Changes and prognostic significance of autonomic cardiac regulation during ageing

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical Pub Date : 2025-02-23 DOI:10.1016/j.autneu.2025.103255

Elisa Karhumaa, Antti Vuoti, Antti M. Kiviniemi, M. Juhani Junttila, Mikko P. Tulppo, Heikki V. Huikuri, Olavi H. Ukkola, Juha S. Perkiömäki

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Abstract

Background

Data on the changes of heart rate variability (HRV) and their prognostic significance during ageing are limited.

Methods

HRV analyzes were done from standardized 45-min ECG recordings, which consisted of 15 min recordings in lying down, sitting positions and during walking. We used time domain-, frequency domain- and non-linear methods to estimate HRV. The baseline ECG recordings were done in 1991–1993 (n = 783) and follow up recordings were done in 2013–2014 (n = 466). Endpoints were reviewed in 2021.

Results

During a mean follow-up of 22.1 ± 0.7 years, high-, low- and very-low-frequency powers (HF, LF, VLF), standard deviation of RR intervals (SDNN), the short-term fractal-like scaling exponent analyzed by the detrended fluctuation analysis (DFA1) and approximate entropy (ApEn) decreased statistically significantly (p-values from <0.05 to <0.001). Larger decrease of VLF(ln) and LF(ln) predicted total and cardiovascular (CV) mortality in the multivariate model (p-values from <0.05 to <0.001). Baseline natural logarithm of LF (LF(ln)) dichotomized and DFA1 had the strongest prognostic value on total and CV-mortality in multivariate analysis after adjustments with relevant clinical characteristics. Also, lower values of baseline ApEn retained their predictive power for total mortality and decreased ratio of LF to HF (LF/HF) for CV-mortality after adjustments.

Conclusions

Almost all the HRV parameters decreased during ageing. Larger decrease of VLF(ln) and LF(ln) predicted total and CV-mortality after adjustments indicating that larger attenuation in cardiac autonomic regulation during ageing yields prognostic information. Of the baseline HRV parameters LF(ln) dichotomized and DFA1 had the strongest prognostic value on total and CV-mortality.

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自律性心脏调节在衰老过程中的变化及其预后意义

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来源期刊

Autonomic Neuroscience-Basic & Clinical 医学-神经科学

CiteScore

5.80

自引率

7.40%

发文量

审稿时长

66 days

期刊介绍： This is an international journal with broad coverage of all aspects of the autonomic nervous system in man and animals. The main areas of interest include the innervation of blood vessels and viscera, autonomic ganglia, efferent and afferent autonomic pathways, and autonomic nuclei and pathways in the central nervous system. The Editors will consider papers that deal with any aspect of the autonomic nervous system, including structure, physiology, pharmacology, biochemistry, development, evolution, ageing, behavioural aspects, integrative role and influence on emotional and physical states of the body. Interdisciplinary studies will be encouraged. Studies dealing with human pathology will be also welcome.