Laszki-Szcząchor Krystyna, Zwolińska Danuta, Sobieszczańska Małgorzata, Tabin Michał, Polak-Jonkisz Dorota
Department of Pathophysiology, Wroclaw Medical University, Poland.
Department of Pediatric Nephrology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2018 Sep;27(9):1225-1231. doi: 10.17219/acem/69255.
The progression of chronic kidney disease is accompanied by multi-organ disorders, among which cardiovascular diseases have the status of a serious clinical problem. The body surface potential mapping (BSPM) technique is a non-invasive method which enables the detection of pathological changes in the bioelectrical activity of the heart.
The aim of this study was to identify possible disturbances in the intraventricular conduction system in peritoneally dialyzed children.
Cardiac examination consisted of 12-lead electrocardiography, echocardiography and BSPM. The evaluation of disturbances in the cardio-electrical field was performed by comparing the qualitative and quantitative features of the heart potentials on the isopotential map.
Data was collected from 10 children treated with automatic peritoneal dialysis (APD) (mean age: 13.6 ±2.3 years) and 26 healthy children. The maps of dialyzed children showed a shift in positive isopotentials toward the left lower part of the thorax, while negative values were observed in its left upper part. A distribution of lines on the isopotential maps revealed disturbances in the stimulation spread within the heart ventricles, especially within the anterior fascicle of the left bundle branch of His.
Intraventricular conduction disturbances were observed in the left bundle branch of His in the peritoneally dialyzed children. The body surface potential mapping was a more sensitive method in identifying the early stage of conduction disturbances within the heart ventricles than 12-lead electrocardiography. Further research involving a larger population of dialyzed children is planned.
慢性肾脏病的进展伴随着多器官功能障碍，其中心血管疾病是一个严重的临床问题。体表电位标测（BSPM）技术是一种非侵入性方法，能够检测心脏生物电活动的病理变化。
本研究旨在确定接受腹膜透析的儿童心室内传导系统可能存在的紊乱情况。
心脏检查包括12导联心电图、超声心动图和BSPM。通过比较等电位图上心脏电位的定性和定量特征来评估心脏电场的紊乱情况。
收集了10名接受自动腹膜透析（APD）治疗的儿童（平均年龄：13.6±2.3岁）和26名健康儿童的数据。接受透析治疗儿童的电位图显示正电位向胸部左下部偏移，而在其左上部观察到负电位。等电位图上的线条分布显示心室内部尤其是希氏束左束支前分支内的刺激传播存在紊乱。
在接受腹膜透析的儿童中，观察到希氏束左束支存在心室内传导紊乱。与12导联心电图相比，体表电位标测是一种更敏感的方法，可用于识别心室内传导紊乱的早期阶段。计划开展涉及更多接受透析治疗儿童的进一步研究。
