D the experiments: JS GY JW XQ. Analyzed the data: LY

D the experiments: JS GY JW XQ. Analyzed the data: LY ZZ. Contributed reagents/materials/analysis tools: WG HW. Wrote the paper: BL JS GY.genes. (TIF)
Sudden cardiac death is the single 10781694 most common cause of mortality in chronic kidney disease (CKD) patients undergoing dialysis, accounting for 20?0 of deaths [1]. A large database study has recently demonstrated that mortality attributed to sudden cardiac death was 14-fold increased among dialysis patients when compared to the general population, while the proportion of deaths from other cardiovascular complications was similar [2]. In CKD patients with documented coronary artery disease, the decrement of glomerular filtration rate (GFR) was shown to be a predictor of sudden cardiac death. Each 10 ml/min decrease in GFR was associated with 11 increase in the risk for sudden cardiac death. Additionally, while for patients with GFR 60 ml/min the sudden cardiac death rate was 3.8 per 1000 patient-years, the rate rose to 7.3 for patients with GFR 15?59 ml/min [3]. Epidemiological and observational studies have demonstrated that overall incidence of sudden cardiac death in CKD populationis indeed greater than the incidence of coronary events [4], suggesting a worrisome increase in the frequency of ventricular arrhythmia, considered the foremost cause of sudden cardiac death. 16985061 Few studies, however, have investigated the occurrence of ventricular arrhythmia in CKD populations. Data coming from our group have previously demonstrated that the frequency of ventricular arrhythmia was 48 in patients on hemodialysis [5], 45 in patients on peritoneal dialysis [6], and 30 among incident kidney transplant recipients [7]. The traditional view of ventricular arrhythmias pathophysiology posits a vulnerable diseased myocardium with a transient Essed between all patients (groups HAT-1 and HAT-2) and the control trigger. In individuals without CKD, the substrate for a terminal arrhythmia is most often an ischemic myocardium due to ruptured arterial plaque, a focal myocardial scar or a reduced left ventricular ejection fraction [8]. It is unknown whether this goes true for CKD patients, who have more frequently diastolic dysfunction, electrolyte disturbances and disorders in the mineral metabolism [9]. Studies are required to better characterize theVentricular Arrhythmia in CKD Patientsassociated risk factors for ventricular arrhythmia in CKD population. Although cardiovascular mortality has shown to be substantially elevated since the early stages of CKD, the occurrence of ventricular arrhythmia and its associated risk factors has not been so far investigated in CKD patients not requiring dialysis. Thus, this study aimed at examining the prevalence of ventricular arrhythmia and investigating the factors associated with ventricular arrhythmia in nondialyzed CKD patients.(Cardios-LightH, Cardios, Sao Paulo, Brazil). Ventricular arrhyth mia was defined as the presence of ventricular extra-systoles.EchocardiogramTwo-dimensional color Doppler echocardiogram (PhilipsH HDI 5000, Royal Philips Electronics, Netherlands) was performed according to the recommendations of the American Society of Echocardiography [13]. Presence of left ventricular Title Loaded From File hypertrophy was considered for a left ventricular mass index 134 g/m2 among men and .110 g/m2 among women. Systolic dysfunction was defined as ejection fraction #55 .Materials and Methods PopulationA total of 111 non-dialyzed patients with CKD stages 2 to 5 were recruited from the outpatient clinic of the Federal University of Sao Paulo, Sa.D the experiments: JS GY JW XQ. Analyzed the data: LY ZZ. Contributed reagents/materials/analysis tools: WG HW. Wrote the paper: BL JS GY.genes. (TIF)
Sudden cardiac death is the single 10781694 most common cause of mortality in chronic kidney disease (CKD) patients undergoing dialysis, accounting for 20?0 of deaths [1]. A large database study has recently demonstrated that mortality attributed to sudden cardiac death was 14-fold increased among dialysis patients when compared to the general population, while the proportion of deaths from other cardiovascular complications was similar [2]. In CKD patients with documented coronary artery disease, the decrement of glomerular filtration rate (GFR) was shown to be a predictor of sudden cardiac death. Each 10 ml/min decrease in GFR was associated with 11 increase in the risk for sudden cardiac death. Additionally, while for patients with GFR 60 ml/min the sudden cardiac death rate was 3.8 per 1000 patient-years, the rate rose to 7.3 for patients with GFR 15?59 ml/min [3]. Epidemiological and observational studies have demonstrated that overall incidence of sudden cardiac death in CKD populationis indeed greater than the incidence of coronary events [4], suggesting a worrisome increase in the frequency of ventricular arrhythmia, considered the foremost cause of sudden cardiac death. 16985061 Few studies, however, have investigated the occurrence of ventricular arrhythmia in CKD populations. Data coming from our group have previously demonstrated that the frequency of ventricular arrhythmia was 48 in patients on hemodialysis [5], 45 in patients on peritoneal dialysis [6], and 30 among incident kidney transplant recipients [7]. The traditional view of ventricular arrhythmias pathophysiology posits a vulnerable diseased myocardium with a transient trigger. In individuals without CKD, the substrate for a terminal arrhythmia is most often an ischemic myocardium due to ruptured arterial plaque, a focal myocardial scar or a reduced left ventricular ejection fraction [8]. It is unknown whether this goes true for CKD patients, who have more frequently diastolic dysfunction, electrolyte disturbances and disorders in the mineral metabolism [9]. Studies are required to better characterize theVentricular Arrhythmia in CKD Patientsassociated risk factors for ventricular arrhythmia in CKD population. Although cardiovascular mortality has shown to be substantially elevated since the early stages of CKD, the occurrence of ventricular arrhythmia and its associated risk factors has not been so far investigated in CKD patients not requiring dialysis. Thus, this study aimed at examining the prevalence of ventricular arrhythmia and investigating the factors associated with ventricular arrhythmia in nondialyzed CKD patients.(Cardios-LightH, Cardios, Sao Paulo, Brazil). Ventricular arrhyth mia was defined as the presence of ventricular extra-systoles.EchocardiogramTwo-dimensional color Doppler echocardiogram (PhilipsH HDI 5000, Royal Philips Electronics, Netherlands) was performed according to the recommendations of the American Society of Echocardiography [13]. Presence of left ventricular hypertrophy was considered for a left ventricular mass index 134 g/m2 among men and .110 g/m2 among women. Systolic dysfunction was defined as ejection fraction #55 .Materials and Methods PopulationA total of 111 non-dialyzed patients with CKD stages 2 to 5 were recruited from the outpatient clinic of the Federal University of Sao Paulo, Sa.