Elevated temporal QT variability index in patients with chronic renal failure

Johansson, Mats; Gao, Sinsia A.; Friberg, Peter; Annerstedt, Marita; Bergström, Göran; Carlström, Jan; Ivarsson, Ted; Jensen, Gert; Ljungman, Susanne; Mathillas, O; Nielsen, Finn-David; Strömbom, Ulf

doi:10.1042/cs20040122

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…36 Johnsson et al reported that Qtvi was increased by 47% in 153 patients with advanced CKD (43 individuals with stage 4 CKD, 67 patients undergoing hemodialysis, and 43 patients on CaPD) during a 30 min rest period compared with 39 age-matched healthy controls. 35 the Qtvi was similar in patients with stage 4 CKD and in those on dialysis, whereas it was higher in patients with diabetes compared with nondiabetic patients with renal failure. 35 Furthermore, in a multiple linear regression analysis, a history of diabetes or coronary artery disease were the only independent predictors of Qtvi in patients with advanced CKD.…”

Section: Epidemiologycontrasting

confidence: 47%

“…35 the Qtvi was similar in patients with stage 4 CKD and in those on dialysis, whereas it was higher in patients with diabetes compared with nondiabetic patients with renal failure. 35 Furthermore, in a multiple linear regression analysis, a history of diabetes or coronary artery disease were the only independent predictors of Qtvi in patients with advanced CKD. 35 the elevated Qtvi in patients with advanced CKD was the result of both reduced rr interval variance (secondary to reduced autonomic control of heart rate) and increased Qt-interval variance.…”

Section: Epidemiologycontrasting

confidence: 47%

“…35 Furthermore, in a multiple linear regression analysis, a history of diabetes or coronary artery disease were the only independent predictors of Qtvi in patients with advanced CKD. 35 the elevated Qtvi in patients with advanced CKD was the result of both reduced rr interval variance (secondary to reduced autonomic control of heart rate) and increased Qt-interval variance. 35,37 in another study by atiga and colleagues, the Qtvi was higher in patients presenting with sudden cardiac death than in patients who presented with other manifestations of heart disease.…”

Section: Epidemiologymentioning

confidence: 99%

“…33 revIewS cohort study of 147 adult patients undergoing dialysis, 34 Qtc interval dispersion (Qtcd) that occurred for longer than 74 ms was an independent predictor of all-cause mortality (relative risk [rr] 1.53, 95% Ci 1.19-1.98, P = 0.0001), cardiovascular mortality (rr 1.57, 95% Ci 1.05-2.36, P = 0.028), and arrhythmia-related mortality (rr 1.58, 95% Ci 0.98-2.54, P = 0.061). 34 Qt variability index (Qtvi)-computerized and calculated as the logarithm of the ratio between the variances of the normalized Qt and rr intervals-can provide an estimation of the temporal variability in the myocardial repolarization process 35 and predict the subsequent risk of sudden cardiac death or ventricular arrhythmia in patients who present for electrophysiological investigation. 36 Johnsson et al reported that Qtvi was increased by 47% in 153 patients with advanced CKD (43 individuals with stage 4 CKD, 67 patients undergoing hemodialysis, and 43 patients on CaPD) during a 30 min rest period compared with 39 age-matched healthy controls.…”

Section: Epidemiologymentioning

confidence: 99%

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Sudden cardiac death in chronic kidney disease: epidemiology and prevention

2011

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Annual cardiovascular mortality in patients with chronic kidney disease (CKD) is much higher than in the general population. The rate of sudden cardiac death increases as the stage of CKD increases and could be responsible for 60% of cardiac deaths in patients undergoing dialysis. In hemodialysis units treating patients with CKD, cardiac arrest occurs at a rate of seven arrests per 100,000 hemodialysis sessions. Important risk factors for sudden cardiac death in patients with CKD include hospitalization within the past 30 days, a drop of 30 mmHg in systolic blood pressure during hemodialysis, duration of life on hemodialysis, time since the previous dialysis session, and the presence of concomitant diabetes mellitus. As a result of the adverse cardiomyopathic and vasculopathic milieu in CKD, the occurrence of arrhythmias, conduction abnormalities, and sudden cardiac death could be exacerbated by electrolyte shifts, divalent ion abnormalities, diabetes, sympathetic overactivity, in addition to inflammation and perhaps iron deposition. Impaired baroreflex effectiveness and sensitivity, as well as obstructive sleep apnea, might also contribute to the risk of sudden death in CKD. The likelihood of survival following cardiac arrest is very low in dialysis patients. Primary and secondary prevention of cardiac arrest could reduce cardiovascular mortality in patients with CKD. Cardioverter-defibrillator implantation decreases the risk of sudden death in patients with CKD. The decision to implant a cardioverter-defibrillator should be influenced by the patient's age and stage of CKD.

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Section: Epidemiologycontrasting

confidence: 47%

Section: Epidemiologycontrasting

confidence: 47%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Sudden cardiac death in chronic kidney disease: epidemiology and prevention

2011

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“…9,10 Pada penderita PGK terdapat pemanjangan QTVI yang bermakna bila dibandingkan dengan kontrol sehat. 11 Angka kejadian aritmia fatal dan kematian jantung mendadak pada penderita PGK meningkat seiring dengan makin rendahnya laju filtrasi glomerulus. 4,6 Hal ini mungkin berhubungan dengan QTVI yang makin panjang sebagai salah satu mekanisme yang mendasarinya, namun belum ada penelitian yang dilakukan untuk membuktikan hal tersebut.…”

Section: Pendahuluanunclassified

Hubungan antara QT Variability Index dan Laju Filtrasi Glomerulus pada Penyakit Ginjal Kronik Predialisis

Sugiantoro¹,

Purnomowati²,

Martakusumah³

et al. 2012

mkb

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AbstrakPenderita penyakit ginjal kronik (PGK) mempunyai risiko yang tinggi untuk mengalami aritmia ventrikel dan kematian mendadak (sudden cardiac death/SCD). Angka kejadian SCD pada penderita PGK meningkat seiring dengan menurunnya laju filtrasi glomerulus (glomerular filtration rate/GFR). Mekanisme patofisiologi yang mendasari SCD pada umumnya aritmia ventrikel yang berhubungan dengan ketidakstabilan repolarisasi miokardium. QT variability index (QTVI), suatu indeks yang menggambarkan ketidakstabilan repolarisasi miokardium, merupakan prediktor yang kuat untuk terjadi aritmia fatal dan SCD. Penelitian ini merupakan studi observasi potong lintang untuk menilai hubungan antara QTVI dan GFR pada penderita PGK predialisis dengan GFR <60 mL/menit. Penelitian ini dilakukan pada penderita PGK yang berobat ke Poliklinik Ginjal Hipertensi Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober-Desember 2011. Penelitian ini melibatkan 51 subjek. Pemeriksaan elektrokardiografi (EKG) istirahat dilakukan pada semua subjek dan selanjutnya dilakukan penghitungan QTVI. Hampir semua subjek menderita hipertensi atau mendapat antihipertensi (94%). Gambaran EKG dengan hipertrofi ventrikel kiri didapatkan pada 37% subjek dan QTVI rata-rata subjek sebesar 0,16 (SD 0,24). Hubungan antara QTVI dan GFR dianalisis menggunakan Spearman's rank correlation. QT variability index mempunyai hubungan yang bermakna baik dengan GFR (r=-0,816; p<0,001) maupun dengan estimated glomerular filtration rate (eGFR) (r=-0,460; p<0,001). Simpulan, terdapat hubungan sangat kuat antara QTVI dan GFR pada penderita PGK predialisis, makin rendah GFR makin panjang nilai QTVI. [MKB. 2012;44(4):193-98]. Kata kunci: Kematian jantung mendadak, laju filtrasi glomerulus, penyakit ginjal kronik, QT variability index Correlation between QT Variability Index and Glomerular Filtration Rate in Predialysis Chronic Kidney Disease AbstractChronic kidney disease (CKD) patients are at increased risk for ventricular arrhythmia and sudden cardiac death (SCD). The rate of SCD in CKD patients increased as glomerular filtration rate decreased. Sudden cardiac death is generally mediated by ventricular arrhythmias associated with instability of myocardial repolarization. QT variability index (QTVI) as an index of myocardial repolarization instability is a strong predictor for fatal ventricular arrhythmias and SCD. The aim of this study was to evaluate correlation between QTVI and GFR(< 60 mL/minute) in predialysis CKD patients. This study was done in Kidney and Hypertension Clinic of Dr. Hasan Sadikin Hospital Bandung, from October to December 2011. A total of 51 subjects were included in this study and had their resting electrocardiography (ECG) recorded and QTVI calculated, 94% had hypertension or received anti hypertension, while only 37% fulfilled the ECG criteria for left ventricular hypertrophy. We determined the correlation between QTVI and GFR using Spearman's rank, with mean QTVI 0.16 (SD 0.24), we had strong and significant correlation between QTVI and GFR (r=-0.816, p <0.0...

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Repolarization Reserve and Proarrhythmic Risk

Varró

2009

Novel Therapeutic Targets for Antiarrhythmic Drugs

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Elevated temporal QT variability index in patients with chronic renal failure

Cited by 14 publications

References 22 publications

Sudden cardiac death in chronic kidney disease: epidemiology and prevention

Sudden cardiac death in chronic kidney disease: epidemiology and prevention

Hubungan antara QT Variability Index dan Laju Filtrasi Glomerulus pada Penyakit Ginjal Kronik Predialisis

Repolarization Reserve and Proarrhythmic Risk

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