血液透析患者的主要心律失常事件及T波形态描述符
Major arrhythmic events and T wave morphology descriptors in hemodialyzed patients.
作者信息
Poulikakos Dimitrios, Banerjee Debasish, Malik Marek
机构信息
Renal and Transplantation Unit, St. George's, University of London, London, United Kingdom; Cardiovascular Sciences Research Centre, St. George's, University of London, London, United Kingdom.
Renal and Transplantation Unit, St. George's, University of London, London, United Kingdom; Cardiovascular Sciences Research Centre, St. George's, University of London, London, United Kingdom.
出版信息
J Electrocardiol. 2014 Mar-Apr;47(2):240-3. doi: 10.1016/j.jelectrocard.2013.11.010. Epub 2013 Nov 27.
BACKGROUND
Sudden cardiac death is common in patients receiving regular hemodialysis (HD). We recently demonstrated that selected repolarization descriptors calculated from electrocardiographic monitoring during HD demonstrate intra-subject stability. In this study we followed up the initial cohort for major arrhythmic events (MAE).
METHODS
Holter electrocardiograms (ECGs) were recorded during dialysis in 81 HD patients and repeated 5 times at 2 week intervals. The QRS-to-T angle (TCRT), the principal component analysis (PCA) ratio and the T wave morphology dispersion (TMD) were calculated in overlapping 10 second ECG segments and averaged overall recordings in each patient. Patients were followed up for MAE and non-arrhythmic mortality.
RESULTS
During 18 ± 3 months, 3 patients experienced MAE. Compared to others, MAE patients exhibited extreme TCRT and TMD values and minimal intradialytic changes.
CONCLUSION
The prognostic value of repolarization descriptors from intradialytic monitoring should be assessed prospectively.
背景
在接受规律血液透析（HD）的患者中，心源性猝死很常见。我们最近证明，从血液透析期间的心电图监测中计算出的特定复极描述符显示出受试者内的稳定性。在本研究中，我们对初始队列进行随访以观察主要心律失常事件（MAE）。
方法
对81例血液透析患者在透析期间进行动态心电图（ECG）记录，并每隔2周重复记录5次。在重叠的10秒心电图片段中计算QRS波至T波角度（TCRT）、主成分分析（PCA）比值和T波形态离散度（TMD），并对每位患者的总体记录进行平均。对患者进行随访以观察主要心律失常事件和非心律失常性死亡。
结果
在18±3个月期间，3例患者发生了主要心律失常事件。与其他患者相比，主要心律失常事件患者表现出极端的TCRT和TMD值，且透析期间变化最小。
结论
应前瞻性评估透析期间监测的复极描述符的预后价值。
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