Arterial stiffness is a reliable prognostic parameter for cardiovascular diseases. The effect of change in arterial stiffness can be measured by the change of the pulse wave velocity (PWV). The Complior system is widely used to measure PWV between the carotid and radial arteries by means of piezoelectric clips placed around the neck and the wrist. The Biopac system is an easier to use alternative that uses ECG and simple optical sensors to measure the PWV between the heart and the fingertips, and thus extends a bit more to the peripheral vasculature compared to the Complior system. The goal of this study was to test under various conditions to what extent these systems provide comparable and correlating values. 25 Healthy volunteers, 20–30 years old, were measured in four sequential position: sitting, lying, standing and sitting. The results showed that the Biopac system measured consistently and significantly lower PWV values than the Complior system, for all positions. Correlation values and Bland–Altman plots showed that despite the difference in PWV magnitudes obtained by the two systems the measurements did agree well. Which implies that as long as the differences in PWV magnitudes are taken into account, either system could be used to measure PWV changes over time. However, when basing diagnosis on absolute PWV values, one should be very much aware of how the PWV was measured and with what system.

Objective: The speed of pressure pulses traveling through the blood, the pulse wave velocity (PWV), is a metric that provides substantial information about the passive and active elasticity of the blood vessels. Therefore, PWV is a valuable parameter in the diagnosis of cardiovascular and vessel-related neurological diseases. The purpose of this study was to investigate whether a novel, simple, easy-to-use, photoplethysmography-based Multi Photodiode Array (MPA) provides PWV measurements that agree with measurements done with more complicated and harder-to-use systems currently used in clinical practice. Methods: An often-used vascular perturbation that changes the conduit artery vasomotor tone during reactive hyperemia was imposed on thirty healthy volunteers. The MPA was used alongside and its results compared to those of a commonly used measurement device, the Biopac-system, during flow-mediated dilation (FMD). This way it was investigated if measurements with these systems, measuring over two different, but partly overlapping vessel trajectories agree. Results: The baseline absolute PWV values were significantly lower for the MPA as compared to the Biopac-system. Additionally, Bland-Altman plots and Pearson's correlation tests suggested good agreement between the two PWV measurement techniques during the FMD. Conclusion: Measuring PWV with the MPA in clinical practice is feasible and provides reliable data. Significance: The MPA may substantially simplify PWV measurements and may enable long-term PWV monitoring as long as one is aware of the relation between PWV and the vascular trajectory over which it is measured.

The multiphotodiode array (MPA) is a novel transmission photoplethysmography (PPG) sensor to measure pulse wave velocity (PWV) in the finger. To validate the MPA, a setup was built to generate a red laser dot traveling over the MPA with known and constant scanning velocities. These scanning velocities were chosen to include speeds at least twice as high as those found in the normal range of PWV in healthy populations and were set at 12.9, 25.8, 36, or 46.7 m/s. The aim of this study was to verify the functionality of the MPA: performing local noninvasive PWV measurements. To illustrate the applicability of the MPA in clinical practice, an in vivo pilot study was conducted using the flow-mediated dilation (FMD) technique. The in vitro accuracy of the MPA was ±0.2%, 0.3%, 0.5%, and 0.6% at the applied scanning velocities. The MPA can measure PWVs with a maximum deviation of 3.0%. The in vivo pilot study showed a PWV before the FMD of 1.1±0.2 m/s. These results suggest that this novel MPA can reliably and accurately measure PWV within clinically relevant ranges and even well beyond.

Photoplethysmography (PPG) is a widely available non-invasive optical technique to visualize pressure pulse waves (PWs). Pulse transit time (PTT) is a physiological parameter that is often derived from calculations on ECG and PPG signals and is based on tightly defined characteristics of the PW shape. PPG signals are sensitive to artefacts. Coughing or movement of the subject can affect PW shapes that much that the PWs become unsuitable for further analysis. The aim of this study was to develop an algorithm that automatically and objectively eliminates unsuitable PWs. In order to develop a proper algorithm for eliminating unsuitable PWs, a literature study was conducted. Next, a ‘7Step PW-Filter’ algorithm was developed that applies seven criteria to determine whether a PW matches the characteristics required to allow PTT calculation. To validate whether the ‘7Step PW-Filter’ eliminates only and all unsuitable PWs, its elimination results were compared to the outcome of manual elimination of unsuitable PWs. The ‘7Step PW-Filter’ had a sensitivity of 96.3% and a specificity of 99.3%. The overall accuracy of the ‘7Step PW-Filter’ for detection of unsuitable PWs was 99.3%. Compared to manual elimination, using the ‘7Step PW-Filter’ reduces PW elimination times from hours to minutes and helps to increase the validity, reliability and reproducibility of PTT data.