scholarly journals Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

2019 ◽  
Vol 22 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Su-Chen Fang ◽  
Yu-Lin Wu ◽  
Pei-Shan Tsai
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cohort Studies ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Coronary Syndrome ◽  
Artery Disease

Lower heart rate variability (HRV) is associated with a higher risk of cardiovascular events and mortality, although the extent of the association is uncertain. We performed a meta-analysis of cohort studies to elucidate the association between HRV and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD) during a follow-up of at least 1 year. We searched four databases (PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials) and extracted the adjusted hazard ratio (HR) from eligible studies. We included 28 cohort studies involving 3,094 participants in the meta-analysis. Results revealed that lower HRV was associated with a higher risk of all-cause death and cardiovascular events; the pooled HRs were 2.12 (95% confidence interval [CI] = [1.64, 2.75]) and 1.46 (95% CI [1.19, 1.77]), respectively. In subgroup analyses, the pooled HR of all-cause death was significant for patients with acute myocardial infarction (AMI) but not for those with heart failure. The pooled HR for cardiovascular events was significant for the subgroup of patients with AMI and acute coronary syndrome but not for those with coronary artery disease and heart failure. Additionally, both time and frequency domains of HRV were significantly associated with risk of all-cause death and cardiovascular events in patients with CVD.

Fried-food consumption and risk of cardiovascular disease and all-cause mortality: a meta-analysis of observational studies

Heart ◽  
2021 ◽  
pp. heartjnl-2020-317883 ◽  
Author(s):  
Pei Qin ◽  
Ming Zhang ◽  
Minghui Han ◽  
Dechen Liu ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Food Consumption ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Case Control ◽  
Fried Food ◽  
Major Cardiovascular Events ◽  
All Cause Mortality

ObjectiveWe performed a meta-analysis, including dose–response analysis, to quantitatively determine the association of fried-food consumption and risk of cardiovascular disease and all-cause mortality in the general adult population.MethodsWe searched PubMed, EMBASE and Web of Science for all articles before 11 April 2020. Random-effects models were used to estimate the summary relative risks (RRs) and 95% CIs.ResultsIn comparing the highest with lowest fried-food intake, summary RRs (95% CIs) were 1.28 (1.15 to 1.43; n=17, I2=82.0%) for major cardiovascular events (prospective: 1.24 (1.12 to 1.38), n=13, I2=75.7%; case–control: 1.91 (1.15 to 3.17), n=4, I2=92.1%); 1.22 (1.07 to 1.40; n=11, I2=77.9%) for coronary heart disease (prospective: 1.16 (1.05 to 1.29), n=8, I2=44.6%; case–control: 1.91 (1.05 to 3.47), n=3, I2=93.9%); 1.37 (0.97 to 1.94; n=4, I2=80.7%) for stroke (cohort: 1.21 (0.87 to 1.69), n=3, I2=77.3%; case–control: 2.01 (1.27 to 3.19), n=1); 1.37 (1.07 to 1.75; n=4, I2=80.0%) for heart failure; 1.02 (0.93 to 1.14; n=3, I2=27.3%) for cardiovascular mortality; and 1.03 (95% CI 0.96 to 1.12; n=6, I2=38.0%) for all-cause mortality. The association was linear for major cardiovascular events, coronary heart disease and heart failure.ConclusionsFried-food consumption may increase the risk of cardiovascular disease and presents a linear dose–response relation. However, the high heterogeneity and potential recall and misclassification biases for fried-food consumption from the original studies should be considered.

scholarly journals Exploring the relationship between schizophrenia and cardiovascular disease: A genetic correlation and multivariable Mendelian randomization study

2021 ◽  
Author(s):  
Rada R Veeneman ◽  
Jentien M Vermeulen ◽  
Abdel Abdellaoui ◽  
Eleanor Sanderson ◽  
Robyn E Wootton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Diastolic Blood Pressure ◽  
Mendelian Randomization ◽  
Genetic Correlations ◽  
Lipid Levels ◽  
Early Repolarization ◽  
Artery Disease

Importance: Individuals with schizophrenia have a reduced life-expectancy compared to the general population, largely due to an increased risk of cardiovascular disease (CVD). Clinical and epidemiological studies have been unable to fully unravel the nature of this relationship. Objective: Investigate genetic correlations and potential bi-directional effects between liability to schizophrenia and CVD. Design, setting, and participants: We obtained summary-data of genome-wide-association studies of schizophrenia (N=130,644), heart failure (N=977,323), coronary artery disease (N=332,477), systolic and diastolic blood pressure (N=757,601), heart rate variability (N=46,952), QT interval (N=103,331), early repolarization and dilated cardiomyopathy ECG patterns (N=63,700). We computed genetic correlations with linkage disequilibrium score regression and conducted bi-directional Mendelian randomization (MR). With multivariable MR, we investigated whether associations were mediated by smoking, body mass index, physical activity, lipid levels, or type 2 diabetes. To ensure robustness, we applied a range of sensitivity methods. Main outcomes and measures: Schizophrenia, heart failure, coronary artery disease, systolic blood pressure, diastolic blood pressure, heart rate variability, QT interval, early repolarization, dilated cardiomyopathy. Results: Genetic correlations between liability to schizophrenia and CVD were close to zero (-0.02 to 0.04). With MR, we found robust evidence that liability to schizophrenia increases heart failure risk. This effect remained consistent with multivariable MR. There was also evidence that liability to schizophrenia increases early repolarization risk, largely mediated by BMI and lipid levels. Finally, there was evidence that liability to schizophrenia increases heart rate variability, a direction of effect contrasting previous studies. In the other direction, there was weak evidence that higher systolic, but not diastolic, blood pressure increases schizophrenia risk. Conclusions and relevance: Our findings indicate that liability to schizophrenia increases the risk of heart failure, and that this is not mediated by key health behaviours. This is consistent with the notion that schizophrenia is characterised by a systemic dysregulation of the body (including inflammation and oxidative stress) with detrimental effects on the heart. To decrease cardiovascular mortality among schizophrenia patients, priority should lie with optimal treatment and interventions in early stages of psychoses. We also identified early repolarization, currently understudied, as a potential CVD marker among patients with schizophrenia.

Twenty-four-hour spectral analysis of heart rate variability in congestive heart failure secondary to coronary artery disease

1991 ◽  
Vol 67 (13) ◽  
pp. 1154-1158 ◽  
Author(s):  
Giancarlo Casolo ◽  
Enrico Balli ◽  
Antonio Fazi ◽  
Cesare Gori ◽  
Angelo Freni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Congestive Heart Failure ◽  
Heart Rate Variability ◽  
Spectral Analysis ◽  
Coronary Artery ◽  
Artery Disease

scholarly journals Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2198
Author(s):  
Alexandru Burlacu ◽  
Crischentian Brinza ◽  
Iolanda Valentina Popa ◽  
Adrian Covic ◽  
Mariana Floria
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inverse Association ◽  
Artery Disease ◽  
The Impact

Psychological stress is a well-established risk factor for cardiovascular disease (CVD). Heart rate variability (HRV)-biofeedback could significantly reduce stress levels and improve autonomic nervous system function and cardiovascular endpoints. We aimed to systematically review the literature to investigate the impact of HRV modulation through HRV-biofeedback on clinical outcomes in patients with CVD. A literature search was performed in the following databases: MEDLINE (PubMed), Embase, and Cochrane from the inception until 1 October 2021. Patients in the HRV-biofeedback group had significantly lower rates of all-cause readmissions than patients who received psychological education (respectively, p = 0.028 and p = 0.001). Heart failure following HRV-biofeedback displayed an inverse association with stress and depression (respectively, p = 0.022 and p = 0.033). When stratified according to left ventricular ejection fraction (LVEF), patients with LVEF ≥ 31% showed improved values of the 6 min walk test after HRV-biofeedback interventions (p = 0.05). A reduction in systolic and diastolic blood pressure associated with HRV-biofeedback was observed (p < 0.01) in pre-hypertensive patients. HRV-biofeedback had beneficial effects on different cardiovascular diseases documented in clinical trials, such as arterial hypertension, heart failure, and coronary artery disease. A standard breathing protocol should be applied in future studies to obtain equivalent results and outcomes. However, data regarding mortality in patients with coronary artery disease are scarce and need further research.

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

2020 ◽  
pp. 1-11
Author(s):  
Letian Yang ◽  
Yuliang Zhao ◽  
Baiyu Qiao ◽  
Yating Wang ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Mortality ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cochrane Central Register ◽  
Number Of Patients

<b><i>Background:</i></b> Heart rate variability (HRV) means the variation in time of beat-to-beat interval. Lower HRV has been shown to be related with death and cardiovascular events in previous studies. In the last few years, the number of patients with ESRD has increased steadily. Maintenance hemodialysis is the most prevalent renal replacement therapy in patients with ESRD. This study aims to investigate if decreased HRV is an independent predictor of mortality in maintenance hemodialysis patients. <b><i>Methods:</i></b> Pubmed/Medline, EMBASE, Ovid, the Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched up to October 1, 2019, for full-text articles in English. Cohort studies reporting the association between HRV and prognosis in hemodialysis patients were selected. Data extraction was performed by 2 reviewers independently, with adjudication by a third reviewer. Extracted data included the study characteristics, HRV measurement and research outcomes. Hazard ratios (HRs) and 95% confidence interval (CI) were pooled in a random-effects model for outcomes of all-cause and cardiovascular mortality. Heterogeneity assessment, subgroup analyses, and sensitivity analysis were conducted. <b><i>Results:</i></b> A total of 7 studies were eligible. HRV metrics consist of SDNN, SDANN, RMSSD, pNN50, HRVTI, ULF, VLF, LF, HF, LF/HF ratio, HRT, DC, and scaling exponents α1 and α2. Decreased HRV was associated with higher all-cause mortality (HR: 1.63, 95% CI: 1.11–2.39, <i>p</i> = 0.014) and cardiovascular mortality (HR: 1.07, 95% CI: 1.00–1.15, <i>p</i> = 0.045). Among the different HRV metrics, decreased SDANN (<i>p</i> &#x3c; 0.001) and decreased LF/HF ratio (<i>p</i> = 0.001) were identified as predictors of all-cause death. Decreased SDNN, SDANN, and LF/HF ratio were identified as predictors of cardiovascular death (<i>p</i> = 0.004, <i>p</i> = 0.001, and <i>p</i> = 0.002). <b><i>Conclusions:</i></b> Decreased HRV is associated with higher risk of all-cause and cardiovascular death in the hemodialysis population. Decreased SDANN and LF/HF were identified as predictors of both all-cause and cardiovascular mortality, while the utility of other HRV metrics requires further investigation. The protocol for this study was registered with PROSPERO (CRD42019141886).

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