Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study

Background Autonomic function can be measured noninvasively using heart rate variability (HRV), which indexes overall sympathovagal balance. Deceleration capacity (DC) of heart rate is a more specific metric of vagal modulation. Higher values of these measures have been associated with reduced morta...

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Main Authors: Minxuan Huang, Amit J. Shah, Rachel Lampert, Donald L. Bliwise, Dayna A. Johnson, Gari D. Clifford, Richard Sloan, Jack Goldberg, Yi‐An Ko, Giulia Da Poian, Erick A. Perez‐Alday, Zakaria Almuwaqqat, Anish Shah, Mariana Garcia, An Young, Kasra Moazzami, J. Douglas Bremner, Viola Vaccarino
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.032740
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author Minxuan Huang
Amit J. Shah
Rachel Lampert
Donald L. Bliwise
Dayna A. Johnson
Gari D. Clifford
Richard Sloan
Jack Goldberg
Yi‐An Ko
Giulia Da Poian
Erick A. Perez‐Alday
Zakaria Almuwaqqat
Anish Shah
Mariana Garcia
An Young
Kasra Moazzami
J. Douglas Bremner
Viola Vaccarino
author_facet Minxuan Huang
Amit J. Shah
Rachel Lampert
Donald L. Bliwise
Dayna A. Johnson
Gari D. Clifford
Richard Sloan
Jack Goldberg
Yi‐An Ko
Giulia Da Poian
Erick A. Perez‐Alday
Zakaria Almuwaqqat
Anish Shah
Mariana Garcia
An Young
Kasra Moazzami
J. Douglas Bremner
Viola Vaccarino
author_sort Minxuan Huang
collection DOAJ
description Background Autonomic function can be measured noninvasively using heart rate variability (HRV), which indexes overall sympathovagal balance. Deceleration capacity (DC) of heart rate is a more specific metric of vagal modulation. Higher values of these measures have been associated with reduced mortality risk primarily in patients with cardiovascular disease, but their significance in community samples is less clear. Methods and Results This prospective twin study followed 501 members from the VET (Vietnam Era Twin) registry. At baseline, frequency domain HRV and DC were measured from 24‐hour Holter ECGs. During an average 12‐year follow‐up, all‐cause death was assessed via the National Death Index. Multivariable Cox frailty models with random effect for twin pair were used to examine the hazard ratios of death per 1‐SD increase in log‐transformed autonomic metrics. Both in the overall sample and comparing twins within pairs, higher values of low‐frequency HRV and DC were significantly associated with lower hazards of all‐cause death. In within‐pair analysis, after adjusting for baseline factors, there was a 22% and 27% lower hazard of death per 1‐SD increment in low‐frequency HRV and DC, respectively. Higher low‐frequency HRV and DC, measured during both daytime and nighttime, were associated with decreased hazard of death, but daytime measures showed numerically stronger associations. Results did not substantially vary by zygosity. Conclusions Autonomic inflexibility, and especially vagal withdrawal, are important mechanistic pathways of general mortality risk, independent of familial and genetic factors.
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spelling doaj.art-15a5011d326b4abe9425fb720df256aa2024-04-02T11:49:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113710.1161/JAHA.123.032740Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins StudyMinxuan Huang0Amit J. Shah1Rachel Lampert2Donald L. Bliwise3Dayna A. Johnson4Gari D. Clifford5Richard Sloan6Jack Goldberg7Yi‐An Ko8Giulia Da Poian9Erick A. Perez‐Alday10Zakaria Almuwaqqat11Anish Shah12Mariana Garcia13An Young14Kasra Moazzami15J. Douglas Bremner16Viola Vaccarino17Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GAYale University School of Medicine New Haven CTDepartment of Neurology, School of Medicine Emory University Atlanta GADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GADepartment of Biomedical Informatics, School of Medicine Emory University Atlanta GADepartment of Psychiatry, College of Physicians and Surgeons Columbia University New York NYDepartment of Epidemiology, School of Public Health University of Washington Seattle WADepartment of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta GADepartment of Health Sciences and Technology ETH Zurich Zurich SwitzerlandDepartment of Biomedical Informatics, School of Medicine Emory University Atlanta GADepartment of Medicine (Cardiology), School of Medicine Emory University Atlanta GADepartment of Medicine (Cardiology), School of Medicine Emory University Atlanta GADepartment of Medicine (Cardiology), School of Medicine Emory University Atlanta GADepartment of Medicine (Cardiology), School of Medicine Emory University Atlanta GADepartment of Medicine (Cardiology), School of Medicine Emory University Atlanta GAAtlanta Veteran Affairs Medical Center Decatur GADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GABackground Autonomic function can be measured noninvasively using heart rate variability (HRV), which indexes overall sympathovagal balance. Deceleration capacity (DC) of heart rate is a more specific metric of vagal modulation. Higher values of these measures have been associated with reduced mortality risk primarily in patients with cardiovascular disease, but their significance in community samples is less clear. Methods and Results This prospective twin study followed 501 members from the VET (Vietnam Era Twin) registry. At baseline, frequency domain HRV and DC were measured from 24‐hour Holter ECGs. During an average 12‐year follow‐up, all‐cause death was assessed via the National Death Index. Multivariable Cox frailty models with random effect for twin pair were used to examine the hazard ratios of death per 1‐SD increase in log‐transformed autonomic metrics. Both in the overall sample and comparing twins within pairs, higher values of low‐frequency HRV and DC were significantly associated with lower hazards of all‐cause death. In within‐pair analysis, after adjusting for baseline factors, there was a 22% and 27% lower hazard of death per 1‐SD increment in low‐frequency HRV and DC, respectively. Higher low‐frequency HRV and DC, measured during both daytime and nighttime, were associated with decreased hazard of death, but daytime measures showed numerically stronger associations. Results did not substantially vary by zygosity. Conclusions Autonomic inflexibility, and especially vagal withdrawal, are important mechanistic pathways of general mortality risk, independent of familial and genetic factors.https://www.ahajournals.org/doi/10.1161/JAHA.123.032740autonomic nervous systemlongitudinal studiesdeathtwins
spellingShingle Minxuan Huang
Amit J. Shah
Rachel Lampert
Donald L. Bliwise
Dayna A. Johnson
Gari D. Clifford
Richard Sloan
Jack Goldberg
Yi‐An Ko
Giulia Da Poian
Erick A. Perez‐Alday
Zakaria Almuwaqqat
Anish Shah
Mariana Garcia
An Young
Kasra Moazzami
J. Douglas Bremner
Viola Vaccarino
Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
autonomic nervous system
longitudinal studies
death
twins
title Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
title_full Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
title_fullStr Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
title_full_unstemmed Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
title_short Heart Rate Variability, Deceleration Capacity of Heart Rate, and Death: A Veteran Twins Study
title_sort heart rate variability deceleration capacity of heart rate and death a veteran twins study
topic autonomic nervous system
longitudinal studies
death
twins
url https://www.ahajournals.org/doi/10.1161/JAHA.123.032740
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