Abstract：
Measures of heart rate variability (HRV) as a predictor of risk of disease and mortality have been investigated from various perspectives for more than six decades. The aim of the present comprehensive meta-analysis is to examine eight different HRV parameters to determine their association with all-cause and cardiac mortality. A total of 32 studies and two individual participant datasets (IPD) with 37 samples and 38,008 participants were included. Lower HRV parameter values were significant predictors of higher mortality across different ages, sex, continents, populations and recording lengths. Most of the examined parameters showed comparable hazard ratios (HR). IPD sub-analysis for heart rate corrected HRV parameters confirmed the strong association between HRV and all-cause mortality. Meta-regressions revealed no effect modifier for HRs extracted from covariate-adjusted studies. Sub-analyses of studies comparing the lowest quartile of 5-min root mean square of successive differences (RMSSD) vs. the other quartiles yielded a combined HR of 1.56 (95% CI: 1.32-1.85). The applicability of HRV measurement in preventive settings is discussed.
摘要：
六十多年来，人们从各种角度研究了心率变异性（HRV）作为疾病和死亡率风险预测指标的指标。本综合荟萃分析的目的是检查八种不同的HRV参数，以确定它们与全因死亡率和心脏死亡率的关系。总共包括32项研究和两个单独的参与者数据集（IPD），包括37个样本和38,008个参与者。较低的HRV参数值是不同年龄段死亡率较高的重要预测因素，性别,大陆,人口和记录长度。大多数检查的参数显示出可比的风险比（HR）。对心率校正的HRV参数的IPD亚分析证实了HRV与全因死亡率之间的强关联。Meta回归显示，从协变量调整研究中提取的HR没有效应修饰。比较5分钟连续差异均方根的最低四分位数（RMSSD）与其他四分位数的综合HR为1.56(95%CI:1.32-1.85)。讨论了HRV测量在预防性设置中的适用性。
