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Selvi F, Korkut M, Bedel C, Kuş G, Zortuk Ö. Evaluation of Tpeak-end interval, Tpeak-end/QT, and Tpeak-end/Qtc ratio during acute migraine attack in the emergency department. Acta Neurol Belg 2024:10.1007/s13760-024-02497-x. [PMID: 38472697 DOI: 10.1007/s13760-024-02497-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION During an acute migraine attack, changes in ventricular repolarisation parameters may occur due to an imbalance in the autonomic nervous system. Tpeak-tend (Tp-e) interval, Tp-e/QT ratio, and Tp-e/corrected QT (QTc) ratio are novel parameters of arrhythmogenesis and can be easily calculated in electrocardiography (ECG). The objective of this study is to demonstrate that novel ventricular repolarisation parameters can anticipate the risk of ventricular dysrhythmia in the migraine attack period. METHODS This research was a prospective case-control study, which recruited a total of 144 participants, including 74 migraine patients and 70 healthy volunteers in the control group (CG) who met the criteria for migraine with or without aura. All participants underwent 12-lead ECG recordings, and the study compared the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio with those of the CG. RESULTS The average age of patients experiencing migraine attacks was 38.14 ± 10.82, with 58 (76%) of these patients being female. The Tp-e interval mean was higher in the migraine attack group than the CG, with a statistically significant difference discovered (74.22 ± 20.20 ms [ms] compared to 65.39 ± 11.33 ms, p = 0.001). However, there were higher mean Tp-e/QT and Tp-e/QTc ratios in the migraine attack group compared to the CG, and this difference was found to be statistically significant (0.20 ± 0.05 vs. 0.17 ± 0.03, p = 0.001, 0.18 ± 0.52 vs 0.16 ± 0.29, p = 0.003, respectively). CONCLUSION Prolonged Tp-e interval and elevated Tp-e/QT and Tp-e/QTc ratios were observed in migraine patients who presented to the emergency department, indicating a potential risk of ventricular dysrhythmia.
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Affiliation(s)
- Fatih Selvi
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey.
| | - Mustafa Korkut
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Cihan Bedel
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Görkem Kuş
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Ökkeş Zortuk
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
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Ömür SE, Zorlu Ç, Açıkel B. The effect of dapagliflozin therapy on ventricular repolarization parameters in electrocardiography in patients with diabetic cardiovascular disease. J Diabetes Complications 2023; 37:108547. [PMID: 37356234 DOI: 10.1016/j.jdiacomp.2023.108547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Dapagliflozin is an agent that has both antihyperglycemic effects and is significantly associated with a lower risk of cardiovascular events in patients with diabetes mellitus (DM). However, there is insufficient data and information about the effect of dapagliflozin on electrocardiographic (ECG) parameters. AIM The effects of dapagliflozin on ventricular repolarization parameters have not been fully elucidated yet. This study aimed to investigate whether dapagliflozin has a positive effect on ventricular repolarization heterogeneity parameters in patients with type 2 DM. METHOD We retrospectively enrolled 140 patients with a known diagnosis of type 2 DM who were newly prescribed dapagliflozin in addition to standard anti-diabetic therapy. The patients were divided into two groups according to whether they had cardiovascular disease (CVD). The effect of dapagliflozin treatment on ventricular repolarization parameters (frontal plane QRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion) was investigated, patient groups were compared before and after treatment. RESULTS Among 140 patients, 70 (50 %) had CVD and 70 (50 %) did not have CVD. Dapagliflozin treatment resulted in significant reductions in ventricular repolarization parameters over the study period in the CVD group with diabetes. Mean fQRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion were significantly lower than baseline values at 6-month follow-up visits in the CVD group (61.61 ± 9.22° vs 52.55 ± 8.31°, 74.45 ± 16.06 msec vs 63.27 ± 13.99 msec, 0.19 ± 0.03 vs 0.16 ± 0.03, 384.12 ± 47.93 msec vs 356.15 ± 43.31 mesc, 55.28 ± 5.50 msec vs 48.08 ± 6.48 msec for all pairwise comparisons p < 0.001). CONCLUSION Similar antihyperglycemic effects were found with dapagliflozin treatment in patients with and without CVD. However, significant reductions in ventricular repolarization parameters were observed only in patients with CVD.
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Affiliation(s)
- Sefa Erdi Ömür
- Department of Cardiology,Tokat Gaziosmanpaşa University, Tokat, Turkey.
| | - Çağrı Zorlu
- Department of Cardiology,Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Barış Açıkel
- Department of Cardiology,Tokat Gaziosmanpaşa University, Tokat, Turkey
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Göçer K, Öztürk B, Kaniyolu M, Tekinalp M. Effect of Smokeless Tobacco (Maras Powder) on the Epicardial Fat Thickness and Ventricular Repolarization Parameters. Medicina (Kaunas) 2023; 59:1127. [PMID: 37374331 DOI: 10.3390/medicina59061127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Smokeless tobacco (ST) use has recently become an alternative to cigarettes, and it has been concluded that ST is at least as harmful as cigarettes. ST use is thought to play a role in the pathogenesis of arrhythmia by affecting ventricular repolarization. In this study, we aimed to examine the relationships of Maras powder (MP), one of the ST varieties, with epicardial fat thickness and new ventricular repolarization parameters, which have not previously been described. Materials and Methods: A total of 289 male individuals were included in this study between April 2022 and December 2022. Three groups, 97 MP users, 97 smokers, and 95 healthy (non-tobacco), were compared according to electrocardiographic and echocardiographic data. Electrocardiograms (ECG) were evaluated with a magnifying glass by two expert cardiologists at a speed of 50 m/s. Epicardial fat thickness (EFT) was measured by echocardiography in the parasternal short- and long-axis images. A model was created with variables that could affect epicardial fat thickness. Results: There were no differences between the groups regarding body mass index (p = 0.672) and age (p = 0.306). The low-density lipoprotein value was higher in the MP user group (p = 0.003). The QT interval was similar between groups. Tp-e (p = 0.022), cTp-e (p = 0.013), Tp-e/QT (p =0.005), and Tp-e/cQT (p = 0.012) were higher in the MP user group. While the Tp-e/QT ratio did not affect EFT, MP predicted the epicardial fat thickness (p < 0.001, B = 0.522, 95%CI 0.272-0.773). Conclusions: Maras powder may play a role in ventricular arrhythmia by affecting EFT and causing an increase in the Tp-e interval.
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Affiliation(s)
- Kemal Göçer
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Bayram Öztürk
- Department of Cardiology, Medical Park Goztepe Hospital, Istanbul 34730, Turkey
| | - Murat Kaniyolu
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Mehmet Tekinalp
- Department of Cardiology, Necip Fazıl City Hospital, Kahramanmaras 46080, Turkey
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Özer S, Şentürk N, Aydın E, Sayın MR. Cardio-ankle brachial index is associated with prolonged Tp-e interval in patients with arterial hypertension. J Electrocardiol 2023; 79:53-7. [PMID: 36934493 DOI: 10.1016/j.jelectrocard.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/02/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
AIM The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and elevated CAVI values have been reported to be associated with an increased risk of cardiovascular mortality and cardiac arrhythmia. This study aimed to evaluate the relationship between Tp-e interval and CAVI, which is associated with cardiac arrhythmia on electrocardiography (ECG). METHOD The study included patients with hypertension whose blood pressure values were taken under control with optimal medical treatment. Arterial stiffness and CAVI were measured using the vascular scanning system VaSera VS-1000. The patients were divided into two groups as CAVI<9 and CAVI≥9. Ventricular repolarization markers QT and QTc intervals, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured using 12‑lead ECG. RESULTS Tp-e interval (78.7 ± 10.3 vs. 63.6 ± 9.1, p < 0.001), Tp-e/QT ratio (0.018 ± 0.02 vs. 0.015 ± 0.02, p < 0.001), and Tp-e/QTc ratio (0.17 ± 0.02 vs. 0.14 ± 0.04, p = 0.025) were statistically significantly higher in the CAVI≥9 group compared to the CAVI<9 group. In the prediction of patients in the CAVI≥9 group, Tp-e interval had an area under the curve value of 0.862 (0.784-0.940, p < 0.001) at the cut-off point of >72.5 msec, indicating a statistically significant result. Left CAVI and right CAVI were found to be significantly correlated with Tp-e interval (r = -0.650, p < 0.001 and r = -0.663, p < 0.001, respectively). CONCLUSION We found that elevated CAVI values were associated and positively correlated with prolonged Tp-e interval values in patients with hypertension. Patients with elevated CAVI values should be followed up closely to prevent cardiac arrhythmic events.
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Avci Y, Demir AR, Bulut U, Demirci G, Karakurt ST, Sancar KM, Aktemur T, Uygur B, Ersoy B, Erturk M. Novel markers of ventricular repolarization are associated with mortality in patients undergoing surgical aortic valve replacement for severe aortic stenosis. J Card Surg 2021; 36:4591-4596. [PMID: 34628679 DOI: 10.1111/jocs.16063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Aortic stenosis (AS) is the most common degenerative valvular heart disease that can affect left ventricular functions. Tp-e interval and Tp-e/QT ratio is a novel repolarization marker which is associated with adverse cardiovascular events in several cardiovascular diseases. In our study, our aim is to investigate the prognostic effect of Tp-e interval, Tp-e/QT and Tp-e/QTc ratios on mortality in patients who underwent successful surgical aortic valve replacement (AVR). METHODS A total of three hundred seventy-five patients undergoing successful surgical AVR were included in this study. Then, patients were divided into two groups according to mortality as group 1 without mortality (342 patients) and group 2 with mortality (33 patients). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were calculated for both groups. RESULTS Tp-e interval (71 (63.7-77); 86 (84-88), p < .001), Tp-e/QT ratio (0.19 (0.17-0.20); 0.23 (0.22-0.23), p < .001) and Tp-e/QTc ratio (0.17 ± 0.02; 0.21 ± 0.01, p < .001) were higher in group 2 compared to group 1. In multivariate logistic regression analyses Tp-e interval (odds ratio [OR]: 1.315, 95% confidence interval [CI]: 1.203-1.437, p < .001), Tp-e/QT ratio (OR: 7.334, 95% CI: 3.274-1.643, p < .001) and Tp-e/QTc ratio (OR: 2.567, 95% CI: 4.106-1.605, p < .001) were found to be independent predictors of mortality. Additionally, a Kaplan-Meier survival analysis also revealed that long term survival was found to be significantly decreased in patients with higher Tp-e/QT ratio (Log-Rank p < .001) and Tp-e/QTc ratio (Log-Rank p < .001). CONCLUSION Tp-e interval, Tp-e dispersion, Tp-e/QT, and Tp-e/QTc ratios are associated with worse prognosis after surgical AVR in patients with severe AS. All of them are also independent predictors of mortality.
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Affiliation(s)
- Yalcin Avci
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali R Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Umit Bulut
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gökhan Demirci
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Seda T Karakurt
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kadriye M Sancar
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tugba Aktemur
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Begüm Uygur
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Burak Ersoy
- Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Bağcı A, Aksoy F, Baş HA, Işık İB, Orhan H. The effect of Systolic and diastolic blood pressure on Tp-e interval in patients divided according to World Health Organization classification for body mass index. Clin Exp Hypertens 2021; 43:642-646. [PMID: 34018865 DOI: 10.1080/10641963.2021.1925684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio are electrocardiographic markers and indices of ventricular arrhythmogenic events. We aimed to investigate ventricular repolarization in normal weight, overweight, obese and morbidly obese individuals by using ECG parameters including the above markers.Methods: A total of 310 obese patients with various cardiac complaints, who were admitted to our outpatient clinic between May 2020 and January 2021, were prospectively included in the study. Using the World Health Organization (WHO) body mass index (BMI) classification, patients were divided into four groups: normal weight (18.5-24.9 kg/m2, n = 48), overweight (25-29.9 kg/m2, n = 98), obese (30-39.9 kg/m2, n = 119), and morbidly obese (>40 kg/m2, n = 45).Results: The morbidly obese and normal groups were younger in age than the other two groups. The Tp-e interval values for Groups I-IV were 72.1 ± 6.9, 73.1 ± 6.2, 75.7 ± 7.3 and 81.1 ± 6.9, respectively, and significantly different (P < .001). We found that age, BMI, systolic blood pressure (BP) and diastolic BP were independent predictors of a prolonged Tp-e interval.Conclusions: The principal finding of our study was the gradual increase in Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio starting from the overweight stage and these parameters gradually increase in obese and morbidly obese patients. Additionally, systolic and diastolic blood pressure predicted Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio.
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Affiliation(s)
- Ali Bağcı
- Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey
| | - Fatih Aksoy
- Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey
| | - Hasan Aydin Baş
- Department of Cardiology, Isparta City Hospital, Isparta, Turkey
| | | | - Hikmet Orhan
- Department of Biostatistics, Suleyman Demirel University, Medical School, Isparta, Turkey
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Sengul C, Sen A, Barutcu S, Cakir C, Sarikaya R. Association of Mild Hyperbilirubinemia with Decreased ECG-Based Ventricular Repolarization Parameters in Young Men. Lab Med 2021; 52:226-231. [PMID: 32885227 DOI: 10.1093/labmed/lmaa063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Hyperbilirubinemia is associated with protection against various oxidative stress-mediated diseases. We aimed to investigate the association between bilirubin and novel electrocardiography (ECG)-based ventricular repolarization parameters. METHODS We enrolled 201 healthy men with mild hyperbilirubinemia (group 1) and 219 healthy men with normal bilirubin levels (group 2). The Tpeak-Tend (Tp-e) interval (defined as the interval from the peak of the T wave to the end of the T wave), corrected (c) Tp-e interval, QT interval, cQT interval, and Tp-e interval/QT interval ratio were measured from leads V5 and V6 with 20 mm/mV amplitude and 50 mm/second rate. RESULTS The Tp-e interval, cTp-e interval, and Tp-e interval/QT interval ratio were significantly lower in group 1 compared with group 2. The cTp-e interval showed a significant negative correlation with total bilirubin, conjugated bilirubin, and unconjugated bilirubin. The cTp-e interval (odds ratio [OR], 0.900; P =.002) and Tp-e interval/QT interval ratio (OR, 0.922; P =.04) were significantly associated with mild hyperbilirubinemia. CONCLUSION We showed the association of mild hyperbilirubinemia with decreased novel ECG-based ventricular repolarization parameters.
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Affiliation(s)
- Cihan Sengul
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Ahmet Sen
- Department of Biochemistry, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Suleyman Barutcu
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Cayan Cakir
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Remzi Sarikaya
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
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Uslu A, Kup A, Gulsen K, Demir S, Kanar BG, Taylan G, Sari M, Akgun T, Kepez A. Acute effect of outflow tract premature ventricular complex ablation on QT dispersion, Tp-e interval and Tp-e/QT ratio. Acta Cardiol 2021; 76:127-131. [PMID: 32406298 DOI: 10.1080/00015385.2020.1761595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is limited data regarding the effect of idiopathic premature ventricular complexes (PVC) on myocardial repolarisation. Most of PVC's originate from right and left ventricular outflow tracts (RVOT and LVOT). AIM The aim of this study is to evaluate the acute effect of outflow tract PVC ablation on electrocardiographic repolarisation markers. METHODS A total of 180 patients (49.2 ± 13.6 years, 74 male) without any exclusion criteria who had undergone outflow tract PVC ablation between 1 January 2015 and 1 November 2018 constituted our study population. Electrocardiographic recordings that had been obtained before and after ablation procedure on the same day were retrospectively evaluated for the QTc dispersion, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Significance of difference between pre- and postablation values was tested. RESULTS There was no significant difference regarding QTc dispersion between pre- and post-ablation state (36.5 ± 20.9 vs. 35.3 ± 16.4 ms, p: NS). However, Tp-e and Tp-e/QT values in all lateral precordial derivations were observed to decrease significantly after PVC ablation (in the respective order on derivation V5: 104.0 ± 21.6 ms vs. 91.1 ± 14.8 ms, p<.001 and 0.26 ± 0.05 vs. 0.23 ± 0.04, p<.001). CONCLUSIONS Based on these observations, it may be suggested that frequent outflow tract PVC's increase transmural dispersion of repolarisation and this effect is attenuated by catheter ablation in the acute phase. Results of further prospective studies are required for evaluation of the long term effects of PVC ablation on myocardial repolarisation.
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Affiliation(s)
- Abdulkadir Uslu
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Kup
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Kamil Gulsen
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Serdar Demir
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Batur Gonenc Kanar
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gokay Taylan
- Department of Cardiology, Trakya University School of Medicine, Edirne, Turkey
| | - Münevver Sari
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Taylan Akgun
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Alper Kepez
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
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Tascanov MB, Havlioglu S, Tanriverdi Z, Gungoren F, Altiparmak İH. Effect of noise on the electrocardiographic parameters. Int Arch Occup Environ Health 2021; 94:1397-403. [PMID: 33646333 DOI: 10.1007/s00420-021-01676-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Noise, defined as any sound that is unpleasant, is one of the most important environmental problems. Prolonged exposure to noise has been shown to be associated with the development of cardiovascular diseases. No study investigated the effect of noise on surface electrocardiography (ECG). AIMS The aim of our study is to investigate the effect of noise on surface ECG parameters including P-wave dispersion (PWD), QT intervals, corrected QT interval (QTc), T-wave peak to end (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios. METHODS A total of 51 people working in the textile factory affected by the noise and 43 volunteers without any disease and who were not exposed to noise were included in this study. The average noise level in the textile factory was 112 dB. A 12-lead ECG was obtained from all individuals. PR interval, PWD, QRS duration, QT interval, QTc interval, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were calculated for all individuals. RESULTS The noise group had significantly increased PWD [35 (28-40) vs. 28 (22-36) p = 0.029], QT interval ( 373.5 ± 27.3 vs. 359.3 ± 2.74, p = 0.001), QTc interval [(409 ± 21 vs. 403 ± 13 p = 0.045)], Tp-e interval [(90.6 ± 6.0 vs. 83.5 ± 7.3 p < 0.001)], Tp-e/QT [(0.24 ± 0.03 vs. 0.23 ± 0.02, p = 0.015)] and Tp-e/QTc [(0.22 ± 0.02 vs. 0.21 ± 0.02 p < 0.001)] compared to control group. Also, duration of working was positively correlated with PWD (r = 0.468, p = 0.001) and Tp-e/QTc ratio (r = 0.328, p = 0.019). In multiple linear regression linear regression analysis, noise was the independent predictor of both PWD (β = 0.244, p = 0.032) and Tp-e/QTc (β = 0.319, p = 0.003) CONCLUSION: We showed that noise significantly increased PWD, QT and Tp-e interval measurements. Also, noise was the independent predictor for both PWD and Tp-e/QTc.
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Ajibare AO, Olabode OP, Fagbemiro EY, Akinlade OM, Akintunde AA, Akinpelu OO, Olatunji LA, Soladoye AO, Opadijo OG. Assessment of Ventricular Repolarization in Sickle Cell Anemia Patients: The Role of QTc Interval, Tp-e Interval and Tp-e/QTc Ratio and Its Gender Implication. Vasc Health Risk Manag 2020; 16:525-533. [PMID: 33324066 PMCID: PMC7733033 DOI: 10.2147/vhrm.s259766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/01/2020] [Indexed: 12/21/2022] Open
Abstract
Background Many specific and non-specific electrocardiographic abnormalities including ventricular arrhythmias have been reported in subjects with sickle cell anemia (SCA). In SCA patients, cardiac electrical abnormalities may be the leading cause of increased risk of arrhythmias. The corrected QT (QTc) interval, peak to the end of the T wave (Tp-e) interval and associated Tp-e/QTc ratio are promising measures of altered ventricular repolarization and increased arrhythmogenesis risk. Aim This study assessed ventricular repolarization abnormalities in subjects with SCA using the QTc interval, Tp-e interval and Tp-e/QTc ratio, and also evaluated the gender differences in these parameters, as well as their determinants. Methods Sixty subjects with SCA and 60 healthy control subjects, matched for age and gender, were studied. All participants underwent physical examination, hematological and biochemical evaluation, and 12-lead electrocardiography (ECG) recording. QT and Tp-e intervals were measured from the ECG, and the QTc interval was calculated using Bazett’s formula. Tp-e/QT and Tp-e/QTc ratios were also derived. Results QT and QTc intervals were prolonged in subjects with SCA. Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were prolonged in male SCA subjects, with a paradoxical shortening in female SCA subjects. Plasminogen activator inhibitor-1 (PAI-1) was an independent determinant of QTc, while body mass index (BMI) was an independent determinant of both Tp-e interval and Tp-e/QTc ratio. Conclusion Our results suggest an elevated risk for ventricular arrhythmogenesis in male SCA subjects. Furthermore, increased BMI and PAI-1 level are possible markers of ventricular repolarization abnormalities in SCA subjects.
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Yilmaz E, Aydin E. The effect of low iron storage without Anaemia on electrocardiography. J Electrocardiol 2020; 64:76-79. [PMID: 33352333 DOI: 10.1016/j.jelectrocard.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Low iron storage is a common health problem around the world. Although the association of low iron storage with cardiovascular events and various electrocardiographic parameters has been investigated, its association with fragmented QRS (fQRS), Tpeak-Tend (Tp-e) interval, Tp-e/QT and Tp-e/QTc ratios, which are important criteria for repolarization, has not been studied in adults. METHODS A total of 201 female patients in the 18-50 age group with no history of chronic and cardiac disease or anaemia were included in the study. Patients were divided into 3 groups based on their ferritin levels. Twelve lead EKGs were obtained from each patient, and fQRS, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were calculated manually. RESULTS A total of 201 female patients with an average age of 37 ± 9 were included in the study. Group 1 (ferritin<15 ng/mL) consisted of 79 (39.3%) patients, Group 2 (ferritin 15-30 ng/mL) consisted of 64 patients (31.8%) and Group 3 (ferritin≥30 ng/mL) consisted of 58 (28.9%) patients. Tp-e interval was significantly higher in Group 1 compared to Group 2 and 3 (p < 0.001). A similar relationship was also observed between Tp-e/QT, Tp-e/QTc and fQRS (p < 0.001). A moderate, negative relationship was found in the correlation analysis of Tp-e, Tp-e/QT, Tp-e/QTc and fQRS with ferritin value [r = -0.519 (p = 0.001), r = -0.485 (p = 0.001), r = -0.540 (p = 0.001) and r = -0.345 (p = 0.001), respectively]. CONCLUSION As a result of the study, it was found that low iron storage may increase arrhythmogenic susceptibility through increased fragmented QRS presence, increased Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in healthy women of childbearing age.
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Affiliation(s)
- Emre Yilmaz
- Op. Dr. Ergun Ozdemir Gorele State Hospital, Department of Cardiology, Giresun, Turkey.
| | - Ercan Aydin
- Vakfikebir State Hospital, Department of Cardiology, Trabzon, Turkey.
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12
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Abstract
BACKGROUND It has been reported in the literature that the increase in body temperature shortens QT interval on electrocardiogram through heart rate modulation. However, the effects of fever on ventricular repolarization are not clearly known. This study elaborates on QT interval of isolated fever, corrected QT (cQT), Tp-e interval, the ratio of corrected Tp-e (cTp-e) and Tp-e/QT, and their impacts on arrhythmia potential. METHODS This prospective study was performed on 74 patients without any active and chronic diseases other than fever and upper respiratory tract infection. The study included patients at the age of 18-50 years suffering from fever above 38.2 °C. QT and Tp-e intervals of the patients were measured from their ECGs taken in febrile and afebrile periods. cQT and cTp-e values were calculated according to Bazett, Fridericia, and Framingham formulations. RESULTS QT and Tp-e intervals were observed to be shorter in the febrile period (p < 0.001 and p = 0.006 respectively). cTp-e was found to be longer in the febrile period according to Bazett, Fridericia, and Framingham formulations (p < 0.001, p = 0.002, p < 0.001, respectively). Tp-e/QT ratio was found to be higher in the febrile period than in the afebrile period (p < 0.001). CONCLUSION Although QT, cQT, and Tpe intervals were shorter, cTpe interval and Tpe/QT ratio were longer and higher in the febrile period, respectively. These findings may indicate that fever may create a proarrhythmic effect by causing variability in the transmural distribution of myocardial repolarization.
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Affiliation(s)
- Emre Gökçen
- Department of Emergency Medicine, Bozok University Faculty of Medicine, Yozgat, Turkey.
| | - Atakan Savrun
- Department of Emergency Medicine, Ordu University Faculty of Medicine, Ordu, Turkey
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Erken Pamukcu H, Hepşen S, Şahan HF, Biçer T, Çakal E, Çimen T, Efe TH, Sunman H. Diabetic microvascular complications associated with myocardial repolarization heterogeneity evaluated by Tp-e interval and Tp-e/QTc ratio. J Diabetes Complications 2020; 34:107726. [PMID: 32912812 DOI: 10.1016/j.jdiacomp.2020.107726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/30/2020] [Accepted: 08/23/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The heterogeneity in myocardial repolarization increases the risk of ventricular arrhythmias and sudden death in patients with diabetes mellitus (DM). The Tp-e interval and Tp-e/QTc ratio are found to be useful in the prediction of ventricular arrhythmias. In this study, we aimed to investigate the Tp-e interval and Tp-e/QTc ratio in diabetic patients with and without microvascular complications. MATERIALS AND METHODS This cross-sectional observational study included patients with type 2 DM who presented to the endocrinology outpatient clinic. Diabetic microvascular complications were evaluated. The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were also calculated. RESULTS A total of 240 patients with type 2 DM (148 patients had microvascular complications) were included in the study. Diabetic neuropathy rate was 30.4%, diabetic nephropathy rate was 38.4%, and diabetic retinopathy rate was 21.7%. Upon comparing patients according to Tp-e/QTc ratio, the median Tp-e/QTc interval of the group of patients with complications was 0.21 (0.19-0.23) and the median Tp-e/QTc ratio of the group of patients without complications was 0.19 (0.18-0.20) (p < 0.001). When patients were grouped according to the presence and severity of retinopathy, the Tp-e/QTc ratio was more prolonged in the proliferative retinopathy group [0.27 (0.23-0.30)] than the non-proliferative retinopathy group [0.20 (0.19-0.22), p < 0.001]. When patients were grouped according to the presence and severity of nephropathy, the Tp-e/QTc ratio was more prolonged in the macroalbuminuria and microalbuminuria group than the normoalbuminuric group [0.25 (0.21-0.30), 0.23 (0.19-0.24), and 0.19 (0.20-0.22), respectively, p = 0.002]. CONCLUSIONS Our study is the first to demonstrate the association of the Tp-e interval and Tp-e/QTc ratio with the presence and severity of microvascular complications in patients with type 2 DM.
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Affiliation(s)
- Hilal Erken Pamukcu
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara.
| | - Sema Hepşen
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara
| | - Haluk Furkan Şahan
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara
| | - Tolga Biçer
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Ophthalmology, Ankara
| | - Erman Çakal
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara
| | - Tolga Çimen
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara
| | - Tolga Han Efe
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara
| | - Hamza Sunman
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara
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Abstract
BACKGROUND Electronic cigarette (e-cigarette) use is constantly increasing. However, the association between e-cigarette use and ventricular arrhythmia is unknown. Thus, in this study, we aimed to evaluate the markers of ventricular repolarization such as QT interval, corrected QT (QTc), QT dispersion (QTd), peak-to-end interval of the T wave (Tp-e), corrected Tp-e and Tp-e/QT ratios in e-cigarette users. METHODS The study population consisted 36 e-cigarette users and 40 healthy subjects. Ventricular repolarization parameters were obtained from 12-lead resting electrocardiogram. Ventricular repolarization parameters of the groups were compared. RESULTS Basal demographic and laboratory data were similar in both groups. According to the electrocardiographic parameters, the Tp-e interval, corrected Tp-e, and Tp-e/QT ratio were significantly higher in individuals using e-cigarettes than in control subjects [74.9±6.4 milliseconds (ms) vs. 80.1±4.1ms, <0.001; 82.9±7.5 ms vs. 87.8±6.3 ms, p=0.003; 0.20±0.01 vs. 0.21±0.01, p=0.002; respectively]. CONCLUSION This is the first study to show the disruption of ventricular repolarization properties in e-cigarette users. E-cigarette use in terms of public health leads to augmentation of transmural dispersion of repolarization, which may be potential indicator of ventricular arrhythmogenesis.
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Affiliation(s)
- Vahit Demir
- Department of Cardiology, Medical Faculty of Bozok University, Yozgat, Turkey
| | - Siho Hidayet
- Department of Cardiology, Medical Faculty of Inonu University, Malatya, Turkey
| | - Yaşar Turan
- Department of Cardiology, Medical Faculty of Bozok University, Yozgat, Turkey
| | - Hüseyin Ede
- Department of Cardiology, Medical Faculty of Bozok University, Yozgat, Turkey
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Yenerçağ M, Arslan U, Doğduş M, Günal Ö, Öztürk ÇE, Aksan G, Erdoğan G, Gül S, Yontar OC, Şen A. Evaluation of electrocardiographic ventricular repolarization variables in patients with newly diagnosed COVID-19. J Electrocardiol 2020; 62:5-9. [PMID: 32731139 PMCID: PMC7373019 DOI: 10.1016/j.jelectrocard.2020.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/08/2020] [Accepted: 07/17/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is a newly recognized infectious disease that has spread rapidly. COVID-19 has been associated with a number of cardiovascular complications, including arrhythmias. The mechanism of ventricular arrhythmias in patients with COVID-19 is uncertain. The aim of the present study was to evaluate the ventricular repolarization by using the Tp-e interval, QT dispersion, Tp-e/QT ratio, and Tp-e/QTc ratio as candidate markers of ventricular arrhythmias in patients with newly diagnosed COVID-19. In addition, the relationship between the repolarization parameters and the CRP (C-reactive protein) was investigated. METHODS 75 newly diagnosed COVID-19 patients, 75 age and sex matched healthy subjects were included in the study between 20th March 2020 and 10th April 2020. The risk of ventricular arrhythmias was evaluated by calculating the electrocardiographic Tp-e and QT interval, Tp-e dispersion, corrected QT(QTc), QT dispersion (QTd), corrected QTd, Tp-e/QT and Tp-e/QTc ratios. CRP values were also measured in patients with newly diagnosed COVID-19. RESULTS Tp-e interval (80.7 ± 4.6 vs. 70.9 ± 4.8; p < .001), Tp-e / QT ratio (0.21 ± 0.01 vs. 0.19 ± 0.01; p < .001) and Tp-e/QTc ratio (0.19 ± 0.01 vs.0.17 ± 0.01; p < .001) were significantly higher in patients with newly diagnosed COVID-19 than the control group. There was a significant positive correlation between Tp-e interval, Tp-e/QTc ratio and CRP in patients with newly diagnosed COVID-19 (rs = 0.332, p = .005, rs = 0.397, p < .001 consecutively). During their treatment with hydroxychloroquine (HCQ), azithromycin and favipiravir, ventricular tachycardia episodes were observed in in two COVID-19 patients during their hospitalization in the intensive care unit. CONCLUSION Our study showed for the first time in literature that the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio, which are evaluated electrocardiographically in patients with newly diagnosed COVID-19, were prolonged compared with normal healthy individuals. A positive correlation was determined between repolarization parameters and CRP. We believe that pre-treatment evaluation of repolarization parameters in newly diagnosed COVID-19 would be beneficial for predicting ventricular arrhythmia risk.
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Affiliation(s)
- Mustafa Yenerçağ
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Uğur Arslan
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey.
| | - Mustafa Doğduş
- Department of Cardiology, University of Usak Training and Research Hospital, Usak, Turkey
| | - Özgür Günal
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Çağatay Erman Öztürk
- Department of of Anaesthesiology and Reanimation, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Gökhan Aksan
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Güney Erdoğan
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Sefa Gül
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Osman Can Yontar
- Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
| | - Ahmet Şen
- Department of of Anaesthesiology and Reanimation, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
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16
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Avci BŞ, Kuvvetli A. Relationship With Calcium, Nutrition Risk, QTc Interval, Tp-e Interval, and Tp-e/QTc Ratio of Critical Care Patients. JPEN J Parenter Enteral Nutr 2020; 45:907-915. [PMID: 32623736 DOI: 10.1002/jpen.1955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/17/2020] [Accepted: 06/23/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND To our knowledge, there are studies related to QTc interval in critical care patients whose nutrition scores are evaluated but no studies evaluating T-wave peak and end interval (Tp-e interval), Tp-e/QT ratio, and Tp-e/QTc ratio, used to evaluate cardiac arrhythmia risk and ventricular repolarization change rates. Therefore, we aimed to investigate whether there is a change in Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients whose nutrition scores are evaluated. METHODS This study was planned as a retrospective cross-sectional study. Forty-four patients with a risk score of ≤3 were defined as low-risk group, and 45 patients with a score of ≥4 were defined as high-risk group. Forty-five healthy patients of similar age and gender were included in the control group. All patients underwent 12-lead electrocardiography (ECG). The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were measured on ECG. The study data were grouped as patients with high Nutritional Risk Screening 2002 (NRS-2002) risk score, low NRS-2002 risk score, and healthy control. RESULTS QTc interval, Tp-e interval, and Tp-e/QTc ratios were significantly higher in patients with high nutrition risk. In a correlation analysis, Tp-e interval and Tp-e/QTc ratio were found to be independently associated with calcium, corrected calcium, and serum albumin level. CONCLUSION QTc interval, Tp-e interval, and Tp-e/QTc ratios are significantly increased in patients with high nutrition risk score compared with healthy people and are independently associated with calcium and serum albumin levels; thus, they can be used more effectively in the follow-up of cardiac fatal arrhythmias.
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Affiliation(s)
- Begüm Şeyda Avci
- Department of Internal Medicine, Adana City Research and Training Hospital, Health Science University, Adana, Turkey
| | - Adnan Kuvvetli
- Department of General Surgery, Adana City Research and Training Hospital, Health Science University, Adana, Turkey
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17
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Güney AY, Şap F, Eklioğlu BS, Oflaz MB, Atabek ME, Baysal T. Investigation of the effect of epicardial adipose tissue thickness on cardiac conduction system in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2020; 33:713-720. [PMID: 32441671 DOI: 10.1515/jpem-2020-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/15/2020] [Indexed: 11/15/2022]
Abstract
Objectives Investigation of the association between epicardial adipose tissue thickness (EATT) and P-wave dispersion (Pd), QT dispersion (QTd), corrected QT dispersion (QTcd) and Tp-e interval in children with Type 1 Diabetes Mellitus (T1DM) was aimed. Methods Forty-one children with T1DM and 41 age- and gender-matched healthy children were included in the study. Demographical characteristics of all cases were examined. In echocardiography; in addition to conventional echocardiographic measurements, end-systolic EATT was measured from right ventricular free wall. In electrocardiogram; Pd, QTd, QTcd and Tp-e interval durations, as well as Tp-e/QT and Tp-e/QTc ratios were calculated. Correlation values between EATT and electrocardiographic parameters were also noted. Results Mean age of the patient group was determined to be 12.43 ± 3.04 years and that of the control group was determined to be 12.08 ± 2.56 years. There was no significant difference between the groups in regard to age, gender, body weight, height and body mass index. In the patient group; EATT, Pd, QTd, QTcd and Tp-e interval were determined to be significantly higher compared to the control group. In the patient group, no significant correlation was determined between EATT and Pd, QTd, QTcd and Tp-e. However, when both patient and control groups were evaluated together, a statistically significant positive correlation was determined between EATT and Pd, QTd, QTcd and Tp-e. Conclusions In children with T1DM, an increase in epicardial adipose tissue thickness and in risk of cardiac arrhythmias has been demonstrated. To reveal the possible unfavorable effects of EATT on cardiac conduction system in T1DM patients needs further studies.
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Affiliation(s)
- Ahmet Yasin Güney
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Şap
- Division of Pediatric Cardiology, Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Akyokus-Meram, Konya, 42080, Turkey
| | - Beray Selver Eklioğlu
- Division of Pediatric Endocrinology, Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Burhan Oflaz
- Division of Pediatric Cardiology, Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Emre Atabek
- Division of Pediatric Endocrinology, Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Baysal
- Division of Pediatric Cardiology, Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Afsin A, Asoğlu R, Orum MH, Cicekci E. Evaluation of TP-E Interval and TP-E/QT Ratio in Panic Disorder. Medicina (Kaunas) 2020; 56:E215. [PMID: 32353958 PMCID: PMC7279486 DOI: 10.3390/medicina56050215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022]
Abstract
Background and Objectives: The autonomic nervous system (ANS) is involved in panic disorders. ANS dysfunction has been shown to be associated with ventricular arrhythmia and increased heterogeneity of ventricular repolarization. However, there remains limited evidence of the relationship between panic disorders and ventricular depolarization markers, including the Tp-e interval and Tp-e/QT ratio. This study aimed to evaluate ventricular repolarization parameters in patients with panic disorder. Materials and Methods: In total, 40 patients with panic disorder, diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, were included in the study group. The control group comprised of 50 age- and sex-matched healthy individuals. A standard 12 lead electrocardiogram was recorded on all participants, and heart rate, QT interval, QRS duration, Tp-e interval, and Tp-e/QT ratio were measured. Results: QRS durations and QT intervals were similar in the study and control groups. Compared to the control group, QTd, Tp-e, and cTp-e intervals as well as Tp-e/QT and Tp-e/QTc ratios were significantly increased in patients with panic disorder (p < 0.05 for all). In the study group, the Severity Measure for Panic Disorder-Adult score had a significant positive correlation with the Tp-e interval (r = 0.369, p < 0001), cTp-e interval (r = 0.531, p < 0.001), Tp-e/QT ratio (r = 0.358, p = 0.001), and Tp-e/QTc ratio (r = 0.351, p = 0.001). Conclusion: These findings indicate that panic disorders are associated with increased ventricular repolarization heterogeneity, which may be attributed to ANS dysregulation.
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Affiliation(s)
- Abdulmecit Afsin
- Department of Cardiology, M.D, Kahta State Hospital, Adıyaman 02450, Turkey
| | - Ramazan Asoğlu
- Department of Cardiology, M.D, Adıyaman Training and Research Hospital, Adıyaman 02450, Turkey;
| | - Mehmet Hamdi Orum
- Department of Psychiatry, M.D, Kahta State Hospital, Adıyaman 02450, Turkey; (M.H.O.); (E.C.)
| | - Elvan Cicekci
- Department of Psychiatry, M.D, Kahta State Hospital, Adıyaman 02450, Turkey; (M.H.O.); (E.C.)
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Yenerçağ M, Arslan U, Ceylan A, Erdoğan G, Seker OO. Evaluation of Tp-e interval and Tp-e/QT ratio in major burn patients. J Electrocardiol 2020; 60:67-71. [PMID: 32304902 DOI: 10.1016/j.jelectrocard.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/14/2020] [Accepted: 04/03/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Major burn injury is an acute stress reaction with systemic effects. Major burn injury has been associated with a number of cardiovascular dysfunctions, including ventricular arrhythmias. The mechanism of increased ventricular arrhythmias in burn patients uncertain. The aim of the present study was to evaluate the ventricular repolarization by using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio as candidate markers of ventricular arrhythmias in patients with major burn patients. In addition, the relationship between the repolarization parameters and the CRP(C-reactive protein) and ABSI(Abbreviated Burn Severity Index) score was investigated. METHODS 55 major burn patients, 55 age and sex matched healthy subjects were included in the study between January 2017 and September 2019. The risk of ventricular arrhythmias was evaluated by calculating the electrocardiographic Tp-e and QT interval, corrected QT(QTc), Tp-e/QT and Tp-e/QTc ratios. ABSI score was calculated in burn patients. Left ventricular functions were evaluated by echocardiography. RESULTS Tp-e interval (80.7 ± 5.7 vs. 67.4 ± 5.7; p < 0.001), Tp-e/QT ratio (0.21 ± 0.01 vs. 0.18 ± 0.01; p < 0.001) and Tp-e/QTc ratio (0.20 ± 0.01 vs.0.17 ± 0.01; p < 0.001) were significantly higher in major burn patients than the control group. There was a significant positive correlation between Tp-e interval, Tp-e/QTc ratio and ABSI score in major burn patients (r = 0.870, p < 0.001, r = 0.312, p = 0.020 consecutively). CONCLUSION Our study showed for the first time in literature that the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio, which were evaluated electrocardiographically in major burn patients, were prolonged compared with normal healthy individuals. A positive correlation was determined between repolarization parameters and ABSI score. Whether these changes increase the risk of ventricular arrhythmia deserve further studies. TAKE-HOME MESSAGE Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio, which were evaluated electrocardiographically in major burn patients, were prolonged compared with normal healthy individuals and a positive correlation was found between these repolarization parameters and burn severity.
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20
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Abstract
BACKGROUND AND PURPOSE To evaluate P-wave dispersion before and after antiepileptic drug (AED) treatment as well as to investigate the risk of ventricular repolarization using the Tpeak-Tend (Tp-e) interval and Tp-e/QT ratio in patients with epileptic disorder. METHODS A total of 63 patients receiving AED therapy and 35 healthy adults were included. ECG recordings were obtained before and 3 months after anti-epileptic treatment among patients with epilepsy. For both groups, Tp-e and Tp-e/QT ratio were measured using a 12-lead ECG device. RESULTS Tp-e interval, Tpe/QT and Tp-e/QTc ratios were found to be higher in the patient group than in the control group (p<0.05, for all), while QTmax ratio was significantly lower in the patient group. After 3 months of AED therapy, significant increases in QT max, QTc max, QTcd, Tp-e, Tp-e/QT, and Tp-e/QTc were found among the patients (p<0.05). When the arrhythmic effects of the drugs before and after treatment were compared, especially in the valproic acid group, there were significant increases in Tp-e interval, Tp-e/QT and Tp-e/QTc values after three months of treatment (p<0.05). Carbamazepine and levetiracetam groups were not statistically significant in terms of pre- and post-treatment values. CONCLUSION It was concluded that an arrhythmogenic environment may be associated with the disease, and patients who received AED monotherapy may need to be followed up more closely for arrhythmia.
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Affiliation(s)
- Yasar Altun
- Department of Neurology, Medical Faculty of Adiyaman University, Adiyaman, Turkey
| | - Erdogan Yasar
- Department of Cardiology, Medical Faculty of Adiyaman University, Adiyaman, Turkey
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Okutucu S, Sabanoglu C, Yetis Sayin B, Aksoy H, Bursa N, Oto A. Switching from ramipril to sacubitril/valsartan favorably alters electrocardiographic indices of ventricular repolarization in heart failure with reduced ejection fraction. Acta Cardiol 2020; 75:20-25. [PMID: 30513267 DOI: 10.1080/00015385.2018.1535818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Angiotensin receptor neprilysin inhibitor (ARNI, sacubitril/valsartan) reduces sudden death in heart failure with reduced ejection fraction (HFrEF). Corrected QT (QTc), T-wave peak to T-wave end interval (Tp-e) and Tp-e/QTc are electrocardiographic indices of ventricular repolarization heterogeneity. We aimed to assess the effects of switching from ramipril to ARNI on electrocardiographic indices of ventricular repolarization.Methods: A total of 48 patients with HFrEF (mean age: 63.3 ± 11.7 years; 36 males, 77.1% ischaemic etiology) were enrolled. All patients had New York Heart Association functional class II-III, left ventricular ejection fraction ≤35% and previously switched from ramipril to ARNI treatment. The standard 12-lead electrocardiograms on ramipril treatment and 1 month after ARNI treatment were analysed; heart rate, QTc, Tp-e and Tp-e/QTc were calculated. Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores and N-terminal pro-BNP (NT-proBNP) values were recorded.Results: QTc (415.2 ± 19.7 ms vs. 408.5 ± 20.8 ms, p = 0.022), Tp-e (100.7 ± 13.8 ms vs. 92.9 ± 12.1 ms, p < 0.001), Tp-e/QTc (0.242 ± 0.028 vs. 0.227 ± 0.029, p = 0.003) and heart rate (73.2 ± 4.7 bpm vs. 71.1 ± 4.9 bpm, p = 0.027) were reduced after ARNI. ARNI switch associated with improvement in MLWHFQ scores (32.4 ± 7.1 ms vs. 22.6 ± 7.0 ms, p < 0.001) and reduction of NT-proBNP (2457 ± 1879 pg/ml to 1377 ± 874 pg/ml, p < 0.001). Pearson's correlation analysis revealed moderate correlations of MLWHFQ score with Tp-e (r = 0.543, p = 0.001) and Tp-e/QTc (r = 0.556, p = 0.001).Conclusions: Switching from ramipril to ARNI favourably alters QTc, Tp-e and Tp-e/QTc in HFREF. ARNI reduces symptoms of HFREF assessed by MLWHFQ and lowers NT-proBNP levels. Reduction in Tp-e and Tp-e/QTc correlate with clinical improvement in patients with HFrEF.
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Affiliation(s)
- Sercan Okutucu
- Department of Cardiology, Memorial Ankara Hospital, Ankara, Turkey
| | - Cengiz Sabanoglu
- Department of Cardiology, High Speciality Hospital, Kirikkale, Turkey
| | | | - Hakan Aksoy
- Department of Cardiology, Memorial Ankara Hospital, Ankara, Turkey
| | - Nurbanu Bursa
- Department of Statistics, Hacettepe University, Ankara, Turkey
| | - Ali Oto
- Department of Cardiology, Memorial Ankara Hospital, Ankara, Turkey
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Wang W, Zhang X, Chen K, Yin L, Gong M, Liu Y, Tse G, Wu L, Li G, Liu T. Effects of nicorandil infusion on ECG parameters in patients with unstable angina pectoris and percutaneous coronary intervention. Ann Noninvasive Electrocardiol 2019; 25:e12736. [PMID: 31849155 PMCID: PMC7358839 DOI: 10.1111/anec.12736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/02/2019] [Accepted: 11/19/2019] [Indexed: 01/01/2023] Open
Abstract
Background Percutaneous coronary intervention (PCI) is effective in treating patients with acute coronary syndrome (ACS) but is associated with some serious complications. Nicorandil is an anti‐anginal agent acting to improve microvascular circulation and to increase coronary blood flow. The objective of this article is to evaluate the effects of intracoronary injection followed with continuous intravenous injection of nicorandil on ECG parameters in patients with unstable angina pectoris (UA) undergoing PCI. Methods A single‐center, self‐controlled clinical trial was conducted at the Second Hospital of Tianjin Medical University between January 2019 and April 2019. Sixty‐three consecutive patients with UA who received coronary angiography and selective PCI were enrolled. ECG was recorded and analyzed before and 24 hr after nicorandil infusion. Results Patients were divided into three groups: control group (n = 23, aged 63.43 ± 12.55 years), short‐term, and prolonged use with nicorandil group (n = 20 and 20, aged 66.45 ± 8.06 years and 65.80 ± 9.49 years, respectively). Clinical characteristics and ECG parameters were similar before PCI among three groups (p > .05). In nicorandil treatment groups, intervals of QTd and Tp‐e in patients post‐PCI were significantly shorter than that in control and pre‐PCI (p < .05). Conclusions Nicorandil infusion reduces QTd and Tp‐e interval in patients with UA. Further studies will be needed to determine whether these electrophysiological changes are associated with a reduction of ventricular arrhythmias and improved outcomes.
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Affiliation(s)
- Weiding Wang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xu Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Kangyin Chen
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Li Yin
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Mengqi Gong
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yang Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Lin Wu
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
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Ucar FM, Ozturk C, Yılmaztepe MA. Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with acute myocarditis. BMC Cardiovasc Disord 2019; 19:232. [PMID: 31640548 PMCID: PMC6805629 DOI: 10.1186/s12872-019-1207-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 09/26/2019] [Indexed: 11/23/2022] Open
Abstract
Background Acute myocarditis (AM) can be defined as an inflammatory disease of the myocardium and characterized by large heterogeneity of clinical presentation. Myocarditis is becoming increasingly recognized as a contributor to unexplained mortality, and is thought to be a major cause of sudden cardiac death in the first two decades of life. The present study aimed to search the assessment of repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT and Tp-e/QTc ratios) in AM patients. Methods Totally 56 patients (mean age was 22 ± 3.7 years and 67% of the patients were male) with AM and 56 control subjects (23 ± 4.7 years and 64% of the patients were male) were enrolled. Tp-e intervals, Tp-e/QT and Tp-e/corrected QT (QTc) ratios were calculated from 12-lead electrocardiogram. Results Heart rate, QT and QTc values were similar between groups. QRS interval was lower in AM group compared to the control group (p < 0.001). Tp-e, Tp-e/QT and Tp-e/ QTc were significantly higher in AM group (p < 0.001, p < 0.001, p = 0.03 respectively) and they were significantly correlated with high troponin and high sensitive C reactive protein levels. In hospital follow-up time was 6 ± 2 days. Four patients have non sustained ventricular tachyarrhythmias and 1 patient dead because of cardiac arrest. Conclusions Our study demonstrated that Tp-e intervals, Tp-e/QT and Tp-e/QTc ratios were higher in patients with AM than control subjects. The increased frequency of ventricular arrhythmias can be clarified by increased indexes of ventricular repolarization parameters in patients with AM.
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Affiliation(s)
- Fatih Mehmet Ucar
- Department of Cardiology, Demiroğlu Bilim University, İstanbul, Turkey.
| | - Cihan Ozturk
- Department of Cardiology, Trakya University Hospital, Edirne, Turkey
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Cosgun A, Oren H, Turkkani MH. The relationship between systolic pulmonary arterial pressure and Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in patients with newly diagnosed chronic obstructive pulmonary disease. Ann Noninvasive Electrocardiol 2019; 25:e12691. [PMID: 31508867 DOI: 10.1111/anec.12691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The risk of sudden cardiac death (SCD) and arrhythmias has been shown to be common in chronic obstructive pulmonary disease (COPD) subjects. We aimed to evaluate the markers of arrhythmia such as QT, QTc (corrected QT), Tp-e, and cTp-e (corrected Tp-e) intervals, Tp-e/QT ratio, and Tp-e/QTc ratio in newly diagnosed COPD subjects in both right and left precordial leads. MATERIALS AND METHODS The study group consisted of 74 subjects with obstructive respiratory function tests (RFTs). The control group consisted of 78 subjects who had nonobstructive RFTs. RFTs, electrocardiograms (ECG), and transthoracic echocardiograms (TTE) were performed, and QTR (QT interval in right precordial leads), QTL (QT interval in left precordial leads), Tp-eR (Tp-e interval in right precordial leads), and Tp-eL (Tp-e interval in left precordial leads) intervals; systolic pulmonary arterial pressure (sPAP); forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC); and peripheral oxygen saturation(POS) values were measured. RESULTS Tp-eR interval 85.82 ± 5.34 millisecond (ms) versus 62.87 ± 3.55 ms (t = 31.29/p < .00001), cTp-eR interval 97.51 ± 7.18 ms versus 71.07 ± 4.58 ms (t = 27.20/p < .00001), Tp-eR/QTR ratio 0.234 ± 0.02 versus 0.164 ± 0.01 (t = 2.2/p = .014), and Tp-eR/QTcR ratio 0.201 ± 0.01 versus 0.141 ± 0.01 (t = 1.92/p = .028) were statistically significantly higher in COPD subjects. There was a strong negative correlation between RFT and sPAP (sPAP, 29.93 ± 5.1 mm Hg; and FEV1 /FVC, 63.78 ± 3.33%, r = -.85/p < .00001). There was a moderate positive correlation between sPAP and Tp-eR. CONCLUSION We found Tp-e and cTp-e intervals, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly higher in the COPD patients than in the control group. In addition, in the COPD group, heart rate variability (HRV) parameters were significantly lower on ECG.
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Affiliation(s)
- Ayhan Cosgun
- Department of Cardiology, Sincan State Hospital, Ankara, Turkey
| | - Huseyin Oren
- Department of Cardiology, Ankara City Hospital, Ankara, Turkey
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Riza Demir A, Celik Ö, Sevinç S, Uygur B, Kahraman S, Yilmaz E, Cemek M, Onal Y, Erturk M. The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp-e interval, 5-year sudden cardiac death risk score in hypertrophic cardiomyopathy patients. Ann Noninvasive Electrocardiol 2019; 24:e12672. [PMID: 31152489 DOI: 10.1111/anec.12672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationship between QT (QTc) interval, Tp-e interval, Tp-e/QTc ratio, 5-year sudden cardiac death (SCD) risk score, and late gadolinium enhancement (LGE) detected by CMR in hypertrophic cardiomyopathy (HCM) patients. METHOD A total of 74 consecutive patients who underwent CMR with HCM diagnosis were included in the study. These patients were divided into two groups according to the presence of LGE on CMR. All patients underwent detailed echocardiography and QTc interval, Tp-e interval, and Tp-e/QTc ratios and 5-year SCD risk scores were calculated. These parameters were compared for two groups. RESULTS CMR revealed LGE in 32 (43.2%) of 74 HCM patients. In the group with LGE, significantly higher QTc interval (p = 0.002), Tp-e interval (p < 0.001), Tp-e/QTc ratio (p = 0.004), and 5-year SCD risk score were detected. In addition, QTc interval, Tp-e interval, Tp-e/QTc ratio, maximum wall thickness, left ventricular mass index, 5-year SCD risk score, and cardiac fibrosis index were found to be correlated with various degrees in correlation analysis. Also, Tp-e interval is found to be an independent predictor of LGE detected by CMR in HCM patients (p = 0.017, OR [%95 CI] = 1.017 [1.001-1.034]). In addition, the Tp-e interval can detect the LGE with a sensitivity of 64.3% and a specificity of 84.2% at 99.4 ms. (p < 0.001, AUC [95% CI] = 0.790 [0.676-0.905]). CONCLUSION The Tp-e interval can be used to optimize SCD risk stratification in HCM patients and determine which patients will benefit from implantable cardioverter-defibrillator (ICD) treatment.
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Affiliation(s)
- Ali Riza Demir
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ömer Celik
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Samet Sevinç
- Department of Cardiology, Akçakale State Hospital, Urfa, Turkey
| | - Begüm Uygur
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Serkan Kahraman
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Emre Yilmaz
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mete Cemek
- Department of Cardiology, Karaman State Hospital, Karaman, Turkey
| | - Yilmaz Onal
- Department of Radiology, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Inanir M, Sincer I, Erdal E, Gunes Y, Cosgun M, Mansiroglu AK. Evaluation of electrocardiographic ventricular repolarization parameters in extreme obesity. J Electrocardiol 2018; 53:36-39. [PMID: 30721839 DOI: 10.1016/j.jelectrocard.2018.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/10/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES The risk of sudden death and cardiac arrhythmia increases in morbidly obese patients. We aimed to evaluate the marker of arrhythmias such as Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios in extreme obesity. METHODS The study included 41 extremely obese patients and 41 control subjects. QTmax, QTmin, QRS, JT and Tp-e intervals were measured od 12‑lead electrocardiographies. In addition, Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc rates and QTc, cQTd and JTc intervals were calculated. RESULTS Tp-e interval (79.2 ± 9.7 ms (milisecond) vs. 68.6 ± 8.1, p < 0.001), QTc interval (395.9 ± 18.8 vs. 377.9 ± 19.3 ms, p < 0.001), JTc interval (317.1 ± 27.0 vs. 297.4 ± 23.2 ms, p = 0.001), Tp-e/QT ratio (0.22 ± 0.03vs. 0.19 ± 0.02, p < 0.001), Tp-e/QTc ratio (0.20 ± 0.26vs. 0.18 ± 0.02, p = 0.001), Tp-e/JT ratio (0.29 ± 0.04 vs. 0.25 ± 0.03, p < 0.001), TPe/JTc ratio (0.25 ± 0.04 vs. 0.23 ± 0.03, p = 0.018), QTd (32.8 ± 10 vs.15 ± 6.4 ms, p < 0.001) and cQTd (70.0 ± 30.1 vs. 31.3 ± 22.4 ms, p < 0.001) were significantly higher in obese patients. CONCLUSION Compared to healthy subjects potential ECG repolarization predictors were significantly increased in extremely obese patients.
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Affiliation(s)
- M Inanir
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey.
| | - I Sincer
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - E Erdal
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Y Gunes
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - M Cosgun
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - A K Mansiroglu
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
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Cekirdekci EI, Bugan B. Can abnormal dispersion of ventricular repolarization be a predictor of mortality in arrhythmogenic right ventricular cardiomyopathy: The importance of Tp-e interval. Ann Noninvasive Electrocardiol 2018; 24:e12619. [PMID: 30412321 DOI: 10.1111/anec.12619] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by ventricular arrhythmias and specific ventricular pathology. Repolarization abnormalities, the significant contributor to life-threatening arrhythmias and mortality, are frequently observed ECG changes in patients with ARVC. This study aimed to evaluate the changes in Tp-e interval, Tp-e/QT, Tp-e/QTc ratio, and traditional electrocardiographic features of electrical dispersion in patients with ARVC. METHODS A total of 105 participants were enrolled in the current study. The ARVC group consisted of 40 subjects (30 men, with a median of 35 (26-41) years), and the control group included of 65 age and sex-matched individuals (42 men, with a median of 37 (24-45) years). The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were measured by the 12-lead electrocardiogram. RESULTS Tp-e interval, cTp-e interval, Tp-e/QT, and Tp-e/QTc ratio were significantly higher in ARVC patients compared to the control group (all p < 0.001). Tp-e interval, cTp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly increased in deceased ARVC patients compared to the survival group (p = 0.038, p < 0.001, p = 0.006, p = 0.032, respectively). In the multivariate analysis, RV-FAC and cTp-e interval level (p < 0.05 for each parameter) were associated with all-cause mortality [odds ratio 1.747 95% CI (1.012-3.018); p = 0.045 and odds ratio 1.166, 95% CI (1.017-1.336); p = 0.027, respectively]. CONCLUSION Tp-e interval, cTp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were prolonged in patients with NC. We revealed that abnormal dispersion of ventricular repolarization suggests the increased risk of mortality in ARVC.
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Affiliation(s)
- Elif Ijlal Cekirdekci
- Department of Cardiology, Dr. Suat Gunsel University of Kyrenia Hospital, Kyrenia, Mersin, Turkey
| | - Barış Bugan
- Department of Cardiology, Dr. Suat Gunsel University of Kyrenia Hospital, Kyrenia, Mersin, Turkey
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Akcay M. The effect of moderate altitude on Tp-e interval, Tp-e/QT, QT, cQT and P-wave dispersion. J Electrocardiol 2018; 51:929-933. [PMID: 30497749 DOI: 10.1016/j.jelectrocard.2018.07.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Long-time exposure to high altitude leads to changing at the respiratory, cardiovascular and hematological systems. There is no sufficient study about cardiovascular changes in moderate altitude. The distance between the peak and the end of the T wave (Tp-e) is a measure of transmyocardial distribution of repolarization and may be associated to dangerous rhythm disorders and ventricular arrhythmias. Again, P-wave dispersion (PWD) described as the extension of interatrial and intraatrial conduction time and inhomogeneous spread of sinus pulses are well recognized electrophysiologic features in patients with atrial fibrillation. We aimed to compare repolarization parameters (Tp-e interval, Tp-e/QT ratio, QT, cQT) and P wave dispersion between healthy people living at moderate altitude and sea level. METHODS In this study included 80 healthy people living at moderate altitude (1600 m, Group I) and 90 people living at sea level (0-4 m, Group II). All people were born and grew up at the same altitude area. Being migrant to living area, people with structural heart disease, rhythm disorders, pulmonary diseases or any systemic chronic disease were excluded criteria in the study. Tp-e interval, QT interval, cQT, Tp-e/QT ratio, P wave durations and PWD were measured from D2 and V5 leads with 20 mm/mV amplitude and 50 mm/s rate. All the measurements were repeated three times and were evaluated manually with a magnifying glass. RESULTS There were no differences in baseline demographic, laboratory, echocardiographic parameters and coronary artery risk factors. The QRS duration (94.2 ± 14.8 msn and 90.2 ± 9.3 msn, p = 0.05) and corrected QT time (415.8 ± 20.1 msn and 403.9 ± 20.5 msn; p = 0.001), Tp-e interval (86.5 ± 11.7 msn and 80.5 ± 10.4 msn p = 0.001) and Tp-e/QT ratio (0.23 ± 0.03 msn and 0.22 ± 0.03 msn p = 0.011) were statistically significantly higher in the moderate altitude group. P wave maximum, minimum time and PWD were similar in both groups (p > 0.05). CONCLUSION Moderate altitude leads to subclinical electrocardiographic changes in healthy individuals such as high altitude. Repolarization parameters (Tp-e interval, Tp-e/QT ratio, and cQT) are prolonged without cardiac structural changes. It should be kept in mind that people living in moderate altitude may be more susceptible to arrhythmia in the future, and findings should be supported in large randomized trials.
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Affiliation(s)
- Murat Akcay
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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Xianpei W, Sha W, Chuanyu G, Juanjuan Y, Chong C, Yongen S, Yu F, Zhenhao L. Tpeak-Tend dispersion as a predictor for malignant arrhythmia events in patients with vasospastic angina. Int J Cardiol 2018; 249:61-65. [PMID: 29121758 DOI: 10.1016/j.ijcard.2017.07.093] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/02/2017] [Accepted: 07/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tpeak-Tend interval (Tp-e interval) in electrocardiogram (ECG) has been reported to predict malignant arrhythmia events (MAE) in ST-segment elevation myocardial infarction and ion channelopathy. Tp-e interval and other ECG parameters as predictors for MAE was evaluated in patients with vasospastic angina (VA). METHODS AND RESULTS Sixty-two patients with VA (Non-MAE group) and 20 patients with VA complicated by MAE (MAE group) were enrolled in our Division of Cardiology between January 2010 and December 2015. Continuous variables were analyzed by t-test and categorical variables by Chi-square analysis. Patients with MAE showed greater QTc (corrected QT interval) dispersion (P=0.005), Tp-ec (corrected Tp-e) interval (P=0.001), Tp-ec dispersion (P<0.001) and Tp-e/QT ratio (P<0.001) than those in non-MAE groups when ST-segment elevated. After elevated ST-segment returned, there were no significant differences in these ECG parameters between two groups (All P>0.05). At univariate binary logistic regression analysis QTc dispersion (odds ratio(OR)=1.133; P=0.013), Tp-ec (OR=1.058; P=0.003), Tp-e/QT (OR=1.403; P=0.001), and Tp-ec dispersion (OR=1.497; P=0.004) were significantly associated with MAE. At multivariable logistic regression analysis, Tp-ec dispersion remained a predictor of MAE. Receiver operating characteristic (ROC) curve analysis showed that only AUC (Area under curve) of Tp-ec dispersion had significant difference with those in QTc dispersion (P<0.001), Tp-ec (P=0.003), and Tp-e/QT ratio (P=0.012), respectively. CONCLUSIONS QTc dispersion, Tp-ec, Tp-e/QT and Tp-ec dispersion were significantly increased in VA patients with MAE than those without MAE when coronary spasm was onset. Prolonged Tp-ec dispersion was the best discriminators and a strong independent predictor of MAE in VA patients.
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Affiliation(s)
- Wang Xianpei
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Wu Sha
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Gao Chuanyu
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China.
| | - Yan Juanjuan
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China.
| | - Chen Chong
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China.
| | - Shi Yongen
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Feng Yu
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China.
| | - Lin Zhenhao
- Department of Cardiology, People's Hospital of Zhengzhou University, Institute of Cardiovascular Epidemiology of Henan Province, Zhengzhou, Henan Province, China.
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Küçük M, Karadeniz C, Ozdemir R, Meşe T. Prolonged T-wave peak-end interval in Down syndrome patients with congenitally normal hearts. Pediatr Int 2018; 60:513-516. [PMID: 29575354 DOI: 10.1111/ped.13567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/26/2018] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Heterogeneity of ventricular repolarization has been assessed using the QT dispersion in Down syndrome (DS) patients with congenitally normal hearts. Novel repolarization indexes, that is, T-wave peak-end (Tp-e) interval and Tp-e/QT ratio, however, have not previously been evaluated in these patients. The aim of this study was therefore to evaluate the Tp-e interval and Tp-e/QT ratio in DS patients without congenital heart defects. METHODS Tp-e interval, Tp-e dispersion, and Tp-e/QT ratio were compared between 160 DS patients and 110 age- and sex-matched healthy controls on 12-lead surface electrocardiogram. RESULTS Heart rate, Tp-e interval, Tp-e dispersion, Tp-e/QT and Tp-e/QTc ratios were significantly higher in the DS group than the control group. CONCLUSION Myocardial repolarization indexes in DS patients with congenitally normal hearts were found to be prolonged compared with those in normal controls. Further evaluation is warranted to elucidate the relationship between prolonged repolarization indexes and arrhythmic events in these patients.
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Affiliation(s)
- Mehmet Küçük
- Department of Pediatric Cardiology, Dr Behcet Uz Children's Hospital, Izmir, Turkey
| | - Cem Karadeniz
- Department of Pediatric Cardiology, Dr Behcet Uz Children's Hospital, Izmir, Turkey
| | - Rahmi Ozdemir
- Department of Pediatric Cardiology, Dr Behcet Uz Children's Hospital, Izmir, Turkey
| | - Timur Meşe
- Department of Pediatric Cardiology, Dr Behcet Uz Children's Hospital, Izmir, Turkey
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Demirtaş K, Yayla Ç, Yüksel M, Açar B, Ünal S, Ertem AG, Kaplan M, Akpinar MY, Kiliç ZMY, Kayaçetin E. Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Rev Clin Esp 2017; 217:439-445. [PMID: 28992960 DOI: 10.1016/j.rce.2017.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 08/14/2017] [Accepted: 09/03/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Celiac disease is a chronic immune-mediated disease of the small intestine. It has been known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with celiac disease. The aim of the study was to assess Tp-e interval and Tp-e/QT ratio in patients with celiac disease. MATERIAL AND METHODS This study was conducted at a single center in collaboration with gastroenterology and cardiology clinics. Between January 2014 and June 2015, a total of 76 consecutive patients were enrolled (38 patients with celiac disease and 38 control subjects). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. RESULTS Tp-e interval (64.2±11.0 vs. 44.5±6.0; p<0.001), Tp-e/QT ratio (0.18±0.02 vs. 0.13±0.02; p<0.001) and Tp-e/QTc ratio (0.16±0.02 vs. 0.11±0.01; p<0.001) were significantly higher in patients with celiac disease than control subjects. There was a significant positive correlation between Tp-e/QTc ratio and disease duration in patients with celiac disease (r=0.480, p=0.003) and also there was a significant positive correlation between Tp-e/QTc ratio and erythrocyte sedimentation rate (r=0.434, p<0.001). CONCLUSIONS Our study showed that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in patients with celiac disease. Whether these changes increase the risk of ventricular arrhythmia deserve further studies.
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Affiliation(s)
- K Demirtaş
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Ç Yayla
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
| | - M Yüksel
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey
| | - B Açar
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - S Ünal
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - A G Ertem
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - M Kaplan
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - M Y Akpinar
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Z M Y Kiliç
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey
| | - E Kayaçetin
- Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey
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Karadeniz C, Özdemir R, Demirol M, Katipoğlu N, Yozgat Y, Meşe T, Ünal N. Low Iron Stores in Otherwise Healthy Children Affect Electrocardiographic Markers of Important Cardiac Events. Pediatr Cardiol 2017; 38:909-914. [PMID: 28271153 DOI: 10.1007/s00246-017-1596-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 02/23/2017] [Indexed: 11/28/2022]
Abstract
Both an excess of iron and iron deficiency (ID) may lead to significant cardiac problems. Parameters that represent ventricular repolarization heterogeneity, like QT dispersion (QTd), corrected QT dispersion (QTcd), the interval between the peak and the end of the T wave (Tp-e), and Tp-e dispersion, have not been evaluated in otherwise healthy children with low iron levels before. Here we assessed the effects of low iron storage on P wave dispersion (PWd), QTd, Tp-e intervals, and Tp-e dispersion in otherwise healthy children. We prospectively reviewed 283 patients who were referred to pediatric cardiology department for cardiac evaluation due to murmurs and who were found to have no structural heart disease. The patients were divided into three groups according to their ferritin levels: Group 1: ferritin <15 ng/mL (n = 58); Group 2: ferritin 15-25 ng/mL (n = 80); Group 3: ferritin >25 ng/mL (n = 145). P wave duration (PW), QT and Tp-e intervals, and PW, QT, corrected QT (QTc), and Tp-e dispersions were significantly higher in patients whose ferritin level was <15 ng/mL. A negative correlation was found between ferritin level and QT and QTc intervals, and QT, QTc, and Tp-e dispersions. Our results showed that a low serum ferritin level is associated with changes in some ECG parameters such as prolonged PWd, Tp-e interval, QT, QTc, and Tp-e dispersions in otherwise healthy children, and studies of other populations indicated that these parameters may predict arrhythmias in selected patients. These patients may be considered at some risk of developing arrhythmias. Therefore, careful evaluation of these ECG parameters is necessary in otherwise healthy children with low iron stores.
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Affiliation(s)
- Cem Karadeniz
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey.
| | - Rahmi Özdemir
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey
| | - Mustafa Demirol
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey
| | - Nagehan Katipoğlu
- Department of Pediatrics, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Yılmaz Yozgat
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey
| | - Timur Meşe
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey
| | - Nurettin Ünal
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, 1374 St. No: 11 Alsancak, Izmir, Turkey
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Gürdal A, Eroğlu H, Helvaci F, Sümerkan MÇ, Kasali K, Çetin Ş, Aksan G, Kiliçkesmez K. Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with subclinical hypothyroidism. Ther Adv Endocrinol Metab 2017; 8:25-32. [PMID: 28377800 PMCID: PMC5363453 DOI: 10.1177/2042018816684423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/24/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prolongation of the peak-to-end interval of the T wave (Tp-e) has been reported as associated with ventricular arrhythmias. The aim of this study was to investigate the ventricular repolarization by using the Tp-e interval, Tp-e/QT ratio and Tp-e/ QTc ratio in patients with subclinical hypothyroidism (SH). METHODS We studied 56 volunteers: These were 28 patients with SH (mean age 45 ± 11 years) and 28 healthy subjects (mean age 34 ± 8 years). All basic biochemical parameters were analyzed and electrocardiograms (ECGs) were recorded. RR and QT intervals, QTc, Tp-e intervals and the Tp-e/QT and Tp-e/QTc ratios were calculated. The categorical and numerical variables were compared using the chi-square test and independent t test, respectively. Correlations were analyzed using the Spearman and Pearson correlation tests. RESULTS We found no difference between QT and QTc intervals between groups. In the subjects with SH, the Tp-e intervals (87 ± 5 ms, 66 ± 5 ms, p< 0.01), Tp-e/ QT ratio (0.23 ± 0.03, 0.18 ± 0.01, p< 0.01) and Tp-e/QTc ratio (0.21 ± 0.02, 0.16 ± 0.01, p< 0.01) were increased compared with healthy subjects. We also found positive correlations between levels of thyroid stimulating hormone (TSH) and Tp-e (r = 0.72, p< 0.01), Tp-e/ QT ratio (r = 0.67 p< 0.01), Tp-e/ QTc ratio (r = 0.68, p< 0.01). In the subjects with SH, Left Ventricular Myocardial Performance Index (LV-MPI) was increased compared with the healthy subjects (0.64 ± 0.08, 0.59 ± 0.09, p = 0.066) although it was not significant. CONCLUSIONS Compared with healthy subjects, patients with SH demonstrated longer Tp-e intervals, and higher Tp-e/QT and Tp-e/QTc ratios. TSH levels were positively correlated with Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
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Affiliation(s)
| | - Hatice Eroğlu
- Department of Internal Medicine, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Füsun Helvaci
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Mutlu Çağan Sümerkan
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Kamber Kasali
- Department of Biostatistic, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Şükrü Çetin
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Gökhan Aksan
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Kadriye Kiliçkesmez
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
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Soylu K, İnci S, Aksan G, Nar G, Yüksel EP, Ocal HS, Çapraz M, Yüksel S, Şahin M. Evaluation of inhomogeneities of repolarization in patients with psoriasis vulgaris. Arch Med Sci 2016; 12:1225-1231. [PMID: 27904512 PMCID: PMC5108400 DOI: 10.5114/aoms.2016.62922] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/08/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The arrhythmia potential has not been investigated adequately in psoriatic patients. In this study, we assessed the ventricular repolarization dispersion, using the Tp-e interval and the Tp-e/QT ratio, and investigated the association with inflammation. MATERIAL AND METHODS Seventy-one psoriasis vulgaris patients and 70 age- and gender-matched healthy individuals were enrolled in the study. The severity of the disease was calculated using Psoriasis Area and Severity Index scoring. The QTd was defined as the difference between the maximum and minimum QT intervals. The Tp-e interval was defined as the interval from the peak of the T wave to the end of the T wave. The Tp-e interval was corrected for heart rate. The Tp-e/QT ratio was calculated using these measurements. RESULTS There were no significant differences between the groups with respect to basal clinical and laboratory characteristics (p > 0.05). The Tp-e interval, the corrected Tp-e interval (cTp-e) and the Tp-e/QT ratio were also significantly higher in psoriasis patients compared to the control group (78.5 ±8.0 ms vs. 71.4 ±7.6 ms, p < 0.001, 86.3 ±13.2 ms vs. 77.6 ±9.0 ms, p < 0.001 and 0.21 ±0.02 vs. 0.19 ±0.02, p < 0.001 respectively). A significant correlation was detected between the cTp-e time and the Tp-e/QT ratio and the PASI score in the group of psoriatic patients (r = 0.51, p < 0.001; r = 0.59, p < 0.001, respectively). CONCLUSIONS In our study, we detected a significant increase in the Tp-e interval and the Tp-e/QT ratio in patients with psoriasis vulgaris. The Tp-e interval and the Tp-e/QT ratio may be predictors for ventricular arrhythmias in patients with psoriasis vulgaris.
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Affiliation(s)
- Korhan Soylu
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Sinan İnci
- Department of Cardiology, Aksaray State Hospital, Aksaray, Turkey
| | - Gökhan Aksan
- Department of Cardiology, Gazi State Hospital, Samsun, Turkey
| | - Gökay Nar
- Department of Cardiology, Aksaray State Hospital, Aksaray, Turkey
| | - Esra Pancar Yüksel
- Department of Dermatology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | | | - Mustafa Çapraz
- Department of Internal Medicine, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Serkan Yüksel
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Mahmut Şahin
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Karakulak UN, Yilmaz OH, Tutkun E, Gunduzoz M, Ercan Onay E. Comprehensive Electrocardiographic Analysis of Lead Exposed Workers: An Arrhythmic Risk Assessment Study. Ann Noninvasive Electrocardiol 2016; 22. [PMID: 27282320 DOI: 10.1111/anec.12376] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To evaluate electrocardiographic parameters which are related with atrial and ventricular arrhythmias measured from 12-lead surface electrocardiogram (ECG) in workers occupationally exposed to lead. METHODS Sixty lead-exposed workers and 60 healthy controls were enrolled. Twelve-lead surface ECG was recorded and measurements of P wave durations (Pmax, Pmin) and P wave dispersion (PWD), QT durations and dispersion (QTd), corrected QT (QTc), Tp-e interval, and Tp-e/QT ratio were analyzed. RESULTS The lead-exposed and control groups were similar with respect to baseline demographic, laboratory, and transthoracic echocardiographic indices. PWD (26.3 ± 9.7 vs 22.0 ± 9.0 ms, P = 0.014), Pmin (89.9 ± 13.8 vs 79.2 ± 10.1 ms, P < 0.001), and Pmax (116.2 ± 15.0 vs 101.2 ± 14.2 ms, P < 0.001), QT maximum (377.0 ± 27.6 vs 364.9 ± 28.5 ms, P = 0.02), QTd (38.4 ± 16.5 vs 30.5 ± 12.4 ms, P = 0.004), Tp-e interval (78.9 ± 16.5 vs 70.3 ± 14.5 ms, P = 0.003), and Tp-e/QT ratio (0.22 ± 0.04 vs 0.20 ± 0.04, P = 0.013) were significantly higher in lead-exposed workers. QT minimum and QTc values did not differ significantly. QT maximum, QTd, and Tp-e/QT ratio were correlated with urine lead level and Tp-e interval was correlated with both blood and urine lead levels. CONCLUSIONS Lead-exposed workers have a higher risk for atrial and ventricular arrhythmias even without overt cardiac diseases compared with healthy subjects. These workers should be followed closely for adverse cardiovascular outcomes especially arrhythmias.
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Affiliation(s)
- Ugur N Karakulak
- Department of Cardiology, Ankara Occupational Diseases Hospital, Ankara, Turkey
| | - Omer H Yilmaz
- Department of Clinical Toxicology, Ankara Occupational Diseases Hospital, Ankara, Turkey
| | - Engin Tutkun
- Department of Clinical Toxicology, Ankara Occupational Diseases Hospital, Ankara, Turkey
| | - Meside Gunduzoz
- Department of Clinical Toxicology, Ankara Occupational Diseases Hospital, Ankara, Turkey
| | - Emine Ercan Onay
- Department of Cardiology, Ankara Occupational Diseases Hospital, Ankara, Turkey
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Akboga MK, Yuksel M, Balci KG, Kaplan M, Cay S, Gokbulut V, Yayla C, Ertem AG, Ayhan MA, Topaloglu S, Aras D. Tp-e Interval, Tp-e/QTc Ratio, and Fragmented QRS Are Correlated with the Severity of Liver Cirrhosis. Ann Noninvasive Electrocardiol 2016; 22. [PMID: 27061341 DOI: 10.1111/anec.12359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, including liver cirrhosis (LC). We intended to evaluate the interval from the peak to the end of the electrocardiographic T wave (Tp-e), Tp-e/QTc ratio, and fQRS as presumed markers of arrhythmias in LC. METHODS In this cross-sectional study, a total of 88 consecutive patients with LC according to clinical, biological, ultrasonographic, or histological criteria and 73 control subjects were enrolled. The severity of cirrhosis was classified according to Pugh-Child's classification and Model for End-Stage Liver Disease (MELD) score. Tp-e interval, Tp-e/QTc ratio, and fQRS rates were measured from the 12-lead electrocardiogram. RESULTS Tp-e interval, Tp-e/QTc ratio and fQRS rates were significantly increased in parallel to the severity of LC (P < 0.001, P < 0.001, and P = 0.003, respectively). In correlation analysis, Pugh-Child stage showed a significantly positive correlation with Tp-e interval (r = 0.462, P < 0.001), QTc interval (r = 0.373, P < 0.001), Tp-e/QTc ratio (r = 0.352, P < 0.001), and fQRS (r = 0.407, P < 0.001). Furthermore, Tp-e interval (r = 0.414, P < 0.001) and Tp-e/QTc ratio (r = 0.426, P< 0.001) had significant positive correlation with MELD score. CONCLUSIONS Our study demonstrated that Tp-e interval, Tp-e/QTc ratios, and fQRS rates were significantly increased in parallel to the severity of LC. Thus, these findings may implicate that Tp-e interval, Tp-e/QTc ratio, and fQRS may be novel and useful indicators for prediction of arrhythmias in LC.
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Affiliation(s)
- Mehmet Kadri Akboga
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mahmut Yuksel
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Kevser Gulcihan Balci
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mustafa Kaplan
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Volkan Gokbulut
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Cagri Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ahmet Goktug Ertem
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Meral Akdogan Ayhan
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Alizade E, Yesin M, Yazicioğlu MV, Karaayvaz EB, Atici A, Arslan Ş, Avci A, Acar G, Tabakci M, Izci S, Pala S. Evaluation of Tp-e Interval, Tp-e/QT Ratio, and Tp-e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy. Ann Noninvasive Electrocardiol 2016; 22. [PMID: 27610610 DOI: 10.1111/anec.12362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/05/2016] [Accepted: 01/23/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio) in asymptomatic ARVD patients METHODS: We selected 27 patients with asymptomatic ARVD and 27 age- and gender-match young, healthy volunteers. RESULTS Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.57, P = 0.02; r = -0.85, P = 0.02; r = -0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.61, P < 0.01; r = -0.67, P < 0.01; r = -0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp-e, Tp-e/QT, and Tp-e/QTc (r = - 0.64, P < 0.001, r = - 0.75, P < 0.01; r = -0,69, P < 0.01; respectively) CONCLUSION: In conclusion, we have presented strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in asymptomatic ARVD patients.
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Affiliation(s)
- Elnur Alizade
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Mahmut Yesin
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Mehmet Vefik Yazicioğlu
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | | | - Adem Atici
- Istanbul University Faculty of Medicine, Cardiology Department, Istanbul, Turkey
| | - Şükrü Arslan
- Gaziosmanpaşa State Hospital, Cardiology Department, Istanbul, Turkey
| | - Anıl Avci
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Göksel Acar
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Mustafa Tabakci
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Servet Izci
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
| | - Selçuk Pala
- Kartal Kosuyolu Heart Research and Training Hospital, Cardiology Department, Istanbul, Turkey
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Duyuler S, Türker Duyuler P, Batur MK. Impact of Iron and Homocysteine Levels on T Peak-to-End Interval and Tp-e/QT Ratio in Elite Athletes. Ann Noninvasive Electrocardiol 2016; 21:557-565. [PMID: 27019094 DOI: 10.1111/anec.12365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Electrocardiography (ECG) is frequently used in preparticipation evaluation of competitive athletes. Repolarization heterogeneities on ECG is a well-known indicator for malignant ventricular arrhythmias and sudden cardiac death. We aimed to investigate the effect of iron and homocysteine levels on arrhythmogenic indicators, T peak-to-end (Tp-e) interval, and Tp-e/QT ratio in elite athletes. METHODS A total of 72 players (48 football and 24 basketball) with a mean age of 25.4 ± 5.0 years were included to the analysis. Blood biochemistry, homocysteine level, and iron parameters (transferrin saturation and serum iron) were obtained by standard methods. Duration of QRS, QT interval, and Tp-e interval were measured manually on the precordial leads and Tp-e/QT ratio was calculated. RESULTS Baseline demographic and clinical characteristics of the study population were compared in two groups according to the median value of Tp-e/QT = 0.219. Both iron and transferrin saturations were higher in the above median group (P = 0.001 and P = 0.002, respectively), however, homocysteine levels were not statistically different among two groups (P = 0.405). In correlation analysis, both serum iron and transferrin saturation were significantly correlated with Tp-e interval (r = 0.368; P = 0.001 and r = 0.394; P = 0.00, respectively) and Tp-e/QT ratio (r = 0.357; P = 0.002 and r = 0.372; P = 0.001, respectively). Multiple stepwise regression analysis revealed that transferrin saturation was an independent predictor of Tp-e interval and Tp-e/QT ratio (β = 0.325; P = 0.002 and β = 0.372; P = 0.001, respectively). CONCLUSION This study showed an independent relationship between iron status and Tp-e interval and Tp-e/QT ratios of elite sport players which were also not correlated with serum homocysteine levels.
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Affiliation(s)
- Serkan Duyuler
- Department of Cardiology, Acıbadem Ankara Hospital, Ankara, Turkey.
| | - Pınar Türker Duyuler
- Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Tokatli A, Kiliçaslan F, Alis M, Yiginer O, Uzun M. Prolonged Tp-e Interval, Tp-e/QT Ratio and Tp-e/QTc Ratio in Patients with Type 2 Diabetes Mellitus. Endocrinol Metab (Seoul) 2016; 31:105-12. [PMID: 26676332 PMCID: PMC4803545 DOI: 10.3803/enm.2016.31.1.105] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/10/2015] [Accepted: 11/04/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with increased risk of malignant ventricular arrhythmias. Cardiac electrical inhomogeneity may be the leading cause of the increased arrhythmic risk in patients with T2DM. The peak and the end of the T wave (Tp-e) interval and associated Tp-e/QT ratio are promising measures of ventricular repolarization indicating transmural dispersion of repolarization. The aim of this study was to assess ventricular repolarization in patients with T2DM by using Tp-e interval, Tp-e/QT ratio and Tp-e/corrected QT interval (QTc) ratio. METHODS Forty-three patients with T2DM and 43 healthy control subjects, matched by gender and age, were studied. All participants underwent electrocardiography (ECG) recording. PR, RR and QT intervals represents the ECG intervals. These are not abbreviations. In all literature these ECG intervals are written like in this text. Tp-e intervals were measured from 12-lead ECG. Rate QTc was calculated by using the Bazett's formula. Tp-e/QT ratio and Tp-e/QTc ratio were also calculated. RESULTS Mean Tp-e interval was significantly prolonged in patients with T2DM compared to controls (79.4±10.3, 66.4±8.1 ms, respectively; P<0.001). We also found significantly higher values of Tp-e/QT ratio and Tp-e/QTc ratio in patients with diabetes than controls (0.21±0.03, 0.17±0.02 and 0.19±0.02, 0.16±0.02, respectively; P<0.001). There was no difference in terms of the other ECG parameters between the groups. CONCLUSION Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were prolonged in patients with T2DM. We concluded that T2DM leads to augmentation of transmural dispersion of repolarization suggesting increased risk for ventricular arrhythmogenesis.
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Affiliation(s)
- Alptug Tokatli
- Department of Cardiology, Golcuk Military Hospital, Kocaeli, Turkey.
| | - Fethi Kiliçaslan
- Cardiology Clinic, Medipol University Medicine Faculty, Istanbul, Turkey
| | - Metin Alis
- Department of Endocrinology, American Hospital, Istanbul, Turkey
| | - Omer Yiginer
- Department of Cardiology, GATA Haydarpasa Hospital, Medipol University, Istanbul, Turkey
| | - Mehmet Uzun
- Department of Cardiology, GATA Haydarpasa Hospital, Medipol University, Istanbul, Turkey
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Yayla Ç, Yayla ME, Yayla KG, Ilgen U, Akboğa MK, Düzgün N. The Assessment of Tp-e Interval and Tp-e/QT Ratio in Patients With Systemic Sclerosis. Arch Rheumatol 2016; 31:139-44. [PMID: 29900933 DOI: 10.5606/ArchRheumatol.2016.5753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/26/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate ventricular repolarization using T-peak to T-end (Tp-e) intervals and Tp-e/QT ratios in patients with systemic sclerosis (SSc). Patients and methods Totally 65 patients (8 males, 57 females; mean age 49.8 years; range 20 to 77 years) with SSc and 63 control subjects (8 males, 55 females; mean age 49.3 years; range 20 to 77 years) were enrolled. Tp-e intervals, Tp-e/QT, and Tp-e/corrected QT (QTc) ratios were measured from the 12-lead electrocardiogram. Results Tp-e intervals, QT intervals, QTc intervals, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients with SSc than control subjects (all p<0.01). There was no difference between patients with diffuse and limited cutaneous SSc in terms of electrocardiogram and echocardiographic findings. Correlation analysis revealed no correlation between Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios with disease duration and anti-Sjögren's syndrome antigen A antibody levels in patients with SSc (all p>0.05). Conclusion Our study showed that Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with SSc than control subjects. The increased frequency of ventricular arrhythmias can be clarified by increased indexes of ventricular repolarization parameters in patients with SSc.
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Gazi E, Gencer M, Temiz A, Barutcu A, Altun B, Gungor ANC, Hacivelioglu S, Uysal A, Cosar E. Does pregnancy-induced hypertension affect the electrophysiology of the heart? J OBSTET GYNAECOL 2015; 36:183-6. [PMID: 26366512 DOI: 10.3109/01443615.2015.1036401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Pregnancy-induced hypertension (PIHT) increases both maternal and neonatal mortality and morbidity in pregnant women. We sought to investigate the electrocardiographic findings in pregnant women with PIHT. Seventeen pregnant women (29.4 ± 5 years) with PIHT and 24 pregnant women (27.3 ± 6.1 years) with normal blood pressure (control group) were included in the study. A 12-lead surface electrocardiogram was used to evaluate the electrocardiographic parameters. Pregnant women with PIHT had higher blood pressure (p = 0.001). The Tp-e interval was longer in PIHT pregnant women at 83.5 ± 7.8 ms versus 75.8 ± 8.4 ms in the control group (p = 0.007). The Tp-e/QTc ratio was higher in pregnant women with PIHT than that in healthy controls (0.19 ± 0.02 vs. 0.18 ± 0.02, respectively). This study demonstrated that Pd, QTd and the P wave durations were similar in the PIHT pregnant women and control group, but the Tp-e and Tp-e/QTc ratio were higher in pregnant women with PIHT than in normotensive pregnant women.
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Affiliation(s)
- E Gazi
- a Department of Cardiology , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - M Gencer
- b Department of Gynecology and Obstetrics , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - A Temiz
- a Department of Cardiology , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - A Barutcu
- a Department of Cardiology , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - B Altun
- a Department of Cardiology , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - A N C Gungor
- b Department of Gynecology and Obstetrics , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - S Hacivelioglu
- b Department of Gynecology and Obstetrics , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - A Uysal
- b Department of Gynecology and Obstetrics , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
| | - E Cosar
- b Department of Gynecology and Obstetrics , Faculty of Medicine, Çanakkale Onsekiz Mart University , Çanakkale , Turkey
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Yayla Ç, Bilgin M, Akboğa MK, Gayretli Yayla K, Canpolat U, Dinç Asarcikli L, Doğan M, Turak O, Çay S, Özeke Ö, Akyel A, Yeter E, Aydoğdu S. Evaluation of Tp-E Interval and Tp-E/QT Ratio in Patients with Aortic Stenosis. Ann Noninvasive Electrocardiol 2015; 21:287-93. [PMID: 26246339 DOI: 10.1111/anec.12298] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The risk of syncope and sudden cardiac death due to ventricular arrhythmias increased in patients with aortic stenosis (AS). Recently, it was shown that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio can be novel indicators for prediction of ventricular arrhythmias and mortality. We aimed to investigate the association between AS and ventricular repolarization using Tp-e interval and Tp-e/QT ratio. METHODS Totally, 105 patients with AS and 60 control subjects were enrolled to this study. The severity of AS was defined by transthoracic echocardiographic examination. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured from the 12-lead electrocardiogram. RESULTS Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly increased in parallel to the severity of AS (P < 0.001, P = 0.001, and P = 0.001, respectively). Also, it was shown that Tp-e/QTc ratio had significant positive correlation with mean aortic gradient (r = 0.192, P = 0.049). In multivariate logistic regression analysis, Tp-e/QTc ratio and left ventricular mass were found to be independent predictors of severe AS (P = 0.03 and P = 0.04, respectively). CONCLUSIONS Our study showed that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with severe AS. Tp-e/QTc ratio and left ventricular mass were found as independent predictors of severe AS.
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Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Murat Bilgin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Lale Dinç Asarcikli
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Doğan
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Osman Turak
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Çay
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Özcan Özeke
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Tokatli A, Yiginer O, Haholu A, Uzun M. Efficiency of quantification of cardiac electrical heterogeneity: via QT dispersion, transmural dispersion, or both. Biol Sport 2015; 32:175-6. [PMID: 26060343 PMCID: PMC4447765 DOI: 10.5604/20831862.1145079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/12/2014] [Accepted: 12/12/2014] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Tokatli
- Golcuk Military Hospital, Department of Cardiology, Kocaeli-Turkey
| | - O Yiginer
- GATA Haydarpasa Hospital, Department of Cardiology, Istanbul-Turkey
| | - A Haholu
- GATA Haydarpasa Hospital, Department of Pathology, Istanbul-Turkey
| | - M Uzun
- GATA Haydarpasa Hospital, Department of Cardiology, Istanbul-Turkey
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Alizade E, Avcı A, Fidan S, Tabakçı M, Bulut M, Zehir R, Simsek Z, Evlice M, Arslantaş U, Çakır H, Emiroglu MY, Akçakoyun M. The Effect of Chronic Anabolic-Androgenic Steroid Use on Tp-E Interval, Tp-E/Qt Ratio, and Tp-E/Qtc Ratio in Male Bodybuilders. Ann Noninvasive Electrocardiol 2015; 20:592-600. [PMID: 25631523 DOI: 10.1111/anec.12256] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The chronic consumption of androgenic anabolic steroids has shown to cause atrial arrhythmias. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT ratio, and Tp-e/cQT ratio) in bodybuilders who are using anabolic androgenic steroids (AAS). METHODS We selected a population of 33 competitive bodybuilders, including 15 actively using AAS for ≥ 2 years (users) and 18 who had never used AAS (nonusers), all men. RESULTS QT, cQT, QTd, cQTd, JT, and cJT were significantly increased in AAS users bodybulders compared to the nonusers (all P < 0.001). Tp-e interval, Tp-e/QT ratio, and Tp-e/cQT ratio were also significantly higher in AAS user group compared to the nonuser group (all P < 0.001). QRS duration was not different between the groups. There were negative correlation between E(m) and Tp-e, Tp-e/QT ratio, Tp-e/cQT ration (r = -0.657, P < 0.01; r = -0.607, P = 0.02; r = -0.583, P = 0.02; respectively).There were also negative correlation between S(m) and Tp-e, Tp-e/QT ratio, Tp-e/cQT ration (r = -0.681, P < 0.01; r = -0.549, P = 0.03; r = -0.544, P = 0.023; respectively). CONCLUSION In conclusion, we have presented a strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in AAS users, which suggest that there might be a link between AAS use and ventricular arrthymias and sudden death.
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Affiliation(s)
- Elnur Alizade
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Anıl Avcı
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Serdar Fidan
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Tabakçı
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Bulut
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Regayip Zehir
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Zeki Simsek
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mert Evlice
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Uğur Arslantaş
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Hakan Çakır
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mehmet Yunus Emiroglu
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Akçakoyun
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
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Cakici M, Dogan A, Cetin M, Suner A, Caner A, Polat M, Kaya H, Abus S, Akturk E. Negative effects of acute sleep deprivation on left ventricular functions and cardiac repolarization in healthy young adults. Pacing Clin Electrophysiol 2014; 38:713-22. [PMID: 25353305 DOI: 10.1111/pace.12534] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/21/2014] [Accepted: 09/16/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep deprivation (SD) is associated with an increased incidence of adverse cardiovascular events, we aimed to determine the impact of acute SD on structural and functional alterations of the left ventricle (LV) and on electrocardiogram (ECG) markers including T wave peak-to-end interval (TpTe), QT interval, and TpTe/QT ratio in healthy subjects after a night of SD. METHODS The study population consisted of 40 healthy young adults (19 males, 21 females; mean age: 28.2 ± 3.86 years). Echocardiographic images and ECGs were obtained from the participants after a night of regular sleep (RS) and SD. The average sleep time of the subjects was 6.67 ± 1.76 hours during RS and 1.25 ± 0.74 hours during a night of SD. RESULTS The myocardial performance index, isovolumic relaxation time, and deceleration time values were significantly higher after SD. In addition, the corrected TpTe interval, corrected QT interval (QTc) max, and TpTe/QT ratio were significantly increased after a night of SD when compared with a night of RS (78.5 ± 6.8 ms vs 70.7 ± 7.6 ms, P < 0.001; 407.5 ± 18.6 ms vs 395.07 ± 21.3 ms, P = 0.001; and 0.189 ± 0.014 ms vs 0. 0.179 ± 0.016 ms, P < 0.001, respectively). However, subjects had similar QTp interval values (defined as beginning of the QRS complex to peak of the T wave) after a night of SD as a night of RS (294.6 ± 19.0 vs 291.9 ± 18.5, P = 233). CONCLUSION Our crossover study revealed the presence of subclinical LV diastolic functional changes and increased QT intervals, TpTe intervals, and TpTe/QT ratios in healthy young adults after one night SD. Therefore, the increased QT interval occurred secondary to the increased TpTe interval in this population.
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Affiliation(s)
- Musa Cakici
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Adnan Dogan
- Department of Cardiology, School of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Mustafa Cetin
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Arif Suner
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Asli Caner
- Department of Biological and Medical Science, Oxford Brookes University, Oxford, UK
| | - Mustafa Polat
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Hakan Kaya
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Sabri Abus
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Erdal Akturk
- Department of Cardiology, School of Medicine, Adiyaman University, Adiyaman, Turkey
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Karaman K, Altunkaş F, Çetin M, Karayakali M, Arısoy A, Akar I, Zencir C, Aygüç B, Çelik A. New markers for ventricular repolarization in coronary slow flow: Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. Ann Noninvasive Electrocardiol 2014; 20:338-44. [PMID: 25267306 DOI: 10.1111/anec.12203] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Coronary slow flow (CSF) is characterized by normal or near-normal coronary arteries with delayed opacification of the distal vasculature that it may cause angina pectoris, acute myocardial infarction, life-threatening arrhythmias, and sudden cardiac death. The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are also known as predictors of ventricular arrhythmogenesis. The aim of this study was to assess ventricular repolarization in patients with CSF by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. METHODS This study included 50 patients with CSF and 51 control subjects. Coronary flow rates of all subjects were documented by thrombolysis in myocardial infarction (TIMI) frame count (TFC). Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups. RESULTS In electrocardiographic parameters analysis, QT, QTc, QTd, and QTcd were significantly increased in CSF patients compared with the control subjects (P < 0.001, P = 0.019, P < 0.001, P < 0.001, respectively). The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in the CSF patients were significantly higher than those in the control subjects (Tp-e: 117 ± 21 milliseconds [ms] vs 96 ± 16 ms, P < 0.001; Tp-e/QT: 0.30 ± 0.06 vs 0.27 ± 0.06, P = 0.005; Tp-e/QTc: 0.27 ± 0.06 vs 0.24 ± 0.05, P < 0.001). In the multivariate analysis, increased Tp-e and Tp-e/QT ratio were associated with CSF. CONCLUSIONS Our study revealed that when compared to the control subjects, Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc were significantly increased in the CSF patients.
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Affiliation(s)
- Kayihan Karaman
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Fatih Altunkaş
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Mustafa Çetin
- Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Metin Karayakali
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Arif Arısoy
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Ilker Akar
- Department of Cardiovascular Surgery, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Cemil Zencir
- Department of Cardiology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Barış Aygüç
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Ataç Çelik
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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Avci A, Demir K, Altunkeser BB, Yilmaz S, Yilmaz A, Ersecgin A, Demir T. Assessment of inhomogeneities of repolarization in patients with systemic lupus erythematosus. Ann Noninvasive Electrocardiol 2014; 19:374-82. [PMID: 24597863 PMCID: PMC6932449 DOI: 10.1111/anec.12145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Systemic lupus erythematosus (SLE) is a chronic disease that affects many organ systems and manifests a broad spectrum of laboratory and clinical features. SLE patients have an increased risk of developing cardiovascular disease. The aim of this study was to evaluate inhomogeneities of repolarization by using Tpeak -Tend (Tp-e) interval and Tp-e/QT ratio were measured from the 12-lead surface electrocardiogram (ECG) in patients with SLE. MATERIAL AND METHOD This study included 69 SLE patients (69 females; mean age 35.8 ± 10.2) and 57 control subjects (57 females; mean age 34.5 ± 8.9). Transthoracic echocardiographic examination was done in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead ECG. These parameters were compared between groups. RESULTS No statistically significant difference was found between two groups in terms of basic characteristics. Diastolic function parameters were similar between the two groups (P > 0.05). In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QT dispersion (cQTd) were significantly increased in SLE patients compared the control group (49.5 ± 16.4 ms vs. 32.8±11.7 ms and 56.7 ± 19.5 ms vs. 36.4 ± 13.1 ms, all P value < 0.001). Tp-e interval and Tp-e/QT ratio were also significantly higher in SLE patients (82.8 ± 18.9 vs. 72.4 ± 17.6 and 0.22 ± 0.05 vs. 0.19 ± 0.05, P = 0.002 and P = 0.001, respectively). Tp-e interval and Tp-e/QT were positively correlated with disease duration (r = 0.29, P = 0.01 and r = 0.24, P = 0.04, respectively). CONCLUSION Our study revealed that QTd, cQTd, Tp-e interval and Tp-e/QT ratio increased in patients with SLE. Also, Tp-e interval and Tp-e/QT were positively correlated with disease duration.
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Affiliation(s)
- Ahmet Avci
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Kenan Demir
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | | | - Sema Yilmaz
- Faculty of MedicineRheumatology DepartmentSelcuk UniversityKonyaTurkey
| | - Ahmet Yilmaz
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Ahmet Ersecgin
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Tarik Demir
- Faculty of Medicine, Internal Medicine DepartmentSelcuk UniversityKonyaTurkey
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Taşolar H, Ballı M, Çetin M, Otlu YÖ, Altun B, Bayramoğlu A. Effects of the coronary collateral circulation on the Tp-e interval and Tp-e/QT ratio in patients with stable coronary artery disease. Ann Noninvasive Electrocardiol 2014; 20:53-61. [PMID: 24934391 DOI: 10.1111/anec.12173] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The clinical utility of the Tp-e interval and Tp-e/QT ratio in the risk stratification of ventricular arrhythmic events is controversial. Therefore, we investigated the impact of CCC on these electrocardiographic indexes in the course of stable CAD. METHODS Two hundred three consecutive patients with stable CAD who underwent coronary angiography and had documented total occlusion of one of the major coronary arteries were enrolled in this prospective cross-sectional study. The Tp-e interval and Tp-e/QT ratio were measured by 12-lead electrocardiogram. RESULTS The Tp-e interval, cTp-e interval, Tp-e/QT ratio, and cTp-e/QT ratio were lower in the grade 3 CCC group compared with the others in all leads. Multivariate linear regression analyses was performed to identify the clinical factors affecting the cTp-e interval and was indicated that age (β = 0.261, P < 0.001), male sex (β = 0.334, P < 0.001), poor Rentrop grade (β = -0.228, P < 0.001), and NLR (β = 0.137, P = 0.027) were independent predictors of a prolonged cTp-e interval. CONCLUSION It could be concluded that the decreased dispersion of ventricular repolarization might contribute to the lower incidence of ventricular arrhythmias and SCD in CAD patients with a good CCC.
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Affiliation(s)
- Hakan Taşolar
- Adiyaman University Training and Research Hospital, Department of Cardiology, Adiyaman, Turkey
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Abstract
AIMS Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with non-dipper hypertension. MATERIALS AND METHOD This study included 80 hypertensive patients. Hypertensive patients were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 non-dipper patients (17 male, mean age 50.6 ± 5.4 years). Tp-e interval and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups. RESULTS No statistically significant difference was found between two groups in terms of basic characteristics. In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in non-dipper patients compared to the dippers (39.4 ± 11.5 versus 27.3 ± 7.5 ms and 37.5 ± 9.5 versus 29.2 ± 6.5 ms, p = 0.001 and p = 0.01, respectively). Tp-e interval and Tp-e/QT ratio were also significantly higher in non-dipper patients (97.5 ± 11.2 versus 84.2 ± 8.3 ms and 0.23 ± 0.02 versus 0.17 ± 0.02, all p value <0.001). CONCLUSION Our study revealed that QTd, Tp-e interval and Tp-e/QT ratio are prolonged in patients with non-dipper hypertension.
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Affiliation(s)
- Mehmet Demir
- Department of Cardiology Yüksek İhtisas Education and Research Hospital , Bursa , Turkey and
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Zhao Z, Yuan Z, Ji Y, Wu Y, Qi Y. Left ventricular hypertrophy amplifies the QT, and Tp-e intervals and the Tp-e/ QT ratio of left chest ECG. J Biomed Res 2010; 24:69-72. [PMID: 23554614 PMCID: PMC3596538 DOI: 10.1016/s1674-8301(10)60011-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the changes in Tp-e interval (an interval from the peak to the end of the T wave), QT interval and Tp-e/QT ratio of the body surface ECG in patients with left ventricular hypertrophy (LVH). METHODS The Tp-e interval and QT interval were measured on body surface ECGs in 42 patients without either hypertension or LVH (control group), 41 patients having hypertension but not LVH (non-LVH group), and 38 patients with both hypertension and LVH (LVH group). RESULTS The mean corrected QT (QTc) interval, and mean corrected Tp-e[T(p-e)c] interval were significantly longer in the LVH group (0.430±0.021s vs. 0.409±0.019s, p < 0.01; 0.098±0.013s vs. 0.088±0.011s, respectively) than those in the control group. The Tp-e/QT ratio was also amplified in LVH group (0.232±0.028 vs.0.218±0.027) (p < 0.05). CONCLUSION LVH increased the QT interval, Tp-e interval and Tp-e/QT ratio of the body surface ECG.
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Affiliation(s)
| | - Zuyi Yuan
- Department of Cardiology, Key Laboratory of Environmental Genes Related to Diseases, Ministry of Education, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
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