QTc dispersion in haemodialysis patients with cardiac complications.
OBJECTIVE
QTc dispersion (Maximum - Minimum QTc interval on a standard 12-lead electrocardiogram (ECG)) is a useful predictor of tachyarrhythmic events and related sudden cardiac death. Recent studies have reported that QTc dispersion is prolonged in patients receiving haemodialysis (HD), and it is often further prolonged following HD treatment. In the present study, we examine whether the patients who are susceptible to prolongation of QTc dispersion by HD are prone to life-threatening cardiovascular events and related deaths.


METHODS
Forty-eight patients with cardiac symptoms such as chest pain (n = 32), arrhythmia (n = 2) or heart failure (n = 14) and receiving chronic HD treatment (40 males and eight females) were subjected to the present study. Twenty-six of a total 48 patients were given a diagnosis of ischaemic heart disease (IHD) by coronary angiography. Ten patients had cerebrovascular accidents and 11 patients had peripheral vascular disease. After the ECG recording, a prospective follow up was conducted for 37 +/- 24 months.


RESULTS
During the follow-up period, 30 patients had cardiac events, and 23 including 18 cardiovascular deaths occurred as outcomes. Throughout the total period, patients who showed prolongation of QTc dispersion after HD had cardiovascular deaths with higher incidence than those did not show the prolongation.


CONCLUSIONS
We consider that prolongation of QTc dispersion after HD treatment can predict the prognosis of patients with renal failure bearing cardiac complications. Great care is necessary for such patients if they show longer QTc dispersion and/or susceptibility for further prolongation after HD treatment.
Nakamura
Satoko
S
Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan. snakamur@hsp.ncvc.go.jp
Ogata
Chinami
C
Aihara
Naohiko
N
Sasaki
Osamu
O
Yoshihara
Fumiki
F
Nakahama
Hajime
H
Inenaga
Takashi
T
Kimura
Genjiro
G
Kawano
Yuhei
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008133:Long QT Syndrome / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors