Prevalence and predictors of arrhythmia in end stage renal disease patients on hemodialysis
Prevalence and predictors of arrhythmia in end stage renal disease patients on hemodialysis
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DOI：
10.1080/08860220701191237
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发表时间：
2007-01-01
期刊：
影响因子：
3
通讯作者：
Ozin, Bulent
中科院分区：
文献类型：
--
作者：
Bozbas, Huseyin;Atar, Ilyas;Ozin, Bulent
背景。猝死在终末期肾病（ESRD）中很常见。 ESRD 患者经常出现心律失常，并且被认为是导致猝死率高的原因。本研究调查了维持性透析患者心律失常的患病率和预测因素。方法。九十四名接受血液透析计划的患者参加了这项研究。记录常规实验室结果。心律失常、无症状缺血期和心率变异性分析均通过 24 小时动态心电图监测记录获得。校正的 QT (QTc) 离散度根据 12 导联表面心电图计算得出。还在透析间日进行超声心动图和组织多普勒检查。室性心律失常按照Lown分类法进行分类； 3级及以上被认为是复杂室性心律失常（CVA）。结果。平均年龄为 52.5 +/- 13.2 岁； 44 名（46.8%）为女性。 80 例（85.1%）患者检测到室性期前收缩，其中 35 例（37.2%）被归类为复杂室性心律失常（CVA）。冠状动脉疾病、高血压和 QTc 离散度似乎是预测 CVA 发展的独立因素。 53 例（56.4%）患者检测出房性早搏（APC），15 例（16%）患者检测出室上性心律失常；全部被诊断为心房颤动。透析治疗持续时间被发现是 APC 的独立预测因素。结论。接受血液透析的 ESRD 患者经常观察到心律失常，这可能是导致突发死亡率高的原因。高血压、CAD 和 QTc 离散度是 CVA 的独立预测因素，透析治疗持续时间是影响这些患者 APC 发展的独立因素。
Background. Sudden death is common in end-stage renal disease (ESRD). Cardiac arrhythmia is observed frequently in patients with ESRD and is thought to be responsible for this high rate of sudden death. This study investigated the prevalence and the predictors of arrhythmia in patients on maintenance dialysis. Methods. Ninety-four patients on hemodialysis program were enrolled in the study. Routine laboratory results were noted. Arrhythmia, periods of silent ischemia, and heart-rate variability analyses were obtained from 24-hour Holter monitor recordings. Corrected QT (QTc) dispersion was calculated from 12-lead surface EKG. Echocardiographic and tissue Doppler examinations were performed on interdialytic days as well. Ventricular arrhythmia was classified according to Lown classification; classes 3 and above were accepted as complex ventricular arrhythmia (CVA). Results. The mean age was 52.5 +/- 13.2 years; 44 (46.8%) were women. Ventricular premature contractions were detected in 80 (85.1%) patients, of whom 35 (37.2%) were classified as complex ventricular arrhythmia (CVA). Coronary artery disease, hypertension, and QTc dispersion appeared as independent factors predictive of CVA development. Atrial premature contractions (APC) were detected in 53 patients (56.4%) and supraventricular arrhythmia in 15 (16%) patients; all were identified as atrial fibrillation. Duration of dialysis ther- apy was found as an independent predictor of APC. Conclusion. Arrhythmia is frequently observed in ESRD patients receiving hemodialysis and may be responsible for the high rate of sudden mortality. Hypertension, CAD, and QTc dispersion are independent predictors of CVA, and duration of dialysis therapy is an independent factor affecting APC development in these patients.