Wu Vin-Cent, Lin Lian-Yu, Wu Kwan-Dun
Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Taipei, Taiwan.
Nephrology (Carlton). 2005 Apr;10(2):109-12. doi: 10.1111/j.1440-1797.2005.00391.x.
The leading cause of mortality in dialysis patients is cardiovascular complications, including ventricular arrhythmias and sudden cardiac death. A reliable non-invasive predictive test of sudden death is therefore important. The interlead variation in duration of the QT interval on the surface electrocardiogram corrected with heart rate (QTc dispersion) might serve as a surrogate for ventricular arrhythmia. Prolonged QTc dispersion is commonly encountered in dialysis patients and possesses an increased risk of all mortality, including cardiovascular mortality. QT dispersion might be affected by shifts of the intracellular electrolytes during dialysis and increasing deposition of iron in cardiac muscles in these patients who have underlying heart diseases. Although no well-designed study has been done, the factors contributing to prolongation of QTc dispersion should be avoided. We summarize the results of the currently available clinical studies that examined QTc dispersion in dialysis patients.
透析患者的主要死亡原因是心血管并发症，包括室性心律失常和心源性猝死。因此，一种可靠的非侵入性猝死预测测试很重要。经心率校正的体表心电图上QT间期时长的导联间差异（QTc离散度）可能可作为室性心律失常的替代指标。QTc离散度延长在透析患者中很常见，且包括心血管死亡率在内的所有死亡率风险均增加。QT离散度可能受透析期间细胞内电解质变化以及这些患有基础心脏病患者心肌中铁沉积增加的影响。尽管尚未开展精心设计的研究，但应避免导致QTc离散度延长的因素。我们总结了目前有关透析患者QTc离散度的临床研究结果。
