ASSESSING SMARTPHONE-DERIVED HEART RATE VARIABILITY AS AN INDICATOR OF GENERAL AND ORAL HEALTH: AN EXPLORATORY STUDY
Dentistry and Heart Rate Variability
DOI:
https://doi.org/10.5327/2525-5711.268Palabras clave:
Heart Rate Variability, Oral health, Periodontal Diseases, Tooth lossResumen
This study aimed to investigate the feasibility and effectiveness of using smartphone-derived heart rate variability (HRV) as a diagnostic tool for assessing both general and oral health conditions. An exploratory and cross-sectional study involving 112 dental patients was conducted. HRV was recorded through Android® operating system smartphone app by photoplethysmography (PPG). Potential associations between HRV and the American Society of Anesthesiologists (ASA) risk classification in dentistry, tooth loss, oral rehabilitation status, and periodontal disease were explored. To validate the heart rate (HR) readings and confirm the reliability of signal acquisition pattern by PPG method via smartphone, HR was compared using four additional devices. The HR derived from the smartphone demonstrated reliability comparable to traditional monitoring devices. Significant associations were found between HRV and ASA classification for risk in dentistry, tooth loss, oral rehabilitation status, and periodontal disease. Smartphone-derived HRV was able to detect comorbidity (ASA grade II or superior) with 68.3% of sensitivity and 61.5% of specificity. Higher HRV scores were associated with better oral health outcomes. This study underscores the potential of smartphone-derived HRV as a complementary diagnostic tool for evaluating both general and oral health conditions. The findings reveal discernible associations between HRV and the ASA classification for risk in dentistry and with the studied oral health parameters. HR derived from smartphone is reliable when compared with traditional cardiac monitoring devices.
Citas
Owens AP. The Role of Heart Rate Variability in the Future of Remote Digital Biomarkers. Front Neurosci. 2020; 14:582145. doi: 10.3389/fnins.2020.582145.
Turcu AM, Ilie AC, Ștefăniu R, Țăranu SM, Sandu IA, Alexa-Stratulat T, et al. The Impact of Heart Rate Variability Monitoring on Preventing Severe Cardiovascular Events. Diagnostics (Basel). 2023; 13(14):2382. doi: 10.3390/diagnostics13142382.
McGovern J, Leadbitter S, Miller G, Hounat A, Kamande I, Dolan RD, et al. The relationship between heart rate variability and TNM stage, co-morbidity, systemic inflammation and survival in patients with primary operable colorectal cancer. Sci Rep. 2023; 13(1):8157. doi: 10.1038/s41598-023-35396-x.
Nicolini P, Malfatto G, Lucchi T. Heart Rate Variability and Cognition: A Narrative Systematic Review of Longitudinal Studies. J Clin Med. 2024; 13(1):280. doi: 10.3390/jcm13010280.
Gullett N, Zajkowska Z, Walsh A, Harper R, Mondelli V. Heart rate variability (HRV) as a way to understand associations between the autonomic nervous system (ANS) and affective states: A critical review of the literature. Int J Psychophysiol. 2023; 192:35-42. doi: 10.1016/j.ijpsycho.2023.08.001.
Li K, Cardoso C, Moctezuma-Ramirez A, Elgalad A, Perin E. Heart Rate Variability Measurement through a Smart Wearable Device: Another Breakthrough for Personal Health Monitoring? Int J Environ Res Public Health. 2023; 20(24):7146. doi: 10.3390/ijerph20247146.
Vanderlei LC, Pastre CM, Hoshi RA, Carvalho TD, Godoy MF. Basic notions of heart rate variability and its clinical applicability. Rev Bras Cir Cardiovasc. 2009; 24(2):205-17. doi: 10.1590/s0102-76382009000200018.
Chinthakanan S, Laosuwan K, Boonyawong P, Kumfu S, Chattipakorn N, Chattipakorn SC. Reduced heart rate variability and increased saliva cortisol in patients with TMD. Arch Oral Biol. 2018; 90:125-129. doi: 10.1016/j.archoralbio.2018.03.011.
Drury RL, Simonetti SA. Heart Rate Variability in Dental Science. Front Med (Lausanne). 2019; 6:13. doi: 10.3389/fmed.2019.00013.
Natarajan A, Pantelopoulos A, Emir-Farinas H, Natarajan P. Heart rate variability with photoplethysmography in 8 million individuals: a cross-sectional study. Lancet Digit Health. 2020; 2(12):e650-e657. doi: 10.1016/S2589-7500(20)30246-6.
Guede-Fernandez F, Ferrer-Mileo V, Ramos-Castro J, Fernandez-Chimeno M, Garcia-Gonzalez MA. Real time heart rate variability assessment from Android smartphone camera photoplethysmography: Postural and device influences. Annu Int Conf IEEE Eng Med Biol Soc. 2015; 2015:7332-5. doi: 10.1109/EMBC.2015.7320085.
Ferrer-Mileo V, Guede-Fernandez F, Fernandez-Chimeno M, Ramos-Castro J, Garcia-Gonzalez MA. Accuracy of heart rate variability estimation by photoplethysmography using an smartphone: Processing optimization and fiducial point selection. Annu Int Conf IEEE Eng Med Biol Soc. 2015; 2015:5700-3. doi: 10.1109/EMBC.2015.7319686.
De Ridder B, Van Rompaey B, Kampen JK, Haine S, Dilles T. Smartphone Apps Using Photoplethysmography for Heart Rate Monitoring: Meta-Analysis. JMIR Cardio. 2018; 2(1):e4. doi: 10.2196/cardio.8802.
Shabaan M, Arshid K, Yaqub M, Jinchao F, Zia MS, Bojja GR, Iftikhar M, Ghani U, Ambati LS, Munir R. Survey: smartphone-based assessment of cardiovascular diseases using ECG and PPG analysis. BMC Med Inform Decis Mak. 2020; 20(1):177. doi: 10.1186/s12911-020-01199-7.
Holmlund A, Holm G, Lind L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years. J Periodontol. 2010; 81(6):870-6. doi: 10.1902/jop.2010.090680.
Yang B, Petrick JL, Abnet CC, Graubard BI, Murphy G, Weinstein SJ, et al. Tooth loss and liver cancer incidence in a Finnish cohort. Cancer Causes Control. 2017; 28(8):899-904. doi: 10.1007/s10552-017-0906-y.
Maisonneuve P, Amar S, Lowenfels AB. Periodontal disease, edentulism, and pancreatic cancer: a meta-analysis. Ann Oncol. 2017; 28(5):985-995. doi: 10.1093/annonc/mdx019.
Scherer RX, Scherer WJ. U.S. state correlations between oral health metrics and Alzheimer's disease mortality, prevalence and subjective cognitive decline prevalence. Sci Rep. 2020; 10(1):20962. doi: 10.1038/s41598-020-77937-8.
Da Silva JD, Ni SC, Lee C, Elani H, Ho K, Thomas C, et al. Association between cognitive health and masticatory conditions: a descriptive study of the national database of the universal healthcare system in Japan. Aging (Albany NY). 2021; 13(6):7943-7952. doi: 10.18632/aging.202843.
Altamura S, Del Pinto R, Pietropaoli D, Ferri C. Oral health as a modifiable risk factor for cardiovascular diseases. Trends Cardiovasc Med. 2023: S1050-1738(23)00030-0. doi: 10.1016/j.tcm.2023.03.003.
Abraham-Inpijn L, Russell G, Abraham DA, Bäckman N, Baum E, Bullón-Fernández P, et al. A patient-administered Medical Risk Related History questionnaire (EMRRH) for use in 10 European countries (multicenter trial). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105(5):597-605. doi: 10.1016/j.tripleo.2007.09.032.
Cardoso RB, Faria KW, Schmidt KA, Campagnoli EB, Claudino M, Bortoluzzi MC. Is there any association between cognitive decline with the oral health condition? ResSocDevelop. 2021; 10(5):e42410514911. doi: 10.33448/rsd-v10i5.14911
Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012; 83(12):1449-54. doi: 10.1902/jop.2012.110664.
Ekuni D, Takeuchi N, Furuta M, Tomofuji T, Morita M. Relationship between malocclusion and heart rate variability indices in young adults: a pilot study. Methods Inf Med. 2011; 50(4):358-63. doi: 10.3414/ME10-01-0045.
Santana MD, Pita Neto IC, Martiniano EC, Monteiro LR, Ramos JL, Garner DM, et al. Non-linear indices of heart rate variability during endodontic treatment. Braz Oral Res. 2016; 30:S1806-83242016000100220. doi: 10.1590/1807-3107BOR-2016.vol30.0029.
Le SH, Tonami K, Umemori S, Nguyen LT, Ngo LT, Mataki S. The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery. Int J Oral Maxillofac Surg. 2018; 47(6):809-815. doi: 10.1016/j.ijom.2018.01.019.
Yamashita K, Uto A, Uchino M, Shidou R, Kibe T, Sugimura M. Sympathetic Nerve Activity During Tooth Extraction in Women Is Related to Dental Anxiety Immediately After Surgery. J Oral Maxillofac Surg. 2021; 79(11):2268.e1-2268.e5. doi: 10.1016/j.joms.2021.06.019.
Padley JR, Ben-Menachem E. Low pre-operative heart rate variability and complexity are associated with hypotension after anesthesia induction in major abdominal surgery. J Clin Monit Comput. 2018; 32(2):245-252. doi: 10.1007/s10877-017-0012-4.
Tada A, Miura H. Association of mastication and factors affecting masticatory function with obesity in adults: a systematic review. BMC Oral Health. 2018; 18(1):76. doi: 10.1186/s12903-018-0525-3.
Lin CS, Chang WJ, Fuh JL. Lower masticatory function relates to cognitive health and intrinsic brain network in older adults. Oral Dis. 2023; 29(7):2895-2906. doi: 10.1111/odi.14487.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Dr. Luiz, Dra. Vanessa, Victoria Lais Pereira, Dra. Michele, Prof. Fábio André, Marcelo Carlos Bortoluzzi
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
