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Electrocardiographic abnormalities and relative bradycardia in patients with hantavirus-induced nephropathia epidemica.

Abstract：

BACKGROUND:Nephropathia epidemica (NE), caused by Puumala virus (PUUV), is characterized by acute kidney injury (AKI) and thrombocytopenia. Cardiac involvement with electrocardiographic (ECG) abnormalities has been previously reported in NE; however, its prognostic value is unknown. Relative bradycardia is an important clinical sign in various infectious diseases, and previous smaller studies have described pulse-temperature deficit in patients with PUUV infection. METHODS:We performed a cross-sectional survey of 471 adult patients with serologically confirmed NE. Data were collected retrospectively from medical records and prospectively at follow-up visits. Patients for whom ECGs were recorded during the acute phase of disease were enrolled retrospectively (n=263). Three patients were excluded because of documented pre-existing ECG abnormalities prior to NE. All patients with ECG abnormalities during the acute phase underwent follow-up. RESULTS:A total of 46 patients had ECG abnormalities at the time of admission to hospital (18%). T-wave inversion was the most frequent ECG abnormality (n=31 patients), followed by ST segment changes (nine patients with elevation and six with depression). No major adverse cardiac events occurred during follow-up (median 37months; range 34-63months). Of note, ECG abnormalities reverted to normal in the majority of the patients during follow-up. During the acute phase of NE, 149 of 186 patients had relative bradycardia, without implications for disease course. CONCLUSIONS:Transient ECG abnormalities were detected in 18% of patients during acute NE but were not associated with negative cardiovascular outcome. Relative bradycardia was identified in 80% of the patients with acute NE.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Kitterer D,Greulich S,Grün S,Segerer S,Mustonen J,Alscher MD,Braun N,Latus J

doi

10.1016/j.ejim.2016.06.001

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

67-73

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(16)30170-4

journal_volume

33

pub_type

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