Journals / Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi / 2022 / Cilt: 9 - Sayı: 1

The Relation of Cardiac Repolarization Parameters with Clinical Findings in Hemodialysis Patients

Hemodiyaliz Hastalarında Kardiyak Repolarizasyon Belirteçlerinin Klinik Bulgularla İlişkisi

Pages
22–27
Publication Date
2022-04-29
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It is feasible to evaluate HD patients for ECG parameters and follow up those with prolonged repolarizations and comorbidities, especially DM.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Sudden cardiac death from arrhythmias is an important cause of mortality in chronic hemodialysis (HD) patients.
📊
Key Findings & Data:The study included 131 adult patients on maintenance HD, and 49 healthy individuals.
💡
Conclusion & Impact:It is feasible to evaluate HD patients for ECG parameters and follow up those with prolonged repolarizations and comorbidities, especially DM.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Diyabetes Mellitus · Hemodiyaliz · Kardiyak Repolarizasyon

Abstract

Sudden cardiac death from arrhythmias is an important cause of mortality in chronic hemodialysis (HD) patients. In this study, we aimed to investigate ventricular repolarization parameters on electrocardiogram (ECG) (QT, corrected QT (QTc), T peak-end (Tp-e), Tp-e/QT and Tp-e/QTc) and their possible relationships with clinical features in HD patients. The study included 131 adult patients on maintenance HD, and 49 healthy individuals. ECG repolarization parameters were recorded. In the HD group, clinical features were recorded along with blood samples and ECG recordings before a midweek HD session. QT and QTc were longer in the HD group (p=0.001, p<0.001). Tp-e values were not different among groups. HD patients with diabetes mellitus (DM), had longer QT and QTc intervals (p<0.001, p=0.001). These associations were still significant after regressions for age, sex, and comorbidities. HD patients with cardiovascular disease had longer QT intervals (p=0.033). QT and QTc were longer in HD patients. This might be an indicator of increased arrhythmia risk. The diagnosis of DM was associated with longer QT and QTc, adjusted for multiple confouners. It is feasible to evaluate HD patients for ECG parameters and follow up those with prolonged repolarizations and comorbidities, especially DM.

Özet

Kardiyak aritmilere bağlı ani ölüm, kronik hemodiyaliz (HD) hastaları için önemli bir mortalite nedenidir. Çalışmamızda HD hastalarında, aritmi riski ile ilişkili olabilecek elektrokardiyogram (EKG) repolarizasyon parametrelerinin (QT, düzeltilmiş QT (QTc), T peak-end (Tp-e), Tp-e/QT ve Tp-e/QTc) klinik özellikler ile olası ilişkilerini araştırdık. Çalışmaya kronik HD programında olan 131 erişkin hasta ve 49 sağlıklı birey alındı. Bütün katılımcıların EKG repolarizasyon parametreleri kaydedildi. HD grubunda klinik özellikler kaydedilirken, kan örnekleri ve EKG kayıtları hafta ortası rutin bir HD seansından önce alındı. HD grubunda QT ve QTc daha uzun bulundu (p=0.001, p<0.001). Gruplar arasında TP-e değerleri farklı bulunmadı. Diyabetes mellitus (DM) olan HD hastalarında, QT ve QTc aralıkları daha uzun bulundu (p<0.001, p=0.001). Bu ilişkiler yaş, cinsiyet ve komorbiditelerle yapılan regresyonlardan sonra anlamlılığını korudu. Kardiyovasküler hastalığı olan HD hastalarında QT mesafesi daha uzundu (p=0.033). HD hastalarında; QT ve QTc ölçümlerinin uzadığı görüldü. Bu durum artmış aritmi riskinin bir işareti olabilir. DM tanısı olanlarda çoklu değişkenlerle yapılan regresyonlardan sonra bile QT ve QTc değerleri anlamlı düzeyde uzundu. Kronik HD programındaki hastalarımızı EKG parametreleri açısından değerlendirmek, repolarizasyon ölçümlerinde uzama ve DM gibi komorbid durumları olanları takipte tutmak akılcı olabilir.

🔖

Cite This Article

KALKAN, S., ERKEN, E., OZTURK, İ., ALTUNÖREN, O., GÜNGÖR, Ö. (2022). The Relation of Cardiac Repolarization Parameters with Clinical Findings in Hemodialysis Patients. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, Cilt: 9 - Sayı: 1, 22–27. https://ajindex.com/articles/692201

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Herzog CA, Mangrum M, Passman R. Sudden cardiac death in dialysis patients. Semin Dial. 2008;21(4):300-7
  2. Alsheikh-Ali AA, Trikalinos TA, Ruthazer R, et al. Risk of arrhythmic and nonarrhythmic death in patients with heart failure and chronic kidney disease. Am Heart J. 2011;161(1):204-9
  3. Di Lullo L, Rivera R, Barbera V, et al. Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies. Int J Cardiol. 2016;15;217:16-27
  4. Secemsky EA, Verrier RL, Cooke G, et al. High prevalence of cardiac autonomic dysfunction and T-wave alternans in dialysis patients. Heart Rhythm. 2011;8(4):592–8
  5. Di Iorio B, Bellasi A. QT interval in CKD and haemodialysis patients. Clin Kidney J. 2013;6(2):137-43
  6. Wu VC, Lin LY, Wu KD. QT interval dispersion in dialysis patients. Nephrology (Carlton). 2005;10(2):109-12
  7. Monfared A, Assadian Rad M, Feizkhah M, et al. Comparison of tpe changing on ECG, in pre and post dialysis and post transplantation. Nephrourol Mon. 2016;8(3):e35864
  8. Hansen S, Rasmussen V, Torp-Pedersen C, et al. QT intervals and QT dispersion determined from a 12-lead 24-hour Holter recording in patients with coronary artery disease and patients with heart failure. Ann Noninvasive Electrocardiol. 2008;13(1):22-30
  9. Erken E, Altunoren O, Yildiz YS, et al. Evaluation of Cardiac Repolarization and Serum Electrolytes in Pre-Dialytic Stages of Chronic Kidney Disease. Turk Neph Dial Transpl. 2018;27(2):189-95
  10. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008;41(6):575-80
  11. National Kidney Foundation Hemodialysis Adequecy 2015 Work Group. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884-930
  12. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305
  13. Kestenbaum B, Rudser KD, Shlipak MG, et al. Kidney function, electrocardiographic findings, and cardiovascular events among older adults. Clin J Am Soc Nephrol. 2007;2(3):501-8
  14. Dobre M, Brateanu A, Rashidi A, et al. Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD. Clin J Am Soc Nephrol. 2012;7(6):949-56
  15. Hage FG, de Mattos AM, Khamash H, et al. QT prolongation is an independent predictor of mortality in end-stage renal disease. Clin Cardiol. 2010;33(6):361-66
  16. Antzelevitch