Relationship between Coefficient of Variation of R-R Intervals in ECG and Skin Perfusion Pressure in Maintenance Hemodialysis Patients

Abstract

　Maintenance dialysis patients are known to have a high prevalence of peripheral arterial disease（PAD）. Skin perfusion pressure（SPP）, a method to evaluate blood flow in the lower extremities, is used to diagnose PAD, but it is difficult to test all patients. On the other hand, autonomic neuropathy is associated with arteriosclerosis and can be measured by the coefficient of variation of R-R intervals（CVRR）measured by electrocardiography. We conducted a cross-sectional study of the association between CVRR and SPP in maintenance hemodialysis patients. The subjects were maintenance hemodialysis patients（n=65）attending our hospital. ROC analysis was performed for CVRR and complications of foot lesions, such as ulcers, and the cutoff value for CVRR was set at 1.42. The subjects were classified into a normal CVRR group（CVRR \u00002265 1.42）and a low CVRR group（CVRR < 1.42）. The SPP of the low CVRR group（51.9 mmHg）was significantly lower than that of the normal CVRR group（73.1 mmHg）（p < 0.001）. These findings suggest that CVRR is associated with SPP and that CVRR may be useful as an additional indicator for the diagnosis of PAD.