The Importance of Corrected QT Interval for Predicting of Mortality in Patients with Severe Coronavirus Disease 2019

Abstract Background Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning. Methods Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated. Results The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021). Conclusions Patients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.

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The effect of antenatal selective serotonin reuptake inhibitor exposure on the corrected QT interval of neonates

Journal of Perinatology ◽

10.1038/s41372-021-01057-y ◽

2021 ◽

Author(s):

Marie Lindsay-Sutherland

Keyword(s):

Selective Serotonin Reuptake Inhibitor ◽

Reuptake Inhibitor ◽

Serotonin Reuptake ◽

Qt Interval ◽

Selective Serotonin ◽

Serotonin Reuptake Inhibitor ◽

Corrected Qt Interval

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Effect of COVID‐19 medications on corrected QT interval and induction of torsade de pointes: Results of a multicenter national survey

International Journal of Clinical Practice ◽

10.1111/ijcp.14182 ◽

2021 ◽

Author(s):

Majid Haghjoo ◽

Reza Golipra ◽

Jalal Kheirkhah ◽

Allahyar Golabchi ◽

Javad Shahabi ◽

...

Keyword(s):

National Survey ◽

Qt Interval ◽

Torsade De Pointes ◽

Corrected Qt Interval

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Electrocardiographic characteristics and associated outcomes in patients with Takotsubo syndrome. Insights from the RETAKO registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.1816 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

I Martin-Demiguel ◽

I Nunez-Gil ◽

A Perez-Castellanos ◽

O Vedia ◽

A Uribarri ◽

...

Keyword(s):

Heart Rate ◽

Primary Endpoint ◽

Qt Interval ◽

Protective Factor ◽

Independent Predictor ◽

Prognostic Significance ◽

Takotsubo Syndrome ◽

St Segment Elevation ◽

Corrected Qt Interval ◽

St Segment

Abstract Background Our aim was to describe the prevalence and prognostic significance of electrocardiographic features in patients with Takotsubo syndrome (TTS). Methods Our data come from the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO). All patients with complete electrocardiogram were included. Results 246 patients were studied, mean age was 71.3±11.5 and 215 (87.4%) were women. ST-segment elevation was seen in 143 patients (59.1%) and was present in ≥2 wall leads in 97 (39.8%). Exclusive elevation in inferior leads was infrequent (5 - 2.0%). After 48 hours, 198 patients (88.0%) developed negative T-waves in a median of 8 leads with a mean amplitude of 0.7±0.5 mV. Mean corrected QT interval was 520±72 ms and it was independently associated with the primary endpoint of all-cause death and nonfatal cardiovascular events (p=0.002) and all-cause death (p=0.008). A higher heart rate at admission was also an independent predictor of the primary endpoint (p=0.001) and of developing acute pulmonary edema (p=0.04). ST-segment elevation with reciprocal depression was an independent predictor of all-cause death (p=0.04). Absence of ST-segment deviation was a protective factor (p=0.005) for the primary endpoint. Arrhythmias were independently associated with cardiogenic shock (p<0.001). Conclusion Prolonged corrected QT interval, arrhythmia, heart rate at admission and broader repolarization alterations are associated with a poor outcome in TTS. Typical ECG at admission and after 48h. Funding Acknowledgement Type of funding source: None

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The rate-corrected QT interval calculated from 24-hour Holter recordings may serve as a significant arrhythmia risk stratifier in heart failure patients

International Journal of Cardiology ◽

10.1016/j.ijcard.2010.12.076 ◽

2011 ◽

Vol 147 (2) ◽

pp. 321-323 ◽

Cited By ~ 12

Author(s):

Petros Arsenos ◽

Konstantinos A. Gatzoulis ◽

Polychronis Dilaveris ◽

Theodoros Gialernios ◽

Skevos Sideris ◽

...

Keyword(s):

Heart Failure ◽

Qt Interval ◽

Heart Failure Patients ◽

Corrected Qt Interval ◽

Holter Recordings

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Relationship between rate-corrected QT interval and wall motion abnormalities in the setting of acute myocardial infarction

International Journal of Cardiology ◽

10.1016/s0167-5273(97)00112-5 ◽

1997 ◽

Vol 61 (1) ◽

pp. 15-20 ◽

Cited By ~ 4

Author(s):

Dimitar Raev

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Qt Interval ◽

Wall Motion ◽

Corrected Qt Interval ◽

Wall Motion Abnormalities

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Metoprolol and diltiazem ameliorate ziprasidone-induced prolonged corrected QT interval in rats

Toxicology and Industrial Health ◽

10.1177/0748233713487249 ◽

2013 ◽

Vol 31 (12) ◽

pp. 1152-1157 ◽

Cited By ~ 4

Author(s):

Oytun Erbas ◽

Mustafa Yilmaz

Keyword(s):

Qt Interval ◽

Corrected Qt Interval

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Abstract 187: Electrocardiographic Heart Rate-corrected Qt Interval And Risk Of Stroke In The REasons For Geographic And Racial Differences In Stroke (REGARDS) Study

Stroke ◽

10.1161/str.43.suppl_1.a187 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Elsayed Z Soliman ◽

George Howard ◽

Mary Cushman ◽

Brett Kissela ◽

...

Keyword(s):

Heart Rate ◽

Racial Differences ◽

Qt Interval ◽

Proportional Hazards ◽

Left Ventricular ◽

Cox Proportional Hazards ◽

Corrected Qt Interval ◽

Cardiovascular Morbidity And Mortality ◽

Increased Risk ◽

Regards Study

Background: Prolongation of heart rate-corrected QT interval (QTc) is a well established predictor of cardiovascular morbidity and mortality. Little is known, however, about the relationship between this simple electrocardiographic (ECG) marker and risk of stroke. Methods: A total of 27,411 participants aged > 45 years without prior stroke from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study were included in this analysis. QTc was calculated using Framingham formula (QTcFram). Stroke cases were identified and adjudicated during an up to 7 years of follow-up (median 2.7 years). Cox proportional hazards analysis was used to estimate the hazard ratios for incident stroke associated with prolonged QTcFram interval (vs. normal) and per 1 standard deviation (SD) increase, separately, in a series of incremental models. Results: The risk of incident stroke in the study participants with baseline prolonged QTcFram was almost 3 times the risk in those with normal QTcFram [HR (95% CI): 2.88 (2.12, 3.92), p<0.0001]. After adjustment for age, race, sex, antihypertensive medication use, systolic blood pressure, current smoking, diabetes, left ventricular hypertrophy, atrial fibrillation, prior cardiovascular disease, QRS duration, warfarin use, and QT-prolonging drugs (full model), the risk of stroke remained significantly high [HR (95% CI): 1.67 (1.16, 2.41), p=0.0060)], and was consistent across several subgroups of REGARDS participants. When the risk of stroke was estimated per 1 SD increase in QTcFram, a 24% increased risk was observed [HR (95% CI): 1.24 (1.16, 1.33), p<0.0001)]. This risk remained significant in the fully adjusted model [HR (95% CI): 1.12 (1.03, 1.21), p=0.0055]. Similar results were obtained when other QTc correction formulas including Hodge’s, Bazett’s and Fridericia’s were used. Conclusions: QTc prolongation is associated with a significantly increased risk of incident stroke independently from known stroke risk factors. In light of our results, examining the risk of stroke associated with QT-prolonging drugs may be warranted.

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