Increment of monthly mean predialysis heart rate reflects early cardiac overload in hemodialysis patients with normal cardiac function.
BACKGROUND
The aim of our study was to examine the association of heart rate (HR) with the onset of congestive heart failure (CHF), and to compare the predictive value of HR with that of the serum level of human atrial natriuretic peptide (hANP) and the cardiothoracic ratio (CTR).


METHODS
Thirty-eight patients on chronic hemodialysis (HD) aged 68 ± 11 years (61% men, 41% with diabetes) who had normal cardiac function were enrolled in this study. Among them, 6 patients had suffered CHF. Baseline characteristics and HR, hANP and CTR were compared between the 2 groups.


RESULTS
At baseline, the monthly mean pre-HR (before HD), CTR and hANP values were higher in CHF patients compared with non-CHF patients. In the CHF group, the monthly mean pre-HR increased progressively beginning 10 months before the onset of CHF, which was earlier than the increments of hANP and CTR. A significant difference between the CHF and non-CHF groups was observed earlier for monthly mean pre-HR (4 months before CHF) and ANP (4 months before CHF) than for CTR (2 months before CHF).


CONCLUSIONS
The increment of monthly mean pre-HR may reflect the early phase of cardiac overload, and is of equal significance to hANP. Further large-scale prospective studies are required to confirm these results.
Tanaka
Yuri
Y
Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
Joki
Nobuhiko
N
Iwasaki
Masaki
M
Nikolov
Igor G
IG
Takahashi
Yasunori
Y
Shiraki
Chie
C
Uchida
Takao
T
Imamura
Yoshihiko
Y
Hase
Hiroki
H
D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006321:Heart / Q000502:physiology*; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D012307:Risk Factors
D009320:Atrial Natriuretic Factor