| Sympathetic overactivity and sudden cardiac death among hemodialysis patients with left ventricular hypertrophy. | |
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MedLine Citation:
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PMID: 19168236 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: We prospectively investigated whether cardiac autonomic imbalance is associated with sudden cardiac death (SCD) among a group of hemodialysis patients with left ventricular hypertrophy (LVH). METHODS: In a prospective cohort study, we enrolled 196 asymptomatic patients on chronic hemodialysis who had LVH as determined by echocardiography and had undergone twenty-four-hour ambulatory Holter electrocardiography between dialysis sessions (males/females, 114/82; mean age, 65+/-12 years) to analyze heart rate variability. We calculated the percentage difference between adjacent NN intervals more than 50 ms (pNN50) and high-frequency component (HF, 0.15-0.40 Hz) as parameters of cardiac parasympathetic activity, and the low-frequency component (LF, 0.04-0.15 Hz)/HF component ratio as a parameter of sympathetic activity. RESULTS: During 4.5+/-1.9-year follow-up, 21 patients who had undergone coronary revascularization within 60 days of enrollment were excluded from the analysis. Among the remaining 175 patients (male/female, 105/70; 66+/-12 years), SCD was recognized in 23 patients. On stepwise Cox hazard analysis, SCD was positively associated with age and LF/HF ratio, and tended to be inversely associated with pNN50. On Kaplan-Meier analysis, SCD-free survival rates at 5 years were 29.4% and 98.1% in patients with LF/HF ratios of 1.9 or more and below 1.9, respectively. CONCLUSIONS: The presence of cardiac sympathetic overactivity may predict the occurrence of SCD in the asymptomatic hemodialysis patients with LVH. |
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Authors:
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Masato Nishimura; Toshiko Tokoro; Masasya Nishida; Tetsuya Hashimoto; Hiroyuki Kobayashi; Satoru Yamazaki; Ryo Imai; Koji Okino; Noriyuki Iwamoto; Hakuo Takahashi; Toshihiko Ono |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-01-24 |
Journal Detail:
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Title: International journal of cardiology Volume: 142 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 80-6 Citation Subset: IM |
Copyright Information:
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Copyright 2008 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan. mnishimura@tea.ocn.ne.jp |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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