Detrended Fluctuation Analysis of Heart Rate Dynamics Is an Important Prognostic Factor in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis

Jiun Yang Chiang, Jenq Wen Huang, Lian Yu Lin, Chin Hao Chang, Fang Ying Chu, Yen Hung Lin, Cho Kai Wu, Jen Kuang Lee, Juei Jen Hwang, Jiunn Lee Lin, Fu Tien Chiang

研究成果: 雜誌貢獻文章

17 引文 斯高帕斯(Scopus)

摘要

Background and Objectives Patients with severe kidney function impairment often have autonomic dysfunction, which could be evaluated noninvasively by heart rate variability (HRV) analysis. Nonlinear HRV parameters such as detrended fluctuation analysis (DFA) has been demonstrated to be an important outcome predictor in patients with cardiovascular diseases. Whether cardiac autonomic dysfunction measured by DFA is also a useful prognostic factor in patients with end-stage renal disease (ESRD) receiving peritoneal dialysis (PD) remains unclear. The purpose of the present study was designed to test the hypothesis. Materials and Methods Patients with ESRD receiving PD were included for the study. Twenty-four hour Holter monitor was obtained from each patient together with other important traditional prognostic makers such as underlying diseases, left ventricular ejection fraction (LVEF) and serum biochemistry profiles. Short-term (DFAá1) and long-term (DFAá2) DFA as well as other linear HRV parameters were calculated. Results A total of 132 patients (62 men, 72 women) with a mean age of 53.7±12.5 years were recruited from July 2007 to March 2009. During a median follow-up period of around 34 months, eight cardiac and six non-cardiac deaths were observed. Competing risk analysis demonstrated that decreased DFA¿1 was a strong prognostic predictor for increased cardiac and total mortality. ROC analysis showed that the AUC of DFA¿1 (<0.95) to predict mortality was 0.761 (95% confidence interval (CI). = 0.617.0.905). DFA¿1† 0.95 was associated with lower cardiac mortality (Hazard ratio (HR) 0.062, 95% CI = 0.007.0.571, P = 0.014) and total mortality (HR = 0.109, 95% CI = 0.033.0.362, P = 0.0003). Conclusion Cardiac autonomic dysfunction evaluated by DFA¿1 is an independent predictor for cardiac and total mortality in patients with ESRD receiving PD.
原文英語
文章編號e0147282
期刊PLoS One
11
發行號2
DOIs
出版狀態已發佈 - 二月 1 2016
對外發佈Yes

    指紋

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

引用此

Chiang, J. Y., Huang, J. W., Lin, L. Y., Chang, C. H., Chu, F. Y., Lin, Y. H., Wu, C. K., Lee, J. K., Hwang, J. J., Lin, J. L., & Chiang, F. T. (2016). Detrended Fluctuation Analysis of Heart Rate Dynamics Is an Important Prognostic Factor in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis. PLoS One, 11(2), [e0147282]. https://doi.org/10.1371/journal.pone.0147282