Association of cardiovascular risk using non-linear heart rate variability measures with the framingham risk score in a rural population

Jelinek, Herbert F.; Imam, Hasan; Al-Aubaidy, Hayder A.; Khandoker, Ahsan H.

doi:10.3389/fphys.2013.00186

Cited by 34 publications

(25 citation statements)

References 47 publications

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“…All groups had increased HbA1c above recommended levels, indicating that glucose control is an important factor in developing diabetic complications [50]. Significant correlations between HRV features and clinical variables as found in this study and previously in a Caucasian cohort suggest that HDL cholesterol may also be contributing to HRV, followed by systolic blood pressure [51, 52]. …”

Section: Discussionsupporting

confidence: 67%

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

et al. 2017

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Microvascular, macrovascular and neurological complications are the key causes of morbidity and mortality among type II diabetes mellitus (T2DM) patients. The aim of this study was to investigate the alterations of cardiac autonomic function of diabetic patients in relation to three types of diabetes-related complications. ECG recordings were collected and analyzed from 169 T2DM patients in supine position who were diagnosed with nephropathy (n = 55), peripheral neuropathy (n = 64) and retinopathy (n = 106) at two hospitals in the UAE. Comparison between combinations of patients with complications and a control diabetic group (CONT) with no complication (n = 34) was performed using time, frequency and multi-lag entropy measures of heart rate variability (HRV). The results show that these measures decreased significantly (p<0.05) depending on the presence and type of diabetic complications. Entropy, (median, 1st- 3rd interquartile range) for the group combining all complications (1.74,1.37–2.09) was significantly lower than the corresponding values for the CONT group (1.77, 1.39–2.24) with lag-1 for sequential beat-to-beat changes. Odds ratios (OR) from the entropy analysis further demonstrated a significantly higher association with the combination of retinopathy and peripheral neuropathy versus CONT (OR: 1.42 at lag 8) and an even OR for the combination of retinopathy and nephropathy (OR: 2.46 at lag 8) compared to the other groups with complications. Also, the OR of low frequency power to high frequency power ratio (LF/HF) showed a higher association with these diabetic-related complications compared to CONT, especially for the patient group combining all complications (OR: 4.92). This study confirms that the type of microvascular or peripheral neuropathy complication present in T2DM patients have different effects on heart rate entropy, implying disorders of multi-organ connectivity are directly associated with autonomic nervous system dysfunction. Clinical practice may benefit from including multi-lag entropy for cardiac rhythm analysis in conjunction with traditional screening methods in patients with diabetic complications to ensure better preventive and treatment outcomes in the Emirati Arab population.

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Section: Discussionsupporting

confidence: 67%

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

et al. 2017

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“…Yoo et al first reported that FRS in Korean men (n=55) was inversely correlated with HRV indices including SDNN, rMSSD, LF and HF, but no significant relationship was identified between FRS and HRV in women (n=30) 14. More recently, Jelinek et al 40 only observed a significant relationship between FRS and SDNN using time and frequency-domain analysis in 170 patients. Because small sample sizes may reduce statistical power, the relationship between FRS and HRV has not been documented clearly.…”

Section: Discussionmentioning

confidence: 99%

A community study of the effect of polycyclic aromatic hydrocarbon metabolites on heart rate variability based on the Framingham risk score

et al. 2014

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Objectives To investigate the effects of the urinary metabolite profiles of background exposure to the atmospheric pollutants polycyclic aromatic hydrocarbons (PAHs), and Framingham risk score (FRS), which assesses an individual’s cardiovascular disease risk, on heart rate variability (HRV). Methods The study, conducted from April to May 2011 in Wuhan, China, included 1,978 adult residents with completed questionnaires, physical examinations, blood and urine samples, and 5-min HRV indices [including standard deviation of NN intervals (SDNN), root mean square successive difference (rMSSD), low frequency (LF), high frequency (HF) and their ratio (LF/HF), and total power (TP)] obtained from 3-channel Holter monitor. 12 urinary PAH metabolites were measured by gas chromatography–mass spectrometry. FRS was calculated based on age, sex, lipid profiles, blood pressure, diabetes, and smoking status. Linear regression models were constructed after adjusting for potential confounders. Results Elevated ΣOHNa was significantly associated, in a dose-responsive manner, with decreased SDNN and LF/HF (Ptrend = 0.014 and 0.007, respectively); elevated ΣOHFlu was significantly associated with reduced SDNN, LF, and LF/HF (Ptrend = 0.027, 0.003, and < 0.0001, respectively); and elevated ΣOH-PAHs was associated with decreased LF and LF/HF (Ptrend = 0.005 and < 0.0001, respectively). Moreover, increasing quartiles of FRS were significantly associated with decreased HRV indices, except LF/HF (Ptrend <0.001). Interestingly, individuals in low-risk subgroups had greater decreases in SDNN, LF, and LF/HF in relation to ΣOH-PAHs, ΣOHNa, and ΣOHFlu than those in high-risk subgroups (all P <0.05). Conclusions Environmental PAHs exposure may differentially affect HRV based on individual coronary risk profiles.

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“…HRV measures are sensitive to age, gender, and cardiovascular diseases, such as diabetes, hypertension, obesity, dyslipidemia, and atherosclerosis (Campos et al, 2013; Jelinek et al, 2013). We hypothesized that indices of HRV analysis are independently associated with carotid atherosclerotic IMT in cohort with at least one cardiovascular disease risk factor.…”

Section: Introductionmentioning

confidence: 99%

Association between Carotid Intima Media Thickness and Heart Rate Variability in Adults at Increased Cardiovascular Risk

et al. 2017

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Background: Atherosclerotic carotid intima-media thickness (IMT) may be associated with alterations in the sensitivity of carotid baroreceptors. The aim of this study was to investigate the association between carotid IMT and the autonomic modulation of heart rate variability (HRV).Methods: A total of 101 subjects were enrolled in this prospective observational study. The carotid IMT was determined by duplex ultrasonography. The cardiac autonomic function was determined through HRV measures during the Deep Breathing Test. Linear regression models, adjusted for demographics, comorbidities, body mass index, waist-hip-ratio, and left ventricular ejection fraction were used to evaluate the association between HRV parameters and carotid IMT.Results: Participants had a mean age of 60.4 ± 13.4 years and an estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk score (using the Pooled Cohort Equations) of 16.4 ± 17. The mean carotid media thickness was highest (0.90 ± 0.19 mm) in the first quartile of the standard deviation of all RR intervals (SDNN) (19.7 ± 5.1 ms) and progressively declined in each subsequent quartile to 0.82 ± 0.21 mm, 0.81 ± 0.16 mm, and 0.68 ± 0.19 in quartiles 2 (36.5 ± 5.9 ms), 3 (57.7 ± 6.2 ms) and 4 (100.9 ± 22.2 ms), respectively. In multivariable adjusted models, there was a statistical significant association between SDNN and carotid IMT (OR −0.002; 95%CI −0.003 to −0.001, p = 0.005). The same significant association was found between carotid IMT and other measures of HRV, including coefficient of variation of RR intervals (CV) and dispersion of points along the line of identity (SD2).Conclusions: In a cohort of individuals at increased cardiovascular risk, carotid IMT as a marker of subclinical atherosclerosis was associated with alterations of HRV indicating an impaired cardiac autonomic control, independently of other cardiovascular risk factors.

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Association of cardiovascular risk using non-linear heart rate variability measures with the framingham risk score in a rural population

Cited by 34 publications

References 47 publications

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

A community study of the effect of polycyclic aromatic hydrocarbon metabolites on heart rate variability based on the Framingham risk score

Association between Carotid Intima Media Thickness and Heart Rate Variability in Adults at Increased Cardiovascular Risk

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