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Noninvasive Detection of the Hemodynamic Stress of Exercise Using the Photoplethysmogram

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Abstract

Exercise induced hemodynamic stress has been studied extensively using a wide range of physiological sensors. While athletes can modulate their training intensity using EKG-based heart rate monitors, there are currently no noninvasive monitors that can be used to ascertain with a high degree of certainty the hemodynamic stress an individual is experiencing because of fatigue or an underlying pathology. We propose that cardiac stress will result in detectable changes in skin blood flow. In a clinical trial with eleven healthy subjects performing the Bruce Protocol treadmill test low frequency waves were observed in the blood flow to both the forehead and ear, but not the finger, using photople- thysmographs (PPG) measured by a pulse oximeter. As volitional fatigue approached, the low frequency (f = 0.05–0.2 Hz) amplitude modulation observed in the PPG became more pronounced; then, within several seconds of the cessa- tion of the protocol, they disappeared. Using a software-based detector, these distinct waves are reliably detected, with a low incidence of false positives, in all subjects before the onset of volitional fatigue. We hypothesize that the low frequency waves observed in the PPG of individuals exercising to volitional fatigue provide a mechanism for noninvasively detecting hemodynamic stress to the human vascular system.

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Authors and Affiliations

  1. Intel, One Cambridge Center, Cambridge, MA, 02142, USA

    Stephen Paul Linder PhD

  2. Thayer School and ISTS, Dartmouth College, Hanover, NH, USA

    Suzanne Wendelken MS

  3. Department of Cardiology, Dartmouth Hitchcock Medical Center Hanover, Hanover, NH, USA

    Jeffrey Clayman MD & Paul R. Steiner MD

Authors
  1. Stephen Paul Linder PhD
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  2. Suzanne Wendelken MS
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  3. Jeffrey Clayman MD
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  4. Paul R. Steiner MD
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Corresponding author

Correspondence to Stephen Paul Linder PhD.

Additional information

Linder SP, Wendelken S, Clayman J, Steiner PR. Noninvasive detection of the hemodynamic stress of exercise using the photoplethysmogram.

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Linder, S.P., Wendelken, S., Clayman, J. et al. Noninvasive Detection of the Hemodynamic Stress of Exercise Using the Photoplethysmogram. J Clin Monit Comput 22, 269–278 (2008). https://doi.org/10.1007/s10877-008-9129-9

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  • DOI: https://doi.org/10.1007/s10877-008-9129-9

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