The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

ludc webb

Isabel Goncalves


ludc webb

Cardiovagal Function Measured by the Deep Breathing Test : Relationships With Coronary Atherosclerosis


  • Gunnar Engström
  • Viktor Hamrefors
  • Artur Fedorowski
  • Anders Persson
  • Maria E Johansson
  • Ellen Ostenfeld
  • Isabel Goncalves
  • Hanna Markstad
  • Linda S B Johnson
  • Margaretha Persson
  • Jonas Carlson
  • Pyotr G Platonov

Summary, in English

Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population-based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration-inspiration differences (E-Is) of heart rates were calculated, and reduced RSA was defined as E-I in the lowest decile of the population. The relationship between reduced RSA and CACS (CACS≥100 or CACS≥300) was calculated using multivariable-adjusted logistic regression. The proportion of CACS≥100 was 24% in the lowest decile of E-I and 12% in individuals with E-I above the lowest decile (P<0.001), and the proportion of CACS≥300 was 12% and 4.8%, respectively (P<0.001). The adjusted odds ratio (OR) for CACS≥100 was 1.42 (95% CI, 1.10-1.84) and the adjusted OR for CACS≥300 was 1.62 (95% CI, 1.15-2.28), when comparing the lowest E-I decile with deciles 2 to 10. Adjusted ORs per 1 SD lower E-I were 1.17 (P=0.001) for CACS≥100 and 1.28 (P=0.001) for CACS≥300. Conclusions Low RSA during deep breathing is associated with increased coronary atherosclerosis as assessed by CACS, independently of traditional cardiovascular risk factors. Cardiovagal dysfunction could be a prevalent and modifiable risk factor for coronary atherosclerosis in the general population.


  • Cardiovascular Research - Epidemiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Cardiovascular Research - Hypertension
  • Lund Cardiac MR Group
  • Clinical Physiology (Lund)
  • Cardiovascular Research - Translational Studies
  • Internal Medicine - Epidemiology
  • Electrocardiology Research Group - CIEL

Publishing year





Journal of the American Heart Association





Document type

Journal article




  • Cardiac and Cardiovascular Systems



Research group

  • Cardiovascular Research - Epidemiology
  • Cardiovascular Research - Hypertension
  • Lund Cardiac MR Group
  • Cardiovascular Research - Translational Studies
  • Internal Medicine - Epidemiology
  • Electrocardiology Research Group - CIEL


  • ISSN: 2047-9980