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Published on: June 5, 2019
Heart rate variability and cardiovascular diseases: A Mendelian randomization study
Yan Zhao1, Hangtian Yu1, Angwei Gong1
1Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Insights
This study found that higher peak-valley respiratory sinus arrhythmia or high-frequency power (pvRSA/HF) is genetically linked to an increased risk of cardiac arrest. This genetic evidence clarifies a potential causal relationship in cardiovascular disease events.
Area of Science:
- Cardiology
- Genetics
- Epidemiology
Background:
- The link between heart rate variability (HRV) and cardiovascular diseases (CVD) remains unclear, with inconsistent findings in existing research.
- Mendelian randomization studies offer a method to investigate potential causal relationships using genetic variants.
Purpose of the Study:
- To explore the causal relationship between heart rate variability and cardiovascular diseases and associated events.
- To utilize Mendelian randomization to assess the genetic influence of HRV on CVD outcomes.
Main Methods:
- Selected instrumental variables for HRV: standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), and peak-valley respiratory sinus arrhythmia/high-frequency power (pvRSA/HF).
- Utilized publicly available genome-wide association study data for exposures and outcomes, including various CVDs and related events.
- Employed inverse variance weighted (IVW) for primary causal estimation, with MR-Egger, Cochran's Q test, and leave-one-out analyses to assess heterogeneity and pleiotropy.
Main Results:
- Genetically predicted pvRSA/HF showed a significant association with an increased risk of cardiac arrest (OR 2.02, 95% CI 1.25-3.28, p=0.004).
- The association remained robust, with no significant heterogeneity or pleiotropy detected.
- Leave-one-out analysis confirmed the reliability of the findings.
Conclusions:
- This Mendelian randomization study provides strong genetic evidence for a causal relationship between pvRSA/HF and cardiac arrest.
- The findings contribute to understanding the role of autonomic function, specifically parasympathetic activity reflected by pvRSA/HF, in cardiac arrest etiology.
Background:
The causal relationship between heart rate variability and cardiovascular diseases and the associated events is still unclear, and the conclusions of current studies are inconsistent. We aimed to explore the relationship between heart rate variability and cardiovascular diseases and the associated events with the Mendelian randomization study.
Methods:
We selected normal-to-normal inter-beat intervals (SDNN), root mean square of the successive differences of inter-beat intervals (RMSSD) and peak-valley respiratory sinus arrhythmia or high-frequency power (pvRSA/HF) as the three sets of instrumental variables for heart rate variability. The outcome for cardiovascular diseases included essential hypertension, heart failure, angina pectoris, myocardial infarction, nonischemic cardiomyopathy and arrhythmia. Cardiac arrest, cardiac death and major coronary heart disease event were defined as the related events of cardiovascular diseases. The data for exposures and outcomes were derived from publicly available genome-wide association studies. Inverse variance weighted was used for the main causal estimation. Analyses of heterogeneity and pleiotropy were conducted using the Cochran Q test of Inverse variance weighted and MR-Egger, leave-one-out analysis, and MR-Pleiotropy Residual Sum and Outlier methods.
Results:
The Inverse variance weighted method indicated that genetically predicted pvRSA/HF was associated with the increased risk of cardiac arrest (odds ratio 2.02, 95% confidence interval 1.25-3.28, p = .004). The results were free of heterogeneity and pleiotropy. There were no outliers and the leave-one-out analysis proved that the results were reliable.
Conclusions:
This study provides genetic evidence that pvRSA/HF is causally related to cardiac arrest.
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