Completed

NCT Number: NCT06671171

Wearable Assessment of Thoracic, Cardiac Health and Exercise Performance Trial

Wearable health technology, particularly smartwatches, has revolutionized personal health monitoring by enabling continuous, non-invasive tracking of various physiological parameters. The potential applications of these devices in cardiology are extensive, but it is crucial to validate their accuracy against established medical-grade devices.

The Apple Watch Series 9 (Apple, USA) exemplifies the capabilities of modern smartwatches, offering a wide range of health tracking features. These include heart rate monitoring, detection of irregular heart rhythms suggestive of atrial fibrillation, electrocardiogram recording, blood oxygen level measurement, and comprehensive mobility metrics (including VO2 max, six-minute walk distance, walking speed, step length, double support time, and walking asymmetry). Many of these parameters are highly relevant for cardiovascular patients, potentially aiding in disease progression monitoring and adverse event prediction. However, there is a lack of comprehensive validation studies for these devices in specific cardiovascular disease populations.

This investigator-initiated prospective observational study involving 50-100 participants that aims to validate smartwatchbased assessments using medical-grade devices and techniques. The study will focus on adult patients with congenital heart disease, pulmonary hypertension, heart failure, and coronary artery disease, as well as athletes undergoing cardiovascular assessment. By comparing smartwatch data with established clinical measurements, the investigators seek to determine the reliability and potential clinical utility of these wearable devices in diverse cardiovascular contexts. This research will help bridge the gap between consumer-grade wearable technology and clinical practice in cardiology.

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Key information

Conditions

Congenital Heart Disease Arterial Occlusive Diseases Arteriosclerosis Cardiovascular Abnormalities Cardiovascular Diseases Congenital Abnormalities Congenital, Hereditary, and Neonatal Diseases and Abnormalities Coronary Artery Disease Coronary Disease Heart Defects, Congenital Heart Diseases Heart Failure Hypertension Hypertension, Pulmonary Lung Diseases Myocardial Ischemia Pulmonary Hypertension Respiratory Tract Diseases Vascular Diseases

Age range

20 year–70 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Department of Medicine Queen Marry Hospital

Hong Kong

About this study

Trial participants from Queen Mary Hospital and the University of Hong Kong will be recruited. Potential participants will be contacted and provided with a detailed explanation of the study, including its purpose, procedures, risks, and benefits. Written informed consent will be obtained from all participants before enrolment. This process involves providing individuals with the informed consent document, allowing time for review and questions, and obtaining their signature if they agree to participate. Participants will receive a copy of the signed consent form for their records.

At Visit 1, Comprehensive demographic and clinical data will be collected from each participant, Clinical Management System (CMS), Electronic Patient Record (ePR), and Clinical Data Analysis and Reporting System (CDARS) of the Hospital Authority in Hong Kong. This will include age, sex, height, weight, body mass index, and detailed medical history focusing on cardiovascular conditions. Information about current medications and smoking status will also be recorded. Additionally, participants will undergo a baseline clinical examination, including blood pressure measurement, heart rate, and a 12-lead electrocardiogram.

Participants will undergo a conventional cardiopulmonary exercise test (CPX) to determine their maximal oxygen uptake (VO2max) at Visit 1. This test will be conducted in a controlled clinical setting under the supervision of cardiologists. Participants will exercise on a treadmill while their respiratory gas exchange is measured using a metabolic cart. The exercise intensity will be gradually increased until the participant reaches volitional exhaustion or predetermined safety criteria are met. The highest oxygen uptake value achieved during the test will be recorded as the VO2max. Participant will concurrently be wearing the investigational smartwatch for pre- and post-SaO2 and VO2max assessment. This gold-standard measurement will serve as the reference for validating the smartwatch's continuous VO2max estimation.

The 6-minute walk distance will be assessed in a hospital setting at Visit 2 under the supervision of a research staff. Participants will be instructed to walk as far as possible in six minutes along a predetermined course, typically a straight hallway. The total distance walked will be measured and recorded. During the test, the research nurse will monitor the participant's heart rate, blood oxygen saturation, and perceived exertion at regular intervals. Participant will concurrently be wearing the investigational smartwatch for pre- and post SaO2 and VO2max assessment.

Participants will be provided with a medical-grade pulse oximeter for home use. They will be instructed to measure their oxygen saturation once daily throughout the one-week study period. Measurements should be taken at approximately the same time each day, preferably in the morning after waking and before any strenuous activity. Participants will record their oxygen saturation readings in a provided log. These daily measurements will serve as reference points for validating the continuous oxygen saturation data collected by the smartwatch.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Age 20 to 70 years old
Ability to provide informed consent
History of the following cardiovascular conditions
Adult congenital heart disease
Pulmonary hypertension
Heart failure
Coronary artery disease
Athletes undergoing cardiovascular assessment

Exclusion criteria

Contraindication for undergoing physical exertion including cardio-pulmonary exercise testing (CPX) and 6-minute walk test (6MWT)
Pregnancy
Known allergy to components of the investigational product

Treatment and study plan

Apple Watch Series 9

Device

Participants will wear Apple Watch Series 9 during cardiopulmonary exercise test (in Visit 1), 1-week study period and 6-Minute walk distance test (in Visit 2) to have assessment of maximal oxygen uptake and pre- and post-SaO2.

During 1-week study period, participants will measure their oxygen saturation once daily with a medical-grade pulse oximeter while wearing the smartwatch continuously.

Primary outcomes

Correlation between CPX VO2max and smartwatch parameters (virtual VO2 max, physical activity parameters)

Time frame: During treadmill exercise in the day of recruitment and concurrently baseline assessment (Visit 1/ Week 1)

VO2 max (ml/min/kg) concurrently measured with a medical-grade device and a smartwatch which has virutal VO2 max and physical activity parameters as assessed during treadmill exercise

Secondary outcomes

Correlation between VO2 max (ml/min/kg) obtained using medical-grade device and smartwatch

Time frame: From enrollment to end of follow up at Visit 2(Week 2)

VO2 max (ml/min/kg) obtained using medical-grade device and smartwatch during supervised treadmill exercise, supervised 6-minute walk test and mean and max value during other exercise
Correlation between SaO2 (%) obtained using medical-grade device and smartwatch

Time frame: From enrollment to end of follow up at Visit 2(Week 2)

SaO2 (%) obtained using medical-grade device and smartwatch during supervised treadmill exercise, supervised 6-minute walk test and during other exercise in the follow up period.
SaO2 (%) measured by the smartwatch

Time frame: From enrollment to end of follow up at Visit 2(Week 2)

SaO2 (%) measured by the smartwatch from enrollment to end of follow up period
SaO2 (%) in participants with severe disease and participants with mild disease

Time frame: From enrollment to end of follow up at Visit 2(Week 2)

SaO2 (%) in participants with severe versus mild disease from enrollment to end of follow up period
Novel markers or patterns

Time frame: From enrollment to end of follow up at Visit 2(Week 2)

Novel markers or patterns indicative of disease severity or predictive of adverse events as assessed from enrollment to end of follow up period

Sponsors and collaborators

Lead sponsor

The University of Hong Kong

Other

Registry information

Acronym: WATCH-X

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Nov 4, 2024
Registry last updated: May 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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