Using the photoplethysmography method to monitor age-related changes in the cardiovascular system.

Introduction: Aging is a physiological process characterized by progressive changes in all organ systems. In the last few decades, the elderly population has been growing, so the scientific community is focusing on the investigation of the aging process, all in order to improve the quality of life in elderly. One of the biggest challenges in studying the impact of the aging on the human body represents the monitoring of the changes that inevitably occur in arterial blood vessels. Therefore, the medical community has invested a great deal of effort in studying and discovering new methods and tools that could be used to monitor the changes in arterial blood vessels caused by the aging process. The goal of our research was to develop a new diagnostic method using a photoplethysmographic sensor and to examine the impact of the aging process on the cardiovascular system in adults. Long-term recorded arterial blood flow waveforms were analyzed using detrended fluctuation analysis. Materials and Methods: The study included 117 respondents, aged 20-70 years. The waveform of the arterial blood flow was recorded for 5 min, with an optical sensor placed above the left common carotid artery, simultaneously with a single-channel ECG. For each cardiac cycle, the blood flow amplitude was determined, and a new time series was formed, which was analyzed non-linearly (DFA method). The values of the scalar coefficients α 1 and α 2, particularly their ratio (α 1/α 2) were obtained, which were then monitored in relation to the age of the subjects. Result: The values of the scalar ratio (α 1/α 2) were significantly different between the subjects older and younger than 50 years. The value of the α 1/α 2 decreased exponentially with the aging. In the population of middle-aged adults, this ratio had a value around 1, in young adults the value was exclusively higher than 1 and in older adults the value was exclusively lower than 1. Conclusion: The results of this study indicated that the aging led to a decrease in the α 1/α 2 in the population of healthy subjects. With this non-invasive method, changes in the cardiovascular system due to aging can be detected and monitored.

Biophysical modeling of wave propagation phenomena: experimental determination of pulse wave velocity in viscous fluid-filled elastic tubes in a gravitation field.

Biophysical understanding of arterial hemodynamics plays an important role in proper medical diagnosis and investigation of cardiovascular disease pathogens. One of the major cardiovascular parameters is pulse wave velocity (PWV), which depends on the mechanical properties of the arterial wall. The PWV contains information on the condition of the cardiovascular system as well as its physiological age. In humans and most animals, blood flow through the blood vessels is affected by several internal and external forces. The most influencing external force on blood flow is gravity. In the upright position of the body, blood moves from heart to head, opposite to gravity, and from the heart to the legs, in direction of the gravitational force. To investigate how gravity affects PWV, we have developed a biophysical model of cardiovascular system that simulates blood flow in the upright position of the body. The paper presents the results of measurement of PWV in an elastic tube filled with fluids of different viscosities in the gravitational field.

An improved design of optical sensor for long-term measurement of arterial blood flow waveform.

We present here the improved design and development of optical sensor for non-invasive measurements of arterial blood flow waveform. The sensor is based on a physical principle of reflective photoplethysmography (PPG). As the light source we used serially connected infrared diodes whereas NPN silicon phototransistors were used as light detectors. The electronic components were molded into square package and poured with silicone. Such preparation produced an elastic superficies that allowed excellent attachment of the sensor on the skin's surface. Moreover, a serial connection of infrared diodes and phototransistors completely eliminated signal artifacts caused by minor muscle contractions. The sensor recording performances were examined at the photoplethysmographic sites on three different arteries; the commune carotid, femoral and radial and, on each site the sensor demonstrated remarkable capability to make a consistent, reproducible measurements. Because of the advantageous physical and electrical properties, the new sensor is suitable for various cardiovascular diagnostics procedures, especially when long-term measurements of arterial blood flow waveform are required, for monitoring of different parameters in cardiovascular units and for research.

Quantification of the acute effect of a low dose of red wine by nonlinear measures of RR and QT interval series in healthy subjects.

The measures of nonlinear properties of RR interval and QT interval time series are sensitive to physiologically- or pathologically-induced complexity/regularity changes, but were not used to estimate the effect of alcohol intake. We wanted to examine the potential of these measures to quantify the acute effect of a low dose of red wine in healthy subjects. In separate experiments, fourteen young volunteers drank 200ml of red wine and a control drink with equal concentration of ethanol. ECG in supine position was recorded 20min before and 60min after drink intake. RR interval and QT interval series were extracted from ECG and we calculated variability, scaling exponents (α1 and α2) and sample entropy (SampEn) for both series. Systolic and diastolic blood pressures (BP) were measured every 10min. The immediate effect of both the drinks was equal: HR, BP and QT variability exhibited a sudden increase and then a decrease. However, the prolonged effect of wine and the control drink was different. Wine decreased both BP (p<0.05) and reduced complexity of RR and QT series (increased scaling exponents and decreased SampEn). The control drink prolonged QT and RR intervals (p<0.05). These results point out that the nonlinear properties of RR and QT interval series could be used to differentiate the effect of wine and ethanol. Changes in RR and QT interval series induced by a low dose of red wine are more detectable by methods that quantify the structure of the series than by methods that quantify their variability.

Contractions of the whole and longitudinally cut rat's portal vein.

To investigate the role of lateral interactions, we quantified spontaneous contractions of whole and longitudinally cut rat´s portal vein in vitro. The disruption of the wall had no effect on basic frequency determined from spectra and complexity index (CI) calculated by multiscale entropy analysis. Endothelium was disrupted and nonfunctional in all samples. Considering amplitude, frequency and CI we identified two modes of contractions. Neither mode of contractions nor the effect of aminopyridine (4-AP) depended on the integrity of the wall. We concluded that contractions in vitro originate in smooth muscle cells without involvement of the endothelium and lateral interactions.

Complexity of heartbeat interval series in young healthy trained and untrained men.

The origin of heart rate variability (HRV) is largely in parasympathetic activity. The direct influence of sympathetic activity and other control mechanisms, especially at an increased HR, is not well understood. The objectives of the study were to investigate the influence of increasing HR on the properties of heartbeat interval (RR) series in young healthy subjects. ECG was recorded in 9 trained and 11 untrained young men during supine rest, standing, incremental running exercise and relaxation. During exercise, a breath-to-breath gas exchange was monitored. The RR time series analysis included the spectral analysis, detrended fluctuations analysis method and sample entropy (SampEn) calculation. During exercise, spectral powers were reduced dramatically in both groups. The dependence of short-term scaling exponent (alpha(1)) on the RR included a characteristic maximum, while SampEn for the same value of the RR had a minimum. The value of HR corresponding to the maximum of alpha(1) and minimum of SampEn (IHR) corresponded to the intrinsic HR obtained by an autonomic blockade. In trained subjects, the curves alpha(1) versus RR and SampEn versus RR were moved toward larger RR, compared with control. For HR values higher than IHR, alpha(1) decreased and SampEn increased. These results reveal that the complexity of the heart rhythm above intrinsic HR decreases with an increase in HR. We suggest that at the highest HR intrinsic heart control is reflected in the heart rhythm. We point out the possibility of developing a new non-invasive method for the determination of intrinsic HR from the curve alpha(1) versus RR.

Linear and non-linear heart rate variability measures in chronic and acute phase of anorexia nervosa.

Previous results on heart rate variability (HRV) analysis in anorexia nervosa (AN) include some apparently conflicting data. In order to find out the reason for different results and to improve understanding of autonomic control in AN we compare HRV in acute and chronic AN. Spectral powers, fractal scaling exponent and sample entropy were computed from 24 h RR series derived from Holter ECG recordings in 17 anorexic patients, nine chronic and eight healthy women. We found that all linear and non-linear HRV measures change in different direction in acute and chronic AN. Acute AN is characterized by decreased HR and increased HRV. In chronic AN, HR is increased, HRV reduced and the difference between awake and sleeping values is high. HRV measures are associated with body mass index only in chronic AN. As HRV measures are significantly different between acute and chronic AN, we propose that HRV analysis might provide additional data in clinical practice.