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Diyaliz Hastalarında QTc Dispersiyonun Sıklığının ve Klinik ve Laboratuvar Parametrelerle İlişkisinin Değerlendirilmesi

Evaluation of the Frequency of QTc Dispersion and Its Relationship with Clinical and Laboratory Parameters in Dialysis Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
10.5262/tndt.2013.1002.11

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: QTc dispersion is defi ned as the difference between the maximal and minimal correct QT interval on standard 12-lead ECG. Increased QTc dispersion has been reported in ESRD patients. In our study, we aimed to evaluate the frequency of QTc dispersion and its relationship between clinical and laboratory parameters in patients on regular dialysis programme. MATERIAL and METHODS: Sixty patients underwent dialysis (30 HD, 30 CAPD) and another 30 healthy subjects were enrolled into the study. The standard 12 lead ECGs were performed and QTcd was measured from all dialysis patients and control subjects. Blood samples were collected for the measurement of laboratory parameters. RESULTS: Dialysis patients showed signifi cantly higher QTcd than control subjects (55.75±36.48 versus 28.73±28.27; p=0.001). Patients with QTcd >50 ms had signifi cantly higher SBP, urea and ferritin levels, but signifi cantly lower iron binding capacity and calcium levels compared those with QTcd ≤ 50 ms(p<0.05). Positive correlations were found between QTcd and urea, ferritin and SBP levels, and inverse correlations with iron binding capacity level (p<0.05). CONCLUSION: The frequency of QTc dispersion was 40% among the dialysis patients .Although serum calcium was signifi cantly lower in patients who had QTcd >50 ms than QTcd ≤ 50 ms (p<0.05), there was no signifi cant correlation between QTcd and calcium.
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Abstract (Original Language): 
AMAÇ: 12 derivasyonlu standart EKG’de en uzun QTc mesafesi ile en kısa QTc mesafesi arasındaki fark QTc dispersiyonu olarak tanımlanır. SDBY hastalarında artmış QTc dispersiyonu bildirilmiştir. Biz çalışmamızda, diyaliz hastalarında QTc dispersiyonunun sıklığını ve klinik ve laboratuvar parametrelerle ilişkisinin değerlendirilmesini amaçladık. GEREÇ ve YÖNTEMLER: Çalışmaya 60 diyaliz hastası (30 HD, 30 PD) ve 30 sağlıklı birey dahil edildi. Tüm diyaliz hastalarının ve katılımcıların 12 derivasyonlu elektrokardiyografi leri çekildi ve QTcd ölçüldü. Laboratuvar parametreleri için kan örnekleri toplandı. BULGULAR: Diyaliz hastaları kontrol grubundan daha yüksek QTcd’ye sahipti (55,75±36,48 ve 28,73±28,27; p=0.001). QTcd >50 ms olan hastalar QTcd ≤ 50 ms olanlarla karşılaştırıldığında, SKB, üre ve ferritin anlamlı olarak daha yüksek, Ca ve demir bağlama kapasitesi anlamlı olarak daha düşüktü (p<0,05). QTcd ile üre, ferritin, SKB arasında pozitif, demir bağlama kapasitesi arasında ters korelasyon saptandı (p<0,05). SONUÇ: Diyaliz hastaları arasında QTc dispersiyonunun sıklığı %40’tı. QTcd >50 ms olan hastalarda, QTcd ≤ 50 ms olanlardan göre daha düşük serum kalsiyumu olmasına karşın, QTcd ve Ca arasında anlamlı bir korelasyon mevcut değildi.
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REFERENCES

References: 

1. Lorincz I, Mátyus J, Zilahi Z, Kun C, Karányi Z, Kakuk G: QT
dispersion in patients with end-stage renal failure and during
hemodialysis. J Am Soc Nephrol 1999; 10(6): 1297-1302
2. Kimura K, Tabei K, Asano Y, Hosoda S: Cardiac arrhythmias in
hemodialysis patients. Nephron 1989; 53: 201-207
3. Selby NM, McIntyre CW: The acute cardiac effects of dialysis.
Semin Dial 2007; 20(3): 220-228
4. Unubol M, Eryilmaz U, Guney E, Ture M, Akgullu C: QT dispersion
in patients with acromegaly. Endocrine 2013; 43(2): 419-423
5. Wei K, Dorian P, Newman D, Langer A: Association between QT
dispersion and autonomic dysfunction in patients with diabetes
mellitus. J Am Coll Cardiol 1995; 26: 859-863
6. Barr CS, Naas A, Freeman M, Lang CC, Struthers AD: QT
dispersion and sudden unexpected death in chronic heart failure.
Lancet 1994; 343: 327-329
7. Mayet J, Shahi M, McGrath K, Poulter NR, Sever PS, Foale RA,
Thom SA: Left ventricular hypertrophy and QT dispersion in
hypertension. Hypertension 1996; 28: 791-796
8. Yildiz A, Akkaya V, Sahin S, Tükek T, Besler M, Bozfakioglu S,
Korkut F: QT dispersion and signalaveraged electrocardiogram in
hemodialysis and CAPD patients. Perit Dial Int 2001; 21: 186-192
9. Kantarci G, Ozener C, Tokay S, Bihorac A, Akoglu E: QT dispersion
in hemodialysis and CAPD patients. Nephron 2002; 91: 739-741
10. Howse M, Sastry S, Bell GM: Changes in the corrected QT interval
and corrected QT dispersion during haemodialysis. Postgrad Med J
2002; 78(919): 273-275
11. Beaubien ER, Pylypchuk GB, Akhtar J, Biem HJ: Value of corrected
QT interval dispersion in identifying patients initiating dialysis at
increased risk of total and cardiovascular mortality. Am J Kidney
Dis 2002; 39: 834-842
12. Okin PM, Roman MJ, Devereux RB, Kligfi eld P: Electrocardiographic
identifi cation of increased left ventricular mass by simple
voltage-duration products. J Am Coll Cardiol 1995; 25 (2): 417-423
13. Sokolow M, Lyon TP: The ventricular complex in left ventricular
hypertrophy as obtained by unipolar precordial and limb leads. Am
Heart J 1949; 37: 161-186
14. Statters DJ, Malik M, Ward DE, Camm AJ: QT dispersion:
Problems of methodology and clinical signifi cance. J Cardiovasc
Electrophysiol1994; 5: 672-685
15. Macfarlane PW, McLaughlin SC, Rodger JC: Infl uence of lead
selection and population on automated measurement of QT
dispersion. Circulation 1998; 98: 2160-2167
16. Bleyer AJ, Russell GB, Satko SG: Sudden and cardiac death in
hemodialysis patients. Kidney Int 1999; 55: 1553-1559
17. Näppi SE, Virtanen VK, Saha HH, Mustonen JT, Pasternack AI:
QTc dispersion increases during hemodialysis with low-calcium
dialysate. Kidney Int 2000; 57(5): 2117-212218. Kirvelä M, Yli-Hankala A, Lindgren L: QT dispersion and
autonomic function in diabetic and non-diabetic patients with renal
failure. Br J Anaesth 1994; 73(6): 801-804
19. Morris ST, Galiatsou E, Stewart GA, Rodger RS, Jardine AG: QT
dispersion before and after hemodialysis. J Am Soc Nephrol 1999;
10(1): 160-163
20. Wu VC, Huang JW, Wu MS, Chin CY, Chiang FT, Liu YB, Wu
KD: The effect of iron stores on corrected QT dispersion in patients
undergoing peritoneal dialysis. Am J Kidney Dis 2004; 44(4):
720-728
21. Abe S, Yoshizawa M, Nakanishi N, Yazawa T, Yokota K, Honda M,
Sloman G: Electrocardiographic abnormalities in patients receiving
hemodialysis. Am Heart J 1996; 131(6): 1137-1144
22. Nakamura S, Ogata C, Aihara N, Sasaki O, Yoshihara F, Nakahama
H, Inenaga T, Kimura G, Kawano Y: QTc dispersion in haemodialysis
patients with cardiac complications. Nephrology (Carlton) 2005;
10(2): 113-118
23. Foley RN, Parfrey PS, Kent GM, Harnett JD, Murray DC, Barre PE:
Long-term evolution of cardiomyopathy in dialysis patients. Kidney
Int 1998; 54(5): 1720-1725
24. Foley RN, Parfrey PS, Harnett JD, Kent GM, Martin CJ, Murray
DC, Barre PE: Clinical and echocardiographic disease in patients
starting end-stage renal disease therapy. Kidney Int 1995; 47(1):
186-192
25. Costa Fde A, Rivera IR, Vasconcelos ML, Costa AF, Póvoa RM,
Bombig MT, Luna Filho B, Lima VC: Electrocardiography in the
diagnosis of ventricular hypertrophy in patients with chronic renal
disease. Arq Bras Cardiol 2009; 93(4): 380-386, 373-379
26. Perkiömäki JS, Ikäheimo MJ, Pikkujämsä SM, Rantala A, Lilja
M, Kesäniemi YA, Huikuri HV: Dispersion of the QT interval and
autonomic modulation of heart rate in hypertensive men with and
without left ventricular hypertrophy. Hypertension 1996; 28(1):
16-21
27. Mangoni AA, Kinirons MT, Swift CG, Jackson SH: Impact of age
on QT interval and QT dispersion in healthy subjects: A regression
analysis. Age Ageing 2003; 32(3): 326-331
28. Dervişoğlu E, Yilmaz A, Sevin E, Kalender B: The relationship
between iron stores and corrected QT dispersion in patients
undergoing hemodialysis. Anadolu Kardiyol Derg 2007; 7(3):
270-274
29. Buja LM, Roberts WC: Iron in the heart. Etiology and clinical
signifi cance. Am J Med 1971; 51: 209-221
30. Fitchett DH, Coltart DJ, Littler WA, Leyland MJ, Trueman
T, Gozzard DI, Peters TJ: Cardiac involvement in secondary
haemochromatosis: A catheter biopsy study and analysis of
myocardium. Cardiovasc Res 1980; 14: 719-724
31. Kyriazis J, Pikounis V, Smirnioudis N: Use of the QTc interval
and QTc dispersion in patients on haemodialysis: Assessment of
reproducibility. Nephrol Dial Transplant 2004; 19 (2): 516-517

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