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The effect of renal transplantation on ventricular repolarization in children with chronic renal failure
H Amoozgar1, A Tavakoli2, M H Fallahzadeh3
1Division of Pediatric Cardiology.
Insights
Kidney transplantation improves cardiac repolarization in children with chronic renal failure. Ventricular repolarization indices, including QT and QTc dispersion, showed significant improvement post-transplant but remained elevated compared to healthy controls.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Electrophysiology
Background:
- Chronic renal failure and hemodialysis significantly impact cardiac repolarization parameters.
- Understanding these effects is crucial for managing pediatric patients with kidney disease.
Purpose of the Study:
- To evaluate changes in ventricular repolarization before and after kidney transplantation in children.
- To compare repolarization indices in children with end-stage renal disease, post-transplant, and healthy controls.
Main Methods:
- A comparative study involving 45 children with end-stage renal disease, 45 children post-kidney transplant, and 45 healthy controls.
- 12-lead electrocardiogram (ECG) recordings were analyzed for QT dispersion, QTc dispersion, and T peak to T end (TPE) dispersion.
Main Results:
- Ventricular repolarization indices (QT dispersion, QTc dispersion, TPE dispersion) were significantly reduced after kidney transplantation compared to pre-transplant values (p<0.01).
- Post-transplant values, however, remained higher than those in normal, age-matched children.
- Left intra-ventricular diastolic diameter and mitral valve systolic velocity showed correlations with repolarization parameters.
Conclusions:
- Kidney transplantation leads to significant improvement in ventricular repolarization in children with chronic renal failure.
- Despite improvements, repolarization abnormalities persist post-transplant, suggesting ongoing cardiac effects or the need for continued monitoring.
Background:
Chronic renal failure and hemodialysis affect many ECG parameters which can affect cardiac repolarization.
Objective:
To investigate the change in ventricular repolarization before and after kidney transplantation in children.
Methods:
A total of 45 children with end-stage renal disease, 45 children at least 6 months after successful renal transplantation, and 45 normal age-matched subjects were enrolled into this study. A 12-lead ECG was recorded in the 3 groups. QT dispersion, QTc dispersion, and T peak to T end (TPE) dispersion were measured.
Results:
In the patients before and after renal transplantation and the normal children, respectively, the mean±SD QT dispersion was 0.083±0.033, 0.056±0.029, and 0.033±0.016 (p<0.01); the mean±SD QTc dispersion was 0.104±0.038, 0.066±0.033, and 0.039±0.020 (p<0.01); the mean±SD TPE interval dispersion was 0.060±0.021, 0.045±0.021, and 0.034±0.019 (p<0.01). There was a significant correlation between left intra-ventricular diastolic diameter and QT dispersion, QTc dispersion, and TPE dispersion. The systolic velocity of the mitral valve also correlated with TPE dispersion (r=0.44, p=0.01).
Conclusion:
In children with chronic renal failure, indices of ventricular repolarization improve after transplantation, though they still remain longer than the normal values.
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