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2015 ; 5
(4
): 267-77
Nephropedia Template TP
gab.com Text
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English Wikipedia
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
#MMPMID26648943
Matsukane A
; Hayashi T
; Tanaka Y
; Iwasaki M
; Kubo S
; Asakawa T
; Takahashi Y
; Imamura Y
; Hirahata K
; Joki N
; Hase H
Cardiorenal Med
2015[Oct]; 5
(4
): 267-77
PMID26648943
show ga
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 <0 mV, respectively.
The endpoint was all-cause death. 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.