Key result
COPD linked to longer QTc intervals vs matched controls, with prolonged QTc in ~32% of patients.
Why the study?
The prevalence and mechanisms contributing to altered cardiac repolarization in COPD patients were unknown.
Is COPD associated with altered cardiac repolarization and increased dispersion of repolarization compared to matched and healthy controls?
Observational (n=164)
Is COPD associated with altered cardiac repolarization and increased dispersion of repolarization compared to matched and healthy controls?
Absolute Event Rate: 437.9% vs 420.1%
p-value: p=0.001
COPD is associated with a high prevalence of altered cardiac repolarization, which is independently associated with lower oxygen saturation and may increase the risk of malignant ventricular arrhythmias.
May warrant QTc monitoring in COPD; leaves open whether hypoxemia-targeted interventions reduce arrhythmia risk.
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. (2014) conducted an observational in COPD (n=164). COPD vs. Matched controls and healthy subjects was evaluated on QTc interval (p=0.001). COPD patients had a significantly longer QTc interval compared to matched controls (437.9 vs. 420.1 ms, p=0.001), with prolonged QTc (>450ms) present in 31.9% of the COPD group.
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