Microvolt T-Wave Alternans in End-Stage Renal Disease Patients--Associations with Uremic Cardiomyopathy

Patel, R.K., Mark, P.B. , Halliday, C., Steedman, T., Dargie, H. J., Cobbe, S.M. and Jardine, A.G. (2011) Microvolt T-Wave Alternans in End-Stage Renal Disease Patients--Associations with Uremic Cardiomyopathy. Clinical Journal of the American Society of Nephrology, 6(3), pp. 519-527. (doi:10.2215/CJN.06370710)

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Publisher's URL: http://dx.doi.org/10.2215/CJN.06370710


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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Patel, Dr Rajan and Mark, Dr Patrick and Cobbe, Professor Stuart and Jardine, Professor Alan
Authors: Patel, R.K., Mark, P.B., Halliday, C., Steedman, T., Dargie, H. J., Cobbe, S.M., and Jardine, A.G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Clinical Journal of the American Society of Nephrology

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