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      Reproducibility of Heart Rate Variability Revealed by Repeated Measurements during and after Hemodialysis

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          Abstract

          Background/Aims: Trajectory of heart rate variability (HRV) represents a noninvasive real-time measure of autonomous nervous system (ANS) and carries the capability of providing new insights into the hemodynamic compensation reserve during hemodialysis (HD). However, studies on HRV reproducibility during HD are scarce and did not refer to different reading periods. In this observational study, we aimed to establish the best suited and most reliable and reproducible HRV index in routine HD treatments including different reading rates. Methods: HRV was characterized by standardized mathematical variation expressions of R/R’ intervals: SD of all R/R’ intervals (ms), square root of the root mean square of the sum of all differences between adjacent R/R’ intervals (ms), percentage of consecutive R/R’ intervals that differ by >50 ms (%), low-frequency spectral analysis HRV (LF, expressing sympathetic activity), and high-frequency HRV (HF, expressing parasympathetic activity). To compare robustness of these HRV indices during HD procedures, we compared HRV indices means between different HD sessions and controlled for association with clinical parameters. Results: In 72 HD treatments of 34 patients, we detected the highest reproducibility (89%) of HRV measures when analyzing the low-frequency to high-frequency (LF/HF) ratio in long-term (3 h) readings. Long-term LF/HF was able to discriminate ­between patients with and without heart failure NYHA classes ≥3 ( p = 0.009) and type 2 diabetes ( p = 0.023). We were unable to study relationships between ANS and intradialytic complications because they did not appear in our cohort. Short-term readings of HRV indices did not show any significance of pattern change during HD. Conclusion: In summary, our data provide evidence for high robustness of long-term LF/HF in analyzing HRV in HD patients using future automated monitoring systems. For short-term analysis, mathematical real-time analysis must evolve.

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          Author and article information

          Journal
          BPU
          Blood Purif
          10.1159/issn.0253-5068
          Blood Purification
          S. Karger AG
          0253-5068
          1421-9735
          2020
          May 2020
          06 December 2019
          : 49
          : 3
          : 356-363
          Affiliations
          aDepartment of Nephrology and Kuratorium for Dialysis and Transplantation (KfH) Renal Unit, Hospital St. Georg, Leipzig, Germany
          bUniversity of Applied Science, Bonn-Rhein-Sieg, Rheinbach, Germany
          cDepartment of Nephrology and Intensive Care, Charité Universitätsmedizin, Berlin, Germany
          dExperimental and Clinical Research Center (ECRC), Charité, Universitätsmedizin Berlin, Max-Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
          eMartin-Luther-University Halle, Wittenberg, Germany
          Author notes
          *Joachim Beige, Deptartment of Nephrology, Kuratorium for Dialysis and Transplantation, Hospital St. Georg, Delitzscher Street 141 (Haus 54), DE–04129 Leipzig (Germany), E-Mail Joachim.Beige@sanktgeorg.de
          Article
          504525 Blood Purif 2020;49:356–363
          10.1159/000504525
          31812967
          © 2019 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 6, Tables: 1, Pages: 8
          Categories
          Research Article

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