The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis
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 vent...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-019-1624-3 |
| _version_ | 1818602452322091008 |
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| author | Andrzej Jaroszyński Jacek Furmaga Tomasz Zapolski Tomasz Zaborowski Sławomir Rudzki Wojciech Dąbrowski |
| author_facet | Andrzej Jaroszyński Jacek Furmaga Tomasz Zapolski Tomasz Zaborowski Sławomir Rudzki Wojciech Dąbrowski |
| author_sort | Andrzej Jaroszyński |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T13:07:30Z |
| format | Article |
| id | doaj.art-12afe25864e34283a34cc88da9d7649d |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-16T13:07:30Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-12afe25864e34283a34cc88da9d7649d2022-12-21T22:30:42ZengBMCBMC Nephrology1471-23692019-12-012011810.1186/s12882-019-1624-3The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysisAndrzej Jaroszyński0Jacek Furmaga1Tomasz Zapolski2Tomasz Zaborowski3Sławomir Rudzki4Wojciech Dąbrowski5Institute of Medical Sciences, Jan Kochanowski University in KielceDepartment of General and Transplant Surgery and Nutritional Treatment, Medical University of LublinDepartment of Cardiology, Medical University of LublinDepartment of Anesthesiology and Intensive Care, Medical University of LublinDepartment of General and Transplant Surgery and Nutritional Treatment, Medical University of LublinDepartment of Anesthesiology and Intensive Care, Medical University of LublinAbstract 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.https://doi.org/10.1186/s12882-019-1624-3QRS-T angleRenal transplantationHypervolemiaEjection fractionReverse remodeling |
| spellingShingle | Andrzej Jaroszyński Jacek Furmaga Tomasz Zapolski Tomasz Zaborowski Sławomir Rudzki Wojciech Dąbrowski 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 QRS-T angle Renal transplantation Hypervolemia Ejection fraction Reverse remodeling |
| title | The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis |
| title_full | The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis |
| title_fullStr | The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis |
| title_full_unstemmed | The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis |
| title_short | The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis |
| title_sort | improvement of qrs t angle as a manifestation of reverse electrical remodeling following renal transplantation in end stage kidney disease patients on haemodialysis |
| topic | QRS-T angle Renal transplantation Hypervolemia Ejection fraction Reverse remodeling |
| url | https://doi.org/10.1186/s12882-019-1624-3 |
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