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The association between heart rhythm complexity and the severity of abdominal aorta calcification in peritoneal
Cheng-Hsuan Tsai1, Chen Lin2, Yi-Heng Ho3,4
1Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Insights
Heart rhythm complexity, specifically DFAα1, is strongly linked to abdominal aorta calcification (AAC) in peritoneal dialysis (PD) patients. This finding suggests DFAα1 could serve as a valuable cardiovascular marker for PD patients.
Area of Science:
- Cardiology
- Nephrology
- Biomedical Engineering
Background:
- Abdominal aorta calcification (AAC) is linked to adverse outcomes in peritoneal dialysis (PD) patients.
- Heart rhythm complexity analysis shows promise for predicting cardiovascular disease outcomes.
Purpose of the Study:
- To investigate the association between heart rhythm complexity and AAC in PD patients.
- To determine if heart rhythm complexity can serve as a cardiovascular marker in this population.
Main Methods:
- Prospective analysis of 133 PD patients.
- Assessment of heart rhythm complexity using detrended fluctuation analysis (DFA) and multiscale entropy.
- Linear and non-linear analyses of heart rate variability.
Main Results:
- Higher AAC was associated with significantly lower linear heart rate variability parameters.
- Non-linear analysis revealed lower DFAα1, slope 1-5, scale 5, and area 6-20 in patients with higher AAC.
- DFAα1 demonstrated the highest discriminatory power for AAC, and was independently associated with higher AAC ratio along with HbA1c.
Conclusions:
- DFAα1 is significantly associated with abdominal aorta calcification in PD patients.
- DFAα1 shows potential as a novel cardiovascular marker for PD patients.
- Incorporating DFAα1 improves the prediction of AAC beyond traditional linear parameters.
Abstract:
Abdominal aorta calcification (AAC) has been associated with clinical outcomes in peritoneal dialysis (PD) patients. Heart rhythm complexity analysis has been shown to be a promising tool to predict outcomes in patients with cardiovascular disease. In this study, we aimed to analyze the association between heart rhythm complexity and AAC in PD patients. We prospectively analyzed 133 PD patients. Heart rhythm complexity including detrended fluctuation analysis and multiscale entropy was performed. In linear analysis, the patients in the higher AAC group (AAC ≥15%) had a significantly lower standard deviation of normal RR intervals, very low frequency, low frequency, high frequency and low/high frequency ratio. In non-linear analysis, DFAα1, slope 1-5, scale 5 and area 6-20 were significantly lower in the patients with higher AAC. Receiver operating characteristic curve analysis showed that DFAα1 had the greatest discriminatory power to differentiate these two groups. Multivariate logistic regression analysis showed that DFAα1 and HbA1c were significantly associated with higher AAC ratio. Adding DFAα1 significantly improved the discriminatory power of the linear parameters in both net reclassification improvement and integrated discrimination improvement models. In conclusion, DFAα1 is highly associated with AAC and a potential cardiovascular marker in PD patients.
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