Impact of Vascular Calcification on QT Interval and QT Dispersion in CKD and Dialysis Patients

Abstract Background Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning. Methods Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated. Results The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021). Conclusions Patients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.

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Relationship between Vascular Calcification, Protein-Energy Wasting Syndrome, and Sarcopenia in Maintenance Automated Peritoneal Dialysis

Life ◽

10.3390/life11070666 ◽

2021 ◽

Vol 11 (7) ◽

pp. 666

Author(s):

Gustavo Leal-Alegre ◽

Claudia Lerma ◽

Gabriela Leal-Escobar ◽

Bernardo Moguel-González ◽

Karen Belén Martínez-Vázquez ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Peritoneal Dialysis ◽

Vascular Calcification ◽

Automated Peritoneal Dialysis ◽

Dialysis Patients ◽

Protein Energy Wasting ◽

Wasting Syndrome ◽

Protein Energy ◽

Inflammation Score

Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.

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QT interval and QT dispersion in endurance athletes and in power athletes using large doses of anabolic steroids

The American Journal of Cardiology ◽

10.1016/s0002-9149(99)00299-4 ◽

1999 ◽

Vol 84 (3) ◽

pp. 364-366 ◽

Cited By ~ 39

Author(s):

Anu Stolt ◽

Tuomo Karila ◽

Matti Viitasalo ◽

Matti Mäntysaari ◽

Urho M Kujala ◽

...

Keyword(s):

Qt Interval ◽

Anabolic Steroids ◽

Qt Dispersion ◽

Endurance Athletes

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Adjacent QT dispersion: A good predictor of ventricular arrhythmias after myocardial infarction

Open Medicine ◽

10.2478/s11536-007-0055-x ◽

2008 ◽

Vol 3 (2) ◽

pp. 179-182 ◽

Cited By ~ 1

Author(s):

Mohammad Ostovan ◽

Shahdad Khosropanah ◽

Shohreh Hooshmand

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Qt Interval ◽

Regional Variation ◽

Ventricular Arrhythmias ◽

Qt Dispersion ◽

Maximum Difference ◽

Simple Method ◽

Qtc Dispersion ◽

Surface Electrocardiogram

AbstractThe 12-lead surface electrocardiogram adjacent QTc dispersion, which is the maximum difference of corrected QT interval between two adjacent leads, is a simple method to determine regional variation in repolarization and refractoriness. The aim of this study is to evaluate adjacent QTc dispersion as a marker of susceptibility to ventricular arrhythmias after myocardial infarction. A total of 135 consecutive patients with acute myocardial infarction were enrolled in the study. Adjacent QTc, measured by lens magnifier, was calculated on the first, second and third days after acute myocardial infarction. On the second day after acute myocardial infarction, adjacent QTc dispersion was significantly greater in patients with ventricular arrhythmias (P < 0.001). Adjacent QTc dispersion on the first and fifth day after acute myocardial infarction was not associated with development of ventricular arrhythmias. On the second day after acute myocardial infarction, adjacent QTc dispersion is a simple and feasible method for prediction of ventricular arrhythmias.

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Relationship between Fetuin A, Vascular Calcification and Fracture Risk in Dialysis Patients

PLoS ONE ◽

10.1371/journal.pone.0158789 ◽

2016 ◽

Vol 11 (7) ◽

pp. e0158789 ◽

Cited By ~ 9

Author(s):

Hung Yuan Chen ◽

Yen Ling Chiu ◽

Shih Ping Hsu ◽

Mei Fen Pai ◽

Ju Yeh Yang ◽

...

Keyword(s):

Fracture Risk ◽

Vascular Calcification ◽

Dialysis Patients ◽

Fetuin A

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MP384SCREENING FOR VASCULAR CALCIFICATION ININCIDENT DIALYSIS PATIENTS IS NOT SYSTEMATICALLY PERFORMED

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw190.41 ◽

2016 ◽

Vol 31 (suppl_1) ◽

pp. i467-i467

Author(s):

Pablo Antonio Urena Torres ◽

Dominique Prié ◽

Eric Daugas ◽

Denis Fouque

Keyword(s):

Vascular Calcification ◽

Dialysis Patients

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Change of the main parameters of 24-hour ekg monitoring in patients with myocardial infarction associated with ventricular arrhythmias

Kazan medical journal ◽

10.17816/kmj1583 ◽

2013 ◽

Vol 94 (2) ◽

pp. 176-180

Author(s):

I V Logacheva ◽

N G Barantseva

Keyword(s):

Myocardial Infarction ◽

Ventricular Arrhythmia ◽

Qt Interval ◽

Ventricular Arrhythmias ◽

Heart Rhythm ◽

Qt Dispersion ◽

Heart Rhythm Variability ◽

Corrected Qt Interval ◽

Grade 3 ◽

Q Wave

Aim. To study the change of the main parameters of 24-hour EKG monitoring over time in patients with myocardial infarction associated with ventricular arrhythmias of different grades. Methods. The change of the echocardiography parameters, heart rhythm variability, corrected QT interval duration and dispersion, late ventricular potentials, heart rhythm turbulence were examined in 70 adult men (mean age 52.6±1.3 years) with primary Q-wave myocardial infarction on 10-14th day of the disease and after 6 months. Patients were assigned into 3 groups depending on ventricular arrhythmias severity (according to Lown classification modified by Ryan): А1 (n=29) - grade 1-2, А2 (n=23) - grade 3-4, А3 (n=18) - patients with paroxysmal ventricular tachycardia. Results. Presence of late ventricular potentials and pathologic heart rhythm turbulence in patients in acute period of myocardial infarction suggested high grade of ventricular arrhythmia. Ventricular arrhythmias were associated with severe sympathicotonia, prolongation of corrected QT interval and QT dispersion. 6 months after Q-wave myocardial infarction an autonomic imbalance increased and no positive changes of myocardial homogenicity parameters, late ventricular potentials and pathologic heart rhythm turbulence were observed with increasing ventricular arrhythmia grading and heart rate frequency. A relationship between left ventricle ejection fraction, myocardium mass and myocardial electric non-stability values was revealed. In patients with Q-wave myocardial infarction ventricular arrhythmias are mediated by several mechanisms: systolic and autonomic disorder, repolarization abnormalities, late ventricular potentials pathologic heart rhythm turbulence. The severity of abnormalities is marked by the ventricular arrhythmias grade. Conclusion. 6 months after myocardial infarction (in healing stage) the significant positive changes are found only in patients with 1-2 grades ventricular arrhythmias. The significant non-homogeneity of myocardial electrophysiological features still persists in patients with life-threatening ventricular arrhythmias.

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