title: Cardiac response to hemodialysis with different cardiovascular tolerance: heart rate variability and QT interval analysis.
abstract: A therapy-specific worsening of cardiovascular stability during bicarbonate dialysis (BD) with respect to acetate-free biofiltration (AFB) have been previously reported. We further investigated the impact of the 2 therapies on electrocardiographic parameters in order to gain novel insight into the cardiac responses. Holter ECG acquired during hypotension-free sessions (12 BD + 12 AFB) were retrospectively analyzed. R-R intervals were extracted from ECG recordings. An autoregressive spectral technique was used to compute low- and high-frequency (LF and HF) components of heart rate variability (HRV). QT interval duration was measured with a computer-assisted technique and corrected for HR. In BD the LF component of HRV after an initial increase was slowly depressed with respect to AFB (p < 0.05). QT duration showed a significant (p < 0.01) hemodialysis-induced reduction. QT shortening was more pronounced (p < 0.05) in BD than in AFB (-31 vs. -10 ms), even after correction for HR (p < 0.05). Cardiac electrical activity is significantly affected by the hemodialysis technique. The decrease in the LF component of HRV and the QT shortening are coherent with the worse cardiovascular tolerance observed in BD and with the hypothesis of an enhanced production of endogenous nitric oxide.
authors.affiliation: Biomedical Engineering Laboratory, D.E.I.S., University of Bologna, Cesena, Italy. sseveri@deis.unibo.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Severi
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciandrini
authors.forename: Eleonora
authors.initials: E
authors.lastname: Grandi
authors.forename: Silvio
authors.initials: S
authors.lastname: Cavalcanti
authors.forename: Stefano
authors.initials: S
authors.lastname: Bini
authors.forename: Fabio
authors.initials: F
authors.lastname: Badiali
authors.forename: Andrea
authors.initials: A
authors.lastname: Gattiani
authors.forename: Leonardo
authors.initials: L
authors.lastname: Cagnoli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000096:biosynthesis; D006435:Renal Dialysis
chemical_list: D009569:Nitric Oxide