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Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in diabetic haemodialysis patients.
Nephrol Dial Transplant. 2004 Oct; 19(10):2532-8.ND

Abstract

BACKGROUND

Patients with diabetic nephropathy are likely to have neurological complications including cardiovascular autonomic dysfunction, which is related to increased risk of mortality. We investigated whether cardiovascular autonomic neuropathy is associated with left ventricular hypertrophy (LVH) in diabetic haemodialysis patients.

METHODS

Holter electrocardiography was carried out for 24 h with time and frequency domain analyses of heart rate variability in 154 diabetic (age 62+/-11 years) and 63 non-diabetic haemodialysis patients (62+/-10 years). The left ventricular mass index (LVMI) was determined by echocardiography. We used the percentage of differences exceeding 50 ms between adjacent normal RR intervals (pNN50) in time domain analysis and the power in the high-frequency range (HF: 0.15-0.40 Hz) in frequency domain analysis as indicators of parasympathetic activity.

RESULTS

The mean LVMI was greater in diabetic than in non-diabetic patients (168+/-63 vs 144+/-54 g/m(2), P<0.01). LVMI inversely correlated with pNN50 (r = -0.270, P = 0.0007, n = 154) and HF (r = -0.277, P = 0.0005, n = 154) in diabetic patients, but not in non-diabetic patients. By multiple logistic analysis, LVH was strongly associated with pNN50 (odds ratio 0.088; 0, <2%; 1, >/=2%) and HF (odds ratio 0.058; 0, <500 ms(2); 1, >/=500 ms(2)) in diabetic patients.

CONCLUSIONS

Impaired parasympathetic activity, which indicates cardiovascular autonomic neuropathy, was associated with the presence of LVH in diabetic haemodialysis patients. The co-existence of cardiovascular autonomic neuropathy and LVH may be one of the key factors for the high incidence of cardiovascular events in diabetic haemodialysis patients.

Authors+Show Affiliations

Cardiovascular Division, Toujinkai Hospital, 16 Negoro, Momoyama-cho, Fushimi-ku, Kyoto 612-8024, Japan. tojinkai.hosp@dream.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15252162

Citation

Nishimura, Masato, et al. "Association Between Cardiovascular Autonomic Neuropathy and Left Ventricular Hypertrophy in Diabetic Haemodialysis Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 19, no. 10, 2004, pp. 2532-8.
Nishimura M, Hashimoto T, Kobayashi H, et al. Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in diabetic haemodialysis patients. Nephrol Dial Transplant. 2004;19(10):2532-8.
Nishimura, M., Hashimoto, T., Kobayashi, H., Fukuda, T., Okino, K., Yamamoto, N., Nakamura, N., Yoshikawa, T., Takahashi, H., & Ono, T. (2004). Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in diabetic haemodialysis patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 19(10), 2532-8.
Nishimura M, et al. Association Between Cardiovascular Autonomic Neuropathy and Left Ventricular Hypertrophy in Diabetic Haemodialysis Patients. Nephrol Dial Transplant. 2004;19(10):2532-8. PubMed PMID: 15252162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in diabetic haemodialysis patients. AU - Nishimura,Masato, AU - Hashimoto,Tetsuya, AU - Kobayashi,Hiroyuki, AU - Fukuda,Toyofumi, AU - Okino,Koji, AU - Yamamoto,Noriyuki, AU - Nakamura,Naoto, AU - Yoshikawa,Toshikazu, AU - Takahashi,Hakuo, AU - Ono,Toshihiko, Y1 - 2004/07/13/ PY - 2004/7/15/pubmed PY - 2005/1/14/medline PY - 2004/7/15/entrez SP - 2532 EP - 8 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 19 IS - 10 N2 - BACKGROUND: Patients with diabetic nephropathy are likely to have neurological complications including cardiovascular autonomic dysfunction, which is related to increased risk of mortality. We investigated whether cardiovascular autonomic neuropathy is associated with left ventricular hypertrophy (LVH) in diabetic haemodialysis patients. METHODS: Holter electrocardiography was carried out for 24 h with time and frequency domain analyses of heart rate variability in 154 diabetic (age 62+/-11 years) and 63 non-diabetic haemodialysis patients (62+/-10 years). The left ventricular mass index (LVMI) was determined by echocardiography. We used the percentage of differences exceeding 50 ms between adjacent normal RR intervals (pNN50) in time domain analysis and the power in the high-frequency range (HF: 0.15-0.40 Hz) in frequency domain analysis as indicators of parasympathetic activity. RESULTS: The mean LVMI was greater in diabetic than in non-diabetic patients (168+/-63 vs 144+/-54 g/m(2), P<0.01). LVMI inversely correlated with pNN50 (r = -0.270, P = 0.0007, n = 154) and HF (r = -0.277, P = 0.0005, n = 154) in diabetic patients, but not in non-diabetic patients. By multiple logistic analysis, LVH was strongly associated with pNN50 (odds ratio 0.088; 0, <2%; 1, >/=2%) and HF (odds ratio 0.058; 0, <500 ms(2); 1, >/=500 ms(2)) in diabetic patients. CONCLUSIONS: Impaired parasympathetic activity, which indicates cardiovascular autonomic neuropathy, was associated with the presence of LVH in diabetic haemodialysis patients. The co-existence of cardiovascular autonomic neuropathy and LVH may be one of the key factors for the high incidence of cardiovascular events in diabetic haemodialysis patients. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/15252162/Association_between_cardiovascular_autonomic_neuropathy_and_left_ventricular_hypertrophy_in_diabetic_haemodialysis_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh361 DB - PRIME DP - Unbound Medicine ER -