scholarly journals Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

2017 ◽  
Vol 42 (1) ◽  
pp. 76-88 ◽  
Author(s):  
Jiun-Chi Huang ◽  
I-Ching Kuo ◽  
Yi-Chun Tsai ◽  
Jia-Jung Lee ◽  
Lee-Moay Lim ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients

scholarly journals P0948ASSOCIATION OF PHASE ANGLE WITH NUTRITION, MORTALITY, MAJOR ADVERSE CARDIOVASCULAR EVENTS AND SARCOPENIA IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Lower Phase ◽  
All Cause Mortality ◽  
History Of ◽  
Maintenance Hemodialysis Patients

Abstract Background and Aims Nutrition has been consistently important in end stage renal disease patients. However, it is difficult to obtain adequate nutritional status while avoiding fluid overload, hyperphosphatemia and hyperkalemia in hemodialysis patients. In addition, there is no golden standard for diagnosing protein energy wasting (PEW) in maintenance hemodialysis patients. We studied the clinical significance of phase angle using bioelectrical impedance analysis (BIA), one of the PEW diagnostic tools, to predict various clinical outcomes in maintenance hemodialysis patients. Method We retrospectively enrolled patients who received hemodialysis for more than 3 months from 2016 to March 2019, excluding patients had active cancer, or died within 30 days, had no BIA data. We evaluated the factors related phase angle and the role of phase angle as predictors of all-cause mortality and major adverse cardiovascular events (MACE), sarcopenia. Results Of 191 patients, 63.4% were men, mean age was 64.2 ± 12.4 years, mean body mass index (BMI) was 23.8 ± 6.9 kg/m2, and the most common underlying disease were hypertension and diabetes mellitus. Lower phase angle group (phase angle ≤4°) patients had older age, higher portion of women, malnourished, and history of coronary artery disease (CAD) than higher phase angle group (phase angle >4°) patients. Phase was significantly related with nutritional parameters. During a median follow up of 16.7 months, 14.1% (n=27) patients experienced a MACE, 11.0% (n=21) patients died. In multivariate Cox analyses, lower phase angle, higher CRP level and history of CAD were significantly related with all-cause mortality even after adjustment for covariates. However, phase angle was not significantly associated with MACE and sarcopenia. Conclusion In maintenance hemodialysis patients, phase angle was significantly related to mortality as well as nutritional status, but MACE and sarcopenia were not. Clinicians should be careful to find and treat correctable factors with low phase angle and high CRP level in maintenance hemodialysis patients.

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

2020 ◽  
pp. 1-11
Author(s):  
Letian Yang ◽  
Yuliang Zhao ◽  
Baiyu Qiao ◽  
Yating Wang ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Mortality ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cochrane Central Register ◽  
Number Of Patients

<b><i>Background:</i></b> Heart rate variability (HRV) means the variation in time of beat-to-beat interval. Lower HRV has been shown to be related with death and cardiovascular events in previous studies. In the last few years, the number of patients with ESRD has increased steadily. Maintenance hemodialysis is the most prevalent renal replacement therapy in patients with ESRD. This study aims to investigate if decreased HRV is an independent predictor of mortality in maintenance hemodialysis patients. <b><i>Methods:</i></b> Pubmed/Medline, EMBASE, Ovid, the Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched up to October 1, 2019, for full-text articles in English. Cohort studies reporting the association between HRV and prognosis in hemodialysis patients were selected. Data extraction was performed by 2 reviewers independently, with adjudication by a third reviewer. Extracted data included the study characteristics, HRV measurement and research outcomes. Hazard ratios (HRs) and 95% confidence interval (CI) were pooled in a random-effects model for outcomes of all-cause and cardiovascular mortality. Heterogeneity assessment, subgroup analyses, and sensitivity analysis were conducted. <b><i>Results:</i></b> A total of 7 studies were eligible. HRV metrics consist of SDNN, SDANN, RMSSD, pNN50, HRVTI, ULF, VLF, LF, HF, LF/HF ratio, HRT, DC, and scaling exponents α1 and α2. Decreased HRV was associated with higher all-cause mortality (HR: 1.63, 95% CI: 1.11–2.39, <i>p</i> = 0.014) and cardiovascular mortality (HR: 1.07, 95% CI: 1.00–1.15, <i>p</i> = 0.045). Among the different HRV metrics, decreased SDANN (<i>p</i> &#x3c; 0.001) and decreased LF/HF ratio (<i>p</i> = 0.001) were identified as predictors of all-cause death. Decreased SDNN, SDANN, and LF/HF ratio were identified as predictors of cardiovascular death (<i>p</i> = 0.004, <i>p</i> = 0.001, and <i>p</i> = 0.002). <b><i>Conclusions:</i></b> Decreased HRV is associated with higher risk of all-cause and cardiovascular death in the hemodialysis population. Decreased SDANN and LF/HF were identified as predictors of both all-cause and cardiovascular mortality, while the utility of other HRV metrics requires further investigation. The protocol for this study was registered with PROSPERO (CRD42019141886).

scholarly journals SP555STUDY OF CATALYTIC IRON AND OTHER INFLAMMATORY MARKERS AND THEIR CORRELATION WITH CARDIOVASCULAR EVENTS IN MAINTENANCE HEMODIALYSIS PATIENTS

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii320-iii321
Author(s):  
Umapati Hegde ◽  
Vipul Chakurkar ◽  
Mohan Rajapurkar ◽  
Banibrata Mukhopadhyay ◽  
Sishir Gang ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients

scholarly journals Outcome of patients with normal and decreased heart rate variability coronary artery bypass grafting surgey

2021 ◽  
Vol 35 ◽  
pp. 115-123
Author(s):  
Ngo Van Thanh ◽  
Pham Truong Son ◽  
Nguyen Quang Tuan
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Cardiovascular Events ◽  
Artery Bypass ◽  
Major Adverse Cardiovascular Events ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction and objectives: Previous studies have shown that after coronary artery bypass grafting (CABG), heart rate variability (HRV) becomes decreased. The aim of this study was to evaluate the role of decreased heart rate variability in coronary artery bypass grafting patients. Methods: The study involved 119 consecutive patients who underwent the first CABG operation with sinus rhythm. All subjects underwent assessed with 24-hour Holter recordings 2 days preoperative and 7 days postoperative at Hanoi Heart Hospital from 6/2016 to 8/2018. Major adverse cardiovascular events was defined as cardiac death, recurrent myocardial infarction, stroke, decompensated heart failure and re-hospitalization. The patients were followed up for 6 months. Main results: The incidence of major adverse cardiovascular events was 10.8% followed to 6 months. The incidence of pre and postoperative low HRV varies from 28.6% (preop) to 51.8% (postop 7 days). In which, decreased HRV preoperative predictors of major adverse cardiac events in patients undergoing coronary artery bypass graft surgery: followed up for 3 months: (OR:3,40; 95%CI: 0,97 – 12,11; p>0,05), followed up for 6 months (OR:3,41; 95%CI: 1,05 – 11,05; p<0,05). Conclusions: Preoperative with low HRV was pedict a risk factor for major adverse cardiovascular events.

scholarly journals Measuring Heart Rate Variability in Patients Admitted with ST-Elevation Myocardial Infarction for the Prediction of Subsequent Cardiovascular Events: A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1021
Author(s):  
Crischentian Brinza ◽  
Mariana Floria ◽  
Adrian Covic ◽  
Alexandru Burlacu
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
St Elevation Myocardial Infarction ◽  
Major Adverse Cardiovascular Events ◽  
Prognostic Information ◽  
Increased Risk ◽  
All Cause Mortality ◽  
St Elevation

Ischemic heart disease represents the leading cause of death, emphasizing risk stratification and early therapeutic intervention. Heart rate variability (HRV), an indirect marker of autonomic nervous system activity, was investigated extensively as a risk factor for adverse cardiovascular events following acute myocardial infarction. Thus, we systematically reviewed the literature to investigate the association of HRV parameters with mortality and adverse cardiovascular events in patients presenting with ST-elevation myocardial infarction (STEMI). Following the search process in the MEDLINE (PubMed), Embase, and Cochrane databases, nine studies were included in the final analysis. Lower time-domain HRV parameters and a higher ratio between power in the low-frequency (LF) band and power in the high-frequency (HF) band (LF/HF) were associated with higher all-cause mortality during follow-up, even in patients treated mainly with percutaneous coronary interventions (PCI). Although most studies measured HRV on 24 h ECG recordings, short- and ultra-short-term measures (1 min and 10 s, respectively) were also associated with an increased risk of all-cause mortality. Although data were discrepant, some studies found an association between HRV and cardiac mortality, reinfarction, and other major adverse cardiovascular events. In conclusion, HRV measurement in patients with STEMI could bring crucial prognostic information, as it was associated with an increased risk of all-cause mortality documented in clinical studies. More and larger clinical trials are required to validate these findings in contemporary patients with STEMI in the context of the new generation of drug-eluting stents and current antithrombotic and risk-modifying therapies.

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