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Cardiac response to hemodialysis with different cardiovascular tolerance: Heart rate variability and QT interval analysis
Author(s) -
SEVERI Stefano,
CIANDRINI Andrea,
GRANDI Eleonora,
CAVALCANTI Silvio,
BINI Stefano,
BADIALI Fabio,
GATTIANI Andrea,
CAGNOLI Leonardo
Publication year - 2006
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2006.00110.x
Subject(s) - medicine , hemodialysis , qt interval , cardiology , heart rate variability , dialysis , heart rate , nitric oxide , blood pressure
A therapy‐specific worsening of cardiovascular stability during bicarbonate dialysis (BD) with respect to acetate‐free biofiltration (AFB) have been previously reported. We further investigated the impact of the 2 therapies on electrocardiographic parameters in order to gain novel insight into the cardiac responses. Holter ECG acquired during hypotension‐free sessions (12 BD+12 AFB) were retrospectively analyzed. R–R intervals were extracted from ECG recordings. An autoregressive spectral technique was used to compute low‐ and high‐frequency (LF and HF) components of heart rate variability (HRV). QT interval duration was measured with a computer‐assisted technique and corrected for HR. In BD the LF component of HRV after an initial increase was slowly depressed with respect to AFB (p<0.05). QT duration showed a significant (p<0.01) hemodialysis‐induced reduction. QT shortening was more pronounced (p<0.05) in BD than in AFB (−31 vs. −10 ms), even after correction for HR (p<0.05). Cardiac electrical activity is significantly affected by the hemodialysis technique. The decrease in the LF component of HRV and the QT shortening are coherent with the worse cardiovascular tolerance observed in BD and with the hypothesis of an enhanced production of endogenous nitric oxide.