Vision4PPG: Emergent PPG Analysis Capability of Vision Foundation Models for Vital Signs like Blood Pressure

Photoplethysmography (PPG) sensor in wearable and clinical devices provides valuable physiological insights in a non-invasive and real-time fashion. Specialized Foundation Models (FM) or repurposed time-series FMs are used to benchmark physiological tasks. Our experiments with fine-tuning FMs reveal that Vision FM (VFM) can also be utilized for this purpose and, in fact, surprisingly leads to state-of-the-art (SOT A) performance on many tasks, notably blood pressure estimation. We leverage VFMs by simply transforming one-dimensional PPG signals into image-like two-dimensional representations, such as the Short-Time Fourier transform (STFT). Using the latest VFMs, such as DINOv3 and SIGLIP-2, we achieve promising performance on other vital signs and blood lab measurement tasks as well. Our proposal, Vision4PPG, unlocks a new class of FMs to achieve SOT A performance with notable generalization to other 2D input representations, including STFT phase and recurrence plots. Our work improves upon prior investigations of vision models for PPG by conducting a comprehensive study, comparing them to state-of-the-art time-series FMs, and demonstrating the general PPG processing ability by reporting results on six additional tasks. Thus, we provide clinician-scientists with a new set of powerful tools that is also computationally efficient, thanks to Parameter-Efficient Fine-Tuning (PEFT) techniques. 1 Introduction