Harry Pribadi, Agnes Lucia Panda, Benny Mulyanto Setiadi


Background: Ventricular arrhythmias (VA) is common in dialytic patients. Left Ventricular Mechanical Dispersion (LVMD) could provide an inhomogeneous of left ventricular myocardium contraction lead to VA. Reduced Left Ventricular Ejection Fraction (LVEF) and QT Dispersion (QTd) are well-known VA predictors in dialytic patients. This study aimed to determine the relationship between LVMD and LVEF on QT dispersion in ESRD patients before and after dialysis.
Methods: This cross-sectional study was conducted in November 2021 - February 2022. All study subjects who met the inclusion criteria underwent history taking and physical examination including age, sex, body weight, body height, electrocardiography, echocardiography, and routine laboratory studies.
Results: Among 43 subjects, 24 (55.8%) were male, with mean age of 51,14±11,6 was conducted in this study. The most common comorbidities were hypertension (79%) and diabetes mellitus (44.19%). Pre-dialysis LVMD mean was 28.99±15.98 ms and significantly decrease to 24.16±15.77 ms after dialysis (p<0.05). There was insignificant decrease in the QTd value before dialysis with a mean 61.72±25.93 ms to 54.60±21.26 ms. There was no difference in the mean LVEF before dialysis (57.19±5.17%) and after dialysis (57.54±5.04%). There are no correlation between LVEF, LVMD and QTd variables before and after dialysis.
Conclusion: There was a significant decrease of LVMD after dialysis period, but there was no significant difference in the LVEF and QTd parameters. No correlation was found between QTd parameters, LVMD, or LVEF in ESRD patients on HD both before and after dialysis.

Save to Mendeley


Sudden cardiac death; end-stage renal disease; hemodialysis; left ventricular mechanical dispersion; left ventricular ejection fraction; QT dispersion

Full Text:



Farida LS, Thaha M, Susanti D. Characteristics of Patients with End-Stage Renal Disease at Dialysis Unit Dr. Soetomo General Hospital Surabaya. Biomol Heal Sci J. 2018 Nov 26;1(2):97.

Siswanto. Riset Kesehatan Dasar Indonesia Kementrian Kesehatan Republik Indonesia.2018. - Laporan Riskesdas 2018 Nasional-1.pdf

Rantanen JM, Riahi S, Schmidt EB, et al. Arrhythmias in Patients on Maintenance Dialysis: A Cross-sectional Study. Am J Kidney Dis. 2020 Feb 1;75(2):214–24.

Pun PH, Lehrich RW, Honeycutt EF, et al. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney Int. 2011 Jan 2;79(2):218–27.

Silva RT, Martinelli Filho M, Peixoto G de L, et al. Predictors of Arrhythmic Events Detected by Implantable Loop Recorders in Renal Transplant Candidates. Arq Bras Cardiol. 2015;

Hensen LCR, Goossens K, Podlesnikar T, et al. Left Ventricular Mechanical Dispersion and Global Longitudinal Strain and Ventricular Arrhythmias in Predialysis and Dialysis Patients. J Am Soc Echocardiogr. 2018 Jul 1;31(7):777–83.

Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. Vol. 36, Journal of the American College of Cardiology. Elsevier; 2000. p. 1749–66.

Pernefri PNI. 11 th Report Of Indonesian Renal Registry 2018. 2018.pdf

Antlanger M, Aschauer S, Kopecky C, et al. Heart Failure with Preserved and Reduced Ejection Fraction in Hemodialysis Patients: Prevalence, Disease Prediction and Prognosis. Kidney Blood Press Res. 2017 May 1;42(1):165–76.

Rodríguez-Zanella H, Haugaa K, Boccalini F, et al. Physiological Determinants of Left Ventricular Mechanical Dispersion: A 2-Dimensional Speckle Tracking Echocardiographic Study in Healthy Volunteers. Vol. 11, JACC: Cardiovascular Imaging. Elsevier Inc.; 2018. p. 650–1.

Tong YQ, Hou HM. The alteration of QT dispersion in hemodialysis subjects. Kidney Blood Press Res. 2006 Nov;29(4):231–6.

Sohal P, Goel A, Gupta D, et al. Effect of hemodialysis on corrected QT interval and QTc dispersion. Indian J Nephrol [Internet]. 2018 Sep 1;28(5):335–8.

Liu C, Yan ZN, Fan L, et al. Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients. BMC Cardiovasc Disord. 2020 Jan 9;20(1):1–12.

Rahman Helmy Ali HA, Razik Mohamad NA, El-Deen Mohammad HS, et al. 2-D Speckle tracking in the assessment of left and right ventricular functions in hemodialysis versus recently diagnosed uremic patients with preserved systolic function. Egypt J Crit Care Med. 2016 Dec 1;4(3):139–44.

Samanta R, Chan C, Chauhan VS. Arrhythmias and Sudden Cardiac Death in End Stage Renal Disease: Epidemiology, Risk Factors, and Management. Vol. 35, Canadian Journal of Cardiology. Elsevier Inc.; 2019. p. 1228–40.