Nephrology Center and 2nd Department of Internal Medicine, Medical Faculty, University of Pécs, Hungary.
Nephrol Dial Transplant. 2010 Feb;25(2):509-13. doi: 10.1093/ndt/gfp504. Epub 2009 Sep 25.
Attenuated heart rate recovery (HRR) is an independent predictor of cardiac and total mortality. Diminished renal function is a similar predictor. There are no data concerning the interaction between the two risk factors. We studied HRR in patients with a homogeneous renal disease, IgA nephropathy.
One hundred and seven patients with biopsy-proven chronic IgA nephropathy (71 males, 36 females aged 45 +/- 11 years) performed a graded exercise treadmill stress test. HRR was measured as the heart rate difference between the peak value and the heart rate 1 min after exercise. The patients were divided into three groups based on estimated glomerular filtration rate (eGFR): CKD 1, eGFR >or= 90 ml/min (n = 46); CKD 2, eGFR 60-89 ml/min (n = 38), CKD 3-4, eGFR 15-59 ml/min (n = 23). We compared these data with 29 normal controls (aged 46 +/- 14 years).
HRR values corresponded to eGFR as follows: 29.9 +/- 8.8 bpm normal controls, 27.8 +/- 9.2 bpm CKD 1, 24.5 +/- 10.5 bpm CKD 2 and 16.3 +/- 9.3 bpm CKD 3-4. The latter differed from the other groups significantly (P < 0.05). Metabolic syndrome was common in IgA nephropathy patients (27%). Metabolic syndrome patients had a HRR of 19.6 +/- 10.1 bpm, compared to 25.8 +/- 10.4 bpm in patients without metabolic syndrome (P = 0.007). Nevertheless, a multivariate regression analysis accepted only eGFR as an independent predictor of HRR.
eGFR predicts HRR in patients with a homogenous renal disease. Metabolic syndrome influences HRR, albeit not independently in this cohort.
心率恢复（HRR）减弱是心脏和全因死亡率的独立预测因子。肾功能下降也是类似的预测因子。目前尚无关于这两种危险因素相互作用的数据。我们研究了同种肾脏疾病——IgA 肾病患者的 HRR。
107 例经活检证实的慢性 IgA 肾病患者（71 名男性，36 名女性，年龄 45 ± 11 岁）进行了分级运动平板运动试验。HRR 测量为运动峰值心率与运动后 1 分钟心率之间的差值。根据估计肾小球滤过率（eGFR）将患者分为三组：CKD 1 期，eGFR≥90ml/min（n=46）；CKD 2 期，eGFR 60-89ml/min（n=38）；CKD 3-4 期，eGFR 15-59ml/min（n=23）。我们将这些数据与 29 名正常对照者（年龄 46 ± 14 岁）进行比较。
HRR 值与 eGFR 相对应，正常对照组为 29.9 ± 8.8bpm，CKD 1 期为 27.8 ± 9.2bpm，CKD 2 期为 24.5 ± 10.5bpm，CKD 3-4 期为 16.3 ± 9.3bpm。后两组与其他组相比差异有统计学意义（P＜0.05）。代谢综合征在 IgA 肾病患者中很常见（27%）。代谢综合征患者的 HRR 为 19.6 ± 10.1bpm，而无代谢综合征的患者为 25.8 ± 10.4bpm（P=0.007）。然而，多元回归分析仅接受 eGFR 作为 HRR 的独立预测因子。
eGFR 可预测同种肾脏疾病患者的 HRR。代谢综合征影响 HRR，但在本队列中并非独立影响。
