EVALUATION OF AUTONOMIC NERVOUS SYSTEM BY MEASURING HEART RATE VARIABILITY IN PATIENTS WITH INTRADIALYTIC HYPOTENSION.

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E-Poster

https://storage.unitedwebnetwork.com/files/1099/75658f1fc5b574b175c01ad6cd939cb7.pdf

Abstract Title

First Name *

Ibrahima Lyra

Last Name *

SARR

Co-author 1

Baratou Coundoul baratoucdlndiaye@yahoo.fr Ouakam military hospital Ouakam Dakar

Co-author 2

Abdou Khadir Sow sowdjily4@hotmail.com Cheikh Anta Diop University Dakar Dakar

Co-author 3

Sidy Mohamed Seck sidy-mohamed.seck@ugb.edu.sn Gaston Berger University Saint Louis Saint Louis

Co-author 4

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Co-author 7

Co-author 8

Co-author 9

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Introduction

Intradialytic hypotension (IDH) increases cardiovascular morbidity and mortality in chronic hemodialysis patients. Its pathophysiology is complex and poorly understood. However, autonomic nervous system (ANS) dysfunction is thought to be a risk factor for IDH. The aim of this study was to assess the ANS in patients with IHD by measuring heart rate variability (HRV).

Methods

This was a cross-sectional study carried out at Ouakam Military Hospital in Senegal from 1 January to 31 March 2023. Patients over 18 years of age who had been on hemodialysis for 3 months and had given their consent were included. Patients hospitalised during the previous month for an acute pathology and those with a cardiac rhythm abnormality were not included. All patients included received 3 HRV measurements (before, during and after an index hemodialysis session). They were then classified according to changes in systolic blood pressure (SBP) during index hemodialysis. Three groups were formed: group I (increase > 10 mmHg in mean intradialytic SBP vs SBP before the session), group II (decrease > 10 mmHg in mean intradialytic SBP vs SBP before the session) and group III (other). We then compared the HRV indices between the three groups before, during and after the session.

Results

Fifty-two patients (31 men, mean age 47.54 years) were included and classified into group I (n = 14, 26.9%), group II (n = 13, 25%) and group III (n = 25, 48.1%). Compared with group I and/or group III, patients in group II were older (p = 0.01) and had a higher Kt/v (p = 0.03). There were no significant differences between the groups in other socio-demographic, clinical, biological or dialysis parameters. These patients had less cardiac autonomic neuropathy (p = 0.03) and arterial baroreflex was impaired in most of them (p = 0.02). The HRV indices were statistically significantly higher, particularly total power, low and high frequencies before and during the middle phase of the hemodialysis. There was no significant difference in HRV indices between the three groups at the end of the session.

Conclusions

HRV indices appear to be better in patients with IDH before and during the middle phase of the hemodialysis session.

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