Electrocardiographic abnomalties and atherosclerosis in patients on maintenance hemodialysis

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  • 維持血液透析患者における心電図異常と動脈硬化
  • イジ ケツエキ トウセキ カンジャ ニ オケル シンデンズ イジョウ ト ドウミャク コウカ

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Abstract

Increasing medical knowledge and improved hemodialysis techniques have permitted longer survival in patients receiving hemodialysis. However, the risk of cardiovascular disease, which is mainly caused by atherosclerosis, substantially increases in proportion to the longer survival of hemodialysis patients. At present, cardiovascular disease is a major cause of morbidity and mortality. The present study was designed to investigate the relations between electrocardiographic abnormalities (e.g. ischemic change, left ventricular hypertrophy, arrhythmia and conduction block) and the progression of atherosclerosis, the atherosclerotic risk factors (e.g. diabetes, hypertension, hyperlipidemia and smoking) and aortic calcification in patients on maintenance hemodialysis. Pulse wave velocity (PWV) was used as the index of atherosclerosis. PWV levels were singficantly higher in ischemic change (1,993±99cm/s), left ventricular hypertrophy (2,103±120cm/s), arrhythmia (2,015±120cm/s), and condition block groups (2,014±119cm/s) than in the nomal group (1,627±69cm/s). Also, PWV levels corrected by diastolic blood pressure in all abnormal groups were significantly higher. Serum Creactive protein levels in all abnormal groups also tended to be higher than those in the normal group. With regard to atherosclerotic risk factors, the incidence of diabetes and hypertention tended to be higher in abnormal groups. Especially the incidence of hypertension was significantly higher in ischemic change (66.7%), left ventricular hypertrophy (50.0%) and conduction block groups (55.6%) than that in the normal group (16.7%). These results suggest that the electrocardiographic changes are related to the progression of atherosclerosis, and among atherosclerotic risk factors, hypertension most affects the electrocardiographic changes in patients on maintenance hemodialysis.

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