Key result
A fall in the smartphone-derived HRV score from baseline was a moderate diagnostic marker of severe acute mountain sickness (AUC 0.80), though baseline scores did not predict future AMS development.
Why the study?
Does smartphone-derived HRV score predict and diagnose acute mountain sickness in healthy adults at high altitude?
Observational (n=21)
Does smartphone-derived HRV score predict and diagnose acute mountain sickness in healthy adults at high altitude?
Smartphone-derived HRV scores can help identify severe acute mountain sickness during high-altitude treks, though baseline scores do not predict future AMS development.
INTRODUCTION: The autonomic system and sympathetic activation appears integral in the pathogenesis of acute mountain sickness (AMS) at high altitude (HA), yet a link between heart rate variability (HRV) and AMS has not been convincingly shown. In this study we investigated the utility of the smartphone-derived HRV score to predict and diagnose AMS at HA. METHODS: Twenty-one healthy adults were investigated at baseline at 1400 m and over 10 days during a trek to 5140 m. HRV was recorded using the ithlete HRV device. RESULTS: Acute mountain sickness occurred in 11 subjects (52.4%) at >2650 m. HRV inversely correlated with AMS Scores (r = -0.26; 95% CI, -0.38 to -0.13: P < 0.001). HRV significantly fell at 3700, 4100, and 5140 m versus low altitude. HRV scores were lower in those with both mild (69.7 ± 14.0) and severe AMS (67.1 ± 13.1) versus those without AMS (77.5 ± 13.1; effect size n = 0.043: P = 0.007). The HRV score was weakly predictive of severe AMS (AUC 0.74; 95% CI, 0.58-0.89: P = 0.006). The change (delta) in the HRV Score (compared with baseline at 1400 m) was a moderate diagnostic marker of severe AMS (AUC 0.80; 95% CI, 0.70-0.90; P = 0.0004). A fall in the HRV score of >5 had a sensitivity of 83% and specificity of 60% to identify severe AMS (likelihood ratio 1.9). Baseline HRV at 1400 m was not predictive of either AMS at higher altitudes. CONCLUSIONS: The ithlete HRV score can be used to help in the identification of severe AMS; however, a baseline score is not predictive of future AMS development at HA.
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Mellor et al. (2017) conducted an observational in Acute Mountain Sickness (n=21). Smartphone-derived Heart Rate Variability (ithlete™ HRV score) vs. Baseline at 1400m was evaluated on Diagnostic accuracy of change in HRV score for severe AMS (AUC 0.80, 95% CI 0.70-0.90, p=0.0004). A fall in the smartphone-derived HRV score from baseline was a moderate diagnostic marker of severe acute mountain sickness (AUC 0.80), though baseline scores did not predict future AMS development.
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