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Effects of physical training on heart rate variability in patients on hemodialysis.
Am J Cardiol 1999; 84(2):197-202AJ

Abstract

Dysfunction of the cardiac autonomic nervous system is a known complication of end-stage renal disease. The objective of the study was to mainly investigate the effects of physical training on 24-hour vagal cardiac activity in dialysis patients. Sixty chronic uremic patients (mean age 48 +/- 12 years) on maintenance hemodialysis were studied. After initial evaluation, 30 patients (group A) were randomly assigned to a 6-month exercise training program (3/week). The other 30 patients (group B) and 30 nonuremic sedentary persons (group C) remained untrained and were used as controls. Parasympathetic activity was assessed at the beginning and the end of the study noninvasively from 24-hour electrocardiographic ambulatory monitoring by calculating heart rate variability (HRV). HRV index, mean NN interval, and standard deviation NN (SDNN) were measured according to the "triangular method." At baseline HRV index, mean RR, SDNN, and aerobic capacity were significantly reduced in both hemodialysis groups compared with values in group C. Also, 40% of all patients on hemodialysis and 16% of group C had arrhythmias (Lown class >II). Moreover, hemodialysis patients with a more depressed HRV index (<25, n = 37) had a higher incidence of arrhythmias (60%) compared to those with HRV index >25 (p <0.05). Exercise training in group A significantly increased HRV index from 22 +/- 7 to 28 +/- 9 (p <0.05) and SDNN from 0.11 +/- 0.03 to 0.13 +/- 0.04 (p <0.05). Furthermore, fewer patients continued to have an HRV index <25 (by 40%) and arrhythmias (by 33%) compared with baseline data. Training was also associated with a significant improvement in fitness level, as assessed by maximal oxygen consumption (by 41%; p <0.05) and exercise testing duration (by 33%; p <0.05). There was a significant correlation in HRV index and maximal oxygen consumption. No changes were observed in the control groups between baseline and follow-up data. Results demonstrate that physical training in hemodialysis patients augments cardiac vagal activity and decreases vulnerability to arrhythmias.

Authors+Show Affiliations

Sports Medicine Laboratory, TEFAA, Department of Medicine, Aristotle University of Thessaloniki, Greece.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10426340

Citation

Deligiannis, A, et al. "Effects of Physical Training On Heart Rate Variability in Patients On Hemodialysis." The American Journal of Cardiology, vol. 84, no. 2, 1999, pp. 197-202.
Deligiannis A, Kouidi E, Tourkantonis A. Effects of physical training on heart rate variability in patients on hemodialysis. Am J Cardiol. 1999;84(2):197-202.
Deligiannis, A., Kouidi, E., & Tourkantonis, A. (1999). Effects of physical training on heart rate variability in patients on hemodialysis. The American Journal of Cardiology, 84(2), pp. 197-202.
Deligiannis A, Kouidi E, Tourkantonis A. Effects of Physical Training On Heart Rate Variability in Patients On Hemodialysis. Am J Cardiol. 1999 Jul 15;84(2):197-202. PubMed PMID: 10426340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of physical training on heart rate variability in patients on hemodialysis. AU - Deligiannis,A, AU - Kouidi,E, AU - Tourkantonis,A, PY - 1999/7/30/pubmed PY - 1999/7/30/medline PY - 1999/7/30/entrez SP - 197 EP - 202 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 84 IS - 2 N2 - Dysfunction of the cardiac autonomic nervous system is a known complication of end-stage renal disease. The objective of the study was to mainly investigate the effects of physical training on 24-hour vagal cardiac activity in dialysis patients. Sixty chronic uremic patients (mean age 48 +/- 12 years) on maintenance hemodialysis were studied. After initial evaluation, 30 patients (group A) were randomly assigned to a 6-month exercise training program (3/week). The other 30 patients (group B) and 30 nonuremic sedentary persons (group C) remained untrained and were used as controls. Parasympathetic activity was assessed at the beginning and the end of the study noninvasively from 24-hour electrocardiographic ambulatory monitoring by calculating heart rate variability (HRV). HRV index, mean NN interval, and standard deviation NN (SDNN) were measured according to the "triangular method." At baseline HRV index, mean RR, SDNN, and aerobic capacity were significantly reduced in both hemodialysis groups compared with values in group C. Also, 40% of all patients on hemodialysis and 16% of group C had arrhythmias (Lown class >II). Moreover, hemodialysis patients with a more depressed HRV index (<25, n = 37) had a higher incidence of arrhythmias (60%) compared to those with HRV index >25 (p <0.05). Exercise training in group A significantly increased HRV index from 22 +/- 7 to 28 +/- 9 (p <0.05) and SDNN from 0.11 +/- 0.03 to 0.13 +/- 0.04 (p <0.05). Furthermore, fewer patients continued to have an HRV index <25 (by 40%) and arrhythmias (by 33%) compared with baseline data. Training was also associated with a significant improvement in fitness level, as assessed by maximal oxygen consumption (by 41%; p <0.05) and exercise testing duration (by 33%; p <0.05). There was a significant correlation in HRV index and maximal oxygen consumption. No changes were observed in the control groups between baseline and follow-up data. Results demonstrate that physical training in hemodialysis patients augments cardiac vagal activity and decreases vulnerability to arrhythmias. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/10426340/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(99)00234-9 DB - PRIME DP - Unbound Medicine ER -