Evaluation of Cardiovascular Risk and Its Correlation with Cardiac Autonomic FunctionTesting in Adults

Abstract

In India, NCDs are responsible for 60% of deaths, with cardiovascular incidents being more
prevalent in rural areas.1 Advances in the understanding of cardiac autonomic functioning have
led to more accessible and effective strategies for preventing and managing major adverse
cardiac events (MACE), even with minimal setup. Hospital based prospective observational
study of 150 sample size was carried out on adult subjects over the age 20 years reported to
Departmentof Cardiology, Gandhi Medical College, Bhopal from August 2022 to December
2023. MACE risk was assessed by Framingham risk score in all subjects and correlated with
Cardiac Autonomic function testing. Among 150 subjects, 40% were diagnosed with Early
CAN, 21.33% with Definite CAN, and 2% with Severe CAN based on Ewing’s criteria.
Regarding MACE risk, 37.33% were at very high risk, 19.33% at high risk, 15.3% at moderate
risk, and 28% at mild risk. Diabetic subjects had early and definite CAN at 40.63% each.
Hypertensives primarily had early CAN (21.33%), while smokers had a high rate of Definite
CAN (43.75%). A significant positive correlation (R=0.2959, p=0.000237) was found between
Mean CAN scores and Mean FRS. Weak positive correlations were observed in some cardiac
autonomic function tests (lying to standing up, Valsalva) with FRS, while others showed weak
negative correlations. Significant correlations (p<0.05) were noted between CAN scores and
FRS parameters like age, diabetes, and smoking. Individual FRS parameters also had a highly
significant correlation with CAFTs (P<0.0001). Hence, we conclude that this prospective study,
established a positive correlation between Cardiac Autonomic Function Testing (CAFT) and
Cardiovascular Risk in adults. Thus, CAFT could be used as a cost-effective and accessible test
for even healthcare centers with limited resources for early identification and screening of
MACE.