Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, Mexico, DF Mexico.
Artif Organs. 2012 Jun;36(6):543-51. doi: 10.1111/j.1525-1594.2011.01382.x. Epub 2011 Dec 21.
This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P < 0.05). Concurrent acute and gradual ECG changes during HDF are identified by the 3DECG, which could be useful as a preventive and prognostic method.
这项研究评估了心电图轨迹三维表现（3DECG）在终末期肾病（ESRD）患者血液透析滤过（HDF）全过程中揭示急性和逐渐变化的有用性。纳入了 15 名 ESRD 患者（6 名男性，9 名女性，年龄 46±19 岁）。在 HDF 前后测量血清电解质、血压、心率和血尿素氮（BUN）。使用 HDF 期间通过 Holter 监测获得的连续心电图（ECG）用于生成 3DECG。3DECG 图像识别出几种主要的干扰：QRS 波振幅增加（47%）、T 波振幅降低（33%）、心率增加（33%）和心律失常发生（53%）。不同类型的心律失常经常同时发生，包括孤立性室上性早搏（N=5）、心房颤动或房性二联律（N=2）和孤立性室性早搏（N=6）。与 T 波振幅降低的患者相比，T 波振幅降低的患者在 HDF 前后和总清除时的钾和 BUN 水平更高（均 P<0.05）。3DECG 可识别 HDF 期间并发的急性和逐渐性 ECG 变化，这可能是一种有用的预防和预后方法。
