Association of Mild Hyperbilirubinemia with Decreased ECG-Based Ventricular Repolarization Parameters in Young Men

2020 ◽  
Author(s):  
Cihan Sengul ◽  
Ahmet Sen ◽  
Suleyman Barutcu ◽  
Cayan Cakir ◽  
Remzi Sarikaya
Keyword(s):  
Odds Ratio ◽  
Qt Interval ◽  
Total Bilirubin ◽  
Significant Negative Correlation ◽  
Ventricular Repolarization ◽  
Healthy Men ◽  
T Wave ◽  
Group 2 ◽  
Interval Ratio ◽  
Group 1

Abstract Objective Hyperbilirubinemia is associated with protection against various oxidative stress-mediated diseases. We aimed to investigate the association between bilirubin and novel electrocardiography (ECG)-based ventricular repolarization parameters. Methods We enrolled 201 healthy men with mild hyperbilirubinemia (group 1) and 219 healthy men with normal bilirubin levels (group 2). The Tpeak-Tend (Tp-e) interval (defined as the interval from the peak of the T wave to the end of the T wave), corrected (c) Tp-e interval, QT interval, cQT interval, and Tp-e interval/QT interval ratio were measured from leads V5 and V6 with 20 mm/mV amplitude and 50 mm/second rate. Results The Tp-e interval, cTp-e interval, and Tp-e interval/QT interval ratio were significantly lower in group 1 compared with group 2. The cTp-e interval showed a significant negative correlation with total bilirubin, conjugated bilirubin, and unconjugated bilirubin. The cTp-e interval (odds ratio [OR], 0.900; P =.002) and Tp-e interval/QT interval ratio (OR, 0.922; P =.04) were significantly associated with mild hyperbilirubinemia. Conclusion We showed the association of mild hyperbilirubinemia with decreased novel ECG-based ventricular repolarization parameters.

scholarly journals New insights into vitamin D regulation: is there a role for alkaline phosphatase?

2021 ◽  
Author(s):  
G. Bellastella ◽  
L. Scappaticcio ◽  
M. Longo ◽  
R. Carotenuto ◽  
C. Carbone ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Liver Function ◽  
Significant Negative Correlation ◽  
Liver Function Tests ◽  
Bone Alkaline Phosphatase ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests ◽  
Group 2 ◽  
Group 1

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r =  − 0.03; p = 0.8), ALT (r =  − 0.02; p = 0.91), GGT (r =  − 0.08; p = 0.68), direct bilirubin (r =  − 0.02; p = 0.89), indirect bilirubin (r =  − 0.24; p = 0.21), and total bilirubin (r =  − 0.24; p = 0.21) but one between 25OHD and ALP (r =  − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r =  − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

scholarly journals Relationship between plasma aldosterone and left ventricular structure and function in patients with heart failure with preserved ejection fraction

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
A. N. Shevelok
Keyword(s):  
Odds Ratio ◽  
Left Ventricular ◽  
Structure And Function ◽  
Plasma Aldosterone ◽  
Preserved Ejection Fraction ◽  
Concentric Hypertrophy ◽  
Group 2 ◽  
Lv Diastolic Dysfunction ◽  
And Function ◽  
Group 1

Aim. To study the relationship between plasma aldosterone level and left ventricular (LV) structure and function in heart failure with preserved ejection fraction (HFpEF).Material and methods. This prospective study included 158 patients (58 men and 100 women, mean age, 62,3±7,4 years) with compensated HFpEF. Patients had no history of primary aldosteronism and did not use the mineralocorticoid receptor antagonists during the last 6 weeks. The plasma aldosterone was determined by enzyme immunoassay in all patients and the severity of structural and functional cardiac changes was assessed. The concentration of 40160 pg/ml was considered the reference values. Assessment of cardiac structure and function was carried out using transthoracic echocardiography.Results. According to the laboratory results, all patients were divided into two groups: group 1 — 99 (62,7%) patients (95% confidence interval (CI), 55,0-70,0%) with normal aldosterone levels; group 2 — 59 (37,3%) patients (95% Cl, 30,0-45,0%) with hyperaldosteronism. End-diastolic volume, left atrial volume, LV mass index, severity of LV diastolic dysfunction and the prevalence of concentric hypertrophy were significantly higher in group 2 patients compared with group 1 (p<0,05 for all). Blood aldosterone levels positively correlated with E/e’ (r=0,63, p<0,001). Regression analysis, adjusted for age and comorbidity, demonstrated that plasma aldosterone levels were closely associated with E/e’ (odds ratio, 3,42; 95% CI, 1,65-9,64, p=0,001) and LV concentric hypertrophy (odds ratio, 1,12; 95% CI, 1,08-3,16, p=0,042).Conclusion. The development of secondary hyperaldosteronism in patients with HFpEF is an independent predictor of LV diastolic dysfunction and unfavorable prognostic types of LV remodeling.

scholarly journals Electrocardiographic evaluation of two anesthetic combinations in dogs

2000 ◽  
Vol 52 (2) ◽  
pp. 138-143 ◽  
Author(s):  
K.M. Tárraga ◽  
H.S. Spinosa ◽  
A.A. Camacho
Keyword(s):  
Heart Rate ◽  
Cardiac Rhythm ◽  
T Wave ◽  
Qt Intervals ◽  
St Segment ◽  
Electrocardiographic Changes ◽  
Group 2 ◽  
Group 1

This study aimed to investigate electrocardiographic changes in dogs aged 5 years or more submitted to two anesthetic combinations: atropine, levomeprazine, thiopental and halothane (ALTH), and atropine, tiletamine and zolazepam (ATZ). Forty dogs (24 males/16 females) weighing 5-24kg, were used. Dogs had no cardiac problems and were submitted to tartarectomy. All animals were submitted to two electrocardiograms (ECG), one before anesthesia and other immediately before surgery. The dogs were divided into two groups: group 1 received ALTH and group 2 received ATZ. Alterations in the ST segment, T wave, cardiac rhythm and a significant reduction of vagal tonus index were observed in both groups, but in group 2 a significant reduction of the PR and QT intervals and an increase in heart rate were also observed. These data suggest that the ALTH combination caused fewer changes in the ECG than the ATZ combination.

scholarly journals Comparison Between Clinical and Echocardiographic Findings in Infants and Children Diagnosed with Hypertrophic Cardiomyopathy

2015 ◽  
Vol 61 (2) ◽  
pp. 83-86
Author(s):  
Blesneac Cristina ◽  
Şuteu Carmen ◽  
Togănel Rodica ◽  
Benedek Theodora ◽  
I Benedek
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Odds Ratio ◽  
Age Of Onset ◽  
Hereditary Disease ◽  
Left Ventricular ◽  
Late Gene Expression ◽  
Septal Hypertrophy ◽  
Group 2 ◽  
Echocardiographic Findings ◽  
Group 1

Abstract Background: Hypertrophic cardiomyopathy is a rather common hereditary disease with an autozomal dominant character, caused by mutations of genes that code for proteins of the cardiac sarcomere. The observed prevalence of this disease is much lower in pediatric patients compared to adults, because it’s late gene expression. Hypertrophic cardiomyopathy presenting in infancy has been shown to have a very high mortality. Methods: Thirty-nine patients diagnosed with hypertrophic cardiomyopathy in the IIIrd Pediatric Cardiology Department from Tîrgu Mureş were included in this study. Patients were divided into two groups: group 1 – patients diagnosed during infancy, group 2 – patients diagnosed after 1 year of age. Data regarding familial and personal history, and echocardiographic findings were compared between these two groups. Results: Group 1 included 17 patients and group 2 - 22 patients. Positive familial history was found in both groups (group 1 – 6 cases, group 2 – 3 cases), all of them in obstructive forms. Syncope was found in four cases, all of them in group 1 (p=0.02; odds ratio 15; 95% CI, 0.7473 to 301.1). While in group 1, asymmetric septal hypertrophy was predominant (64.7%), in group 2 – concentric left ventricular hypertrophy predominated (54.5%). Obstructive hypertrophic cardiomyopathy was found in 14 patients in group 1 (82.4%) compared to 13 patients in group 2 (59.1%). Diastolic function was impaired more predominantly in group 1 (p=0.0274; odds ratio 11.67; 95% CI, 1.526 to 89.17). Conclusions: hypertrophic cardiomyopathy has an extensive clinical variability with regard to age of onset, severity and progression of disease.

scholarly journals Prognostic value of soluble ST2 biomarker in heart failure patients with obstructive sleep apnea syndrome

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Kopeva ◽  
EV Grakova ◽  
AV Yakovlev ◽  
SN Shilov ◽  
NF Yakovleva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Odds Ratio ◽  
Sleep Apnea Syndrome ◽  
Myocardial Mass ◽  
Heart Failure Patients ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Objective. To analyze the relationships between soluble ST2 (sST2) levels, apnea/hypopnea index (AHI) and echocardiographic parameters in heart failure patients with preserved ejection fraction (HFpEF) and to evaluate prognostic values of sST2 in the development of adverse cardiac events (ASE) during the 12-month follow-up period. Methods. A total of 86 men, median age of 62.0 (41.0; 78.0) years with obstructive sleep apnea syndrome (OSAS) and HF of NYHA class I-III with baseline LVEF of 60% [52; 65]% were enrolled in the study. The severity of obstructive breathing disorders during sleep was assessed by AHI. Serum levels of NT-proBNP and sST2 were measured using ELISA at baseline. Two-dimensional transthoracic echocardiography with assessment of right ventricular (RV) function and 6-minute walk test (6MWT) were performed at baseline. Results. The values of AHI significantly correlated with body mass index (r = 0.362), left atrial volume (r = 0.570), fractional change in the area of the RV (r=-0.527), RV myocardial function index (r=-0.377), NT-proBNP (r = 0.611), 6MWT (r=-0.511), RV anterior wall thickness (r = 0,472), while the levels of sST2 significantly correlated with LV remodeling parameters: LVEF (r =-0.301), end-systolic volume (r =0.453), end-diastolic volume (r =0.396), end-systolic dimension (r = 0.373), end-diastolic dimension (r =0.288). Based on ROC-analysis, sST2 ≥29.67 ng/mL (sensitivity 63.6%, specificity 73.6%, AUC = 0.645; p &lt; 0.0001) were identified as a cut-off values predicting the development of ACE. At 12 months of follow-up period all patients were divided into 2 groups according to cut-off values of sST2: group 1 (n = 29) comprised patients with sST2 ≥29.67 ng/mL, group 2 (n = 42) comprised patients with sST2 &lt;29.67 ng/mL. The median baseline values of sST2 were 41.39 [33.31; 50.99] ng/mL in group 1, and 22.18 [20.64; 25.5] ng/mL in group 2. The concentrations of NT-proBNP did not differ between the groups. During the 12-month follow-up period in group 1 the rate of ACE was 29.7% cases, and 5.2% in group 2, respectively. According to Kaplan-Meier analysis, a higher sST2 levels was associated with a higher frequency of ACE during 12 months of follow-up (р&lt;0.0001). Univariable and multivariable Cox regression analyses showed sST2 concentrations were significantly associated with ACE (odds ratio 2.25, 95%CI: 2.06 to 3.29, p &lt; 0.001), when adding AHI and LV myocardial mass index improved reclassification of risk stratification (odds ratio 3,28, 95%CI: 3,09 to 4,49, p &lt; 0.001, AUC of 0.945, percent of cases correctly classified of 90.14 %). However, NT-proBNP addition had a limited effect on risk stratification. Conclusion. Our data suggest that sST2 may be used as a diagnostic biomarker for prediction of ACE in patients with HFpEF and OSAS during the 12-month follow-up period. The combined evaluation of sST2, AHI and LV myocardial mass index values demonstrated higher diagnostic sensitivity and specificity for prediction of ACE.

scholarly journals Impact of condom balloon tamponade on the rate of obstetric hysterectomy: a ten-year study

2020 ◽  
Vol 9 (9) ◽  
pp. 3638
Author(s):  
Archana Roy ◽  
Nalini Mishra ◽  
Mamta Sai ◽  
Sanjita Pal
Keyword(s):  
Odds Ratio ◽  
Placenta Previa ◽  
Historical Cohort ◽  
Balloon Tamponade ◽  
Effective Option ◽  
Secondary Objective ◽  
Uterine Balloon Tamponade ◽  
Group 2 ◽  
Psychosocial Morbidity ◽  
Group 1

Background: The objective of this present study was to assess the efficacy of condom uterine balloon tamponade (C-UBT) in averting the obstetric hysterectomy (OH) in cases of major postpartum haemorrhage (PPH) over a period of 10 years.Methods: A retrospective cohort study from January 2010 to December 2019. A historical cohort was drawn from a group of women who had OH for major PPH between Jan 2010 to December 2014 (Group 1) whereas those from January 2015 to December 2019 were designated as Group 2. Total 305 C-UBT were used in the later period. Women who had OH at <28 weeks were excluded from the study. Primary outcome was to determine the efficacy of C-UBT in averting the risk of OH. Secondary objective was to determine the success rate of C-UBT after five years of useResults: Total 37463 births occurred from January 2010 to December 2014 and 38808 during January 2015 to December 2019. Cases of OH were 33 in the first five years period (Group 1) and 20 in the later (Group 2), p=<05, odds ratio=0.58 with 95% CI 0.335-1.019 favoring C-UBT.  After exclusion of rupture uterus and placenta accreta syndrome, OH for uterine atony alone were 22 (66.6%) for Group 1 and 08 (40%) for Group 2, P=0.01 odds ratio=0.350 (95% CI 0.156-0.788). No OH was done in group 2 for placenta previa. Efficacy of C-UBT was 96%.Conclusions: C-UBT is very safe, cheap and effective option for averting OH and associated physical, emotional and psychosocial morbidity.

scholarly journals TBS Predict Coronary Artery Calcification in Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tzyy-Ling Chuang ◽  
Fu-Tsung Hsiao ◽  
Yi-Da Li ◽  
Yuh-Feng Wang
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Odds Ratio ◽  
Multinomial Logistic Regression ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Mineral Density ◽  
Unadjusted Odds Ratio ◽  
Group 2 ◽  
Group 1

Purpose. This study analyzes the association between the bony microarchitecture score (trabecular bone score, TBS) and coronary artery calcification (CAC) in adults undergoing health exams.Materials and Methods. We retrospectively collected subjects (N=81) who underwent coronary computed tomography and bone mineral density studies simultaneously. CAC was categorized to three levels (Group 0, G0, no CAC, score = 0,N=45; Group 1, G1, moderate CAC, score = 1–100,N=17; Group 2, G2, high CAC, score≧101,N=19). Multinomial logistic regression was used to study the association between TBS and CAC levels.Results. CAC is present in 44.4% of the population. Mean TBS ± SD was1.399±0.090. Per 1 SD increase in TBS, the unadjusted odds ratio (2.393) of moderate CAC compared with no CAC was significantly increased (95% CI, 1.219–4.696,p=0.011). However, there has been no association of TBS with high CAC (OR: 1.026, 95% CI: 0.586–1.797,p=0.928). These relationships also existed when individually adjusted for age, sex, and multiple other covariates.Conclusions. Higher TBS was related to moderate CAC, but not high CAC; a possible explanation may be that bone microarchitecture remodeling becomes more active when early coronary artery calcification occurs. However, further researches are needed to clarify this pathophysiology.

scholarly journals The study of cardiotoxicity of hydroxychloroquine and azithromycine combination in hospitalized patients with COVID-19

2020 ◽  
Vol 11 (2) ◽  
pp. 29-39
Author(s):  
Yu. N. Belenkov ◽  
I. V. Menshikova ◽  
I. S. Ilgisonis ◽  
Yu. I. Naimann ◽  
Yu. V. Pak ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Qt Interval ◽  
Ministry Of Health ◽  
Cardiovascular Comorbidity ◽  
Corrected Qt Interval ◽  
Number Of Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Hydroxychloroquine (HCH) is included in guidelines for treatment of novel coronavirus infection (COVID-19). Data on increased risk of cardiovascular complications when using it have been published. Aim. To evaluate the safety and tolerability of HCH and azithromycine (AZM) combination for the treatment of the patients with COVID-19 in recommended by Russian Ministry of Health doses in real practice.Methods. 132 patients (62 men and 70 women of average age 59.2 ± 9.3 years), 59% of whom had cardiovascular comorbidities, were included in prospective сohort study. 112 patients took HCH + AZM (group 1) and 20 patients took other medications without potential cardiotoxicity (group 2). At the admission to the hospital and after 5–7 days of the treatment corrected QT interval was calculated, new rhythm and conduction disorders, other side effects and hospital mortality have been registering. Relative risk (RR) and 95% confidence interval (CI) were calculated. Results. Elongation of corrected QT-interval within the normal range was registered in 22.3% of patients in group 1 and in 15% — in group 2. An increase in the QT length to the upper limit of the norm (480 msec) was observed in 1.8% of patients in group 1. There were no statistically significant differences between the groups in the number of patients with prolonged QT interval (RR = 1.488, 95% CI: 0.496–4.466, р = 0.478). The occurrence of new arrhythmias, conduction disturbances and allergic reactions was not recorded. Tolerability of combination HCH + AZM was satisfactory in the majority of patients. The hospital mortality in group 1 was 1.8%, in group 2 — 5% without statistically significant difference (p = 0.374). Conclusion. A combination of HCL + AZM according to the scheme recommended by the Ministry of Health of the Russian Federation for the treatment of the patients with COVID-19 and cardiovascular comorbidity in inpatient conditions is safe.

scholarly journals Comparison of Olfactory Cleft Width and Volumes in Patients with COVID-19 Anosmia and COVID-19 Cases Without Anosmia

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Deniz Esin Tekcan Sanli ◽  
Aytug Altundag ◽  
Duzgun Yıldırım ◽  
Sedat Giray Kandemirli ◽  
Ahmet Necati Sanli
Keyword(s):  
Negative Correlation ◽  
Test Scores ◽  
Significant Negative Correlation ◽  
Olfactory Dysfunction ◽  
Olfactory Cleft ◽  
Identification Test ◽  
Group 2 ◽  
The Relationship ◽  
Tdi Score ◽  
Group 1

<b><i>Introduction:</i></b> The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia. <b><i>Methods:</i></b> This study consisted of PCR-proven COVID-19 patients. Cases with COVID-19-related anosmia constituted Group 1 and cases without any olfactory dysfunction (OD) throughout COVID-19 infection or after recovery constituted Group 2. A total of 50 patients were included in the study, comprising 24 cases in Group 1 and 26 cases in Group 2. Group 1 patients underwent a 4-item-odor identification test during active symptoms and a Sniffin’ Sticks test after reconversion of PCR results to negative. All patients in Group 2 also underwent the Sniffin’ Stick test to document normosmia. All cases had paranasal sinus CT performed. Olfactory cleft widths and olfactory volumes were measured. The differences in width and volume between groups and the correlation with odor test scores (threshold-discrimination-identification [TDI]) were calculated. In addition, regression analyzes analysis was performed for cleft widths, volumes, and TDI scores according to age. <b><i>Results:</i></b> Olfactory cleft widths and olfactory volumes were significantly higher in Group 1 than those in Group 2 (<i>p</i> = 0.001; <i>p</i> &#x3c; 0.01). There was a significant negative correlation between total TDI scores and olfactory cleft widths and total olfactory volumes (<i>r</i> = −0.665; <i>r</i> = −0.731, respectively). Patients younger than 40 years of age had significantly higher right olfactory cleft width, left olfactory cleft width, and olfactory cleft volume than those in patients older than 40 years of age (<i>p</i> = 0.004, <i>p</i> = 0.005, <i>p</i> = 0.003; <i>p</i> &#x3c; 0,01, respectively). However, patients younger than 40 years of age had a significantly lower total TDI score and in all other values individually (t-d-i) than those in patients older than 40 years of age (<i>p</i> = 0.004; <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> Patients with COVID-19-related OD had larger olfactory cleft width and volumes than those without OD in this study. Total TDI score was found to be inversely correlated with cleft width and volume.

scholarly journals Nocturnal ventricular repolarization lability predicts cardiovascular mortality in the Sleep Heart Health Study

2019 ◽  
Vol 316 (3) ◽  
pp. H495-H505 ◽  
Author(s):  
Martin Schmidt ◽  
Mathias Baumert ◽  
Thomas Penzel ◽  
Hagen Malberg ◽  
Sebastian Zaunseder
Keyword(s):  
Eye Movement ◽  
Qt Interval ◽  
Wave Amplitude ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Sleep Stage ◽  
Ventricular Repolarization ◽  
Health Study ◽  
Sleep Stages ◽  
T Wave

The objective of the present study was to quantify repolarization lability and its association with sex, sleep stage, and cardiovascular mortality. We analyzed polysomnographic recordings of 2,263 participants enrolled in the Sleep Heart Health Study (SHHS-2). Beat-to-beat QT interval variability (QTV) was quantified for consecutive epochs of 5 min according to the dominant sleep stage [wakefulness, nonrapid eye movement stage 2 (NREM2), nonrapid eye movement stage 3 (NREM3), and rapid eye movement (REM)]. To explore the effect of sleep stage and apnea-hypopnea index (AHI) on QT interval parameters, we used a general linear mixed model and mixed ANOVA. The Cox proportional hazards model was used for cardiovascular disease (CVD) death prediction. Sex-related differences in T wave amplitude ( P < 0.001) resulted in artificial QTV differences. Hence, we corrected QTV parameters by T wave amplitude for further analysis. Sleep stages showed a significant effect ( P < 0.001) on QTV. QTV was decreased in deep sleep compared with wakefulness, was higher in REM than in NREM, and showed a distinct relation to AHI in all sleep stages. The T wave amplitude-corrected QTV index (cQTVi) in REM sleep was predictive of CVD death (hazard ratio: 2.067, 95% confidence interval: 1.105–3.867, P < 0.05) in a proportional hazards model. We demonstrated a significant impact of sleep stages on ventricular repolarization variability. Sex differences in QTV are due to differences in T wave amplitude, which should be corrected for. Independent characteristics of QTV measures to sleep stages and AHI showed different behaviors of heart rate variability and QTV expressed as cQTVi. cQTVi during REM sleep predicts CVD death. NEW & NOTEWORTHY We demonstrate here, for the first time, a significant impact of sleep stages on ventricular repolarization variability, quantified as QT interval variability (QTV). We showed that QTV is increased in rapid eye movement sleep, reflective of high sympathetic drive, and predicts death from cardiovascular disease. Sex-related differences in QTV are shown to be owing to differences in T wave amplitude, which should be corrected for.

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