Johanna Härtl , Dirk Sander , Ikenberg David Ikenberg , Georg Schmidt , Bernhard Hemmer , Silke Wunderlich , Bernhard Nimmrichter , Klaus Pürner , Alexander Hapfelmeier
{"title":"通过颈动脉内膜-中膜厚度测量,访间心率变异性与动脉病变介导的心血管疾病之间是否存在关联?","authors":"Johanna Härtl , Dirk Sander , Ikenberg David Ikenberg , Georg Schmidt , Bernhard Hemmer , Silke Wunderlich , Bernhard Nimmrichter , Klaus Pürner , Alexander Hapfelmeier","doi":"10.1016/j.jstrokecerebrovasdis.2025.108348","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Visit-to-visit heart rate variation (HRV-VV) is associated with mortality and cardiovascular events. Mechanisms of the interaction between HRV-VV and vascular disease are not clearly understood. Our study aimed to evaluate the association between HRV-VV and carotid intima-media thickness (IMT) and their potential impact on cardiovascular disease development.</div></div><div><h3>Methods</h3><div>The study population is derived from a cohort of elderly patients enrolled in the primary-care-based INtervention project on cerebroVAscular diseases and Dementia in the community of Ebersberg (INVADE). We included all patients with a follow-up of eight years and five follow-up visits in regular two-year intervals. HRV-VV was defined by the standard deviation of between-visit measurements (SD). Uni- and multivariable regression models were used to identify associations between HRV-VV, IMT, and a combined cardiovascular endpoint of new onset stroke and myocardial infarction.</div></div><div><h3>Results</h3><div>2815 patients were included in the study. HRV-VV was positively associated with IMT in multivariable analysis (<em>p</em> = 0.026). Every SD HRV-VV of 10 bpm was associated with a change of IMT of 18 ± 8 µm. Furthermore, HRV-VV showed a numerical and positive association with the combined cardiovascular endpoint (<em>p</em> = 0.07), while a simultaneous increase in HRV-VV and IMT increased the likelihood more than either factor alone (<em>p</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>HRV-VV showed a positive association with IMT, a surrogate marker for early arteriopathy. Both parameters furtherly demonstrated a synergistic impact on the likelihood of cardiovascular disease development. Given its widespread availability by continuous monitoring with wearables, HRV-VV may provide a potentially modifiable medical target for personalized cardiovascular risk stratification.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108348"},"PeriodicalIF":2.0000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Is the association between visit- to- visit heart rate variability and cardiovascular disease mediated by arteriopathy as measured by carotid intima- media thickness?\",\"authors\":\"Johanna Härtl , Dirk Sander , Ikenberg David Ikenberg , Georg Schmidt , Bernhard Hemmer , Silke Wunderlich , Bernhard Nimmrichter , Klaus Pürner , Alexander Hapfelmeier\",\"doi\":\"10.1016/j.jstrokecerebrovasdis.2025.108348\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Visit-to-visit heart rate variation (HRV-VV) is associated with mortality and cardiovascular events. Mechanisms of the interaction between HRV-VV and vascular disease are not clearly understood. Our study aimed to evaluate the association between HRV-VV and carotid intima-media thickness (IMT) and their potential impact on cardiovascular disease development.</div></div><div><h3>Methods</h3><div>The study population is derived from a cohort of elderly patients enrolled in the primary-care-based INtervention project on cerebroVAscular diseases and Dementia in the community of Ebersberg (INVADE). We included all patients with a follow-up of eight years and five follow-up visits in regular two-year intervals. HRV-VV was defined by the standard deviation of between-visit measurements (SD). Uni- and multivariable regression models were used to identify associations between HRV-VV, IMT, and a combined cardiovascular endpoint of new onset stroke and myocardial infarction.</div></div><div><h3>Results</h3><div>2815 patients were included in the study. HRV-VV was positively associated with IMT in multivariable analysis (<em>p</em> = 0.026). Every SD HRV-VV of 10 bpm was associated with a change of IMT of 18 ± 8 µm. Furthermore, HRV-VV showed a numerical and positive association with the combined cardiovascular endpoint (<em>p</em> = 0.07), while a simultaneous increase in HRV-VV and IMT increased the likelihood more than either factor alone (<em>p</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>HRV-VV showed a positive association with IMT, a surrogate marker for early arteriopathy. Both parameters furtherly demonstrated a synergistic impact on the likelihood of cardiovascular disease development. Given its widespread availability by continuous monitoring with wearables, HRV-VV may provide a potentially modifiable medical target for personalized cardiovascular risk stratification.</div></div>\",\"PeriodicalId\":54368,\"journal\":{\"name\":\"Journal of Stroke & Cerebrovascular Diseases\",\"volume\":\"34 8\",\"pages\":\"Article 108348\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Stroke & Cerebrovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1052305725001260\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stroke & Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1052305725001260","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Is the association between visit- to- visit heart rate variability and cardiovascular disease mediated by arteriopathy as measured by carotid intima- media thickness?
Background
Visit-to-visit heart rate variation (HRV-VV) is associated with mortality and cardiovascular events. Mechanisms of the interaction between HRV-VV and vascular disease are not clearly understood. Our study aimed to evaluate the association between HRV-VV and carotid intima-media thickness (IMT) and their potential impact on cardiovascular disease development.
Methods
The study population is derived from a cohort of elderly patients enrolled in the primary-care-based INtervention project on cerebroVAscular diseases and Dementia in the community of Ebersberg (INVADE). We included all patients with a follow-up of eight years and five follow-up visits in regular two-year intervals. HRV-VV was defined by the standard deviation of between-visit measurements (SD). Uni- and multivariable regression models were used to identify associations between HRV-VV, IMT, and a combined cardiovascular endpoint of new onset stroke and myocardial infarction.
Results
2815 patients were included in the study. HRV-VV was positively associated with IMT in multivariable analysis (p = 0.026). Every SD HRV-VV of 10 bpm was associated with a change of IMT of 18 ± 8 µm. Furthermore, HRV-VV showed a numerical and positive association with the combined cardiovascular endpoint (p = 0.07), while a simultaneous increase in HRV-VV and IMT increased the likelihood more than either factor alone (p = 0.009).
Conclusion
HRV-VV showed a positive association with IMT, a surrogate marker for early arteriopathy. Both parameters furtherly demonstrated a synergistic impact on the likelihood of cardiovascular disease development. Given its widespread availability by continuous monitoring with wearables, HRV-VV may provide a potentially modifiable medical target for personalized cardiovascular risk stratification.
期刊介绍:
The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.