ABSTRACT
Objective To investigate the feasibility of serum cardiac troponin T(cTnT) as a marker of cardiovascular events and hemodialysis (HD) adequacy in maintainence hemodialysis (MHD) patients.Methods Forty-seven cases of MHD patients were randomly divided into two groups (group A and group B).Group A received intermittent HD 4 h thrice one week,and group B received intermittent HD 4 h twice one week plus high-flux hemodiafiltration(HDF) 4 h once one week.Serum examination for blood biochemical indicator,cTnT and echocardiogram was performed every three months and at the time of recruitment.All the patients were followed up until the occurrence of death or cardiovascular events.Results After 3 months treatment,serum cTnT deceased significantly in group B compared with group A,and maintained the lower levels throughout the follow-up.E/A and LVEF had been reduced since 3 months treatment in group A,but stable in group B,E/A was lower in group A after 18 months treatment than that in group B,LVEF was lower in group A after 12 months treatment than that in group B.There were positive correlations between cTnT and E/A or LVEF in 42 cases who accomplished the follow-up of 12 months (r =0.54,0.66,P ＜0.05).Kaplan-Meier survival curve showed that the occurrence of cardiovascular events in patients with cTnT≥0.1μ g/L was higher than that with cTnT ＜0.1 μg/L in (28.5 ± 9.7) months' follow- up (Log-rank test: P =0.02).Both survival analysis and Cox analysis indicated that serum cTnT was a predictor of cardiovascular events in MHD patients.Conclusions Serum level of cTnT can be used as a marker of HD adequacy,and it is a predictor of cardiac events in MHD patients.Regular high-flux HDF increases the adequacy of HD treatment and improves the quality of life in MHD patients.
ABSTRACT
Objective To investigate the effective dose and safety of adenosine triphosphate(ATP) in inducing dual atrioventricular nodal pathways(DAVNP)phenomenon.Methods The ATP(the initial dose was 0.15 mg/kg,incremented 0.10 mg/kg each time)was injected to 40 patients who had slow-fast atrioventricular nodal reentrant tachycardia(AVNRT)through a femoral vein until signs of DAVNP,second-or third-degrec atrioventricular block(AVB)appared.The surface and intracardiac electrocardiogram was recorded consecutively.Results Forty patients of the slow-fast AVNRT had AVB after injecting ATP (16.1±5.8)mg(9-22 mg),29 patients(72.5%,29/40)occurred DAVNP phenomenon,of which 11 (37.9%,11/29)revealed DAVNP phenomenon after injecting ATP 0.15 mg/kg.Seventeen patients had side-effects of dyspnea,dizziness,cough,cardiopalmus and so on,but these side-effects were generally minor,short duration.Forty patients had transient cardiac arrhythmia.Conclusions The incremental low-dose method in inducing DAVNP has higher positive rate.The side-effects of ATP are mostly light and short duration,and can not cause serious consequence.