Key result
Dengue virus infection was associated with a significantly prolonged QTc interval compared to healthy controls (407.4 vs 391.8 msec, p=0.00004), with 5% of patients showing abnormal lengthening.
Why the study?
Although ECG changes can occur in dengue virus infection, little is known about ventricular repolarization parameters in these patients.
Does non-complicated dengue virus infection cause abnormalities in electrocardiographic ventricular repolarization?
Case-Control (n=186)
No
Does non-complicated dengue virus infection cause abnormalities in electrocardiographic ventricular repolarization?
Effect estimate: + 4%
Absolute Event Rate: 407.4% vs 391.8%
p-value: p=0.00004
Patients with non-complicated dengue virus infection exhibit significant lengthening of the QTc interval, suggesting mild myocardial involvement and supporting the use of routine 12-lead ECG screening during epidemics.
May warrant ECG caution in dengue; hypothesis-generating for repolarization effects and needs prospective confirmation.
INTRODUCTION: Dengue virus infection (DENV) is an arboviral disease that affects millions of people in many countries throughout the world every year. The disease is caused by the bite of a mosquito (Aedes aegypti and / or Aedes albopictus). The symptoms/signs observed in this arboviral disease are unspecific, and the blood count usually shows leukopenia and thrombocytopenia. Although ECG changes may be observed in DENV, little is known about parameters of ventricular repolarization in patients with this condition. Accordingly, the aim of this study was to evaluate the QTc and QT interval dispersion to detect ventricular repolarization changes in patients with DENV. METHODOLOGY: Ninety-three consecutive patients seen during DENV epidemics in a small town with non-complicated DENV were included; 93 normal individuals served as controls. Clinical data, blood count and the 12-lead ECG were obtained from each individual. RESULTS: The QTc duration was higher in patients with DENV in comparison to controls. Furthermore, 5% of DENV patients had abnormal lengthening of the QTc interval. No difference regarding QT interval dispersion was observed between DENV patients and controls. No DENV patient had increased lengthening of the QT interval dispersion. CONCLUSIONS: Myocardial repolarization changes do occur in patients with DENV. Having into account the potential impact of these changes on patients' outcome, and because 12-lead ECG is not routinely recommended in the setting of DENV in our country, we recommend that a 12-lead ECG be taken from each patient with this condition during DENV epidemics.
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Furlan-Daniel et al. (2019) conducted a case-control in Dengue virus infection (n=186). Dengue virus infection vs. Healthy controls was evaluated on QTc interval (msec) (+ 4%, p=0.00004). Dengue virus infection was associated with a significantly prolonged QTc interval compared to healthy controls (407.4 vs 391.8 msec, p=0.00004), with 5% of patients showing abnormal lengthening.
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