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March 29, 2026Gaziantep Islam Science and Technology University0 citationsOpen Access

Evaluation of the QT Interval to QRS Duration Ratio as a Non-Invasive Arrhythmia Marker in Psoriatic Arthritis Patients Without Cardiovascular Comorbidities

NKNedim KabanYHYusuf Hoşoğlu

Key Result

Psoriatic arthritis patients without cardiovascular comorbidities showed no significant difference in the index of cardio-electrophysiological balance compared to healthy controls (4.20 vs 4.05, p=0.284).

Key Points

  • This study aims to assess differences in cardiac electrophysiological balance in psoriatic arthritis patients without cardiovascular comorbidities.
  • Retrospective case-control design
  • 24 psoriatic arthritis patients compared with 24 matched healthy controls
  • Review of standard 12-lead ECGs
  • Calculation of QTc using Bazett's formula
  • Statistical comparisons utilizing Mann–Whitney U test and Spearman’s coefficient
  • No significant differences in iCEB or iCEBc between psoriatic arthritis patients and controls (p > 0.05)
  • Similar baseline ECG parameters across both groups
  • iCEB and iCEBc were not correlated with various clinical factors within the PsA group (p > 0.05)

Study Design

Type

Case-Control (n=48)

Multicenter

No

Structured PICO

Does psoriatic arthritis alter the index of cardio-electrophysiological balance (iCEB) in patients without cardiovascular comorbidities compared to healthy controls?

P
Population
Adults aged 18-65 with Psoriatic arthritis (PsA) without cardiovascular comorbidities, metabolic disease, or cardiac medication use
C
Comparator
Age- and sex-matched healthy controls free from cardiovascular, metabolic, or inflammatory disorders
O
Outcome
Index of cardio-electrophysiological balance (iCEB = QT/QRS) and its corrected form (iCEBc = QTc/QRS)surrogate

In psoriatic arthritis patients without cardiovascular comorbidities, the index of cardio-electrophysiological balance (iCEB) is preserved, suggesting that PsA alone may not increase arrhythmic risk through iCEB-related mechanisms.

Main Result

Absolute Event Rate: 4.2% vs 4.05%

p-value: p=0.284

Limitations

  • Modest sample size of 24 patients per group
  • Single-center, retrospective, and cross-sectional design
  • Use of Bazett's formula for heart rate correction
  • Lack of data on disease activity indices (e.g., DAPSA) and sensitive inflammatory biomarkers like IL-6
  • Imbalance in the proportion of female participants between groups
  • Single-center, retrospective, and cross-sectional design limits causal inference and external validity
  • Use of Bazett's formula for heart rate correction can over-correct at high heart rates
  • Lacked data on disease activity indices (e.g., DAPSA) and more sensitive inflammatory biomarkers like IL-6
  • Strict exclusion criteria limits generalizability to the wider PsA population with concomitant cardiovascular risk factors

Abstract

PurposePsoriatic arthritis (PsA) is associated with increased cardiovascular (CV) events. Conduction disturbances and arrhythmias are reported, yet electrophysiological mechanisms are unclear. The index of cardio-electrophysiological balance (iCEB = QT/QRS) and its corrected form (iCEBc = QTc/QRS) are new ECG markers of ventricular depolarization-repolarization balance. This study examined whether iCEB or iCEBc differ in PsA patients without CV comorbidities.MethodsIn this retrospective case–control study, 24 PsA patients and 24 age- and sex-matched healthy controls were evaluated. Individuals with cardiovascular or metabolic disease, electrolyte or thyroid abnormalities, or cardiac medication use were excluded. Standard 12-lead ECGs were reviewed. QTc was calculated with Bazett’s formula. Group comparisons used the Mann–Whitney U test; correlations used Spearman’s coefficient.ResultsThe PsA and control groups were comparable regarding age, sex distribution, biochemical findings, and baseline ECG parameters (all p 0.05). No significant differences were observed in iCEB (4.20 vs 4.05, p = 0.284) or iCEBc (4.51 vs 4.32, p = 0.307). Within the PsA group, iCEB and iCEBc were not associated with age, duration of disease, sex, smoking status, LDL-cholesterol, or CRP (p 0.05).Discussion And ConclusionIn PsA patients without cardiovascular comorbidity, iCEB and iCEBc values were similar to those of healthy individuals, indicating preserved depolarization–repolarization balance. These results suggest that PsA alone may not increase arrhythmic risk through iCEB-related mechanisms. Larger prospective studies are required to determine whether iCEB becomes altered in patients with higher inflammatory activity or established cardiac involvement.

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Cite This Study

Kaban et al. (2026) conducted a case-control in Psoriatic arthritis without cardiovascular comorbidities (n=48). Psoriatic arthritis vs. Healthy controls was evaluated on Index of cardio-electrophysiological balance (iCEB) (p=0.284). Psoriatic arthritis patients without cardiovascular comorbidities showed no significant difference in the index of cardio-electrophysiological balance compared to healthy controls (4.20 vs 4.05, p=0.284).

synapsesocial.com/papers/69c8c336de0f0f753b39ddd0https://doi.org/10.46871/eams.1896830
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