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. 2011 Mar;6(3):519-27.
doi: 10.2215/CJN.06370710. Epub 2010 Nov 18.

Microvolt T-wave alternans in end-stage renal disease patients--associations with uremic cardiomyopathy

Rajan K Patel  1 , Patrick B Mark, Crawford Halliday, Tracey Steedman, Henry J Dargie, Stuart M Cobbe, Alan G Jardine
Affiliations

Microvolt T-wave alternans in end-stage renal disease patients--associations with uremic cardiomyopathy

Rajan K Patel et al. Clin J Am Soc Nephrol. 2011 Mar.

Abstract

Background and objectives: Premature cardiovascular (CV) events, especially sudden cardiac death, are common in ESRD patients and associated with uremic cardiomyopathy. Identification of high-risk patients is difficult. Microvolt T-wave alternans (MTWA) is a noninvasive method of detecting variability in electrocardiogram (ECG) T-wave morphology and is a promising technique for identifying patients at high risk of ventricular tachyarrhythmias. MTWA results of ESRD and hypertensive left ventricular hypertrophy (LVH) patients were assessed to determine the prevalence of abnormal results and associations with uremic cardiomyopathy.

Design, setting, participants, & measurements: In this single-center observational study, 200 ESRD and 30 LVH patients underwent assessment including CV history, ECG, cardiac magnetic resonance imaging, and an MTWA exercise test. MTWA results were classified as "negative" or "abnormal" on the basis of previously published reports.

Results: An abnormal MTWA result was more common in ESRD compared with LVH patients (57.5% versus 26.7%, respectively; P = 0.002). In ESRD patients, MTWA was significantly associated with uremic cardiomyopathy, clinical history of atherosclerosis (coronary, cerebral, peripheral) and diabetes mellitus, older age, and hemodialysis therapy. Independent associations with an abnormal MTWA result were older age, macrovascular disease, increased left ventricle (LV) mass, and LV dilation.

Conclusions: Features of uremic cardiomyopathy are associated with an abnormal MTWA result.

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Figures

Figure 1.
Figure 1.
Bar chart showing MTWA result for ESRD and LVH patients.
See this image and copyright information in PMC

References

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