The Relationship Between Patient Survival and ECG aVR T Wave Positivity in Hemodialysis Patients

Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented voltage right) T wave and cardiovascular mortality in hemodialysis patients. The aim of our study was to investigate the relationship between ECG T aVR positivity and overall mortality together with other known risk factors in hemodialysis patients. Materials and methods: One hundred and one hemodialysis patients were retrospectively screened for ECG T aVR wave positivity. In parallel, the relationship between T aVR positivity and age, gender, calcium phosphorus index, heart rate, ECG and echocardiographic parameters, mortality, smoking, presence of diabetes mellitus, hypertension, myocardial infarction were investigated. RESULTS: Univariate analyzes revealed that patients with positive T aVR (16%) had a statistically lower dialysis time and ejection fraction compared to patient with negative T aVR (p=0.041 and p=0.046, respectively). Survival analysis revealed statistically significantly better prognosis for T aVR-negative patients compared to T aVR-positive patients (5-year survival 70.9%, and 45.5%, respectively; p=0.027). Among tested parameters, independent risk factors affecting survival in hemodialysis patients were found to be age (hazard ratio, HR: 1.03), high heart rate (HR: 1.03), smoking (HR: 3.37) and presence of diabetes mellitus (HR: 2.91). CONCLUSIONS: Our results indicate that routine monitorization of T wave in aVR derivation together with evaluation of other risk factors may provide information about the cardiovascular risk profile, mortality and life habits of hemodialysis patients.