The Impact of Hemodialysis on the Dispersion of Ventricular Repolarization

Kalantzi, Kallirroi; Gouva, Chara; Letsas, Κonstantinos P.; Vlachopanou, Aphrodite; Foulidis, V.; Bechlioulis, Aris; Katopodis, Konstantinos P.; Goudevenos, John; Korantzopoulos, Panagiotis

doi:10.1111/pace.12066

Cited by 15 publications

(10 citation statements)

References 34 publications

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“…found that both intervals were increased in duration after a single hemodialysis session. 17 Prolongation of TpTe or TpTe/QT was not associated with changes in electrolytes, which suggest that the changes in TpTe were not related to the large electrolyte shifts that routinely occur in patients receiving hemodialysis. Other authors have examined the effect of hemodialysis on QT dispersion, which is another marker of the dispersion of ventricular repolarization.…”

Section: Discussionmentioning

confidence: 95%

“… 15 , 16 Although hemodialysis has been shown to prolong the TpTe interval, no study have examined the predictive ability of a baseline TpTe interval in patients with ESRD. 17 We hypothesized that TpTe and TpTe/QT are independent risk factors for SCD in ESRD. The aim of this study was to assess the prognostic value of TpTe and TpTe/QT for SCD in ESRD patients, independent of the mechanism for prolongation of the TpTe interval.…”

Section: Introductionmentioning

confidence: 99%

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TpTe and TpTe/QT: novel markers to predict sudden cardiac death in ESRD?

et al. 2019

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

TpTe and TpTe/QT: novel markers to predict sudden cardiac death in ESRD?

et al. 2019

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“…[ 39 ], Tp-e was reported to be increased in the patients with ESRD, compared to the controls. In another study reporting no changes in QTc interval and QT dispersion, it was reported that Tp-e interval and Tp-e/QT ratio increased after hemodialysis and also speculated that hemodialysis induced ventricular arrythmias [ 40 ]. Because the number of studies is too limited, we consider that no speculation can be made on Tp-e interval and Tp-e/QT ratio in the patients with CKD and that these entities should be supported with novel studies with larger sample size.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Objective: The risks of sudden death and cardiac arrhythmia are increased in patients with chronic kidney disease (CKD). Here, we aimed to evaluate the indicators of arrhythmias, such as p-wave dispersion (P-WD), QTc dispersion, Tp-e and Tp-e/QT ratio in patients with CKD stages 3–5 on no renal replacement therapy (RRT).Material and methods: One-hundred and thirty three patients with CKD stages 3–5 and 32 healthy controls were enrolled into the study. No patients received RRT. QTc dispersion, P-WD and Tp-e interval were measured using electrocardiogram and Tp-e/QT ratio was also calculated.Results: Mean age rates were found similar in patients and controls (60.8 ± 14.2 and 61 ± 12.9 y, p = .937, respectively). Compared patients with controls, P-WD (45.85 ± 12.42 vs. 21.17 ± 6.6 msec, p < .001), QTc-min (366.99 ± 42.31 vs. 387.15 ± 20.5 msec, p < .001), QTc dispersion (71.13 ± 27.95 vs. 41.25 ± 14.55 msec, p < .001), Tp-e maximum (81.04 ± 10.34 vs. 75.49 ± 10.9 msec, p < .001), Tp-e minimum (62.25 ± 7.58 vs. 54.8 ± 6.72 msec, p < .001) and Tp-e/QTc ratio (0.19 ± 0.02 vs. 0.18 ± 0.01, p = .001) were found to be different. QTc-max and Tp-e interval were found to be similar in both groups.Conclusion: P-WD and QTc dispersion, Tp-e interval and Tp-e/QTc ratio were found to be increased in with CKD stages 3–5 on no RRT.

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“…Approximately half of these deaths are likely triggered by fatal arrhythmia (ventricular tachycardia/fibrillation), superimposed on susceptible substrates with myocardial ischemia or systolic dysfunction ( Wang et al, 2010 ). Furthermore, electrocardiographic alterations, such as QTc interval alterations and repolarization dispersions, have been reported to be pathogenic in ventricular arrhythmia among chronic hemodialysis patients, serving as potential risk factors for SCD ( Kalantzi et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Frailty severity is significantly associated with electrocardiographic QRS duration in chronic dialysis patients

Chao

Huang

2015

PeerJ

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End-stage renal disease (ESRD) patients are at increased risk of sudden cardiac death, the risk of which is presumably related to arrhythmia. Electrocardiographic (ECG) parameters have been found to correlate with arrhythmia and predict cardiovascular outcomes in ESRD patients. Frailty is also a common feature in this population. We investigate whether the severity of dialysis frailty is associated with ECG findings, including PR interval, QRS duration, and QTc interval. Presence and severity of frailty was ascertained using six different self-report questionnaires with proven construct validity. Correlation analysis between frailty severity and ECG was made, and those with significant association entered into multiple regression analysis for confirmation. Among a cohort of chronic hemodialysis patients, we found that frailty severity, assessed by the Edmonton frailty scale, is significantly associated with QRS duration (r = − 0.3, p < 0.05). Dialysis patients with QRS longer than 120 ms had significantly lower severity of frailty than those with QRS less than 120 ms (p = 0.01 for the Edmonton frailty scale and 0.05 for simple FRAIL scale). Regression analysis showed that frailty severity, assessed by the Edmonton frailty scale and simple FRAIL scale, was significantly associated with QRS duration independent of serum electrolyte levels. In conclusion, a significant relationship exists between the severity of frailty and QRS duration in ESRD patients. This might be an under-recognized link between frailty and its adverse cardiovascular impact in these patients.

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The Impact of Hemodialysis on the Dispersion of Ventricular Repolarization

Cited by 15 publications

References 34 publications

TpTe and TpTe/QT: novel markers to predict sudden cardiac death in ESRD?

TpTe and TpTe/QT: novel markers to predict sudden cardiac death in ESRD?

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

Frailty severity is significantly associated with electrocardiographic QRS duration in chronic dialysis patients

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