ArticleBMJ open2019
Longitudinal effect of nocturnal R-R intervals changes on cardiovascular outcome in a community-based cohort.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Propranolol mitigates sleep apnea-related cardiac responses during CPAP withdrawal: a randomized placebo-controlled cross-over clinical study.Sleep & breathing = Schlaf & Atmung · 2026Trial
- Beyond coexistence: attempting to unlock the diabetes-COMISA Link.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Electrocardiographic assessment in obstructive sleep apnea: bridging pathophysiology and clinical practice.Frontiers in physiology · 2026Article
- Role of automated detection of respiratory related heart rate changes in the diagnosis of sleep disordered breathing.Frontiers in sleep · 2023Article
- Cardiovascular Complications of Obstructive Sleep Apnea in the Intensive Care Unit and Beyond.Medicina (Kaunas, Lithuania) · 2022Review
- Cardiovascular Outcomes in Sleep-Disordered Breathing: Are We Under-estimating?Frontiers in neurology · 2022Review
- The Nadir Oxygen-Specific Heart Rate Response in Sleep Apnea Links With the Occurrence of Acute Myocardial Infarction.Frontiers in cardiovascular medicine · 2022Article
- ECG and Heart Rate Variability in Sleep-Related Breathing Disorders.Advances in experimental medicine and biology · 2022Article
- Article
- Can Pulse Rate Responses Be a Metric of Cardiovascular Outcome in Patients with Obstructive Sleep Apnea?American journal of respiratory and critical care medicine · 2021Article
- The Sleep Apnea-Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality.American journal of respiratory and critical care medicine · 2021Article
- Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity.Sleep · 2021Observational
- Does Heart Rate Play a Role in Cardiovascular Outcome in Patients with Obstructive Sleep Apnea?American journal of respiratory and critical care medicine · 2021Article
- The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea.Frontiers in psychiatry · 2021Review
- Characteristics of the Dynamic Electrocardiogram in the Elderly with Nonvalvular Atrial Fibrillation Combined with Long R-R Intervals.Evidence-based complementary and alternative medicine : eCAM · 2021Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
rationaleSleep-disordered breathing (SDB) is strongly linked to adverse cardiovascular outcomes (cardiovascular diseases (CVD)). Whether heart rate changes measured by nocturnal R-R interval (RRI) dips (RRI dip index (RRDI)) adversely affect the CVD outcomes is unknown.
objectivesTo test whether nocturnal RRDI predicts CVD incidence and mortality in the Wisconsin Sleep Cohort study (WSCS), independent of the known effects of SDB on beat-to-beat variability.
methodsThe study analysed electrocardiograph obtained from polysomnography study to assess the nocturnal total RRDI (the number of RRI dips divided by the total recording time) and sleep RRDI (the number of RRI dips divided by total sleep time). A composite CVD risk as a function of total and sleep RRDI was estimated by Cox proportional hazards in the WSCS.
resultsThe study sample consisted of 569 participants from the WSCS with no prior CVD at baseline were followed up for up to 15 years. Nocturnal total RRDI (10-unit change) was associated with composite CVD event(s) (HR, 1.24 per 10-unit increment in RRDI (95% CI 1.10 to 1.39), p<0.001). After adjusting for demographic factors (age 58±8 years old; 53% male; and body mass index 31±7 kg/m
conclusionIncreased nocturnal RRDI predicts cardiovascular mortality and morbidity, independent of the known effects of SDB on beat-to-beat variability. The frequency of RRDI is higher in men than in women, and is significantly associated with new-onset CVD event(s) in men but not in women.
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