QT interval dispersion in dialysis patients

Wu, Vin‐Cent; Lin, Lian‐Yu; Wu, Kwan‐Dun

doi:10.1111/j.1440-1797.2005.00391.x

Cited by 46 publications

(60 citation statements)

References 40 publications

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“…Prolongation of QT interval and increased QT dispersion in end stage renal disease are subjects of interest for a long time. Previously published articles mainly point out similar findings: these indices of sudden death on the surface ECG are significantly higher in patients receiving HD [6,14]. Hemodialysis itself is pro-arrhythmogenic, but also there is high variety of comorbidities in end stage renal disease patient population.…”

Section: Discussionmentioning

confidence: 58%

“…These indices mainly depend on the QT interval [6,7]. Prolongation of QT interval, dispersion of QT interval; which is calculated by extracting minimum measured QT interval from maximum measured QT interval, were widely utilized in many studies and were shown to be related with increased sudden death risk in HD patients [8][9][10][11][12][13][14]. Recent studies indicate that prolongation of the T wave peak to T wave end interval (Tp-e) on the 12-lead ECG is a marker of ventricular arrhythmogenesis [15][16].…”

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confidence: 99%

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Tp-e Interval and Tp-e/QT Ratio in Chronic Renal Failure Patients Requiring Hemodialysis

2016

Ann Clin Anal Med

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ÖzetAmaç: Kronik renal yetersizlik (KRY) ventriküler aritmi için ana etkenlerden birisidir. Kronik infilamasyon ve diğer faktörler aritmojenik yüzeyin oluşumuna katkıda bulunurlar. Çalışmamızın amacı hemodiyaliz uygulanan KRY hastalarında QT dispersiyonu, hastalarında T dalga zirve ile sonlanım noktası arası mesafe (Tp-e aralığı), Tp-e/QT oranı ve Tp-e/QTc oranını kullanarak ventrikü-ler repolarizasyonu değerlendirmekti. Gereç ve Yöntem: KRY nedeniyle hemodiyaliz tedavisi almakta olan 35 hastanın elektrokardiyogramları incelendi. T dalga zirve ile sonlanım noktası arası mesafe, QT süresi, düzeltilmiş QT sü-resi ve EKG aralıkları ölçüldü. Yaş ve cinsiyet uyumlu 30 sağlıklı kişinin elektrokardiyogramları ile karşılaştırıldı. Bulgular: KRY grubu ile kontrol grubu birbirlerinden hesaplanmış Tp-e (92.9±24.7 ya karşı 77.0±9.6, p=0.002), Tp-e/ QTc (0.20±0.0 a karşı 0.18±0.0, p=0.007) , QTd (58.9±45.6 ya karşı 27.3±7.6, p=0.001) ve Tp-e/QT (0.24±0.1 e karşı 0.21±0.0, p=0.034) açısından anlamlı derecede farklıydı. QTc (457.9±50.8 e karşı 436.4±43.1, p=0.077) ise her iki grupta da benzerdi. Tartışma: QTd, Tp-e, Tp-e/QT ve Tp-e/QTc repolarizasyonu kusurlarını gösteren oldukça yeni göstergelerdir. Bizim bulgularımız bu göstergelerin KRY nedeniyle hemodiyalize giren hastalarda ventriküler elektriksel kararsızlığın belirlenmesinde kullanılabileceğini göstermektedir. Anahtar KelimelerTp-e; Kronik Renal Yetersizlik; Hemodiyaliz; Aritmi Abstract Aim: Chronic renal failure (CRF) is a major factor for ventricular arrhythmia. Chronic inflammation and other factors contribute to formation of arrhythmogenic substrate. The aim of our study was to assess ventricular repolarization in CRF patients receiving hemodialysis, by using QT dispersion, T wave peak to T wave end interval (Tp-e interval), Tp-e/QT ratio, and Tp-e/QTc ratio. Material and Method: Electrocardiogram of 35 CRF patients receiving hemodialysis were studied. T wave peak to end interval, QT and corrected QT intervals and some other ECG intervals were measured. Electrocardiograms of age and sex matched 30 healthy individuals were also analyzed for comparison. Results: CRF group and control group were significantly different from each other for calculated p=0.002), Tp-e/ QTc (0.20±0.0 vs 0.18±0.0, p=0.007) , QTd (58.9±45.6 vs 27.3±7.6, p=0.001), and Tp-e/QT (0.24±0.1 vs 0.21±0.0, p=0.034)values. QTc (457.9±50.8 e karşı 436.4±43.1, p=0.077) values were similar in both groups. Discussion: QTd, Tp-e, Tp-e/QT and Tp-e/QTc are relatively new markers which also indicate repolarization defects. Our findings indicate that these new markers may be useful in determination of ventricular electrical instability in CRF patients receiving hemodialysis.

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Section: Discussionmentioning

confidence: 58%

mentioning

confidence: 99%

Tp-e Interval and Tp-e/QT Ratio in Chronic Renal Failure Patients Requiring Hemodialysis

2016

Ann Clin Anal Med

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“…On se izračunava pomoću Bazettove formule: QTc = , gde RR predstavlja dužinu između dve depolarizacije komora u milisekundama. Kod bolesnika na hemodijalizi QTc veći od 500 ms ukazuje na povećan rizik od komorskih poremećaja srčanog ritma (36,37). Standardni EKG pruža mogućnost da se proceni promenljivost trajanja QT intervala (disperzija QTc intervala).…”

Section: Otkrivanje Bolesnika Sa Povećanim Rizikom Od Iznenadne Srčanunclassified

“…Promenljivost korigovanog QTc intervala koristi se za procenu rizika od nastanka komorskih poremećaja srčanog ritma kod bolesnika na hemodijalizi. Promenljivost QTc intervala definiše se kao razlika između najdužeg i najkraćeg QTc intervala registrovanog standardnim elektrokardiogramom (36,37). Normalna promenljivost QTc intervala iznosi 40-50 ms. Kod bolesnika na hemodijalizi, kod kojih je promenljivost QTc intervala veća od 50 ms postoji povećan rizik od nastanka komorskih poremećaja srčanog ritma i iznenadne srčane smrti (36,37).…”

Section: Otkrivanje Bolesnika Sa Povećanim Rizikom Od Iznenadne Srčanunclassified

10.5937/mckg48-4123 = Diastolic heart failure in patients on hemodialysis: Etiopathogenesis, diagnostics and therapy

Nedeljković¹,

Miloradović²,

Radovanović³

et al. 2014

Medicinski casopis

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UVODBolesti srca su vodeći uzrok smrti bolesnika koji se leče redovnim hemodijalizama. Kod ovih bolesnika prisutni su brojni faktori rizika kao što su povišen arterijski krvni pritisak, poremećaj metabolizma lipida, oksidativni stres, mikroinflamacija, hiperhomocisteinemija, anemija, povećan protok krvi kroz vaskularni pristup za hemodijalizu, sekundarni hiperparatireoidizam, a koji su odgovorni za razvoj kardiovaskularnih komplikacija (1). Hipertrofija leve komore, ishemijska bolest srca i srčana slabost su najčešće kardiovaskularne komplikacije kod bolesnika na hemodijalizi (1, 2). PREGLED SAŽETAK

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“…These indices mainly depend on the QT interval [10,11] Prolongation of QT interval, dispersion of QT interval; which is calculated by extracting minimum measured QT interval from maximum measured QT interval, were widely utilized in many studies and were shown to be related with increased sudden death risk in HD patients [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Relationship between fibroblast growth factor and arrhythmogenesis in normotensive patients with polycystic kidney disease

Karaagac¹,

Yıldız²,

Yontar³

et al. 2015

Eur Res J

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Autosomal dominant polycystic kidney disease (ADPKD) is the most common life-threatening genetic disease [1]. Cardiovascular disease is the leading cause of morbidity and mortality in patients with ADPKD, with over 80% of deaths attributable to coronary artery disease [2,3]. Left ventricular hypertrophy (LVH) is common in these patients, even in the absence of hypertension [4,5]. LVH is also ABSTRACT 106Objectives. Autosomal dominant polycystic kidney disease (ADPKD) is the most common life-threatening genetic disease. Recent prospective studies showed a powerful and dose dependent association between increasing FGF-23 levels and greater risk of mortality among chronic kidney disease patients. In this study, our aim is to evaluate electrocardiogram derived arrhythmogenesis markers such as Tp-e, Tp-e/QT and Tpe/QTc ratio ADPKD. Methods. Data of 31 patients with ADPKD and age-sex matched 26 healthy were gained for study. Electrocardiogram and echocardiogram measurements, various serum markers were compared between groups. Results. FGF-23 was significantly higher, and eGFR was significantly lower in the ADPKD patients. Myocardial thickness was also higher in ADPKD group. Corrected QT dispersion, Tpe, Tp-e/QT and Tp-e/QTc were also compared between groups. All indicators were significantly worse in ADPKD group. In the correlation analyzes, FGF-23 was significantly correlated with Tp-e, Tp-e/QT and p=0.003; r=0.472, p<0.0001; r=0.442, p=0.001, respectively). Conclusions. In this occasion, we suggest that FGF-23, which probably accumulates ventricular electrical remodeling, may be helpful for risk stratification in patients with ADPKD when used with other indicators. Myocardial cell de-arrangement and electrical remodelling due to fibrosis are suggested mechanisms for this effect.

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QT interval dispersion in dialysis patients

Cited by 46 publications

References 40 publications

Tp-e Interval and Tp-e/QT Ratio in Chronic Renal Failure Patients Requiring Hemodialysis

Tp-e Interval and Tp-e/QT Ratio in Chronic Renal Failure Patients Requiring Hemodialysis

10.5937/mckg48-4123 = Diastolic heart failure in patients on hemodialysis: Etiopathogenesis, diagnostics and therapy

Relationship between fibroblast growth factor and arrhythmogenesis in normotensive patients with polycystic kidney disease

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