Hemodiyaliz Hastalarında Kardiyak Repolarizasyon Belirteçlerinin Klinik Bulgularla İlişkisi

Year 2022, Volume: 9 Issue: 1, 22 - 27, 29.04.2022

Suna Kalkan , Ertugrul Erken , İlyas Ozturk , Orçun Altunören , Özkan Güngör

https://doi.org/10.47572/muskutd.789334

Abstract

Kardiyak aritmilere bağlı ani ölüm, kronik hemodiyaliz (HD) hastaları için önemli bir mortalite nedenidir. Çalışmamızda HD hastalarında, aritmi riski ile ilişkili olabilecek elektrokardiyogram (EKG) repolarizasyon parametrelerinin (QT, düzeltilmiş QT (QTc), T peak-end (Tp-e), Tp-e/QT ve Tp-e/QTc) klinik özellikler ile olası ilişkilerini araştırdık. Çalışmaya kronik HD programında olan 131 erişkin hasta ve 49 sağlıklı birey alındı. Bütün katılımcıların EKG repolarizasyon parametreleri kaydedildi. HD grubunda klinik özellikler kaydedilirken, kan örnekleri ve EKG kayıtları hafta ortası rutin bir HD seansından önce alındı. HD grubunda QT ve QTc daha uzun bulundu (p=0.001, p<0.001). Gruplar arasında TP-e değerleri farklı bulunmadı. Diyabetes mellitus (DM) olan HD hastalarında, QT ve QTc aralıkları daha uzun bulundu (p<0.001, p=0.001). Bu ilişkiler yaş, cinsiyet ve komorbiditelerle yapılan regresyonlardan sonra anlamlılığını korudu. Kardiyovasküler hastalığı olan HD hastalarında QT mesafesi daha uzundu (p=0.033). HD hastalarında; QT ve QTc ölçümlerinin uzadığı görüldü. Bu durum artmış aritmi riskinin bir işareti olabilir. DM tanısı olanlarda çoklu değişkenlerle yapılan regresyonlardan sonra bile QT ve QTc değerleri anlamlı düzeyde uzundu. Kronik HD programındaki hastalarımızı EKG parametreleri açısından değerlendirmek, repolarizasyon ölçümlerinde uzama ve DM gibi komorbid durumları olanları takipte tutmak akılcı olabilir. 

Keywords

Diyabetes Mellitus, Hemodiyaliz, Kardiyak Repolarizasyon, QTc, Tp-e İntervali

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The Relation of Cardiac Repolarization Parameters with Clinical Findings in Hemodialysis Patients

Abstract

Sudden cardiac death from arrhythmias is an important cause of mortality in chronic hemodialysis (HD) patients. In this study, we aimed to investigate ventricular repolarization parameters on electrocardiogram (ECG) (QT, corrected QT (QTc), T peak-end (Tp-e), Tp-e/QT and Tp-e/QTc) and their possible relationships with clinical features in HD patients. The study included 131 adult patients on maintenance HD, and 49 healthy individuals. ECG repolarization parameters were recorded. In the HD group, clinical features were recorded along with blood samples and ECG recordings before a midweek HD session. QT and QTc were longer in the HD group (p=0.001, p<0.001). Tp-e values were not different among groups. HD patients with diabetes mellitus (DM), had longer QT and QTc intervals (p<0.001, p=0.001). These associations were still significant after regressions for age, sex, and comorbidities. HD patients with cardiovascular disease had longer QT intervals (p=0.033). QT and QTc were longer in HD patients. This might be an indicator of increased arrhythmia risk. The diagnosis of DM was associated with longer QT and QTc, adjusted for multiple confouners. It is feasible to evaluate HD patients for ECG parameters and follow up those with prolonged repolarizations and comorbidities, especially DM.

Keywords

Diabetes Mellitus, Hemodialysis, Cardiac Repolarization, QTc, tp-e Interval

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