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. 2019 Jan 3;14(1):e0209297.
doi: 10.1371/journal.pone.0209297. eCollection 2019.

Changes in QTc interval in long-term hemodialysis patients

Yoshihiro Matsumoto  1 , Yasuo Mori  2 , Shinji Kageyama  3 , Kazuo Arihara  4 , Hidemaro Sato  5 , Kijun Nagata  5 , Yasushi Shimada  1 , Yohichi Nojima  1 , Koichiro Iguchi  1 , Toshikazu Sugiyama  6
Affiliations

Changes in QTc interval in long-term hemodialysis patients

Yoshihiro Matsumoto et al. PLoS One. .

Abstract

Background: Cardiovascular diseases, including sudden cardiac death (SCD), are the leading cause of death in hemodialysis (HD) patients. A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for SCD in HD patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged along with dialysis vintage.

Methods: A total of 102 HD patients were retrospectively studied. Their ECG data were analyzed at 1, 4, and 7 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. QTc was measured according to the Bazett formula. The association between QTc interval and dialysis vintage was studied. Additionally, clinically relevant variables related to QTc duration at 1 year after HD initiation were assessed.

Results: Average QTc interval at 4 and 7 years after HD initiation was significantly longer than that at 1 year after HD initiation (443, 445, and 437 ms) (p<0.05). On the other hand, QTc interval in the control group was 425 ms in the first year and 426 ms after an average of 6 years. They had no significant differences, although they were much shorter than that in HD patients. Multivariate regression analysis of baseline variables revealed that the corrected calcium levels (p = 0.041) and diabetes (p = 0.043) were independently associated with longer QTc interval.

Conclusions: The QTc interval at 1 year after HD initiation was longer than in the control subjects and was 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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Changes in QTc interval in hemodialysis (HD) group and control group.
(A) The QTc interval at 1 year, 4 years, and 7 years after HD initiation in the HD group was compared by Dunett type multiple comparison. (B) For comparison between the QTc interval at first year and after 6 years in the control group, a paired Student’s t test was used. The QTc interval at 1 year after HD initiation in the HD group was significantly longer than that at first year in the control group (p<0.001, an unpaired Student’s t test).
See this image and copyright information in PMC

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