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Heart Rate as a Predictor of 6-Month Pneumonia Risk in Patients With Dysphagia
Yuval Nachalon1,2, Nogah Nativ-Zeltzer2, Yosef Kula3,4
1Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery Tel-Aviv Sourasky Medical Center Tel-Aviv Israel.
Laryngoscope Investigative Otolaryngology
|December 19, 2025
Summary
Elevated resting heart rate (HR) in patients with dysphagia predicts a higher risk of developing pneumonia. This simple measurement may aid in identifying individuals needing closer monitoring for respiratory complications.
Area of Science:
- Cardiology
- Pulmonology
- Geriatrics
Background:
- Dysphagia, a swallowing disorder, increases pneumonia risk.
- Autonomic dysfunction and inflammation may contribute to respiratory complications in dysphagia patients.
- Heart rate variability (HRV) is a potential indicator of autonomic regulation.
Purpose of the Study:
- To investigate if resting heart rate (HR) or HRV predicts 6-month pneumonia risk in patients with dysphagia.
- To explore the utility of finger photoplethysmography (PPG) derived metrics for risk stratification.
Main Methods:
- 301 patients undergoing videofluoroscopic swallow study (VFSS) were enrolled.
- Resting HR and HRV metrics (SDNN, RMSSD) were measured using finger sensors.
- Pneumonia incidence was tracked for 6 months via interviews and medical records.
Main Results:
- 20 patients (7%) developed pneumonia, primarily within 3 months.
- Higher resting HR was significantly associated with increased pneumonia risk (p < 0.01).
- Risk increased stepwise with HR thresholds; HRV metrics showed no significant association.
Conclusions:
- Elevated resting HR, even within normal limits, is linked to higher pneumonia risk in dysphagia patients.
- Resting HR may serve as a simple, non-invasive tool for pneumonia risk stratification.
- Further validation in larger studies is required due to preliminary findings.
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