| Literature DB >> 33924324 |
Xiaoxiao Sun1,2, Liang Zhou1, Shendong Chang3, Zhaohui Liu1.
Abstract
According to the WTO, there were 1.13 billion hypertension patients worldwide in 2015. The WTO encouraged people to check the blood pressure regularly because a large amount of patients do not have any symptoms. However, traditional cuff measurement results are not enough to represent the patient's blood pressure status over a period of time. Therefore, there is an urgent need for portable, easy to operate, continuous measurement, and low-cost blood pressure measuring devices. In this paper, we adopted the convolutional neural network (CNN), based on the Hilbert-Huang Transform (HHT) method, to predict blood pressure (BP) risk level using photoplethysmography (PPG). Considering that the PPG's first and second derivative signals are related to atherosclerosis and vascular elasticity, we created a dataset called PPG+; the images of PPG+ carry information on PPG and its derivatives. We built three classification experiments by collecting 582 data records (the length of each record is 10 s) from the Medical Information Mart for Intensive Care (MIMIC) database: NT (normotension) vs. HT (hypertension), NT vs. PHT (prehypertension), and (NT + PHT) vs. HT; the F1 scores of the PPG + experiments using AlexNet were 98.90%, 85.80%, and 93.54%, respectively. We found that, first, the dataset established by the HHT method performed well in the BP grade prediction experiment. Second, because the Hilbert spectra of the PPG are simple and periodic, AlexNet, which has only 8 layers, got better results. More layers instead increased the cost and difficulty of training.Entities:
Keywords: blood pressure; convolutional neural network; derivatives of PPG; ensemble empirical mode decomposition; photoplethysmography
Year: 2021 PMID: 33924324 PMCID: PMC8070388 DOI: 10.3390/bios11040120
Source DB: PubMed Journal: Biosensors (Basel) ISSN: 2079-6374
Figure 1PPG (photoplethysmography) and its first derivative (PPG′) and second derivative (PPG″). The data comes from the MIMIC database.
Blood pressure classification according to JNC7.
| Classification | Systolic Blood Pressure (mmHg) | Diastolic Blood Pressure (mmHg) | |
|---|---|---|---|
| normotension | <120 | and | <80 |
| prehypertension | 120–139 | or | 80–89 |
| hypertension | >140 | or | >90 |
Figure 2EMD (empirical mode decomposition) processing algorithm. IMF (intrinsic mode function) conditions: (1) In the entire time range, the number of local extreme points and zero points of the function must be the same or differ by one at most. (2) At any point in time, the average value of the envelope of the local maximum of the function (upper envelope) and the envelope of the local minimum (lower envelope) must be zero.
Figure 3Process of processing PPG signal and its derivatives by the HHT (Hilbert–Huang transform) method.
Figure 4HHT spectrograms of three patients in different time periods. (a) PPG signals. (b) HHT spectra of PPG signals. (c) RGB images of PPG and its first and second derivative (PPG+) spectrogram combination. No. 408, No. 230 and No. 224 are the numbers of the patients.
Figure 5PPG signals processing procedure and the classification experiment (AlexNet).
Classification performance of the proposed deep learning method. TPR stands for true positive rate and refers to the sensitivity of the model. TNR is short for true negative rate and refers to the specificity of the model.
| CNN | Layers | Trail | PPG | PPG+ | ||||
|---|---|---|---|---|---|---|---|---|
| F1 Score | TPR | TNR | F1 Score | TPR | TNR | |||
| AlexNet | 8 | NT vs. HT | 96.33% | 94.69% | 97.93% | 98.90% | 99.27% | 98.31% |
| NT vs. PHT | 80.35% | 78.98% | 84.08% | 85.80% | 95.26% | 71.88% | ||
| (NT + PHT) vs. HT | 90.79% | 90.39% | 91.36% | 93.54% | 95.32% | 91.74% | ||
| ResNet18 | 18 | NT vs. HT | 93.94% | 94.51% | 93.17% | 94.09% | 95.36% | 92.33% |
| NT vs. PHT | 82.34% | 82.85% | 82.89% | 84.37% | 84.51% | 84.59% | ||
| (NT + PHT) vs. HT | 87.35% | 90.06% | 84.62% | 88.52% | 88.87% | 88.92% | ||
| GoogLeNet | 22 | NT vs. HT | 89.48% | 88.79% | 90.61% | 89.24% | 90.19% | 88.26% |
| NT vs. PHT | 78.05% | 77.73% | 79.95% | 80.03% | 80.79% | 77.47% | ||
| (NT + PHT) vs. HT | 84.04% | 81.51% | 88.30% | 83.46% | 83.76% | 83.14% | ||
| ResNet34 | 34 | NT vs. HT | 93.04% | 93.04% | 93.41% | 94.01% | 93.85% | 94.26% |
| NT vs. PHT | 81.33% | 81.75% | 82.75% | 84.77% | 83.71% | 86.34% | ||
| (NT + PHT) vs. HT | 86.76% | 88.00% | 83.23% | 88.39% | 87.15% | 90.19% | ||
Figure 6The ROC (receiver operating characteristic) curve of the three classification trials of AlexNet.
Figure 7The diagram of epoch and accuracy (referred to as acc in the figure) of the NT vs. HT (a), NT + PHT vs. HT (b) and NT vs. PHT (c) in AlexNet.
Comparison with well-established related work in terms of data source, feature, signal processing, and method.
| Author | Data Source | Feature | Signal Process | Method |
|---|---|---|---|---|
| Slapničar et al. [ | MIMIC | PPG, PPG′, PPG″ | Spectro-temporal | ResNet |
| Liang et al. [ | MIMIC | PPG | CWT | GoogLeNet |
| Our work | MIMIC | PPG, PPG′, PPG″ | EEMD | AlexNet |