The QT Interval Dynamic in a Human Experimental Model of Controlled Heart Rate and QRS Widening
Abstract
:1. Introduction
2. Experimental Section
2.1. Patients and Experimental Protocol
2.2. ECG Measurements, Frequency Correction and Definitions
2.3. Statistics and Data Analysis
3. Results
3.1. Patients and the Dynamic of ECG Intervals
3.2. Performance of Frequency-Correction Formulas
4. Discussion
4.1. Increased QRS Duration and Its Relationship with the QT Interval Dynamics
4.2. Increased QRS Duration and Its Relationship with Frequency-Correction Formulas
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | N = 23 | ||
Age (years) | 84 (±4) | ||
Weight (Kg) | 70.29 (±12.98) | ||
Height (cm) | 158 (±8) | ||
Body mass index | 28.06 (±4, 9) | ||
Male Gender (N; %) | 11 (48%) | ||
Cardiovascular Risk Factors | |||
Hypertension (N; %) | 20 (87%) | ||
Diabetes (N; %) | 7 (30%) | ||
Dyslipidemia (N; %) | 17 (74%) | ||
Smoking (N; %) | 0 (0%) | ||
Former | 5 (22%) | ||
Coronary artery disease (N; %) | 8 (35%) | ||
Peripheral vascular disease (N; %) | 6 (26%) | ||
Chronic Kidney disease (N; %) | 10 (44%) | ||
Dialysis treatment | 0 (0%) | ||
Echocardiographics findings | |||
IVS (cm) | 1.6 (±0.3) | ||
LVED Diameter (cm) | 4,8 (±0.8) | ||
LV mass (g/m2) | 167.76 (±55.18) | ||
RWT | 0.59 (±0.19) | ||
LV ejection fraction (%) | 56 (±14) | ||
Aortic mean gradient (mmHg) | 50 (±14) | ||
Antiarrhythmics | |||
Class I (N; %) | 0 (0%) | ||
Class II (N; %) | 12 (52%) | ||
Class III (N; %) | 0 (0%) | ||
Class IV (N; %) | 1 (4%) | ||
Ivabradine (N; %) | 1 (4%) |
Baseline-Phase | Released-Phase | δ Released-Baseline (IC95%) | p-Value | ||
---|---|---|---|---|---|
QRS (ms) | 98.50 (±21.78) | 131.0 (±25.77) | 32.5 (31.5–33.6) | p < 0.001 | |
Axis (degrees) | 8.55° (±36.2) | 3.18º (±43.64) | p = 0.376 | ||
LBBB % (N) | 0 | 39% (9) | p = 0.001 | ||
RBBB % (N) | 9% (2) | 17% (4) | p = 0.162 | ||
LAFH % (N) | 13% (3) | 13% (3) | |||
LPFH % (N) | 0 | 0 | |||
QT (ms) | 409.2 (±37.63) | 444.6 (±45.41) | 35.4 (33.4–37.4) | p < 0.001 | |
50bpm | 469.33 (±27.09) | 520.0 (±17.53) | |||
60bpm | 448.53 (±26.44) | 477.16 (±37.80) | |||
70bpm | 432.44 (±22.96) | 468.0 (±31.79) | |||
80bpm | 417.37 (±24.59) | 454.48 (±32.06) | |||
90bpm | 401.60 (±19.53) | 435.60 (±34.58) | |||
100bpm | 382.22 (±2.08) | 417.33 (±33.97) | |||
110bpm | 368.67 (±20.60) | 404.67 (±30.60) | |||
120bpm | 359.67 (±17.31) | 388.0 (±31.42) | |||
QTpeak (ms) | 322.2 (±32.12) | 353.6 (±44.46) | 31.3 (27.8–35.2) | p = 0.001 | |
Tpeak-Tend (ms) | 87.0 (±19.31) | 91.07 (±28.35) | 4.07 (−0.16–7.90) | p = 0.044 | |
QRSend-Tpeak (ms) | 223.7 (±34.64) | 222.5 (±43.92) | −1.18 (−4.84–2.61) | p = 0.563 | |
QTc Bazett’s (ms) | 480.9 (±31.47) | 522.5 (±4.21) | 41.6 (38.6–44.5) | p < 0.001 | |
QTc Fridericia (ms) | 454.5 (±23.92) | 493.8 (±35.16) | 39.3 (36.8–41.8) | p < 0.001 | |
QTc Framingham (ms) | 449.2 (±22.35) | 484.4 (±31.95) | 35.3 (33.2–37.4) | p < 0.001 | |
QTc Hodges (ms) | 453.6 (±21.65) | 488.9 (±31.19) | 35.4 (33.4–37.4) | p < 0.001 |
Baseline-Phase (SD) | Released-Phase (SD) | p-Value | |
---|---|---|---|
Telesystolic LV presure (mmHg) | 197.44 (±30.77) | 159.61 (±33.65) | <0.001 |
Telediastolic LV presure mmHg | 3.17 (±7.98) | 17.06 (±17.85) | 0.006 |
Temperature (°C) | 36.77 (±0.4) | 36.9 (±0.27) | 0.047 |
Na+ (mmol/l) | 141.61 (±3.09) | 138.72 (±2.78) | 0.053 |
K+ (mmol/l) | 3.70 (±0.29) | 3.70 (±0.37) | 0.929 |
Ca2+ (mmol/l) | 1.17 (±0.55) | 1.12 (±0.52) | 0.061 |
Cl−(mmol/l) | 106.94 (±3.70) | 106.17 (±3.94) | 0.255 |
Glucose (mg/dl) | 108.39 (±35.92) | 107.56 (±34.23) | 0.697 |
pH | 7.37 (±0.33) | 7.34 (±0.44) | 0.049 |
pCO2 (mmHg) | 46.83 (±6.03) | 46.85 (±6.52) | 0.981 |
HCO3− (mmol/l) | 27.32 (±3.25) | 25.30 (±3.42) | 0.051 |
Hemoglobin (g/dl) | 11.76 (±1.60) | 11.05 (±1.69) | 0.069 |
Lactate (mmol/l) | 0.55 (±0.22) | 0.57 (±0.29) | 0.959 |
QTc/deviation * (ms; CI95%) | Correlation Coefficient with QT60 (CI95%) | |||
---|---|---|---|---|
Basaline-Phase | Released-Phase | Basaline-Phase | Released-Phase | |
Bazett | −31.1 (−35,0 – [−26.8]) | −41.8 (−46.9 – [−36.4]) | 0.462 (0.344–0.574) | 0.613 (0.505–0.706) |
Fridericia | −6.46 (−8.61 – [−4.26]) | −14.8 (−17.2 – [−12.4]) | 0.694 (0.628–0.755) | 0.825 (0.783–0.862) |
Framinghan | −1.14 (−3.38 – 1.19) | −5.42 (−7.51 – [−3.24]) | 0.698 (0.633–0.761) | 0.843 (0.796–0.888) |
Hodges | −5.05 (−6.78 – [−3.29]) | −9.43 (−11.2 – [−7.70]) | 0.722 (0.651–0.789) | 0.867 (0.836–0.897) |
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Colunga, S.; Padrón, R.; García-Iglesias, D.; Rubín, J.M.; Pérez, D.; del Valle, R.; Avanzas, P.; Morís, C.; Calvo, D. The QT Interval Dynamic in a Human Experimental Model of Controlled Heart Rate and QRS Widening. J. Clin. Med. 2019, 8, 1417. https://doi.org/10.3390/jcm8091417
Colunga S, Padrón R, García-Iglesias D, Rubín JM, Pérez D, del Valle R, Avanzas P, Morís C, Calvo D. The QT Interval Dynamic in a Human Experimental Model of Controlled Heart Rate and QRS Widening. Journal of Clinical Medicine. 2019; 8(9):1417. https://doi.org/10.3390/jcm8091417
Chicago/Turabian StyleColunga, Santiago, Remigio Padrón, Daniel García-Iglesias, José Manuel Rubín, Diego Pérez, Raquel del Valle, Pablo Avanzas, César Morís, and David Calvo. 2019. "The QT Interval Dynamic in a Human Experimental Model of Controlled Heart Rate and QRS Widening" Journal of Clinical Medicine 8, no. 9: 1417. https://doi.org/10.3390/jcm8091417