Left Ventricular Ejection Time Estimation from Blood Pressure and Photoplethysmography Signals Based on Tidal Wave

Featured Application Left ventricular ejection time estimation by analyzing the morphology of arterial blood pressure and photoplethysmography signal.Abstract Left ventricular ejection time (LVET) is an important parameter for assessing cardiovascular disorders. In a medical office, it is typically measured using the Tissue Doppler Imaging technique, but new wearable devices have led to a growing interest in integrating this parameter into them, increasing accessibility to personalized healthcare for users and patients. In the cardiovascular domain, photoplethysmography (PPG) is a promising technology that shares two distinctive features with invasive arterial blood pressure (ABP) tracing: the tidal wave (TDW) and the dicrotic wave (DCW). In the early years of cardiovascular research, the duration of the dicrotic point was initially linked to the ending phase of left ventricular ejection. Subsequent studies reported deviations from the initial association, suggesting that the ejection period is related to the tidal wave feature. In this current study, we measured left ventricular ejection time in both ABP and PPG waveforms, considering recent research results. A total of 27,000 cardiac cycles were analyzed for both afore-mentioned signals. The reference value for ejection time was computed based on the T-wave segment duration from the electrocardiogram waveform. In lower blood pressure, which is associated with decreased heart contractility, the results indicated an underestimation of -29 +/- 19 ms in ABP and an overestimation of 18 +/- 31 ms in PPG. On the other side of the spectrum, during increased contractility, the minimum errors were -3 +/- 18 ms and 4 +/- 33 ms, respectively. Since the tidal wave feature is strongly affected by arterial tree compliance, the population evaluation results indicate a Pearson's correlation factor of 0.58 in the ABP case, and 0.53 in PPG. These findings highlight the need for advanced compensation techniques, in particular for PPG assessment, to achieve clinical-grade accuracy.