Shannon B Fadaee1, Kassia S Beetham1, Erin J Howden2, Tony Stanton3,4, Nicole M Isbel3,5, Jeff S Coombes1. 1. a School of Human Movement and Nutrition Sciences, The University of Queensland , Brisbane , Australia. 2. b Institute for Exercise and Environmental Medicine, University of Texas Southwestern Medical Centre , Dallas , USA. 3. c School of Medicine, The University of Queensland , Brisbane , Australia. 4. d Cardiovascular Imaging Research Group, The University of Queensland , Brisbane , Australia. 5. e Department of Nephrology , Princess Alexandra Hospital , Brisbane , Australia.
Abstract
OBJECTIVES:Elevated oxidative stress and reduced heart rate variability (HRV) is prevalent in patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. Previous studies have identified a positive association between elevated oxidative stress and autonomic dysfunction, however this relationship has not yet been investigated in the CKD population. METHODS: Plasma was collected from 78 patients with stage 3-4 CKD (estimated glomerular filtration rate 25-60 ml/min/1.73 m2) for the assessment of oxidative stress, including plasma total F2-isoprostanes, glutathione peroxidase activity and total antioxidant capacity. Time and frequency HRV parameters were measured from a three lead electrocardiogram. RESULTS: Participants with elevated F2-isoprostanes had reduced HRV compared to patients with normal levels of F2-isoprostanes. A number of HRV parameters were found to be inversely correlated with F2-isoprostanes in all CKD patients, including SDNN (r = -0.337; P < 0.01), VLF (r = -0.281, P = 0.01), LF (r = -0.315, P < 0.01) and total power (r = -0.288, P = 0.01). Multiple linear regression found F2-isoprostanes to be an independent predictor of SDNN (r2 = 0.287, β = -0.272, P = 0.01). DISCUSSION: Oxidative stress is significantly and independently associated with HRV in patients with CKD. Identifying oxidative stress in the pathogenesis of autonomic dysfunction may help target therapeutic strategies.
RCT Entities:
OBJECTIVES: Elevated oxidative stress and reduced heart rate variability (HRV) is prevalent in patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. Previous studies have identified a positive association between elevated oxidative stress and autonomic dysfunction, however this relationship has not yet been investigated in the CKD population. METHODS: Plasma was collected from 78 patients with stage 3-4 CKD (estimated glomerular filtration rate 25-60 ml/min/1.73 m2) for the assessment of oxidative stress, including plasma total F2-isoprostanes, glutathione peroxidase activity and total antioxidant capacity. Time and frequency HRV parameters were measured from a three lead electrocardiogram. RESULTS:Participants with elevated F2-isoprostanes had reduced HRV compared to patients with normal levels of F2-isoprostanes. A number of HRV parameters were found to be inversely correlated with F2-isoprostanes in all CKD patients, including SDNN (r = -0.337; P < 0.01), VLF (r = -0.281, P = 0.01), LF (r = -0.315, P < 0.01) and total power (r = -0.288, P = 0.01). Multiple linear regression found F2-isoprostanes to be an independent predictor of SDNN (r2 = 0.287, β = -0.272, P = 0.01). DISCUSSION: Oxidative stress is significantly and independently associated with HRV in patients with CKD. Identifying oxidative stress in the pathogenesis of autonomic dysfunction may help target therapeutic strategies.
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