Key result
In elderly patients on hemodialysis, the Tp-e interval was prolonged before dialysis compared to controls and further increased after the hemodialysis session.
Why the study?
Sudden cardiac death is a major cause of death in elderly hemodialysis patients, and prolonged Tp-e interval and increased Tp-e/QTc ratio are strongly associated with sudden cardiac death. The study investigated the effects of serum electrolyte changes on pre- and post-hemodialysis ECG parameters, particularly Tp-e.
Does a standard hemodialysis session and its associated electrolyte shifts alter the Tp-e interval and Tpe/QTc ratio in elderly patients?
Cross-Sectional (n=240)
No
Does a standard hemodialysis session and its associated electrolyte shifts alter the Tp-e interval and Tpe/QTc ratio in elderly patients?
Hemodialysis significantly prolongs the Tp-e interval and increases the Tpe/QTc ratio in elderly patients, changes that correlate with calcium and phosphorus shifts and may indicate an increased risk for ventricular arrhythmias.
Answers are grounded in this paper and cite their sources.
Post-dialysis Tp-e prolongation may signal arrhythmia vulnerability in elderly hemodialysis patients; leaves open causal links and prospective validation.
Aim: Sudden cardiac death (SCD) due to arrhythmias is a major cause of death in elderly patients on hemodialysis (HD). It has been found that prolonged Tp-e interval (Tpe) on electrocardiography (ECG) and increased Tpe/QTc ratio are strongly associated with SCD. In this study, we aimed to inves¬tigate the effects of changes in serum electrolyte levels on the pre- and post-HD ECG parameters, particularly Tpe. Methods: The study included 160 HD patients (with no disease or medication known to affect the QT interval) and 80 age- and sex-matched controls with normal kidney functions. All participants were aged 55 years or older. Pre- and post-HD serum electrolyte values and ECG re¬cordings were obtained. The heart rate, QRS interval, QTc, Tpe, and Tpe/QTc values were calculated. The pre-HD data were compared with the post-HD data as well as with controls. Results: The pre- and post-HD Tpe (p<0.001 for both comparisons) and Tpe/QTc (p=0.024 and p<0.001, respectively) values were significantly higher in the HD group than in the control group. The post-HD Tpe and Tpe/QTc values were significantly increased compared to the pre-HD values (p<0.001 for each comparison). The pre-HD Tpe was longer in patients with hypocalcemia or hy¬perphosphatemia than in normocalcemic and normophosphatemic patients (p=0.04 for both data¬sets). ΔTpe was significantly correlated with Δcalcium (r=-0.19, p=0.02) and Δphosphorus (r=-0.23, p=0.004). Conclusion: In the elderly patients on HD, Tpe, which was prolonged before HD, was even more prolonged after HD. Hypocalcemia and hyperphosphatemia may be among the un¬derlying factors.
No takes yet. Share an insight, caveat, or question.
Candemir et al. (2021) conducted a cross-sectional in End-Stage Renal Disease on Hemodialysis (n=240). Hemodialysis vs. Pre-hemodialysis baseline was evaluated on Tp-e interval (Tpe) duration in milliseconds (p=<0.001). In elderly patients on hemodialysis, the Tp-e interval was prolonged before dialysis compared to controls and further increased after the hemodialysis session.
Synapse has enriched 10 related papers. Consider them for comparative context: