Enzmann G, Bianco F, Panzetta G
Autonomic function during hemodialysis-induced hypotensive
collapses with different heart rate patterns
Clin Hyp Nephrol (Calab)
(Sep) : 1995
We employed the spectral analysis of heart rate variability during
18 HD-induced collapses. During 5 bradycardic collapses (HR drop >
20 BPM) the integral of the power spectrum in the low frequency
(IPS-LF) range (0.02-0.15 Hz), a marker of both sympathetic
and parasympathetic activity, (3.7 at baseline) rose markedly just
before the collapses (59.0; p=0.062) and fell during the collapses
(12.9 p=0.062). On the other hand, the integral of the power spectrum
inthe high frequency (IPS-HF) range (0.2 - 0.35 Hz), a marker of
parasympathetic activity only (2.3 at baseline) rose quickly from 0.9
at six minutes before the collapses, to 14.9 during the
collapses(p=0.062). During 11 collapses without a significant change
in HR (<5 bpm) IPS-LF (3.4 at baseline) rose to 20.7 four minutes
before the collapses and fell to 3.4 during the collapses (p< 0.02),
whereas IPS-HF didn't show significant changes during the session.
The results suggest that a drop in sympathetic tone at the end of
a strong activation is a common feature of all collapses we studied,
despite the fact that concomitant changes in HR often were
small. Bradycardic collapses differed from the others in that they
showed a greater increase in sympathetic activity before the collapse
and a rise in parasympathetic activity during the collapse.
(C. Zoccali)
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Basic hemodialysis :
Complications (acute)