Cystatin C estimated renal dysfunction predicts T wave axis deviation in US adults: results from NHANES III

Abstract

Patients with impaired kidney function are at increased risk of ventricular arrhythmia and sudden death. The association between chronic kidney disease and frontal T wave axis deviation, a cardiovascular risk factor, in individuals without heart disease is unexplored and unknown. To test the hypothesis that chronic kidney disease predicts frontal T-wave axis deviation, American participants 40 years of age or older from NHANES III, were categorized as having and not having chronic kidney disease based on glomerular filtration rates estimated by both serum cystatin C and serum creatinine and serum creatinine alone. Frontal T-wave axis deviation was measured from the standard 12-lead electrocardiogram. Multivariable adjustments for age, ace, smoking, metabolic syndrome, albuminuria, left ventricular mass, QRS duration and heart rate were performed. In multivariable weighted regression analysis, the odds ratio for abnormal frontal T wave axis deviations and their corresponding 95% CIs in patients with decreased glomerular filtration rate determined by an equation included cystatin and creatinine was 1.90 (1.20-3.32). The odds ratio of frontal T wave axis deviation due to decreased kidney function, determined using an equation included serum creatinine alone, was 1.65 (1.10-2.90). This study suggests that abnormal frontal T wave axis deviation abnormalities occur in subjects with chronic kidney disease. Those with decline in renal function should be considered at risk for potentially serious T-wave associated arrhythmias and thus carefully monitored.

Electrocardiogram Abnormalities and Cardiovascular Mortality in Elderly Patients with CKD

“…Although several studies have examined the cross-sectional association between electrocardiogram (ECG) abnormalities and CKD, there are limited data on the prevalence of ECG abnormalities and their association with longitudinal cardiovascular outcomes in patients with CKD, particularly in the elderly (6,(10)(11)(12)(13)(14)(15). The purpose of our study was to assess the prevalence of significant ECG abnormalities and evaluate their association with subsequent cardiovascular morbidity and mortality in a large cohort of older adults with CKD enrolled in the Cardiovascular Health Study (CHS).…”

Cystatin C at Admission in the Intensive Care Unit Predicts Mortality among Elderly Patients

“…Yet, methods to determine cystatin C and creatinine vary. However, cystatin C has been reported to be a better marker of renal failure in older adults compared to serum creatinine, mainly in those with low creatinine, which could reinforce cystatin C as a marker not only of renal failure, but also may be an indicator of death in this population [35]. …”

Frontal plane T-wave axis orientation predicts coronary events: Findings from the Moli-sani study

“…T-axis is associated with several risk factors (9)(10)(11) and with some cardiac abnormalities, such as left ventricular hypertrophy, predictive of such cardiovascular conditions (12). It has been recently speculated that obesity and hypertension could have a relevant role in the pathogenesis of abnormal T-axis (13).…”

“…Blood samples were obtained between 07:00 and 09:00 from participants who had fasted overnight and had refrained from smoking for at least 6 h. Hemocromocytometric, high sensitivity C reactive protein (CRP), lipids and glucose analyses were performed in the centralized Moli-sani laboratory on fresh samples within three hours from venipuncture (10). All hemocromocytometric analyses were performed by the same cell counter (Coulter HMX, Beckman-Coulter, IL-Milan, Italy).…”