The thalamus is a central hub of the autonomic network and thalamic volume has been associated with high‐risk phenotypes for sudden cardiac death. Heart rate response to physiological stressors (e.g., standing) and the associated recovery patterns provide reliable indicators of both autonomic function and cardiovascular risk. Here we examine if thalamic volume may be a risk marker for impaired heart rate recovery in response to orthostatic challenge. The Irish Longitudinal Study on Aging involves a nationally representative sample of older individuals aged ≥50 years. Multimodal brain magnetic resonance imaging and orthostatic heart rate recovery were available for a cross‐sectional sample of 430 participants. Multivariable regression and linear mixed‐effects models were adjusted for head size, age, sex, education, body mass index, blood pressure, history of cardiovascular diseases and events, cardiovascular medication, diabetes mellitus, smoking, alcohol intake, timed up‐and‐go (a measure of physical frailty), physical exercise and depression. Smaller thalamic volume was associated with slower heart rate recovery (−1.4 bpm per 1 cm³ thalamic volume, 95% CI −2.01 to −0.82; p  < .001). In multivariable analysis, participants with smaller thalamic volumes had a mean heart rate recovery −2.7 bpm slower than participants with larger thalamic volumes (95% CI −3.89 to −1.61; p  < .001). Covariates associated with smaller thalamic volume included age, history of diabetes, and heavy alcohol consumption. Thalamic volume may be an indicator of the structural integrity of the central autonomic network. It may be a clinical biomarker for stratification of individuals at risk of autonomic dysfunction, cardiovascular events, and sudden cardiac death.

中文翻译：

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受损的直立性心率恢复与较小的丘脑体积有关：爱尔兰纵向衰老研究 (TILDA) 的结果。

丘脑是自主神经网络的中枢，丘脑容积与心源性猝死的高危表型有关。对生理应激源（例如站立）的心率反应和相关的恢复模式提供了自主神经功能和心血管风险的可靠指标。在这里，我们检查丘脑体积是否可能是响应直立性挑战时心率恢复受损的风险标志物。爱尔兰老龄化纵向研究涉及 50 岁以上老年人的全国代表性样本。多模式脑磁共振成像和直立心率恢复可用于 430 名参与者的横截面样本。多变量回归和线性混合效应模型根据头部大小、年龄、性别、教育、体重指数、血压、心血管疾病和事件的病史、心血管药物、糖尿病、吸烟、饮酒、定时起床（衡量身体虚弱）、体育锻炼和抑郁。较小的丘脑体积与较慢的心率恢复有关（-1.4 bpm/1 cm³丘脑容积，95% CI -2.01 至 -0.82；p  < .001）。在多变量分析中，丘脑容量较小的参与者的平均心率恢复比丘脑容量较大的参与者慢 -2.7 bpm（95% CI -3.89 至 -1.61；p  < .001）。与较小丘脑体积相关的协变量包括年龄、糖尿病史和大量饮酒。丘脑体积可能是中枢自主神经网络结构完整性的指标。它可能是对有自主神经功能障碍、心血管事件和心源性猝死风险的个体进行分层的临床生物标志物。