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RÉSUMÉ
Introduction. Les atteintes du système cardiovasculaire liées à la maladie rénale chronique (MRC) peuvent avoir des répercussions sur l’activation électrique du myocarde. Notre but était de décrire les anomalies électrocardiographiques chez les patients souffrant de MRC comparativement aux patients MRC hémodialysés chroniques. Matériel et méthodes. Il s’agissait d’une étude transversale et analytique conduite à l’hôpital général de Douala de février à juin 2021. Nous avons réalisé un électrocardiogramme à 3 groupes de patients appariés selon l’âge et le sexe dont 50 sans MRC (Non MRC), 50 avec MRC non hémodialysés (MRC-ND) et 50 avec MRC hémodialysés (HD). Une valeur p < 0,05 était considérée significative. Résultats. Sur 150 patients inclus, 87 (58%) étaient de sexe masculin et l’âge moyen était similaire dans les 3 groupes (53,06 (11,64) ans chez les HD, 53,85 (11,53) ans chez les MRC ND et 53.84 (11,74) ans chez les non MRC). Les anomalies électrocardiographiques étaient significativement retrouvées chez les HD (86%) par rapport aux MRC ND (56%) et non MRC (24%) (OR=9,2 ; IC : 3,77-22,51, P < 0,0001). Ces anomalies étaient l’HVG (66%, OR = 8.84, IC : 4.06 – 19.22, p < 0,0001), l’intervalle QT allongé (28%, OR=5,16, IC :1,93 –13,84 et p = 0,001) et l’HAG (26%, OR=6.67, IC :2.27 – 20.03, p = 0,0006). Conclusion. Les anomalies ECG étaient fréquentes chez les patients HD, notamment l’HVG, l’intervalle QT allongé et l’HAG. Ces résultats incitent à améliorer les interventions spécifiques sur les causes de l’HVG chez l’hémodialysé telles l’hypertension artérielle et l’anémie.
ABSTRACT
Introduction. Chronic kidney disease (CKD)-related impairment of the cardiovascular system may affect myocardial electrical activation. The aim of this study was to describe electrocardiographic abnormalities in patients with CKD compared to stable chronic haemodialysis patients. Material and methods. This was a cross-sectional and analytical study at the Douala General Hospital from February to June 2021. We performed an electrocardiogram in 3 groups of patients matched according to age and sex, including 50 without CKD (Non-CKD), 50 with CKD but dialysis naïve (CKD-ND) and 50 with CKD on hemodialysis (HD). A p-value < 0.05 was considered significant. Result. In total, of 150 patients included, 87 (58%) were male and the mean age was similar in the 3 groups (53.06 (11.64) years in HD patients, 53.85 (11.53) years in ND CKD patients and 53.84 (11.74) years in non-CKD patients). Electrocardiographic abnormalities were significantly found (OR=9,2 ; CI : 3,77-22,51 and P < 0,0001) in HD patients (86%) than ND CKD patients (56%) and non-CKD patients (24%) . These abnormalities found in HD patients were LVH (66%, OR = 8.84, CI : 4.06 – 19.22, p < 0,0001),QT prolongation (28%, OR=5,16, CI :1,93 –13,84 and p = 0,001) and left atrial hypertrophy (LAH) (26%, OR=6.67, IC :2.27 – 20.03 and p = 0,0006). Conclusion. Electrocardiographic abnormalities are significantly more frequent in HD patients, particularly LVH, QT interval prolongation and LAH. These results suggest an improvement of specific interventions on the causes of LVH and LAH in hemodialysis patients such as arterial hypertension and anemia.

Keywords

Electrocardiographic abnormalities Chronic kidney disease Haemodialysis Anomalies électrocardiographiques Maladie rénale chronique Hémodialyse

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Sidick Aboubakar Mouliom, Marie Patrice Halle, Marie Solange Ndom, Siddikatou Djibrilla, Gladis Stévenie Makengne, Vincent Gamby, Hermine Fouda, Viche Lade, Henri Ngote, Félicité Kamdem, & Anastase Dzudie Tamdja. (2022). Anomalies Électrocardiographiques chez les Patients avec Maladie Rénale Chronique Naïfs de Dialyse Versus Hémodialysés à Douala : Étude Comparative. HEALTH SCIENCES AND DISEASE, 23(12). https://doi.org/10.5281/hsd.v23i12.4047
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