Title:Are Markers of Cardiac Dysfunction Useful in the Assessment of Cardiovascular Risk in Dialysis Patients?
VOLUME: 23 ISSUE: 20
Author(s):Beata Franczyk, Anna Gluba-Brzózka*, Piotr Bartnicki, Maciej Banach and Jacek Rysz
Affiliation:Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Department of Nephrology, Hypertension and Family Medicine, WAM Teaching Hospital, Lodz, Poland, Zeromskiego 113, 90-549 Lodz, Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Department of Hypertension, Medical University of Lodz, Lodz, Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz
Keywords:Cardiac dysfunction, hemodialysis, ventricular arrhythmias, biomarkers, copeptin, GDF-15, HFABP.
Abstract:Background: Cardiovascular morbidity and mortality of dialysis patients are major problems in this
group of patients.
Methods: The purpose of this study was also to evaluate whether any of the studied markers are better than troponin
in early detection of the occurrence of ventricular arrhythmias and prolongation of QT interval. This study
included 45 patients undergoing hemodialysis. ECG Holter and echocardiographic examination were performed
before and after dialysis. The concentrations of markers: copeptin, GDF-15, HFABP and troponin were measured
with the use of ELISA tests.
Results: We observed significantly higher QT (p=0.004), QTc (0.018), right atrium volume (p=0.006) and concentrations
of copeptin (p<0.0001) and H-FABP (p<0.0001) as well as smaller left atrium volume (p<0.0001) and
width of inferior vena cava (p<0.0001) after dialysis than before it. Significantly longer QT and higher copeptin
levels were seen in patients with ventricular arrhythmia. A trend between the increase in copeptin concentration
and H-FABP level and the presence of ventricular arrhythmias was also noted.
Conclusion: Generally, we failed to find any strong predictor of post-dialysis ventricular arrhythmia or the prolongation
of QT, however, it seems that copeptin may have prognostic value, but this has to be analyzed in large
studies.