A Multimodal System for Comprehensive Cardiovascular Monitoring Using ECG, PCG, and PPG Signal Fusion

This study proposes a low-cost, wearable multimodal system for comprehensive cardiovascular monitoring, integrating electrocardiogram (ECG), phonocardiogram (PCG), and photoplethysmogram (PPG) signals. By leveraging the complementary strengths of these modalities, the system extracts key physiological markers: pre-ejection period (PEP) from ECG-PCG fusion to assess myocardial electromechanical timing; pulse transit time (PTT) from PCG-PPG fusion to reflect arterial stiffness; and pulse arrival time (PAT) from ECG-PPG fusion to characterize heart-arterial coupling. Experimental results show that PEP is significantly associated with body mass index (BMI) but not age, suggesting that age-related changes primarily affect the arterial system rather than myocardial function. In contrast, both PTT and PAT demonstrate moderate negative correlations with age and BMI, supporting their relevance as noninvasive indicators of vascular aging. Additionally, PAT exhibits a significant sex-based difference, highlighting physiological disparities between male and female cardiovascular systems. Overall, the proposed fusion-based approach demonstrates technical feasibility and clinical potential for scalable, preventive cardiovascular healthcare, enabling early risk detection, continuous at-home monitoring, and improved long-term health management.