Heart Rate Variability in Congenital Heart Disease and Controls Using Wearable Technology and a Health Application Programming Interface—A Cross-sectional Study

CJC Pediatric and Congenital Heart Disease Pub Date : 2026-02-01 Epub Date: 2025-08-07 DOI:10.1016/j.cjcpc.2025.07.004

Charlotte Schöneburg MSc , Isabel Uphoff MSc , Renate Oberhoffer-Fritz MD , Peter Ewert MD , Jan Müller PhD

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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使用可穿戴技术和健康应用程序编程接口控制先天性心脏病的心率变异性-横断面研究。

背景：随着95%的先天性心脏病（CHD）患者进入成年期，人们关注的焦点已经从早期死亡率转向长期发病率。慢性健康状况与心脏和心理负担增加有关，这可能影响自主神经功能。这项研究比较了成人冠心病患者和对照组的心率变异性（HRV）水平。方法：在2023年9月至2024年2月期间，124名成年冠心病患者（33.7±10.5岁，女性占47.6%）和43名对照组（34.3±12.0岁，女性占44.2%）参加了基于可穿戴设备的生理评估。使用Garmin vivosmart 5连续记录HRV 7天，并通过健康应用程序编程接口同步数据。根据个人睡眠和清醒时间计算白天和夜间的连续差异均方根（rMSSD）。结果：冠心病患者的rMSSD总体低于对照组（CHD: 39.9 [33.6； 48.1] vs对照组：47.0 [39.9;53.3];P = 0.001），这是由于夜间rMSSD减少（CHD: 43.5 [34.5； 55.3] vs对照组：53.1 [47.2;65.4],P < 0.001），而白天无显著差异（CHD: 35.9 [31.8； 41.6] vs对照组：39.0 [32.3;45.1],P = 0.212）。冠心病患者夜间HRV比白天高17.4%，而对照组HRV比白天高46.4%，这表明夜间对照组的自主神经恢复明显更好（P < 0.001）。在患者中，VO2峰值与白天（P < 0.001）和总rMSSD呈正相关（P = 0.017）。结论：与对照组相比，冠心病患者似乎有较低的整体HRV，这是由于夜间HRV降低所致。夜间HRV是了解恢复、睡眠质量和健康的关键。通过健康应用程序编程接口进行持续监测可以支持可靠的慢性健康评估和个性化护理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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CJC Pediatric and Congenital Heart Disease

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