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The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis.
BMC Nephrol. 2019 12 02; 20(1):441.BN

Abstract

BACKGROUND

Successful renal transplantation (RT) reverses some of the cardiac changes and reduces cardiac mortality in hemodialysis (HD) patients. Widened QRS-T angle reflects both ventricular repolarization and depolarization. It is considered a sensitive and strong predictor of heart ventricular remodeling as well as a powerful and independent risk stratifier suitable in predicting cardiac events in various clinical settings. The study aimed to assess the influence of the RT on QRS-T angle and to evaluate factors influencing QRS-T changes in renal transplanted recipients (RTRs).

METHODS

Fifty-four selected HD patients who have undergone RT were included. Blood chemistry, echocardiography, and QRS-T angle were evaluated 5 times: about 1 week, 3 months, 6 months, 1 year and 3 years after RT.

RESULTS

An improvement of echocardiographic parameters was observed. The dynamics of changes in individual parameters were, however, variable. QRS-T angle correlated with echocardiographic parameters. The biphasic pattern of the decreases of QRS-T angle was observed. The first decrease took place in the third month of follow-up. The second decrease of QRS-T angle was observed after 1 year of follow-up. The QRS-T angle was higher in RTRs compared with controls during each evaluation. Multivariable analysis demonstrated that the decrease of left ventricle enddiastolic volume was an independent predictor of early QRS-T angle improvement. The increase of left ventricle ejection fraction was found to be the independent predictor of the late QRS-T angle improvement.

CONCLUSIONS

RT induces biphasic reverse electrical remodeling as assessed by the narrowing of QRS-T angle. Early decrease of QRS-T angle is mainly due to the normalization of volume status, whereas late decrease is associated predominantly with the improvement of cardiac contractile function.

Authors+Show Affiliations

Institute of Medical Sciences, Jan Kochanowski University in Kielce, Al. IX Wieków Kielc 19A, 25-317, Kielce, Poland. jaroszynskiaj@interia.pl. Department of Family Medicine, Medical University of Lublin, Lublin, Poland. jaroszynskiaj@interia.pl.Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Lublin, Poland.Department of Cardiology, Medical University of Lublin, Lublin, Poland.Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Lublin, Poland.Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31791259

Citation

Jaroszyński, Andrzej, et al. "The Improvement of QRS-T Angle as a Manifestation of Reverse Electrical Remodeling Following Renal Transplantation in End-stage Kidney Disease Patients On Haemodialysis." BMC Nephrology, vol. 20, no. 1, 2019, p. 441.
Jaroszyński A, Furmaga J, Zapolski T, et al. The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis. BMC Nephrol. 2019;20(1):441.
Jaroszyński, A., Furmaga, J., Zapolski, T., Zaborowski, T., Rudzki, S., & Dąbrowski, W. (2019). The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis. BMC Nephrology, 20(1), 441. https://doi.org/10.1186/s12882-019-1624-3
Jaroszyński A, et al. The Improvement of QRS-T Angle as a Manifestation of Reverse Electrical Remodeling Following Renal Transplantation in End-stage Kidney Disease Patients On Haemodialysis. BMC Nephrol. 2019 12 2;20(1):441. PubMed PMID: 31791259.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis. AU - Jaroszyński,Andrzej, AU - Furmaga,Jacek, AU - Zapolski,Tomasz, AU - Zaborowski,Tomasz, AU - Rudzki,Sławomir, AU - Dąbrowski,Wojciech, Y1 - 2019/12/02/ PY - 2019/08/16/received PY - 2019/11/13/accepted PY - 2019/12/4/entrez PY - 2019/12/4/pubmed PY - 2019/12/4/medline KW - Ejection fraction KW - Hypervolemia KW - QRS-T angle KW - Renal transplantation KW - Reverse remodeling SP - 441 EP - 441 JF - BMC nephrology JO - BMC Nephrol VL - 20 IS - 1 N2 - BACKGROUND: Successful renal transplantation (RT) reverses some of the cardiac changes and reduces cardiac mortality in hemodialysis (HD) patients. Widened QRS-T angle reflects both ventricular repolarization and depolarization. It is considered a sensitive and strong predictor of heart ventricular remodeling as well as a powerful and independent risk stratifier suitable in predicting cardiac events in various clinical settings. The study aimed to assess the influence of the RT on QRS-T angle and to evaluate factors influencing QRS-T changes in renal transplanted recipients (RTRs). METHODS: Fifty-four selected HD patients who have undergone RT were included. Blood chemistry, echocardiography, and QRS-T angle were evaluated 5 times: about 1 week, 3 months, 6 months, 1 year and 3 years after RT. RESULTS: An improvement of echocardiographic parameters was observed. The dynamics of changes in individual parameters were, however, variable. QRS-T angle correlated with echocardiographic parameters. The biphasic pattern of the decreases of QRS-T angle was observed. The first decrease took place in the third month of follow-up. The second decrease of QRS-T angle was observed after 1 year of follow-up. The QRS-T angle was higher in RTRs compared with controls during each evaluation. Multivariable analysis demonstrated that the decrease of left ventricle enddiastolic volume was an independent predictor of early QRS-T angle improvement. The increase of left ventricle ejection fraction was found to be the independent predictor of the late QRS-T angle improvement. CONCLUSIONS: RT induces biphasic reverse electrical remodeling as assessed by the narrowing of QRS-T angle. Early decrease of QRS-T angle is mainly due to the normalization of volume status, whereas late decrease is associated predominantly with the improvement of cardiac contractile function. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/31791259/The_improvement_of_QRS-T_angle_as_a_manifestation_of_reverse_electrical_remodeling_following_renal_transplantation_in_end-stage_kidney_disease_patients_on_haemodialysis L2 - https://www.biomedcentral.com/1471-2369/20/441 DB - PRIME DP - Unbound Medicine ER -
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