Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application Programming Interface—A Cross-sectional Study
With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares hea...
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| Vydáno v: | CJC pediatric and congenital heart disease |
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2025
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| Abstract | With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares heart rate variability (HRV) levels between adults with CHD and controls.
Between September 2023 and February 2024, 124 adults with CHD (33.7 ± 10.5 years, 47.6% women) and 43 controls (34.3 ± 12.0 years, 44.2% women) participated in a wearable-based physiological assessment. HRV was continuously recorded using Garmin vivosmart 5 for 7 days, with data synchronized via a health application programming interface. The root mean square of successive differences (rMSSD) was calculated for day and nighttime based on individual sleep and waking schedules.
Patients with CHD exhibited lower overall rMSSD than controls (CHD: 39.9 [33.6; 48.1] vs controls: 47.0 [39.9; 53.3]; P = 0.001), driven by reduced nighttime rMSSD (CHD: 43.5 [34.5; 55.3] vs controls: 53.1 [47.2; 65.4]; P < 0.001), with no significant daytime differences (CHD: 35.9 [31.8; 41.6] vs controls: 39.0 [32.3; 45.1]; P = 0.212). CHD showed a 17.4% higher HRV at night compared with the day, whereas controls exhibited a 46.4% increase, indicating significantly better autonomic recovery in controls during the night (P < 0.001). In patients, VO2 peak correlated positively with daytime (P < 0.001) and overall rMSSD (P = 0.017).
Patients with CHD appear to have lower overall HRV, driven by decreased nighttime HRV compared with controls. Nighttime HRV is key for understanding recovery, sleep quality, and health. Continuous monitoring via health application programming interfaces could support reliable chronic health assessment and personalized care strategies.
Aujourd’hui, 95 % des patients qui présentent une cardiopathie congénitale (CC) atteignent l’âge adulte, et l’intérêt se porte maintenant davantage sur la morbidité à long terme que sur la mortalité précoce. Or, les maladies chroniques sont associées à un risque plus élevé de problèmes cardiaques et psychologiques qui peuvent influer sur la fonction autonome. Nous comparons dans cette étude la variabilité de la fréquence cardiaque (VFC) chez des adultes atteints de CC à celle de sujets témoins.
Entre septembre 2023 et février 2024, 124 adultes atteints de CC (33,7 ans ± 10,5 ans, 47,6 % de femmes) et 43 sujets témoins (34,3 ans ± 12 ans, 44,2 % de femmes) ont participé à une évaluation physiologique au moyen de la technologie portable. La VFC a été enregistrée en continu à l’aide de l’appareil vivosmart® 5 de Garmin pendant 7 jours. Une interface de programmation d’applications (API) en santé permettait de synchroniser les données. On a calculé la moyenne quadratique des écarts successifs entre les battements cardiaques (rMSSD) de jour et de nuit en fonction des cycles individuels de sommeil et d’éveil.
Les patients atteints de CC affichaient une rMSSD globale inférieure à celle des témoins (CC : 39,9 [33,6; 48,1] vs témoins : 47,0 [39,9; 53,3]; p = 0,001), un résultat attribuable à une rMSSD nocturne basse (CC : 43,5 [34,5; 55,3] vs témoins : 53,1 [47,2; 65,4]; p < 0,001); les différences diurnes n’étaient pas significatives (CC : 35,9 [31,8; 41,6] vs témoins : 39,0 [32,3; 45,1]; p = 0,212). Chez les patients atteints de CC, la VFC était de 17,4 % plus élevée la nuit que le jour, alors que chez les témoins, la VFC était de 46,4 % plus élevée la nuit que le jour, signe d’une récupération de la fonction autonome significativement meilleure chez les témoins pendant la nuit (p < 0,001). Une corrélation positive entre la consommation maximale d’oxygène (VO2 max) et la rMSSD diurne (p < 0,001) et la rMSSD globale (p = 0,017) a été observée chez les patients.
Les patients atteints de CC semblent avoir une VFC globale moindre, qui s’explique par une VFC nocturne basse comparativement à celle des témoins. La VFC nocturne est un paramètre essentiel pour la compréhension de la récupération, de la qualité du sommeil et de la santé. Une surveillance continue par des API en santé pourrait permettre une évaluation fiable au long cours de l’état de santé et servir de base à des stratégies personnalisées de prise en charge. |
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| AbstractList | AbstractBackgroundWith 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares heart rate variability (HRV) levels between adults with CHD and controls. MethodsBetween September 2023 and February 2024, 124 adults with CHD (33.7 ± 10.5 years, 47.6% women) and 43 controls (34.3 ± 12.0 years, 44.2% women) participated in a wearable-based physiological assessment. HRV was continuously recorded using Garmin vivosmart 5 for 7 days, with data synchronized via a health application programming interface. The root mean square of successive differences (rMSSD) was calculated for day and nighttime based on individual sleep and waking schedules. ResultsPatients with CHD exhibited lower overall rMSSD than controls (CHD: 39.9 [33.6; 48.1] vs controls: 47.0 [39.9; 53.3]; P = 0.001), driven by reduced nighttime rMSSD (CHD: 43.5 [34.5; 55.3] vs controls: 53.1 [47.2; 65.4]; P < 0.001), with no significant daytime differences (CHD: 35.9 [31.8; 41.6] vs controls: 39.0 [32.3; 45.1]; P = 0.212). CHD showed a 17.4% higher HRV at night compared with the day, whereas controls exhibited a 46.4% increase, indicating significantly better autonomic recovery in controls during the night ( P < 0.001). In patients, VO 2 peak correlated positively with daytime ( P < 0.001) and overall rMSSD ( P = 0.017). ConclusionsPatients with CHD appear to have lower overall HRV, driven by decreased nighttime HRV compared with controls. Nighttime HRV is key for understanding recovery, sleep quality, and health. Continuous monitoring via health application programming interfaces could support reliable chronic health assessment and personalized care strategies. With 95% of patients with congenital heart disease (CHD) reaching adulthood, the focus has shifted from early mortality to long-term morbidity. Chronic health conditions are associated with increased cardiac and psychological burdens, which could influence autonomic function. This study compares heart rate variability (HRV) levels between adults with CHD and controls. Between September 2023 and February 2024, 124 adults with CHD (33.7 ± 10.5 years, 47.6% women) and 43 controls (34.3 ± 12.0 years, 44.2% women) participated in a wearable-based physiological assessment. HRV was continuously recorded using Garmin vivosmart 5 for 7 days, with data synchronized via a health application programming interface. The root mean square of successive differences (rMSSD) was calculated for day and nighttime based on individual sleep and waking schedules. Patients with CHD exhibited lower overall rMSSD than controls (CHD: 39.9 [33.6; 48.1] vs controls: 47.0 [39.9; 53.3]; P = 0.001), driven by reduced nighttime rMSSD (CHD: 43.5 [34.5; 55.3] vs controls: 53.1 [47.2; 65.4]; P < 0.001), with no significant daytime differences (CHD: 35.9 [31.8; 41.6] vs controls: 39.0 [32.3; 45.1]; P = 0.212). CHD showed a 17.4% higher HRV at night compared with the day, whereas controls exhibited a 46.4% increase, indicating significantly better autonomic recovery in controls during the night (P < 0.001). In patients, VO2 peak correlated positively with daytime (P < 0.001) and overall rMSSD (P = 0.017). Patients with CHD appear to have lower overall HRV, driven by decreased nighttime HRV compared with controls. Nighttime HRV is key for understanding recovery, sleep quality, and health. Continuous monitoring via health application programming interfaces could support reliable chronic health assessment and personalized care strategies. Aujourd’hui, 95 % des patients qui présentent une cardiopathie congénitale (CC) atteignent l’âge adulte, et l’intérêt se porte maintenant davantage sur la morbidité à long terme que sur la mortalité précoce. Or, les maladies chroniques sont associées à un risque plus élevé de problèmes cardiaques et psychologiques qui peuvent influer sur la fonction autonome. Nous comparons dans cette étude la variabilité de la fréquence cardiaque (VFC) chez des adultes atteints de CC à celle de sujets témoins. Entre septembre 2023 et février 2024, 124 adultes atteints de CC (33,7 ans ± 10,5 ans, 47,6 % de femmes) et 43 sujets témoins (34,3 ans ± 12 ans, 44,2 % de femmes) ont participé à une évaluation physiologique au moyen de la technologie portable. La VFC a été enregistrée en continu à l’aide de l’appareil vivosmart® 5 de Garmin pendant 7 jours. Une interface de programmation d’applications (API) en santé permettait de synchroniser les données. On a calculé la moyenne quadratique des écarts successifs entre les battements cardiaques (rMSSD) de jour et de nuit en fonction des cycles individuels de sommeil et d’éveil. Les patients atteints de CC affichaient une rMSSD globale inférieure à celle des témoins (CC : 39,9 [33,6; 48,1] vs témoins : 47,0 [39,9; 53,3]; p = 0,001), un résultat attribuable à une rMSSD nocturne basse (CC : 43,5 [34,5; 55,3] vs témoins : 53,1 [47,2; 65,4]; p < 0,001); les différences diurnes n’étaient pas significatives (CC : 35,9 [31,8; 41,6] vs témoins : 39,0 [32,3; 45,1]; p = 0,212). Chez les patients atteints de CC, la VFC était de 17,4 % plus élevée la nuit que le jour, alors que chez les témoins, la VFC était de 46,4 % plus élevée la nuit que le jour, signe d’une récupération de la fonction autonome significativement meilleure chez les témoins pendant la nuit (p < 0,001). Une corrélation positive entre la consommation maximale d’oxygène (VO2 max) et la rMSSD diurne (p < 0,001) et la rMSSD globale (p = 0,017) a été observée chez les patients. Les patients atteints de CC semblent avoir une VFC globale moindre, qui s’explique par une VFC nocturne basse comparativement à celle des témoins. La VFC nocturne est un paramètre essentiel pour la compréhension de la récupération, de la qualité du sommeil et de la santé. Une surveillance continue par des API en santé pourrait permettre une évaluation fiable au long cours de l’état de santé et servir de base à des stratégies personnalisées de prise en charge. |
| Author | Uphoff, Isabel Ewert, Peter Müller, Jan Schöneburg, Charlotte Oberhoffer-Fritz, Renate |
| Author_xml | – sequence: 1 givenname: Charlotte orcidid: 0009-0000-2295-1526 surname: Schöneburg fullname: Schöneburg, Charlotte email: charlotte.schoeneburg@tum.de organization: Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technische Universität München, München, Germany – sequence: 2 givenname: Isabel surname: Uphoff fullname: Uphoff, Isabel organization: Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Klinikum der Technischen Universität München, München, Germany – sequence: 3 givenname: Renate surname: Oberhoffer-Fritz fullname: Oberhoffer-Fritz, Renate organization: Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technische Universität München, München, Germany – sequence: 4 givenname: Peter surname: Ewert fullname: Ewert, Peter organization: Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Klinikum der Technischen Universität München, München, Germany – sequence: 5 givenname: Jan orcidid: 0000-0002-7530-2025 surname: Müller fullname: Müller, Jan organization: Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technische Universität München, München, Germany |
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| Keywords | congenital heart disease telemedicine heart rate variability health application programming interface |
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| Title | Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application Programming Interface—A Cross-sectional Study |
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