Losartan and QT Dispersion in Hypertensive Patients on Maintenance Hemodialysis

Abstract

Abstract QT and corrected QT (QTc) intervals and their increased dispersions (QTd, QTcd) have been linked to the occurrence of arrhythmias in hemodialysis (HD) patients. This study was performed to determine the effects of the angiotensin II receptor blocker losartan on these parameters in HD patients. Our cohort comprised 24 dialysis patients and 14 healthy controls. 15 dialysis patients were treated for 16 weeks with losartan (HD losartan group) but not 9 patients (HD control group). Blood pressures (BP) and electrocardiogram-derived data (Sokolow-Lyon and Cornell voltages, QT, QTd, QTc and QTcd) were measured in all patients. At the beginning of the study, there were no differences in patient characteristics among the 3 groups. Baseline maximum QTc, QTd, QTcd and Socolow-Lyon and Cornell voltages and BPs of the healthy group were lower than those of HD groups. While these parameters were similar in the dialysis groups, only BPs in losartan group were higher. After 16 weeks, BPs, Socolow-Lyon and Cornell voltages values in losartan group significantly decreased but not in the HD control group. Whereas maximum QT and QTc, QTd, QTcd, heart rate and QRS interval did not change in the HD groups. Electrocardiographic LVH of 2 patients improved in the losartan group. Losartan reduced BP and electrocardiographic LVH was improved in HD patients without affecting QTd and QTcd during the 16-week study period. Key words: Hemodialysis, losartan, QT dispersion