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Sympathetic overactivity and sudden cardiac death among hemodialysis patients with left ventricular hypertrophy
- Source :
- International Journal of Cardiology. 142:80-86
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- 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.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Left ventricular hypertrophy
Asymptomatic
Sudden cardiac death
Cohort Studies
Renal Dialysis
Internal medicine
medicine
Humans
Heart rate variability
Prospective Studies
Prospective cohort study
Dialysis
Aged
Aged, 80 and over
business.industry
Middle Aged
medicine.disease
Surgery
Death, Sudden, Cardiac
Autonomic Nervous System Diseases
Ambulatory
Cardiology
Female
Hypertrophy, Left Ventricular
Hemodialysis
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 142
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....49a9818325034f2ed1f42f2465b578d8