Weighted Combination and Singular Spectrum Analysis Based Remote Photoplethysmography Pulse Extraction in Low-light Environments

Camera-based vital signs monitoring in recent years has attracted more and more researchers and the results are promising. However, a few research works focus on heart rate extraction under extremely low illumination environments. In this paper, we propose a novel framework for remote heart rate estimation under low-light conditions. This method uses singular spectrum analysis (SSA) to decompose the filtered signal into several reconstructed components. A spectral masking algorithm is utilized to refine the preliminary candidate components on the basis of a reference heart rate. The contributive components are fused into the final pulse signal. To evaluate the performance of our framework in low-light conditions, the proposed approach is tested on a large-scale multi-illumination HR dataset (named MIHR). The test results verify that the proposed method has stronger robustness to low illumination than state-of-the-art methods, effectively improving the signal-to-noise ratio and heart rate estimation precision. We further perform experiments on the PUlse RatE detection (PURE) dataset which is recorded under normal light conditions to demonstrate the generalization of our method. The experiment results show that our method can stably detect pulse rate and achieve comparative results. The proposed method pioneers a new solution to the remote heart rate estimation in low-light conditions.

Passive Heart Rate Monitoring During Smartphone Use in Everyday Life

Resting heart rate (RHR) is an important biomarker of cardiovascular health and mortality, but tracking it longitudinally generally requires a wearable device, limiting its availability. We present PHRM, a deep learning system for passive heart rate (HR) and RHR measurements during everyday smartphone use, using facial video-based photoplethysmography. Our system was developed using 225,773 videos from 495 participants and validated on 185,970 videos from 205 participants in laboratory and free-living conditions, representing the largest validation study of its kind. Compared to reference electrocardiogram, PHRM achieved a mean absolute percentage error (MAPE) < 10% for HR measurements across three skin tone groups of light, medium and dark pigmentation; MAPE for each skin tone group was non-inferior versus the others. Daily RHR measured by PHRM had a mean absolute error < 5 bpm compared to a wearable HR tracker, and was associated with known risk factors. These results highlight the potential of smartphones to enable passive and equitable heart health monitoring.

Machine-learning for photoplethysmography analysis: Benchmarking feature, image, and signal-based approaches

Photoplethysmography (PPG) is a widely used non-invasive physiological sensing technique, suitable for various clinical applications. Such clinical applications are increasingly supported by machine learning methods, raising the question of the most appropriate input representation and model choice. Comprehensive comparisons, in particular across different input representations, are scarce. We address this gap in the research landscape by a comprehensive benchmarking study covering three kinds of input representations, interpretable features, image representations and raw waveforms, across prototypical regression and classification use cases: blood pressure and atrial fibrillation prediction. In both cases, the best results are achieved by deep neural networks operating on raw time series as input representations. Within this model class, best results are achieved by modern convolutional neural networks (CNNs). but depending on the task setup, shallow CNNs are often also very competitive. We envision that these results will be insightful for researchers to guide their choice on machine learning tasks for PPG data, even beyond the use cases presented in this work.

Generalizable deep learning for photoplethysmography-based blood pressure estimation -- A Benchmarking Study

Photoplethysmography (PPG)-based blood pressure (BP) estimation represents a promising alternative to cuff-based BP measurements. Recently, an increasing number of deep learning models have been proposed to infer BP from the raw PPG waveform. However, these models have been predominantly evaluated on in-distribution test sets, which immediately raises the question of the generalizability of these models to external datasets. To investigate this question, we trained five deep learning models on the recently released PulseDB dataset, provided in-distribution benchmarking results on this dataset, and then assessed out-of-distribution performance on several external datasets. The best model (XResNet1d101) achieved in-distribution MAEs of 9.4 and 6.0 mmHg for systolic and diastolic BP respectively on PulseDB (with subject-specific calibration), and 14.0 and 8.5 mmHg respectively without calibration. Equivalent MAEs on external test datasets without calibration ranged from 15.0 to 25.1 mmHg (SBP) and 7.0 to 10.4 mmHg (DBP). Our results indicate that the performance is strongly influenced by the differences in BP distributions between datasets. We investigated a simple way of improving performance through sample-based domain adaptation and put forward recommendations for training models with good generalization properties. With this work, we hope to educate more researchers for the importance and challenges of out-of-distribution generalization.

Artificial Intelligence-derived Vascular Age from Photoplethysmography: A Novel Digital Biomarker for Cardiovascular Health

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

CardiacMamba: A Multimodal RGB-RF Fusion Framework with State Space Models for Remote Physiological Measurement

Heart rate (HR) estimation via remote photoplethysmography (rPPG) offers a non-invasive solution for health monitoring. However, traditional single-modality approaches (RGB or Radio Frequency (RF)) face challenges in balancing robustness and accuracy due to lighting variations, motion artifacts, and skin tone bias. In this paper, we propose CardiacMamba, a multimodal RGB-RF fusion framework that leverages the complementary strengths of both modalities. It introduces the Temporal Difference Mamba Module (TDMM) to capture dynamic changes in RF signals using timing differences between frames, enhancing the extraction of local and global features. Additionally, CardiacMamba employs a Bidirectional SSM for cross-modal alignment and a Channel-wise Fast Fourier Transform (CFFT) to effectively capture and refine the frequency domain characteristics of RGB and RF signals, ultimately improving heart rate estimation accuracy and periodicity detection. Extensive experiments on the EquiPleth dataset demonstrate state-of-the-art performance, achieving marked improvements in accuracy and robustness. CardiacMamba significantly mitigates skin tone bias, reducing performance disparities across demographic groups, and maintains resilience under missing-modality scenarios. By addressing critical challenges in fairness, adaptability, and precision, the framework advances rPPG technology toward reliable real-world deployment in healthcare. The codes are available at: https://github.com/WuZheng42/CardiacMamba.

Joint Attention Mechanism Learning to Facilitate Opto-physiological Monitoring during Physical Activity

Opto-physiological monitoring is a non-contact technique for measuring cardiac signals, i.e., photoplethysmography (PPG). Quality PPG signals directly lead to reliable physiological readings. However, PPG signal acquisition procedures are often accompanied by spurious motion artefacts (MAs), especially during low-to-high-intensity physical activity. This study proposes a practical adversarial learning approach for opto-physiological monitoring by using a generative adversarial network with an attention mechanism (AM-GAN) to model motion noise and to allow MA removal. The AM-GAN learns an MA-resistant mapping from raw and noisy signals to clear PPG signals in an adversarial manner, guided by an attention mechanism to directly translate the motion reference of triaxial acceleration to the MAs appearing in the raw signal. The AM-GAN was experimented with three various protocols engaged with 39 subjects in various physical activities. The average absolute error for heart rate (HR) derived from the MA-free PPG signal via the AM-GAN, is 1.81 beats/min for the IEEE-SPC dataset and 3.86 beats/min for the PPGDalia dataset. The same procedure applied to an in-house LU dataset resulted in average absolute errors for HR and respiratory rate (RR) of less than 1.37 beats/min and 2.49 breaths/min, respectively. The study demonstrates the robustness and resilience of AM-GAN, particularly during low-to-high-intensity physical activities.

Continuous Cardiac Arrest Prediction in ICU using PPG Foundation Model

Non-invasive patient monitoring for tracking and predicting adverse acute health events is an emerging area of research. We pursue in-hospital cardiac arrest (IHCA) prediction using only single-channel finger photoplethysmography (PPG) signals. Our proposed two-stage model Feature Extractor-Aggregator Network (FEAN) leverages powerful representations from pre-trained PPG foundation models (PPG-GPT of size up to 1 Billion) stacked with sequential classification models. We propose two FEAN variants ("1H", "FH") which use the latest one-hour and (max) 24-hour history to make decisions respectively. Our study is the first to present IHCA prediction results in ICU patients using only unimodal (continuous PPG signal) waveform deep representations. With our best model, we obtain an average of 0.79 AUROC over 24~h prediction window before CA event onset with our model peaking performance at 0.82 one hour before CA. We also provide a comprehensive analysis of our model through architectural tuning and PaCMAP visualization of patient health trajectory in latent space.

CodePhys: Robust Video-based Remote Physiological Measurement through Latent Codebook Querying

Remote photoplethysmography (rPPG) aims to measure non-contact physiological signals from facial videos, which has shown great potential in many applications. Most existing methods directly extract video-based rPPG features by designing neural networks for heart rate estimation. Although they can achieve acceptable results, the recovery of rPPG signal faces intractable challenges when interference from real-world scenarios takes place on facial video. Specifically, facial videos are inevitably affected by non-physiological factors (e.g., camera device noise, defocus, and motion blur), leading to the distortion of extracted rPPG signals. Recent rPPG extraction methods are easily affected by interference and degradation, resulting in noisy rPPG signals. In this paper, we propose a novel method named CodePhys, which innovatively treats rPPG measurement as a code query task in a noise-free proxy space (i.e., codebook) constructed by ground-truth PPG signals. We consider noisy rPPG features as queries and generate high-fidelity rPPG features by matching them with noise-free PPG features from the codebook. Our approach also incorporates a spatial-aware encoder network with a spatial attention mechanism to highlight physiologically active areas and uses a distillation loss to reduce the influence of non-periodic visual interference. Experimental results on four benchmark datasets demonstrate that CodePhys outperforms state-of-the-art methods in both intra-dataset and cross-dataset settings.

Direct Estimation of Pediatric Heart Rate Variability from BOLD-fMRI: A Machine Learning Approach Using Dynamic Connectivity

In many pediatric fMRI studies, cardiac signals are often missing or of poor quality. A tool to extract Heart Rate Variation (HRV) waveforms directly from fMRI data, without the need for peripheral recording devices, would be highly beneficial. We developed a machine learning framework to accurately reconstruct HRV for pediatric applications. A hybrid model combining one-dimensional Convolutional Neural Networks (1D-CNN) and Gated Recurrent Units (GRU) analyzed BOLD signals from 628 ROIs, integrating past and future data. The model achieved an 8% improvement in HRV accuracy, as evidenced by enhanced performance metrics. This approach eliminates the need for peripheral photoplethysmography devices, reduces costs, and simplifies procedures in pediatric fMRI. Additionally, it improves the robustness of pediatric fMRI studies, which are more sensitive to physiological and developmental variations than those in adults.