title: Association of Lead aVR T-wave Amplitude With Cardiovascular Events or Mortality Among Prevalent Dialysis Patients.
abstract: In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP. By Cox analysis, aVRT was best associated with both endpoints through model 1 to 3 compared to other ECG findings. Patients categorized according to aVRT amplitude showed a step-by-step increase in hazard ratios for both endpoints. The aVRT amplitude level was significantly associated with not only composite CV events but also with all-cause mortality in prevalent dialysis patients.
authors.affiliation: Dialysis Division, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Joki
authors.affiliation: Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D010446:Peptide Fragments; D012709:Serum Albumin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: Cardiovascular disease; Electrocardiogram; Mortality; T-wave amplitude; aVR lead