Key result
The parameter triplet pNNtri characterizes momentary stress levels significantly better than pNN50 alone, especially for senior persons, although values calculated from PPG may substantially differ from the ECG gold standard.
Observational
No
A novel HRV parameter triplet (pNNtri) from short 1-2 minute recordings provides a more sensitive measure of momentary stress than standard pNN50, particularly in older adults, though PPG-derived measurements may differ from ECG gold standards.
Differences in ECG- and PPG-derived NN intervals warrant caution for short recordings; leaves open equivalence for stress assessment.
The increased stress level of an individual often influences the medical test results. Heart rate variability (HRV) can be used to characterize stress level. Parameters in the time domain are preferred, as they make the assessment possible from relatively short (3 - 5 minute-long) recordings. Electrocardiographic signal (ECG) in Einthoven I lead and photoplethysmographic signal (PPG) at the fingertip were recorded in parallel. This paper analyzes the differences between the lengths of successive heart cycles (NN); the ratio of these differences exceeding 50 ms (pNN50) is considered to be a good measure of stress. The parameter triplet pNNtri has been defined dividing the differences of successive NN intervals into three categories: pNN0_20 (0 – 20 ms), pNN20_50 (20 – 50 ms) and pNN50 (greater than 50 ms). pNNtri characterizes the actual stress level significantly better (especially for senior persons) than pNN50 alone. NN intervals determined from PPG differ from those determined from ECG recorded in parallel.
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Jobbágy et al. (2017) conducted an observational in Healthy individuals and patients with cardiovascular disease. pNNtri (HRV parameter triplet) vs. pNN50 alone was evaluated on Ability to characterize momentary stress level and differences between ECG and PPG derived NN intervals. The parameter triplet pNNtri characterizes momentary stress levels significantly better than pNN50 alone, especially for senior persons, although values calculated from PPG may substantially differ from the ECG gold standard.
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