Paperdoi:10.1038/s41746-021-00447-y

Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients

Venue listed2021Added Nov 5, 2026

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Authors: Elisa Mejía-Mejía, James M. May, Mohamed Elgendi, Panayiotis A. Kyriacou

npj Digital Medicine

TL;DR

Heart rate variability (HRV) utilizes the electrocardiogram (ECG) and has been widely studied as a non-invasive indicator of cardiac autonomic activity. Pulse rate variability (PRV) utilizes photoplethysmography (PPG) and recently has been used as a surrogate for HRV. Several studies have found that PRV is not entirely valid as an estimation of HRV and that several physiological factors, including the pulse transit time (PTT) and blood pressure (BP) changes, may affect PRV differently than HRV.

Abstract

Heart rate variability (HRV) utilizes the electrocardiogram (ECG) and has been widely studied as a non-invasive indicator of cardiac autonomic activity. Pulse rate variability (PRV) utilizes photoplethysmography (PPG) and recently has been used as a surrogate for HRV. Several studies have found that PRV is not entirely valid as an estimation of HRV and that several physiological factors, including the pulse transit time (PTT) and blood pressure (BP) changes, may affect PRV differently than HRV. This study aimed to assess the relationship between PRV and HRV under different BP states: hypotension, normotension, and hypertension. Using the MIMIC III database, 5 min segments of PPG and ECG signals were used to extract PRV and HRV, respectively. Several time-domain, frequency-domain, and nonlinear indices were obtained from these signals. Bland–Altman analysis, correlation analysis, and Friedman rank sum tests were used to compare HRV and PRV in each state, and PRV and HRV indices were compared among BP states using Kruskal–Wallis tests. The findings indicated that there were differences between PRV and HRV, especially in short-term and nonlinear indices, and although PRV and HRV were altered in a similar manner when there was a change in BP, PRV seemed to be more sensitive to these changes.

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Tasks & signals

Tasks

Blood pressure

Signals

Keywords

Kyriacou BibliographyBlood Pressure Vascular Health

How it works

How Method works: Setup → Method → TargetSetup: Signals (PPG). Method: Method. Target: Blood pressure.SetupSignals: PPGSignalsPPGMethodMethodTargetBlood pressureBlood pressure

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Mejía-Mejía, E., May, J. M., Elgendi, M., & Kyriacou, P. A. (2021). Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients. npj Digital Medicine. https://doi.org/10.1038/s41746-021-00447-y
Mejía-Mejía, Elisa, James M. May, Mohamed Elgendi, and Panayiotis A. Kyriacou. 2021. "Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients." npj Digital Medicine. https://doi.org/10.1038/s41746-021-00447-y.
Mejía-Mejía, E., May, J. M., Elgendi, M. and Kyriacou, P. A. (2021) 'Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients', npj Digital Medicine. doi: 10.1038/s41746-021-00447-y.
Mejía-Mejía, Elisa, et al. "Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients." npj Digital Medicine, 2021. https://doi.org/10.1038/s41746-021-00447-y.
E. Mejía-Mejía, J. M. May, M. Elgendi, and P. A. Kyriacou, "Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients," npj Digital Medicine, 2021, doi: 10.1038/s41746-021-00447-y.
@article{mejiamejia2021differential,
  title         = {{Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients}},
  author        = {Mejía-Mejía, Elisa and May, James M. and Elgendi, Mohamed and Kyriacou, Panayiotis A.},
  year          = {2021},
  journal       = {npj Digital Medicine},
  doi           = {10.1038/s41746-021-00447-y}
}

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