L/T-type calcium channel blocker reduces non-Gaussianity of heart rate variability in chronic kidney disease patients under preceding treatment with ARB.
L/T-type calcium channel blocker reduces non-Gaussianity of heart rate variability in chronic kidney disease patients under preceding treatment with ARB.
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DOI：
10.1177/1470320316643905
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Ohte N
中科院分区：
文献类型：
--
作者：
Fukuda M;Ogiyama Y;Sato R;Miura T;Fukuta H;Mizuno M;Kiyono K;Yamamoto Y;Hayano J;Ohte N
慢性肾脏疾病（CKD）患者交感神经活动增加。病理性交感神经活动可以改变心率变异性（HRV），而改变的HRV具有预后重要性，因此减少交感神经活动可能是一个重要的策略。新型非线性hrv，包括减速能力（DC），对死亡率有更强的预测能力。我们最近提出增加HRV的非高斯性指数λ25s，该指数表明火山心率偏离每个标准差水平的概率，作为交感心脏过度驱动的标志。L/ t型钙通道阻滞剂（L/T-CCB） azelnidipine在实验和临床研究中降低交感神经活动。在43例接受血管紧张素受体阻滞剂（ARB）治疗的CKD高血压患者中，我们研究了8周的L/T-CCB治疗是否可以恢复HRV。无论性别、年龄、肾功能或血压，24小时内所有正常到正常间隔的平均值（p<0.0001）和DC （p=0.002）增加，λ25s （p=0.001）减少，而其他hrv无显著变化。减少λ25s可用于评估交感神经抑制治疗的效果。HRV的恢复是否与CKD患者预后的改善直接相关，还需要进一步的研究。
Increased sympathetic nerve activity has been suggested in patients with chronic kidney disease (CKD). Pathologic sympathetic activity can alter heart rate variability (HRV), and the altered HRV has prognostic importance, so that reducing sympathetic activity may be an important strategy. Novel nonlinear HRVs, including deceleration capacity (DC), have greater predictive power for mortality. We have recently proposed an increase in a non-Gaussianity index of HRV, λ25s, which indicates the probability of volcanic heart rate deviations of departure from each standard deviation level, as a marker of sympathetic cardiac overdrive. L/T-type calcium channel blocker (L/T-CCB), azelnidipine, decreases sympathetic nerve activity in experimental and clinical studies. In 43 hypertensive patients with CKD under treatment with an angiotensin receptor blocker (ARB), we investigated whether 8-week add-on L/T-CCB treatment could restore HRV. Means of all normal-to-normal intervals over 24 h (p<0.0001) and DC (p=0.002) increased, and λ25s (p=0.001) decreased regardless of gender, age, renal function or blood pressure, while no significant changes were observed in the other HRVs. Reduction of λ25s is useful to assess the effect of sympathoinhibitory treatment. Further studies are needed to investigate if the restoration of HRV is directly associated with the improvement of prognosis in patients with CKD.
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影响因子：
4.9
作者：
Hamada, T;Watanabe, M;Shigemasa, C
通讯作者：
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168.9
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2.4
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