Theurl Fabian, Schreinlechner Michael, Sappler Nikolay, Toifl Michael, Dolejsi Theresa, Hofer Florian, Massmann Celine, Steinbring Christian, Komarek Silvia, Mölgg Kurt, Dejakum Benjamin, Böhme Christian, Kirchmair Rudolf, Reinstadler Sebastian, Bauer Axel
Department of Internal Medicine III-Cardiology and Angiology, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
Department of Neurology, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
Eur Heart J Digit Health. 2023 Mar 23;4(3):155-164. doi: 10.1093/ehjdh/ztad022. eCollection 2023 May.
We aimed to investigate the concordance between heart rate variability (HRV) derived from the photoplethysmographic (PPG) signal of a commercially available smartwatch compared with the gold-standard high-resolution electrocardiogram (ECG)-derived HRV in patients with cardiovascular disease.
We prospectively enrolled 104 survivors of acute ST-elevation myocardial infarction, 129 patients after an ischaemic stroke, and 30 controls. All subjects underwent simultaneous recording of a smartwatch (Garmin vivoactive 4; Garmin Ltd, Olathe, KS, USA)-derived PPG signal and a high-resolution (1000 Hz) ECG for 30 min under standardized conditions. HRV measures in time and frequency domain, non-linear measures, as well as deceleration capacity (DC) were calculated according to previously published technologies from both signals. Lin's concordance correlation coefficient () between smartwatch-derived and ECG-based HRV markers was used as a measure of diagnostic accuracy. A very high concordance within the whole study cohort was observed for the mean heart rate ( = 0.9998), standard deviation of the averages of normal-to-normal (NN) intervals in all 5min segments (SDANN; = 0.9617), and very low frequency power (VLF power; = 0.9613). In contrast, detrended fluctuation analysis (DF-α1; = 0.5919) and the square mean root of the sum of squares of adjacent NN-interval differences (rMSSD; = 0.6617) showed only moderate concordance.
Smartwatch-derived HRV provides a practical alternative with excellent accuracy compared with ECG-based HRV for global markers and those characterizing lower frequency components. However, caution is warranted with HRV markers that predominantly assess short-term variability.
我们旨在研究市售智能手表的光电容积脉搏波描记法（PPG）信号得出的心率变异性（HRV）与心血管疾病患者中作为金标准的高分辨率心电图（ECG）得出的HRV之间的一致性。
我们前瞻性纳入了104例急性ST段抬高型心肌梗死幸存者、129例缺血性中风后患者和30例对照。所有受试者在标准化条件下同时记录智能手表（佳明vivoactive 4；佳明有限公司，美国堪萨斯州奥拉西）得出的PPG信号和高分辨率（1000 Hz）心电图30分钟。根据先前发表的技术从两种信号中计算出时域和频域的HRV测量值、非线性测量值以及减速能力（DC）。智能手表得出的和基于ECG的HRV标志物之间的林氏一致性相关系数（）用作诊断准确性的指标。在整个研究队列中，观察到平均心率（ = 0.9998）、所有5分钟段中正常到正常（NN）间期平均值的标准差（SDANN； = 0.9617）和极低频功率（VLF功率； = 0.9613）具有非常高的一致性。相比之下，去趋势波动分析（DF-α1； = 0.5919）和相邻NN间期差异平方和的平方根均值（rMSSD； = 0.6617）仅显示出中等一致性。
与基于ECG的HRV相比，智能手表得出的HRV为整体标志物和表征较低频率成分的标志物提供了一种准确性极佳的实用替代方法。然而，对于主要评估短期变异性的HRV标志物，需要谨慎使用。
