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Jackobson G, Carmel NN, Lotan D, Kremer A, Justo D. Reckless administration of QT interval-prolonging agents in elderly patients with drug-induced torsade de pointes. Z Gerontol Geriatr 2016; 51:41-47. [DOI: 10.1007/s00391-016-1155-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/08/2016] [Accepted: 10/20/2016] [Indexed: 11/28/2022]
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Chang KT, Shu HS, Chu CY, Lee WH, Hsu PC, Su HM, Lin TH, Voon WC, Lai WT, Sheu SH. Association between C-reactive protein, corrected QT interval and presence of QT prolongation in hypertensive patients. Kaohsiung J Med Sci 2014; 30:310-5. [PMID: 24835352 DOI: 10.1016/j.kjms.2014.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 02/01/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022] Open
Abstract
C-reactive protein (CRP) and corrected QT (QTc) interval are predictors of cardiovascular disease. Whether CRP is associated with QTc interval and QT prolongation is unknown in hypertensive patients. We recruited hypertensive patients from a cardiovascular clinic in a tertiary medical center in Taiwan. All received standard 12-lead electrocardiogram examination. QT prolongation was defined as QTc interval ≥ 440 ms in men or ≥ 450 ms in women. High-sensitive CRP kits were used for the measurement of the CRP levels. A total of 466 consecutive patients were finally enrolled. Mean age was 60.6 ± 12.0 years. CRP level was correlated with QTc interval (p < 0.001) and presence of QT prolongation (p = 0.014). Multivariate regression analysis showed that CRP level (p = 0.001), age (p = 0.004), sex (p < 0.001), height (p = 0.001), low-density lipoprotein (p = 0.041), and QRS interval (p < 0.001) were associated with QTc interval. Furthermore, CRP level [odds ratio (OR) = 1.203, 95% confidence interval (CI) = 1.027-1.410, p = 0.022], age (OR = 1.040, 95% CI = 1.010-1.071, p = 0.009), waist (OR = 1.033, 95% CI = 1.000-1.066, p = 0.047), triglyceride (OR = 0.993, 95% CI = 0.987-0.999, p = 0.021) and QRS interval (OR = 1.046, 95% CI = 1.028-1.065, p < 0.001) independently predicted the presence of QT prolongation. Because CRP is an independent predictor of QTc interval and presence of QT prolongation, it could be considered in the risk assessment for hypertensive patients.
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Affiliation(s)
- Kai-Ting Chang
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Hsu-Shien Shu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Yuan Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Wen-Hsien Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Po-Chao Hsu
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chol Voon
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Ter Lai
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hsiung Sheu
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Huang JH, Lin YQ, Pan NH, Chen YJ. Aging modulates dispersion of ventricular repolarization in the very old of the geriatric population. Heart Vessels 2010; 25:500-8. [PMID: 20936293 DOI: 10.1007/s00380-010-0026-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 01/25/2010] [Indexed: 11/25/2022]
Abstract
Aging plays an essential role in cardiac pathophysiology. Knowledge on the ventricular repolarization in very old individuals is limited. An increase of QT dispersion is associated with higher cardiovascular mortality. The purpose of this study is to investigate whether aging changes the QT dispersion in the very old. Heart rate, P wave duration, PR interval, QRS axis, QRS duration, QT interval, and QTc interval were measured from 12-lead resting ECG. QT dispersion (46 ± 21, 47 ± 17, 69 ± 31 ms, p < 0.005) was significantly increased in the age group ≧85 years (n = 29, 89 ± 4 years) than in the age group 75-84 years (n = 33, 79 ± 3 years) and the age group 65-74 years (n = 32, 68 ± 3 years). Aging modulates dispersion of ventricular repolarization, which may contribute to the cardiac mortality in the very old Asian population.
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Affiliation(s)
- Jen-Hung Huang
- Division of Cardiovascular Medicine, Taipei Medical University-Wan Fang Hospital, 111, Hsin-Lung Road, Sec. 3, Taipei, Taiwan
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Hansen S, Møller S, Bendtsen F, Jensen G, Henriksen JH. Diurnal variation and dispersion in QT interval in cirrhosis: relation to haemodynamic changes. J Hepatol 2007; 47:373-80. [PMID: 17459513 DOI: 10.1016/j.jhep.2007.03.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Revised: 02/15/2007] [Accepted: 03/05/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS A long QT(C) interval has been described in a substantial fraction of patients with cirrhosis, but information on QT variation and dispersion is sparse. The aim was to determine QT variation with time and QT dispersion (QT(disp)). METHODS The study population comprised 23 patients with cirrhosis, undergoing a haemodynamic investigation. 24-h 12 lead Holter monitoring provided information on QT and heart rate variability. RESULTS Mean QT(C) was above upper normal limit (440 ms(1/2)) in eleven patients (47%) and significantly higher than in controls (441 vs 400 ms(1/2), p<0.01). The minimum value of QT(C) (but not the maximum value) showed a significant diurnal variation both in cirrhosis and controls. QT(disp) in cirrhosis and controls was similar (33 vs 36 ms, ns), but related to indicators of liver dysfunction, central circulation time, and arterial blood pressure (r=0.44-0.58, p=0.03-0.001). No diurnal variation of QT(disp) was found in cirrhosis. Heart rate variability was reduced with a significant relation to central hypovolaemia (r=0.55, p=0.01). CONCLUSIONS Twenty-four hours QT(C) is prolonged in a substantial fraction of patients with cirrhosis, but with normal diurnal variation. The combination of long QT(C) and normal QT(disp) suggests delayed myocyte repolarisation on the cellular level, rather than temporal and spatial heterogeneity in the myocardial wall.
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Affiliation(s)
- Stig Hansen
- Department of Clinical Physiology, 239, H:S Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark
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Su HM, Chiu HC, Lin TH, Voon WC, Liu HW, Lai WT. Longitudinal study of the ageing trends in QT interval and dispersion in healthy elderly subjects. Age Ageing 2006; 35:636-8. [PMID: 17047010 DOI: 10.1093/ageing/afl114] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
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