ENDOTHELIAL CELL DISFUNCTION ASSESMENT BY REACTIVE HYPEREMIA INDUCED BY ARM POSITIONING AND PPG SENSOR

• Main Author: Agathon, Johan
• Format: Theses
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/35353
• Institution: Institut Teknologi Bandung

Cardiovascular diseases (CVDs) are the main cause of death globally. Early detection system is crucial to reduce number of death caused by CVDs. Early detection of CVDs risk can be done by endothelial function measurement. Flow Mediated Dilation (FMD) is a popular method to measure endothelial function. This method uses reactive hyperemia phenomenon after occlution of blood flow. Reactive hyperemia caused blood vessel dilation. This dilation ability is measured and becomes the health index of endothelial function. In conventional FMD methods the measurement of dilation ability is carried out by using Ultrasonography (USG) to measure the diameter of brachial artery before occlusion (baseline) and after occulusion (hyperemia). In its development, ultrasound can be replaced with Photopletysmography (PPG) and is known as Periperal Arterial Volume (PAV) method. The occlusion process using pressure cuff produces discomfort and pain, even some people doubting the safety of this process. On the other hand the occlusion process is still needed to produce a hyperemia reaction to measure endothelial function. Consequently another approach is needed to produce occlusion and flow of blood in the arm blood vessels. When the arm is lifted the flow of blood flow to the fingertips will decrease compared to when the arm is positioned at heart level. Adjustment of the arm position can be an alternative to the occlusion process using pressure cuff. This study aims to see the correlation between the blood flow reduction caused by occlusion process with pressure cuff and by adjusting the position of the arm to produce a hyperemia reaction.Parameters for comparison included PAV index and PPG features (HR, PW, AI, SI, IPA). The results of the study show a strong correlation on PAV index with r = 0.9 and moderate correlation on HR and PW index with r = 0,52 and r = 0,61. This shows that adjusting the arm position can be used as an alternative measure of endothelial function by identifying the PAV index parameter.