Role of Heart Rate Variability in Association Between Glomerular Hyperfiltration and All-Cause Mortality

Hao Chih Chang, Chi Jung Huang, Albert C. Yang, Hao Min Cheng, Shao Yuan Chuang, Wen Chung Yu, Chern En Chiang, Chen Huan Chen, Shih Hsien Sung*

*此作品的通信作者

研究成果: Article同行評審

1 引文 斯高帕斯(Scopus)

摘要

BACKGROUND: Glomerular hyperfiltration (GHF) is paradoxically associated with increased cardiovascular events in healthy in-dividuals, but the pathogenesis remains unclear. We aim to investigate whether GHF is associated with mortality and whether decreased heart rate variability (HRV) is associated with GHF. METHODS AND RESULTS: We retrospectively analyzed 1615 participants (aged 66.1±17.3 years, 61.9% men) without prior cardiovascular events. The glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. GHF was defined as glomerular filtration rate >the 95th percentile after stratification for age and sex, whereas normal filtration was defined as the 25th to 75th percentiles. HRV indexes, including time domain, frequency domain, and sample entropy, were measured using 24-hour ambulatory electrocardiography. Clinical outcomes were defined as all-cause mortality at 2 years. During a mean follow-up of 16.5±8.2 months, there were 117 deaths (7.2%). GHF was associated with a higher risk of death (hazard ratio and 95% CIs, 1.97 [1.15– 3.37]). Reduced HRV indexes, including time domain, frequency domain, and sample entropy (odds ratio and 95% CIs, 0.79 [0.70– 0.89]) were all independently associated with the presence of GHF after accounting for age, sex, mean heart rate, morbidities, and medications. In subgroup analysis, reduced HRV was more predictive of GHF in the young than the elderly. Mediation analysis revealed a significant mediation effect between HRV and GHF in addition to their respective detrimental effects on survival. CONCLUSIONS: Reduced HRV was independently associated with the presence of GHF. Autonomic dysfunction may be in-volved in the pathogenesis of adverse outcomes of GHF in individuals without prior cardiovascular events.

原文English
文章編號e021585
期刊Journal of the American Heart Association
10
發行號24
DOIs
出版狀態Published - 21 12月 2021

指紋

深入研究「Role of Heart Rate Variability in Association Between Glomerular Hyperfiltration and All-Cause Mortality」主題。共同形成了獨特的指紋。

引用此