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01-03-2022 | Sudden Cardiac Death | Original Article

Plasma potassium concentration and cardiac repolarisation markers, T_peak–T_end and T_peak–T_end/QT, during and after exercise in healthy participants and in end-stage renal disease

Authors: Cao Thach Tran, Tania Atanasovska, Claus Graff, Jacob Melgaard, Jørgen K. Kanters, Robert Smith, Aaron C. Petersen, Keld P. Kjeldsen, Michael J. McKenna

Published in: European Journal of Applied Physiology | Issue 3/2022

Abstract

Purpose

The cardiac T-wave peak-to-end interval (T_pe) is thought to reflect dispersion in ventricular repolarisation, with abnormalities in T_pe associated with increased risk of arrhythmia. Extracellular K⁺ modulates cardiac repolarisation, and since arterial plasma K⁺ concentration ([K⁺]) rapidly increases during and declines following exercise, we investigated the relationship between [K⁺] and T_pe with exercise.

Methods

Serial ECGs (T_pe, T_pe/QT ratio) and [K⁺] were obtained from 8 healthy, normokalaemic volunteers and 22 patients with end-stage renal disease (ESRD), at rest, during, and after exhaustive exercise.

Results

Post-exercise [K⁺] nadir was 3.1 ± 0.1, 5.0 ± 0.2 and 4.0 ± 0.1 mmol.L⁻¹ (mean ± SEM) for healthy participants and ESRD patients before and after haemodialysis, respectively. In healthy participants, compared to pre-exercise, recovery-induced low [K⁺] was associated with a prolongation of T_pe (110 ± 8 vs. 87 ± 5 ms, respectively, p = 0.03) and an increase in T_pe/QT ratio (0.28 ± 0.01 vs. 0.23 ± 0.01, respectively, p = 0.01). Analyses of serial data revealed [K⁺] as a predictor of T_pe in healthy participants (β = -0.54 ±0.05, p < 0.0001), in ESRD patients (β = -0.75 ± 0.06, p < 0.0001) and for all data pooled (β = -0.61 ± 0.04, p < 0.0001). The [K⁺] was also a predictor of T_pe/QT ratio in healthy participants and ESRD patients.

Conclusions

T_pe and T_pe/QT ratio are predicted by [K⁺] during exercise. Low [K⁺] during recovery from exercise was associated with increased T_pe and T_pe/QT, indicating accentuated dispersion of ventricular repolarisation. The findings suggest that variations in [K⁺] with physical exertion may unmask electrophysiological vulnerabilities to arrhythmia.

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Title: Plasma potassium concentration and cardiac repolarisation markers, Tpeak–Tend and Tpeak–Tend/QT, during and after exercise in healthy participants and in end-stage renal disease
Authors: Cao Thach Tran
Tania Atanasovska
Claus Graff
Jacob Melgaard
Jørgen K. Kanters
Robert Smith
Aaron C. Petersen
Keld P. Kjeldsen
Michael J. McKenna
Publication date: 01-03-2022
Publisher: Springer Berlin Heidelberg
Keyword: Sudden Cardiac Death
Published in: European Journal of Applied Physiology / Issue 3/2022
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-021-04870-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Plasma potassium concentration and cardiac repolarisation markers, T_peak–T_end and T_peak–T_end/QT, during and after exercise in healthy participants and in end-stage renal disease

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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