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...
Main Authors: | , , , , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
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Wiley
2024-04-01
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Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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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. |
first_indexed | 2024-04-24T15:09:13Z |
format | Article |
id | doaj.art-15a5011d326b4abe9425fb720df256aa |
institution | Directory Open Access Journal |
issn | 2047-9980 |
language | English |
last_indexed | 2024-04-24T15:09:13Z |
publishDate | 2024-04-01 |
publisher | Wiley |
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series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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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