Usefulness of body surface potential mapping for early identification of the intraventricular conduction disorders in young patients with chronic kidney disease.
BACKGROUND
Cardiovascular complications are considered a significant problem in patients with chronic kidney disease (CKD). Body surface potential mapping (BSPM) is a noninvasive method that is useful in detecting early changes involving the heart. The aim of the study was to evaluate possible abnormalities within the cardiac intraventricular conduction system in young patients with CKD using the BSPM method.


METHODS
Based on the BSPM registrations, the QRS-T isointegral maps were created in 42 young patients with CKD (on hemodialysis, subgroup Ia; on peritoneal dialysis, subgroup Ib; on conservative treatment, group II) and in 26 healthy subjects. Serum levels of electrolytes, urea, and creatinine were also assessed in the entire study population.


RESULTS
In the healthy subjects, the maximums of the group mean QRS-T isointegral map were located in the left lower anterior part of the thorax, whereas in the Ia patients, the maximums were focused at the medial sternum line. The QRS-T maps, both for Ib and II groups, showed the positive integrals covering the left part of the anterior thorax. In all the patients with CKD, standard 12-lead electrocardiogram (ECG) and echocardiography findings were within the reference range.


CONCLUSIONS
In the hemodialyzed patients with CKD, the group-mean QRS-T isointegral map distribution suggested a significant delay of excitation propagation in the left bundle branch, although no abnormalities were found with standard ECG. In the patients with CKD treated with peritoneal dialysis or conservatively, the group-mean QRS-T isointegral maps were characteristic for the early phase of conduction disturbances within the left bundle branch, which again was not observed on the standard ECG recordings.
Polak-Jonkisz
Dorota
D
Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland. dpjonkisz@nefped.am.wroc.pl
Laszki-Szczachor
Krystyna
K
Purzyc
Leszek
L
Zwolińska
Danuta
D
Musiał
Kinga
K
Pilecki
Witold
W
Rusiecki
Lesław
L
Janocha
Anna
A
Kałka
Dariusz
D
Sobieszczańska
Małgorzata
M
D000293:Adolescent; D018780:Body Surface Potential Mapping / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult