Reliability analysis of the heart autonomic control parameters during hemodialysis sessions

Abstract

The study of heart autonomic control (HAC) in patients with chronic kidney disease (CKD) undergoing dialysis treatment has been carried out, however, there are no studies reporting the reliability of measurements of HAC parameters involving the mentioned samples and conditions. The reliability of many HAC parameters was evaluated from patients with CKD during two sessions of hemodialysis. The successive R-R intervals were recorded during two sessions of hemodialysis from 14 CKD patients that were undergoing dialysis for at least 6 months and with no history of recurrent hypotensive events. HAC parameters were obtained with time and frequency domain analysis, as well as with nonlinear methods. The reliability was measured with the intraclass correlation coefficient (ICC). The results showed excellent reliability (ICC=0.90-0.98) for most heart rate variability (HRV) parameters, especially the parameters obtained in the time domain [square root of the mean squared differences between successive R-R intervals (RMSSD), percentage of adjacent R-R intervals that differ by more than 50 ms (pNN50), mean of the 5-min standard deviations of R-R intervals (SDNNi), and triangular index] and with non-linear methods [standard deviation of the instantaneous variability beat-to-beat (SD1), standard deviation in long-term continuous R-R intervals (SD2), detrended fluctuation analysis (DFA) α1 and α2, approximate and sample entropies, and correlation dimension (D2): ICC=0.86-0.96]. Among the parameters obtained in the frequency domain (normalized magnitude from the spectrum of low-frequency components (LFnu), normalized magnitude from the spectrum of high-frequency components (HFnu), and LF/HF ratio), the LF/HF ratio showed better reliability (ICC=0.96 vs. ICC=0.70). Measurements of HAC parameters have excellent test-retest reliability for the studied samples and conditions.

Physical Exercise Affects Quality of Life and Cardiac Autonomic Modulation in Patients With Chronic Kidney Failure Submitted to Hemodialysis: A Randomized Clinical Trial

“…There was also an increase in SD1 and SD2 values in the experimental group, due to the aerobic exercise performed in this group. The values of SD1 and SD2, are non-linear variables of heart rate variability and the higher values indicated greater autonomic modulation of heart rate as can occur in hemodialysis ((Da Silva et al, 2016); in both groups, there was an improvement in these values due to the practice of physical exercise (Del Angel et al, 2019).…”

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

“…Moreover, we did not observe any difference of overall HRV (SDNN and triangular index) between day 1 (the dialysis day for in-centre patients) and day 2 (without dialysis), but we did see a significantly higher LF, normalised LF and LF:HF ratio and a lower normalised HF on day 1 compared with day 2. This may be interpreted as a change in the sympatho-vagal balance toward a decrease in vagal modulation and/or an increase in sympathetic modulation on the dialysis day compared with the non-dialysis day, which may be explained by the cardiovascular stress caused by ultrafiltration-induced intravascular hypovolemia on the dialysis day ( 25 ) .…”

Comparison of Heart Autonomic Control between Hemodynamically Stable and Unstable Patients during Hemodialysis Sessions: A Bayesian Approach

“…All patients who met the sample selection criteria and agreed to participate were subjected to the recording of RR intervals through a heart-rate monitor (Polar ® RS800CX, Kempele, Finland). Heart-rate monitors were previously validated for analysis of heart autonomic control [ 24 ] and exhibited good reliability in recording RR intervals during hemodialysis sessions [ 20 , 25 ]. The RR interval data were analyzed in the time and frequency domain and with MSE analysis, aiming to quantify the entropy from the successive RR interval dataset.…”

“…The recorded data were pre-processed using a smoothing procedure with a cutoff frequency of 0.035 Hz to remove disturbing low-frequency baseline trend components, as used and suggested by Luque-Casado et al [ 26 ] and used by Silva et al [ 25 ]. The procedures followed the recommendations of the Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology [ 27 ], and all analyses were performed with the Kubios HRV analysis software 2.2 (Department of Applied Physics, University of Eastern Finland, Kuopio, Finland) [ 28 ].…”