Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS)

Background: It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth). Methods: Data from 1,172 community-dwelling adults, ages 72 ± 5 (65-93) years, who participated in...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 19; no. 11; pp. 1169 - 1175
Autores principales: Stein PK, Barzilay JI, Chaves PHM, Mistretta SQ, Domitrovich PP, Gottdiener JS, Rich MW, Kleiger RE
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2008
      vid: 19
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1540-8167.2008.01232.x
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        atl: Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS)
      aug:
        au:
          Stein PK
          Barzilay JI
          Chaves PHM
          Mistretta SQ
          Domitrovich PP
          Gottdiener JS
          Rich MW
          Kleiger RE
        affil: Washington University School of Medicine, St. Louis, Missouri
      sug:
        subj:
          Cardiovascular Risk Factors In Old Age
          Heart Rate Variability
          Mortality Risk Factors
          Aged
          Data Analysis Software
          Electrocardiography, Ambulatory
          Female
          Funding Source
          Male
          Mortality
          Regression
          Human
          Aged: 65+ years
          Female
          Male
      ab: Background: It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth). Methods: Data from 1,172 community-dwelling adults, ages 72 ± 5 (65-93) years, who participated in the Cardiovascular Health Study (CHS), a study of risk factors for CV disease in people >=65 years. HRT and the short-term fractal scaling exponent (DFA1) derived from 24-hour Holter recordings. HRT categorized as: normal (turbulence slope [TS] and turbulence onset [TO] normal) or abnormal (TS and/or TO abnormal). DFA1 categorized as low (<=1) or high (>1). Cox regression analyses stratified by Framingham Risk Score (FRS) strata (low = <10, mid = 10-20, and high >20) and adjusted for prevalent clinical cardiovascular disease (CVD), diabetes, and quartiles of ventricular premature beat counts (VPCs). Results: CVdths (N = 172) occurred over a median follow-up of 12.3 years. Within each FRS stratum, low DFA1 + abnormal HRT predicted risk of CVdth (RR = 7.7 for low FRS; 3.6, mid FRS; 2.8, high FRS). Among high FRS stratum participants, low DFA1 alone also predicted CVdth (RR = 2.0). VPCs in the highest quartile predicted CVdth, but only in the high FRS group. Clinical CV disease predicted CVdth at each FRS stratum (RR = 2.9, low; 2.6, mid; and 1.9, high). Diabetes predicted CVdth in the highest FRS group only (RR = 2.2). Conclusions: The combination of low DFA1 + abnormal HRT is a strong risk factor for CVdth among older adults even after adjustment for conventional CVD risk measures and the presence of CVD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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