Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration

Chronic kidney disease (CKD) is a progressive pathology characterized by gradual function loss. It is accompanied by complications including cardiovascular disorders. This study involves 4-h electrocardiographic records from the Telemetric and Holter ECG Warehouse (THEW) project database to analyze...

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Main Authors: Gabriel Vega-Martínez, Francisco José Ramos-Becerril, Josefina Gutiérrez-Martínez, Arturo Vera-Hernández, Carlos Alvarado-Serrano, Lorenzo Leija-Salas
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/15/9/5122
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author Gabriel Vega-Martínez
Francisco José Ramos-Becerril
Josefina Gutiérrez-Martínez
Arturo Vera-Hernández
Carlos Alvarado-Serrano
Lorenzo Leija-Salas
author_facet Gabriel Vega-Martínez
Francisco José Ramos-Becerril
Josefina Gutiérrez-Martínez
Arturo Vera-Hernández
Carlos Alvarado-Serrano
Lorenzo Leija-Salas
author_sort Gabriel Vega-Martínez
collection DOAJ
description Chronic kidney disease (CKD) is a progressive pathology characterized by gradual function loss. It is accompanied by complications including cardiovascular disorders. This study involves 4-h electrocardiographic records from the Telemetric and Holter ECG Warehouse (THEW) project database to analyze the dynamics in heart rate variability (HRV) indices of 51 patients with CKD. It proposes three algorithms to process long-term electrocardiography records: QRS complex and R-wave detection, premature ventricular contraction (PVC) identification, and tachograms. PVCs were analyzed with the consideration of the changes occurring before, during, and after hemodialysis, especially during the interdialytic period. The hour with the highest PVCs occurrence was identified and used to assess HRV fluctuations and segmented into 5 min blocks with a 0.77 min overlap, yielding a dynamic HRV vector, one for each of seven HRV indices selected to evaluate autonomic nervous system balance. R-wave and PVC identification resulted in 97.53% and 85.83% positive predictive values, respectively. PVCs’ prevalence and HRV changes’ relationship in 48 h records could relate to cardiovascular risk. The stratification of hemodialysis patients into three distinct PVC patterns (<i>p</i> < 0.001) identified two clinically significant high-risk subgroups: Class 1, indicative of electrical instability, and Class 3, of advanced autonomic dysfunction, demonstrating divergent arrhythmogenic mechanisms with direct implications for risk stratification.
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spelling doaj-art-9e2d7c9f48974a85861dbf5718525b8f2025-08-20T03:49:22ZengMDPI AGApplied Sciences2076-34172025-05-01159512210.3390/app15095122Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk ExplorationGabriel Vega-Martínez0Francisco José Ramos-Becerril1Josefina Gutiérrez-Martínez2Arturo Vera-Hernández3Carlos Alvarado-Serrano4Lorenzo Leija-Salas5Centro de Investigación y de Estudios Avanzados del IPN, Av. Instituto Politécnico Nacional 2508, San Pedro Zacatenco, G.A.M., Mexico City 07360, MexicoInstituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Mexico City 14389, MexicoInstituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Mexico City 14389, MexicoCentro de Investigación y de Estudios Avanzados del IPN, Av. Instituto Politécnico Nacional 2508, San Pedro Zacatenco, G.A.M., Mexico City 07360, MexicoCentro de Investigación y de Estudios Avanzados del IPN, Av. Instituto Politécnico Nacional 2508, San Pedro Zacatenco, G.A.M., Mexico City 07360, MexicoCentro de Investigación y de Estudios Avanzados del IPN, Av. Instituto Politécnico Nacional 2508, San Pedro Zacatenco, G.A.M., Mexico City 07360, MexicoChronic kidney disease (CKD) is a progressive pathology characterized by gradual function loss. It is accompanied by complications including cardiovascular disorders. This study involves 4-h electrocardiographic records from the Telemetric and Holter ECG Warehouse (THEW) project database to analyze the dynamics in heart rate variability (HRV) indices of 51 patients with CKD. It proposes three algorithms to process long-term electrocardiography records: QRS complex and R-wave detection, premature ventricular contraction (PVC) identification, and tachograms. PVCs were analyzed with the consideration of the changes occurring before, during, and after hemodialysis, especially during the interdialytic period. The hour with the highest PVCs occurrence was identified and used to assess HRV fluctuations and segmented into 5 min blocks with a 0.77 min overlap, yielding a dynamic HRV vector, one for each of seven HRV indices selected to evaluate autonomic nervous system balance. R-wave and PVC identification resulted in 97.53% and 85.83% positive predictive values, respectively. PVCs’ prevalence and HRV changes’ relationship in 48 h records could relate to cardiovascular risk. The stratification of hemodialysis patients into three distinct PVC patterns (<i>p</i> < 0.001) identified two clinically significant high-risk subgroups: Class 1, indicative of electrical instability, and Class 3, of advanced autonomic dysfunction, demonstrating divergent arrhythmogenic mechanisms with direct implications for risk stratification.https://www.mdpi.com/2076-3417/15/9/5122autonomic nervous system balancechronic kidney diseasedynamic heart rate variabilityinterdialytic periodpremature ventricular contractions patterns
spellingShingle Gabriel Vega-Martínez
Francisco José Ramos-Becerril
Josefina Gutiérrez-Martínez
Arturo Vera-Hernández
Carlos Alvarado-Serrano
Lorenzo Leija-Salas
Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
Applied Sciences
autonomic nervous system balance
chronic kidney disease
dynamic heart rate variability
interdialytic period
premature ventricular contractions patterns
title Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
title_full Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
title_fullStr Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
title_full_unstemmed Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
title_short Dynamic Heart Rate Variability Vector and Premature Ventricular Contractions Patterns in Adult Hemodialysis Patients: A 48 h Risk Exploration
title_sort dynamic heart rate variability vector and premature ventricular contractions patterns in adult hemodialysis patients a 48 h risk exploration
topic autonomic nervous system balance
chronic kidney disease
dynamic heart rate variability
interdialytic period
premature ventricular contractions patterns
url https://www.mdpi.com/2076-3417/15/9/5122
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