Alterações eletrocardiográficas em pacientes com infecção renal crônica baseado na análise dos componentes principais

Abstract

The study aimed to investigate changes in ECG parameters in patients with CKD based on Principal Component Analysis (PCA). This is a study with a quantitative, descriptive and cross-sectional approach, with the participation of 25 volunteer men aged 36 to 80 years who underwent hemodialysis. For data collection, anthropometric data (weight, height and BMI calculation), hemodynamic data (blood pressure) and ECG parameters (standing out IRR, IPR, QTc) in patients at rest were analyzed to analyze possible changes in electrocardiographic findings and the use of the biplot chart, to understand the importance of each electrocardiographic finding in a patient with CKD. The statistical analysis was performed using the Shapiro-Wilk test, the descriptive analysis was divided into quantitative and qualitative. The qualitative analysis was expressed as a percentage and the quantitative was expressed as a measure of central tendency by the mean and a measure of sample dispersion by the standard deviation. The analysis of the post hoc sampling effect determined the strength of the sample size and the bootstrap was performed to estimate statistics of the ECG parameters in a population based on 1000 samples defined in bias and the confidence intervals. After programming the ACP, the Bartelett Test of Spherecity test was performed in order to verify whether there is a sufficiently strong correlation for the analysis to be applied and the Kaiser-Meyer-Olklincom test in order to measure the use of ACP for the respective database. Subsequently, the Broken Stick test criteria were used to choose the PCs relevant to the analysis. The first two main components were the most representative with 96.8% of the total variance explained by the original variables. CKD was associated with the IRR parameter (used to measure two consecutive heartbeats) with a greater contribution to the first main component and the iPR (marks the beginning of the P wave and the beginning of the QRS complex) and QTc (describes the contraction time of the ventricle) resulted in greater contributions to the second main component, demonstrating the most important parameters in CKD. As for sociodemographic data, SAH was the predominant comorbidity, more than 50% do not do physical activity, have incomplete elementary education and monthly income below one minimum wage. Results of ECG findings in patients with CRF with complications of arterial hypertension, the presence of tachycardia, increased left ventricular hypertrophy, diastolic dysfunction, atrial fibrillation and increased dispersion of the PR, QT and RR interval, mainly due to increased activation of the sympathetic nervous system and decreased parasympathetic activity, vagal reduction of the autonomic nervous system.