Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Sep 8, 2021
Date Accepted: Dec 19, 2021
Vascular Aging Estimation based on Artificial Neural Network Using Photoplethysmogram Waveform Decomposition
ABSTRACT
Background:
For the non-invasive assessment of arterial stiffness, a well-known indicator of arterial aging, various features based on the photoplethysmogram and regression methods have been proposed. However, whether because of the existing characteristics not accurately reflecting the characteristics of the incident and reflected waveforms of the photoplethysmogram, or because of the lack of expressive power of the regression model, a reliable arterial stiffness assessment technique based on a single photoplethysmogram has not yet been proposed.
Objective:
The purpose of this study is to discover highly correlated features from the incident and reflected waves decomposed from a photoplethysmogram waveform, and to develop an artificial neural network-based regression model for the assessment of vascular aging using newly derived features.
Methods:
We obtained photoplethysmogram from 757 participants. All recorded photoplethysmograms were segmented for each beat, and each waveform was decomposed into incident and reflected waves by Gaussian mixture model. The 26 basic features and 52 combined features were defined from the morphological characteristics of the incident and reflected waves. The regression model of artificial neural network was developed using the defined features.
Results:
In correlation analysis, the features from the amplitude of the reflected wave and the skewness of the photoplethysmogram showed relatively strong correlation with the participant’s real age. In the estimation of real age, the artificial neural network model showed 10.0 years of root mean square error (RMSE). Its estimated age and real age had a strong correlation of 0.63 (p-value <0.01).
Conclusions:
This study proved that the features defined from the reflected wave and skewness of the photoplethysmogram are useful to assess vascular aging. Moreover, the regression model of artificial neural network using these features shows the feasibility for the estimation of vascular aging. Clinical Trial: Data acquisition was conducted after obtaining approval from the Asan Medical Center (Seoul Republic of Korea) Research Ethics Committee (IRB No.2015-0104).
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