Cargando…

Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies

BACKGROUND: Heart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantif...

Descripción completa

Detalles Bibliográficos
Autores principales: Qiu, Shanhu, Cai, Xue, Sun, Zilin, Li, Ling, Zuegel, Martina, Steinacker, Juergen Michael, Schumann, Uwe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524096/
https://www.ncbi.nlm.nih.gov/pubmed/28487388
http://dx.doi.org/10.1161/JAHA.117.005505
_version_ 1783252419789979648
author Qiu, Shanhu
Cai, Xue
Sun, Zilin
Li, Ling
Zuegel, Martina
Steinacker, Juergen Michael
Schumann, Uwe
author_facet Qiu, Shanhu
Cai, Xue
Sun, Zilin
Li, Ling
Zuegel, Martina
Steinacker, Juergen Michael
Schumann, Uwe
author_sort Qiu, Shanhu
collection PubMed
description BACKGROUND: Heart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population. METHODS AND RESULTS: A literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95% CIs for the association between baseline HRR and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated HRR versus fast HRR that served as the referent were 1.69 (95% CI 1.05–2.71) for cardiovascular events and 1.68 (95% CI 1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in HRR, the hazard ratios were 1.13 (95% CI 1.05–1.21) and 1.09 (95% CI 1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated HRR and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all P<0.05). CONCLUSIONS: Attenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine.
format Online
Article
Text
id pubmed-5524096
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-55240962017-08-02 Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies Qiu, Shanhu Cai, Xue Sun, Zilin Li, Ling Zuegel, Martina Steinacker, Juergen Michael Schumann, Uwe J Am Heart Assoc Systematic Review and Meta‐Analysis BACKGROUND: Heart rate recovery (HRR) is a noninvasive assessment of autonomic dysfunction and has been implicated with risk of cardiovascular events and all‐cause mortality. However, evidence has not been systematically assessed. We performed a meta‐analysis of prospective cohort studies to quantify these associations in the general population. METHODS AND RESULTS: A literature search using 3 databases up to August 2016 was conducted for studies that reported hazard ratios with 95% CIs for the association between baseline HRR and outcomes of interest. The overall hazard ratios were calculated using a random‐effects model. There were 9 eligible studies in total, with 5 for cardiovascular events enrolling 1061 cases from 34 267 participants, and 9 for all‐cause mortality enrolling 2082 cases from 41 600 participants. The pooled hazard ratios associated with attenuated HRR versus fast HRR that served as the referent were 1.69 (95% CI 1.05–2.71) for cardiovascular events and 1.68 (95% CI 1.51–1.88) for all‐cause mortality. For every 10 beats per minute decrements in HRR, the hazard ratios were 1.13 (95% CI 1.05–1.21) and 1.09 (95% CI 1.01–1.19), respectively. Further analyses suggested that the associations observed between attenuated HRR and risk of fatal cardiovascular events and all‐cause mortality were independent of traditional metabolic factors for cardiovascular disease (all P<0.05). CONCLUSIONS: Attenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine. John Wiley and Sons Inc. 2017-05-09 /pmc/articles/PMC5524096/ /pubmed/28487388 http://dx.doi.org/10.1161/JAHA.117.005505 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Systematic Review and Meta‐Analysis
Qiu, Shanhu
Cai, Xue
Sun, Zilin
Li, Ling
Zuegel, Martina
Steinacker, Juergen Michael
Schumann, Uwe
Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title_full Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title_fullStr Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title_full_unstemmed Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title_short Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies
title_sort heart rate recovery and risk of cardiovascular events and all‐cause mortality: a meta‐analysis of prospective cohort studies
topic Systematic Review and Meta‐Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524096/
https://www.ncbi.nlm.nih.gov/pubmed/28487388
http://dx.doi.org/10.1161/JAHA.117.005505
work_keys_str_mv AT qiushanhu heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT caixue heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT sunzilin heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT liling heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT zuegelmartina heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT steinackerjuergenmichael heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies
AT schumannuwe heartraterecoveryandriskofcardiovasculareventsandallcausemortalityametaanalysisofprospectivecohortstudies