Sato Yuji, Hayashi Toshihide, Joki Nobuhiko, Fujimoto Shouichi
Dialysis Division, University of Miyazaki Hospital, Miyazaki, Japan.
Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan.
Ther Apher Dial. 2017 Jun;21(3):287-294. doi: 10.1111/1744-9987.12512. Epub 2017 Mar 10.
In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP. By Cox analysis, aVRT was best associated with both endpoints through model 1 to 3 compared to other ECG findings. Patients categorized according to aVRT amplitude showed a step-by-step increase in hazard ratios for both endpoints. The aVRT amplitude level was significantly associated with not only composite CV events but also with all-cause mortality in prevalent dialysis patients.