Electrocardiogram abnormalities and heart rate variability in predicting mortality and cardiovascular events among hemodialyzed patients

Badarau, Silvia; Siriopol, Dimitrie; Druguş, Daniela; Dumea, Raluca; Hogaş, Simona; Blaj, Mihaela; Voroneanu, Luminița; Gramaticu, Angelica; Petriş, Antoniu; Burlacu, Alexandru; Covic, Adrian

doi:10.1007/s11255-015-1063-4

Cited by 18 publications

(21 citation statements)

References 28 publications

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“…HRV is a proven tool for monitoring and assessing changes in ANS activity. By analysis of autonomic background of beat-to-beat interval fluctuations in the heart rate record, HRV is also an independent predictor of cardiovascular events mortality and morbidity [ 17 , 18 ]. Clinical and epidemiological studies confirm a high correlation between HRV and cardiovascular disease in human studies [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…By analysis of autonomic background of beat-to-beat interval fluctuations in the heart rate record, HRV is also an independent predictor of cardiovascular events mortality and morbidity [ 17 , 18 ]. Clinical and epidemiological studies confirm a high correlation between HRV and cardiovascular disease in human studies [ 17 , 18 ]. In epidemiological studies, inhalation of particular matter 2.5 μm (PM 2.5) from ambient air can trigger cardiovascular events, which were associated with a reduced HRV [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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The influence of inhaled multi-walled carbon nanotubes on the autonomic nervous system

et al. 2015

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BackgroundHeart rate and cardiovascular function are regulated by the autonomic nervous system. Heart rate variability (HRV) as a marker reflects the activity of autonomic nervous system. The prognostic significance of HRV in cardiovascular disease has been reported in clinical and epidemiological studies. The present study focused on the influence of inhaled multi-walled carbon nanotubes (MWCNTs) on autonomic nervous system by HRV analysis.MethodsMale Sprague–Dawley rats were pre-implanted with a telemetry device and kept in the individual cages for recovery. At week four after device implantation, rats were exposed to MWCNTs for 5 h at a concentration of 5 mg/m3. The real-time EKGs were recorded by a telemetry system at pre-exposure, during exposure, 1 day and 7 days post-exposure. HRV was measured by root mean square of successive differences (RMSSD); the standard deviation of inter-beat (RR) interval (SDNN); the percentage of successive RR interval differences greater than 5 ms (pNN5) and 10 ms (pNN10); low frequency (LF) and high frequency (HF).ResultsExposure to MWCNTs increased the percentage of differences between adjacent R-R intervals over 10 ms (pNN10) (p < 0.01), RMSSD (p < 0.01), LF (p < 0.05) and HF (p < 0.01).ConclusionsInhalation of MWCNTs significantly alters the balance between sympathetic and parasympathetic nervous system. Whether such transient alterations in autonomic nervous performance would alter cardiovascular function and raise the risk of cardiovascular events in people with pre-existing cardiovascular conditions warrants further study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The influence of inhaled multi-walled carbon nanotubes on the autonomic nervous system

et al. 2015

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“…Moreover, we showed the association between the resting heart rate just before starting the first dialysis session and all‐cause mortality among patients without use of BB or heart failure symptom at the first dialysis session. Only a few reports have described an association between resting heart rate and mortality in patients undergoing dialysis . Furthermore, there are no reports that use dialysis initiation as the baseline period.…”

Section: Discussionmentioning

confidence: 99%

“…However, we considered the possibility that patients with higher resting heart rates had increased sympathetic nerve activity. Badarau et al . examined the association between the electrocardiogram findings and mortality in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Association between resting heart rate just before starting the first dialysis session and mortality: A multicentre prospective cohort study

et al. 2018

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“…The two most used approaches for the analysis of HRV are time-domain HRV based on simple statistical and geometrical measures of variability and frequency-domain HRV from power spectral analysis. Autonomic dysfunction characterised by excessive sympathetic activity and/or inadequate parasympathetic tone can be demonstrated by an attenuated HRV (7,8) , which has been shown to be a strong independent predictor of mortality and SCD especially in patients after a myocardial infarction (5,6,8) , but also in other populations including patients on chronic dialysis (7,(9)(10)(11)(12) .…”

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confidence: 99%

Marine n-3 PUFA, heart rate variability and ventricular arrhythmias in patients on chronic dialysis: a cross-sectional study

et al. 2018

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Marine n-3 PUFA may improve autonomic dysfunction by an increase in heart rate variability (HRV) and may reduce the risk of malignant ventricular arrhythmias. Only a few smaller studies have examined such effects in patients on chronic dialysis, who often have autonomic dysfunction and a high risk of sudden cardiac death, which accounts for almost 30 % of all deaths. This cross-sectional study investigated the association between the plasma phospholipid content of n-3 PUFA and 24-h HRV or ventricular arrhythmias in patients on chronic dialysis. A 48-h Holter monitoring was performed on 169 patients on in-centre dialysis (83 %), home haemodialysis (10 %) or peritoneal dialysis (7 %) obtaining data on arrhythmias (n 152) and 24-h HRV (n 135). The mean overall HRV (standard deviation of normal intervals (SDNN)) was low and 71 % had a reduced overall HRV (SDNN<100 ms) indicating autonomic dysfunction. No significant associations between plasma phospholipid content of total marine n-3 PUFA, EPA (22 : 5n-3) or DHA (22 : 6n-3) and time-domain or frequency-domain HRV were detected in crude or adjusted linear regression analysis. However, a higher plasma phospholipid content of DHA was associated with a significantly lower proportion of patients with ventricular tachycardia (higher DHA-tertile: 9 % v. lower DHA-tertile: 28 %, P=0·02). In conclusion, the content of marine n-3 PUFA in plasma phospholipids was not associated with 24-h HRV, but a higher plasma phospholipid content of DHA was associated with a lower occurrence of ventricular tachycardia suggesting an antiarrhythmic effect of marine n-3 PUFA in patients on chronic dialysis.

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Electrocardiogram abnormalities and heart rate variability in predicting mortality and cardiovascular events among hemodialyzed patients

Abstract: Interval changes during hemodialysis are predictive for cardiovascular events and mortality. Autonomic dysfunction and changes in PR should be monitored routinely, particularly in patients with suspected coronary artery disease.

Cited by 18 publications

References 28 publications

The influence of inhaled multi-walled carbon nanotubes on the autonomic nervous system

The influence of inhaled multi-walled carbon nanotubes on the autonomic nervous system

Association between resting heart rate just before starting the first dialysis session and mortality: A multicentre prospective cohort study

Marine n-3 PUFA, heart rate variability and ventricular arrhythmias in patients on chronic dialysis: a cross-sectional study

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