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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
The assessment of P-wave dispersion and myocardial repolarization parameters in patients with chronic kidney disease
Korhan Kollu1, Lutfullah Altintepe2, Cevdet Duran3
1a The Department of Internal Medicine , Konya Health Application and Research Center, University of Health Sciences , Konya , Turkey.
Insights
Patients with chronic kidney disease (CKD) stages 3-5 not on renal replacement therapy exhibit increased indicators of cardiac arrhythmia, including p-wave dispersion and QTc dispersion. These findings highlight potential risks for sudden cardiac events in this population.
Area of Science:
- Cardiology
- Nephrology
- Clinical Electrophysiology
Background:
- Chronic kidney disease (CKD) is associated with a higher risk of sudden cardiac death and arrhythmias.
- Identifying specific electrocardiographic markers can aid in risk stratification for CKD patients.
Purpose of the Study:
- To evaluate key arrhythmia indicators: p-wave dispersion (P-WD), QTc dispersion, Tp-e interval, and Tp-e/QT ratio.
- To assess these markers in patients with stages 3-5 CKD who are not yet on renal replacement therapy (RRT).
Main Methods:
- A cohort of 133 patients with stages 3-5 CKD (no RRT) and 32 healthy controls were studied.
- Electrocardiograms were used to measure P-WD, QTc dispersion, and Tp-e interval.
- The Tp-e/QT ratio was calculated for all participants.
Main Results:
- Patients with CKD showed significantly higher P-WD (p < .001) and QTc dispersion (p < .001) compared to controls.
- Elevated Tp-e maximum (p < .001), Tp-e minimum (p < .001), and Tp-e/QTc ratio (p = .001) were observed in the CKD group.
- No significant differences were found in QTc-max or Tp-e interval between groups.
Conclusions:
- Patients with stages 3-5 CKD not on RRT demonstrate increased P-WD and QTc dispersion.
- The study suggests that these electrophysiological changes may contribute to the heightened arrhythmia risk in non-dialyzed CKD patients.
Objective:
The risks of sudden death and cardiac arrhythmia are increased in patients with chronic kidney disease (CKD). Here, we aimed to evaluate the indicators of arrhythmias, such as p-wave dispersion (P-WD), QTc dispersion, Tp-e and Tp-e/QT ratio in patients with CKD stages 3-5 on no renal replacement therapy (RRT).
Material And Methods:
One-hundred and thirty three patients with CKD stages 3-5 and 32 healthy controls were enrolled into the study. No patients received RRT. QTc dispersion, P-WD and Tp-e interval were measured using electrocardiogram and Tp-e/QT ratio was also calculated.
Results:
Mean age rates were found similar in patients and controls (60.8 ± 14.2 and 61 ± 12.9 y, p = .937, respectively). Compared patients with controls, P-WD (45.85 ± 12.42 vs. 21.17 ± 6.6 msec, p < .001), QTc-min (366.99 ± 42.31 vs. 387.15 ± 20.5 msec, p < .001), QTc dispersion (71.13 ± 27.95 vs. 41.25 ± 14.55 msec, p < .001), Tp-e maximum (81.04 ± 10.34 vs. 75.49 ± 10.9 msec, p < .001), Tp-e minimum (62.25 ± 7.58 vs. 54.8 ± 6.72 msec, p < .001) and Tp-e/QTc ratio (0.19 ± 0.02 vs. 0.18 ± 0.01, p = .001) were found to be different. QTc-max and Tp-e interval were found to be similar in both groups.
Conclusion:
P-WD and QTc dispersion, Tp-e interval and Tp-e/QTc ratio were found to be increased in with CKD stages 3-5 on no RRT.
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