Dervişoğlu Erkan, Yilmaz Ahmet, Sevin Erce, Kalender Betül
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey.
Anadolu Kardiyol Derg. 2007 Sep;7(3):270-4.
Cardiac arrhythmias commonly occur in hemodialysis patients. QT dispersion (QTd=QTmax-QTmin) reflects heterogeneity of cardiac repolarization, and increased QTd is known to predispose the heart to ventricular arrhythmias and sudden cardiac death. The aim of our study was to assess the association of iron stores, reflected by transferrin saturation (TSAT) and ferritin, with the dispersion of corrected QT intervals (QTc) in patients undergoing hemodialysis.
This cross-sectional, case-controlled study included 40 patients (23 men and 17 women) with renal failure undergoing hemodialysis (Patient group) and 27 subjects (10 men and 17 women) with normal renal function (Control group). In all patients and control subjects, QT intervals were measured on electrocardiogram, and QTc intervals and QTc dispersion were calculated. Electrolyte, hemoglobin and serum TSAT and ferritin levels were also determined.
Hemodialysis patients had significantly greater QTc dispersion compared to that of control subjects (61.7+/-23.0 msec vs. 46.0+/-15.7 msec; p=0.001). Though serum iron levels were significantly associated with greater QTc dispersion (r=0.324, p=0.042), other electrolyte levels, duration of dialysis, TSAT and serum ferritin levels were not.
Although hemodialysis patients have greater QTc dispersion than control subjects, their levels of iron stores as reflected by TSAT and ferritin levels, does not correlate with the degree of QT dispersion.
心律失常在血液透析患者中很常见。QT离散度(QTd = QT最大值 - QT最小值)反映了心脏复极的异质性,已知QTd增加会使心脏易患室性心律失常和心源性猝死。我们研究的目的是评估以转铁蛋白饱和度(TSAT)和铁蛋白反映的铁储备与血液透析患者校正QT间期(QTc)离散度之间的关联。
这项横断面病例对照研究纳入了40例接受血液透析的肾衰竭患者(患者组,23例男性和17例女性)和27例肾功能正常的受试者(对照组,10例男性和17例女性)。对所有患者和对照受试者进行心电图QT间期测量,并计算QTc间期和QTc离散度。还测定了电解质、血红蛋白以及血清TSAT和铁蛋白水平。
与对照组相比,血液透析患者的QTc离散度显著更高(61.7±23.0毫秒对46.0±15.7毫秒;p = 0.001)。虽然血清铁水平与更高的QTc离散度显著相关(r = 0.324,p = 0.042),但其他电解质水平、透析时间、TSAT和血清铁蛋白水平与QTc离散度无关。
尽管血液透析患者的QTc离散度高于对照组,但TSAT和铁蛋白水平所反映的铁储备水平与QT离散度程度无关。