Incremental prognostic value of an abnormal baseline spatial QRS-T angle in chronic dialysis patients

Bie, Míhàly K. de; Koopman, M. G.; Gaasbeek, André; Dekker, Friedo W.; Maan, Arie C.; Swenne, Cees A.; Scherptong, Roderick W.C.; Dessel, Pascal F. van; Wilde, Arthur A.M.; Schalij, Martin J.; Rabelink, Ton J.; Jukema, J. Wouter

doi:10.1093/europace/eus306

Cited by 40 publications

(52 citation statements)

References 25 publications

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“…35,36) Moreover, repolarization abnormalities have been associated with SCD and all-cause mortality in patients on dialysis. 33) Patients on dialysis have a 10 to 20-fold higher risk of suffering from SCD than patients without CKD.…”

Section: )mentioning

confidence: 99%

Do Implantable Cardioverter Defibrillators Reduce Mortality in Patients With Chronic Kidney Disease at All Stages?

Zhou

Zhu

et al. 2017

Int. Heart J.

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SummaryThe benefits of implantable cardioverter defibrillator (ICD) implantation in chronic kidney disease (CKD) patients with high sudden cardiac death (SCD) risk are uncertain. To clarify the effects of receiving an ICD in CKD patients, we conducted this meta-analysis to identify the effects of ICDs on patients with CKD, including those on dialysis. We searched the Cochrane library, EMBASE, PubMed, and clinical trials for studies published before July 2016. Eleven studies including 20,196 CKD patients were considered for inclusion. The pooled analysis suggested that patients with an estimated glomerular filtration rate (eGFR) < 60 mL/minute/1.73 m 2 would benefit from receiving treatments with ICDs compared with patients without an ICD device (aHR = 0.77; 95% confidence interval [CI], 0.63 to 0.95). This is the first report of a subgroup analysis on the survival rate of ICD implantation in CKD patients according to an eGFR group. The subgroup analysis indicated a similar protective association of ICDs in stage 3 CKD patients (aHR = 0.71; 95%CI, 0.61 to 0.82) compared with the control group. However, there was no significant improvement in all-cause mortality in stage 4 CKD patients (aHR = 1.02; 95%CI, 0.75 to 1.37) or stage 5 CKD patients (aHR = 0.80; 95%CI, 0.60 to 1.31). This is the first meta-analysis reporting that ICD implantation reduces all-cause mortality in stage 3 CKD patients. However, the data do not indicate there is any benefit to ICD implantation in stage 4 or 5 CKD patients. (Int Heart J 2017; 58: 371-377)

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Section: )mentioning

confidence: 99%

Do Implantable Cardioverter Defibrillators Reduce Mortality in Patients With Chronic Kidney Disease at All Stages?

Zhou

Zhu

et al. 2017

Int. Heart J.

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“…4,5 Widening of the spatial QRS-T angle has been found to be an independent risk factor for cardiac events or mortality [6][7][8] in conditions like coronary artery disease, 9 systemic hypertension, 10 diabetes mellitus 11 and chronic kidney disease. 12 More recently it has also been thought to be associated with increased mortality even in apparently healthy individuals. 6.7 Estimation of the spatial QRS-T angle can be made in ECGs recorded using Frank's orthogonal X, Y and Z leads.…”

Section: Comparison Of the Spatial Qrs-t Angle Derived From Digital Ementioning

confidence: 99%

Comparison of the spatial QRS-T angle derived from digital ECGs recorded using conventional electrode placement with that derived from Mason-Likar electrode position

Salvi

Clark

Karnad

et al. 2016

Journal of Electrocardiology

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“…41 FQRSTA is a very powerful predictor of cardiovascular events (e.g., myocardial ischemia), 42 sudden cardiac death, [13][14][15][16][17]43 appropriate ICD therapy, 44,45 all-cause mortality, 15,[33][34][35][36][37] increased cardiac-related hospitalizations, 17,35 reduced left ventricular function, [34][35][36]46 especially in patients with postinfarction, [13][14][15][16][17] acute myocardial infarction with LVEF ࣘ40%, 47 the elderly, 12 chronic dialysis, [18][19][20] heart failure with preserved ejection fraction, 17 and ischemic stroke 48 considered stronger than any of the classical cardiovascular risk factors. 16,17 Risk factors leading to an elevation in FQRSTA were related to coronary artery disease, dialysis, poor-controlled hypertension, 49,50 pulmonary arterial hypertension, 51 left/right ventricular hypertrophy, 51-54 dilated left ventricle, 55 lower LVEF, 56 DM, 57, 58 smoking, [57][58][59] and female gender.…”

Section: Dm and Fqrstamentioning

confidence: 99%

Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus

Chen

Lin

et al. 2015

Ann Noninvasive Electrocardiol

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Aims: Research related to type 2 diabetes mellitus (DM) and parameters of electrocardiography (ECG) was limited. Patients with and without DM (NDM) were randomly enrolled in a study to exploit the influence of DM on planar QRS and T vectors derived from the Virtual Holter process.Methods: A total of 216 (NDM) and 127 DM patients were consecutively and randomly recruited. We selected a 1-minute length of ECG, which was scheduled for analysis at 4 AM. After a series of calculating algorisms, we received the virtual planar vector parameters.Results: Patients with DM were elderly (65.61 ± 12.08 vs 59.41 ± 16.86 years, P < 0.001); higher morbidity of hypertension (76.38% vs 58.14%, P < 0.001) and coronary artery disease (44.09% vs 32.41%, P = 0.03); thicker interventricular septum (10.92 ± 1.77 vs 10.08 ± 1.96 mm, P < 0.001) and left ventricular posterior wall (9.84 ± 1.38 vs 9.39 ± 1.66 mm, P = 0.03); higher lipid levels and average heart rate (66.67 ± 12.04 vs 61.87 ± 13.36 bpm, P < 0.01); higher angle of horizontal QRS vector (HQRSA, -2.87 ± 48.48 vs -19.00 ± 40.18 degrees, P < 0.01); lower maximal magnitude of horizontal T vector (HTV, 2.33 ± 1.47 vs 2.88 ± 1.89 mm, P = 0.01) and maximal magnitude of right side T vector (2.77 ± 1.55 vs 3.27 ± 1.92 mm, P = 0.03), and no difference in angle of frontal QRS-T vector (FQRSTA, 32.77 ± 54.20 vs 28.39 ± 52.87 degrees, P = 0.74) compared with patients having NDM. After adjusting for confounding factors, DM was significantly effective on FQRSTA (regression coefficient -40.0, 95%CI -66.4 to -13.6, P < 0.01), HQRSA (regression coefficient 22.6, 95%CI 2.5 to 42.8, P = 0.03), and HTV (regression coefficient 0.9, 95%CI 0.2 to 1.7, P = 0.01). Confounding

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Incremental prognostic value of an abnormal baseline spatial QRS-T angle in chronic dialysis patients

Abstract: In chronic dialysis patients the spatial QRS-T angle is a significant and independent predictor of all-cause and especially sudden cardiac death. It implies that this parameter can be used to identify high risk patients.

Cited by 40 publications

References 25 publications

Do Implantable Cardioverter Defibrillators Reduce Mortality in Patients With Chronic Kidney Disease at All Stages?

Do Implantable Cardioverter Defibrillators Reduce Mortality in Patients With Chronic Kidney Disease at All Stages?

Comparison of the spatial QRS-T angle derived from digital ECGs recorded using conventional electrode placement with that derived from Mason-Likar electrode position

Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus

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