Key result
COPD patients exhibited a significantly higher prevalence of prolonged QTc interval compared to matched controls (31.9% vs. 12.5%, p=0.033).
Why the study?
Is COPD associated with an increased prevalence of altered cardiac repolarization compared to matched controls and healthy subjects?
Cross-Sectional (n=164)
Single-blind
No
Is COPD associated with an increased prevalence of altered cardiac repolarization compared to matched controls and healthy subjects?
Absolute Event Rate: 31.9% vs 12.5%
p-value: p=0.033
Approximately one-third of COPD patients exhibit altered cardiac repolarization, independently associated with hypoxia, which may predispose them to malignant ventricular arrhythmias and sudden cardiac death.
BACKGROUND: Altered cardiac repolarization and increased dispersion of repolarization have been identified as risk factors for sudden cardiac death (SCD). The prevalence of and the mechanisms contributing to altered cardiac repolarization are currently unknown in COPD. METHODS: In 91 COPD patients, 32 controls matched for age, cardiovascular risk and medication, and 41 healthy subjects, measures of cardiac repolarization and dispersion of repolarization (QTc interval, QT dispersion) were derived from 12-lead electrocardiography (ECG). Prevalence rates of heart rate corrected QT (QTc) >450ms and QT dispersion >60ms were determined to assess the number of subjects at risk for SCD. Univariate and multivariate analyses were used to identify possible factors contributing to altered cardiac repolarization. RESULTS: QTc was found to be prolonged in 31.9% and QT dispersion in 24.2% of the COPD patients compared to 12.5% in matched controls and 0% in healthy subjects. The QTc interval was longer in COPD patients compared to matched and healthy controls respectively (437.9 ± 29.5 vs. 420.1 ± 25.3 ms, p = 0.001 and vs. 413.4 ± 18.2 ms, p < 0.001). QT dispersion was significantly increased in COPD patients compared to healthy subjects (45.4 (34.8 , 59.5) vs. 39.7 (29.3 , 54.8) ms, p = 0.049). Only oxygen saturation was independently associated with QTc duration in multivariate analysis (β = -0.29, p = 0.015). CONCLUSION: One third of a typical COPD population has altered cardiac repolarization and increased dispersion of repolarization, which may be related to hypoxia. Altered cardiac repolarization may expose these patients to an increased risk for malignant ventricular arrhythmias and SCD.
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Sievi et al. (2013) conducted a cross-sectional in COPD (n=164). COPD vs. Matched controls was evaluated on Prolonged QTc interval (>450ms) (p=0.033). COPD patients exhibited a significantly higher prevalence of prolonged QTc interval compared to matched controls (31.9% vs. 12.5%, p=0.033).
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