The Analysis Of Left Ventricular Mass Index And Heart Rate Variability In Primary Hypertension With Mild To Moderate Chronic Kidney Disease Patients

Objective:1. To study the relationship among glomerular filtration rate, left ventricular mass index and heart rate variability.2. To analyze the correlation between heart rate variability and left ventricular hypertrophy.3. To study the factors of heart rate variability. Methods:A total of 307 patients with hypertension were selected from Jan 2015 to Jan 2016 in the Second Hospital of Tianjin Medical University, and their clinical data were respectively analyzed. According to the staging criteria internationally recognized of the chronic kidney disease, subjects were divided into CKD1 group, CKD2 group and CKD3 group. Then according to the diagnostic criteria of the hypertrophy among European Society of hypertension in 2003, subjects were divided into left ventricular hypertrophy group( LVH)and non-left ventricular hypertrophy group(non-LVH). Results:1.CKD1 group included 140 cases, CKD2 group contained 89 cases and CKD3 contained 78 cases. Age, hemoglobin, uric acid levels, lipid levels, fasting blood glucose and left ventricular mass index were statistically different among the three groups.2. LVH group included 160 cases and non-LVH group contained 147 cases. Hemoglobin, heart rate variability index such as SDNN, SDANN, PNN50 in LVH group was significantly lower than non-LVH group, and the differences were statistically significant by univariate analysis.3. Spearman correlation analysis was applied, Left ventricular mass index was in a correlation with hemoglobin and body mass index; SDNN was in a correlation with age, left ventricular mass index, and estimated glomerular filtration rate; Age, gender, hemoglobin, uric acid, left ventricular mass index, and estimated glomerular filtration rate were associated with SDANN; Age, hemoglobin, left ventricular mass index and estimated glomerular filtration rate were associated with RMSSD; Age, creatinine, fasting blood glucose, left ventricular mass index and estimated glomerular filtration rate were associated with PNN50.4. Heart rate variability index and associated clinical data analysis by using the multivariate stepwise regression showed that the main factors affecting SDNN were estimated glomerular filtration rate and left ventricular mass index; Main factors influencing SDANN were age and left ventricular mass index, where the age was of its greater impact; the main factors affecting RMSSD were estimated glomerular filtration rate and hemoglobin,in which eGFR was of its greater influence; the main factors influencing PNN50 were eGFR and LVMI. Conclusion:1. With the increase of chronic kidney disease stage, hemoglobin level was also decreasing, left ventricular hypertrophy would aggravate, the overall level of heart rate variability would decrease.2. Heart rate variability and hemoglobin levels were in negative correlation with left ventricular hypertrophy.3. The main factors with chronic kidney disease in hypertension patients the main factors of influencing heart rate variability were glomerular filtration rate, left ventricular mass index, hemoglobin levels and age.