Key result
Newly diagnosed COPD is linked to ~23 ms longer Tp-eR intervals versus controls.
Why the study?
The risk of sudden cardiac death and arrhythmias is common in COPD subjects, prompting evaluation of arrhythmia markers such as QT, QTc, Tp-e, and related ratios in right and left precordial leads.
Are ECG markers of ventricular repolarization heterogeneity (Tp-e interval, Tp-e/QT ratio) prolonged in patients with newly diagnosed COPD compared to controls?
Case-Control (n=152)
Are ECG markers of ventricular repolarization heterogeneity (Tp-e interval, Tp-e/QT ratio) prolonged in patients with newly diagnosed COPD compared to controls?
Absolute Event Rate: 85.82% vs 62.87%
p-value: p=<.00001
Patients with newly diagnosed COPD exhibit prolonged Tp-e intervals and higher Tp-e/QT ratios that correlate with systolic pulmonary arterial pressure, suggesting an increased risk for ventricular arrhythmias.
Introduction The risk of sudden cardiac death (SCD) and arrhythmias has been shown to be common in chronic obstructive pulmonary disease (COPD) subjects. We aimed to evaluate the markers of arrhythmia such as QT, QTc (corrected QT), Tp‐e, and cTp‐e (corrected Tp‐e) intervals, Tp‐e/QT ratio, and Tp‐e/QTc ratio in newly diagnosed COPD subjects in both right and left precordial leads. Materials and Methods The study group consisted of 74 subjects with obstructive respiratory function tests (RFTs). The control group consisted of 78 subjects who had nonobstructive RFTs. RFTs, electrocardiograms (ECG), and transthoracic echocardiograms (TTE) were performed, and QTR (QT interval in right precordial leads), QTL (QT interval in left precordial leads), Tp‐eR (Tp‐e interval in right precordial leads), and Tp‐eL (Tp‐e interval in left precordial leads) intervals; systolic pulmonary arterial pressure (sPAP); forced expiratory volume in one second (FEV1)/forced vital capacity (FVC); and peripheral oxygen saturation(POS) values were measured. Results Tp‐eR interval 85.82 ± 5.34 millisecond (ms) versus 62.87 ± 3.55 ms (t = 31.29/p < .00001), cTp‐eR interval 97.51 ± 7.18 ms versus 71.07 ± 4.58 ms (t = 27.20/p < .00001), Tp‐eR/QTR ratio 0.234 ± 0.02 versus 0.164 ± 0.01 (t = 2.2/p = .014), and Tp‐eR/QTcR ratio 0.201 ± 0.01 versus 0.141 ± 0.01 (t = 1.92/p = .028) were statistically significantly higher in COPD subjects. There was a strong negative correlation between RFT and sPAP (sPAP, 29.93 ± 5.1 mm Hg; and FEV1/FVC, 63.78 ± 3.33%, r = −.85/p < .00001). There was a moderate positive correlation between sPAP and Tp‐eR. Conclusion We found Tp‐e and cTp‐e intervals, Tp‐e/QT ratio, and Tp‐e/QTc ratio were significantly higher in the COPD patients than in the control group. In addition, in the COPD group, heart rate variability (HRV) parameters were significantly lower on ECG.
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Coşgun et al. (2019) conducted a case-control in Chronic obstructive pulmonary disease (n=152). Chronic obstructive pulmonary disease vs. Nonobstructive respiratory function tests (control) was evaluated on Tp-eR interval (p=<.00001). Newly diagnosed COPD was associated with significantly higher Tp-eR intervals compared to controls (85.82 vs 62.87 ms, p<0.00001).
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