Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease

Sivri, Serkan; Çelik, Mustafa

doi:10.1016/j.jelectrocard.2019.03.011

Cited by 25 publications

(23 citation statements)

References 28 publications

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“…In our study, both pre-HD and post-HD Tpe and Tpe/QTc values were significantly higher in the HD group than in the control group. Also, as in previous studies (21,22), the values were significantly increased after HD. Tpe prolongation has also been reported in type 2 diabetes mellitus (23), hypertrophic cardiomyopathy (24), and subclinical hypothyroidism (25).…”

Section: Discussionsupporting

confidence: 89%

An Evaluation of Tp-e Interval and its Associations with Electrolyte Imbalances in the Electrocardiography of Elderly Patients on Hemodialysis

Candemir

Demir²,

Candemir³

et al. 2021

Anadolu Kliniği Tıp Bilimleri Dergisi

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Aim: Sudden cardiac death (SCD) due to arrhythmias is a major cause of death in elderly patients on hemodialysis (HD). It has been found that prolonged Tp-e interval (Tpe) on electrocardiography (ECG) and increased Tpe/QTc ratio are strongly associated with SCD. In this study, we aimed to investigate the effects of changes in serum electrolyte levels on the pre-and post-HD ECG parameters, particularly Tpe. Methods: The study included 160 HD patients (with no disease or medication known to affect the QT interval) and 80 age-and sex-matched controls with normal kidney functions. All participants were aged 55 years or older. Pre-and post-HD serum electrolyte values and ECG recordings were obtained. The heart rate, QRS interval, QTc, Tpe, and Tpe/QTc values were calculated. The pre-HD data were compared with the post-HD data as well as with controls. Results: The pre-and post-HD Tpe (p<0.001 for both comparisons) and Tpe/QTc (p=0.024 and p<0.001, respectively) values were significantly higher in the HD group than in the control group. The post-HD Tpe and Tpe/QTc values were significantly increased compared to the pre-HD values (p<0.001 for each comparison). The pre-HD Tpe was longer in patients with hypocalcemia or hyperphosphatemia than in normocalcemic and normophosphatemic patients (p=0.04 for both datasets). ΔTpe was significantly correlated with Δcalcium (r=-0.19, p=0.02) and Δphosphorus (r=-0.23, p=0.004). Conclusion:In the elderly patients on HD, Tpe, which was prolonged before HD, was even more prolonged after HD. Hypocalcemia and hyperphosphatemia may be among the underlying factors.

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Section: Discussionsupporting

confidence: 89%

An Evaluation of Tp-e Interval and its Associations with Electrolyte Imbalances in the Electrocardiography of Elderly Patients on Hemodialysis

Candemir

Demir²,

Candemir³

et al. 2021

Anadolu Kliniği Tıp Bilimleri Dergisi

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“…Of interest, several studies have reported that ECG can be affected by various extracardiac diseases. For example, ventricular repolarization was altered by hemodialysis [ 26 ], prolonged QTc was observed in end-stage liver disease [ 27 , 28 ] and non-alcoholic fatty liver disease [ 29 ], ST segment and T waves can be altered in acute cholecystitis [ 30 ], ST depression, left ventricular hypertrophy, prolonged QTc, and T wave inversion were observed in patients with intracranial hemorrhage [ 31 , 32 ], other ECG abnormalities were reported in patients with brain injury and stroke [ 31 ], and higher heart rate, prolonged QTc, and low voltage was observed in patients with thyroid dysfunction [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of biological age and all-cause mortality by 12-lead electrocardiogram in patients without structural heart disease

et al. 2021

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Background There is a well-established relationship between 12-lead electrocardiogram (ECG) and age and mortality. Furthermore, there is increasing evidence that ECG can be used to predict biological age. However, the utility of biological age from ECG for predicting mortality remains unclear. Methods This was a single-center cohort study from a cardiology specialized hospital. A total of 19,170 patients registered in this study from February 2010 to March 2018. ECG was analyzed in a final 12,837 patients after excluding those with structural heart disease or with pacing beats, atrial or ventricular tachyarrhythmia, or an indeterminate axis (R axis > 180°) on index ECG. The models for biological age were developed by principal component analysis (BA) and the Klemera and Doubal’s method (not adjusted for age [BAE] and adjusted for age [BAEC]) using 438 ECG parameters. The predictive capability for all-cause death and cardiovascular death by chronological age (CA) and biological age using the three algorithms were evaluated by receiver operating characteristic analysis. Results During the mean follow-up period of 320.4 days, there were 55 all-cause deaths and 23 cardiovascular deaths. The predictive capabilities for all-cause death by BA, BAE, and BAEC using area under the curves were 0.731, 0.657, and 0.685, respectively, which were comparable to 0.725 for CA (p = 0.760, 0.141, and 0.308, respectively). The predictive capabilities for cardiovascular death by BA, BAE, and BAEC were 0.682, 0.685, and 0.692, respectively, which were also comparable to 0.674 for CA (p = 0.775, 0.839, and 0.706, respectively). In patients aged 60–74 years old, the area under the curves for all-cause death by BA, BAE, and BAEC were 0.619, 0.702, and 0.697, respectively, which tended to be or were significantly higher than 0.482 for CA (p = 0.064, 0.006, and 0.005, respectively). Conclusion Biological age by 12-lead ECG showed a similar predictive capability for mortality compared to CA among total patients, but partially showed a significant increase in predictive capability among patients aged 60–74 years old.

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“…There are limited data about iCEB according to the literature. Sivri et al 26 demonstrated elevated iCEB levels after hemodialysis that indicate an increased risk of TdP-mediated ventricular arrhythmia. In another study, no significant relationship between the iCEB and the degree of coronary collateral circulation in patients with chronic total occlusion was shown27 .…”

Section: Discussionmentioning

confidence: 99%

Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism

Alsancak

Sahın

Gürbüz

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT. First, the high-risk APE patients’ ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups’ ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group ( P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group ( P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio ( P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P -value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT ( P -value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT. It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.

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Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease

Cited by 25 publications

References 28 publications

An Evaluation of Tp-e Interval and its Associations with Electrolyte Imbalances in the Electrocardiography of Elderly Patients on Hemodialysis

An Evaluation of Tp-e Interval and its Associations with Electrolyte Imbalances in the Electrocardiography of Elderly Patients on Hemodialysis

Prediction of biological age and all-cause mortality by 12-lead electrocardiogram in patients without structural heart disease

Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism

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