Delayed effect of blood pressure fluctuations on heart rate in patients with end-stage kidney disease.

The time delay of the baroreflex may be affected by decreased autonomic activity in uremia. To assess the magnitude and the time delay of heart rate response in patients with end-stage renal disease, continuous beat-to-beat intervals (IBI) and systolic blood pressure (SBP) recordings were monitored...

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Publicado en:Medical & Biological Engineering & Computing Vol. 49; no. 9; pp. 1045 - 1056
Autores principales: Sapoznikov D, Rubinger D, Sapoznikov, Dan, Rubinger, Dvora
Formato: research Journal Article
Publicado: Springer Nature Sep2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2011
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      pub: Springer Nature
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        atl: Delayed effect of blood pressure fluctuations on heart rate in patients with end-stage kidney disease.
      aug:
        au:
          Sapoznikov D
          Rubinger D
          Sapoznikov, Dan
          Rubinger, Dvora
        affil: Department of Medicine, Nephrology and Hypertension Services, Hadassah University Medical Center, Ein Kerem 91120, P. O. Box 12000, Jerusalem, Israel
      sug:
        subj:
          Blood Pressure Physiology
          Heart Rate Physiology
          Kidney Failure, Chronic Physiopathology
          Adult
          Aged
          Baroreflex Physiology
          Case Control Studies
          Female
          Kidney Failure, Chronic Therapy
          Kidney Transplantation
          Male
          Middle Age
          Postoperative Period
          Hemodialysis
          Signal Processing, Computer Assisted
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: The time delay of the baroreflex may be affected by decreased autonomic activity in uremia. To assess the magnitude and the time delay of heart rate response in patients with end-stage renal disease, continuous beat-to-beat intervals (IBI) and systolic blood pressure (SBP) recordings were monitored in hemodialysis (HD) patients (n = 72), in patients after renal transplantation (TX) (n = 41) and in age-matched controls (C) (n = 34). A 2-term prediction model was computed, in which each IBI change was represented as a function of SBP difference values of two immediately preceding beats. Baroreflex slope and the frequency domain variables low frequency (LF) α index, phase shift, and lag time were also calculated. b₁ coefficient, representing the dependence of IBI difference with the first previous SBP difference was lower in HD than in Cs, but increased after TX. b₁ correlated with age, baroreflex slope, and LF α, and b₂ (the 2nd term), with both the phase shift between SBP and IBI and lag time. The latter was lower in Cs than in HD or transplanted patients. These findings show that the time delay of the heart rate response to SBP variations is increased in renal insufficiency. The prolonged delay may contribute to the circulatory instability in uremic patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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