Summary
OBJECTIVE: Heart rate-corrected QT interval (QTc) and QTc dispersion (QTcd) are increased and associated with ventricular arrhythmia and an increase in sudden death in a variety of diseases. This study aimed to examine QTc and QTcd in pulmonary hypertension and assess their relationship with pulmonary arterial pressure. PATIENTS AND METHODS: A total of 201 patients who had undergone right heart catheterization for a preliminary diagnosis of pulmonary hypertension between December 2003 and July 2008 were included in the study. Resting 12-lead electrocardiogram was recorded. QT interval was measured manually and corrected using Bazett's formula. Patients were divided into groups with mild-to-moderate and severe pulmonary hypertension and a control group according to mean pulmonary arterial pressure. RESULTS: In all observed cases, mean QTc was higher in severe pulmonary hypertension than in controls (428.6 ± 32.8 ms vs. 411.1 ± 28.4 ms, P = 0.018) and QTcd was higher in mild-to-moderate (60.1 ± 17.2 ms) and severe pulmonary hypertension (63.9 ± 20.5 ms) than in controls (47.3 ± 10.6 ms) (P = 0.031; P = 0.004). In men, there was no significant difference in mean QTc and QTcd. In women, mean QTc was higher in severe pulmonary hypertension than in controls (436.1 ± 39.4 ms vs. 407.6 ± 24.8 ms, P = 0.037) and QTcd was higher in severe pulmonary hypertension (68.5 ± 20.9 ms) than in both the controls (45.1 ± 12.6 ms) and patients with mild-to-moderate pulmonary hypertension (58.6 ± 14.7ms) (P = 0.002; P = 0.003). In addition, in women with pulmonary hypertension, mean QTc and QTcd were positively correlated to mean pulmonary arterial pressure (r = 0.207, P = 0.03; r = 0.236, P = 0.012). CONCLUSIONS: In women with pulmonary hypertension, mean QTc and QTcd are positively correlated to mean pulmonary arterial pressure and are significantly increased in patients with severe pulmonary hypertension.
Similar content being viewed by others
References
Day CP, McComb JM, Campbell RW (1992) QT dispersion in sinus beats and ventricular extrasystoles in normal hearts. Br Heart J 67: 39–41
Zabel M, Portnoy S, Franz MR (1995) Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol 25: 746–752
Puddu PE, Bourassa MG (1986) Prediction of sudden death from QTc interval prolongation in patients with chronic ischemic heart disease. J Electrocardiol 19: 203–211
Dekker JM, Schouten EG, Klootwijk P, Pool J, Kromhout D (1994) Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen Study. Circulation 90: 779–785
Glancy JM, Garratt CJ, Woods KL, de Bono DP (1995) QT dispersion and mortality after myocardial infarction. Lancet 345: 945–948
Perkiömäki JS, Koistinen MJ, Yli-Mäyry S, Huikuri HV (1995) Dispersion of the QT interval in patients with and without susceptibility to ventricular tachyarrhythmias after previous myocardial infarction. J Am Coll Cardiol 26: 174–179
Barr CS, Naas A, Freeman M, Lang CC, Struthers AD (1994) QT dispersion and sudden unexpected death in chronic heart failure. Lancet 343: 327–329
Ichkhan K, Molnar J, Somberg J (1997) Relation of left ventricular mass and QT dispersion in patients with systematic hypertension. Am J Cardiol 79: 508–511
Naas AA, Davidson NC, Thompson C, Cummings F, Ogston SA, Jung RT, et al (1998) QT and QTc dispersion are accurate predictors of cardiac death in newly diagnosed non-insulin dependent diabetes: cohort study. BMJ 316: 745–746
Joppa P, Petrásová D, Stancák B, Dorková Z, Tkácová R (2007) Oxidative stress in patients with COPD and pulmonary hypertension. Wien Klin Wochenschr 119: 428–434
Vonbank K, Funk G, Marzluf B, Burian B, Ziesche R, Stiebellehner L, et al (2008) Abnormal pulmonary artery pressure limits exercise capacity in patients with COPD. Wien Klin Wochenschr 120: 749–756
Sehgal PB, Mukhopadhyay S (2007) Pulmonary arterial hypertension: a disease of tethers, SNAREs and SNAPs? Am J Physiol Heart Circ Physiol 293: H77–85
Tuncer M, Gunes Y, Guntekin U, Aslan S, Gumrukcuoglu HA, Eryonucu B, et al (2008) Association of increased QTc dispersion and right ventricular hypertrophy. Med Sci Monit 14: CR102–105
Akgül F, Seyfeli E, Melek I, Duman T, Seydaliyeva T, Gali E, et al (2007) Increased QT dispersion in sickle cell disease: effect of pulmonary hypertension. Acta Haematol 118: 1–6
Dursunoglu D, Dursunoglu N (2007) Effect of CPAP on QT interval dispersion in obstructive sleep apnea patients without hypertension. Sleep Med 8: 478–483
Bazett HC (1920) An analysis of the time-relations of electrocardiograms. Heart 7: 353–370
Martin AB, Garson A Jr, Perry JC (1994) Prolonged QT interval in hypertrophic and dilated cardiomyopathy in children. Am Heart J 127: 64–70
Haigney MC, Zareba W, Nasir JM, McNitt S, McAdams D, Gentlesk PJ, et al (2009) Gender differences and risk of ventricular tachycardia or ventricular fibrillation. Heart Rhythm 6: 180–186
Nakagawa M, Ooie T, Ou B, Ichinose M, Takahashi N, Hara M, et al (2005) Gender differences in autonomic modulation of ventricular repolarization in humans. J Cardiovasc Electrophysiol 16: 278–284
de Bruyne MC, Hoes AW, Kors JA, Hofman A, van Bemmel JH, Grobbee DE (1999) Prolonged QT interval predicts cardiac and all-cause mortality in the elderly. The Rotterdam study. Eur Heart J 20: 278–284
Okin PM, Devereux RB, Howard BV, Fabsitz RR, Lee ET, Welty TK (2000) Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: the strong heart study. Circulation 101: 61–66
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hong-liang, Z., Qin, L., Zhi-hong, L. et al. Heart rate-corrected QT interval and QT dispersion in patients with pulmonary hypertension. Wien Klin Wochenschr 121, 330–333 (2009). https://doi.org/10.1007/s00508-009-1184-9
Issue Date:
DOI: https://doi.org/10.1007/s00508-009-1184-9