Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease

Shogo Watanabe, Eisuke Amiya, Masafumi Watanabe, Munenori Takata, Atsuko Ozeki, Aya Watanabe, Shuichi Kawarasaki, Tomoko Nakao, Yumiko Hosoya, Kazuko Omori, Koji Maemura, Issei Komuro, Ryozo Nagai

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Endothelial dysfunction and autonomic nervous system imbalance are both risk markers of atherosclerotic vascular damage. The relationship between these 2 factors, however, has not been clarified concisely. Methods and Results: Flow-mediated dilation (FMD) was measured in 47 patients with ischemic heart disease (IHD; mean age, 68.1±7.1 years) using an ultrasound semi-automatic measuring system (UNEXEF18G), and autonomic nervous system activity was evaluated by simultaneous measurements of heart rate variability. FMD was significantly correlated with standard deviation of normal-to-normal beats (r=0.33, P=0.022) and the power ratio of low-frequency power to high-frequency power (LF/HF; r=-0.38, P=0.0087). Furthermore, multiple regression analysis indicated that LF/HF was the most important predictor of the magnitude of FMD. This interaction was severely blunted by β-blockers and the presence of diabetes. Moreover, standardized FMD according to autonomic nervous system activity was a better predictor of future cardiovascular events than FMD. Subjects with cardiovascular events had a significantly smaller corrected FMD (event (+), 3.62±0.41; event (-), 5.10±2.35; P=0.001), and the higher corrected FMD was associated with longer event-free survival. Conclusions: Autonomic nervous system activity is an important regulatory factor of FMD in subjects with IHD. Assessment of this interaction can help provide more accurate risk stratification of subjects with IHD.

Original languageEnglish
Pages (from-to)1018-1025
Number of pages8
JournalCirculation Journal
Volume77
Issue number4
DOIs
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Myocardial Ischemia
Dilatation
Heart Rate
Autonomic Nervous System
Disease-Free Survival
Blood Vessels
Regression Analysis

Keywords

  • Autonomic nervous system
  • Endothelial function
  • Flow-mediated dilation
  • Ischemic heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease. / Watanabe, Shogo; Amiya, Eisuke; Watanabe, Masafumi; Takata, Munenori; Ozeki, Atsuko; Watanabe, Aya; Kawarasaki, Shuichi; Nakao, Tomoko; Hosoya, Yumiko; Omori, Kazuko; Maemura, Koji; Komuro, Issei; Nagai, Ryozo.

In: Circulation Journal, Vol. 77, No. 4, 2013, p. 1018-1025.

Research output: Contribution to journalArticle

Watanabe, S, Amiya, E, Watanabe, M, Takata, M, Ozeki, A, Watanabe, A, Kawarasaki, S, Nakao, T, Hosoya, Y, Omori, K, Maemura, K, Komuro, I & Nagai, R 2013, 'Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease', Circulation Journal, vol. 77, no. 4, pp. 1018-1025. https://doi.org/10.1253/circj.CJ-12-1043
Watanabe, Shogo ; Amiya, Eisuke ; Watanabe, Masafumi ; Takata, Munenori ; Ozeki, Atsuko ; Watanabe, Aya ; Kawarasaki, Shuichi ; Nakao, Tomoko ; Hosoya, Yumiko ; Omori, Kazuko ; Maemura, Koji ; Komuro, Issei ; Nagai, Ryozo. / Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease. In: Circulation Journal. 2013 ; Vol. 77, No. 4. pp. 1018-1025.
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AU - Ozeki, Atsuko

AU - Watanabe, Aya

AU - Kawarasaki, Shuichi

AU - Nakao, Tomoko

AU - Hosoya, Yumiko

AU - Omori, Kazuko

AU - Maemura, Koji

AU - Komuro, Issei

AU - Nagai, Ryozo

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N2 - Background: Endothelial dysfunction and autonomic nervous system imbalance are both risk markers of atherosclerotic vascular damage. The relationship between these 2 factors, however, has not been clarified concisely. Methods and Results: Flow-mediated dilation (FMD) was measured in 47 patients with ischemic heart disease (IHD; mean age, 68.1±7.1 years) using an ultrasound semi-automatic measuring system (UNEXEF18G), and autonomic nervous system activity was evaluated by simultaneous measurements of heart rate variability. FMD was significantly correlated with standard deviation of normal-to-normal beats (r=0.33, P=0.022) and the power ratio of low-frequency power to high-frequency power (LF/HF; r=-0.38, P=0.0087). Furthermore, multiple regression analysis indicated that LF/HF was the most important predictor of the magnitude of FMD. This interaction was severely blunted by β-blockers and the presence of diabetes. Moreover, standardized FMD according to autonomic nervous system activity was a better predictor of future cardiovascular events than FMD. Subjects with cardiovascular events had a significantly smaller corrected FMD (event (+), 3.62±0.41; event (-), 5.10±2.35; P=0.001), and the higher corrected FMD was associated with longer event-free survival. Conclusions: Autonomic nervous system activity is an important regulatory factor of FMD in subjects with IHD. Assessment of this interaction can help provide more accurate risk stratification of subjects with IHD.

AB - Background: Endothelial dysfunction and autonomic nervous system imbalance are both risk markers of atherosclerotic vascular damage. The relationship between these 2 factors, however, has not been clarified concisely. Methods and Results: Flow-mediated dilation (FMD) was measured in 47 patients with ischemic heart disease (IHD; mean age, 68.1±7.1 years) using an ultrasound semi-automatic measuring system (UNEXEF18G), and autonomic nervous system activity was evaluated by simultaneous measurements of heart rate variability. FMD was significantly correlated with standard deviation of normal-to-normal beats (r=0.33, P=0.022) and the power ratio of low-frequency power to high-frequency power (LF/HF; r=-0.38, P=0.0087). Furthermore, multiple regression analysis indicated that LF/HF was the most important predictor of the magnitude of FMD. This interaction was severely blunted by β-blockers and the presence of diabetes. Moreover, standardized FMD according to autonomic nervous system activity was a better predictor of future cardiovascular events than FMD. Subjects with cardiovascular events had a significantly smaller corrected FMD (event (+), 3.62±0.41; event (-), 5.10±2.35; P=0.001), and the higher corrected FMD was associated with longer event-free survival. Conclusions: Autonomic nervous system activity is an important regulatory factor of FMD in subjects with IHD. Assessment of this interaction can help provide more accurate risk stratification of subjects with IHD.

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