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Heart rate variability is associated with haptoglobin phenotype in patients with coronary artery disease
Jeppe Hagstrup Christensen1, Henrik Bygum Krarup, Sam Riahi
1Department of Nephrology, Aalborg Hospital, Aalborg, Denmark. jhc@dadlnet.dk
Insights
The haptoglobin 2-2 phenotype is linked to reduced heart rate variability in coronary artery disease patients. This finding may explain the poorer prognosis observed in individuals with the Hp 2-2 genotype.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Biomarkers
Background:
- Haptoglobin (Hp) phenotypes (Hp 1-1, Hp 2-2, Hp 2-1) influence coronary artery disease (CAD) risk.
- The haptoglobin 1 allele may offer partial protection against CAD.
- Attenuated heart rate variability (HRV) is a predictor of poor outcomes in CAD patients.
Purpose of the Study:
- To investigate the association between haptoglobin phenotype and heart rate variability in patients with suspected coronary artery disease.
Main Methods:
- A cross-sectional study involving 255 patients undergoing elective coronary angiography.
- 24-hour electrocardiogram recordings were used to assess time-domain heart rate variability.
- Haptoglobin phenotype was determined for all participants.
Main Results:
- Patients with the Hp 2-2 phenotype (n=98) exhibited significantly lower 24-h HRV compared to those with Hp 1-1 or Hp 2-1 (n=159).
- Specific HRV parameters (RR, RMSSD, pNN50) were significantly reduced in the Hp 2-2 group.
- Hp 2-2 was independently associated with attenuated HRV (P=0.02).
Conclusions:
- The Hp 2-2 phenotype is associated with reduced heart rate variability in patients with coronary artery disease.
- This association may contribute to the understanding of the poorer prognosis reported in Hp 2-2 patients.
- Haptoglobin phenotype could serve as a prognostic biomarker in cardiovascular disease.
Background:
Three haptoglobin phenotypes exist called Hp 1-1, Hp 2-2, and Hp 2-1. Patients carrying the haptoglobin 1 allele seem to be partly protected against coronary artery disease. An attenuated heart rate variability is associated with a poor outcome in patients with coronary artery disease. Therefore, we hypothesized that the presence of the haptoglobin 1 allele would be associated with a favourable heart rate variability.
Design:
A cross-sectional study.
Methods:
We included 255 patients who were referred for elective coronary angiography as a result of suspected coronary artery disease, and all underwent 24-h electrocardiogram recordings to assess heart rate variability in the time domain. The haptoglobin phenotype was also determined in each patient.
Results:
There were 159 patients in the Hp 1-1 and Hp 2-1 groups and 98 patients in the Hp 2-2 group. The two groups were comparable with respect to clinical parameters. However, the Hp 2-2 group had significantly lower 24-h heart rate variability values compared with the other group (RR 882 versus 921 ms, P=0.02; RMSSD 26 versus 30 ms, P<0.01; pNN50 6 versus 9%, P=0.01). Furthermore, Hp 2-2 was independently and negatively associated with heart rate variability (P=0.02).
Conclusion:
Hp 2-2 was associated with an attenuated heart rate variability in patients with coronary artery disease that may help to explain other results reporting a poor prognosis in Hp 2-2 patients.
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