Very Short-Term Photoplethysmography-Based Heart Rate Variability for Continuous Autoregulation Assessment

Featured Application A signal processing combination of instantaneous pulse rate variability and time shift multiscale entropy for autoregulation assessment was proposed. Background: Heart rate variability (HRV) has been widely applied for disease diagnosis. However, the 5 min signal length for HRV analysis is needed. Method: A signal processing procedure for very short-term photoplethysmography (PPG) signal for fever detection and autoregulation assessment was proposed. The Time-Shift Multiscale Entropy Analysis (TSME) was applied to instantaneous pulse rate time series (iPR) and normalized by the cumulative distribution function (CDF) of all scales to calculate novel indices. A total of 33 subjects were recruited for the study. Fifteen participants whose body temperatures were higher than 37.9 degrees C were served as the fever group. Others were served as the non-fever group. The total 15 s PPG signal with 200 sampling rates was used for iPR calculation. Result: The CDF value of entropy on the scale k = 19 (CDF(E(k = 19))) of iPR had the lowest p-value calculated by the Weltch t-test between two groups (p < 0.001). The Spearman correlation r between CDF(E(k = 19)) and body temperature is -0.757, 0.287, and -0.830 in all subjects, the non-fever group and the Fever group, respectively. The area under the curve, calculated from the receiver operating characteristic of CDF(E(k = 19)) of iPR is 0.915. Conclusion: The entropy of iPR is useful for detecting fever. Moreover, a short-term PPG signal is suitable to develop real-time applications, and multiscale entropy provides different scales of information for daily healthcare.