Erişkin kronik hemodiyaliz hastalarında asemptomatik EKG değişiklikleri ve ilişkili faktörler

ECG alterations and related factors in asymptomatic chronic hemodialysis patients

Özet

AMAÇ: Düzenli HD hizmeti veren kurumlarda, kardiyovasküler hastalık açıdan asemptomatik HD hastalarında EKG bulgularını değerlendirmek ve ilişkili faktörleri belirlemek.GEREÇ ve YÖNTEMLER: Çalışmaya 10 ayrı HD merkezinde tedavi gören 545 HD hastası alındı. Angina pektoris, belgelenmiş koroner arter hastalığı ve kalp yetmezliği olan hastalar çalışma dışı bırakıldı. Hastaların son 3 ay içinde çalışılmış olan; tam kan sayımı, kan biyokimyasal testleri, lipid profili sonuçlarının ortalamaları hesaplandı ve istatistiksel değerlendirmede kullanıldı. Tüm hastalarda, 12 derivasyonlu 25 mm/sn hızla standart elektrokardiyogram elde edildi. BULGULAR: Hastaların 274'ünde (%50,2) P-mitrale, 249'ünde (%45,6) klasik iskemik T-dalgaları, 90'ında (%16,5) sol ventrikül hipertrofisi (SVH) voltaj ölçütü, 88'inde (%16,1) ritm bozukluğu, 83'ünde (%15,2) dal bloğu belirlendi. Bu anormalliklerden özellikle iskemik T-dalga değişiklikleri (p

Abstract

OBJECTIVE: We aimed to evaluate the ECG findings in asymptomatic HD patients for CVD, and to determine related factors with these findings.MATERIAL and METHODS: 545 maintenance HD patients treated at 10 different HD centers were included. The patients with angina pectoris, documented coronary artery disease, heart failure, and chronic obstructive pulmonary disease were excluded. The mean complete blood count, blood biochemical tests, and lipid profile obtained in the last three months were recorded. Standard 12-derivation ECG with 25 mm/sec speed was performed in all patients. RESULTS: P-mitrale was found in 274 patients (50.2%), ischemic T wave alterations were found in 249 patients (45.6%), left ventricular hypertrophy was found in 90 patients (16.5%), arrhythmia was found in 88 patients (16.1%), and bundle branch block was found in 83 patients (15.3%). These abnormalities, especially ischemic T wave alterations and SVH, were determined more frequently in diabetic patients and patients with lower hemoglobin level. We did not observe any differential diagnostic attempts for these alterations in last three months. CONCLUSION: ECG abnormalities are prevalent in asymptomatic HD patients. Surprisingly, whether these abnormalities result from cardiovascular disease or not has not been investigated by medical teams. We concluded that this behavior may due to the symptom-free condition, or perception of HD treatment as a routine treatment method.