U-Shaped Association of the Heart Rate Variability Triangular Index and Mortality in Hemodialysis Patients With Atrial Fibrillation

BRAUNISCHMC, M. C., C. C. MAYER, S. WERFEL, A. BAUER, B. HALLER, G. LORENZ, R. GÜNTHNER, J. MATSCHKAL, Q. BACHMANN, S. THUNICH, M. SCHLEGL, M. LUDWIG, C. HOLZMANN-LITTIG, T. ASSALI, M. PACHMANN, C. KÜCHLE, L. RENDERS, S. WASSERTHEURER, A. MÜLLER, G. SCHMIDT, U. HEEMANN, Marek MALÍK and C. SCHMADERER. U-Shaped Association of the Heart Rate Variability Triangular Index and Mortality in Hemodialysis Patients With Atrial Fibrillation. Frontiers in Cardivascular Medicine. LAUSANNE: FRONTIERS MEDIA SA, 2021, vol. 8, November 2021, p. 1-14. ISSN 2297-055X. Available from: https://dx.doi.org/10.3389/fcvm.2021.751052.

Basic information

Original name

U-Shaped Association of the Heart Rate Variability Triangular Index and Mortality in Hemodialysis Patients With Atrial Fibrillation

Authors

BRAUNISCHMC, M. C. (guarantor), C. C. MAYER, S. WERFEL, A. BAUER, B. HALLER, G. LORENZ, R. GÜNTHNER, J. MATSCHKAL, Q. BACHMANN, S. THUNICH, M. SCHLEGL, M. LUDWIG, C. HOLZMANN-LITTIG, T. ASSALI, M. PACHMANN, C. KÜCHLE, L. RENDERS, S. WASSERTHEURER, A. MÜLLER, G. SCHMIDT, U. HEEMANN, Marek MALÍK (203 Czech Republic, belonging to the institution) and C. SCHMADERER

Edition

Frontiers in Cardivascular Medicine, LAUSANNE, FRONTIERS MEDIA SA, 2021, 2297-055X

---

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.846

RIV identification code

RIV/00216224:14110/21:00124285

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3389/fcvm.2021.751052

UT WoS

001026548000001

Keywords in English

atrial fibrillation; heart rate variability triangular index; HRVi; cardiovascular mortality; hemodialysis; risk prediction

Tags

14110211, rivok

Tags

International impact, Reviewed

---

Abstract

V originále

Background: Atrial fibrillation (AF) is common in hemodialysis patients and contributes to increased mortality. We aimed to examine heart rate variability triangular index (HRVI) in hemodialysis patients with AF as it has recently been reported to predict mortality in AF patients without kidney disease. Methods: A total of 88 patients on hemodialysis with a medical history of AF or newly diagnosed AF underwent 24-h electrocardiography recordings. The primary endpoint of cardiovascular mortality was recorded during a median follow up of 3.0 years. Risk prediction was assessed by Cox regression, both unadjusted and adjusted for the Charlson Comorbidity Index and the Cardiovascular Mortality Risk Score. Results: Median age was 76 years, median dialysis vintage was 27 months. Altogether, 22 and 44 patients died due to cardiovascular and non-cardiovascular causes. In 55% of patients AF was present during the recording. Kaplan-Meier plots of HRVI quartiles suggested a non-linear association between HRVI, cardiovascular, and all-cause mortality which was confirmed in non-linear Cox regression analysis. Adjusted linear Cox regression revealed a hazard ratio of 6.2 (95% CI: 2.1–17.7, p = 0.001) and 2.2 (95% CI: 1.3–3.8, p = 0.002) for the outer quartiles (combined first and fourth quartile) for cardiovascular and all-cause mortality, respectively. Patients in the first quartile were more likely to have sinus rhythm whereas patients in the fourth quartile were more likely to have AF. Conclusions: We found a U-shaped association between HRVI and mortality in hemodialysis AF patients. The results might contribute to risk stratification independent of known risk scores in hemodialysis AF patients.