City Research Online

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

Mejía-Mejía, E. ORCID: 0000-0002-5357-4329, May, J.M. ORCID: 0000-0002-8659-756X, Elgendi, Mohamed and Kyriacou, P. A. ORCID: 0000-0002-2868-485X (2021). Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients.. npj Digital Medicine, 4, 82.. doi: 10.1038/s41746-021-00447-y


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.

Publication Type: Article
Additional Information: This article has been published in npj Digital Medicine, Nature Research (DOI: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.
Subjects: R Medicine > RC Internal medicine
Departments: School of Mathematics, Computer Science & Engineering > Engineering > Electrical & Electronic Engineering
Date available in CRO: 26 May 2021 13:11
Date deposited: 26 May 2021
Date of acceptance: 16 March 2021
Date of first online publication: 14 May 2021
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

Download (1MB) | Preview



Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login