Cardiac Autonomic Dysfunction And Incidence Of Heart Failure: The Atherosclerosis Risk In Communities Study

Introduction: Interventions to modify autonomic tone have been sought as a way to improve outcomes in heart failure (HF) patients. Low heart rate variability (HRV) measures signify autonomic dysfunction. However, the role of autonomic dysfunction in the etiology of heart failure (HF) remains unclear. Hypothesis: Lower HRV will be associated with a higher risk of HF. Methods: We analyzed data on 9,088 participants to the Atherosclerosis Risk in Communities (ARIC) Study. HRV measures derived from 2-minute rhythm ECG at baseline visit (1987-89), included standard deviation of RR intervals (SDNN) and frequency domain measures. Incident HF was ascertained through hospital discharge or death certificate codes thorough 2010. Results: During a median follow-up of 21.6 years, 1,345 (15%) participants developed HF (incidence rate 7.7/1,000 person-years). Low HRV measures were associated with a higher incidence of HF. For instance, for each unit lower standard deviation of log (SDNN) HF risk was 55% higher (Hazards ...