Link between Peripheral Artery Disease and Heart Rate Variability in Hemodialysis Patients

Chen, Szu-Chia; Chen, Chuan-Mu; Huang, Jiun-Chi; Lee, Mei‐Yueh; Chen, Jui-Hsin; Chang, Jer‐Ming; Hwang, Shiuh-Lin; Chen, Hung‐Chun

doi:10.1371/journal.pone.0120459

Cited by 12 publications

(14 citation statements)

References 46 publications

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“…Since baroreceptors are detected in aortic arch and carotid sinus, the calcification of peripheral artery may reduce these stretch receptors or result in insensitivity to the change of blood pressure. This hypothesis is at least supported by the linkage between HRV and peripheral artery disease [25] . Thus, the clinical implication of cardiac valve or artery calcification may not be the same.…”

Section: Discussionmentioning

confidence: 93%

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Hsueh²,

Lee³

et al. 2017

Nephron

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Background: Both cardiovascular calcification and autonomic dysfunction are frequently encountered in hemodialysis patients. We aimed to investigate the relationship between cardiovascular calcification and heart rate variability (HRV) and their influence on long-term outcome. Methods: Seventy-eight hemodialysis patients underwent echocardiogram and radiography of the pelvis and hands to identify valvular and vascular calcification. HRV was evaluated using a commercial machine. Results: Based on the average, the patients were divided into higher and lower subgroups of high frequency (HF) and low frequency (LF) respectively. Patients with higher LF were younger and were found to have a lower proportion of diabetes. Their hemoglobin, albumin, and bone morphogenic protein (BMP)-7 levels were significantly higher and both high-sensitive C-reactive protein (hs-CRP) and osteoprotegerin levels were lower (all p < 0.05). In patients of the higher HF group, the proportion of diabetes was lower but they were found to have higher levels of BMP-7 and lower levels of hs-CRP, interleukin-6 (all p < 0.05). Significantly higher LF and HF were noted in patients without vascular calcification, but only hand artery (HA) calcification was negatively correlated with both LF and HF in multivariate analysis. Low LF and high hs-CRP were the independent predictors of mortality. Coexistence of low LF band and HA calcification was associated with the worse outcome. Conclusions: Abnormal autonomic nervous function was closely related to inflammation and mortality in hemodialysis patients. Calcification of HA was associated with autonomic dysfunction and patients with lower autonomic tone and HA calcification had the highest mortality rate in this population.

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Section: Discussionmentioning

confidence: 93%

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Hsueh²,

Lee³

et al. 2017

Nephron

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“…The detailed methods of measuring the ABI have been described in previous studies [21,25,26]. ABI was measured once in each patient using an ABI-form device (VP1000; Omron Colin Co. Ltd., Komaki, Japan) and calculated as systolic blood pressure in the ankle/systolic blood pressure in the arm.…”

Section: Assessment Of Ankle-brachial Index (Abi) and Definition Of Paodmentioning

confidence: 99%

Associations between Triglyceride-Glucose Index and Micro- and Macro-Angiopathies in Type 2 Diabetes Mellitus

et al. 2020

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The aim of this study was to investigate the associations between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and microangiopathies and macroangiopathies in patients with type 2 diabetes mellitus (DM). Our study enrolled 1990 type 2 diabetic patients from local hospitals in Taiwan during the period of 2002–2004. Multivariate logistic regression analysis was used to identify the factors related to microangiopathies, macroangiopathiess and TyG index. The patients were stratified by TyG index quartile (Q1–Q4). Adjusted odds ratios (aORs) of albuminuria for Q3 versus Q1 and Q4 versus Q1 were 1.424 (95% confidence interval [CI], 1.062–1.910, p = 0.018) and 1.948 (95% CI, 1.437–2.642, p < 0.001), respectively. The aOR of cerebrovascular disease (CVA) was 2.264 for Q4 versus Q1 (95% CI, 1.243–4.122, p = 0.008), but there were no significant associations with diabetic retinopathy (DR), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). Significant stepwise increases were found in CVA (p = 0.0013) and albuminuria ≥30 mg/g (p < 0.001) corresponding to TyG index quartiles, but not DR (p = 0.573), CAD (p = 0.880) or PAOD (p = 0.223). There was a significant association between a high TyG index and a high risk of microalbuminuria and CVA in the study cohort. Further studies to investigate the use of medications in patients with DM to prevent micro- and macro-angiopathies are thus warranted.

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“…Patients with diabetes presenting with PAD have a higher level of dysfunction of autonomic modulation than patients without PAD . Heart rate variability increased after hemodialysis in patients without PAD, but failed to increase in patients with PAD, showing a link between impaired autonomic dysfunction and PAD . In the present study, we assumed that a low ABI is related to BP fluctuations through autonomic dysfunction.…”

Section: Discussionmentioning

confidence: 74%

Increased blood pressure variability during the subacute phase in patients with ischemic stroke presenting with a low ankle‐brachial index

Naito

Hosomi

Kuzume

et al. 2020

Geriatrics Gerontology Int

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Aim: This study aimed to evaluate the associations of blood pressure (BP) variability in patients with ischemic stroke during the subacute phase using ambulatory blood pressure monitoring and the ankle-brachial index (ABI). Methods:We retrospectively examined 831 consecutive patients (women 44.8%, mean age 76 AE 12 years) with acute ischemic stroke who underwent 24-h ambulatory blood pressure monitoring during the subacute phase of stroke (median 9 days from onset) and an ABI examination. BP variability was evaluated by assessing the standard deviation and coefficient of variation of systolic BP and diastolic BP. A low ABI was defined as an ABI <0.9.Results: Of the 831 patients, 201 (24.2%) had a low ABI. Older age, lower body mass index, diabetes mellitus, chronic kidney disease, atrial fibrillation and a higher National Institutes of Health Stroke Scale score at admission were independently associated with a low ABI. The patients with a low ABI had a higher mean 24-h diastolic BP, higher standard deviation of both BP measurements (systolic BP and diastolic BP) and a higher coefficient of variation in both BP measurements than those with a higher ABI. According to the multivariable linear regression analysis, a low ABI was independently associated with increased BP variability (a high standard deviation or coefficient of variation of both BP measurements) after adjusting for baseline confounders. Conclusions:A low ABI was associated with increased BP variability during the subacute ischemic phase. Geriatr Gerontol Int 2020; 20: 448-454.

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Link between Peripheral Artery Disease and Heart Rate Variability in Hemodialysis Patients

Cited by 12 publications

References 46 publications

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Associations between Triglyceride-Glucose Index and Micro- and Macro-Angiopathies in Type 2 Diabetes Mellitus

Increased blood pressure variability during the subacute phase in patients with ischemic stroke presenting with a low ankle‐brachial index

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