Abstract: TH-PO691
Changes in QT Interval in Long-Term Hemodialysis Patients
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention
Authors
- Matsumoto, Yoshihiro, Shizuoka City Hospital, Shizuoka, Japan
- Mori, Yasuo, Shibukawa Clinic, Shizuoka, Japan
- Kageyama, Shinji, Kageyama Urological Clinic, Shziuoka city, Japan
- Arihara, Kazuo, Ohtemachi Clinic, Shizuoka, Japan
- Toshikazu, Sugiyama, Sugiyama Clinic, Shizuoka, Japan
Background
A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for sudden cardiac death (SCD) in hemodialysis (HD) patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged in relation to the number of years undergoing dialysis treatment.
Methods
A total of 102 patients treated with HD for more than 7 years were studied. All patients had ECG data at 1, 4, and 7 years after HD initiation and 75 of the patients also had ECG data at 10 years after HD initiation. The control group comprised 68 age-matched individuals who had normal renal function and two available ECG reports at an interval of more than 4 years. Patients with ECGs showing heart rates <57 or >103 bpm, extrasystoles, or any rhythm other than sinus were excluded. QTc was measured according to the Bazett formula. The association between QTc interval and dialysis vintage was analyzed. Additionally, clinically relevant variables related to QTc duration at 1 year after HD initiation were assessed.
Results
The average QTc interval in the control group was 425 ms in the first year and 426 ms after an average of 6 years, indicating no significant difference. However, the QTc interval at 1 year after HD initiation in 75 HD patients was 436 ms, which was much higher than that in the control group (P<0.001). In addition, the QTc interval at 4, 7, and 10 years after HD initiation was 441, 439, and 449 ms, respectively, increasing with dialysis vintage (p=0.20, 0.42, and <0.001, for 1 year after HD initiation by Dunnett’s multiple comparison). Multivariate regression analysis of baseline variables in 102 HD patients revealed that corrected calcium levels (p=0.041) and diabetes (p = 0.043) were independently associated with the longer QTc interval.
Conclusion
The QTc interval at 1 year after HD initiation was longer in HD patients than in the control subjects and was further prolonged over several years of HD treatment. Providing clinical management with a focus on QTc interval may be helpful for reducing the incidence of SCD in HD patients.