Dataset Information

Changes in QTc interval in long-term hemodialysis patients.

ABSTRACT: BACKGROUND:Cardiovascular diseases, including sudden cardiac death (SCD), are the leading cause of death in hemodialysis (HD) patients. A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for SCD in HD patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged along with dialysis vintage. METHODS:A total of 102 HD patients were retrospectively studied. Their ECG data were analyzed at 1, 4, and 7 years after HD initiation. The control group comprised 68 age-matched individuals who had normal renal function and two available ECG reports at an interval of more than 4 years. QTc was measured according to the Bazett formula. The association between QTc interval and dialysis vintage was studied. Additionally, clinically relevant variables related to QTc duration at 1 year after HD initiation were assessed. RESULTS:Average QTc interval at 4 and 7 years after HD initiation was significantly longer than that at 1 year after HD initiation (443, 445, and 437 ms) (p<0.05). On the other hand, QTc interval in the control group was 425 ms in the first year and 426 ms after an average of 6 years. They had no significant differences, although they were much shorter than that in HD patients. Multivariate regression analysis of baseline variables revealed that the corrected calcium levels (p = 0.041) and diabetes (p = 0.043) were independently associated with longer QTc interval. CONCLUSIONS:The QTc interval at 1 year after HD initiation was longer than in the control subjects and was prolonged over several years of HD treatment. Providing clinical management with a focus on QTc interval may be helpful for reducing the incidence of SCD in HD patients.

SUBMITTER: Matsumoto Y

PROVIDER: S-EPMC6317809 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Changes in QTc interval in long-term hemodialysis patients.

Matsumoto Yoshihiro Y Mori Yasuo Y Kageyama Shinji S Arihara Kazuo K Sato Hidemaro H Nagata Kijun K Shimada Yasushi Y Nojima Yohichi Y Iguchi Koichiro K Sugiyama Toshikazu T

PloS one 20190103 1

<h4>Background</h4>Cardiovascular diseases, including sudden cardiac death (SCD), are the leading cause of death in hemodialysis (HD) patients. A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for SCD in HD patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged along with dialysis vintage.<h4>Methods</h4>A total of 102 HD patients were retrospectively studied. Their ECG data were analyzed at 1, 4, and 7 years after HD initiat ...[more]

PMID: 30605455

Similar Datasets

Project description:BACKGROUND:Sudden cardiac death is one of the primary causes of mortality in chronic hemodialysis (HD) patients. Prolonged QTc interval is associated with increased rate of sudden cardiac death. The aim of this article is to assess the abnormalities found in electrocardiograms (ECGs), and to explore factors that can influence the QTc interval. METHODS:A total of 141 conventional HD patients were enrolled in this study. ECG tests were conducted on each patient before a single dialysis session and 15 minutes before the end of dialysis session (at peak stress). Echocardiography tests were conducted before dialysis session began. Blood samples were drawn by phlebotomy immediately before and after the dialysis session. RESULTS:Before dialysis, 93.62% of the patients were in sinus rhythm, and approximately 65% of the patients showed a prolonged QTc interval (i.e., a QTc interval above 440 ms in males and above 460ms in females). A comparison of ECG parameters before dialysis and at peak stress showed increases in heart rate (77.45±11.92 vs. 80.38±14.65 bpm, p = 0.001) and QTc interval (460.05±24.53 ms vs. 470.93±24.92 ms, p<0.001). After dividing patients into two groups according to the QTc interval, lower pre-dialysis serum concentrations of potassium (K+), calcium (Ca2+), phosphorus, calcium* phosphorus (Ca*P), and higher concentrations of plasma brain natriuretic peptide (BNP) were found in the group with prolonged QTc intervals. Patients in this group also had a larger left atrial diameter (LAD) and a thicker interventricular septum, and they tended to be older than patients in the other group. Then patients were divided into two groups according to ?QTc (?QTc = QTc peak-stress- QTc pre-HD). When analyzing the patients whose QTc intervals were longer at peak stress than before HD, we found that they had higher concentrations of Ca2+ and P5+ and lower concentrations of K+, ferritin, UA, and BNP. They were also more likely to be female. In addition, more cardiac construction abnormalities were found in this group. In multiple regression analyses, serum Ca2+ concentration before HD and LAD were independent variables of QTc interval prolongation. UA, ferritin, and interventricular septum were independent variables of ?QTc. CONCLUSION:Prolonged QT interval is very common in HD patients and is associated with several risk factors. An appropriate concentration of dialysate electrolytes should be chosen depending on patients' clinical conditions.

Project description:Protein-energy wasting is common in chronic kidney disease and is associated with decreases in body muscle and fat stores and poor outcomes. The accuracy and reliability of field methods to measure body composition is unknown in this population.Cross-sectional observational study.118 maintenance hemodialysis patients were seen at the General Clinical Research Center at Harbor-UCLA Medical Center, Torrance, CA.Triceps skinfold, near-infrared interactance, and bioelectrical impedance analysis using the Segal, Kushner, and Lukaski equations.Dual-energy x-ray absorptiometry (DEXA).Participants (42% women, 52% with diabetes, 40% African Americans, and 38% Hispanics) were aged 49.4 +/- 11.5 (mean +/- SD) years, and had undergone dialysis therapy for 41.1 +/- 32.9 months. Body mass index was 27.0 +/- 6.0 kg/m(2). Using DEXA as the reference test, the bioelectrical impedance analysis-Kushner equation, triceps skinfold, and near-infrared interactance were most accurate of the index tests in estimating total-body fat percentage, whereas bioelectrical impedance analysis-Segal equation and bioelectrical impedance analysis-Lukaski equation overestimated total body fat percentage. Bland-Altman analyses and difference plots showed that bioelectrical impedance analysis-Kushner and near-infrared interactance were most similar to the reference test. Bioelectrical impedance analysis-Kushner, triceps skinfold, and near-infrared interactance had the smallest mean differences from DEXA, especially in women (1.6%, 0.7%, and 1.2%, respectively). Similar results were observed in African American participants (n = 47).Measurements were performed 1 day after a hemodialysis treatment, leading to more fluid retention, which may have affected the reference and index tests differently.Using DEXA as the reference test, both near-infrared interactance and bioelectrical impedance analysis-Kushner method yield more consistent estimates of total body fat percentage in maintenance hemodialysis patients compared with the other index tests. Near-infrared interactance is not affected by skin color. Field methods with portable devices may provide adequate precision.

Dataset Information

Changes in QTc interval in long-term hemodialysis patients.

Publications

Changes in QTc interval in long-term hemodialysis patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets