{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T23:06:28Z","timestamp":1765667188321,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2017,10,25]],"date-time":"2017-10-25T00:00:00Z","timestamp":1508889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Chronotropic incompetence (CI) has been proven to be an important factor in the diagnosis and management of cardiovascular diseases. In this paper, we extend the existing CI parameters and propose chronotropic competence indices (CCI) to describe the exercise response of the cardiopulmonary system. A cardiac chronotropic competence Test (3CT), dedicated to CCI measurement using a wearable device, is also presented. Preliminary clinical trials are presented for the validation of 3CT measurement accuracy, and to show the potential of CCI in the prevention and rehabilitation of cardiovascular diseases.<\/jats:p>","DOI":"10.3390\/s17112441","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T10:39:18Z","timestamp":1508841558000},"page":"2441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Chronotropic Competence Indices Extracted from Wearable Sensors for Cardiovascular Diseases Management"],"prefix":"10.3390","volume":"17","author":[{"given":"Jiankang","family":"Wu","sequence":"first","affiliation":[{"name":"The University of Chinese Academy of Sciences, Beijing 100049, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianan","family":"Li","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital, No. 200 Guangzhou Road, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Seely","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital, No. 200 Guangzhou Road, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisi","family":"Huang","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital, No. 200 Guangzhou Road, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqin","family":"Wang","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital, No. 200 Guangzhou Road, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital, No. 200 Guangzhou Road, Nanjing 210008, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongliang","family":"Wang","sequence":"additional","affiliation":[{"name":"The University of Chinese Academy of Sciences, Beijing 100049, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herry","family":"Christophe","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13167","DOI":"10.3390\/s121013167","article-title":"Development of a respiratory inductive plethysmography module supporting multiple sensors for wearable systems","volume":"12","author":"Zhang","year":"2012","journal-title":"Sensors"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3390\/diseases2020120","article-title":"The role of exercise testing in the modern management of pulmonary arterial hypertension","volume":"2","author":"Johnson","year":"2014","journal-title":"Diseases"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1161\/CIR.0b013e3181e52e69","article-title":"Clinician\u2019s Guide to Cardiopulmonary Exercise Testing in Adults","volume":"122","author":"Balady","year":"2010","journal-title":"Circulation"},{"key":"ref_4","first-page":"817","article-title":"CPET Lab setting requirements and Quality Control in Clinical Practice","volume":"42","author":"Sun","year":"2014","journal-title":"China J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1161\/CIRCULATIONAHA.110.940577","article-title":"Chronotropic Incompetence","volume":"123","author":"Brubaker","year":"2011","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3226","DOI":"10.1161\/01.CIR.94.12.3226","article-title":"Chronotropic Response to Exercise","volume":"94","author":"Okin","year":"1996","journal-title":"Circulation"},{"key":"ref_7","first-page":"309","article-title":"Diagnostic value of chronotropic incompetence in coronary heart disease","volume":"32","author":"Luo","year":"2007","journal-title":"J. Cent. South Univ. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/j.amjcard.2015.06.038","article-title":"Association of Chronic Kidney Disease With Chronotropic Incompetence in Heart Failure With Preserved Ejection Fraction","volume":"116","author":"Klein","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1161\/CIRCHEARTFAILURE.114.001615","article-title":"Exercise Training in Patients with Heart Failure and Preserved Ejection Fraction: A Meta-analysis of Randomized Control Trials","volume":"8","author":"Pandey","year":"2014","journal-title":"Circ. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/2047487312444368","article-title":"Chronotropic incompetence predicts impaired response to exercise training in heart failure patients with sinus rhythm","volume":"20","author":"Schmid","year":"2013","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"724","DOI":"10.2337\/dc10-1424","article-title":"Heart Rate Recovery After Exercise Is a Predictor of Silent Myocardial Ischemia in Patients With Type 2 Diabetes","volume":"34","author":"Yamada","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ijcard.2008.01.036","article-title":"Long-term prognostic value of heart-rate recovery after treadmill testing in patients with diabetes mellitus","volume":"134","author":"Georgoulias","year":"2009","journal-title":"Int. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"536.e7","DOI":"10.1016\/j.amjmed.2016.01.014","article-title":"Exercise Heart Rate Reserve and Recovery as Predictors of Incident Type 2 Diabetes","volume":"129","author":"Jae","year":"2016","journal-title":"Am. J. Med."},{"key":"ref_14","first-page":"87","article-title":"Heart rate recovery and chronotropic incompetence in patients with prehypertension","volume":"106","author":"Shin","year":"2015","journal-title":"Min. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1093\/ajh\/hpt173","article-title":"Delayed Heart Rate Recovery is Strongly Associated With Early and Late-Stage Prehypertension During Exercise Stress Testing","volume":"27","author":"Aneni","year":"2014","journal-title":"Am. J. Hypertens."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1161\/01.CIR.93.8.1485","article-title":"Chronotropic Incompetence","volume":"93","author":"Ellestad","year":"1996","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1161\/01.CIR.93.8.1520","article-title":"Impaired Heart Rate Response to Graded Exercise","volume":"93","author":"Lauer","year":"1996","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1161\/CIRCULATIONAHA.110.939249","article-title":"Heart Rate Response to Exercise Stress Testing in Asymptomatic Women","volume":"122","author":"Gulati","year":"2010","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e000559","DOI":"10.1161\/JAHA.113.000559","article-title":"Cardiopulmonary Fitness and Heart Rate Recovery as Predictors of Mortality in a Referral Population","volume":"3","author":"Dhoble","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jacc.2004.02.060","article-title":"The incremental prognostic value of percentage of heart rate reserve achieved over myocardial perfusion single-photon emission computed tomography in the prediction of cardiac death and all-cause mortality","volume":"44","author":"Azarbal","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1016\/j.amjcard.2015.08.037","article-title":"Prognostic Contribution of Exercise Capacity, Heart Rate Recovery, Chronotropic Incompetence, and Myocardial Perfusion Single-Photon Emission Computerized Tomography in the Prediction of Cardiac Death and All-Cause Mortality","volume":"116","author":"Arbit","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/S0733-8651(18)30211-X","article-title":"Exercise testing for chronotropic assessment","volume":"10","author":"Wilkoff","year":"1992","journal-title":"Cardiol. Clin."},{"key":"ref_23","first-page":"16","article-title":"Wearable Cardiac Rehab Equipment and Cloud Service System","volume":"6","author":"Wu","year":"2016","journal-title":"Int. Rehabil. Eng. Devices"},{"key":"ref_24","first-page":"387","article-title":"Heart rate as a treatable risk factor in cardiovascular disease","volume":"34","author":"Cowie","year":"2012","journal-title":"Medicographia"},{"key":"ref_25","unstructured":"ACSM (2013). ACSM\u2019s Guidelines for Exercise Testing and Prescription, Lippincott Williams & Wilkins."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/j.1532-5415.1992.tb01992.x","article-title":"The mini-mental state examination: A comprehensive review","volume":"40","author":"Tombaugh","year":"1992","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/oxfordjournals.pubmed.a024606","article-title":"A shorter form health survey: Can the SF-12 replicate results from the SF-36 in longitudinal studies?","volume":"19","author":"Jenkinson","year":"1997","journal-title":"J. Public Health Med."},{"key":"ref_28","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1258\/RSMSMJ.53.1.44","article-title":"Dr John Rankin; his life, legacy and the 50th anniversary of the Rankin Stroke Scale","volume":"53","author":"Quinn","year":"2008","journal-title":"Scott. Med. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1136\/jnnp.53.7.576","article-title":"Assessing motor impairment after stroke: A pilot reliability study","volume":"53","author":"Collin","year":"1990","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_31","unstructured":"World Health Organization (2013). How to Use the ICF: A Practical Manual for Using The International Classification of Functioning, Disability and Health, International Coach Federation (ICF). Exposure Draft for Comment."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/17\/11\/2441\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:48:21Z","timestamp":1760208501000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/17\/11\/2441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,25]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2017,11]]}},"alternative-id":["s17112441"],"URL":"https:\/\/doi.org\/10.3390\/s17112441","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2017,10,25]]}}}