Spectral Analysis of Fluctuations in Heart Rate: An Objective Evaluation of Autonomic Nervous Control in Chronic Renal Failure

Abstract

A quantitative, noninvasive method of assessing autonomic control, based on the spectral analysis of beat-to-beat fluctuations in heart rate (HR), was applied to patients with chronic renal failure (RF). Since the power spectrum of HR fluctuations measures the dynamic nervous control of HR, it can be used to quantitate a normal control system as opposed to a disturbed or depressed system. Indeed, in RF patients, a strong reduction in the HR power spectrum was observed in all frequency ranges, both sympathetically and parasympathetically mediated. A similar depression in autonomic control was demonstrated in patients on hemodialysis or peritoneal dialysis. RF patients not yet undergoing dialysis show a lesser degree of depression. Spectral analysis of HR fluctuations in RF patients makes it possible to quantitate autonomic dysfunction and to reliably measure its development as a function of time, and requires only a 10-min standard electrocardiogram recording.

Consciously Controlled Breathing Decreases the High-Frequency Component of Heart Rate Variability by Inhibiting Cardiac Parasympathetic Nerve Activity

“…Pomeranz et al (1985) showed atropine, a parasympathetic muscarinic blocker, practically abolished the HF component. Some studies demonstrated through spectral analysis that the HF component decreased in myocardial infarction (Lombardi et al 1987), congestive heart failure (Axelrod et al 1987), diabe-tes mellitus (Lindmark et al 2003), and aging (Fukusaki et al 2000), and during standing compared with being in the supine position (Siebert et al 2004). A decrease in the HF component indicates the inhibition of parasympathetic nerve activity in the heart.…”

Early Sympathetic Activation in the Initial Clinical Stages of Chronic Renal Failure

“…Key Words: chronic renal failure Ⅲ microneurography Ⅲ sympathetic nervous system A dvanced renal failure is accompanied by a marked activation of sympathetic cardiovascular influences, as documented by the increase in the circulating plasma levels of norepinephrine, the elevated number of sympathetic neural bursts recorded in the peroneal nerve via the microneurographic technique, and the augmented oscillations in the high-frequency band of the heart rate power spectra. [1][2][3][4][5][6][7][8][9][10][11][12][13] Whether the sympathetic activation also characterizes the earlier clinical phases of the renal failure state is not clear, however. This is because in the few studies performed so far in patients with mild renal disease, the population sample was small, and the plasma levels of norepinephrine showed inconsistent changes.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Whether the sympathetic activation also characterizes the earlier clinical phases of the renal failure state is not clear, however. This is because in the few studies performed so far in patients with mild renal disease, the population sample was small, and the plasma levels of norepinephrine showed inconsistent changes.…”

The Study of Spectral Analysis of Heart Rate Variability in Different Blood Pressure Types in Euvolemic Peritoneal Dialysis Patients

“…25,26 However, other groups have reported reduced HF, increased LF, and LF/HF in HD patients. 27 Indeed, Giordano et al 27 have suggested that this increased sympathetic activity may predispose to sudden cardiac death in waiting list renal transplant patients.…”