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Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: A review from VascAgeNet

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Paliakaite, Birute 
Pilt, Kristjan 
Bachler, Martin 
Zanelli, Serena 


The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular ageing, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarises research into assessing vascular age from the PPG. Three categories of approaches are described: (i) those which use a single PPG signal (based on pulse wave analysis); (ii) those which use multiple PPG signals (such as pulse transit time measurement); and (iii) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realise the full potential of photoplethysmography for assessing vascular age.



ageing, arterial stiffness, arteriosclerosis, atherosclerosis, blood pressure, distensibility, photoplethysmography, pulse arrival time, pulse transit time, pulse wave, pulse wave velocity, signal processing, vascular ageing

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American Journal of Physiology: Heart and Circulatory Physiology

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American Physiological Society
British Heart Foundation (FS/20/20/34626)
This paper is based upon work from COST ACTION "Network for Research in Vascular Ageing" CA18216 supported by COST (European Cooperation in Science and Technology). The work was supported in part by British Heart Foundation (BHF) grants PG/15/104/31913 and FS/20/20/34626, in part by the European Regional Development Fund (project No. 01.2.2-LMT-K-718-01-0030) under grant agreement with the Research Council of Lithuania, in part by the Estonian Ministry of Education and Research under personal post-doctoral research funding PUTJD815, and in part by the Serbian Ministry of Education, Science and Technological Development Grants 32040 and 41022.

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