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Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients

Received: 19 April 2023     Accepted: 17 May 2023     Published: 29 May 2023
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Abstract

Cardiorespiratory fitness as represented by maximum oxygen uptake, VO2max, is considered the best indicator for overall cardiovascular health. Fitness technology such as wrist worn devices, now allows for an easy method to monitor an individual’s VO2max. This study sought to compare the estimated VO2max measurements from the Polar Ignite (Polar Electro Oy, Kempele, Finland) fitness watch (Polar Ignite) against the gold standard, cardiopulmonary exercise testing (CPET) in normal cardiac anatomy and Fontan pediatric patients. This single-center, prospective study enrolled patients with normal cardiac anatomy and single ventricle patients with Fontan palliation (Fontan) between 13-21 years. The Polar Ignite was fastened on the patient’s right or left wrist while supine and estimated VO2max was generated based on a non-exercise test (Polar Fitness Test). A maximal voluntary CPET using the standard Bruce Treadmill Protocol was then completed. Measurements from the two tests were compared using the intraclass correlation coefficient (ICC), Pearson correlation coefficient and Bland-Altman method. Forty-seven patients were enrolled, including n=36 (77%) normal cardiac patients and n=11 (23%) Fontan patients. The majority of participants were white (n=41, 87%) and female (n=36, 66%). Patients were 15.3±1.9 years old, weighed 65.7±16.6 kg, and were 168.0±10.4 cm tall on average. The mean estimated Polar Ignite VO2max and peak CPET VO2 was 43.9±6.1 ml/kg/min vs 37.7±8.2 ml/kg/min, respectively in the normal cardiac group, and 42.6±3.9 ml/kg/min vs 22.6±5.6 ml/kg/min, respectively in the Fontan group. We found poor validity (ICC=0.21) and a weak correlation (r=0.31, p=0.07) between VO2max measured by the Polar Ignite and CPET in the normal cardiac group and poor validity (ICC=0.08) and strong correlation (r=0.84, p=0.001) in the Fontan group. In Bland-Altman analyses, the mean bias between VO2max as measured by the Polar Ignite and CPET was 6.85 ml/kg/min among the normal cardiac group and 20.05 ml/kg/min among the Fontan group. The Polar Ignite overestimated VO2max compared to CPET in both the normal cardiac and Fontan groups and cannot replace formal testing.

Published in American Journal of Pediatrics (Volume 9, Issue 2)
DOI 10.11648/j.ajp.20230902.15
Page(s) 79-84
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Wearable Devices, Cardiopulmonary Exercise Testing, VO2max, Fontan

References
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[3] Raghuveer, G., et al., Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation, 2020. 142 (7): p. e101-e118.
[4] Fletcher, G. F., et al., Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation, 2013. 128 (8): p. 873-934.
[5] Takken, T., et al., Cardiopulmonary Exercise Testing in Pediatrics. Ann Am Thorac Soc, 2017. 14 (Supplement_1): p. S123-S128.
[6] Takken, T., et al., Cardiopulmonary exercise testing in congenital heart disease: (contra) indications and interpretation. Neth Heart J, 2009. 17 (10): p. 385-92.
[7] Mantegazza, V., A. Apostolo, and A. Hager, Cardiopulmonary Exercise Testing in Adult Congenital Heart Disease. Ann Am Thorac Soc, 2017. 14 (Supplement_1): p. S93-S101.
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[14] Kraft, G. L. and M. Dow, Validation of the Garmin Forerunner 920XT VO2max Estimation and the Polar RS300X Fitness Test. International Journal for Innovation Education and Research, 2019. 7 (9): p. 22-28.
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[17] Dahlqvist, J. A., et al., Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation? Pediatr Cardiol, 2019. 40 (4): p. 685-693.
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[20] Crumpton, S., Validity of the Polar M52 Heart Rate Monitor in Predicting VO2max Medicine & Science in Sports & Exercise, 2003. 35 (5).
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Cite This Article
  • APA Style

    Brian Hernandez, Bayley Roberts, Erica Jamro-Comer, Anusha Kodidhi, Lisa Roelle, et al. (2023). Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients. American Journal of Pediatrics, 9(2), 79-84. https://doi.org/10.11648/j.ajp.20230902.15

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    ACS Style

    Brian Hernandez; Bayley Roberts; Erica Jamro-Comer; Anusha Kodidhi; Lisa Roelle, et al. Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients. Am. J. Pediatr. 2023, 9(2), 79-84. doi: 10.11648/j.ajp.20230902.15

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    AMA Style

    Brian Hernandez, Bayley Roberts, Erica Jamro-Comer, Anusha Kodidhi, Lisa Roelle, et al. Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients. Am J Pediatr. 2023;9(2):79-84. doi: 10.11648/j.ajp.20230902.15

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  • @article{10.11648/j.ajp.20230902.15,
      author = {Brian Hernandez and Bayley Roberts and Erica Jamro-Comer and Anusha Kodidhi and Lisa Roelle and Nathan Miller and Lauren Littell and Aecha Ybarra and Jonathan Silva and Jennifer Silva and William Orr},
      title = {Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients},
      journal = {American Journal of Pediatrics},
      volume = {9},
      number = {2},
      pages = {79-84},
      doi = {10.11648/j.ajp.20230902.15},
      url = {https://doi.org/10.11648/j.ajp.20230902.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230902.15},
      abstract = {Cardiorespiratory fitness as represented by maximum oxygen uptake, VO2max, is considered the best indicator for overall cardiovascular health. Fitness technology such as wrist worn devices, now allows for an easy method to monitor an individual’s VO2max. This study sought to compare the estimated VO2max measurements from the Polar Ignite (Polar Electro Oy, Kempele, Finland) fitness watch (Polar Ignite) against the gold standard, cardiopulmonary exercise testing (CPET) in normal cardiac anatomy and Fontan pediatric patients. This single-center, prospective study enrolled patients with normal cardiac anatomy and single ventricle patients with Fontan palliation (Fontan) between 13-21 years. The Polar Ignite was fastened on the patient’s right or left wrist while supine and estimated VO2max was generated based on a non-exercise test (Polar Fitness Test). A maximal voluntary CPET using the standard Bruce Treadmill Protocol was then completed. Measurements from the two tests were compared using the intraclass correlation coefficient (ICC), Pearson correlation coefficient and Bland-Altman method. Forty-seven patients were enrolled, including n=36 (77%) normal cardiac patients and n=11 (23%) Fontan patients. The majority of participants were white (n=41, 87%) and female (n=36, 66%). Patients were 15.3±1.9 years old, weighed 65.7±16.6 kg, and were 168.0±10.4 cm tall on average. The mean estimated Polar Ignite VO2max and peak CPET VO2 was 43.9±6.1 ml/kg/min vs 37.7±8.2 ml/kg/min, respectively in the normal cardiac group, and 42.6±3.9 ml/kg/min vs 22.6±5.6 ml/kg/min, respectively in the Fontan group. We found poor validity (ICC=0.21) and a weak correlation (r=0.31, p=0.07) between VO2max measured by the Polar Ignite and CPET in the normal cardiac group and poor validity (ICC=0.08) and strong correlation (r=0.84, p=0.001) in the Fontan group. In Bland-Altman analyses, the mean bias between VO2max as measured by the Polar Ignite and CPET was 6.85 ml/kg/min among the normal cardiac group and 20.05 ml/kg/min among the Fontan group. The Polar Ignite overestimated VO2max compared to CPET in both the normal cardiac and Fontan groups and cannot replace formal testing.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients
    AU  - Brian Hernandez
    AU  - Bayley Roberts
    AU  - Erica Jamro-Comer
    AU  - Anusha Kodidhi
    AU  - Lisa Roelle
    AU  - Nathan Miller
    AU  - Lauren Littell
    AU  - Aecha Ybarra
    AU  - Jonathan Silva
    AU  - Jennifer Silva
    AU  - William Orr
    Y1  - 2023/05/29
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajp.20230902.15
    DO  - 10.11648/j.ajp.20230902.15
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 79
    EP  - 84
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20230902.15
    AB  - Cardiorespiratory fitness as represented by maximum oxygen uptake, VO2max, is considered the best indicator for overall cardiovascular health. Fitness technology such as wrist worn devices, now allows for an easy method to monitor an individual’s VO2max. This study sought to compare the estimated VO2max measurements from the Polar Ignite (Polar Electro Oy, Kempele, Finland) fitness watch (Polar Ignite) against the gold standard, cardiopulmonary exercise testing (CPET) in normal cardiac anatomy and Fontan pediatric patients. This single-center, prospective study enrolled patients with normal cardiac anatomy and single ventricle patients with Fontan palliation (Fontan) between 13-21 years. The Polar Ignite was fastened on the patient’s right or left wrist while supine and estimated VO2max was generated based on a non-exercise test (Polar Fitness Test). A maximal voluntary CPET using the standard Bruce Treadmill Protocol was then completed. Measurements from the two tests were compared using the intraclass correlation coefficient (ICC), Pearson correlation coefficient and Bland-Altman method. Forty-seven patients were enrolled, including n=36 (77%) normal cardiac patients and n=11 (23%) Fontan patients. The majority of participants were white (n=41, 87%) and female (n=36, 66%). Patients were 15.3±1.9 years old, weighed 65.7±16.6 kg, and were 168.0±10.4 cm tall on average. The mean estimated Polar Ignite VO2max and peak CPET VO2 was 43.9±6.1 ml/kg/min vs 37.7±8.2 ml/kg/min, respectively in the normal cardiac group, and 42.6±3.9 ml/kg/min vs 22.6±5.6 ml/kg/min, respectively in the Fontan group. We found poor validity (ICC=0.21) and a weak correlation (r=0.31, p=0.07) between VO2max measured by the Polar Ignite and CPET in the normal cardiac group and poor validity (ICC=0.08) and strong correlation (r=0.84, p=0.001) in the Fontan group. In Bland-Altman analyses, the mean bias between VO2max as measured by the Polar Ignite and CPET was 6.85 ml/kg/min among the normal cardiac group and 20.05 ml/kg/min among the Fontan group. The Polar Ignite overestimated VO2max compared to CPET in both the normal cardiac and Fontan groups and cannot replace formal testing.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Department of Pediatrics, St. Louis Children’s Hospital, St. Louis, MO, USA

  • Department of Pediatrics, St. Louis Children’s Hospital, St. Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Electrophysiology Laboratory, St Louis Children’s Hospital, St Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Department of Biomedical Engineering, Washington University McKelvey School of Engineering, St Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

  • Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

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