{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:21Z","timestamp":1786977501855,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014688","name":"Region Uppsala","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014688","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification of individuals at risk of developing heart failure (HF) may improve poor prognosis. A dominant sympathetic activity is common in HF and associated with worse outcomes; however, less is known about the autonomic balance before HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis<\/jats:title>\n                    <jats:p>A low frequency\/high frequency (L\u2010F\/H\u2010F) ratio, index of heart rate variability, and marker of the autonomic balance predict the development of HF and may improve the performance of the HF prediction model when added to traditional cardiovascular (CV) risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Individuals in the PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091016, all aged 70 years) were included. Exclusion criteria were prevalent HF, electrocardiographic QRS duration \u2265130\u2009millisecond, major arrhythmias, or conduction blocks at baseline. The association between the L\u2010F\/H\u2010F ratio and incident HF was assessed using Cox proportional hazard analysis. The C\u2010statistic evaluated whether adding the L\u2010F\/H\u2010F\u2010ratio to traditional CV risk factors improved the discrimination of incident HF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HF developed in 107\/836 study participants during 15 years of follow\u2010up. A nonlinear, inverse association between the L\u2010F\/H\u2010F ratio and incident HF was mainly driven by an L\u2010F\/H\u2010F ratio of &lt;30. The association curve was flat for higher values (hazard ratio, HR for the total curve\u2009=\u20090.78 [95% confidence interval, CI: 0.69\u22120.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001]; HR\u2009=\u20092 for L\u2010F\/H\u2010F ratio\u2009=\u200910). The traditional prediction model improved by 3.3% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.03) when the L\u2010F\/H\u2010F ratio was added.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An L\u2010F\/H\u2010F ratio of &lt;30 was related to incident HF and improved HF prediction when added to traditional CV risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.24241","type":"journal-article","created":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T09:44:05Z","timestamp":1708854245000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An association between heart rate variability and incident heart failure in an elderly 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