Abstract: D. Hernandez-Obin, G. H. Gonzalez-Gomez, A. Torres-Machorro, C. Lerma (in press)

Peripheral artery disease (PAD) is the partial or complete occlusion of the major systemic arter-ies, and its diagnosis is commonly assessed using the ankle-brachial index (ABI). However, ABI is limitedby arterial compressibility and is considered operator-dependent. Given the importance of early diagnosisfor better outcomes and the complexity of PAD management, studying complementary tests and PAD'smechanisms might help in its assessment. Photoplethysmography (PPG) is a low-cost, non-invasive tech-nique that does not have arterial compressibility as a limitation and requires no advanced training toimplement. The mean and standard deviation of PPG morphological parameters (pulse transit time, max-imum systolic slope and pulse amplitude) have been studied before for PAD patients, but their non-lineardynamics have not been assessed. In this work, we performed recurrence quantification analysis (RQA) ofPPG morphological parameters. A total of 40 legs from PAD patients with compressible ABI were studiedfor general description and to explore the relationship between PPG RQA indices and ABI. It was shownthat RR interval dynamics differed from those of PPG-derived parameters despite their shared regulatorymechanisms. The central tendency and general variability of the PPG-derived parameters are related tochanges in their dynamical states, which can increase or decrease their predictability, stationarity, or com-plexity. However, they do not clearly relate to PAD progression or PAD diagnosis. Further studies areneeded, considering the results of this work and its limitations, to continue exploring the interesting PPGdynamics for a broader number of groups with different physiological conditions.

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Recurrence quantification analysis of photoplethysmography time series for assessing patients with peripheral artery disease