Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego Street 1, 50-368, Wroclaw, Poland.
Pediatr Nephrol. 2012 Feb;27(2):251-9. doi: 10.1007/s00467-011-1982-y. Epub 2011 Aug 11.
Children with chronic kidney disease (CKD) are affected by cardiovascular complications, including disturbances in the intraventricular conduction system. Body surface potential mapping (BSPM) is a non-invasive method of assessing the cardioelectrical field. Our aim was to investigate conduction disturbances in young CKD patients using ventricular activation time (VAT) maps. Our study comprised 22 CKD children (mean age: 13.1 ± 2.5 years) treated conservatively and 29 control patients. For each child 12-lead electrocardiogram (ECG) readings were taken, and blood pressure and serum concentrations of iPTH, Pi, t-Ca, creatinine, Fe(+3), ferritin, and Hb, as well as eGFR were measured. All children underwent registration in the 87-lead BSPM system, and group-mean VAT maps and a difference map, which presents statistically significant differences between the groups, were created. The VAT map distribution in CKD patients revealed abnormalities specific to left anterior fascicle block. The difference map displays the areas of intergroup VAT changes, which are of discriminative value in detecting intraventricular conduction disturbances. Intraventricular conduction impairments in the left bundle branch may occur in children with CKD. BSPM enables conduction disturbances in CKD children to be detected earlier than using 12-lead ECG. The difference map derived from the group-mean isochrone maps precisely localizes the sites of disturbed conduction in the heart intraventricular conduction system.
患有慢性肾脏病 (CKD) 的儿童会受到心血管并发症的影响，包括室内传导系统紊乱。体表电位图 (BSPM) 是评估心电场的一种非侵入性方法。我们的目的是使用心室激活时间 (VAT) 图研究年轻 CKD 患者的传导障碍。我们的研究包括 22 名接受保守治疗的 CKD 儿童（平均年龄：13.1±2.5 岁）和 29 名对照患者。对每个孩子进行 12 导联心电图 (ECG) 读数，并测量血压和血清甲状旁腺激素 (iPTH)、Pi、总钙 (t-Ca)、肌酐、Fe(+3)、铁蛋白和 Hb 浓度，以及 eGFR。所有儿童均在 87 导联 BSPM 系统中进行登记，并创建组平均 VAT 图和差异图，该差异图显示组间 VAT 差异具有统计学意义。CKD 患者的 VAT 图分布显示出左前束支阻滞的特异性异常。差异图显示了组间 VAT 变化的区域，这些区域在检测室内传导障碍方面具有区分价值。左束支的室内传导损伤可能发生在 CKD 儿童中。BSPM 能够比 12 导联 ECG 更早地检测到 CKD 儿童的传导障碍。从组平均等时线图得出的差异图精确地标定了心脏室内传导系统中传导障碍的部位。
