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Pulse rate variability is not a surrogate for heart rate variability.
1Service d'Anesthésie Réanimation Pédiatrique, Hôpital d'enfants Armand Trousseau, 26 av. du Dr Arnold Netter, 75571 Paris cedex 12, France. isabelle.costant@trs.ap-hop-paris.fr
Clinical Science (London, England : 1979)
|September 24, 1999
Summary
Pulse rate variability (PRV) using finger pulse waves may overestimate respiratory influences compared to heart rate variability (HRV) from ECG. ECG is recommended for accurate HRV assessment, especially in standing healthy subjects and those with low HRV.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Pediatric Cardiology
Background:
- Heart rate (HR) variability and pulse rate (PR) variability are commonly used to assess autonomic function.
- Distal pulse wave analysis is a non-invasive method, but its accuracy compared to ECG-derived HRV needs further investigation, particularly in pediatric populations.
Purpose of the Study:
- To investigate the differences between short-term HR variability and PR variability.
- To evaluate the influence of posture and respiratory modulation on PR and HR variability in children.
Main Methods:
- Short-term variability of finger pulse wave (using Finapres) and ECG signals were measured in 10 children with ventricular pacemakers and 10 healthy children.
- Power spectra for HR and PR were calculated in supine and orthostatic positions.
- Analysis focused on respiratory peaks and postural effects on variability measures.
Main Results:
- PR variability spectra showed respiratory peaks in paced subjects where HR spectra were flat.
- Respiratory fluctuations were more pronounced in PR variability than HR variability in healthy children.
- The overestimation of respiratory fluctuations in PR was more significant in the standing position for healthy subjects.
- Mechanical respiratory modulation of PR was observed, independent of HR modulation.
Conclusions:
- Respiratory PR variability does not precisely reflect respiratory HR variability in standing healthy subjects and patients with low HR variability.
- ECG is the preferred method for studying HR modulation.
- Distal pulse wave analysis can be an acceptable alternative when ECG is unavailable.