BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk of life-threatening cardiovascular arrhythmias. Although these arrhythmias are usually secondary to structural heart diseases that are commonly associated with CKD, a significant proportion of cases with sudden cardiac death have no obvious structural heart disease. This study aims to explore the relationship of cardiac repolarization in patients with CKD and worsening kidney function. HYPOTHESIS: There is cardiac repolarization abnormalities among patients with chronic kidney disease. METHODS: This was a retrospective, chart-review study of admissions or clinic visits to a university hospital between 2005 and 2010 by patients with a diagnosis of CKD. Inclusion criteria selected patients who had 12-lead surface electrocardiography (ECG), renal function tests within 24 hours, and transthoracic echocardiography within 6 months. Cases with a documented etiology for the corrected Qt (Qtc) interval prolongation including structural heart disease, QT prolonging drugs, or relevant disease conditions, were excluded. RESULTS: Our sample size was 154 ECGs. Two-thirds of patients with CKD had QTc interval prolongation, and about 20% had a QTc interval >500 ms. QTc interval was significantly different and increased with each successive stage of CKD using the Bazett (P < 0.006) or Fridericia (P = 0.03) formula. QTc interval correlated significantly with serum creatinine (P = 0.01). These finding were independent of age, gender, potassium, and calcium concentrations. CONCLUSIONS: The progression of CKD resulted in a significant delay of cardiac repolarization, independent of other risk factors. This effect may potentially increase the risk of sudden cardiac death, and may also increase the susceptibility of drug-induced arrhythmia.
BACKGROUND:Patients with chronic kidney disease (CKD) are at increased risk of life-threatening cardiovascular arrhythmias. Although these arrhythmias are usually secondary to structural heart diseases that are commonly associated with CKD, a significant proportion of cases with sudden cardiac death have no obvious structural heart disease. This study aims to explore the relationship of cardiac repolarization in patients with CKD and worsening kidney function. HYPOTHESIS: There is cardiac repolarization abnormalities among patients with chronic kidney disease. METHODS: This was a retrospective, chart-review study of admissions or clinic visits to a university hospital between 2005 and 2010 by patients with a diagnosis of CKD. Inclusion criteria selected patients who had 12-lead surface electrocardiography (ECG), renal function tests within 24 hours, and transthoracic echocardiography within 6 months. Cases with a documented etiology for the corrected Qt (Qtc) interval prolongation including structural heart disease, QT prolonging drugs, or relevant disease conditions, were excluded. RESULTS: Our sample size was 154 ECGs. Two-thirds of patients with CKD had QTc interval prolongation, and about 20% had a QTc interval >500 ms. QTc interval was significantly different and increased with each successive stage of CKD using the Bazett (P < 0.006) or Fridericia (P = 0.03) formula. QTc interval correlated significantly with serum creatinine (P = 0.01). These finding were independent of age, gender, potassium, and calcium concentrations. CONCLUSIONS: The progression of CKD resulted in a significant delay of cardiac repolarization, independent of other risk factors. This effect may potentially increase the risk of sudden cardiac death, and may also increase the susceptibility of drug-induced arrhythmia.
Authors: Beata Franczyk-Skóra; Anna Gluba-Brzózka; Jerzy Krzysztof Wranicz; Maciej Banach; Robert Olszewski; Jacek Rysz Journal: Int Urol Nephrol Date: 2015-05-12 Impact factor: 2.370
Authors: Kathrin Weidner; Michael Behnes; Christel Weiß; Christoph Nienaber; Linda Reiser; Armin Bollow; Gabriel Taton; Thomas Reichelt; Dominik Ellguth; Niko Engelke; Jonas Rusnak; Tobias Schupp; Seung-Hyun Kim; Christian Barth; Jorge Hoppner; Muharrem Akin; Kambis Mashayekhi; Martin Borggrefe; Ibrahim Akin Journal: Heart Vessels Date: 2019-05-10 Impact factor: 2.037
Authors: Martin Huemer; Ann-Kristin Becker; Alexander Wutzler; Philipp Attanasio; Abdul S Parwani; Philipp Lacour; Leif-Hendrik Boldt; Burkert Pieske; Wilhelm Haverkamp; Florian Blaschke Journal: Cardiol J Date: 2018-02-05 Impact factor: 2.737