{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:37:30Z","timestamp":1786700250585,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart rate variability (HRV) is a critical biomarker for assessing autonomic dysfunction, particularly in elderly and type 2 diabetes mellitus (T2DM) populations. However, traditional HRV indices, derived from R-R intervals (RRIs), often fail to detect subtle autonomic dysfunction in complex clinical scenarios. This study proposes a novel Direct TRI Correction (DTRC) sequence to optimize HRV assessment by directly extracting TR intervals (DTRI) and applying a single-step correction. The aim is to enhance accuracy in evaluating HRV, particularly in elderly and T2DM cohorts, where early detection is critical for preventing cardiovascular complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study enrolled 124 participants (60 T2DM patients and 64 healthy controls) stratified into three groups based on glycemic control. HRV indices were derived from traditional RRI sequences, two-step corrected TRC sequences, and the novel single-step corrected DTRC sequences, respectively. Statistical analyses were performed on the HRV indices of three sequences to evaluate the comparative performance of DTRC sequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DTRC-based HRV indices demonstrated superior sensitivity and discriminative capability compared to both RRI-based and TRC-based HRV indices. Significant improvements were observed in RMSSD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), pNN50 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), SDSD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), LHR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), SSR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), BEI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), and MSE\n                      <jats:sub>LS<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Visualization analysis and ROC curves confirmed clearer inter-group separation, particularly for T2DM patients with poor glycemic control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The DTRC sequence significantly enhances HRV assessment accuracy, offering a reliable tool for early detection of autonomic dysfunction in high-risk populations. Its simplified correction process and improved sensitivity hold promise for clinical diagnostics and wearable health monitoring applications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1899142","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:10:22Z","timestamp":1786698622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced ECG signal based on heart rate variability: validation of the direct TR correction sequence in diabetes"],"prefix":"10.3389","volume":"13","author":[{"given":"Shanglin","family":"Yang","sequence":"first","affiliation":[{"name":"School of Electrical and Information Engineering, North Minzu University","place":["Yinchuan, Ningxia, China"]},{"name":"Microelectronics and Solid-State Electronics Device Research Center, North Minzu University","place":["Yinchuan, Ningxia, 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