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Cardiovagal Function Measured by the Deep Breathing Test : Relationships With Coronary Atherosclerosis

Engström, Gunnar LU ; Hamrefors, Viktor LU orcid ; Fedorowski, Artur LU orcid ; Persson, Anders LU orcid ; Johansson, Maria E LU ; Ostenfeld, Ellen LU orcid ; Goncalves, Isabel LU orcid ; Markstad, Hanna LU ; Johnson, Linda S B LU and Persson, Margaretha LU orcid , et al. (2022) In Journal of the American Heart Association 11(7).
Abstract

Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population-based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration-inspiration differences (E-Is) of heart rates were calculated, and reduced RSA was defined... (More)

Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population-based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration-inspiration differences (E-Is) of heart rates were calculated, and reduced RSA was defined as E-I in the lowest decile of the population. The relationship between reduced RSA and CACS (CACS≥100 or CACS≥300) was calculated using multivariable-adjusted logistic regression. The proportion of CACS≥100 was 24% in the lowest decile of E-I and 12% in individuals with E-I above the lowest decile (P<0.001), and the proportion of CACS≥300 was 12% and 4.8%, respectively (P<0.001). The adjusted odds ratio (OR) for CACS≥100 was 1.42 (95% CI, 1.10-1.84) and the adjusted OR for CACS≥300 was 1.62 (95% CI, 1.15-2.28), when comparing the lowest E-I decile with deciles 2 to 10. Adjusted ORs per 1 SD lower E-I were 1.17 (P=0.001) for CACS≥100 and 1.28 (P=0.001) for CACS≥300. Conclusions Low RSA during deep breathing is associated with increased coronary atherosclerosis as assessed by CACS, independently of traditional cardiovascular risk factors. Cardiovagal dysfunction could be a prevalent and modifiable risk factor for coronary atherosclerosis in the general population.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the American Heart Association
volume
11
issue
7
publisher
Wiley-Blackwell
external identifiers
  • scopus:85128245548
  • pmid:35352566
ISSN
2047-9980
DOI
10.1161/JAHA.121.024053
language
English
LU publication?
yes
id
f1d2cd58-a516-42e9-b6e3-46c992c3f5bb
date added to LUP
2022-04-01 19:47:58
date last changed
2024-04-16 13:23:48
@article{f1d2cd58-a516-42e9-b6e3-46c992c3f5bb,
  abstract     = {{<p>Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population-based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration-inspiration differences (E-Is) of heart rates were calculated, and reduced RSA was defined as E-I in the lowest decile of the population. The relationship between reduced RSA and CACS (CACS≥100 or CACS≥300) was calculated using multivariable-adjusted logistic regression. The proportion of CACS≥100 was 24% in the lowest decile of E-I and 12% in individuals with E-I above the lowest decile (P&lt;0.001), and the proportion of CACS≥300 was 12% and 4.8%, respectively (P&lt;0.001). The adjusted odds ratio (OR) for CACS≥100 was 1.42 (95% CI, 1.10-1.84) and the adjusted OR for CACS≥300 was 1.62 (95% CI, 1.15-2.28), when comparing the lowest E-I decile with deciles 2 to 10. Adjusted ORs per 1 SD lower E-I were 1.17 (P=0.001) for CACS≥100 and 1.28 (P=0.001) for CACS≥300. Conclusions Low RSA during deep breathing is associated with increased coronary atherosclerosis as assessed by CACS, independently of traditional cardiovascular risk factors. Cardiovagal dysfunction could be a prevalent and modifiable risk factor for coronary atherosclerosis in the general population.</p>}},
  author       = {{Engström, Gunnar and Hamrefors, Viktor and Fedorowski, Artur and Persson, Anders and Johansson, Maria E and Ostenfeld, Ellen and Goncalves, Isabel and Markstad, Hanna and Johnson, Linda S B and Persson, Margaretha and Carlson, Jonas and Platonov, Pyotr G}},
  issn         = {{2047-9980}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Cardiovagal Function Measured by the Deep Breathing Test : Relationships With Coronary Atherosclerosis}},
  url          = {{http://dx.doi.org/10.1161/JAHA.121.024053}},
  doi          = {{10.1161/JAHA.121.024053}},
  volume       = {{11}},
  year         = {{2022}},
}