticityandother
featuresofthevascularsystem(seeFig.2).

Fig.2.PPGsignal
PPGsignalsarenotstrictlyrepeatingandperiodical,thereareslightfluctuationsofthesignalamplitude,baselineandperiod[3].Consequently,thefluctuationstake
placerelativelytosomevirtuallystablemeansingleperiodPPG(SPPPG)signal.ThismeansignalcanbeidentifiedbyaveraginganumberofsequentPPGpulsesover
atimeintervallongerthan50seconds(whichisthelongestfluctuationperiod[3]).InourprojectdevelopedtechniqueofthereflectedPPGsignalaccumulationand

integratedprocessingmadepossibletodetectandanalyzethemeanSPPPGsignalswithfairlygoodaccuracyandquality[4,5].Followinginitialresults,themean
SPPPGsignalshapeappearstobeaveryindividualfeatureforeachmonitoredpersonqualitativedifferencesinsignalshapesforhealthyindividualscomparedtothose
forpersonswithcardiovasculardisorderswereobserved.Obviously,theSPPPGsignalshapecontainscertaincodedinformationregardingthecardiovascularstateof
thepatient,andadetailedshapeanalysiseventuallymightprovideclinicaldataforearlycardiovasculardiagnosticsinfuture.Tocheckthisopportunityinclinical
environmentforlargernumberofpatients,morespecificsensordesignandsignalprocessingtechniquehadtobedeveloped.Thispaperdescribesthedesignandsignal
processingconceptsofdevelopedPPGsensoraswellassomeresultsofclinicaltrialscarriedoutwiththisdevice.
2.DESIGNOFTHEUNIT
Thebasicdesignoftheunitisrelativelysimple.Itconsistsofopticalcontactprobe,biosignalamplifying/filteringcircuit(bothpoweredbyarechargeablebattery)anda
laptopcomputerwithspeciallydevelopedsoftwareforADconversion,storage,processinganddisplayofthePPGsignals.Allequipmentisplacedinahandheldcase
.TheadvancedSPPPGsensorisintendedforclinicaluseinconjunctionwithanystandardPC.Threebasicmodulesareneededforitsoperationthesensorhead
(fingertipprobewithamplifier),standardADcardandastandardharddisk(preferablyseparate)withthesignalprocessingsoftwareandspaceforstorageoftherecorded
data.FeedingofallelectroniccircuitsisprovidedbythePSpowersupply(seeFig.3).

TissueContactprobeAmplifierADcardHarddiscMonitor
Fig.3.BlockdiagramoftheopticalPPGsensorunit
BlockdiagramofthedeviceispresentedonFig.3.ThefingercontactprobesensorheadcomprisesacontinuouslyemittingdiodeLED(GaAs,lmax~940nm)
integratedwithaphotodiodePD(Si,1cm2activearea)seeFig.3andapreamplifierchipPA.ThepreamplifiedPDoutputsignalwaspassedviaaflexiblecabletothe
broadbandamplifierandfurthertotheADcardinput.Onlytheaccomponentofthephotodiodeoutputsignalwasamplifiedandfurtherprocessedtheamplifierprovided
about400foldmagnification.Followingresultsofrecentstudy[4],frequencyfilteringoftheremittedPPGsignalsmaycausetheirshapedeformations,thereforesignals
ofallfrequencieswereamplifiedandpassedtoinputofthe12byteADcard.

Fig.4.ThePPGcontactprobe
TheLEDandphotodiodeofthefingertipprobeweredownorientedduringthemeasurements,andadditionalcalibratedloadwasappliedtoprovideequalpressureforce
(0.65N)tothefingertipskinforallmonitoredpatients.Thecontactprobewasplacedwithinaverticalcylindricalcapsule,whichservedsimultaneouslyasafingerholder,
externallightshieldandslidingguidefortheopticalprobe.The3rd(middle)fingerofleftarmwasmainlyusedforthePPGsignalrecording,andthepatientswerekeptin
horizontalposition(lyingontheirback)duringthemeasurements.
3.THESIGNALPROCESSING
Thesignalprocessingsoftwarewasstoredonaseparateharddisk,whichservedforoperationofthesensordeviceandforstorageofthemeasuredandcalculateddata.
ThealgorithmforintegrationandaveragingofthedetectedPPGsignals[4]wasupdatedfollowingourrecentexperience,andaserviceprogramwasadded.Atthe
beginningofeachtrial,awindowforenteringthemonitoredpatientdata(name,age,pathology,etc.)wasopened.Thenameasurementwindowwithinstructions
appeared,andafterproperplacingofthefingertipprobethemeasurementswerestarted.Thedatawererecordedfor6080seconds,thenthewholePPGsignalwas
storedintheHDmemoryandprocessed.
AspecialalgorithmcalculatedthemeannormalizedSPPPGsignalforthemonitoredpersonandthecorrespondingsignalshapeparameters(maxims,minims,amplitude
ratios,integralarea,etc.).Heartbeatrateandarrhythmiacouldbecalculated,aswell.AllthesedataappearedonthePCmonitorwithinlessthan5seconds,sothetime
necessaryforthewholeprocedurenormallydidnotexceedtwominutes.
4.THESOFTWAREPROGRAMING
SpecialsoftwarewasdevelopedforthePPGbiosignalacquisition,processinganddatastorage,offeringthefollowingoptions[56]:
Fillingthefirstwindowforpatientdataname,age,gender,complains,doctorscomments,etc.
Presettingofthemeasurementtimeschedule
ThePPGsignalregistrationanddisplayinrealtime
Signalcleanup(specialfilteringalgorithm)andcalculationofthemeansingleperiodPPG(SPPPG)signalshape
Calculationofspecificcardiovascularparametersfortheregisteredsignalsheartbeatrate,anacrotarisetime,timedelayandrelativeamplitudeofthesecondary
peak(dycroticnotch),etc.
DisplayofthecorrespondingPPGparametersetwithsubsequentcardiovascularassessmentresults
Storageofthemeasurement/assessmentdata.

5.THEPPGCONTACTPROBE
TheoptoelectroniccontactprobecontinuouslyemitsradiationintotheunderskintissueswithbloodvesselsanddetectstheACcomponentofthebackscattered
radiationthatreflectsthebloodvolumepulsations.

ab
Fig.4.ThePPGcontactprobe(a)anditsapplicationforthefingertipmonitoring(b)
TheprobecomprisesaGaAsemittingdiode(diameteroftheemittingarea~2mm,power~10mW,peakwavelength~940nm),andaSiphotodiodewithsquare
detectionarea~5x5mm).BothdiodesarecloselymountedonasoftplasticpillowandfixedontothemeasurementsitebymeansofastickybandseeFig.4,b.The
bandlengthisadjustedtothefingertipmeasurements(Fig.4,a)however,thebandeasilycanbeextendedbysparebands,ifnecessary,soprovidingpossibilitytotake
PPGmeasurementsfromdifferentlocationsofthebody,forehead,neck,forearm,knee(Fig.5).

Fig.5.ApplicationofthePPGcontactprobeatforehead,neck,forearmandknee
6.THEMEASUREMENTRESULTS:
SOMEEXAMPLES
Thedevelopedbiosensorunithadundergoneseveraltests,andsomeinterestingclinicalresultswereobtainedtheywillbepresentedanddiscussedbelow.Mostof
thesemeasurementsweretakenfromthemiddlefingertipofthelefthand.
Weobservedandrecordedseveralabnormalitiesofheartfunction,includingpartialortotallackofoneheartbeatinthecardiacsequence(seefig.6).Typically,thenext
heartbeatafterthemissingoneismoreintensivethanothersinthesequence,soobviouslytheheartisautocompensatingtheshorttermlackofbloodpumping.The
monitoredpersonsdidnotfeelanydiscomfortduringthemissingheartbeat.Thisphenomenonwasrecordedseveraltimes,sotherewaslittledoubtthatbothpersons
hadtroublewithheartfunctioning,andtheywererecommendedtovisitcardiologistforfurtherinvestigations.
Consequently,thePPGsensorunitappearedhelpfulforearlywarningofcardiovasculardysfunction,soitseemstohavegoodpotentialforprimarycardiovascular
assessmentandearlyscreeningoftheriskpatientgroupsinfuture.

ab
Fig.6.Theobservedheartbeatirregularitiesfortwomonitoredpersons
7.SUMMARY
AsmallsizeportablePPGsensordevice(44329cm,4,1kg,batterypowered)isdesigned,constructedandtested.
Thecontactprobedesignprovidesreliablepulsatingbloodflowmeasurementsatdifferentsitesofthebody.
SeveralinterestingclinicalconditionshavebeenrecordedwiththedevicebytemporalanalysisofthePPGsignalsheartbeatirregularities,arrhythmicand
spasmaticresponsestointensivephysicalexercises,rightlefthandfingertipbloodflowdifferences,etc.
ShapesofmeanSPPPGsignalsrecordedatvariouslocationsofthebodycontainvaluablecardiovascularinformation.
Theproposedapproachandsensordesignprovedtobesuitableforfastprimarycardiovascularassessmentandearlyscreening.
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AlekseevV.A.,HamdanS.,YuranS.I.STUDYINGTHEBLOODFLOWSIGNALUSINGPHOTOPLETHYSMOGRAPHY//.
2005.6.5559
URL:www.rae.ru/use/?section=content&op=show_article&article_id=7782153(:22.10.2015).

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