Department of Cardiology, An-Najah National University Hospital, Nablus, Palestine.
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
BMC Nephrol. 2022 Feb 24;23(1):79. doi: 10.1186/s12882-022-02707-9.
Right ventricular (RV) function is an important prognostic predictor for end-stage renal disease (ESRD) patients. Non-invasive evaluation of RV function by simple electrocardiogram (ECG) is not yet evident. The purpose of this article was to investigate the presence and association of pathological right ventricular changes in synthesized ECG with cardiac hospitalization and mortality.
A prospective cohort study of 137 ESRD patients (mean age: 56 years) were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. Synthesized ECG was done right before the hemodialysis (HD) session. The pathological right ventricular changes were recorded for each patient. The relationship between pathological RV changes and mortality, cardiac and non-cardiac hospitalization was assessed through a 6-months follow-up period.
Right ventricular Q wave was found in 2.2% of patients, while right ventricular ST elevation was found in 0.7% of patients, and right ventricular negative T wave was found in 0.7% of patients. During the 6-month period of follow-up, 36 (26.3%) patients were hospitalized, nine patients (6.6%) due to cardiac causes. A total of 8 (5.83%) patients died, out of those 4 patients (2.91%) due to cardiac causes. Using Fisher's exact test, there was a significant association between pathological abnormalities in synthesized ECG and hospitalization among hemodialysis patients, (p = 0.047). Pathological changes in synthesized ECG were less prevalent in non-cardiac hospitalizations than in cardiac hospitalizations.
The presence of pathological RV synthesized ECG changes can predict cardiac hospitalization in ESRD patients. Synthesized ECG is a good available tool that can be easily performed in ESRD patients. To determine whether Synthesized ECG can be used as a screening tool for pathological RV changes in a dialysis patients, more research with a larger number of patients and a longer follow-up period is required.
右心室（RV）功能是终末期肾病（ESRD）患者的重要预后预测指标。通过简单的心电图（ECG）对 RV 功能进行非侵入性评估尚不清楚。本文旨在探讨合成 ECG 中病理性右心室变化与心脏住院和死亡率的存在和相关性。
从巴勒斯坦纳布卢斯的纳贾赫国立大学医院血液透析中心招募了 137 名 ESRD 患者（平均年龄：56 岁）进行前瞻性队列研究。在血液透析（HD）治疗前进行合成 ECG。记录每位患者的病理性 RV 变化。通过 6 个月的随访期评估病理性 RV 变化与死亡率、心脏和非心脏住院之间的关系。
2.2%的患者出现 RV 导联 Q 波，0.7%的患者出现 RV 导联 ST 段抬高，0.7%的患者出现 RV 导联负 T 波。在 6 个月的随访期间，36 名（26.3%）患者住院，9 名（6.6%）因心脏原因住院。共有 8 名（5.83%）患者死亡，其中 4 名（2.91%）因心脏原因死亡。使用 Fisher 精确检验，合成 ECG 中的病理性异常与血液透析患者的住院之间存在显著相关性（p=0.047）。病理性变化在非心脏住院患者中比在心脏住院患者中更为常见。
病理性 RV 合成 ECG 变化的存在可以预测 ESRD 患者的心脏住院。合成 ECG 是一种简单易行的良好工具，可用于 ESRD 患者。为了确定合成 ECG 是否可以作为透析患者病理性 RV 变化的筛查工具，需要进行更多具有更大患者数量和更长随访期的研究。
