The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography
Yıl: 2021 Cilt: 37 Sayı: 1 Sayfa Aralığı: 5 - 10 Metin Dili: İngilizce DOI: 10.30733/std.2021.01491 İndeks Tarihi: 04-06-2021
The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography
Öz: Cardiovascular events, including ventricular arrhythmias and sudden cardiac death (SCD), are theprimary source of death in hemodialysis (HD) patients. Checking ECG parameters such as QT interval, QTdispersion (QTd), TPe interval, TPe/QT ratio, and cardiac-electrophysiological balance (iCEB = QT/QRS)can be useful for classifying patients with high arrhythmia and SCD risk. Our study aimed to comparethe change of electrocardiographic parameters before and after the HD session with the healthy controlgroup.Patients and Methods: The study was conducted between January 2020 and March 2020, including 49HD patients and 50 healthy volunteers. The groups were divided into two groups as hemodialysis andcontrol group. ECGs of the hemodialysis group were evaluated before and after dialysis. ECG data werescanned and evaluated on a digital platform. QT, cQT, QTd, TPe, TPe/QT, TPe/cQT, QT/QRS, and cQT/QRS were measured.Results: While QTd, cQTd, TPe, TPe / QTc, and QRS decreased significantly after hemodialysis comparedto pre-HD(p <0.05 for each), HR, iCEB, and iCEBc showed a significant increase after dialysis treatment(p <0.05 for each). Comparing pre-dialysis ECG parameters with the control group, QT, cQT, QTd, cQTd,TPe and iCEBc were significantly higher in pre-HD (p <0.05 for each). Comparing the ECG parametersafter dialysis, HR, cQT, QTd, cQTd, iCEB, and iCEBc values were significantly higher than the controlgroup (p <0.05 for each).Conclusion: By evaluating the electrocardiographic parameters showing ventricular repolarization anddepolarization together, the risk of arrhythmia and sudden cardiac death can be predicted in HD patients.
Anahtar Kelime: Hemodiyaliz Tedavisinin Elektrokardiyografide Ventriküler Aritmogenez Parametrelerine Etkisi
Öz: Hemodiyaliz (HD) hastalarında ventriküler aritmiler ve ani kardiyak ölüm (AKÖ) dahil kardiyovasküler olaylar birincil ölüm kaynağıdır. QT aralığı, QT dispersiyonu (QTd), TPe aralığı, TPe / QT oranı ve kardiyak-elektrofizyolojik denge (iCEB = QT / QRS) gibi EKG parametrelerinin kontrol edilmesi, yüksek aritmi ve SCD riski olan hastaların sınıflandırılmasında yararlı olabilir. Çalışmamız, HD seansı öncesi ve sonrasında elektrokardiyografik parametrelerdeki değişimi sağlıklı kontrol grubu ile karşılaştırmayı amaçladı. Hastalar ve Yöntem: Çalışma Ocak 2020 ile Mart 2020 arasında 49 HD hastası ve 50 sağlıklı gönüllü dahil edilerek yapıldı. Gruplar hemodiyaliz ve kontrol grubu olarak iki gruba ayrıldı. Hemodiyaliz grubunun EKG'leri diyaliz öncesi ve sonrası değerlendirildi. EKG verileri tarandı ve dijital bir platformda değerlendirildi. QT, cQT, QTd, TPe, TPe / QT, TPe / cQT, QT / QRS ve cQT / QRS ölçüldü. Bulgular: Hemodiyaliz sonrası QTd, cQTd, TPe, TPe / QTc ve QRS pre-HD'ye göre anlamlı olarak azalırken (her biri için p <0,05), diyaliz tedavisi sonrası HR, iCEB ve iCEBc anlamlı artış gösterdi (p <0,05 için her biri). Diyaliz öncesi EKG parametreleri ile kontrol grubu karşılaştırıldığında QT, cQT, QTd, cQTd, TPe ve iCEBc pre-HD'de anlamlı olarak daha yüksekti (her biri için p <0.05). Diyaliz sonrası EKG parametreleri karşılaştırıldığında, HR, cQT, QTd, cQTd, iCEB ve iCEBc değerleri kontrol grubuna göre anlamlı olarak yüksekti (her biri için p <0.05). Sonuç: HD hastalarında ventriküler repolarizasyon ve depolarizasyonu birlikte gösteren elektrokardiyografik parametreler değerlendirilerek aritmi ve ani kardiyak ölüm risk i öngörülebilir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Pilmore H, Dogra G, Roberts M, et al. Cardiovascular disease in patients with chronic kidney disease. Nephrology (Carlton) 2014;19(1):3-10.
- 2. Collins AJ, Foley RN, Gilbertson DT, et al. United states renal data system public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011) 2015;5(1):2-7.
- 3. Hanafusa N, Nakai S, Iseki K, et al. Japanese society for dialysis therapy renal data registry-a window through which we can view the details of Japanese dialysis population. Kidney Int Suppl (2011) 2015;5(1):15-22.
- 4. Saran R, Li Y, Robinson B, et al. US Renal data system 2015 annual data report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis 2016;67(3 Suppl 1):Svii-S305.
- 5. Mozos I. Laboratory markers of ventricular arrhythmia risk in renal failure. Biomed Res Int 2014;2014:509204.
- 6. Kalantzi K, Gouva C, Letsas KP, et al. The impact of hemodialysis on the dispersion of ventricular repolarization. Pacing Clin Electrophysiol 2013;36(3):322-7.
- 7. Waks JW, Tereshchenko LG, Parekh RS. Electrocardiographic predictors of mortality and sudden cardiac death in patients with end stage renal disease on hemodialysis. J Electrocardiol 2016;49(6):848-54.
- 8. Weiss JN, Qu Z, Shivkumar K. Electrophysiology of hypokalemia and hyperkalemia. Circ Arrhythm Electrophysiol 2017;10(3):e004667.
- 9. Green D, Roberts PR, New DI, et al. Sudden cardiac death in hemodialysis patients: An in-depth review. Am J Kidney Dis 2011;57(6):921-9.
- 10. Joki N, Tokumoto M, Takahashi N, et al. Current perspectives on sudden cardiac death in hemodialysis patients. Contrib Nephrol 2018;196:5-12.
- 11. Sohal PM, Goel A, Gupta D, et al. Effect of hemodialysis on corrected QT interval and cQT dispersion. Indian J Nephrol 2018;28(5):335-8.
- 12. Genovesi S, Rossi E, Nava M, et al. A case series of chronic haemodialysis patients: Mortality, sudden death, and QT interval. Europace 2013;15(7):1025-33.
- 13. Astan R, Akpinar I, Karan AE, et al. The effect of hemodialysis on electrocardiographic parameters. Ann Noninvasive Electrocardiol 2015;20(3):253-7.
- 14. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41(6):575-80.
- 15. Kaplan O, Kurtoglu E, Nar G, et al. Evaluation of electrocardiographic T-peak to T-end interval in subjects with increased epicardial fat tissue thickness. Arq Bras Cardiol 2015;105(6):566-72.
- 16. Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008;41(6):567-74.
- 17. Erikssen G, Liestøl K, Gullestad L, et al. The terminal part of the QT interval (T peak to T end): A predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol 2012;17(2):85-94.
- 18. Tse G, Gong M, Li CKH, et al. Tpeak-Tend, Tpeak-Tend/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome: A systematic review and meta-analysis. J Arrhythm 2018;34(6):587-97.
- 19. Sökmen E, Özbek SC, Çelik M, et al. Changes in the parameters of ventricular repolarization during preapnea, apnea, and postapnea periods in patients with obstructive sleep apnea. Pacing Clin Electrophysiol 2018;41(7):762-6.
- 20. Ardahanli I, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22.
- 21. Jaroszyński AJ, Załuska WT, Ksiazek A. Effect of haemodialysis on regional and transmural inhomogeneities of the ventricular repolarisation phase. Nephron Clin Pract 2005;99(1):c24-c30.
- 22. Robyns T, Lu HR, Gallacher DJ, et al. Evaluation of index of cardio-electrophysiological balance (iCEB) as a new biomarker for the identification of patients at increased arrhythmic risk. Ann Noninvasive Electrocardiol 2016;21(3):294-304.
- 23. Lu HR, Yan GX, Gallacher DJ. A new biomarker--index of cardiac electrophysiological balance (iCEB)--plays an important role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs). J Pharmacol Toxicol Methods 2013;68(2):250-9.
- 24. Nafakhi H, Al-Mosawi AA, Alareedh M, et al. Index of cardiac electrophysiological balance and transmural dispersion of the repolarization index relationships with pericardial fat volume and coronary calcification. Biomark Med 2018;12(4):321-8.
- 25. Hemmeryckx B, Feng Y, Frederix L, et al. Evaluation of cardiac arrhythmic risks using a rabbit model of left ventricular systolic dysfunction. Eur J Pharmacol 2018;832:145-55.
- 26. Sivri S, Çelik M. Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease. J Electrocardiol 2019;54:72-5.
| APA | Ardahanlı İ, Akyüz O (2021). The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. , 5 - 10. 10.30733/std.2021.01491 |
| Chicago | Ardahanlı İsa,Akyüz Okan The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. (2021): 5 - 10. 10.30733/std.2021.01491 |
| MLA | Ardahanlı İsa,Akyüz Okan The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. , 2021, ss.5 - 10. 10.30733/std.2021.01491 |
| AMA | Ardahanlı İ,Akyüz O The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. . 2021; 5 - 10. 10.30733/std.2021.01491 |
| Vancouver | Ardahanlı İ,Akyüz O The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. . 2021; 5 - 10. 10.30733/std.2021.01491 |
| IEEE | Ardahanlı İ,Akyüz O "The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography." , ss.5 - 10, 2021. 10.30733/std.2021.01491 |
| ISNAD | Ardahanlı, İsa - Akyüz, Okan. "The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography". (2021), 5-10. https://doi.org/10.30733/std.2021.01491 |
| APA | Ardahanlı İ, Akyüz O (2021). The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selçuk Tıp Dergisi, 37(1), 5 - 10. 10.30733/std.2021.01491 |
| Chicago | Ardahanlı İsa,Akyüz Okan The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selçuk Tıp Dergisi 37, no.1 (2021): 5 - 10. 10.30733/std.2021.01491 |
| MLA | Ardahanlı İsa,Akyüz Okan The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selçuk Tıp Dergisi, vol.37, no.1, 2021, ss.5 - 10. 10.30733/std.2021.01491 |
| AMA | Ardahanlı İ,Akyüz O The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selçuk Tıp Dergisi. 2021; 37(1): 5 - 10. 10.30733/std.2021.01491 |
| Vancouver | Ardahanlı İ,Akyüz O The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selçuk Tıp Dergisi. 2021; 37(1): 5 - 10. 10.30733/std.2021.01491 |
| IEEE | Ardahanlı İ,Akyüz O "The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography." Selçuk Tıp Dergisi, 37, ss.5 - 10, 2021. 10.30733/std.2021.01491 |
| ISNAD | Ardahanlı, İsa - Akyüz, Okan. "The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography". Selçuk Tıp Dergisi 37/1 (2021), 5-10. https://doi.org/10.30733/std.2021.01491 |
