Baroreceptor Sensitivity in Individuals with CKD and Heart Failure

Area of Science:

• Cardiology
• Nephrology
• Physiology

Background:

• Heart failure (HF) is a common cardiovascular complication of chronic kidney disease (CKD).
• Baroreflex impairment is a potential contributor to cardiovascular mortality in CKD patients.
• The interplay between CKD, HF, and baroreflex sensitivity (BRS) requires further investigation regarding cardiovascular outcomes.

Purpose of the Study:

• To investigate the associations between CKD, HF, and BRS.
• To determine the relationship between CKD, BRS, and cardiovascular mortality.

Main Methods:

• Retrospective analysis of 247 patients with moderate to severe HF.
• Assessment of BRS using intravenous phenylephrine, electrocardiography, and echocardiography.
• Logistic and Cox proportional hazards models to evaluate associations of CKD and BRS with cardiovascular mortality.

Main Results:

• Lower estimated glomerular filtration rate (eGFR) was observed in patients with depressed BRS.
• A majority of CKD patients exhibited depressed BRS compared to non-CKD patients (60% vs. 29%).
• CKD and BRS were independently associated with cardiovascular mortality, with significantly increased risk in those with depressed BRS.

Conclusions:

• Cardiac BRS is depressed in patients with mild to moderate CKD and HF.
• Depressed BRS is associated with increased cardiovascular mortality in this population.
• Further research is needed to confirm the role of BRS in cardiovascular mortality, especially in advanced CKD.