Document Detail


Sympathetic overactivity and sudden cardiac death among hemodialysis patients with left ventricular hypertrophy.
MedLine Citation:
PMID:  19168236     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Masato Nishimura; Toshiko Tokoro; Masasya Nishida; Tetsuya Hashimoto; Hiroyuki Kobayashi; Satoru Yamazaki; Ryo Imai; Koji Okino; Noriyuki Iwamoto; Hakuo Takahashi; Toshihiko Ono
Related Documents :
9202356 - Depressed heart rate variability as an independent predictor of death in chronic conges...
10973766 - Comparison between invasive and non-invasive measurements of baroreflex sensitivity; im...
8898816 - Abnormal heart rate variability as a manifestation of autonomic dysfunction in hemisphe...
20817016 - Differential heart rate dynamics in transient left ventricular apical and midventricula...
20676796 - Secondary prevention for coronary artery disease: are we following the guidelines?
15989696 - Postresuscitation encephalopathy. current views, management, and prognostication.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-24
Journal Detail:
Title:  International journal of cardiology     Volume:  142     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  80-6     Citation Subset:  IM    
Copyright Information:
Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan. mnishimura@tea.ocn.ne.jp
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization...
Next Document:  Endothelial dysfunction, ADMA and insulin resistance in essential hypertension.