Depressed cardiac autonomic modulation in patients with chronic kidney disease

Oliveira, Carlos Alberto de; Brito, Hélio Lima de; Bastos, Marcus Gomes; Oliveira, Felipe Gomes de; Casali, Thaís Gomes; Bignoto, Tiago Costa; Fernandes, Natália; Beraldo, Antonio Fernando de Castro Alves; Paula, Rogério Baumgratz de

doi:10.5935/0101-2800.20140025

Cited by 15 publications

(11 citation statements)

References 35 publications

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“…Studies on arterial stiffness indices are in concordance to our results that PWV[ 18 19 20 21 22 23 ] in CKD Stage 4 and 5 predialytic patients is higher than controls while AI[ 23 ] is similar in predialytic patients and controls. On similar grounds, studies on predialytic CKD patients have found a reduction in HRV parameters[ 24 25 26 27 ] while there is paucity of studies in short-term (5 min) BPV. Recent literature has tried to decipher the mechanism responsible for reduced BRS in CKD patients by exploring the relationship between vascular (arterial stiffness) and neural (HRV) components[ 7 8 28 ] in renal transplant recipients and peritoneal dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Reduced baroreflex sensitivity, decreased heart rate variability with increased arterial stiffness in predialysis

et al. 2017

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High cardiovascular morbidity and mortality is observed in predialytic chronic kidney disease (CKD) patients. The underlying mechanism of cardiovascular dysfunction often remains unclear. The present study was designed to perform multiparametric assessment of baroreflex sensitivity (BRS), arterial stiffness indices, and cardiovascular variabilities (heart rate variability [HRV] and blood pressure variability [BPV]) together in predialytic CKD patients; compare it with normal healthy controls; and determine their relationships in predialytic nondiabetic CKD patients. Thirty CKD Stage 4 and 5 predialytic non-diabetic patients and 30 healthy controls were enrolled in the study. BRS was determined by spontaneous sequence method. Short-term HRV and BPV were assessed using 5 min beat-to-beat data of RR intervals and blood pressure by time domain and frequency domain analysis. Arterial stiffness indices - carotid-femoral pulse wave velocity (PWV) and augmentation index - were measured using SphygmoCor Vx device (AtCor Medical, Australia). Predialytic CKD patients had significantly low BRS, high PWV, and low HRV as compared to healthy controls. Independent predictors of reduced systolic BRS in predialytic CKD patient group on multiple regression analysis emerged to be increase in calcium-phosphate product, increase in BPV, and decrease in HRV. Predialytic nondiabetic CKD Stage 4 and 5 patients have poor hemodynamic profile (higher PWV, lower HRV, and reduced BRS) than healthy controls. Reduced HRV and altered calcium-phosphate homeostasis emerged to be significant independent predictors of reduced BRS.

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Section: Discussionmentioning

confidence: 99%

Reduced baroreflex sensitivity, decreased heart rate variability with increased arterial stiffness in predialysis

et al. 2017

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“…Moreover, it has been supported that daily hemodialysis induced structural effects on the heart of uremic patients which was associated with alterations in HRV [97]. In particular, ANS dysfunction worsens as the disease progresses [98,99] and the duration of hemodialysis session increases [100] while age is an important player which contributes in the parasympathetic dysfunction often seen in CKD patients [101].…”

Section: Discussion-conclusionmentioning

confidence: 99%

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

Καλτσάτου¹,

Karatzaferi²,

Mitrou³

et al. 2016

CPD

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“…Imbalances in autonomic control are increasingly being linked to chronic ECG abnormality in the literature ( Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996 ; Sareban et al, 2020 ), especially in clinical populations (e.g., Smith, 1982 ; Binkley et al, 1991 ; Bigger et al, 1992 ; Algra et al, 1993 ; Kocovic et al, 1993 ; Hartikainen et al, 1996 ; de Oliveira et al, 2014 ). A relatively simple and non-invasive method that has shown promise for monitoring autonomic control is through heart rate variability (HRV) assessment, which is used to measure changes in intervals between successive heartbeats and is a non-invasive reflection of the health of the cardiac automatic nervous system (ANS) ( Rajendra Acharya et al, 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Sympathovagal Balance Is a Strong Predictor of Post High-Volume Endurance Exercise Cardiac Arrhythmia

et al. 2022

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Regular physical activity is important for cardiovascular health. However, high-volume endurance exercise has been associated with increased number of electrocardiogram (ECG) abnormalities, including disturbances in cardiac rhythm (arrhythmias) and abnormalities in ECG pattern. The aim of this study was to assess if heart rate variability (HRV) is associated with ECG abnormalities. Fifteen participants with previous cycling experience completed a 21-day high-volume endurance exercise cycle over 3,515 km. Participants wore a 5-lead Holter monitor for 24 h pre- and post-exercise, which was used to quantify ECG abnormalities and export sinus R-to-R intervals (NN) used to calculate HRV characteristics. As noise is prevalent in 24-h HRV recordings, both 24-h and heart rate collected during stable periods of time (i.e., deep sleep) were examined. Participants experienced significantly more arrhythmias post high-volume endurance exercise (median = 35) compared to pre (median = 12; p = 0.041). All 24-h and deep sleep HRV outcomes were not different pre-to-post high-volume endurance exercise (p > 0.05). Strong and significant associations with arrhythmia number post-exercise were found for total arrhythmia (total arrhythmia number pre-exercise, ρ = 0.79; age, ρ = 0.73), supraventricular arrhythmia (supraventricular arrhythmia number pre-exercise: ρ = 0.74; age: ρ = 0.66), and ventricular arrhythmia (age: ρ = 0.54). As a result, age and arrhythmia number pre-exercise were controlled for in hierarchical regression, which revealed that only deep sleep derived low frequency to high frequency (LF/HF) ratio post high-volume endurance exercise predicted post total arrhythmia number (B = 0.63, R2Δ = 34%, p = 0.013) and supraventricular arrhythmia number (B = 0.77, R2Δ = 69%, p < 0.001). In this study of recreationally active people, only deep sleep derived LF/HF ratio was associated with more total and supraventricular arrhythmias after high-volume endurance exercise. This finding suggests that measurement of sympathovagal balance during deep sleep might be useful to monitor arrhythmia risk after prolonged high-volume endurance exercise performance.

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Depressed cardiac autonomic modulation in patients with chronic kidney disease

Abstract: CKD patients not yet on dialysis have reduced HRV, indicating cardiac autonomic dysfunction early in the course of CKD.

Cited by 15 publications

References 35 publications

Reduced baroreflex sensitivity, decreased heart rate variability with increased arterial stiffness in predialysis

Reduced baroreflex sensitivity, decreased heart rate variability with increased arterial stiffness in predialysis

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

Sympathovagal Balance Is a Strong Predictor of Post High-Volume Endurance Exercise Cardiac Arrhythmia

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