Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation

Krittayaphong, Rungroj; Boonyapisit, Warangkna; Sairat, Poom; Lip, Gregory Y. H.

doi:10.1055/s-0043-1768580

Cited by 2 publications

(1 citation statement)

References 42 publications

(59 reference statements)

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“…This conclusion is similar to our study, which found a U-shaped relationship between VVHRV and all-cause mortality. Another recent study (Krittayaphong et al, 2023), conducted with data from multiple centers in Thailand, revealed that VVHRV is an independent predictor of poor prognosis in patients with AF. VVHRV exhibits a J-curve effect on allcause mortality in that study.…”

Section: Discussionmentioning

confidence: 99%

The impact of visit‐to‐visit heart rate variability on all‐cause mortality in atrial fibrillation

Zhou,

Yuan,

Yuan

et al. 2024

Noninvasive Electrocardiol

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ObjectiveWe aimed to investigate the association between visit‐to‐visit heart rate variability (VVHRV) and all‐cause mortality in patients diagnosed with atrial fibrillation (AF). Previous studies have shown a positive correlation between VVHRV and several adverse outcomes. However, the relationship between VVHRV and the prognosis of AF remains uncertain.MethodsIn our study, we aimed to examine the relationship between VVHRV and mortality rates among 3983 participants with AF, who were part of the AFFIRM study (Atrial Fibrillation Follow‐Up Investigation of Rhythm Management). We used the standard deviation of heart rate (HRSD) to measure VVHRV and divided the patients into four groups based on quartiles of HRSD (1st, <5.69; 2nd, 5.69–8.00; 3rd, 8.01–11.01; and 4th, ≥11.02). Our primary endpoint was all‐cause death, and we estimated the hazard ratios for mortality using the Cox proportional hazard regressions.ResultsOur analysis included 3983 participants from the AFFIRM study and followed for an average of 3.5 years. During this period, 621 participants died from all causes. In multiple‐adjustment models, we found that the lowest and highest quartiles of HRSD independently predicted an increased risk of all‐cause mortality compared to the other two quartiles, presenting a U‐shaped relationship (1st vs 2nd, hazard ratio = 2.28, 95% CI = 1.63–3.20, p < .01; 1st vs. 3rd, hazard ratio = 2.23, 95% CI = 1.60–3.11, p < .01; 4th vs. 2nd, hazard ratio = 1.82, 95% CI = 1.26–2.61, p < .01; and 4th vs. 3rd, hazard ratio = 1.78, 95% CI = 1.25–2.52, p < .01).ConclusionIn patients with AF, we found that both lower VVHRV and higher VVHRV increased the risk of all‐cause mortality, indicating a U‐shaped curve relationship.

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Section: Discussionmentioning

confidence: 99%

The impact of visit‐to‐visit heart rate variability on all‐cause mortality in atrial fibrillation

Zhou,

Yuan,

Yuan

et al. 2024

Noninvasive Electrocardiol

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Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis

Mirzohreh,

Panahi,

Heidari

2024

Syst Rev

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Objectives Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It has significant implications for female endocrine function, reproductive health, and metabolic disturbances, including insulin resistance, impaired glucose tolerance, and dyslipidemia. Studies have shown that decreased heart rate variability (HRV), a marker of autonomic dysfunction, is associated with adverse cardiovascular events. Recent research has focused on investigating autonomic function in PCOS, and some studies have suggested altered autonomic drive in these patients. The aim of this systematic review and meta-analysis was to evaluate cardiac autonomic function by analyzing HRV in women with PCOS. Methods This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI). Results Seventeen articles were included in the final analysis, varied in quality, ranging from a "low" to a "high risk of bias". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases. Conclusion The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.

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Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation

Cited by 2 publications

References 42 publications

The impact of visit‐to‐visit heart rate variability on all‐cause mortality in atrial fibrillation

The impact of visit‐to‐visit heart rate variability on all‐cause mortality in atrial fibrillation

Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis

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