脉率变化不等于心率变化:来自大型,多样化的临床人群研究的发现
Allen B Kantrowitz1, Kfir Ben-David2,3, Michael Morris4,5
1Department of Neurosurgery, Mount Sinai Medical Center, Miami Beach, FL, United States.
Frontiers in physiology
|August 14, 2025
概括
光电心电图-心率波动 (PPG-PRV) 并不是电心电图-心率波动 (ECG-HRV) 的可靠替代品. 这项研究发现PPG-PRV和ECG-HRV指标之间存在显著的分歧,强调需要在研究和产品声明中明确区分.
科学领域:
- 生物医学工程 生物医学工程
- 心血管生理学心血管生理学
- 可穿戴技术可穿戴技术
背景情况:
- 光电心电图 (PPG) 在消费者设备中越来越多地用于心率变化 (HRV) 评估,通常假定与心电图 (ECG) 衍生的HRV.
- 新出现的证据表明,PPG的脉冲率变化 (PRV) 不能与ECG的HRV互换,因此需要进一步调查它们的一致性.
研究的目的:
- 在一大群成年人中,研究PPG衍生的PRV和ECG衍生的HRV之间的比较一致性.
- 评估PPG-PRV作为ECG-HRV的替代品在不同时间域指数 (SDNN,rMSSD,pNN50) 和特定慢性疾病患者中的准确性.
主要方法:
- 从高等学术医疗中心招募了931名成年人.
- 同时获得了ECG和PPG (通过胸部和双腿Warfighter MonitorTM设备) 的记录.
- 时间域HRV (SDNN,rMSSD,pNN50) 和PRV指标被计算并使用皮尔森相关性,布兰德-阿尔特曼分析和ANOVA进行比较.
主要成果:
- 在所有测量指数 (SDNN,rMSSD,pNN50) 中,在ECG-HRV和PPG-PRV之间观察到显著的分歧 (p < 0.001).
- 在心血管,内分泌,神经和呼吸系统疾病组中,PPG-PRV始终低估了ECG-HRV指标.
- 针对rMSSD,SDNN和pNN50报告了特定的平均差异和置信区间,这表明存在实质性偏差.
结论:
- PPG衍生的PRV是ECG衍生的HRV的一个糟糕的替代品,显著低估了关键的变化指标.
- 普遍认为PRV与HRV相当的假设是不准确的,需要在临床和研究环境中进行纠正.
- 研究人员,临床医生和制造商必须区分PRV和HRV,以避免对数据和产品声明的误解.
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