Left ventricular ejection time (LVET) is an important parameter for assessing cardiovascular disorders. In a medical office, it is typically measured using the Tissue Doppler Imaging technique, but new wearable devices have led to a growing interest in integrating this parameter into them, increasing accessibility to personalized healthcare for users and patients. In the cardiovascular domain, photoplethysmography (PPG) is a promising technology that shares two distinctive features with invasive arterial blood pressure (ABP) tracing: the tidal wave (TDW) and the dicrotic wave (DCW). In the early years of cardiovascular research, the duration of the dicrotic point was initially linked to the ending phase of left ventricular ejection. Subsequent studies reported deviations from the initial association, suggesting that the ejection period is related to the tidal wave feature. In this current study, we measured left ventricular ejection time in both ABP and PPG waveforms, considering recent research results. A total of 27,000 cardiac cycles were analyzed for both afore-mentioned signals. The reference value for ejection time was computed based on the T-wave segment duration from the electrocardiogram waveform. In lower blood pressure, which is associated with decreased heart contractility, the results indicated an underestimation of −29 ± 19 ms in ABP and an overestimation of 18 ± 31 ms in PPG. On the other side of the spectrum, during increased contractility, the minimum errors were −3 ± 18 ms and 4 ± 33 ms, respectively. Since the tidal wave feature is strongly affected by arterial tree compliance, the population evaluation results indicate a Pearson’s correlation factor of 0.58 in the ABP case, and 0.53 in PPG. These findings highlight the need for advanced compensation techniques, in particular for PPG assessment, to achieve clinical-grade accuracy.

Resistance exercise training is well documented as having cardiovascular benefits, but paradoxically, it seems to increase arterial stiffness, favoring the development of high blood pressure. The present study investigates the potential effects of oral supplementation with arginine in healthy individuals performing exercise resistance training. We studied 70 non-smoking male subjects between the ages of 30 and 45 with normal or mildly increased blood pressure on ambulatory monitoring (for 24 h) and normal blood samples and echocardiography, who performed regular resistance exercise training for at least five years with a minimum of three workouts per week. They were divided into two groups in a random manner: 35 males were placed in the arginine group (AG) that followed a 6-month supplementation of their regular diets with 5 g of oral arginine powder taken before their exercise workout, and the control (non-arginine) group (NAG) consisted of 35 males. All subjects underwent body composition analysis, 24 h blood pressure monitoring and pulse wave analysis at enrollment and at six months. After six months of supplementation, blood pressure values did not change in the NAG, while in the AG, we found a decrease of 5.6 mmHg (p < 0.05) in mean systolic blood pressure and a decrease of 4.5 mmHg (p < 0.05) in diastolic values. There was also a 0.62% increase in muscle mass in the AG vs. the NAG (p < 0.05), while the body fat decreased by 1% (p < 0.05 in AG vs. NAG). Overall, the AG gained twice the amount of muscle mass and lost twice as much body fat as the NAG. No effects on the mean weighted average heart rate were recorded in the subjects. The results suggest that oral supplementation with arginine can improve blood pressure and body composition, potentially counteracting the stress induced by resistance exercise training. Supplementation with arginine can be a suitable adjuvant for these health benefits in individuals undertaking regular resistance training.