Electrocardiographic effects of potassium. I. Perfusion through the coronary bed

Lanari, A; Chait, Leonardo; Capurro, Carlos

doi:10.1016/0002-8703(64)90009-2

Cited by 29 publications

(10 citation statements)

References 8 publications

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“…The earliest electrocardiographic manifestation of hyperkalemia is the appearance of narrow-based, peaked, T-waves 10 11 12 . We hypothesized that the morphological changes in the T-wave due to changes in potassium could be captured by a combination of simple measurements reflecting to what extent the T-wave is “narrow and peaked”.…”

Section: Methodsmentioning

confidence: 99%

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Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients

Corsi

Cortesi

Callisesi

et al. 2017

Sci Rep

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Blood potassium concentration ([K+]) influences the electrocardiogram (ECG), particularly T-wave morphology. We developed a new method to quantify [K+] from T-wave analysis and tested its clinical applicability on data from dialysis patients, in whom [K+] varies significantly during the therapy. To elucidate the mechanism linking [K+] and T-wave, we also analysed data from long QT syndrome type 2 (LQT2) patients, testing the hypothesis that our method would have underestimated [K+] in these patients. Moreover, a computational model was used to explore the physiological processes underlying our estimator at the cellular level. We analysed 12-lead ECGs from 45 haemodialysis and 12 LQT2 patients. T-wave amplitude and downslope were calculated from the first two eigenleads. The T-wave slope-to-amplitude ratio (TS/A) was used as starting point for an ECG-based [K+] estimate (KECG). Leave-one-out cross-validation was performed. Agreement between KECG and reference [K+] from blood samples was promising (error: −0.09 ± 0.59 mM, absolute error: 0.46 ± 0.39 mM). The analysis on LQT2 patients, also supported by the outcome of computational analysis, reinforces our interpretation that, at the cellular level, delayed-rectifier potassium current is a main contributor of KECG correlation to blood [K+]. Following a comprehensive validation, this method could be effectively applied to monitor patients at risk for hyper/hypokalemia.

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Section: Methodsmentioning

confidence: 99%

“…Electrocardiographic effects of potassium have been well known for many years 10 11 12 . Hyperkalemia first manifests in the ECG with the appearance of narrow-based, peaked T-waves, which represent the repolarization of the ventricles.…”

mentioning

confidence: 99%

Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients

Corsi

Cortesi

Callisesi

et al. 2017

Sci Rep

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“…[K + ] and [Ca 2+ ] variations are known to influence the electrocardiogram (ECG) [7], [9]- [11]. In a recent large-scale study on unselected individuals, shorter QT intervals were associated with higher [K + ] and [Ca 2+ ] [7].…”

Section: Introductionmentioning

confidence: 99%

Characterization of T Wave Amplitude, Duration and Morphology Changes During Hemodialysis: Relationship With Serum Electrolyte Levels and Heart Rate

Bukhari

Palmieri

Ramírez

et al. 2021

IEEE Trans. Biomed. Eng.

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Objective: Chronic kidney disease affects 7 more than 10% of the world population. Changes in serum 8 ion concentrations increase the risk for ventricular ar-9 rhythmias and sudden cardiac death, particularly in end-10 stage renal disease (ESRD) patients. We characterized how 11 T wave amplitude, duration and morphology descriptors 12 change with variations in serum levels of potassium and 13 calcium and in heart rate, both in ESRD patients and in 14 simulated ventricular fibers. Methods: Electrocardiogram 15 (ECG) recordings from twenty ESRD patients undergoing 16 hemodialysis (HD) and pseudo-ECGs (pECGs) calculated 17 from twenty-two simulated ventricular fibers at varying 18 transmural heterogeneity levels were processed to quantify 19 T wave width (T w ), T wave slope-to-amplitude ratio (T S/A ) 20 and four indices of T wave morphological variability based 21 on time warping (d w , d NL w , d a and d NL a ). Serum potassium 22 and calcium levels and heart rate were measured along 23 HD. Results: d NL a was the marker most strongly correlated 24

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“…At present, the significance of the different cardiac responses to transient and prolonged hyperkalemia is not entirely clear-dissimilarities may be clue to increased intracellular K in heart cells of K-loaded dogs (8).…”

Section: Time (Min)mentioning

confidence: 97%

Hyperkalemia and the electrocardiogram in dogs

Hiatt

1988

Basic Res Cardiol

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Rapid i.v. injection of 2 ml KCl solution with 0.1 mmol/kg abruptly doubles the basal concentration of coronary artery serum K and produces no ECG change; 2 ml with 0.3 mmol KCl/kg quadruples it and provokes fibrillation of the ventricular myocardium in 18 s, there is no visible effect on atrial activity. Continuous infusion of 2 mEq KCl/kg body weight gradually doubles basal serum K concentration and produces ECG changes that herald the imminent onset of ventricular fibrillation. Ventricular myocardium and, especially, the sinus node are more tolerant of transient than of prolonged hyperkalemia.

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Electrocardiographic effects of potassium. I. Perfusion through the coronary bed

Cited by 29 publications

References 8 publications

Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients

Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients

Characterization of T Wave Amplitude, Duration and Morphology Changes During Hemodialysis: Relationship With Serum Electrolyte Levels and Heart Rate

Hyperkalemia and the electrocardiogram in dogs

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