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Multicenter Study
. 2015;40(1):99-108.
doi: 10.1159/000381665. Epub 2015 Jul 4.

Non-Linear Heart Rate Variability Indices in the Frequent Hemodialysis Network Trials of Chronic Hemodialysis Patients

Manuela Ferrario  1 , Jochen G Raimann, Brett Larive, Andreas Pierratos, Stephan Thijssen, Sanjay Rajagopalan, Tom Greene, Sergio Cerutti, Gerald Beck, Christopher Chan, Peter Kotanko; Frequent Hemodialysis Network (FHN) Trial Group
Collaborators, Affiliations
Multicenter Study

Non-Linear Heart Rate Variability Indices in the Frequent Hemodialysis Network Trials of Chronic Hemodialysis Patients

Manuela Ferrario et al. Blood Purif. 2015.

Abstract

Background: Non-linear heart rate variability (HRV) indices were hypothesized to correlate with cardiac function, fluid overload and physical performance in hemodialysis patients.

Methods: Twenty-four-hour Holter electrocardiograms were recorded in patients enrolled in the Frequent Hemodialysis Network (FHN) Daily Dialysis Trial. Correlations between non-linear HRV indices and left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), extracellular volume (ECV)/total body water (TBW) ratio, the SF-36 Physical Health Composite (PHC) and Physical Functioning (PF) scores were tested.

Results: We studied 210 subjects (average age 49.8 ± 13.5 years, 62% men, 42% diabetics). In non-diabetic patients, multiscale entropy (MSE) slope sample entropy (SampEn) and approximate entropy (ApEn) correlated positively with LVEF, PF and PHC and inversely with LVEDV and ECV/TBW. Spectral power slope correlated positively with ECV/TBW (r = 0.27). Irregularity measures (MSE ApEn and MSE SampEn) correlated positively with LVEDV (r = 0.19 and 0.20).

Conclusion: Non-linear HRV indices indicated an association between a deteriorated heart rate regulatory system and impaired cardiac function, fluid accumulation and poor physical condition.

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Figures

Figure 1
Figure 1
Scatter plot relating Multiscale Entropy Slope (MSE ApEn) and left ventricular ejection fraction (LVEF) in diabetic (r=0.19; n.s.) and non-diabetic (r=0.26; P<0.01) subjects is shown. Local regression curve are displayed.
Figure 2
Figure 2
Scatter plot relating Spectral Power Slope (SPS) and Extracellular Volume/Total Body Water (ECV/TBW) in diabetic (r=0.12; n.s.) and non-diabetic (r=0.25; P<0.05) subjects is shown. Local regression curve are displayed.
Figure 3
Figure 3
Scatter plot relating Multiscale Entropy Slope (MSE ApEn) and Extracellular Volume/Total Body Water (ECV/TBW) in diabetic (r=−0.18 n.s.) and non-diabetic (r=−0.33; P<0.01) subjects is shown. Local regression curve are displayed.
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