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Table of Contents
Vol. 33, No. 6, 2011
Issue release date: June 2011
Section title: Original Report: Patient-Oriented, Translational Research
Am J Nephrol 2011;33:491–498
(DOI:10.1159/000327829)

Attenuated Cardiovascular Response to Sympathetic System Activation during Exercise in Patients with Dialysis-Induced Hypotension

Fotbolcu H.a · Duman D.c · Ecder S.A.b · Oduncu V.d · Cevik C.e · Tigen K.d · Şirin G.a · Özker E.a · Kıran B.d · Basaran Y.d
aDivision of Cardiology, Goztepe Medical Park Hospital, bNephrology and Dialysis Unit, Goztepe Training and Research Hospital, cDepartment of Cardiology, Medipol University, and dDivision of Cardiology, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey; eCardiology Division, Texas Heart Institute St. Luke’s Episcopal Hospital, Baylor College of Medicine, Houston, Tex., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: March 06, 2011
Accepted: March 22, 2011
Published online: May 05, 2011
Issue release date: June 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN

Abstract

Background: We wished to investigate potential causes of dialysis-induced hypotension (DIH), including the attenuated cardiovascular response to sympathetic system activation during exercise and myocardial dysfunction. Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (Non-DIH), and 30 control subjects. Each patient was evaluated with echocardiography and a symptom-limited treadmill stress test. The chronotropic index (CRI), heart rate recovery (HRR), systolic blood pressure response to exercise (SBP response), and tissue Doppler systolic myocardial velocities were calculated. Results: The HRR and velocities were reduced in dialysis patients compared to controls; however, they were similar in patients with and without DIH. Patients with DIH had the lowest CRI compared to theNon-DIH group (0.62 ± 0.15 vs. 0.73 ± 0.17, p = 0.020) and controls (0.62 ± 0.15 vs. 0.86 ± 0.11, p < 0.001). Similarly, patients with DIH had the lowest SBP response values compared to the Non-DIH (34.88 ± 15.01 vs. 55.67 ± 25.42, p = 0.002) and controls (34.88 ± 15.01 vs. 59.70 ± 23.04, p < 0.001). Conclusion: Patients with DIH have inadequate sympathetic activity of the cardiovascular system during exercise and impaired left ventricular systolic function. Both factors could contribute to the development of hypotension during hemodialysis.

© 2011 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: March 06, 2011
Accepted: March 22, 2011
Published online: May 05, 2011
Issue release date: June 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN


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