Research Article
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Year 2021, Volume 7, Issue 5, 481 - 487, 04.09.2021
https://doi.org/10.18621/eurj.939697

Abstract

References

  • 1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351:1296-305.
  • 2. Turner S, Onalan O, Bickle B. Prevention of de ath in chronic kidney disease: the role of implantable cardioverter defibrillators. CANNT J 2009;19:29-36.
  • 3. Collins AJ, Li S, Gilbertson DT, Chen SC, Herzog CA. Chronic kidney disease and cardiovascular disease in the Medicare population. Kidney Int Suppl 2003;87:S24-31.
  • 4. Liviakis L, Pogue B, Paramsothy P, Bourne A, Gill EA. Carotid intima-media thickness for the practicing lipidologist. J Clin Lipidol 2010;4:24-35.
  • 5. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14-22.
  • 6. Roumeliotis A, Roumeliotis S, Panagoutsos S, Theodoridis M, Argyriou C, Tavridou A, et al. Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease. Ren Fail 2019;41:131-8.
  • 7. Wong M, Edelstein J, Wollman J, Bond MG. Ultrasonic-pathological comparison of the human arterial wall: verification of intima-media thickness. Arterioscler Thromb 1993;13:482-6.
  • 8. Basaran Y, Tigen K, Karaahmet T, İsiklar I, Cevik C, Gurel E, et al. Fragmented QRS complexes are associated with cardiac fibrosis and significant intraventricular systolic dyssynchrony in nonischemic dilated cardiomyopathy patients with a narrow QRS interval. Echocardiography 2011;28:62-8.
  • 9. Park SJ, On YK, Kim JS, Park SW, Yang JH, Jun TG, et al. Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of Fallot. Am J Cardiol 2012;109:110-5.
  • 10. Güçlü A, Nar G, İçli A, Özhan N, Sezer S. Relationship between fragmented QRS complex and aortic stiffness in chronic hemodialysis patients. Med Princ Pract 2017;26:66-70.
  • 11. Pietrasik G, Zaręba W. QRS fragmentation: diagnostic and prognostic significance. Cardiol J 2012;19:114-21.
  • 12. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978;58:1072-83.
  • 13. Wood PW, Choy JB, Nanda NC, Becher H. Left ventricular ejection fraction and volumes: it depends on the imaging method. Echocardiography 2014;31:87-100.
  • 14. Fortes PC, Versari PH, Stinghen AE, Pecoits-Filho R. Controlling inflammation in peritoneal dialysis: the role of pd-related factors as potential intervention targets. Perit Dial Int 2007;27 Suppl 2:S76-81.
  • 15. Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Nowack C, et al. Design and baseline characteristics of the finerenone in reducing kidney failure and disease progression in diabetic kidney disease trial. Am J Nephrol 2019;50:333-44.
  • 16. Maraj M, Kuśnierz-Cabala B, Dumnicka P, Gala-Bladzinska A, Gawlik K, Pawlica-Gosiewska D, et al. Malnutrition, Inflammation, Atherosclerosis Syndrome (MIA) and Diet Recommendations among End-Stage Renal Disease Patients Treated with Maintenance Hemodialysis. Nutrients 2018;10:69.
  • 17. Carpenter M, Sinclair H, Kunadian V. Carotid intima media thickness and its utility as a predictor of cardiovascular disease: a review of evidence. Cardiol Rev 2016;24:70-5.
  • 18. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur J Cardiovasc Prev Rehabil 2007;14 Suppl 2:E1-40.
  • 19. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-536.
  • 20. Ravani A, Werba JP, Frigerio B, Sansaro D, Amato M, Tremoli E, et al. Assessment and relevance of carotid intima-media thickness (C-IMT) in primary and secondary cardiovascular prevention. Curr Pharm Des 2015;21:1164-71.
  • 21. Benedetto FA, Mallamaci F, Tripepi G, Zoccali C. Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 2004;12:2458-64.
  • 22. Selim G, Stojceva-Taneva O, Tozija L, Zafirova-Ivanovska B, Spasovki G, Gerasimovska V, et al. Uric acid and left ventricular hypertrophy: another relationship in hemodialysis patients. Clin Kidney J 2019;14:578-85.
  • 23. Lopez B, Gonzalez A, Hermida N, Laviades C, Diez J. Myocardial fibrosis in chronic kidney disease: potential benefits of torasemide. Kidney Int Suppl 2008:111:S19-23.
  • 24. Díez J. Mechanisms of cardiac fibrosis in hypertension. J Clin Hypertens (Greenwich). 2007;9:546-50.
  • 25. Cozzolino M, Mangano M, Stucchi A, Ciceri P, Conte F, Galassi A. Cardiovascular disease in dialysis patients. Nephrol Dial Transplant 2018;33(suppl 3):iii28-iii34.
  • 26. Díez J, González A, López B, Querejeta R. Mechanisms of disease: pathologic structural remodeling is more than adaptive hypertrophy in hypertensive heart disease. Nat Clin Pract Cardiovasc Med 2005;2:209-16.
  • 27. Ari H, Cetinkaya S, Ari S, Koca V, Bozat T. The prognostic significance of a fragmented QRS complex after primary percutaneous coronary intervention. Heart Vessels 2012;27:20-8.
  • 28. Pietrasik G, Goldenberg I, Zdzienicka J, Moss AJ, Zareba W. Prognostic significance of fragmented QRS complex for predicting the risk of recurrent cardiac eventsin patients with Q-wave myocardial infarction. Am J Cardiol 2007;100:583-6.
  • 29. Ulusoy S, Ozkan G, Adar A, Bektaş H, Kırış A, Celik S. Relationship between fragmented QRS complex and left ventricular systolic and diastolic function in kidney transplant patients. Prog Transplant 2014 24:146-51.
  • 30. Adar A, Kiriş A, Ulusoy S, Ozkan K, Bektaş H, Okutucu S, et al. Fragmented QRS is associated with subclinical left ventricular dysfunction in patients with chronic kidney disease. Acta Cardiol 2014;69:385-90.
  • 31. Kadı H, Demir AK, Ceyhan K, Damar İH, Karaman K, Zorlu Ç. Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients. Turk Kardiyol Dern Ars 2015;43:149-56.

Fragmented QRS formation may be associated with increased carotid intima-media thickness in patients with end-stage renal disease

Year 2021, Volume 7, Issue 5, 481 - 487, 04.09.2021
https://doi.org/10.18621/eurj.939697

Abstract

Objectives: The aim of this study was to evaluate the relationship between carotid intima-media thickness and the presence of fragmented QRS in end-stage renal disease patients.

Methods: The study included 100 end-stage renal disease patients who received hemodialysis treatment. Two groups were formed according to the presence of electrocardiography and fragmented QRS: the fragmented QRS (+) (Group I) and the fragmented QRS (-) (Group II). Echocardiographic measurements of the cardiac dimensions and carotid intima-media thickness were examined.

Results: The study population included 41 end-stage renal disease patients with fragmented QRS (48.8% male) and a control group of 59 end-stage renal disease patients without fragmented QRS (35.6% male) on electrocardiography. Left ventricular end systolic diameters (p = 0.012),left ventricular end diastolic diameters (p < 0.001), left atrial diameter (p = 0.001), interventricular septal thickness (p < 0.001), posterior wall thickness (p < 0.001) and left ventricular hypertrophy (p < 0.001), blood urea nitrogen (p = 0.011), creatinine (p = 0.014), uric acid (p < 0.05) and parathyroid hormone (p < 0.05) values were found to be significantly increased in the fragmented QRS (+) group. The right and left carotid intima-media thickness values were significantly higher in fragmented QRS (+) patients than fragmented QRS (-) patients (right:[0.81 ± 0.19] vs [0.62 ± 0.14] mm, p < 0.001) and left: [0.83 ± 0.19 vs 64 ± 0.14], p < 0.001; respectively).

Conclusions: In end-stage renal disease patients, the presence of fragmented QRS, left ventricular hypertrophy and increased carotid intima-media thickness are important markers in the evaluation of the inflammatory process of atherosclerosis.

References

  • 1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351:1296-305.
  • 2. Turner S, Onalan O, Bickle B. Prevention of de ath in chronic kidney disease: the role of implantable cardioverter defibrillators. CANNT J 2009;19:29-36.
  • 3. Collins AJ, Li S, Gilbertson DT, Chen SC, Herzog CA. Chronic kidney disease and cardiovascular disease in the Medicare population. Kidney Int Suppl 2003;87:S24-31.
  • 4. Liviakis L, Pogue B, Paramsothy P, Bourne A, Gill EA. Carotid intima-media thickness for the practicing lipidologist. J Clin Lipidol 2010;4:24-35.
  • 5. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14-22.
  • 6. Roumeliotis A, Roumeliotis S, Panagoutsos S, Theodoridis M, Argyriou C, Tavridou A, et al. Carotid intima-media thickness is an independent predictor of all-cause mortality and cardiovascular morbidity in patients with diabetes mellitus type 2 and chronic kidney disease. Ren Fail 2019;41:131-8.
  • 7. Wong M, Edelstein J, Wollman J, Bond MG. Ultrasonic-pathological comparison of the human arterial wall: verification of intima-media thickness. Arterioscler Thromb 1993;13:482-6.
  • 8. Basaran Y, Tigen K, Karaahmet T, İsiklar I, Cevik C, Gurel E, et al. Fragmented QRS complexes are associated with cardiac fibrosis and significant intraventricular systolic dyssynchrony in nonischemic dilated cardiomyopathy patients with a narrow QRS interval. Echocardiography 2011;28:62-8.
  • 9. Park SJ, On YK, Kim JS, Park SW, Yang JH, Jun TG, et al. Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of Fallot. Am J Cardiol 2012;109:110-5.
  • 10. Güçlü A, Nar G, İçli A, Özhan N, Sezer S. Relationship between fragmented QRS complex and aortic stiffness in chronic hemodialysis patients. Med Princ Pract 2017;26:66-70.
  • 11. Pietrasik G, Zaręba W. QRS fragmentation: diagnostic and prognostic significance. Cardiol J 2012;19:114-21.
  • 12. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978;58:1072-83.
  • 13. Wood PW, Choy JB, Nanda NC, Becher H. Left ventricular ejection fraction and volumes: it depends on the imaging method. Echocardiography 2014;31:87-100.
  • 14. Fortes PC, Versari PH, Stinghen AE, Pecoits-Filho R. Controlling inflammation in peritoneal dialysis: the role of pd-related factors as potential intervention targets. Perit Dial Int 2007;27 Suppl 2:S76-81.
  • 15. Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Nowack C, et al. Design and baseline characteristics of the finerenone in reducing kidney failure and disease progression in diabetic kidney disease trial. Am J Nephrol 2019;50:333-44.
  • 16. Maraj M, Kuśnierz-Cabala B, Dumnicka P, Gala-Bladzinska A, Gawlik K, Pawlica-Gosiewska D, et al. Malnutrition, Inflammation, Atherosclerosis Syndrome (MIA) and Diet Recommendations among End-Stage Renal Disease Patients Treated with Maintenance Hemodialysis. Nutrients 2018;10:69.
  • 17. Carpenter M, Sinclair H, Kunadian V. Carotid intima media thickness and its utility as a predictor of cardiovascular disease: a review of evidence. Cardiol Rev 2016;24:70-5.
  • 18. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur J Cardiovasc Prev Rehabil 2007;14 Suppl 2:E1-40.
  • 19. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-536.
  • 20. Ravani A, Werba JP, Frigerio B, Sansaro D, Amato M, Tremoli E, et al. Assessment and relevance of carotid intima-media thickness (C-IMT) in primary and secondary cardiovascular prevention. Curr Pharm Des 2015;21:1164-71.
  • 21. Benedetto FA, Mallamaci F, Tripepi G, Zoccali C. Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 2004;12:2458-64.
  • 22. Selim G, Stojceva-Taneva O, Tozija L, Zafirova-Ivanovska B, Spasovki G, Gerasimovska V, et al. Uric acid and left ventricular hypertrophy: another relationship in hemodialysis patients. Clin Kidney J 2019;14:578-85.
  • 23. Lopez B, Gonzalez A, Hermida N, Laviades C, Diez J. Myocardial fibrosis in chronic kidney disease: potential benefits of torasemide. Kidney Int Suppl 2008:111:S19-23.
  • 24. Díez J. Mechanisms of cardiac fibrosis in hypertension. J Clin Hypertens (Greenwich). 2007;9:546-50.
  • 25. Cozzolino M, Mangano M, Stucchi A, Ciceri P, Conte F, Galassi A. Cardiovascular disease in dialysis patients. Nephrol Dial Transplant 2018;33(suppl 3):iii28-iii34.
  • 26. Díez J, González A, López B, Querejeta R. Mechanisms of disease: pathologic structural remodeling is more than adaptive hypertrophy in hypertensive heart disease. Nat Clin Pract Cardiovasc Med 2005;2:209-16.
  • 27. Ari H, Cetinkaya S, Ari S, Koca V, Bozat T. The prognostic significance of a fragmented QRS complex after primary percutaneous coronary intervention. Heart Vessels 2012;27:20-8.
  • 28. Pietrasik G, Goldenberg I, Zdzienicka J, Moss AJ, Zareba W. Prognostic significance of fragmented QRS complex for predicting the risk of recurrent cardiac eventsin patients with Q-wave myocardial infarction. Am J Cardiol 2007;100:583-6.
  • 29. Ulusoy S, Ozkan G, Adar A, Bektaş H, Kırış A, Celik S. Relationship between fragmented QRS complex and left ventricular systolic and diastolic function in kidney transplant patients. Prog Transplant 2014 24:146-51.
  • 30. Adar A, Kiriş A, Ulusoy S, Ozkan K, Bektaş H, Okutucu S, et al. Fragmented QRS is associated with subclinical left ventricular dysfunction in patients with chronic kidney disease. Acta Cardiol 2014;69:385-90.
  • 31. Kadı H, Demir AK, Ceyhan K, Damar İH, Karaman K, Zorlu Ç. Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients. Turk Kardiyol Dern Ars 2015;43:149-56.

Details

Primary Language English
Subjects Cardiac and Cardiovascular Systems, Urology ve Nephrology
Journal Section Original Articles
Authors

Tolga DOĞAN (Primary Author)
Department of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
0000-0003-1281-942X
Türkiye


Mucahit YETİM
Department of Cardiology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
0000-0002-2444-7523
Türkiye


İbrahim DOĞAN
Department of Nephrology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
0000-0001-8489-4985
Türkiye


Macit KALÇIK
Department of Cardiology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
0000-0002-8791-4475
Türkiye


Lütfü BEKAR
Department of Cardiology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
0000-0002-3920-1382
Türkiye


Oguzhan CELIK
Department of Cardiology, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
0000-0001-7841-0227
Türkiye


Yusuf KARAVELİOĞLU
Department of Cardiology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
0000-0002-2544-1975
Türkiye

Publication Date September 4, 2021
Application Date May 20, 2021
Acceptance Date June 28, 2021
Published in Issue Year 2021, Volume 7, Issue 5

Cite

EndNote %0 The European Research Journal Fragmented QRS formation may be associated with increased carotid intima-media thickness in patients with end-stage renal disease %A Tolga Doğan , Mucahit Yetim , İbrahim Doğan , Macit Kalçık , Lütfü Bekar , Oguzhan Celık , Yusuf Karavelioğlu %T Fragmented QRS formation may be associated with increased carotid intima-media thickness in patients with end-stage renal disease %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 5 %R doi: 10.18621/eurj.939697 %U 10.18621/eurj.939697

e-ISSN: 2149-3189 


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