title: Cardiac vascular calcification and QT interval in ESRD patients: is there a link?
abstract: We will present our experience and our preliminary data about the correlation between cardiac calcification and QT interval (and QT dispersion) in uraemia. We studied 32 haemodialysis (HD) patients (age 69 +/- 16 years, time on dialysis 32 +/- 27 months) and 12 chronic kidney disease stage 4 (CKD-4) patients (age 66 +/- 17 years, uraemia duration 38 +/- 16 months). The patients were characterized by a good mineral control, as shown by serum phosphate levels (3.6 +/- 1.3 mg/dl in CKD-4 and 4.3 +/- 1.6 mg/dl in HD patients) and Ca x P product (46 +/- 17 and 49 +/- 16 mg(2)/dl(2), respectively). The parathyroid hormone levels were higher in HD than CKD-4 patients (p < 0.0001). A TC score >400 was found to be highly prevalent in both groups. Significantly more HD patients (62.5%) showed cardiac calcification than CKD-4 patients (33%; p = 0.01). The patients were matched for TC scores higher or lower than 400. The two groups differed by gender (p < 0.05), age (p = 0.026), frequency of diabetes mellitus (p < 0.01), uraemia follow-up period (p < 0.001), low-density lipoprotein cholesterol level (p = 0.009), Ca x P product (p = 0.002), parathyroid hormone level (p < 0.0001), and corrected QT dispersion (p < 0.0001). The QT interval was higher in HD and CKD-4 patients with higher TC scores (approximately 11%), but QT interval dispersion was significantly higher in patients with TC scores >400. QT dispersion showed a linear correlation with TC scores in both groups (r = 0.899 and p < 0.0001 and r = 0.901 and p < 0.0001). Male gender, age, time (months) of uraemia, low-density lipoprotein cholesterol, albumin, calcium x phosphorus product, parathyroid hormone, and TC score are important determinants of QT dispersion. Our data show that it is possible to link dysrhythmias and cardiac calcification in uraemic patients.
authors.affiliation: UO di Nefrologia e Dialisi, PO 'A. Landolfi', Solofra, Italia. b.diiorio@tiscali.it
authors.forename: Biagio R
authors.initials: BR
authors.lastname: Di Iorio
authors.forename: Sara
authors.initials: S
authors.lastname: Bortone
authors.forename: Carmine
authors.initials: C
authors.lastname: Piscopo
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Grimaldi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cucciniello
authors.forename: Ernesto
authors.initials: E
authors.lastname: D'Avanzo
authors.forename: Fiorentino
authors.initials: F
authors.lastname: Mondillo
authors.forename: Nicola
authors.initials: N
authors.lastname: Cillo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bellizzi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001798:Blood Proteins / Q000032:analysis; D002114:Calcinosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis; D012737:Sex Factors; D013997:Time Factors; D014511:Uremia / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000628:therapy
chemical_list: D001798:Blood Proteins; D010710:Phosphates; D002118:Calcium