Correlación entre biomarcadores de variabilidad de la frecuencia cardiaca obtenidos desde PPG y los índices de ansiedad/depresión en población pediátrica.
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Date
2025
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Universidad de Concepción
Abstract
El estudio tuvo como objetivo evaluar la relación entre biomarcadores de variabilidad de la frecuencia cardíaca (HRV), obtenidos a partir de señales fotopletismográficas (PPG), y los niveles de ansiedad y depresión en población pediátrica. Para ello, se procesaron registros PPG de 45 minutos por participante mediante un pipeline que incluyó filtrado pasabanda, detección de picos y un método robusto basado en el rango intercuartílico (IQR) para descartar intervalos no fisiológicos. Las señales fueron segmentadas en bloques consecutivos de cinco minutos y solo se retuvieron para el análisis aquellos participantes que presentaron entre cinco y ocho ventanas válidas, con al menos un 75% de intervalos NN coherentes en cada segmento.
A partir de cada ventana se calcularon métricas HRV en dominios temporal y frecuencial, incluyendo MeanNN, SDNN, RMSSD, LF, HF y el índice LF/HF. Estos biomarcadores se integraron con los puntajes de ansiedad y depresión obtenidos mediante cuestionarios psicométricos validados. Sobre esta base, se realizaron análisis descriptivos, correlaciones de Spearman con corrección por Falsa Tasa de Descubrimiento (FDR) y exploraciones visuales mediante gráficos de dispersión y diagramas de pares (pairplots).
Los resultados mostraron que los biomarcadores HRV derivados de las señales PPG presentaron valores y patrones de correlación interna coherentes con la fisiología autonómica descrita en menores, así como tendencias asociadas a la edad compatibles con la maduración autonómica. Sin embargo, las correlaciones entre HRV en reposo y los niveles de ansiedad y depresión fueron de baja magnitud (|ρ| ≤ 0,21) y ninguna asociación alcanzó significancia estadística tras la corrección por FDR. Los análisis visuales evidenciaron una alta variabilidad interindividual y una marcada superposición entre los grupos de probabilidad de ansiedad y depresión, lo que indica una capacidad discriminativa limitada de la HRV basal en esta población.
Se concluye que, aunque la HRV refleja aspectos relevantes del funcionamiento autonómico y puede obtenerse de manera fiable a partir de señales PPG mediante un pipeline reproducible, su uso como indicador aislado de estados emocionales en menores resulta limitado bajo condiciones de reposo. Se propone como línea futura la incorporación de protocolos dinámicos y la integración de la HRV con otros marcadores fisiológicos y psicológicos, con el fin de mejorar la sensibilidad para detectar diferencias emocionales clínicamente significativas.
The aim of this study was to evaluate the relationship between heart rate variability (HRV) biomarkers derived from photoplethysmography (PPG) and anxiety/depression levels in a pediatric population. Forty-five–minute PPG recordings were processed using a pipeline that included band-pass filtering, peak detection and a robust interquartile-range (IQR)–based method to remove non-physiological intervals. Signals were segmented into consecutive five-minute windows, and only participants with five to eight valid segments, each containing at least 75% stable NN intervals, were retained for analysis. Time- and frequency-domain HRV metrics—including MeanNN, SDNN, RMSSD, LF, HF and the LF/HF ratio—were computed for each window and averaged per participant. These biomarkers were then matched with anxiety and depression scores obtained from validated psychometric questionnaires. Descriptive statistics, Spearman correlations with False Discovery Rate (FDR) correction and visual analyses using scatterplots and pairplots were conducted to explore the association between autonomic modulation and emotional states. The results showed that HRV biomarkers derived from PPG exhibited physiologically coherent values and internal correlation patterns consistent with autonomic regulation in children and adolescents, as well as age-related trends compatible with autonomic maturation. However, correlations between resting HRV and anxiety/depression levels were small in magnitude (|ρ| ≤ 0.21), and none remained statistically significant after FDR correction. Visual analyses revealed high interindividual variability and substantial overlap between emotional groups, indicating a limited discriminative capacity of resting HRV in this population. Overall, the findings suggest that, although HRV captures relevant aspects of autonomic function and can be reliably extracted from PPG using a reproducible processing pipeline, it is insufficient as a standalone indicator of emotional states in children and adolescents under resting conditions. Future research should incorporate dynamic protocols and combine HRV with additional physiological and psychological measures to enhance sensitivity to clinically meaningful emotional differences.
The aim of this study was to evaluate the relationship between heart rate variability (HRV) biomarkers derived from photoplethysmography (PPG) and anxiety/depression levels in a pediatric population. Forty-five–minute PPG recordings were processed using a pipeline that included band-pass filtering, peak detection and a robust interquartile-range (IQR)–based method to remove non-physiological intervals. Signals were segmented into consecutive five-minute windows, and only participants with five to eight valid segments, each containing at least 75% stable NN intervals, were retained for analysis. Time- and frequency-domain HRV metrics—including MeanNN, SDNN, RMSSD, LF, HF and the LF/HF ratio—were computed for each window and averaged per participant. These biomarkers were then matched with anxiety and depression scores obtained from validated psychometric questionnaires. Descriptive statistics, Spearman correlations with False Discovery Rate (FDR) correction and visual analyses using scatterplots and pairplots were conducted to explore the association between autonomic modulation and emotional states. The results showed that HRV biomarkers derived from PPG exhibited physiologically coherent values and internal correlation patterns consistent with autonomic regulation in children and adolescents, as well as age-related trends compatible with autonomic maturation. However, correlations between resting HRV and anxiety/depression levels were small in magnitude (|ρ| ≤ 0.21), and none remained statistically significant after FDR correction. Visual analyses revealed high interindividual variability and substantial overlap between emotional groups, indicating a limited discriminative capacity of resting HRV in this population. Overall, the findings suggest that, although HRV captures relevant aspects of autonomic function and can be reliably extracted from PPG using a reproducible processing pipeline, it is insufficient as a standalone indicator of emotional states in children and adolescents under resting conditions. Future research should incorporate dynamic protocols and combine HRV with additional physiological and psychological measures to enhance sensitivity to clinically meaningful emotional differences.
Description
Tesis presentada para optar al título de Ingeniero/a Civil Biomédico/a.
Keywords
Frecuencia cardíaca, Ansiedad, Depresión, Pediatría