Long-term prediction of mortality by heart rate turbulence in hemodialysis patients and the impact of diabetes mellitus-a longitudinal observational study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F25%3A00143839" target="_blank" >RIV/00216224:14110/25:00143839 - isvavai.cz</a>

Výsledek na webu

<a href="https://academic.oup.com/joneph/article/38/8/2261/8457489" target="_blank" >https://academic.oup.com/joneph/article/38/8/2261/8457489</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s40620-025-02357-8" target="_blank" >10.1007/s40620-025-02357-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Long-term prediction of mortality by heart rate turbulence in hemodialysis patients and the impact of diabetes mellitus-a longitudinal observational study

Popis výsledku v původním jazyce

Background Diabetes-driven impaired autonomic nervous system function might contribute to increased mortality in hemodialysis patients. Our study aimed to validate heart rate turbulence as a long-term predictor of mortality in this vulnerable cohort. Methods Heart rate turbulence is a non-invasive, 24 h electrocardiography-Holter-based assessment of cardiovascular autonomic responses. Hemodialysis patients of the "rISk strAtification in end-stage Renal disease" (ISAR) study, a prospective, multicenter observational study, were followed up for six years. Mortality hazard, and correlations between clinical characteristics and mortality, were assessed using Cox regression models. Results Heart rate turbulence measurement at baseline was available in 290 hemodialysis patients, 99 (34%) with diabetes mellitus. In a multivariable analysis, abnormal heart rate turbulence was associated with a 2.1-fold (95% CI: 1.4-3.2; p &lt; 0.001) increased risk for all-cause and 3.1-fold (95% CI: 1.5-6.2; p = 0.001) increased risk for cardiovascular mortality. The co-occurrence of abnormal heart rate turbulence and diabetes mellitus represented the strongest risk constellation, increasing all-cause mortality risk to a hazard ratio of 5.8 (95% CI: 3.3-10.4; p &lt; 0.001) and cardiovascular mortality risk to 6.1 (95% CI: 2.5-15.1; p &lt; 0.001). This association with mortality risk remained significant after multivariate adjustment. The interaction term between the two comorbidities indicated an approximately additive effect on mortality risk. Conclusions Heart rate turbulence significantly contributed to the prediction of long-term mortality risk in hemodialysis patients. Diabetes mellitus is a major driver of cardiovascular autonomic dysfunction, which plays a crucial role in mortality among dialysis patients. Heart rate turbulence measurement identifies high-risk patients in the dialysis setting, enhancing precision in risk prediction and stratification, and allowing an opportunity for personalized monitoring and prevention.

Název v anglickém jazyce

Long-term prediction of mortality by heart rate turbulence in hemodialysis patients and the impact of diabetes mellitus-a longitudinal observational study

Popis výsledku anglicky

Background Diabetes-driven impaired autonomic nervous system function might contribute to increased mortality in hemodialysis patients. Our study aimed to validate heart rate turbulence as a long-term predictor of mortality in this vulnerable cohort. Methods Heart rate turbulence is a non-invasive, 24 h electrocardiography-Holter-based assessment of cardiovascular autonomic responses. Hemodialysis patients of the "rISk strAtification in end-stage Renal disease" (ISAR) study, a prospective, multicenter observational study, were followed up for six years. Mortality hazard, and correlations between clinical characteristics and mortality, were assessed using Cox regression models. Results Heart rate turbulence measurement at baseline was available in 290 hemodialysis patients, 99 (34%) with diabetes mellitus. In a multivariable analysis, abnormal heart rate turbulence was associated with a 2.1-fold (95% CI: 1.4-3.2; p &lt; 0.001) increased risk for all-cause and 3.1-fold (95% CI: 1.5-6.2; p = 0.001) increased risk for cardiovascular mortality. The co-occurrence of abnormal heart rate turbulence and diabetes mellitus represented the strongest risk constellation, increasing all-cause mortality risk to a hazard ratio of 5.8 (95% CI: 3.3-10.4; p &lt; 0.001) and cardiovascular mortality risk to 6.1 (95% CI: 2.5-15.1; p &lt; 0.001). This association with mortality risk remained significant after multivariate adjustment. The interaction term between the two comorbidities indicated an approximately additive effect on mortality risk. Conclusions Heart rate turbulence significantly contributed to the prediction of long-term mortality risk in hemodialysis patients. Diabetes mellitus is a major driver of cardiovascular autonomic dysfunction, which plays a crucial role in mortality among dialysis patients. Heart rate turbulence measurement identifies high-risk patients in the dialysis setting, enhancing precision in risk prediction and stratification, and allowing an opportunity for personalized monitoring and prevention.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JOURNAL OF NEPHROLOGY

ISSN

1121-8428

e-ISSN

1724-6059

Svazek periodika

38

Číslo periodika v rámci svazku

8

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

12

Strana od-do

2261-2272

Kód UT WoS článku

001529445200001

EID výsledku v databázi Scopus

2-s2.0-105010746128