Normal Values of Corrected Heart-Rate Variability in 10-Second Electrocardiograms for All Ages
Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into acco...
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| Published in: | Frontiers in physiology Vol. 9; p. 424 |
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| Abstract | Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes.
Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc).
There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women.
We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research. |
|---|---|
| AbstractList | Purpose: Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes. Methods: Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc). Results: There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women. Conclusion: We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research.Purpose: Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes. Methods: Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc). Results: There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women. Conclusion: We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research. Purpose: Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes.Methods: Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc).Results: There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women.Conclusion: We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research. Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes. Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc). There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women. We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research. |
| Author | Hillege, Hans Hofman, Albert Rijnbeek, Peter R. Bots, Michiel L. Stricker, Bruno H. Niemeijer, Maartje N. Eijgelsheim, Mark van den Berg, Marten E. Swenne, Cees A. Kors, Jan A. van Herpen, Gerard |
| AuthorAffiliation | 2 Department of Epidemiology, Erasmus University Medical Center , Rotterdam , Netherlands 3 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Utrecht , Netherlands 6 Department of Internal Medicine, University Medical Center Groningen , Groningen , Netherlands 8 Health and Youth Care Inspectorate , Utrecht , Netherlands 4 Department of Cardiology, University Medical Center Groningen , Groningen , Netherlands 1 Department of Medical Informatics, Erasmus University Medical Center , Rotterdam , Netherlands 5 Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands 7 Department of Internal Medicine, Erasmus University Medical Center , Rotterdam , Netherlands |
| AuthorAffiliation_xml | – name: 7 Department of Internal Medicine, Erasmus University Medical Center , Rotterdam , Netherlands – name: 6 Department of Internal Medicine, University Medical Center Groningen , Groningen , Netherlands – name: 1 Department of Medical Informatics, Erasmus University Medical Center , Rotterdam , Netherlands – name: 3 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Utrecht , Netherlands – name: 8 Health and Youth Care Inspectorate , Utrecht , Netherlands – name: 2 Department of Epidemiology, Erasmus University Medical Center , Rotterdam , Netherlands – name: 4 Department of Cardiology, University Medical Center Groningen , Groningen , Netherlands – name: 5 Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands |
| Author_xml | – sequence: 1 givenname: Marten E. surname: van den Berg fullname: van den Berg, Marten E. – sequence: 2 givenname: Peter R. surname: Rijnbeek fullname: Rijnbeek, Peter R. – sequence: 3 givenname: Maartje N. surname: Niemeijer fullname: Niemeijer, Maartje N. – sequence: 4 givenname: Albert surname: Hofman fullname: Hofman, Albert – sequence: 5 givenname: Gerard surname: van Herpen fullname: van Herpen, Gerard – sequence: 6 givenname: Michiel L. surname: Bots fullname: Bots, Michiel L. – sequence: 7 givenname: Hans surname: Hillege fullname: Hillege, Hans – sequence: 8 givenname: Cees A. surname: Swenne fullname: Swenne, Cees A. – sequence: 9 givenname: Mark surname: Eijgelsheim fullname: Eijgelsheim, Mark – sequence: 10 givenname: Bruno H. surname: Stricker fullname: Stricker, Bruno H. – sequence: 11 givenname: Jan A. surname: Kors fullname: Kors, Jan A. |
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| ContentType | Journal Article |
| Copyright | Copyright © 2018 van den Berg, Rijnbeek, Niemeijer, Hofman, van Herpen, Bots, Hillege, Swenne, Eijgelsheim, Stricker and Kors. 2018 van den Berg, Rijnbeek, Niemeijer, Hofman, van Herpen, Bots, Hillege, Swenne, Eijgelsheim, Stricker and Kors |
| Copyright_xml | – notice: Copyright © 2018 van den Berg, Rijnbeek, Niemeijer, Hofman, van Herpen, Bots, Hillege, Swenne, Eijgelsheim, Stricker and Kors. 2018 van den Berg, Rijnbeek, Niemeijer, Hofman, van Herpen, Bots, Hillege, Swenne, Eijgelsheim, Stricker and Kors |
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| Keywords | normal values children elderly adults heart-rate variability heart-rate correction electrocardiography |
| Language | English |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Mark Potse, Inria Bordeaux - Sud-Ouest Research Centre, France This article was submitted to Cardiac Electrophysiology, a section of the journal Frontiers in Physiology Reviewed by: Bas J. Boukens, University of Amsterdam, Netherlands; Julia Ramirez Garcia, Queen Mary University of London, United Kingdom; Ana Minchole, University of Oxford, United Kingdom |
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| Title | Normal Values of Corrected Heart-Rate Variability in 10-Second Electrocardiograms for All Ages |
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