Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study
Background Sex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear. Methods 12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standa...
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| Veröffentlicht in: | Clinical research in cardiology 2023-06, Vol.112 (6), p.747-758 |
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| creator | Geurts, Sven Tilly, Martijn J. Arshi, Banafsheh Stricker, Bruno H. C. Kors, Jan A. Deckers, Jaap W. de Groot, Natasja M. S. Ikram, M. Arfan Kavousi, Maryam |
| description | Background
Sex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear.
Methods
12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standard deviation of normal RR intervals (SDNN), SDNN corrected for heart rate (SDNNc), RR interval differences (RMSSD), RMSSD corrected for heart rate (RMSSDc), and heart rate were assessed at baseline and follow-up examinations. Joint models, adjusted for cardiovascular risk factors, were used to determine the association between longitudinal measures of HRV with new-onset AF. Genetic variants for HRV were used as instrumental variables in a Mendelian randomization (MR) analysis using genome-wide association studies (GWAS) summary-level data.
Results
During a median follow-up of 9.4 years, 1302 incident AF cases occurred among 12,334 participants (mean age 64.8 years, 58.3% women). In joint models, higher SDNN (fully-adjusted hazard ratio (HR), 95% confidence interval (CI) 1.24, 1.04–1.47,
p
= 0.0213), and higher RMSSD (fully-adjusted HR, 95% CI 1.33, 1.13–1.54,
p
= 0.0010) were significantly associated with new-onset AF. Sex-stratified analyses showed that the associations were mostly prominent among women. In MR analyses, a genetically determined increase in SDNN (odds ratio (OR), 95% CI 1.60, 1.27–2.02,
p
= 8.36 × 10
–05
), and RMSSD (OR, 95% CI 1.56, 1.31–1.86,
p
= 6.32 × 10
–07
) were significantly associated with an increased odds of AF.
Conclusion
Longitudinal measures of uncorrected HRV were significantly associated with new-onset AF, especially among women. MR analyses supported the causal relationship between uncorrected measures of HRV with AF. Our findings indicate that measures to modulate HRV might prevent AF in the general population, in particular in women.
Graphical abstract
AF
; atrial fibrillation,
GWAS
; genome-wide association study,
IVW
; inverse variance weighted,
MR
; Mendelian randomization,
MR-PRESSO
; MR-egger and mendelian randomization pleiotropy residual sum and outlier,
RMSSD
; root mean square of successive RR interval differences,
RMSSDc
; root mean square of successive RR interval differences corrected for heart rate,
SDNN
; standard deviation of normal to normal RR intervals,
SDNNc
; standard deviation of normal to normal RR intervals corrected for heart rate,
WME
; weighted median estimator.
a
Rotterdam Study
n
=12,334
b
HR |
| doi_str_mv | 10.1007/s00392-022-02072-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10241681</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2702183489</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-3119a7a98b96791c55b4bf1cace6688880a217a14da0a0074bdff73bbd1ee4683</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhonR2Fr9Ay4MiRs3o3wO4MY0jVqTGje6JocZ5pZmLlyBaXL76-U69fqxkIQAeZ_zAudF6Dklrykh6k0hhBvWEXaYRLFOPkCnVPe0I71hD497LU7Qk1JuCJGUcPEYnXBpeqY5P0V3lx5yxRmqx7eQA7gwh7rHEEcMtZ1nPAWXwzxDDSniEHG99njjo89N26XdsipvMeA5xU2oyxhikw4On30c_RwgtgvimLbhbnUpDdo_RY8mmIt_dr-eoW8f3n-9uOyuvnz8dHF-1Q1CydpxSg0oMNqZXhk6SOmEm-gAg-973QYBRhVQMQKB1hbhxmlS3LmRei96zc_Qu9V3t7itHwcfa3u63eWwhby3CYL9W4nh2m7SraWECdpr2hxe3Tvk9H3xpdptKINvPYk-LcUyRRjVXGjT0Jf_oDdpya0fjdKMSakMO1BspYacSsl-Or6GEnvI1q7Z2pat_Zmtla3oxZ__OJb8CrMBfAVKk-LG5993_8f2B4dtsiE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2822557929</pqid></control><display><type>article</type><title>Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Geurts, Sven ; Tilly, Martijn J. ; Arshi, Banafsheh ; Stricker, Bruno H. C. ; Kors, Jan A. ; Deckers, Jaap W. ; de Groot, Natasja M. S. ; Ikram, M. Arfan ; Kavousi, Maryam</creator><creatorcontrib>Geurts, Sven ; Tilly, Martijn J. ; Arshi, Banafsheh ; Stricker, Bruno H. C. ; Kors, Jan A. ; Deckers, Jaap W. ; de Groot, Natasja M. S. ; Ikram, M. Arfan ; Kavousi, Maryam</creatorcontrib><description>Background
Sex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear.
Methods
12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standard deviation of normal RR intervals (SDNN), SDNN corrected for heart rate (SDNNc), RR interval differences (RMSSD), RMSSD corrected for heart rate (RMSSDc), and heart rate were assessed at baseline and follow-up examinations. Joint models, adjusted for cardiovascular risk factors, were used to determine the association between longitudinal measures of HRV with new-onset AF. Genetic variants for HRV were used as instrumental variables in a Mendelian randomization (MR) analysis using genome-wide association studies (GWAS) summary-level data.
Results
During a median follow-up of 9.4 years, 1302 incident AF cases occurred among 12,334 participants (mean age 64.8 years, 58.3% women). In joint models, higher SDNN (fully-adjusted hazard ratio (HR), 95% confidence interval (CI) 1.24, 1.04–1.47,
p
= 0.0213), and higher RMSSD (fully-adjusted HR, 95% CI 1.33, 1.13–1.54,
p
= 0.0010) were significantly associated with new-onset AF. Sex-stratified analyses showed that the associations were mostly prominent among women. In MR analyses, a genetically determined increase in SDNN (odds ratio (OR), 95% CI 1.60, 1.27–2.02,
p
= 8.36 × 10
–05
), and RMSSD (OR, 95% CI 1.56, 1.31–1.86,
p
= 6.32 × 10
–07
) were significantly associated with an increased odds of AF.
Conclusion
Longitudinal measures of uncorrected HRV were significantly associated with new-onset AF, especially among women. MR analyses supported the causal relationship between uncorrected measures of HRV with AF. Our findings indicate that measures to modulate HRV might prevent AF in the general population, in particular in women.
Graphical abstract
AF
; atrial fibrillation,
GWAS
; genome-wide association study,
IVW
; inverse variance weighted,
MR
; Mendelian randomization,
MR-PRESSO
; MR-egger and mendelian randomization pleiotropy residual sum and outlier,
RMSSD
; root mean square of successive RR interval differences,
RMSSDc
; root mean square of successive RR interval differences corrected for heart rate,
SDNN
; standard deviation of normal to normal RR intervals,
SDNNc
; standard deviation of normal to normal RR intervals corrected for heart rate,
WME
; weighted median estimator.
a
Rotterdam Study
n
=12,334
b
HRV GWAS
n
=53,174
c
AF GWAS
n
=1,030,836</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-022-02072-5</identifier><identifier>PMID: 35962833</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Atrial Fibrillation - epidemiology ; Atrial Fibrillation - genetics ; Cardiac arrhythmia ; Cardiology ; Cardiovascular diseases ; Confidence intervals ; Female ; Fibrillation ; Genetic diversity ; Genetic variance ; Genome-wide association studies ; Genome-Wide Association Study ; Genomes ; Health risks ; Heart rate ; Heart Rate - physiology ; Humans ; Longitudinal Studies ; Male ; Median (statistics) ; Medicine ; Medicine & Public Health ; Mendelian Randomization Analysis ; Middle Aged ; Original Paper ; Outliers (statistics) ; Pleiotropy ; Population studies ; Randomization ; Risk factors ; Sex differences ; Standard deviation ; Variability</subject><ispartof>Clinical research in cardiology, 2023-06, Vol.112 (6), p.747-758</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-3119a7a98b96791c55b4bf1cace6688880a217a14da0a0074bdff73bbd1ee4683</citedby><cites>FETCH-LOGICAL-c475t-3119a7a98b96791c55b4bf1cace6688880a217a14da0a0074bdff73bbd1ee4683</cites><orcidid>0000-0001-5976-6519</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-022-02072-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-022-02072-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35962833$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Geurts, Sven</creatorcontrib><creatorcontrib>Tilly, Martijn J.</creatorcontrib><creatorcontrib>Arshi, Banafsheh</creatorcontrib><creatorcontrib>Stricker, Bruno H. C.</creatorcontrib><creatorcontrib>Kors, Jan A.</creatorcontrib><creatorcontrib>Deckers, Jaap W.</creatorcontrib><creatorcontrib>de Groot, Natasja M. S.</creatorcontrib><creatorcontrib>Ikram, M. Arfan</creatorcontrib><creatorcontrib>Kavousi, Maryam</creatorcontrib><title>Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Background
Sex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear.
Methods
12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standard deviation of normal RR intervals (SDNN), SDNN corrected for heart rate (SDNNc), RR interval differences (RMSSD), RMSSD corrected for heart rate (RMSSDc), and heart rate were assessed at baseline and follow-up examinations. Joint models, adjusted for cardiovascular risk factors, were used to determine the association between longitudinal measures of HRV with new-onset AF. Genetic variants for HRV were used as instrumental variables in a Mendelian randomization (MR) analysis using genome-wide association studies (GWAS) summary-level data.
Results
During a median follow-up of 9.4 years, 1302 incident AF cases occurred among 12,334 participants (mean age 64.8 years, 58.3% women). In joint models, higher SDNN (fully-adjusted hazard ratio (HR), 95% confidence interval (CI) 1.24, 1.04–1.47,
p
= 0.0213), and higher RMSSD (fully-adjusted HR, 95% CI 1.33, 1.13–1.54,
p
= 0.0010) were significantly associated with new-onset AF. Sex-stratified analyses showed that the associations were mostly prominent among women. In MR analyses, a genetically determined increase in SDNN (odds ratio (OR), 95% CI 1.60, 1.27–2.02,
p
= 8.36 × 10
–05
), and RMSSD (OR, 95% CI 1.56, 1.31–1.86,
p
= 6.32 × 10
–07
) were significantly associated with an increased odds of AF.
Conclusion
Longitudinal measures of uncorrected HRV were significantly associated with new-onset AF, especially among women. MR analyses supported the causal relationship between uncorrected measures of HRV with AF. Our findings indicate that measures to modulate HRV might prevent AF in the general population, in particular in women.
Graphical abstract
AF
; atrial fibrillation,
GWAS
; genome-wide association study,
IVW
; inverse variance weighted,
MR
; Mendelian randomization,
MR-PRESSO
; MR-egger and mendelian randomization pleiotropy residual sum and outlier,
RMSSD
; root mean square of successive RR interval differences,
RMSSDc
; root mean square of successive RR interval differences corrected for heart rate,
SDNN
; standard deviation of normal to normal RR intervals,
SDNNc
; standard deviation of normal to normal RR intervals corrected for heart rate,
WME
; weighted median estimator.
a
Rotterdam Study
n
=12,334
b
HRV GWAS
n
=53,174
c
AF GWAS
n
=1,030,836</description><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - genetics</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular diseases</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Genetic diversity</subject><subject>Genetic variance</subject><subject>Genome-wide association studies</subject><subject>Genome-Wide Association Study</subject><subject>Genomes</subject><subject>Health risks</subject><subject>Heart rate</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Median (statistics)</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mendelian Randomization Analysis</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Outliers (statistics)</subject><subject>Pleiotropy</subject><subject>Population studies</subject><subject>Randomization</subject><subject>Risk factors</subject><subject>Sex differences</subject><subject>Standard deviation</subject><subject>Variability</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vFSEUhonR2Fr9Ay4MiRs3o3wO4MY0jVqTGje6JocZ5pZmLlyBaXL76-U69fqxkIQAeZ_zAudF6Dklrykh6k0hhBvWEXaYRLFOPkCnVPe0I71hD497LU7Qk1JuCJGUcPEYnXBpeqY5P0V3lx5yxRmqx7eQA7gwh7rHEEcMtZ1nPAWXwzxDDSniEHG99njjo89N26XdsipvMeA5xU2oyxhikw4On30c_RwgtgvimLbhbnUpDdo_RY8mmIt_dr-eoW8f3n-9uOyuvnz8dHF-1Q1CydpxSg0oMNqZXhk6SOmEm-gAg-973QYBRhVQMQKB1hbhxmlS3LmRei96zc_Qu9V3t7itHwcfa3u63eWwhby3CYL9W4nh2m7SraWECdpr2hxe3Tvk9H3xpdptKINvPYk-LcUyRRjVXGjT0Jf_oDdpya0fjdKMSakMO1BspYacSsl-Or6GEnvI1q7Z2pat_Zmtla3oxZ__OJb8CrMBfAVKk-LG5993_8f2B4dtsiE</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Geurts, Sven</creator><creator>Tilly, Martijn J.</creator><creator>Arshi, Banafsheh</creator><creator>Stricker, Bruno H. C.</creator><creator>Kors, Jan A.</creator><creator>Deckers, Jaap W.</creator><creator>de Groot, Natasja M. S.</creator><creator>Ikram, M. Arfan</creator><creator>Kavousi, Maryam</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5976-6519</orcidid></search><sort><creationdate>20230601</creationdate><title>Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study</title><author>Geurts, Sven ; Tilly, Martijn J. ; Arshi, Banafsheh ; Stricker, Bruno H. C. ; Kors, Jan A. ; Deckers, Jaap W. ; de Groot, Natasja M. S. ; Ikram, M. Arfan ; Kavousi, Maryam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-3119a7a98b96791c55b4bf1cace6688880a217a14da0a0074bdff73bbd1ee4683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - genetics</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiovascular diseases</topic><topic>Confidence intervals</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Genetic diversity</topic><topic>Genetic variance</topic><topic>Genome-wide association studies</topic><topic>Genome-Wide Association Study</topic><topic>Genomes</topic><topic>Health risks</topic><topic>Heart rate</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Median (statistics)</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mendelian Randomization Analysis</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Outliers (statistics)</topic><topic>Pleiotropy</topic><topic>Population studies</topic><topic>Randomization</topic><topic>Risk factors</topic><topic>Sex differences</topic><topic>Standard deviation</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Geurts, Sven</creatorcontrib><creatorcontrib>Tilly, Martijn J.</creatorcontrib><creatorcontrib>Arshi, Banafsheh</creatorcontrib><creatorcontrib>Stricker, Bruno H. C.</creatorcontrib><creatorcontrib>Kors, Jan A.</creatorcontrib><creatorcontrib>Deckers, Jaap W.</creatorcontrib><creatorcontrib>de Groot, Natasja M. S.</creatorcontrib><creatorcontrib>Ikram, M. Arfan</creatorcontrib><creatorcontrib>Kavousi, Maryam</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Geurts, Sven</au><au>Tilly, Martijn J.</au><au>Arshi, Banafsheh</au><au>Stricker, Bruno H. C.</au><au>Kors, Jan A.</au><au>Deckers, Jaap W.</au><au>de Groot, Natasja M. S.</au><au>Ikram, M. Arfan</au><au>Kavousi, Maryam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>112</volume><issue>6</issue><spage>747</spage><epage>758</epage><pages>747-758</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Background
Sex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear.
Methods
12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standard deviation of normal RR intervals (SDNN), SDNN corrected for heart rate (SDNNc), RR interval differences (RMSSD), RMSSD corrected for heart rate (RMSSDc), and heart rate were assessed at baseline and follow-up examinations. Joint models, adjusted for cardiovascular risk factors, were used to determine the association between longitudinal measures of HRV with new-onset AF. Genetic variants for HRV were used as instrumental variables in a Mendelian randomization (MR) analysis using genome-wide association studies (GWAS) summary-level data.
Results
During a median follow-up of 9.4 years, 1302 incident AF cases occurred among 12,334 participants (mean age 64.8 years, 58.3% women). In joint models, higher SDNN (fully-adjusted hazard ratio (HR), 95% confidence interval (CI) 1.24, 1.04–1.47,
p
= 0.0213), and higher RMSSD (fully-adjusted HR, 95% CI 1.33, 1.13–1.54,
p
= 0.0010) were significantly associated with new-onset AF. Sex-stratified analyses showed that the associations were mostly prominent among women. In MR analyses, a genetically determined increase in SDNN (odds ratio (OR), 95% CI 1.60, 1.27–2.02,
p
= 8.36 × 10
–05
), and RMSSD (OR, 95% CI 1.56, 1.31–1.86,
p
= 6.32 × 10
–07
) were significantly associated with an increased odds of AF.
Conclusion
Longitudinal measures of uncorrected HRV were significantly associated with new-onset AF, especially among women. MR analyses supported the causal relationship between uncorrected measures of HRV with AF. Our findings indicate that measures to modulate HRV might prevent AF in the general population, in particular in women.
Graphical abstract
AF
; atrial fibrillation,
GWAS
; genome-wide association study,
IVW
; inverse variance weighted,
MR
; Mendelian randomization,
MR-PRESSO
; MR-egger and mendelian randomization pleiotropy residual sum and outlier,
RMSSD
; root mean square of successive RR interval differences,
RMSSDc
; root mean square of successive RR interval differences corrected for heart rate,
SDNN
; standard deviation of normal to normal RR intervals,
SDNNc
; standard deviation of normal to normal RR intervals corrected for heart rate,
WME
; weighted median estimator.
a
Rotterdam Study
n
=12,334
b
HRV GWAS
n
=53,174
c
AF GWAS
n
=1,030,836</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35962833</pmid><doi>10.1007/s00392-022-02072-5</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-5976-6519</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2023-06, Vol.112 (6), p.747-758 |
| issn | 1861-0684 1861-0692 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10241681 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Atrial Fibrillation - epidemiology Atrial Fibrillation - genetics Cardiac arrhythmia Cardiology Cardiovascular diseases Confidence intervals Female Fibrillation Genetic diversity Genetic variance Genome-wide association studies Genome-Wide Association Study Genomes Health risks Heart rate Heart Rate - physiology Humans Longitudinal Studies Male Median (statistics) Medicine Medicine & Public Health Mendelian Randomization Analysis Middle Aged Original Paper Outliers (statistics) Pleiotropy Population studies Randomization Risk factors Sex differences Standard deviation Variability |
| title | Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study |
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