Analysis of T-wave Morphology for Prediction of Long-term Prognosis in Patients Initiating Hemodialysis
Date Issued
2007
Date
2007
Author(s)
Lin, Chien-Yu
DOI
en-US
Abstract
Background—Cardiovascular disease remains the most common cause of death in end-stage renal disease (ESRD). Different attempts have been made to use the 12-lead surface electrocardiogram (ECG) for risk stratification of patients prone to cardiac mortality, in particular sudden cardiac death. Recently, novel descriptors of T-wave morphology have been suggested as measures of repolarization heterogeneity and adverse prognosis in nonuremic populations. However, whether these T-wave descriptors provide prognostic information in uremic populations has not been examined. The present study aimed to determine the prognostic value of novel T-wave morphology variables in predicting total, cardiovascular, and arrhythmia-related mortality in ESRD patients initiating hemodialysis.
Methods and Results—The study was a retrospective cohort of adult ESRD patients starting hemodialysis between 1998 and 2005; follow-up was until Sep. 2006. A total of 336 patients were studied. Novel ECG variables characterizing repolarization and the T-wave loop were analyzed. Of 336 patients with technically analyzable data, 159 (47.3%) died after a mean follow-up of 25.47+21.5 months. Direct comparison between cardiovascular death and non-cardiovascular death patients showed that the so-called relative T-wave residium (the relative amount of nondipolar contents within the T wave) predicted cardiovascular mortality (0.20+0.20% versus 0.25+0.21%, P=0.003). In Cox modeling, relative T-wave residium was an independent predictor of cardiovascular (relative risk [RR]=1.999; P =0.005) and arrhythmia-related mortality (RR=2.238; P =0.006).
Conclusions—The heterogeneity of myocardial repolarization, measured by the so-called relative T-wave residuum in the ECG, appears to be an independent predictor of cardiovascular and arrhythmia-related mortality in patients initiating hemodialysis.
Subjects
心血管死亡
心律不整死亡
末期腎衰竭
T波型態
心室再極化
cardiovascular mortality
end stage renal disease
relative T wave residium
T wave morphology
ventricular repolarization
SDGs
Type
thesis
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