Avaliação da Variabilidade da Frequência Cardíaca Derivada de Smartphone: Implicações para Saúde Oral e Classificação de Risco ASA

Abstract

Objectives: This study aims to assess the feasibility and effectiveness of using smartphone- derived Heart Rate Variability (HRV) as a diagnostic tool to identify potential associations with

both general health and oral health conditions. The hypothesis is that HRV may demonstrate discernible associations with the ASA classification for risk in dentistry, as well as with oral health conditions, including tooth loss and oral rehabilitation Materials and Methods: This study was classified as observational, cross-sectional, prospective, and exploratory. HRV was obtained through photoplethysmography using a smartphone camera. For comparison, heart rate (HR) was compared using different methods including automatic blood pressure monitor, pulse oximeter, multiparameter cardiac monitor, and handheld electrocardiogram. General health condition was obtained through a modified questionnaire based on the American Society of Anesthesiologists (ASA) classification. Oral health data were obtained through intraoral clinical examination and included the number of remaining teeth and oral rehabilitation status. Results: The sample consisted of 112 patients. Among the included patients, females represented 65.2% of the sample (73 cases). Age ranged from 19 to 86 years (mean 38.3 years,

SD± 16.2). HR obtained by smartphone showed comparability with other methods (Bland- Altman analysis) with few discrepant measures and highly similar mean, median, standard

deviation, and coefficients of variation among the five methods employed. HRV exhibited a negative correlation with increasing ASA classification (Spearman's test, two-tailed, rs -.25, p= .008). When compared with a cutoff value of 35 points for HRV, aiming to differentiate between healthy patients and those with comorbidities, the test showed a sensitivity of 68.3% and specificity of 61.5% for detecting ASA alteration. Heart rate variability (HRV) showed correlation with the number of remaining teeth in the oral cavity (Spearman's test, two-tailed, rs .26, p= .005). The function and rehabilitation condition indicated that the more preserved or

rehabilitated masticatory function, the better the results obtained in HRV (Spearman's test, two- tailed, rs .22, p= .02). Conclusions: The results indicate that smartphone-derived HRV can be

an auxiliary and promising method for detecting overall health conditions by showing an association with ASA classification or patients with comorbidities, suggesting potential for risk detection in dental procedures. The association between HRV and tooth loss, as well as oral rehabilitation condition, may suggest a connection between oral health and cardiovascular health. HRV assessment may offer a different perspective on patient well-being, stress response, and cardiovascular health, which can inform risk assessment, treatment planning, and patient management strategies in dental practice. By integrating HRV monitoring into routine dental care, practitioners may enhance patient safety, comfort, and overall treatment outcomes.