Evaluation of Pulse Wave Velocity by

Photoplethysmography and
Electrocardiogram

(PWV)

i
 ABSTRACT

Under the environment with developments of new technologies, modern medicine

keeps advancing. Traditional concept of medical treatment is change gradually from
cure after sick happen to pre-examination or pre-protection. Many researchers believe
that prior evaluations of sick reasons and take early care can reduce dangers and
possible complications. Pulse wave velocity (PWV) was correlated well with the degree
of arteriosclerosis, and PWV can be one of parameters during clinical evaluation of
arteriosclerosis. The study proposes a PWV measurement system that it can measure
simultaneously the PWV, which form heart to four extremities by the location of
electrocardiogram. The differences of the PWV, which from heart to four extremities,
were observed and the comparisons of correlations were tested. Besides, the PWV were
compared with the PWV, which from different sites (finger and toe). The differences of
two evaluated PWV methods were also assessed. To improve the precision of measured
value, the system with high sample rate during long-term measurement. The study
expected to provide more complete method for evaluation of PWV, and to understand
the differences between different measure methods.

ii


iii


................................................................................................................................... i

ABSTRACT......................................................................................................................ii

.................................................................................................................................iii

................................................................................................................................. iv

............................................................................................................................. vi

............................................................................................................................vii

.................................................................................................................... 1
1.1 ............................................................................................ 3
1.2 ............................................................................ 5
1.3 .................................................................................................... 7
1.4 .................................................................................................... 8

............................................................................................ 9
2.1 ............................................................................................. 10
2.1.1 ...................................................................... 10
2.1.2 ............................................................................... 13
2.1.3 ............................................................... 15
2.2 .......................................................................................... 17
2.2.1 ............................................................................... 17
2.2.2 ....................................................................... 18

.......................................................................... 21
3.1 .............................................................................. 22
3.2 .......................................................................... 27
3.3 .............................................................................................. 28

iv
 3.4 .......................................................................................... 32
3.5 ................................................................................................. 35

.............................................................................................. 40
4.1 .................................................................................................. 40
4.2 .................................................................................................. 42

.................................................................................................................. 45

........................................................................................................................ 47

2.1 ..18
3.1 ..37
3.2 A/D .37
3.3 ..37
3.4 A/D .38
4.1 ..42
4.2 ..43
4.3 / PWV ..44

vi


1.1 ..2
1.2 ..3
1.3 ..5
1.4 ..6
2.1 ..9
2.2 .11
2.3 .12
2.4 .....13
2.5 .14
2.6 .....16
2.7 .18
2.8 .19
2.9 .20
3.1 .21
3.2 .22
3.3 OPA 24
3.4 .....25
3.5 .25
3.6 .26
3.7 .....26
3.8 .27
3.9 .28
3.10 MSP430x14x ..29
3.11 MSP430 ADC12 .30
3.12 MSP430 UART ...31
vii
 3.13 MSP430 ...32
3.14 ..33
3.15 ..34
3.16 ..35
3.17 ..36
3.18 ..36
3.19 ..38
3.20 ..39
4.1 ..40
4.2 (1).....41
4.3 (2).....41

viii


24

(
)

93
9.62% 9.55%

30.00

25.00


20.00


15.00

(%)
10.00

5.00

0.00

1.1 ()

2
1.1

65

1.2
3


4
1.2

(Invasive)(Noninvasive)
(Fiberoptic
angioscope)(Intravascular ultrasound, IVUS)

1.3
(www.medixtra.de/info/ medical/illustration.htm, www.sakakibara-hp.com/ menu_n_nagare/m_cath/IVUS/,
www.chinaneuro.com/ educate/case_lsmpic1.asp, www.koranyi.iif.hu/MKT/CH/0103/5.html )

(Pulse wave velocity, PWV)

1.4
(www.med.kindai.ac.jp/ rounai/pwv1.htm, www8.ocn.ne.jp/ ~koto-hp/Ln01.html,
www.micromedical.co.uk/products/pulsetracepca.asp )

6
1.3

PWV
1989
Masahiko Okada

PWV
PWV

1997 David S. Charles Martin D. Fox

R
2001 M.
Maguire T. Ward
2002
Akimitsu Harada Takashi Okada

2004

SphygmoCor Vx 0.9 2005

7
1.4

2004

2005

2.1
(http://info.med.yale.edu/intmed/cardio/echo_atlas/references/heart_anatomy.html)

9
2.1

20 3000
( 10000 ) 6 ( 10 )

2.1.1

(Electrocardiogram, ECG)

-90mV -90mV

-60mV
20mV

10
-90mV

2.2
(http://medlib.med.utah.edu/kw/ecg/index.html)

2.2 1.(Sinoatrial Node. SA

Node) 2. 3.(Atrioventricular Node. AV Node) 4.(His
Bundle) 5. 6.(Purkinje Fiber System)
60~100

11
(Bachmanns Bundle)

2.3

2.3

2.3 ()

()
()

12
2.1.2

2.4

2.4

P P-R QRS ST
T 2.5

13
 2.5
(http://medlib.med.utah.edu/kw/ecg/index.html)

P QRS T
P

QRS

14
2.1.3

(Willen Einthoven, 1860~1927))

(Einthoven) EMF(Electromotive Force)

(Bipolar limb Leads)

Lead ILead II Lead III

1.Lead I = LA RA
2.Lead II = LF RA
3.Lead III = LF LA
LA = Lift Arm RA = Right Arm LF = Lift Foot

EMF Wilson Golberger

(Augmented unipolar limb leads)

aVRaVLaVF

1.aVR = RA ( LA + LL ) / 2
2.aVL = LA ( RA + LL ) / 2
3.aVF = LL ( RA + LA) / 2

15

Lead I
Lead II
Lead III
aVRaVL aVF
2.6

Lead I Lead II Lead III

RA LA RA LA RA LA

_ _ _
+ + +
RL LL RL LL RL LL

Bipolar limb Leads

aVR aVL aVF

RA LA RA LA RA LA

_ _ _
+ + +
RL LL RL LL RL LL

Augmented unipolar limb Leads

2.6

16
2.2

2.2.1

()
()

(
)

()

,,

7-9

17
 2.7

2.2.2

5L 8%

7.5

120

2.1

400-450106/ul()
450-550106/ul()
4,000-10,000/ul

150-400103/ul

18


(HbO2)

(The Beers Law)

2.8

Io I

I = I o e ( ) cd
(
)
c
d

19


(Photoplethysmography, PPG)

2.8

2.9

20


3.1

3.1

()

21
3.1

(Texas Instruments
Incorporated) MSP430F149 (A/D)
RS232

3.2

3.2

22


(mV)

Lead ILead IILead IIIaVRaVLaVF

(mV)
60Hz

V+ + V
Vo = Ad (V+ V ) + Acm ( )
2
Ad Acm
60Hz
60Hz
Ad Acm
(CMRR)

23
 Ad
CMRR = 20 log
Acm

CMRR 3.3 OPA

3.3 OPA

3.4
ECG

3.4

3.5

24
 EMG

ECG

EEG

EOG

0.1 1 10 100 1000 10000 Hz

3.4 (EMGECGEEGEOG)

3.5
f OL f OH

1 1
f OL = f OH =
2R 2C1 2R6C 2

25


3.6

3.6

AC 110V/220V 60Hz
AC 110V
60Hz 60Hz

60Hz 60Hz

3.7

3.7
26
3.2

MSP430F149 (A/D)

3.8

3.8

MSP430F149

MSP430F149 A/D
3.9

27
 3.9

3.3

MCU A/D MCU
MSP430F149 12bit A/D MCU
MSP430F149 A/D ECG
RS232 ECG
MCU MSP430F149
MSP430
A/D UART Flash ROM

MSP430
MSP430
MSP430
16-Bits RISC 16-Bit integrated
6ms
MSP430F14x 16bit timer 12bit A/D
converter (USART) 48 I/O

28
 3.10 MSP430x14x

MSP430 12Bits A/D

Sample Rate 200kbps

AVCC
VREF+ 1.5V
2.5V VeREF+

16 A/D

29
 3.11 MSP430 ADC12

A/D
MSP430F149
MSP430
UART RS232

(UART)
BYTE
bit bit 8 bit
bit bit 8 bit
BYTE MAP430 UART UART0
UART1
(1) 7 or 8 bit data(2)(3)

ACLK 32768Hz 2400bps 32768/2400=13.68

000Dh UBR1 00hUBR2
0Dh UART 2400bps MSP430 UART
30
 3.12 MSP430 UART

31
 MSP430 MSP430 RS232

3.14 MSP430

3.4

MCU MSP430

PWV

32
 (Microsoft) Visual
BasicVisual Basic

3.15

A/D CH1
Lead II CH2 CH5

33
 StartStop
TestEndTest

Test

PWV MATLABMATLAB
3.16

3.16

34
3.5

(Agilent Technologies)(Agilent 33250A)
MATLAB A/D

3.17

35
 3.18

3.19
36


1.2Hz 1mV MSP430MSP430
RS232 MATLAB

A/D RS232 VB

3.1

A/D CH1 CH2 CH3 CH4 CH5

1.2Hz 1.1999Hz 1.1997Hz 1.1997Hz 1.1997Hz 1.1997Hz
1mV 0.0231 0.0152 0.0069 0.0136 0.0064

3 216
A/D
0.025% A/D CH1

3.2 A/D
A/D CH2-CH1 CH3-CH1 CH4-CH1 CH5-CH1

1.3953 1.0558 0.8791 0.8465

13.3601 11.7456 12.8745 11.6282

1 1KHz
1ms 1.2Hz 1mV

3.3

A/D CH1 CH2 CH3 CH4 CH5

1.2Hz 1.1997Hz 1.1997Hz 1.1997Hz 1.1997Hz 1.1997Hz
1mV 0.0007 0.0007 0.0007 0.0007 0.0007

37

0.025% 0.007 A/D

3.4 A/D
A/D CH2-CH1 CH3-CH1 CH4-CH1 CH5-CH1

-0.0047 0.1302 -0.0140 -0.0233

0.0682 0.3766 0.1522 0.1511

A/D

Agilent 33250A

3.20
38


3.27

39


4.1

10
5
Welch Allyn Atlas (621S-E1, Welch
Allyn, USA) 5

4.1

40
 4.2

4.3

30 6 24
21 27
6
PWV
41
4.2

30 MATLAB 5

5 3

R
R Welch Allyn Atlas
5
4.1 (/)

001 002 003 004 005 006

78.9 62.4 95.1 68.1 67.1 69.3
(HR)
4.9 4.8 3.9 3.4 4.0 1.8
Welch Allyn Atlas
78.4 61.6 93.8 69.8 63.2 69.2
(HR)

007 008 009 010 011 012

63.7 57.8 86.4 65.1 98.2 79.3
(HR)
2.9 5.1 4.6 3.5 3.7 7.0
Welch Allyn Atlas
63.8 57.2 84.2 62.8 101.6 76.6
(HR)

013 014 015 016 017 018

83.4 73.9 66.4 73.5 61.7 60.4
(HR)
4.0 2.4 2.8 2.9 1.8 2.5
Welch Allyn Atlas
88.2 77.4 68.2 73.8 64.6 59.2
(HR)

42
 019 020 021 022 023 024

87.5 78.6 71.2 70.8 61.0 73.4
(HR)
3.4 2.5 3.8 3.7 2.8 3.9
Welch Allyn Atlas
90.4 77.6 70.8 79 59.4 71.2
(HR)

025 026 027 028 029 030

79.4 79.7 80.7 70.6 89.8 71.1
(HR)
5.1 4.5 3.6 2.8 5.6 4.6
Welch Allyn Atlas
74.6 79 75.8 70 81.2 65.6
(HR)

Welch Allyn Atlas

1 2
022 8

3~4

PWV
MATLAB
6 PWV (
)
PWV
4.2 (/)

rhfPWV 4.6 lhtPWV 5.3

0.1 0.1
rhtPWV 5.2 rftPWV 6.7
0.1 0.4
lhfPWV 4.6 lftPWV 7.1
0.1 0.5
* r: right l: left h: heart f: finger t: toe
43
 HR(74.13.8 /) PWV

QRS /
HR/PWV (time
event)

PWV
(lhfPWV=4.6 m/s, rhfPWV=4.6 m/s, lhtPWV=5.3 m/s, rhtPWV=5.2 m/s
v.s. lftPWV=7.1 m/s, rftPWV=6.7 m/s) PWV
QRS complex Q peak
PWV
PWV /
PWV ()

4.3 / PWV
lhfPWV rhfPWV lhtPWV rhtPWV lftPWV rftPWV
0.663* 0.609* 0.734* 0.684* 0.464* 0.475*
0.564* 0.606* 0.659* 0.616* 0.461* 0.346
* p<0.05

PWV (lftPWV v.s. rftPWV)

(correlation=.765; p=0.000) paired samples test
PWV (p=0.008)(lhfPWV v.s. rhfPWV)
(correlation=.945; p=0.000) paired samples test
PWV (p=0.116)(lhtPWV v.s. rhtPWV)
(correlation=.959; p=0.000) paired samples test
PWV (p=0.112)
PWV
PWV

44


(
)

PWV
3 2

30

PWV
rhfPWV rhtPWV lhfPWV lhtPWV PWV
PWV

PWV

rhfPWVrhtPWVlhfPWVlhtPWV
rftPWVlftPWV
PWV

45


PWV PWV
6~8(m/s) PWV
PWV

PWV 10(m/s) 4(m/s)

R
PWV
QRS

PWV

46


1. Masahiko Okada, Mihoko Okada and Minoru Yakata, Evaluation of Arterial Pulse
Wave Velocity on The Basis of Multivariate Analysis, Proceedings of the Annual
International Conference of the IEEE Engineering, Page(s):136-137 vol.1, 1989
2. David S. Charles and Martin D. Fox, Pulse Wave Velocity for Cardiovascular
Characterization, Proceedings of the IEEE 1997 23rd Northeast, Page(s):77-78,
1997
3. Gerfried Gratze, Jurgen Fortin, Albert Holler, Karin Grasenick, Gert Pfurtscheller,
Paul Wach, Josef Schonegger, Peter Kotanko, Falko Skrabal, A Software Package
for Non-invasive, Real-time Beat-to-beat Monitoring of Stroke Volume, Blood
pressure, Total Peripheral Resistance and for Assessment of Autonomic Function,
Computers in Biology and Medicine 28 121-142, 1998
4. Shu-Mei Wu, Yio-Wha Shau, Bor-Shyh Lin, Fok-Ching Chong, Effects of
Mechanical Pumping on The Arterial Pulse Wave Velocity : Peripheral Artery and
Micro-Vessels, Proceedings of the 23rd Annual EMBS International Conference,
Oct. 2001
5. M. Maguire, T. Ward, C. Markham, D. OShea and L. Kevin, A Comparative
Study in The Use of Brachial Photoplethysmography and The QRS Complex as
Timing References in Determination of Pulse Transmit Time, Proceeding of the
23rd Annual EMBS International Conference, Page(s):215-218 vol.1, 2001
6. Yuxing Yang, Dongyuan Yin, Richard Freyer, Development of A Digital Signal
Processor-based New 12-lead Synchronization electrocardiogram automatic analysis
system, Computer Methods and Programs in Biomedicine 69 57-63, 2002
7. Yung-Kang Chen, Hsien-Tsai Wu, Chih-Kai Chi, Wei-Chuan Tsai, Ju-Yi Chen and
Ming-Chun Wang, A New Dual Channel Pulse Wave Velocity Measurement
System, Bioinformatics and Bioengineering, 2004. BIBE 2004. Proceedings.
Fourth IEEE Symposium, Page(s):17-21, 2004
8. Hsien-Tsai Wu, Chin-Shan Ho, Ji-Shiang Weng, Wei-Chuan Tsai, Ming-Chen
Wang, A Novel Method for Measurement of Pulse Wave Velocity by Dual-channel
Photoplethysmography, Biomedical Circuits and Systems, 2004 IEEE International
Workshop, Page(s):S2/6 - 8-10, 2004
47
9.
93
10.
93
11.
94
12.
94
13. 87
14. 87
15. Thomas L. Floyd,David Buchla ,
88
16. 16 MSP430
92

48