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Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: findings from the Heart and Soul Study

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Abstract

Background

Chronic low-grade systemic inflammation is a key component in atherogenesis. Decreased heart rate variability (HRV), a strong predictor of cardiovascular events, has been associated with elevations in circulating levels of C-reactive protein (CRP), interleukin (IL)-6, and fibrinogen in apparently healthy individuals. We investigated whether decreased HRV is associated with inflammatory markers in patients with coronary heart disease (CHD).

Methods

We studied the relationship between HRV and CRP, IL-6, and fibrinogen in 862 outpatients with CHD. All participants provided fasting blood samples and underwent 24-h ambulatory monitoring to assess time-domain measures of HRV (MeanNN, SDNN, SDANN, and RMSSD). Regression analyses were adjusted for age, sex, ethnicity, body mass index, smoking, diabetes, beta blocker use, and cardiopulmonary history.

Results

MeanNN, SDNN, and SDANN were significantly and inversely associated with CRP and IL-6 levels in age-adjusted models and after adjustment for all covariates (p ≤ 0.02). MeanNN, SDNN, and SDANN were also inversely associated with fibrinogen levels in age-adjusted models (p < 0.03), but not significantly so in multivariable-adjusted models. Reduced vagal modulation of heart rate (RMSSD) was not significantly associated with any inflammatory measures.

Conclusions

Reduced cardiac autonomic control is associated with increased systemic inflammation in patients with stable CHD. This relationship was largely independent of important covariates.

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Acknowledgments

The Heart and Soul Study was supported by grants from the Department of Veterans Affairs (Epidemiology Merit Review Program), Washington, DC; The Robert Wood Johnson Foundation (Generalist Physician Faculty Scholars Program), Princeton, New Jersey; the American Federation for Aging Research (Paul Beeson Faculty Scholars in Aging Research Program), New York, NY; and the Ischemia Research and Education Foundation, San Bruno, CA.

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Authors and Affiliations

  1. Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland

    Roland von Känel

  2. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA

    Robert M. Carney

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, USA

    Shoujun Zhao

  4. Section of General Internal Medicine, San Francisco VA Medical Center, San Francisco, USA

    Mary A. Whooley

  5. Department of Medicine, University of California, San Francisco, USA

    Mary A. Whooley

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  1. Roland von Känel
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  2. Robert M. Carney
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  4. Mary A. Whooley
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Correspondence to Roland von Känel.

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von Känel, R., Carney, R.M., Zhao, S. et al. Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: findings from the Heart and Soul Study. Clin Res Cardiol 100, 241–247 (2011). https://doi.org/10.1007/s00392-010-0236-5

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  • DOI: https://doi.org/10.1007/s00392-010-0236-5

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