dc.contributor.author | Nelson, A | en_US |
dc.contributor.author | Otto, J | en_US |
dc.contributor.author | Whittle, J | en_US |
dc.contributor.author | Stephens, RCM | en_US |
dc.contributor.author | Martin, DS | en_US |
dc.contributor.author | Prowle, JR | en_US |
dc.contributor.author | Ackland, GL | en_US |
dc.date.accessioned | 2016-06-13T14:09:33Z | |
dc.date.available | 2016-01-12 | en_US |
dc.date.issued | 2016 | en_US |
dc.date.submitted | 2016-06-13T14:41:50.673Z | |
dc.identifier.issn | 2053-3624 | en_US |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/12835 | |
dc.description.abstract | OBJECTIVE: Reduced exercise capacity is well documented in end-stage chronic kidney disease (CKD), preceded by changes in cardiac morphology in CKD stage 3. However, it is unknown whether subclinical cardiopulmonary dysfunction occurs in CKD stage 3 independently of heart failure. METHODS: Prospective observational cross-sectional study of exercise capacity assessed by cardiopulmonary exercise testing in 993 preoperative patients. Primary outcome was peak oxygen consumption (VO2peak). Anaerobic threshold (AT), oxygen pulse and exercise-evoked measures of autonomic function were analysed, controlling for CKD stage 3, age, gender, diabetes mellitus and hypertension. RESULTS: CKD stage 3 was present in 93/993 (9.97%) patients. Diabetes mellitus (RR 2.49 (95% CI 1.59 to 3.89); p<0.001), and hypertension (RR 3.20 (95% CI 2.04 to 5.03); p<0.001)) were more common in CKD stage 3. Cardiac failure (RR 0.83 (95% CI 0.30 to 2.24); p=0.70) and ischaemic heart disease (RR 1.40 (95% CI 0.97 to 2.02); p=0.09) were not more common in CKD stage 3. Patients with CKD stage 3 had lower predicted VO2peak (mean difference: 6% (95% CI 1% to 11%); p=0.02), lower peak heart rate (mean difference:9 bpm (95% CI 3 to 14); p=0.03)), lower AT (mean difference: 1.1 mL/min/kg (95% CI 0.4 to 1.7); p<0.001) and impaired heart rate recovery (mean difference: 4 bpm (95% CI 1 to 7); p<0.001)). CONCLUSIONS: Subclinical cardiopulmonary dysfunction in CKD stage 3 is common. This study suggests that maladaptive cardiovascular/autonomic dysfunction may be established in CKD stage 3, preceding pathophysiology reported in end-stage CKD. | en_US |
dc.format.extent | e000370 - ? | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Open Heart | en_US |
dc.rights | CC-BY-NC | |
dc.subject | AUTONOMIC NERVOUS SYSTEM | en_US |
dc.subject | CARDIAC FUNCTION | en_US |
dc.subject | RENAL DISEASE | en_US |
dc.title | Subclinical cardiopulmonary dysfunction in stage 3 chronic kidney disease. | en_US |
dc.type | Article | |
dc.rights.holder | © 2016, British Medical Journal Publishing Group | |
dc.identifier.doi | 10.1136/openhrt-2015-000370 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/27127638 | en_US |
pubs.issue | 1 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 3 | en_US |
dcterms.dateAccepted | 2016-01-12 | en_US |
qmul.funder | Parasympathetic modulation of perioperative myocardial injury.::Royal College Of Anaesthetists/ British Journal of Anaesthesia | en_US |