title: Longitudinal association of short-term, metronome-paced heart rate variability and echocardiographically assessed cardiac structure at a 4-year follow-up: results from the prospective, population-based CARLA cohort.
abstract: OBJECTIVE
  To assess the value of cardiac structure/function in predicting heart rate variability (HRV) and the possibly predictive value of HRV on cardiac parameters.
  
  
  RESULTS
  Baseline and 4-year follow-up data from the population-based CARLA cohort were used (790 men, 646 women, aged 45-83 years at baseline and 50-87 years at follow-up). Echocardiographic and HRV recordings were performed at baseline and at follow-up. Linear regression models with a quadratic term were used. Crude and covariate adjusted estimates were calculated. Missing values were imputed by means of multiple imputation. Heart rate variability measures taken into account consisted of linear time and frequency domain [standard deviation of normal-to-normal intervals (SDNN), high-frequency power (HF), low-frequency power (LF), LF/HF ratio] and non-linear measures [detrended fluctuation analysis (DFA1), SD1, SD2, SD1/SD2 ratio]. Echocardiographic parameters considered were ventricular mass index, diastolic interventricular septum thickness, left ventricular diastolic dimension, left atrial dimension systolic (LADS), and ejection fraction (Teichholz). A negative quadratic relation between baseline LADS and change in SDNN and HF was observed. The maximum HF and SDNN change (an increase of roughly 0.02%) was predicted at LADS of 3.72 and 3.57 cm, respectively, while the majority of subjects experienced a decrease in HRV. There was no association between further echocardiographic parameters and change in HRV, and there was no evidence of a predictive value of HRV in the prediction of changes in cardiac structure.
  
  
  CONCLUSIONS
  In the general population, LADS predicts 4-year alteration in SDNN and HF non-linearly. Because of the novelty of the result, analyses should be replicated in other populations.
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Medenwald
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Cees A
authors.initials: CA
authors.lastname: Swenne
authors.affiliation: Department of Medicine III, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Frantz
authors.affiliation: Department of Medicine III, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Nuding
authors.affiliation: Department of Medical Informatics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Kors
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Pietzner
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tiller
authors.affiliation: German Cancer Research Center, Division of Cancer Epidemiology, Heidelberg, Germany.
authors.forename: Karin H
authors.initials: KH
authors.lastname: Greiser
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluttig
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Haerting
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D064752:Atrial Remodeling; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D010507:Periodicity; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: Atrial size; Echocardiography; General population; Heart rate variability; Longitudinal study; Ventricular mass