Association of Lead aVR T-wave Amplitude With Cardiovascular Events or Mortality Among Prevalent Dialysis Patients

Ther Apher Dial. 2017 Jun;21(3):287-294. doi: 10.1111/1744-9987.12512. Epub 2017 Mar 10.

Abstract

In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP. By Cox analysis, aVRT was best associated with both endpoints through model 1 to 3 compared to other ECG findings. Patients categorized according to aVRT amplitude showed a step-by-step increase in hazard ratios for both endpoints. The aVRT amplitude level was significantly associated with not only composite CV events but also with all-cause mortality in prevalent dialysis patients.

Keywords: Cardiovascular disease; Electrocardiogram; Mortality; T-wave amplitude; aVR lead.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality
  • Cohort Studies
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical*
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / therapy
  • Serum Albumin / metabolism

Substances

  • Peptide Fragments
  • Serum Albumin
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein