Exploring the association of natriuretic peptides with QTc interval in hemodialysis patients.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2025-12-01 Epub Date: 2025-02-17 DOI:10.1080/0886022X.2025.2460720
Yoshihiro Matsumoto, Yasuo Mori, Shinji Kageyama, Kazuaki Yoshimura, Takao Saito, Risako Terada, Yohichi Nojima
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引用次数: 0

Abstract

Background: In patients undergoing hemodialysis (HD), cardiovascular (CV) disease, particularly sudden cardiac death (SCD), is a major cause of mortality. Independent predictors of SCD include a prolonged QT interval on electrocardiography (ECG) and elevated levels of natriuretic peptides (NPs). This study explores the association between the QTc interval and NPs in HD patients.

Methods: This cross-sectional study involved 207 HD patients, having a heart rate of 57 to 103 bpm, displaying sinus rhythm and no extrasystoles in ECG reports. Before the 2nd HD of the week, we conducted ECG and blood tests for atrial NP (ANP), brain NP (BNP), and N-terminal proBNP (NT-proBNP). The heart rate-corrected QT (QTc) was calculated using Bazett formula. Our analysis focused on the association between QTc and each NP, along with evaluating clinically relevant variables related to the QTc interval.

Results: Univariate analyses indicated robust correlations among the NPs, with each NP significantly associated with the QTc interval. Multiple regression analyses of the three NPs revealed that NT-proBNP demonstrated the strongest predictive ability for the QTc interval. Independent predictors of prolonged QTc included lower corrected calcium (cCa) levels (p = 0.001), lower potassium (K) levels (p < 0.001), and higher log NT-proBNP (p = 0.004).

Conclusion: In HD patients, NT-proBNP shows a stronger link with the QTc interval than BNP or ANP. Integrating clinical management considering both QTc and log NT-proBNP levels might help reduce CV events. Additionally, vigilance regarding low K or cCa levels is recommended from the perspective of the QTc interval.

探讨血液透析患者尿钠肽与QTc间期的关系。
背景:在接受血液透析(HD)的患者中,心血管(CV)疾病,特别是心源性猝死(SCD),是死亡的主要原因。SCD的独立预测因素包括心电图QT间期延长和利钠肽(NPs)水平升高。本研究探讨HD患者QTc间期与NPs之间的关系。方法:本横断面研究纳入了207例HD患者,心率为57 ~ 103 bpm,心电图报告显示窦性心律,无心动过速。在第2周HD之前,我们做了心电图和血液检查心房NP (ANP)、脑NP (BNP)和n端proBNP (NT-proBNP)。采用Bazett公式计算心率校正QT (QTc)。我们的分析侧重于QTc与每个NP之间的关系,以及评估与QTc间隔相关的临床相关变量。结果:单变量分析表明NP之间存在强相关性,每个NP与QTc间隔显著相关。三种np的多元回归分析显示NT-proBNP对QTc区间的预测能力最强。QTc延长的独立预测因子包括较低的校正钙(cCa)水平(p = 0.001),较低的钾(K)水平(p = 0.004)。结论:在HD患者中,NT-proBNP与QTc间期的关系强于BNP或ANP。综合考虑QTc和日志NT-proBNP水平的临床管理可能有助于减少心血管事件。此外,建议从QTc间隔的角度警惕低K或低cCa水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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