The assessment of P-wave dispersion and myocardial repolarization parameters in patients with chronic kidney disease

Kollu, Korhan; Altıntepe, Lütfullah; Duran, Cevdet; Topal, Mustafa; Ecirli, Şâmil

doi:10.1080/0886022x.2017.1419962

Cited by 8 publications

(18 citation statements)

References 40 publications

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“…The study of Deo et al 17 included 3587 CKD participants and demonstrated that increased heart rate, prolongation of PR and QTc intervals, and increased QRS duration were independent risk factors for cardiovascular death. Kollu et al 2 showed that PWD, QTc dispersion, Tp‐e interval, and Tp‐e/QTc ratio increased with CKD stages 3‐5 compared with healthy controls. Sherif et al 19 showed that retrospective analysis of 154 patients, the advancement of CKD resulted the important prolongation of QTc interval, independent of age, gender, and electrolyte abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of cardiovascular mortality and arrhythmias may be changed with different treatment modalities in patients with CKD 2 . Several studies have demonstrated that hemodialysis (HD) affects a variety of electrolyte, fluid, and acid–base parameters, as well as electrocardiography (ECG) results 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Cardiovascular diseases (CVD) are the major cause of morbidity and mortality in patients with CKD 1 . Coronary artery disease, heart failure, pericarditis, atrial fibrillation (AF), and arrhythmias are the most common CVD causing death as a result of CKD 1,2 . Increased risk factors such as diabetes mellitus (DM), hypertension, hyperlipidemia, left ventricular hypertrophy, myocardial fibrosis, arterial stiffness, progression of atherosclerosis, and changes in the concentrations of serum electrolytes are the main contributing factors 1,2 …”

Section: Introductionmentioning

confidence: 99%

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Effect of dialysis and transplantation on myocardial repolarization parameters and P‐wave dispersion in chronic kidney disease

Akçay

Yildirim

2021

Journal of Arrhythmia

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Background Chronic kidney disease (CKD) patients are at higher risk for cardiac arrhythmias. The risk of arrhythmia may change with different treatment modalities. We proposed to compare the effects of varied therapy methods on myocardial repolarization parameters (Tp‐e, QT, QTc intervals, Tp‐e/QT, Tp‐e/QTc ratios) and P‐wave dispersion (PWD) in patients with CKD. Methods Three groups were formed from the patients aged between 18 and 65 years, as Group 1 consisting of CKD patients receiving hemodialysis (HD) three times a week, Group 2 consisting of predialysis CKD patients and Group 3 consisting of CKD patients who underwent successful transplantation. All patients’ basic demographic data, risk factors, and echocardiographic parameters were recorded, and electrocardiographic repolarization parameters and PWD were analyzed. Results The PR, QT, and QTc intervals were significantly shorter in the transplantation group compared to the other groups (P = .020, P < .001, P = .035; respectively). Tp‐e interval, Tp‐e/QT, and Tp‐e/QTc ratios were significantly higher in the predialysis group compared to the other groups (P < .001, P < .001, P = .001; respectively), while there was no significant variation between the HD and transplantation groups (P > .05). PWD was significantly increased in the predialysis group compared to other two groups (P < .001), while no significant variation between the HD and transplantation groups was observed. Conclusion We found that the Tp‐e interval, Tp‐e/QT, Tp‐e/QTc, and PWD were significantly higher in the predialysis CKD group, but the PR, QT, and QTc intervals were significantly shorter in the transplantation group compared to the other groups. The prognostic significance and prediction of these parameters in arrhythmic events in CKD patients requires further evaluation with long‐time follow‐up.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of dialysis and transplantation on myocardial repolarization parameters and P‐wave dispersion in chronic kidney disease

Akçay

Yildirim

2021

Journal of Arrhythmia

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“…So far, many studies which keep duplicating the same erroneous methodology and keep reproducing the same erroneous results have been carried out. For the clarity of the presentation, the data was gathered in Table 1 [17][18][19][20][21][22][23][24].…”

Section: The Followersmentioning

confidence: 99%

Dlaczego załamek P powinien być dokładnie mierzony?

Zawadzki

Radziejewska

et al. 2021

Folia Cardiologica

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The electrophysiological activity of the heart is recorded and presented in form of electrocardiogram (ECG). In 1998 the concept of the P-wave dispersion as the risk factor for atrial fibrillation recurrence was introduced. The presented review aims to prove the P-wave dispersion is an artifact of low accuracy in P-wave measurement, basing on the overview of the publications and the own research in this field. By comparing and contrasting various publications on this topic, the authors observed that it was the imprecise measurement method that resulted in different durations of all P-wave parameters in contrast with the precise measurements. It was indicated that the value of the imprecise P-wave dispersion correlated highly with the maximal P-wave duration measured similarly. In contrast with the imprecise measurement method the minimal and the maximal duration of the P-waves, measured accurately, were almost identical. The studies and the methodological considerations indicate that the P-wave dispersion is a derivative of the imprecise measurement of the ECG recording, inconsistent with the physics rules describing the flow of electric current. The results confirm the authors' observation that the precise measurement of the P-wave makes the phenomenon of dispersion no longer exists. Unfortunately, only a few researchers dare to question the phenomenon of the P-wave dispersion. The discussion should continue, because the P-wave parameters are the data of great importance, as they reflect the dimensions of the atria, electrical conductivity and the condition of the muscle.

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“…Then P duration was measured with the distance between the beginning of the P-wave deflection from the isoelectric baseline and the returning of the P-wave offset to the isoelectric baseline on the six ECG leads (I, II, III, aVR, aVL, aVF) at five cardiac cycles. P d was assessed based on the mean value obtained by the differences between P min and P max values of the P-wave from the five measurements (Noszczyk-Nowak et al 2008;Noszczyk-Nowak et al 2011;Okutucu et al 2016;Kollu et al 2018). The P d dispersion was calculated based on the measurements using computerised methods with a software program (BTL Cardiopoint, Ankara, Turkey).…”

Section: Evaluation Of P-wave Dispersionmentioning

confidence: 99%

P-wave dispersion and renal biomarkers in canine visceral leishmaniasis stage III and IV infected dogs

Erdoğan¹,

Erdoğan²,

Paşa³

et al. 2020

Vet. Med. - Czech

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Canine visceral leishmaniasis is a protozoan disease affecting most vital organs and also causing myocardial and/or renal damage. P-wave dispersion, a newly used non-invasive ECG indicator, is used to follow atrial arrhythmias, atrial fibrillation, valvular disease in both human and veterinary medicine. The purpose of this study involving Canine Visceral Leishmaniasis (CVL)-infected dogs in stage III and IV was to verify whether the P-wave dispersion was related to the renal failure. For this purpose, a total of 17 dogs of different ages, both sexes, comprising eleven animals with CVL (at stage III and IV) diagnosed using a rapid ELISA (enzyme-linked immunosorbent assay) test and serological IFAT (immunofluorescence.antibody titres) and six healthy dogs used as controls were enrolled. Significant differences between the P-wave dispersion (regarding the mean values) of the control, stage III and IV-infected groups (P = 0.003) were detected as follows: 21.8 ± 0.5, 20.6 ± 1.2 and 25.0 ± 0.4 ms, respectively. The P-wave dispersion value was moderately longer in the stage IV-infected group compared with the control one (P = 0.022), however, the aforementioned relationship was determined as significant between the stage IV and III-infected groups (P = 0.003). Regarding all of the biomarkers of the renal function monitored within this study, there were differences between the control and stage IV-infected group for the creatinine (P = 0.002), the control and stage IV-infected group for the urine protein/creatinine ratio (P < 0.001), and the stage III and stage IV-infected groups for the urine protein/creatinine ratio (P < 0.001). In conclusion, an increased P-wave dispersion was not associated with renal failure. It might be related to the limitation of our study including small sample sizes in the groups. Therefore, the cardiac indicators were not analysed. For more accurate results, it is desirable to perform further studies including a larger sample size along with an investigation of the cardiac and renal indicators.

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The assessment of P-wave dispersion and myocardial repolarization parameters in patients with chronic kidney disease

Cited by 8 publications

References 40 publications

Effect of dialysis and transplantation on myocardial repolarization parameters and P‐wave dispersion in chronic kidney disease

Effect of dialysis and transplantation on myocardial repolarization parameters and P‐wave dispersion in chronic kidney disease

Dlaczego załamek P powinien być dokładnie mierzony?

P-wave dispersion and renal biomarkers in canine visceral leishmaniasis stage III and IV infected dogs

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