Key result
In end-stage renal disease patients, QT hysteresis was negatively correlated with the decrease in plasma potassium during recovery from exercise (β = -28 ms/mM, P=0.006).
Why the study?
Does hemodialysis alter exercise-induced plasma potassium dynamics and QT hysteresis in end-stage renal disease patients?
Observational (n=22)
Does hemodialysis alter exercise-induced plasma potassium dynamics and QT hysteresis in end-stage renal disease patients?
Effect estimate: β = -28 ms/mM
p-value: p=0.006
In end-stage renal disease patients, the acute plasma potassium shift after exercise modulates QT interval adaptation, which may trigger cardiac arrhythmias.
QT-potassium correlation may heighten arrhythmia risk in ESRD exercise recovery; leaves open hemodialysis effects on these dynamics.
Disturbances in plasma potassium concentration (pK) are well known risk factors for the development of cardiac arrhythmia. The aims of the present study were to evaluate the effect of hemodialysis on exercise pK dynamics and QT hysteresis, and whether QT hysteresis is associated with the pK decrease following exercise. Twenty-two end-stage renal disease patients exercised on a cycle ergometer with incremental work load before and after hemodialysis. ECG was recorded and pK was measured during exercise and recovery. During exercise, pK increased from 5.1 ± 0.2 to 6.1 ± 0.2 mM (mean ± SE; P < 0.0001) before hemodialysis and from 3.8 ± 0.1 to 5.1 ± 0.1 mM (P < 0.0001) after hemodialysis. After 2 min of recovery, pK had decreased to 5.0 ± 0.2 mM and 4.1 ± 0.1 mM (P < 0.0001) before and after hemodialysis, respectively. pK increase during exercise was accentuated after hemodialysis. The pK increase was negatively linearly correlated with pK before exercise (β = -0.21, R(2) = 0.23, P = 0.001). QT hysteresis was negatively linearly correlated with the decrease in pK during recovery (β = -28 ms/mM, R(2) = 0.36, P = 0.006). Thus, during recovery, low pK was associated with relatively longer QT interval. In conclusion, new major findings are an accentuated increase in pK during exercise after hemodialysis, an attenuated increase in pK in hyperkalemia, and an association between pK and QT interval adaptation during recovery. The acute pK shift after exercise may modulate QT interval adaptation and trigger cardiac arrhythmias.
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Tran et al. (2013) conducted an observational in End-stage renal disease (n=22). Hemodialysis vs. Before hemodialysis was evaluated on Plasma potassium (pK) dynamics and QT hysteresis during exercise and recovery (β = -28 ms/mM, p=0.006). In end-stage renal disease patients, QT hysteresis was negatively correlated with the decrease in plasma potassium during recovery from exercise (β = -28 ms/mM, P=0.006).