Key result
Hemodialysis and CAPD patients had significantly higher filtered-QRS duration compared to healthy controls (105 and 104 ms vs 95 ms, p=0.04), and HD patients had longer QT dispersion than CAPD.
Why the study?
Do QT dispersion and signal-averaged ECG parameters differ between patients on hemodialysis, CAPD, and healthy controls?
Cross-Sectional (n=86)
Do QT dispersion and signal-averaged ECG parameters differ between patients on hemodialysis, CAPD, and healthy controls?
Answers are grounded in this paper and cite their sources.
Patients on hemodialysis have longer QT dispersion than those on CAPD, and both groups show increased filtered-QRS duration compared to healthy controls, potentially indicating higher arrhythmic risk.
OBJECTIVE: The aim of this study was to compare QT dispersion (QTd) and signal-averaged electrocardiogram (SA-ECG) parameters that may predict risk of malignant arrhythmias in patients on hemodialysis (HD), on continuous ambulatory peritoneal dialysis (CAPD), and in controls. SETTING: Controlled cross-sectional study in a tertiary-care setting. PATIENTS: 28 HD (M/F 18/10; mean age 32 +/- 9 years), 29 CAPD (M/F 17/12; mean age 34 +/- 10 years), and 29 healthy controls (M/F 17/12; mean age 32 +/- 8 years) were included. INTERVENTIONS: On ECG, minimum (QTmin) and maximum (QTmax) QT duration and their difference (QTd) were measured. In SA-ECG, duration of filtered QRS, HFLA signals less than 40 microV, and RMS voltage (40 ms) were also measured. RESULTS: Higher serum Ca2+ and lower K+ levels were found in CAPD compared to HD. All QT parameters were increased in HD and CAPD compared to controls. QT dispersion was significantly prolonged in HD compared to CAPD. In HD, QTd was correlated with left ventricular (LV) mass index (r = 0.53, p = 0.004), but not in CAPD (r = -0.09, p = 0.63). QT dispersion was significantly prolonged in patients with LV hypertrophy compared to patients without hypertrophy on HD (68 +/- 18 ms vs 49 +/- 18 ms, p = 0.008). In the analysis of SA-ECG, 3 of the 28 (11%) HD and 2 of the 29 (7%) CAPD patients had abnormal late potentials. Patients on HD and CAPD had significantly higher filtered-QRS duration compared to controls (105 +/- 15 ms and 104 +/- 12 ms vs 95 +/- 5 ms, respectively, p = 0.04). Patients with LV hypertrophy had higher filtered-QRS duration compared to patients without hypertrophy (109 +/- 12 ms vs 95 +/- 8 ms, p < 0.001). CONCLUSION: Dialysis patients had prolonged QTd and increased filtered-QRS duration in SA-ECG compared to controls. Patients on HD had longer QTd than patients on CAPD. QTd has been correlated to LV mass index in HD, but not in CAPD. This difference might be due to the effect of different dialysis modalities on electrolytes, especially the higher serum Ca2+ levels.
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Yıldız et al. (2001) conducted a cross-sectional in End-stage renal disease on dialysis (n=86). Hemodialysis and CAPD vs. Healthy controls was evaluated on QT dispersion (QTd) and signal-averaged electrocardiogram (SA-ECG) parameters (p=0.04). Hemodialysis and CAPD patients had significantly higher filtered-QRS duration compared to healthy controls (105 and 104 ms vs 95 ms, p=0.04), and HD patients had longer QT dispersion than CAPD.
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