Polak-Jonkisz Dorota, Laszki-Szczachor Krystyna, Zwolińska Danuta, Rusiecki Lesław, Miler Maria, Sobieszczańska Małgorzata
Medical University of Wroclaw, Department of Pediatric Nephrology.
Pol Merkur Lekarski. 2009 Apr;26(154):276-80.
The highest percent of cardiac muscle damages is written down in children which are exposed to hemodialysis. In this group the heart examinations using body surface heart potential mapping (BSPM) method have been carried out. The aim of the study was to assess the influence of hemodialysis on heart's electrodynamics in children and adolescent during replacement therapy.
Multielectrode recording have been done in every kid before and after hemodialysis. For every record it was created isopotential map. By the comparing our maps with model maps for healthy children it was affirmed that in greater part of studied examples of hemodialysed children there are present early changes indicating conducting disturbances in left bundle of fasciculus atrioventricularis (His) and initial stage of left ventricular hypertrophy (LVH). That changes haven't been confirmed in classic ECG, which suggests that the disturbances in excitation conductance observed on isointegral maps are far beyond the area detected by 12-electrode classic ECG recording.
The maps made before dialysis are characterised by large, unsymmetrical isopotential lines changes over the left and right ventricle. After carried out of hemodialysis the image of ECG records was improving. In all of cases the isoline distribution in sternal and anterior lower left part of chest comes back to norm. Changes are visible merely over the left ventricle and in anterior upper right part of chest what is connected with just stabilised conducting disturbances in the left branch of His bundle, left bundle of fasciculus atrioventricularis (His bundle).
接受血液透析的儿童中心肌损伤比例最高。在该组中，已使用体表心脏电位标测（BSPM）方法进行心脏检查。本研究的目的是评估血液透析对儿童和青少年替代治疗期间心脏电动力学的影响。
在每次血液透析前后对每个儿童进行多电极记录。为每次记录创建等电位图。通过将我们的图与健康儿童的模型图进行比较，证实了在大多数接受血液透析儿童的研究实例中，存在早期变化，表明房室束左束支（希氏束）传导障碍以及左心室肥厚（LVH）的初始阶段。这些变化在经典心电图中未得到证实，这表明在等积分图上观察到的兴奋传导障碍远远超出了12电极经典心电图记录检测到的区域。
透析前制作的图的特征是左右心室上等电位线变化大且不对称。进行血液透析后，心电图记录图像有所改善。在所有病例中，胸骨和左下胸部前部的等压线分布恢复正常。变化仅在左心室和右上胸部前部可见，这与希氏束左支、房室束左束支（希氏束）中刚刚稳定的传导障碍有关。
