The combination of low heart rate variability and high pulse wave velocity was associated with the highest risk of the composite outcome of cardiovascular disease or death in patients with CKD.
Cohort (n=240)
Yes
Are low heart rate variability and high pulse wave velocity associated with increased risk of cardiovascular disease, death, and progression to ESRD in patients with chronic kidney disease?
In patients with CKD stages 3-5, the combination of low heart rate variability and high pulse wave velocity identifies those at the highest risk for cardiovascular events and death.
BACKGROUND: Arterial stiffness and low heart rate variability (HRV) have each been associated with increased cardiovascular risk in a variety of patient populations. We explored the relationship between HRV and pulse wave velocity (PWV measure of arterial stiffness) in patients with chronic kidney disease (CKD prior to ESRD) along with examining their association with the outcomes of cardiovascular disease (CVD), death, and progression to end stage renal disease (ESRD). METHODS: The RRI-CKD Study is a 4-center prospective cohort study of CKD stages 3 - 5 (n = 834). A subset underwent both HRV testing by 24-hour Holter and carotid-femoral PWV (n = 240). Multiple linear regression was used to assess predictors of PWV and Cox regression to investigate the association of HRV and PWV with time to first CVD event or death and ESRD. RESULTS: Although several HRV measures were inversely correlated with PWV, this association was attenuated after adjustment for age and/or diabetes and no longer significant after adjustment for C-reactive protein. Low HRV and high PWV were individually associated with increased risk of the composite endpoint of CVD/death in multivariable analysis. The risk of the composite of CVD/death was highest for patients with both low HRV and high PWV. CONCLUSION: Age, diabetes, and inflammation together explained the inverse association between HRV and PWV. Inflammation may play a role in the pathogenesis of both low HRV and high PWV. The combination of low HRV and high PWV showed the strongest association with a composite CVD outcome. Mechanisms underlying abnormalities in PWV and HRV, and the role of these measures as intermediate outcomes in future trials in CKD patients, merit further study.
Chandra et al. (Fri,) conducted a cohort in Chronic kidney disease (stages 3-5) (n=240). Heart rate variability (HRV) and pulse wave velocity (PWV) assessment was evaluated on Composite of cardiovascular disease (CVD) event or death. The combination of low heart rate variability and high pulse wave velocity was associated with the highest risk of the composite outcome of cardiovascular disease or death in patients with CKD.