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====== Heart rate variability validation and derivatives ======

Researchers from the [[https://www.rug.nl/staff/i.m.nolte/|University Medical Center Groningen]] performed a validation of the [[ECG]] from participants at [[1a_visit_1|1A visit 1]] and [[2a_visit_1|2A visit 1]]. Additionally, derivative variables have been created. ([[sections]]: [[physical state]] ([[ECG]]) and [[secondary & linked variables]]))\\

The heart rate variability (HRV) variables can be requested in the Lifelines catalogue or by email (data@lifelines.nl).\\

===== Validation =====
For participants 13 years or older, 10 second single  12 –lead resting electrocardiogram [[ECG]] was recorded using Cardioperfect software (Welch Allyn DT100 recorder, Welch Allyn, Skaneateles Falls, NY). To calculate heart rate variability (HRV), ECG signals were extracted from the Lifelines ECG database. Lifelines cardiologistst inspected all the ECG signals to determine whether the ECG could be used or not. 
ECG signals were retrieved from the Lifelines ECG database using an in-house software developed by Dr. van Roon from Department of Vascular Medicine (UMCG) in collaboration with [[https://www.rug.nl/staff/h.snieder/|Prof. Snieder]] at Department of Epidemiology (UMCG). This software semi-automatically calculates the HRV indices. All ECG recordings with arrhythmia, pacemaker, and triggering failure were excluded.\\
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===== Derivatives =====
Using the ECG recordings that passed the validation stage, some derivative variables were calculated:
  - new HRV indices corrected for the effect of mean interbeat interval using coefficient of variation
  - ln-transformation of HRV indices (because of skewed distribution)
  - identification of outliers (value above/below 5SDs from the mean)

Additionally, a correction has been performed in case two ECG measurements were available for one participant: the measurement with the lowest mean interbeat interval was excluded.
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===== Variables =====
| **Label English**                                                                                                                 | **Label Dutch**                                                                                                                                         | **Code**                     | **Variable**      | **Assessment**                       | **Age**  |
| status ECG recording                                                                                                              | status ECG opname                                                                                                                                       | ecg_status_adu_c_1           | Status            | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| mean interbeat interval (ms)                                                                                                      | gemiddelde interbeat interval (ms)                                                                                                                      | ibi_mean_adu_c_1             | mIBI              | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| extreme value for mean interbeat interval (>5SD from mean)                                                                        | extreme waarde voor gemiddelde interbeat interval (>5SD van het gemiddelde)                                                                             | ibi_mean_adu_c_1_o           | mIBI_outlier      | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| number of heart beats used to calculate mean and standard deviation of the interbeat interval                                     | aantal gebruikte hartslagen voor berekening van gemiddelde en standaarddeviatie van het interbeat interval                                              | ibi_number_adu_c_1           | nIBI              | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| log-transformed root mean square of successive differences (ms)                                                                   | log-getransformeerde vierkantswortel van opeenvolgende verschillen (ms)                                                                                 | rmssd_ln_adu_c_1             | lnRMSSD           | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| extreme value for log-transformed root mean square of successive differences (>5SD from mean)                                     | extreme waarde voor log-getransformeerde vierkantswortel van opeenvolgende verschillen (>5SD van het gemiddelde)                                        | rmssd_ln_adu_c_1_o           | lnRMSSD_outlier   | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| log-transformed root mean square of successive differences corrected for heart rate (ms)                                          | log-getransformeerde vierkantswortel van opeenvolgende verschillen gecorrigeerd voor hartslag (ms)                                                      | rmssd_lncorrected_adu_c_1    | lnRMSSDc          | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| extreme value for log-transformed root mean square of successive differences corrected for heart rate (>5SD from mean)            | extreme waarde voor log-getransformeerde vierkantswortel van opeenvolgende verschillen gecorrigeerd voor hartslag                                       | rmssd_lncorrected_adu_c_1_o  | lnRMSSDc_outlier  | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| root mean square of successive differences (ms)                                                                                   | vierkantswortel van opeenvolgende verschillen (ms)                                                                                                      | rmssd_ms_adu_c_1             | RMSSD             | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| root mean square of successive differences corrected for heart rate (ms)                                                          | vierkantswortel van opeenvolgende verschillen gecorrigeerd voor hartslag (ms)                                                                           | rmssd_mscorrected_adu_c_1    | RMSSDc            | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| log-transformed standard deviation of interbeat interval (ms)                                                                     | log-getransformeerde standaarddeviatie van het interbeat interval (ms)                                                                                  | sdnn_ln_adu_c_1              | lnSDNN            | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| extreme value for log-transformed standard deviation of interbeat interval (>5SD from mean)                                       | extreme waarde voor log-getransformeerde standaarddeviatie van het interbeat interval (>5SD van het gemiddelde)                                         | sdnn_ln_adu_c_1_o            | lnSDNN_outlier    | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| log-transformed standard deviation of interbeat interval corrected for heart rate (ms)                                            | log-getransformeerde standaarddeviatie van het interbeat interval gecorrigeerd voor hartslag (ms)                                                       | sdnn_lncorrected_adu_c_1     | lnSDNNc           | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| extreme value for log-transformed standard deviation of interbeat interval corrected for heart rate (>5SD from mean)              | extreme waarde voor log-getransformeerde standaarddeviatie van het interbeat interval gecorrigeerd voor hartslag (>5SD van het gemiddelde)              | sdnn_lncorrected_adu_c_1_o   | lnSDNNc_outlier   | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| standard deviation of interbeat interval (ms)                                                                                     | standaarddeviatie van het interbeat interval (ms)                                                                                                       | sdnn_ms_adu_c_1              | SDNN              | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| standard deviation of interbeat interval corrected for heart rate (ms)                                                            | standaarddeviatie van het interbeat interval gecorrigeerd voor hartslag (ms)                                                                            | sdnn_mscorrected_adu_c_1     | SDNNc             | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
| number of values used to calculate mean, standard deviation and root mean square of successive differences of interbeat interval  | aantal gebruikte waarden voor berekening van gemiddelde, standaarddeviatie en vierkantswortel van opeenvolgende verschillen van het interbeat interval  | ssd_number_adu_c_1           | nSSD              | [[1A Visit 1|1A]] [[2A Visit 1|2A]]  | 13+      |
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===== Papers using HRV data =====
  * [[https://doi.org/10.1016/j.hrthm.2018.05.006|Tegegne, B. S., Man, T., van Roon, A. M., Riese, H., & Snieder, H. (2018). Determinants of heart rate variability in the general population: the Lifelines Cohort Study. Heart rhythm, 15(10), 1552-1558.]]
  * [[https://doi.org/10.1177/2047487319872567|Tegegne, B. S., Man, T., van Roon, A. M., Snieder, H., & Riese, H. (2020). Reference values of heart rate variability from 10-second resting electrocardiograms: the Lifelines Cohort Study. European journal of preventive cardiology, 27(19), 2191-2194.]]
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