Photoplethysmographic waveform characteristics of newborns with coarctation of the aorta.
Fetal echocardiography, physical examination and pulse oximetry detect only half of coarctation of aorta (CoA) cases. We aimed to quantify delayed arrival and diminished amplitude of lower extremity photoplethysmographic (PPG) pulses relative to the right hand in affected patients.



We studied 8 CoA infants and 32 healthy controls. The pulse arrival time difference between foot and hand (f-hTD) and pulse amplitude ratio (F/H) were measured on PPG signal waveforms by digitally-determining maxima and minima of systolic decrease of light transmission. Mann-Whitney test was used for group comparisons.



In comparison to healthy newborns, CoA infants' PPG waveforms demonstrated prolonged f-hTD (mean±s.d. of 73.2±26.6 versus 35.2±8.3 ms, P<0.001) and lower F/H (0.57±0.26 versus 0.99±0.58, P=0.014).



F-hTD and F/H are quantifiable from hand- and foot-derived PPG waveforms and are significantly different in CoA versus healthy newborns. Larger studies are needed to validate PPG for improved critical congenital heart disease screening.
Department of Pediatrics, Cohen Children's Medical Center of New York/Northwell Health System, New Hyde Park, NY, USA.|Hofstra Northwell School of Medicine, Hempstead, NY, USA.
L
L
Palmeri
Department of Applied Physics/Electro-Optics, Lev Academic Center-Jerusalem College of Technology, Jerusalem, Israel.
G
G
Gradwohl
Department of Applied Physics/Electro-Optics, Lev Academic Center-Jerusalem College of Technology, Jerusalem, Israel.
M
M
Nitzan
Department of Applied Physics/Electro-Optics, Lev Academic Center-Jerusalem College of Technology, Jerusalem, Israel.
E
E
Hoffman
Department of Applied Physics/Electro-Optics, Lev Academic Center-Jerusalem College of Technology, Jerusalem, Israel.
Y
Y
Adar
Department of Pediatrics, Cohen Children's Medical Center of New York/Northwell Health System, New Hyde Park, NY, USA.|Hofstra Northwell School of Medicine, Hempstead, NY, USA.
Y
Y
Shapir
Department of Pediatrics, Cohen Children's Medical Center of New York/Northwell Health System, New Hyde Park, NY, USA.|Hofstra Northwell School of Medicine, Hempstead, NY, USA.
R
R
Koppel
D001017:Aortic Coarctation / Q000175:diagnosis* / Q000503:physiopathology*; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D010092:Oximetry; D017156:Photoplethysmography; D000075082:Proof of Concept Study
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