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Recurrence plot analysis of heart rate variability in end-stage renal disease treated twice-weekly by hemodialysis with or without intradialytic hypotension

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Abstract

Recurrence quantitative analysis (RQA) indices of heart rate variability (HRV) have shown a different adjustment in the sympathetic-driven dynamical response to active standing (AS) and hemodialysis (HD), characterized by increased laminar states in HRV. AS test is a maneuver in which subjects actively change their body posture from supine position (SP) to AS. In end-stage renal disease (ESRD) patients treated twice-weekly by HD, we found reduced changes in RQA indices to AS before HD that are partially recovered after treatment; laminarity, trapping time and recurrence time of the second type values were significantly lower in SP than during AS (\(p<0.05\)). Patients who developed intradialytic hypotension (IDH) did not show a significant response to AS in contrast with patients who did not develop IDH. Also, the mean duration of heartbeat intervals significantly influenced RQA indices (\(p<0.05\)), and this correlation depended on the observation moment (before or after HD). These findings suggest that the cardiac response to the autonomic modulation measured by RQA is different in IDH patients even before HD. Furthermore, the influence of the mean heart rate changes seems to play an important role in the short-term control of HRV behavior in ESRD.

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Acknowledgement

Martín Calderón-Juárez received a Ph.D. scholarship by CONACYT.

Author information

Authors and Affiliations

  1. Plan de Estudios Combinados en Medicina, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, México

    Martín Calderón-Juárez

  2. Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, México

    Martín Calderón-Juárez & Claudia Lerma

  3. Department of Nephrology, Hospital General Dr. Miguel Silva, Morelia, Mexico

    Dafne Anaid Gutiérrez Alvarado, Jesús Arellano-Martínez, Israel David Campos-González, Luis Alfonso Mariscal-Ramírez & Diana Laura Pérez-Negrete

  4. Department of Physics, Faculty of Sciences, Universidad Nacional Autónoma de México, Mexico City, México

    Gertrudis Hortensia González Gómez

  5. Department of Electrical Engineering, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, México

    Juan C. Echeverría

  6. Nefrología y Diálisis de León S.C., León, Mexico

    Emmanuel Pérez-Granados

  7. Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, México

    Salvador López-Gil

Authors
  1. Martín Calderón-Juárez
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  2. Dafne Anaid Gutiérrez Alvarado
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Contributions

MC-J, GHGG, JCE, JA-M, EP-G, SL-G, IDC-G, LAM-R and CL: conceptualization and methodology. MC-J, GHGG, JCE, JA-M and CL: writing—original draft preparation. MC-J and CL: software. MC-J, DG and DLP-N: data gathering. MC-J, GHGG, JCE, JA-M, EP-G, SL-G, IDC-G, LAM-R, DLP-N and CL: writing—review and editing. All authors have read and agreed to the submitted version of the manuscript.

Corresponding author

Correspondence to Claudia Lerma.

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Conflict of interest

All authors declare no conflict of interests.

Ethical approval

The studies involving human participants were reviewed and approved by the Research and Ethics Committee of the Hospital General Dr. Miguel Silva (protocol number 573/01/21) and the Instituto Nacional de Cardiología Ignacio Chávez (protocol number 21-1236). All patients provided their written informed consent to participate in this study.

Additional information

Trends in Recurrence Analysis of Dynamical Systems. Guest editors: Norbert Marwan, Charles Webber Jr., Andrzej Rysak.

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Calderón-Juárez, M., Gutiérrez Alvarado, D.A., González Gómez, G.H. et al. Recurrence plot analysis of heart rate variability in end-stage renal disease treated twice-weekly by hemodialysis with or without intradialytic hypotension. Eur. Phys. J. Spec. Top. 232, 99–110 (2023). https://doi.org/10.1140/epjs/s11734-022-00682-8

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