{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T20:38:07Z","timestamp":1769891887437,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether resting heart rate (HR) or heart rate variability (HRV) derived from finger photoplethysmography (PPG) predicts 6\u2010month pneumonia risk in patients with dysphagia. HRV reflects autonomic regulation of inflammation which may predispose to respiratory complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 301 patients who underwent a videofluoroscopic swallow study (VFSS) in 2020\u20132021 were enrolled. Prior to VFSS, resting HR was measured using the CorSense HRV finger sensor (ELITE HRV). Additional HRV metrics, including the standard deviation of normal\u2010to\u2010normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were collected from a subset of 153 participants. Pneumonia incidence was assessed at 3 and 6\u2009months through phone interviews and medical record review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age was 66.3\u2009\u00b1\u200912.5\u2009years, and 38% were female. Twenty patients (7%) developed pneumonia, with 75% of cases occurring within 3\u2009months. Patients who developed pneumonia had higher resting HR than those who did not (83.4 vs. 74.3\u2009bpm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). This association remained significant after adjusting for age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Pneumonia risk increased stepwise with higher HR thresholds, with a 2.4\u2010fold greater risk observed at HR \u2265\u200982\u2009bpm and a 2.8\u2010fold risk at HR \u2265\u200990\u2009bpm. HRV metrics were not significantly associated with pneumonia incidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated resting HR, though within the normal range, was associated with increased pneumonia risk in patients with dysphagia. This may reflect underlying inflammation or autonomic dysfunction. Because comorbidities, medications, and VFSS severity were not accounted for, these findings should be interpreted as preliminary. Resting HR may represent a simple, non\u2010invasive tool for pneumonia risk stratification in this population, but larger studies are needed for validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70321","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T14:29:22Z","timestamp":1765981762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart Rate as a Predictor of 6\u2010Month Pneumonia Risk in Patients With Dysphagia"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6202-4647","authenticated-orcid":false,"given":"Yuval","family":"Nachalon","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery Tel\u2010Aviv Sourasky Medical Center  Tel\u2010Aviv Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nogah","family":"Nativ\u2010Zeltzer","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosef","family":"Kula","sequence":"additional","affiliation":[{"name":"Health Psychology Unit, Institute of Psychology University of Graz  Austria"},{"name":"Department of Nursing, Faculty of Social Welfare and Health Sciences Haifa University  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Tran","sequence":"additional","affiliation":[{"name":"School of Medicine University of California  Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie Reshma","family":"Warrior","sequence":"additional","affiliation":[{"name":"School of Medicine University of California  Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0288-2839","authenticated-orcid":false,"given":"Peter C.","family":"Belafsky","sequence":"additional","affiliation":[{"name":"Center for Voice and Swallowing, Department of Otolaryngology, Head &amp; Neck Surgery University of California  Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2013.02.014"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.834240"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148424"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.129"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29770"},{"issue":"6","key":"e_1_2_8_7_1","first-page":"487","article-title":"Dysregulated Inflammation as a Risk Factor for Pneumonia in the Elderly","volume":"2","author":"Boyd A. R.","year":"2011","journal-title":"Aging and Disease"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X16671964"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri2566"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-042617-053158"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.11.009"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010023\u201012058\u20105"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.12.022"},{"issue":"2","key":"e_1_2_8_14_1","first-page":"189","article-title":"Continuous Monitoring Is Superior to Manual Measurements in Detecting Vital Sign Deviations in Patients With COVID\u201019","volume":"67","author":"Gr\u00f8nbaek K. K.","year":"2023","journal-title":"Acta Anaesthesiologica Scandinavica"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/28890"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.630273"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735\u20101097(00)01121\u20109"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/35013070"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70321","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.70321","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:43:48Z","timestamp":1769838228000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/lio2.70321"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70321","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70321"}}