Comparison of heart rate variability between end stage renal disease patients on hemodialysis and hypertensive patients

Oh, Joon Seok; Bae, Woo Hyung; Lee, Hwa Mock; Kim, Hyun Ju; Kim, Nam Sik; Yun, Sung Han; Lee, Seung Eun; Park, Yong Ki; Shin, Yong Hoon; Kim, Joong Kyung

Abstract

BACKGROUND/AIMS: Heart rate variability (HRV) can be used to assess the effects of drugs and other interventions, including exercise, respiration, metabolic changes, and psychological or physical stressors, on cardiac autonomic tone. HRV is regulated by the balance of sympathetic and parasympathetic tone. Few studies pertaining to HRV in end stage renal disease (ESRD) patients have been performed in Korea. Thus, autonomic nervous system activity as indicated by HRV was investigated in patients on hemodialysis due to ESRD.
METHODS
We compared the pattern of cardiac sympathetic and parasympathetic activity through time- and frequency- domain analyses of HRV with 24-hour Holter monitoring in 30 ESRD patients and 64 hypertensive control subjects. The ESRD patients had undergone hemodialysis therapy at the Bongseng Hospital between January 2006 and June 2007.
RESULTS
The mean age of ESRD patients and hypertensive controls was 51.17+/-11.91 and 55.02+/-13.72 years, respectively. In the ESRD group, all time- and frequency-domain HRV measures, including the standard deviation of all normal sinus R-R intervals over 24 hours (SDNN), the HRV index, the very low-frequency (VLF) normalized unit of low-frequency (LFnorm), and the ratio of low-frequency power to high-frequency power (LF/HF), were reduced; the normalized unit of high frequency (HFnorm) was increased in the ESRD patients compared with the control group.
CONCLUSION
The autonomic tone in ESRD patients on hemodiaysis was decreased compared with hypertensive patients. The parasympathetic tone in ESRD patients on hemodyalysis was dominant over the sympathetic tone.