Valsangiacomo Emanuela, Neuhaus Thomas J, Goetschel Philippe, Bauersfeld Urs
Division of Pediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
Pediatr Nephrol. 2002 Oct;17(10):837-41. doi: 10.1007/s00467-002-0976-1. Epub 2002 Aug 27.
Cardiovascular complications are the leading causes of morbidity and mortality in adult dialysis patients. The aim of this study was to evaluate the cardiovascular system of children on hemodialysis (HD), with special focus on rhythm disturbances. Nine patients, aged 15.6+/-4.1 years, underwent electrocardiographic examination (ECG) including 12-lead ECG, Holter-ECG, QT dispersion, signal-averaged ECG, and exercise testing. Echocardiography and 24-h blood pressure measurement were also performed. Patients had been on HD for a median period of 7 months (range 1-29 months). Normal findings were obtained with 12-lead ECG, exercise testing, QT dispersion, and signal-averaged ECG. Holter-ECG showed short runs of slow monomorphic ventricular tachycardia in two patients. Echocardiography was normal except for ventricular hypertrophy in two patients. In conclusion, rhythm disturbances were rare, with slow monomorphic ventricular tachycardias being the only significant finding. The absence of late potentials and normal QT dispersion suggest that myocardial electrical excitability and recovery are preserved in children on HD.
心血管并发症是成年透析患者发病和死亡的主要原因。本研究的目的是评估接受血液透析（HD）儿童的心血管系统，特别关注心律失常。9名年龄为15.6±4.1岁的患者接受了心电图检查（ECG），包括12导联心电图、动态心电图、QT离散度、信号平均心电图和运动试验。还进行了超声心动图和24小时血压测量。患者接受HD的中位时间为7个月（范围1 - 29个月）。12导联心电图、运动试验、QT离散度和信号平均心电图检查结果正常。动态心电图显示2例患者有短阵单形性室性心动过速。除2例患者有心室肥厚外，超声心动图检查正常。总之，心律失常很少见，短阵单形性室性心动过速是唯一的重要发现。无晚电位及QT离散度正常提示HD儿童心肌电兴奋性和恢复能力得以保留。
