Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era

Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the prognostic significance of baseline heart rate variability in 1,757 ARTEMIS study patients with angiographically verified CAD. During an average follow-up time of 8.7 ± 2.2 years, a total of 285 (16.2%) patients died. Of the patients, 63 (3.6%) suffered sudden cardiac death or were resuscitated from sudden cardiac arrest (SCD/SCA), 60 (3.4%) experienced non-sudden cardiac death (NSCD), and death attributable to non-cardiac causes (NCD) occurred in 162 (9.2%) patients. For every 10 ms decrease in standard deviation of normal to normal intervals the risk for SCD/SCA, NSCD and NCD increased significantly: HR 1.153 (95% CI 1.075–1.236, p<0.001), HR 1.187 (95% CI 1.102–1.278, p<0.001) and HR 1.080 (95% CI 1.037–1.125, p<0.001), respectively. The natural logarithm of the low-frequency component of the power spectrum and the short-term scaling exponent of the detrended fluctuation analysis also had significant association with all modes of death (p<0.001). After relevant adjustment, standard deviation of normal-to-normal intervals retained its association with NSCD and NCD (p<0.01), the natural logarithm of the low-frequency component of the power spectrum with all modes of death (p from <0.05 to <0.01), and the short-term scaling exponent of the detrended fluctuation analysis with SCD/SCA (p<0.05) and NCD (p<0.001). In conclusion, impairment of many measures of heart rate variability predicts mortality but is not associated with any specific mode of death in patients with stable CAD during the current treatment era, limiting the clinical applicability of heart rate variability to targeting therapy.

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Detrended Fluctuation Analysis of Heart Rate Variability in Noise Exposure

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.1044-1045.1129 ◽

2014 ◽

Vol 1044-1045 ◽

pp. 1129-1134 ◽

Cited By ~ 1

Author(s):

Shih Tsung Chen ◽

Li Ho Tseng ◽

Yuan Po Lee ◽

Hong Zhun Wu ◽

Chia Yi Chou

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Detrended Fluctuation Analysis ◽

Low Frequency ◽

Fluctuation Analysis ◽

Frequency Noise ◽

Cardiovascular Activity ◽

Low Frequency Noise ◽

Rr Intervals ◽

Detrended Fluctuation

During the past two decades, most studies have employed questionnaires to characterize the effects of noise on behavior and health. Developments in physiological techniques have provided a noninvasive method for recording cardiovascular autonomic activity by using an electrocardiogram (ECG). We investigated cardiovascular activity changes in exposure to exposure to low-frequency noise for various noise intensities by using detrended fluctuation analysis (DFA) of heart rate variability (HRV). We hypothesized that distinct noise intensities would affect cardiovascular activity, which would be reflected in the HRV and DFA parameters. A total of 17 healthy volunteers participated in this study. The test intensities of noises were no noise, 70-dBC, 80-dBC, and 90-dBC. Each noise was sustained for 5 minutes and the ECG was recorded simultaneously. The cardiovascular responses were evaluated using DFA of the beat-to-beat (RR) intervals obtained from ECG signals. The results showed that the mean RR intervals variability and mean blood pressure did not substantially change relative to the noises. However, the short-term scaling exponent (α1) of the DFA of the background noise (no noise) condition was lower than the 70-dBC, 80-dBC and 90-dBC noises (P< 0.05, repeated measures analysis of variance). The α1of 90-dBC noise was significantly higher than the α1of BN condition according to a Mann–Whitney U test (P< 0.01). We concluded that exposure to low-frequency noise significantly affects the temporal correlations of HRV, but it does not influence RR intervals variability.

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Postural response of low frequency component of heart rate variability is an increased risk for mortality in patients with coronary artery disease

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(02)80375-8 ◽

2002 ◽

Vol 39 ◽

pp. 87-88

Author(s):

Jun-ichiro Hayano ◽

Seiji Mukai ◽

Selichiro Sakata ◽

Hidekatsu Fukuta ◽

Shinji Ishihara ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Coronary Artery ◽

Low Frequency ◽

Frequency Component ◽

Postural Response ◽

Increased Risk ◽

Artery Disease

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Sex differences in linear and nonlinear heart rate variability during early recovery from supramaximal exercise

Applied Physiology Nutrition and Metabolism ◽

10.1139/h10-028 ◽

2010 ◽

Vol 35 (S1) ◽

pp. 439-446 ◽

Cited By ~ 35

Author(s):

Goncalo V. Mendonca ◽

Kevin S. Heffernan ◽

Lindy Rossow ◽

Myriam Guerra ◽

Fernando D. Pereira ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Low Frequency ◽

Autonomic Response ◽

Fluctuation Analysis ◽

Scaling Exponent ◽

Supramaximal Exercise ◽

Early Recovery ◽

Additional Information ◽

Linear And Nonlinear

Women demonstrate greater RR interval variability than men of similar age. Enhanced parasympathetic input into cardiac regulation appears to be not only greater in women, but also protective during periods of cardiac stress. Even though women may have a more favorable autonomic profile after exercise, little research has been conducted on this issue. This study was designed to examine the cardiac autonomic response, in both male and female participants, during the early recovery from supramaximal exercise. Twenty-five individuals, aged 20 to 33 years (13 males and 12 females), performed a 30-s Wingate test. Beat-to-beat RR series were recorded before and 5 min after exercise, with the participants in the supine position and under paced breathing. Linear (spectral analysis) and nonlinear analyses (detrended fluctuation analysis (DFA)) were performed on the same RR series. At rest, women presented lower raw low frequency (LF) power and higher normalized high frequency (HF) power. Under these conditions, the LF/HF ratio of women was also lower than that of men (p < 0.05), but there were no differences in the short-term scaling exponent (α1). Even though both sexes showed a significant modification in linear and nonlinear measures of heart rate variability (HRV) (p < 0.05), women had a greater change in LF/HF ratio and α1 than men from rest to recovery. This study demonstrates that the cardiac autonomic function of women is more affected by supramaximal exercise than that of men. Additionally, DFA did not provide additional information about sexual dimorphisms, compared with conventional spectral HRV techniques.

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HEART RATE VARIABILITY AND BODY COMPOSITION AS VO2MAX DETERMINANTS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220172304152157 ◽

2017 ◽

Vol 23 (4) ◽

pp. 317-321 ◽

Cited By ~ 2

Author(s):

Henry Humberto León-Ariza ◽

Daniel Alfonso Botero-Rosas ◽

Aura Catalina Zea-Robles

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Body Composition ◽

Standard Error ◽

Low Frequency ◽

Standing Position ◽

Fluctuation Analysis ◽

Maximum Oxygen Consumption ◽

Detrended Fluctuation ◽

Cardiorespiratory Endurance

ABSTRACT Introduction: The maximum oxygen consumption (VO2max) is the gold standard in the cardiorespiratory endurance assessment. Objective: This study aimed to develop a mathematical model that contains variables to determine the VO2max of sedentary people. Methods: Twenty participants (10 men and 10 women) with a mean age of 19.8±1.77 years were included. For each participant, body composition (percentage of fat and muscle), heart rate variability (HRV) at rest (supine and standing), and VO2max were evaluated through an indirect test on a cycloergometer. A multivariate linear regression model was developed from the data obtained, and the model assumptions were verified. Results: Using the data obtained, including percentage of fat (F), percentage of muscle (M), percentage of power at very low frequency (VLF), α-value of the detrended fluctuation analysis (DFAα1), heart rate (HR) in the resting standing position, and age of the participants, a model was established for men, which was expressed as VO2max = 4.216 + (Age*0.153) + (F*0.110) - (M*0.053) - (VLF*0.649) - (DFAα1*2.441) - (HR*0.014), with R2 = 0.965 and standard error = 0.146 L/min. For women, the model was expressed as VO2max = 1.947 - (Age*0.047) + (F*0.024) + (M*0.054) + (VLF*1.949) - (DFAα1*0.424) - (HR*0.019), with R2 = 0.987 and standard error = 0.077 L/min. Conclusion: The obtained model demonstrated the influence exerted by body composition, the autonomic nervous system, and age in the prediction of VO2max.

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