Hemodialysis causes changes in dynamic vectorcardiographic ischemia monitoring parameters.
Clin Nephrol
; 54(3): 227-33, 2000 Sep.
Article
en En
| MEDLINE
| ID: mdl-11020021
AIMS: The aim of this study was to establish whether changes in parameters reflecting myocardial ischemia QRS vector difference (QRS-VD), ST change vector magnitude (STC-VM) and ST vector magnitude (ST-VM6) during hemodialysis (HD) registered by MIDA (myocardial infarction dynamic analysis) are related to changes in blood volume (BV), extracellular water (ECW) and blood biochemistry. PATIENTS AND METHODS: Fifteen hemodialysis (HD) patients were studied. Computerized vectorcardiography was used for on-line dynamic analysis of ST segment and QRS complex changes. BV changes were monitored non-invasively and continuously with the CRIT-LINE instrument. Bioelectric impedance analysis (BIA) was used for ECW estimation. Blood samples were taken before and after hemodialysis for hemoglobin (B-Hb), hematocrit (B-Hcr), sodium (P-Na), chloride (P-Cl), magnesium (P-Mg), potassium (P-K), ionized calcium (P-iCa), phosphate (P-Pi) and astrup measurement. RESULTS: During dialysis treatment QRS-VD, ST-VM6 and STC-VM did not change in parallel. According to the linear mixed model, no statistically significant changes were noted in ST-VM6 during dialysis (time effect p = 0.5635). On the other hand, QRS-VD and STC-VM showed a statistically significant linear trend (time effect for QRS-VD p = 0.0001 and for STC-VM p = 0.0004). Changes in both ECW and BV affected the change in QRS-VD and in STC-VM. CONCLUSION: During HD treatment changes in the vectorcardiographic ischemia monitoring parameters QRS-VD and STC-VM are mostly related to ECW and BV changes and may give a false positive impression of myocardial ischemia. The ST-VM6 trend is less markedly influenced by volume changes.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vectorcardiografía
/
Diálisis Renal
/
Isquemia Miocárdica
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Nephrol
Año:
2000
Tipo del documento:
Article
País de afiliación:
Finlandia
Pais de publicación:
Alemania