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QT dispersion before and after hemodialysis
S T Morris1, E Galiatsou, G A Stewart
1The Renal Unit and Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland, United Kingdom.
Journal of the American Society of Nephrology : JASN
|January 16, 1999
Summary
Patients undergoing hemodialysis exhibit elevated QT dispersion, a marker of cardiac electrical instability. This dispersion increases post-hemodialysis, raising the risk of sudden cardiac death in this vulnerable population.
Area of Science:
- Cardiology
- Nephrology
Background:
- Sudden cardiac death (SCD) is a significant concern for patients on hemodialysis.
- Ventricular premature complexes are frequently observed post-hemodialysis.
- QT dispersion is linked to arrhythmias post-myocardial infarction but unstudied in chronic renal failure.
Purpose of the Study:
- To assess QT dispersion in patients with chronic renal failure before and after hemodialysis.
- To compare QT dispersion in hemodialysis patients to control subjects.
Main Methods:
- Electrocardiograms (ECGs) were recorded from 50 hemodialysis patients and 20 control subjects.
- ECGs were analyzed for QT dispersion (Maximum - Minimum QT interval).
- Measurements were taken before and after a single hemodialysis session.
Main Results:
- Hemodialysis patients had significantly higher baseline QT dispersion (63.1 ms) versus controls (36.0 ms).
- QT dispersion significantly increased post-hemodialysis in patients (76.6 ms).
- Post-hemodialysis QT dispersion levels were comparable to those after myocardial infarction.
Conclusions:
- Hemodialysis patients exhibit increased QT dispersion, indicating nonhomogeneous ventricular recovery.
- The post-hemodialysis period may pose a heightened risk for reentrant arrhythmias and SCD.
- QT dispersion is a potential risk marker for SCD in hemodialysis patients.