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Usefulness of an Upright T-Wave in Lead aVR for Predicting the Short-Term Prognosis of Incident Hemodialysis Patients: A Potential Tool for Screening High-Risk Hemodialysis Patients

Authors :
Takasuke Asakawa
Toshihide Hayashi
Koichi Hirahata
Yasunori Takahashi
Yuri Tanaka
Masaki Iwasaki
Shun Kubo
Ai Matsukane
Hiroki Hase
Nobuhiko Joki
Yoshihiko Imamura
Source :
Cardiorenal Medicine. 5:267-277
Publication Year :
2015
Publisher :
S. Karger AG, 2015.

Abstract

Background/Aims: An upright T-wave in lead aVR (aVRT) has recently been reported to be associated with cardiovascular death and mortality among the general population and patients with prior cardiovascular disease (CVD). However, evidence for the predictive ability of aVRT in patients with chronic kidney disease is lacking. Therefore, a hospital-based, prospective, cohort study was conducted to evaluate the predictive ability of an upright aVRT for the short-term prognosis in incident hemodialysis patients. Methods: Among 208 patients who started maintenance hemodialysis, 79 with preexisting CVD (CVD cohort) and 129 with no history of CVD (non-CVD cohort), were studied. An upright and non-upright aVRT were defined as a wave with a positive deflection in amplitude of ≥0 mV and a negative deflection in amplitude of Results: Overall, the prevalence of an upright aVRT was 22.6% at baseline. During the mean follow-up period of 2.1 ± 1.0 years, 33 deaths occurred. Cumulative survival rates at 3 years after starting dialysis in patients with an upright and non-upright aVRT were 50.0 and 80.7%, respectively, in the CVD cohort and 92.0 and 91.3%, respectively, in the non-CVD cohort. In the CVD cohort, multivariate Cox regression analysis showed that an upright aVRT was an independent predictor of death after adjusting for confounding variables. Conclusion: Among Japanese hemodialysis patients at high risk for CVD, an upright aVRT seems to be useful for predicting death.

Details

ISSN :
16645502 and 16643828
Volume :
5
Database :
OpenAIRE
Journal :
Cardiorenal Medicine
Accession number :
edsair.doi.dedup.....352e13bb32c166ac77d85cb197f36f15
Full Text :
https://doi.org/10.1159/000433562