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Evaluation of T-wave alternans in pediatric patients with chronic renal failure

Olgu Hallioglu1, Meryem Keceli2, Gulcin Bozlu2

  • 1Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey; Division of Pediatric Cardiology, University of Mersin Faculty of Medicine, Mersin, Turkey.

Journal of Electrocardiology
|July 13, 2018
PubMed

Insights

Microvolt T-wave alternans (TWA) is elevated in children with chronic renal failure (CRF), indicating potential cardiac risks. This finding suggests TWA may aid early risk assessment in pediatric CRF patients.

Area of Science:

  • Cardiology
  • Pediatric Nephrology

Background:

  • Cardiac issues contribute significantly to mortality in pediatric patients with chronic renal failure (CRF).
  • Microvolt T-wave alternans (TWA) is a known predictor of ischemia and sudden cardiac death in high-risk adults.
  • No prior studies have investigated TWA in children suffering from CRF.

Purpose of the Study:

  • To assess Holter-derived microvolt T-wave alternans (TWA) measurements in pediatric patients with CRF.
  • To compare TWA values in children with CRF against a healthy control group.

Main Methods:

  • A prospective study involving 40 children with CRF and 48 healthy controls.
  • Evaluation of patient history, echocardiography, and 24-hour ECG recordings for microvolt TWA analysis.
  • TWA analysis was performed using three ECG leads: V5, V1, and AVF.

Main Results:

  • Children with CRF exhibited significantly higher mean systolic and diastolic blood pressure, and average heart rates compared to controls.
  • Left ventricular internal dimensions and end-diastolic volume were significantly increased in the CRF group.
  • While TWA values were higher across all leads in the CRF group, only the increase in the V5 lead reached statistical significance (p=0.028).

Conclusions:

  • Microvolt TWA values are elevated in pediatric patients diagnosed with chronic renal failure.
  • Increased TWA in pediatric CRF patients suggests potential utility for early cardiac risk stratification.
  • Further research could establish TWA as a valuable tool for managing cardiac health in children with CRF.
Abstract

Keywords:
ChildrenChronic renal failureT-wave alternans

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