TY - JOUR
T1 - Severe coronary stenosis is an important factor for induction and lengthy persistence of ventricular arrhythmias during and after hemodialysis
AU - Kitano, Yukari
AU - Kasuga, Hirotake
AU - Watanabe, Midoriko
AU - Takahashi, Hiroshi
AU - Ibuki, Koichi
AU - Kawade, Yasumasa
AU - Yasuda, Kaoru
AU - Iwashima, Shigejiro
AU - Toriyama, Takanobu
AU - Matuo, Seiichi
AU - Kawahara, Hirohisa
PY - 2004/8
Y1 - 2004/8
N2 - Background: Ventricular arrhythmias have been shown to be the major cause of sudden cardiac death in hemodialysis (HD) patients. We investigated whether angiographic coronary stenosis was responsible for the induction of ventricular arrhythmias in HD patients. Methods: HD patients (n = 150) showing ischemic signs in exercise electrocardiography or echocardiography were divided into 2 groups: the stenotic group (n = 61), with significant coronary stenosis (≥75% in diameter), and the nonstenotic group (n = 89), without significant coronary stenosis on coronary angiography. Severity of ventricular arrhythmias was evaluated by means of ambulatory 24-hour Holter monitoring in HD patients with and without significant coronary stenosis. Results: The frequency of ventricular premature contractions and prevalence of patients with Lown class 4 ventricular arrhythmias were significantly greater in the stenotic than nonstenotic group during HD and for 12 hours after HD (P < 0.03). In the stenotic group, a significantly greater frequency of ventricular premature contractions and prevalence of patients with complex arrhythmias were observed during HD (1.33% and 31.1%, respectively) compared with before HD (0.50% and 11.5%, respectively), and the high incidence persisted for 6 hours after HD. In the nonstenotic group, a slightly increased incidence was observed only during HD compared with before HD. Multivariate analysis showed only coronary stenosis (odds ratio, 5.69; P = 0.041) as an independent and significant factor for the induction of complex arrhythmias. Conclusion: These data clearly indicate that severe coronary stenosis, which may cause myocardial ischemia, is an important factor for the induction and lengthy persistence of ventricular arrhythmias during and after HD.
AB - Background: Ventricular arrhythmias have been shown to be the major cause of sudden cardiac death in hemodialysis (HD) patients. We investigated whether angiographic coronary stenosis was responsible for the induction of ventricular arrhythmias in HD patients. Methods: HD patients (n = 150) showing ischemic signs in exercise electrocardiography or echocardiography were divided into 2 groups: the stenotic group (n = 61), with significant coronary stenosis (≥75% in diameter), and the nonstenotic group (n = 89), without significant coronary stenosis on coronary angiography. Severity of ventricular arrhythmias was evaluated by means of ambulatory 24-hour Holter monitoring in HD patients with and without significant coronary stenosis. Results: The frequency of ventricular premature contractions and prevalence of patients with Lown class 4 ventricular arrhythmias were significantly greater in the stenotic than nonstenotic group during HD and for 12 hours after HD (P < 0.03). In the stenotic group, a significantly greater frequency of ventricular premature contractions and prevalence of patients with complex arrhythmias were observed during HD (1.33% and 31.1%, respectively) compared with before HD (0.50% and 11.5%, respectively), and the high incidence persisted for 6 hours after HD. In the nonstenotic group, a slightly increased incidence was observed only during HD compared with before HD. Multivariate analysis showed only coronary stenosis (odds ratio, 5.69; P = 0.041) as an independent and significant factor for the induction of complex arrhythmias. Conclusion: These data clearly indicate that severe coronary stenosis, which may cause myocardial ischemia, is an important factor for the induction and lengthy persistence of ventricular arrhythmias during and after HD.
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U2 - 10.1053/j.ajkd.2004.04.037
DO - 10.1053/j.ajkd.2004.04.037
M3 - Article
C2 - 15264192
AN - SCOPUS:3242731561
SN - 0272-6386
VL - 44
SP - 328
EP - 336
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -