Heart Rate Variability, Left Ventricular Functions, and Cardiac Autonomic Neuropathy in Patients Undergoing Chronic Hemodialysis

Karayaylalı, İbrahim; Şan, Mustafa; Kudaiberdieva, Gulmira; Niyazova-Karben, Zarema A.; Seyrek, Neslihan; Balal, Mustafa; Paydaş, Saime; Sağlıker, Yahya

doi:10.1081/jdi-120024299

Cited by 16 publications

(10 citation statements)

References 18 publications

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“…This suggested that slight increases in the WHR in obese individuals could increase their risk of cardiovascular morbidity and mortality through CAN [18]. Obesity causes a reduction HRV indices consistent with a reduction in PNS activity that disrupts the normal maturation of cardiac autonomic control in healthy obese children [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review

et al. 2019

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Cardiac autonomic neuropathy (CAN) is a major complication of type 1 and type 2 diabetes mellitus (T1DM and T2DM). The increased morbidity, cardiovascular and allcause mortality associated with CAN is established from numerous epidemiological studies. However, CAN is increasingly recognised in people with prediabetes (pre-DM) and the metabolic syndrome (MetS) with a reported prevalence up to 11% and 24% respectively. CAN is associated with components of MetS including hypertension and obesity, predating hyperglycaemia. The aetiology of CAN is multifactorial and there is a reciprocal relationship with insulin resistance and MetS. Obstructive sleep apnoea (OSA) is also associated with CAN possibly through MetS and an independent mechanism. An estimated global prevalence of the impaired glucose tolerance (IGT) form of pre-DM of 587 million people by 2045 means CAN will become a major clinical problem. CAN is independently associated with silent myocardial ischaemia, major cardiovascular events, myocardial dysfunction and cardiovascular mortality. Screening for CAN in pre-DM using risk scores with analysis of heart rate variability (HRV) or Sudoscan is important to allow earlier treatment at a reversible stage. The link between obesity and CAN highlights the therapeutic potential of lifestyle interventions including diet and physical activity to reverse MetS and prevent CAN. Weight loss achieved using these dietary and exercise lifestyle interventions improves the sympathetic and Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9824660.

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Section: Introductionmentioning

confidence: 99%

Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review

et al. 2019

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“…Besides left ventricular hypertrophy, systolic and diastolic dysfunction, interstitial fibrosis, and autonomic neuropathy were found among patients with end stage renal disease [36, 37]. …”

Section: Renal Diseasementioning

confidence: 99%

Laboratory Markers of Ventricular Arrhythmia Risk in Renal Failure

Mozoş

2014

BioMed Research International

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Sudden cardiac death continues to be a major public health problem. Ventricular arrhythmia is a main cause of sudden cardiac death. The present review addresses the links between renal function tests, several laboratory markers, and ventricular arrhythmia risk in patients with renal disease, undergoing or not hemodialysis or renal transplant, focusing on recent clinical studies. Therapy of hypokalemia, hypocalcemia, and hypomagnesemia should be an emergency and performed simultaneously under electrocardiographic monitoring in patients with renal failure. Serum phosphates and iron, PTH level, renal function, hemoglobin and hematocrit, pH, inflammatory markers, proteinuria and microalbuminuria, and osmolarity should be monitored, besides standard 12-lead ECG, in order to prevent ventricular arrhythmia and sudden cardiac death.

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“…Patients with ESRD undergoing chronic hemodialysis is usually present a dysfunction of the ANS, exhibited as low parasympathetic/vagal modulation associated with high sympathetic modulation of the heart rate assessed by heart rate variability (HRV) analysis [6][7][8] . Several previous studies have used HRV parameters based on traditional linear HRV analysis to predict patient outcomes and found that lower HRV is related to an increased risk of cardiovascular and all-cause mortality in patients with ESRD receiving chronic hemodialysis [9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Heart Rhythm Complexity as Predictors for the Prognosis of End-Stage Renal Disease Patients Undergoing Hemodialysis

Liu

Zhan

Shi

et al. 2020

Preprint

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Objective Heart rhythm complexity, a measure of heart rate dynamics and a risk predictor in various clinical diseases, has not been systematically studied in patients with end-stage renal disease. The aim of this study is to investigate the heart rhythm complexity and its prognostic value for mortality in end-stage renal disease patients undergoing hemodialysis.Methods To assess heart rhythm complexity and conventional heart rate variability measures, 4-hour continuous electrocardiography for a retrospective cohort of 202 ostensibly healthy control subjects and 51 hemodialysis patients with end-stage renal disease were analyzed. Heart rhythm complexity was quantified by the complexity index from the measurement of the multiscale entropy profile.Results During a median follow-up of 13 months, 8 people died in the patient group. Values of either traditional heart rate variability measurements or complexity indices were found significantly lower in patients than those in healthy controls. In addition, the complexity indices (Area 1-5, Area 6-15 and Area 6-20) in the mortality group were significantly lower than those in the survival group, while there were no significant differences in traditional heart rate variability parameters between the two groups. In receiver operating characteristic curve analysis, Area 6-20 (AUC = 0.895, p<0.001) showed the strongest predictive power between mortality and survival groups.Conclusion The results suggest that heart rhythm complexity is impaired for patients with end-stage renal disease. Furthermore, the complexity index of heart rate variability quantified by multiscale entropy may be a powerful independent predictor of mortality in end-stage renal disease patients undergoing hemodialysis.

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Heart Rate Variability, Left Ventricular Functions, and Cardiac Autonomic Neuropathy in Patients Undergoing Chronic Hemodialysis

Abstract: As a result, the dependence of cardiac autonomic neuropathy on the disease duration and degree of left ventricular function impairment was shown in the patients undergoing chronic hemodialysis.

Cited by 16 publications

References 18 publications

Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review

Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review

Laboratory Markers of Ventricular Arrhythmia Risk in Renal Failure

Heart Rhythm Complexity as Predictors for the Prognosis of End-Stage Renal Disease Patients Undergoing Hemodialysis

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