QT interval prolongation, torsade de pointes and renal disease

Patanè, Salvatore; Marte, Filippo; Bella, Gianluca Di; Currò, Alessio; Coglitore, Sebastiano

doi:10.1016/j.ijcard.2007.11.070

Cited by 31 publications

(24 citation statements)

References 6 publications

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“…Case reports have described SCD associated with QTc prolongation in ESRD patients. 24,25 A study by Beaubien et al showed that QT dispersion was an independent predictor of adverse events, including total and cardiovascular mortality, in ESRD patients. 26 Our findings confirmed the high prevalence of QTc prolongation in ESRD, with 39% of our population having prolonged QTc.…”

Section: Discussionmentioning

confidence: 99%

QT Prolongation Is an Independent Predictor of Mortality in End‐Stage Renal Disease

Hage

Mattos

Khamash

et al. 2010

Clinical Cardiology

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Background: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). Hypothesis: QT-interval prolongation is an independent prognosticator in ESRD. Methods: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. Results: During 40 ± 28 months of follow-up, 132 of the 280 (47%) patients died prior to renal transplantation. Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95% confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. Conclusions: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.

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Section: Discussionmentioning

confidence: 99%

QT Prolongation Is an Independent Predictor of Mortality in End‐Stage Renal Disease

Hage

Mattos

Khamash

et al. 2010

Clinical Cardiology

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“…The risks of antiarrhythmic therapy may be magnifi ed in patients with CKD, owing to the need for renal dose adjustment of certain antiarrhythmic agents [21], as well as to the co-morbidity that often accompanies CKD and that may promote pro-arrhythmia. The development of fi brosis and left ventricular hypertrophy associated with kidney disease is hypothesized to predispose CKD patients to cardiac arrhythmia and sudden death by its effects on the QT interval and QT dispersion [22,23]. As a result, evidence from clinical trials on rate and rhythm control strategies in AF may not be generalizable to patients with impaired renal function, so data are limited in this regard.…”

Section: Discussionmentioning

confidence: 99%

Rate versus rhythm control and outcomes in patients with atrial fibrillation and chronic kidney disease: Data from the GUSTO-III Trial

Williams

Thompson²,

Chiswell³

et al. 2013

Cardiol J

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“…QTc pailgėjimas ir torsades de pointes yra susijusios su terminaline inkstų liga, o tai gali sukelti staigią kardialinę mirtį [28].…”

Section: Elektrokardiografiniai Pokyčiaiunclassified

“…Ligoniai, sergantys terminaline inkstų liga, turi toleranciją hiperkalemijai su mažiau akivaizdžiomis širdies ir neuromuskulinėmis pasekmėmis negu pacientai, kurių inkstų veikla yra normali [31]. Ligoniams, kurių kraujo serume prieš dializę nustatytas didelis kalio kiekis, EKG T bangos tipinių pokyčių nenustatyta [28]. Kalio kiekis po HD yra labai svarbus aritmogenezės pažeidimo procese, kadangi hipokalemija ir hiperkalemija yra aritmogeniniai faktoriai [32,33,34].…”

Section: Elektrokardiografiniai Pokyčiaiunclassified

Damoklo kardas: širdies įvykiai dializės metu

Januškevičius

Grigutis

Rimševičius

et al. 2015

Medicinos Teorija Ir Praktika

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santraukaReikšminiai žodžiai: hemodializė, aritmija, prieširdžių virpėjimas, staigi kardialinė mirtis. Lėtinė inkstų liga, kai reikalinga pakaitinė inkstų terapija, -svarbi visuomenės sveikatos problema. Kiekvienos hemodializės (HD) metu atsiranda didelė apkrova širdies ir kraujagyslių sistemai, susijusi su skysčių ir elektrolitų pokyčiais. Šiame straipsnyje apžvelgiami dažniausiai pasitaikantys širdies ir kraujagyslių sistemos pokyčiai HD pacientams. Prieširdžių virpėjimas (PV) -viena dažniausių aritmijų klinikinėje praktikoje. Hipokalemija -svarbus rizikos veiksnys, susijęs su prieširdžių virpė-jimo atsiradimu. Staigi kardialinė mirtis -tai netikėta žmogaus mirtis dėl širdies priežasčių, atsirandančių per trumpą laiką, kuriam anksčiau buvo arba nebuvo nustatyta širdies patologija, o akivaizdi terminalinė būklė anksčiau nebuvo diagnozuota. HD metu dažnai pastebimi pokyčiai elektrokardiogramoje. QT intervalas (norma 0,24-0,45 s) yra žinomas kaip skilvelinės repoliarizacijos žymuo, o jo pailgėjimas susijęs su padidėjusia aritmijų rizika. Hipokalemijai būdinga T bangos pailgėjimas, ST segmento depresija, patologinis U dantelis, supraventrikulinės ir skilvelinės tachikardijos bei aritmijos. Šiuos rizikos veiksnius ir širdies sutrikimus būtina laiku nustatyti ir koreguoti, todėl svarbus pastovus širdies parametrų (širdies dažnio variabilumo, elektrokardiogramos) fiksavimas hemodializės metu. aBstract Key words: hemodialysis, arrhythmia, atrial fibrillation, sudden cardiac death. Chronic kidney disease requiring renal replacement therapy is an important social problem. A large strain appears for the heart and cardiovascular system during each hemodialysis (HD) session. It is associated with changes of fluids and electrolytes. Most common cardiovascular system abnormalities during hemodialysis are reviewed in this article. Atrial fibrillation is one of the most frequent arrhythmia in clinical practice. Hypokalemia is an important risk factor related to the developing of atrial fibrillation. Sudden cardiac death is unexpected death due to heart causes, which appears in a short time, when no cardiac pathology was identified earlier and no fatal condition was diagnosed. QT interval (0,24-0,45 s) is known as a ventricular repolarisation marker and its elongation is associated with increased risk of arrhythmias. T wave elongation, ST segment depression, pathological U peak, supraventricular, ventricular tachycardia, arrhythmias are specific to hypokalemia. These risk factor and cardiac events must be diagnosed and treated. This condition requires intradialytic monitoring of cardiac parameters, such as heart rate variability and ECG. ĮVADASInkstų ligos, kai reikalinga pakaitinė inkstų terapija, -svarbi visuomenės sveikatos problema. Standartinė hemodializė (HD) dažniausiai atliekama tris kartus per savaitę -kiekvieno gydymo metu atkuriamas skysčių ir elektrolitų disbalansas. Nepaisant tobulėjančių technologijų dializės srityje, tik vienas iš dviejų ligonių išgyvena trejus metus po dializės pradžios. Kasmetis mirtingumas yra...

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QT interval prolongation, torsade de pointes and renal disease

Cited by 31 publications

References 6 publications

QT Prolongation Is an Independent Predictor of Mortality in End‐Stage Renal Disease

QT Prolongation Is an Independent Predictor of Mortality in End‐Stage Renal Disease

Rate versus rhythm control and outcomes in patients with atrial fibrillation and chronic kidney disease: Data from the GUSTO-III Trial

Damoklo kardas: širdies įvykiai dializės metu

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