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Relationship between HRV measurements and demographic and clinical variables in a population of patients with atrial fibrillation

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Abstract

Little is known about the role of HRV in atrial fibrillation (AF) patients. Aim of our study was to assess the relationship between HRV measurements and demographic and clinical variables in a population of 274 AF patients. We selected all consecutive patients with persistent/permanent AF among whom had performed a Holter ECG in our Department from April 2010 to April 2015. Time-domain analysis of HRV was evaluated. Demographic and clinical variables were collected for each patient. At multivariable logistic regression, a higher pNN50 was associated with ACE inhibitors/ARBs (p = 0.016) and a lower pNN50 with obesity (p = 0.037) and higher heart rate (HR) (p < 0.0005). A higher RMSSD was associated with ACE inhibitors/ARBs (p = 0.001), digitalis (p < 0.0005) and beta-blockers (p = 0.002) and a lower RMSSD with a higher HR (p < 0.0005). A higher SDNNi was associated with ACE inhibitors/ARBs (p < 0.0005), digitalis (p < 0.0005) and beta-blockers (p = 0.002) and a lower SDNNi with dysthyroidism (p = 0.048) and higher HR (p < 0.0005). A higher SDANN was associated with non-dihydropyiridine calcium-channel-blockers (p = 0.002) and ACE inhibitors/ARBs (p = 0.002) and a lower SDANN with hypertension (p = 0.034), obesity (p = 0.011), stroke (p = 0.031), pneumonia (p = 0.005) and higher HR (p < 0.0005). A higher SDNN was associated with ACE inhibitors/ARBs (p < 0.0005), digitalis (p < 0.0005) and beta-blockers (p = 0.022) and a lower SDNN with obesity (p = 0.012), pneumonia (p = 0.049) and higher HR (p < 0.0005). Our study showed that, in AF patients, there is a direct relationship between some clinical variables and HRV measurements; as for patients with sinus rhythm, even in AF patients this relationship seemed to reflect the autonomic nervous system activity.

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References

  1. Khand AU, Rankin AC, Cleland JCF, Gemmell I, Clark E, Macfarlane PW (2006) The assessment of autonomic function in chronic atrial fibrillation: description of a non-invasive technique based on circadian rhythm of atrioventricular nodal functional refractory periods. Europace 8:927–934

    Article  PubMed  Google Scholar 

  2. Fujiki A, Yoshioka R, Sakabe M (2015) Evaluation of repolarization dynamics using the QT–RR regression line slope and intercept relationship during 24-h Holter ECG. Heart Vessels 30:235–240

    Article  PubMed  Google Scholar 

  3. Sosnowski M, Macfarlane PW, Tendera M (2011) Determinants of a reduced heart rate variability in chronic atrial fibrillation. Ann Noninvasive Electrocardiol 16:321–326

    Article  PubMed  Google Scholar 

  4. van den Berg MP, Haaksma J, Brouwer J, Tieleman RG, Mulder G, Crijns HJ (1997) Heart rate variability in patients with atrial fibrillation is related to vagal tone. Circulation 96:1209–1216

    Article  PubMed  Google Scholar 

  5. Okada A, Kashima Y, Tomita T, Takeuchi T, Aizawa K, Takahashi M, Ikeda U (2014) Characterization of cardiac oxidative stress levels in patients with atrial fibrillation. Heart Vessels. doi:10.1007/s00380-014-0582-8

    Google Scholar 

  6. Platonov PG, Holmqvist F (2011) Atrial fibrillatory rate and irregularity of ventricular response as predictors of clinical outcome in patients with atrial fibrillation. J Electrocardiol 44:673–677

    Article  PubMed  Google Scholar 

  7. Yamada A, Hayano J, Sakata S, Okada A, Mukai S, Ohte N, Kimura G (2000) Reduced ventricular response irregularity is associated with increased mortality in patients with chronic atrial fibrillation. Circulation 102:300–306

    Article  CAS  PubMed  Google Scholar 

  8. Frey B, Heinz G, Binder T, Wutte M, Schneider B, Schmidinger H, Weber H, Pacher R (1995) Diurnal variation of ventricular response to atrial fibrillation in patients with advanced heart failure. Am Heart J 129:58–65

    Article  CAS  PubMed  Google Scholar 

  9. Cygankiewicz I, Corino V, Vazquez R, Bayes-Genis A, Mainardi L, Zareba W, de Luna AB, Platonov PG, MUSIC Trial Investigators (2015) Reduced irregularity of ventricular response during atrial fibrillation and long-term outcome in patients with heart failure. Am J Cardiol 116:1071–1075

    Article  PubMed  Google Scholar 

  10. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354–381

    Article  Google Scholar 

  11. Hayano J, Sakata S, Okada A, Mukai S, Fujinami T (1998) Circadian rhythms of atrioventricular conduction properties in chronic atrial fibrillation with and without heart failure. J Am Coll Cardiol 31:158–166

    Article  CAS  PubMed  Google Scholar 

  12. Corino VD, Holmqvist F, Mainardi LT, Platonov PG (2014) Beta-blockade and A1-adenosine receptor agonist effects on atrial fibrillatory rate and atrioventricular conduction in patients with atrial fibrillation. Europace 16:587–594

    Article  PubMed  Google Scholar 

  13. Hsieh MH, Chen SA, Wen ZC, Tai CT, Chiang CE, Ding YA, Chang MS (1998) Effects of antiarrhythmic drugs on variability of ventricular rate and exercise performance in chronic atrial fibrillation complicated with ventricular arrhythmias. Int J Cardiol 64:37–45

    Article  CAS  PubMed  Google Scholar 

  14. Corino VD, Ulimoen SR, Enger S, Mainardi LT, Tveit A, Platonov PG (2015) Rate-control drugs affect variability and irregularity measures of RR intervals in patients with permanent atrial fibrillation. J Cardiovasc Electrophysiol 26:137–141

    Article  PubMed  Google Scholar 

  15. Whitworth JA; World Health Organization, International Society of Hypertension Writing Group (2003) 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21:1983–1992

    Article  Google Scholar 

  16. Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members (2013) Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 158:825–830

    Article  Google Scholar 

  17. Organisation European Stroke, Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clément D, Collet JP, Cremonesi A, De Carlo M, Erbel R, Fowkes FG, Heras M, Kownator S, Minar E, Ostergren J, Poldermans D, Riambau V, Roffi M, Röther J, Sievert H, van Sambeek M, Zeller T, ESC Committee for Practice Guidelines (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 32:2851–2906

    Article  Google Scholar 

  18. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, Elkind MS, George MG, Hamdan AD, Higashida RT, Hoh BL, Janis LS, Kase CS, Kleindorfer DO, Lee JM, Moseley ME, Peterson ED, Turan TN, Valderrama AL, Vinters HV, American Heart Association Stroke Council, Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Peripheral Vascular Disease; Council on Nutrition, Physical Activity and Metabolism (2013) An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44:2064–2089

    Article  PubMed  Google Scholar 

  19. Bollmann A, Husser D, Mainardi L, Lombardi F, Langley P, Murray A, Rieta JJ, Millet J, Olsson SB, Stridh M, Sörnmo L (2006) Analysis of surface electrocardiograms in atrial fibrillation: techniques, research, and clinical applications. Europace 8:911–926

    Article  PubMed  Google Scholar 

  20. Sosnowski M, Korzeniowska B, Macfarlane PW, Tendera M (2011) Relationship between R-R interval variation and left ventricular function in sinus rhythm and atrial fibrillation as estimated by means of heart rate variability fraction. Cardiol J 18:538–545

    Article  PubMed  Google Scholar 

  21. Lahiri MK, Kannankeril PJ, Goldberger JJ (2008) Assessment of autonomic function in cardiovascular disease: physiological basis and prognostic implications. J Am Coll Cardiol 51:1725–1733

    Article  PubMed  Google Scholar 

  22. Del Colle S, Morello F, Rabbia F, Milan A, Naso D, Puglisi E, Mulatero P, Veglio F (2007) Antihypertensive drugs and the sympathetic nervous system. J Cardiovasc Pharmacol 50:487–496

    Article  PubMed  Google Scholar 

  23. Routledge HC, Chowdhary S, Townend JN (2002) Heart rate variability—a therapeutic target? J Clin Pharm Ther 27:85–92

    Article  CAS  PubMed  Google Scholar 

  24. Ranpuria R, Hall M, Chan CT, Unruh M (2008) Heart rate variability (HRV) in kidney failure: measurement and consequences of reduced HRV. Nephrol Dial Transplant 23:444–449

    Article  PubMed  Google Scholar 

  25. Carthy ER (2013) Autonomic dysfunction in essential hypertension: a systematic review. Ann Med Surg (Lond) 3(1):2–7

    Article  Google Scholar 

  26. Desai MY, Watanabe MA, Laddu AA, Hauptman PJ (2011) Pharmacologic modulation of parasympathetic activity in heart failure. Heart Fail Rev 16:179–193

    Article  CAS  PubMed  Google Scholar 

  27. Khan SS, Gheorghiade M (2015) Digoxin use in atrial fibrillation: a critical reappraisal. Lancet 385(9985):2330–2332

    Article  PubMed  Google Scholar 

  28. Chintala KK, Krishna BH, N MR (2015) Heart rate variability in overweight health care students: correlation with visceral fat. J Clin Diagn Res 9(1):CC06-CC08

  29. Hillebrand S, Swenne CA, Gast KB, Maan AC, le Cessie S, Jukema JW, Rosendaal FR, den Heijer M, de Mutsert R (2015) The role of insulin resistance in the association between body fat and autonomic function. Nutr Metab Cardiovasc Dis 25:93–99

    Article  CAS  PubMed  Google Scholar 

  30. Johncy SS, Karthik CS, Bondade SY, Jayalakshmi MK (2015) Altered cardiovascular autonomic function in young normotensive offspring of hypertensive parents—Is obesity an additional risk factor? J Basic Clin Physiol Pharmacol. doi:10.1515/jbcpp-2014-0068

    PubMed  Google Scholar 

  31. Wu JS, Lu FH, Yang YC, Lin TS, Huang YH, Wu CH, Chen JJ, Chang CJ (2008) Epidemiological evidence of altered cardiac autonomic function in overweight but not underweight subjects. Int J Obes (Lond) 32(5):788–794

    Article  Google Scholar 

  32. Somers VK, Mark AL, Abboud FM (1988) Sympathetic activation by hypoxia and hypercapnia—implications for sleep apnea. Clin Exp Hypertens A 10(Suppl 1):413–422

    PubMed  Google Scholar 

  33. van Gestel AJ, Steier J (2010) Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD). J Thorac Dis 2:215–222

    PubMed  PubMed Central  Google Scholar 

  34. Corrales-Medina VF, Suh KN, Rose G, Chirinos JA, Doucette S, Cameron DW, Fergusson DA (2011) Cardiac complications in patients with community-acquired pneumonia: a systematic review and meta-analysis of observational studies. PLoS Med 8:e1001048

    Article  PubMed  PubMed Central  Google Scholar 

  35. Falcone C, Matrone B, Bozzini S, Guasti L, Falcone R, Benzi A, Colonna A, Savulescu I, Vailati A, Pelissero G (2014) Time-domain heart rate variability in coronary artery disease patients affected by thyroid dysfunction. Int Heart J 55:33–38

    Article  CAS  PubMed  Google Scholar 

  36. Petretta M, Bonaduce D, Spinelli L, Vicario ML, Nuzzo V, Marciano F, Camuso P, De Sanctis V, Lupoli G (2001) Cardiovascular haemodynamics and cardiac autonomic control in patients with subclinical and overt hyperthyroidism. Eur J Endocrinol 145:691–696

    Article  CAS  PubMed  Google Scholar 

  37. Cacciatori V, Gemma ML, Bellavere F, Castello R, De Gregori ME, Zoppini G, Thomaseth K, Moghetti P, Muggeo M (2000) Power spectral analysis of heart rate in hypothyroidism. Eur J Endocrinol 143:327–333

    Article  CAS  PubMed  Google Scholar 

  38. Akıl E, Tamam Y, Akıl MA, Kaplan İ, Bilik MZ, Acar A, Tamam B (2015) Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels. J Neurosci Rural Pract 6:145–150

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lakusić N, Mahović D, Babić T, Sporis D (2003) Changes in autonomic control of heart rate after ischemic cerebral stroke. Acta Med Croatica 57:269–273

    PubMed  Google Scholar 

  40. Sykora M, Siarnik P, Diedler J, Acute Collaborators VISTA (2015) β-blockers, pneumonia, and outcome after ischemic stroke: evidence From Virtual International Stroke Trials Archive. Stroke 46:1269–1274

    Article  CAS  PubMed  Google Scholar 

  41. Thayer JF, Yamamoto SS, Brosschot JF (2010) The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 141:122–131

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. U.O.C. Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy

    Carmelo Buttà, Antonino Tuttolomondo, Rossella Petrantoni, Giuseppe Miceli, Francesco Cuttitta & Antonio Pinto

  2. Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy

    Alessandra Casuccio

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  1. Carmelo Buttà
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  2. Antonino Tuttolomondo
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  3. Alessandra Casuccio
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Correspondence to Carmelo Buttà.

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Buttà, C., Tuttolomondo, A., Casuccio, A. et al. Relationship between HRV measurements and demographic and clinical variables in a population of patients with atrial fibrillation. Heart Vessels 31, 2004–2013 (2016). https://doi.org/10.1007/s00380-016-0826-x

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