Heart rhythm complexity impairment in patients undergoing peritoneal dialysis.
Cardiovascular disease is one of the leading causes of death in patients with advanced renal disease. The objective of this study was to investigate impairments in heart rhythm complexity in patients with end-stage renal disease. We prospectively analyzed 65 patients undergoing peritoneal dialysis (PD) without prior cardiovascular disease and 72 individuals with normal renal function as the control group. Heart rhythm analysis including complexity analysis by including detrended fractal analysis (DFA) and multiscale entropy (MSE) were performed. In linear analysis, the PD patients had a significantly lower standard deviation of normal RR intervals (SDRR) and percentage of absolute differences in normal RR intervals greater than 20 ms (pNN20). Of the nonlinear analysis indicators, scale 5, area under the MSE curve for scale 1 to 5 (area 1-5) and 6 to 20 (area 6-20) were significantly lower than those in the control group. In DFA anaylsis, both DFA α1 and DFA α2 were comparable in both groups. In receiver operating characteristic curve analysis, scale 5 had the greatest discriminatory power for two groups. In both net reclassification improvement model and integrated discrimination improvement models, MSE parameters significantly improved the discriminatory power of SDRR, pNN20, and pNN50. In conclusion, PD patients had worse cardiac complexity parameters. MSE parameters are useful to discriminate PD patients from patients with normal renal function.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Yen-Hung
YH
Lin
Biomedical Engineering, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chen
C
Lin
Department of Biomedical Sciences and Engineering, National Central University, Chungli, Taiwan.|Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
Yi-Heng
YH
Ho
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Vin-Cent
VC
Wu
Biomedical Engineering, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Men-Tzung
MT
Lo
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Kuan-Yu
KY
Hung
Department of Agronomy, Biometry Division, National Taiwan University, Taipei, Taiwan.
Li-Yu Daisy
LY
Liu
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Lian-Yu
LY
Lin
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Jenq-Wen
JW
Huang
Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA.
Chung-Kang
CK
Peng
D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009200:Myocardial Contraction; D010507:Periodicity; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011446:Prospective Studies; D012372:ROC Curve