BACKGROUND AND OBJECTIVES: Cardiovascular events are common in patients with ESRD. Whether sympathetic overactivity or vagal withdrawal contribute to cardiovascular events is unclear. We determined the general prevalence and clinical correlates of heart rate variability in patients on hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We collected baseline information on demographics, clinical conditions, laboratory values, medications, physical performance, left ventricular mass (LVM), and 24-hour Holter monitoring on 239 subjects enrolled in the Frequent Hemodialysis Network Daily Trial. RESULTS: The mean R-R interval was 812 ± 217 ms. The SD of R-R intervals was 79.1 ± 40.3 ms. Spectral power analyses showed low-frequency (sympathetic modulation of heart rate) and high-frequency power (HF; vagal modulation of heart rate) to be 106.0 (interquartile range, 48.0 to 204 ms(2)) and 42.4 ms(2) (interquartile range, 29.4 to 56.3 ms(2)), respectively. LVM was inversely correlated with log HF (-0.02 [-0.0035; -0.0043]) and the R-R interval (-1.00 [-1.96; -0.032]). Physical performance was associated with mean R-R intervals (1.98 [0.09; 3.87]) and SD of R-R intervals (0.58 [0.049; 1.10]). After adjustment for age, race, ESRD vintage, diabetes, and physical performance, the relationship between log HF and LVM (per 10 g) remained significant (-0.025 [-0.042; -0.0085]). CONCLUSIONS: Holter findings in patients on hemodialysis are characterized by sympathetic overactivity and vagal withdrawal and are associated with higher LVM and impaired physical performance. Understanding the spectrum of autonomic heart rate modulation and its determinants could help to guide preventive and therapeutic strategies.
BACKGROUND AND OBJECTIVES: Cardiovascular events are common in patients with ESRD. Whether sympathetic overactivity or vagal withdrawal contribute to cardiovascular events is unclear. We determined the general prevalence and clinical correlates of heart rate variability in patients on hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We collected baseline information on demographics, clinical conditions, laboratory values, medications, physical performance, left ventricular mass (LVM), and 24-hour Holter monitoring on 239 subjects enrolled in the Frequent Hemodialysis Network Daily Trial. RESULTS: The mean R-R interval was 812 ± 217 ms. The SD of R-R intervals was 79.1 ± 40.3 ms. Spectral power analyses showed low-frequency (sympathetic modulation of heart rate) and high-frequency power (HF; vagal modulation of heart rate) to be 106.0 (interquartile range, 48.0 to 204 ms(2)) and 42.4 ms(2) (interquartile range, 29.4 to 56.3 ms(2)), respectively. LVM was inversely correlated with log HF (-0.02 [-0.0035; -0.0043]) and the R-R interval (-1.00 [-1.96; -0.032]). Physical performance was associated with mean R-R intervals (1.98 [0.09; 3.87]) and SD of R-R intervals (0.58 [0.049; 1.10]). After adjustment for age, race, ESRD vintage, diabetes, and physical performance, the relationship between log HF and LVM (per 10 g) remained significant (-0.025 [-0.042; -0.0085]). CONCLUSIONS: Holter findings in patients on hemodialysis are characterized by sympathetic overactivity and vagal withdrawal and are associated with higher LVM and impaired physical performance. Understanding the spectrum of autonomic heart rate modulation and its determinants could help to guide preventive and therapeutic strategies.
Authors: J M Guralnik; L Ferrucci; C F Pieper; S G Leveille; K S Markides; G V Ostir; S Studenski; L F Berkman; R B Wallace Journal: J Gerontol A Biol Sci Med Sci Date: 2000-04 Impact factor: 6.053
Authors: Markus P Schlaich; Flora Socratous; Sarah Hennebry; Nina Eikelis; Elisabeth A Lambert; Nora Straznicky; Murray D Esler; Gavin W Lambert Journal: J Am Soc Nephrol Date: 2008-09-17 Impact factor: 10.121
Authors: K L Johansen; G M Chertow; A V Ng; K Mulligan; S Carey; P Y Schoenfeld; J A Kent-Braun Journal: Kidney Int Date: 2000-06 Impact factor: 10.612
Authors: R S Suri; A X Garg; G M Chertow; N W Levin; M V Rocco; T Greene; G J Beck; J J Gassman; P W Eggers; R A Star; D B Ornt; A S Kliger Journal: Kidney Int Date: 2006-12-13 Impact factor: 10.612
Authors: Christopher T Chan; Glenn M Chertow; John T Daugirdas; Tom H Greene; Peter Kotanko; Brett Larive; Andreas Pierratos; John B Stokes Journal: Nephrol Dial Transplant Date: 2013-09-26 Impact factor: 5.992
Authors: Kathrin Weidner; Michael Behnes; Christel Weiß; Christoph Nienaber; Linda Reiser; Armin Bollow; Gabriel Taton; Thomas Reichelt; Dominik Ellguth; Niko Engelke; Jonas Rusnak; Tobias Schupp; Seung-Hyun Kim; Christian Barth; Jorge Hoppner; Muharrem Akin; Kambis Mashayekhi; Martin Borggrefe; Ibrahim Akin Journal: Heart Vessels Date: 2019-05-10 Impact factor: 2.037
Authors: Ashok Krishnaswami; Mary-Lou Kiley; Faith F Anthony; Yuexin Chen; Jason Chen; Sumanth Rajagopal; Taylor I Liu; Charlie Young; Elizabeth W Paxton Journal: Perm J Date: 2015-11-02
Authors: Maria Angela M Q Carreira; André B Nogueira; Felipe M Pena; Marcio G Kiuchi; Ronaldo C Rodrigues; Rodrigo R Rodrigues; Jorge P S Matos; Jocemir R Lugon Journal: PLoS One Date: 2015-06-04 Impact factor: 3.240