BACKGROUND: @entity65 mortality among @entity1 with @entity454 ( @entity454 ) exceeds that which is predicted by traditional risk factors. @entity944 accounts for up to 15-38% of @entity1 with @entity454 found dead at home. Heart rate variability (HRV) is a reliable measure of autonomic modulation and has a very strong predictive value for @entity943 and @entity944 . A lower HRV is associated with increased risk. Modifying autonomic tone pharmacologically reduces @entity204 from @entity943 in the general population but has not been studied in @entity454 . METHODS: We examined the effect of @entity3372 , an @entity1289 inhibitor (ACEI) known in the general population to increase HRV, on cardiac function and heart rate variability in @entity1 with @entity177 . Eligible subjects on haemodialysis underwent a 2-week washout period free of ACEI or beta blockers, during which time @entity101 was treated with @entity3591 , which has been shown not to affect HRV. Haemodynamic and HRV measurements were obtained at baseline and after subjects were treated for 4 weeks with an ACEI. RESULTS: Haemodynamics did not differ at 0 and 4 weeks. Baseline HRV values were markedly below those found in the general population, indicating pronounced predominance of sympathetic tone over vagal tone. Actual worsening of HRV with ACEI treatment was evident in several major time domains. The time domain SDNN (the standard deviation of all normal RR intervals) fell from 42.0 +/- 24.8 ms to 20.1 +/- 16.1 ms (P = 0.004) and the triangulation index fell from 178.0 +/- 94.0 to 115 +/- 59.2 (P = 0.01). A trend toward reduced HRV was seen in several other time domains. CONCLUSION: These findings suggest that, unlike the general population, treatment of @entity454 @entity1 with an @entity1289 inhibitor may cause a deleterious shift toward increased cardiac sympathetic nervous system tone.

Influence of @entity1289 inhibitor treatment on cardiac autonomic modulation in XXXX receiving haemodialysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3372 :: ('MESH:D017257', 'Chemical') :: ['ramipril'] @entity1289 :: ('1636', 'Gene') :: ['angiotensin converting enzyme'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity944 :: ('MESH:D003645', 'Disease') :: ['sudden death', 'Sudden death'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity3591 :: ('MESH:D017311', 'Chemical') :: ['amlodipine'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity943 :: ('MESH:D001145', 'Disease') :: ['dysrhythmia', 'ventricular arrhythmias'] @entity65 :: ('MESH:D002318', 'Disease') :: ['Cardiovascular disease'] @entity454 :: ('MESH:D007676', 'Disease') :: ['ESRD', 'end stage renal disease']
@entity1 :: (9606,Species) :: ['patients']
