The effect of the physical activity on polymorphic premature ventricular complexes in chronic kidney disease.
10.23876/j.krcp.2017.36.2.167
- Author:
Márcio G KIUCHI
1
;
Shaojie CHEN
Author Information
1. Division of Cardiac Surgery and Artificial Cardiac Stimulation, Department of Medicine, Hospital e Clínica São Gonçalo, São Gonçalo, RJ, Brazil. marciokiuchi@gmail.com
- Publication Type:Original Article
- Keywords:
β blocker;
Physical activity;
Polymorphic premature ventricular complexes;
Sympathetic hyperactivity;
Ventricular arrhythmias
- MeSH:
Arrhythmias, Cardiac;
Creatinine;
Electrocardiography, Ambulatory;
Follow-Up Studies;
Heart Diseases;
Heart Rate;
Humans;
Hypertension;
Motor Activity*;
Obesity;
Physical Examination;
Renal Insufficiency, Chronic*;
Sleep Apnea Syndromes;
Ventricular Premature Complexes*
- From:Kidney Research and Clinical Practice
2017;36(2):167-174
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Polymorphic premature ventricular complexes (PVCs) are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Endurance exercise training clearly lowers sympathetic activity in sympatho-excitatory disease states and may be tolerated by patients with chronic kidney disease (CKD). METHODS: We assessed 40 CKD patients with hypertension with polymorphic PVCs. Patients underwent a complete medical history and physical examination. We evaluated the effectiveness of β blocker only or β blocker + exercise during 12 months of follow-up regarding the changes of the numbers of PVCs and mean heart rate (HR) by 24-hour-Holter. RESULTS: We observed in the β blocker group a significant decrease in the number of polymorphic PVCs from baseline 36,515 ± 3,518 to 3, 6, 9 and 12 months of follow-up, 28,314 ± 2,938, 23,709 ± 1,846, 22,564 ± 1,673, and 22,725 ± 1,415, respectively (P < 0.001). In the β blocker + exercise group a significant decrease in the number of polymorphic PVCs also occurred from baseline 36,091 ± 3,327 to 3, 6, 9 and 12 months of follow-up, 29,252 ± 3,211, 20,948 ± 2,386, 14,238 ± 3,338, and 6,225 ± 2,319, respectively (P < 0.001). Comparisons between the two groups at the same time point showed differences from the sixth month onwards: the 6th (Δ = −2,761, P = 0.045), 9th (Δ = −8,325, P < 0.001) and 12th (Δ = −16,500, P < 0.001) months. There was an improvement during the 12 months of follow-up vs. baseline, after the β blocker or β blocker + exercise in mean 24-hour HR Holter monitoring, creatinine values, eGFR, and ACR. CONCLUSION: Polymorphic PVCs may be modifiable by physical activity in CKD patients with hypertension without structural heart disease.
