Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals

doi:10.1016/j.jelectrocard.2014.03.002

. 2014 May-Jun;47(3):356-61.

doi: 10.1016/j.jelectrocard.2014.03.002. Epub 2014 Mar 6.

Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals

Kapuaola S Gellert¹, Pentti Rautaharju², Michelle L Snyder³, Eric A Whitsel⁴, Kunihiro Matsushita⁵, Gerardo Heiss³, Elsayed Z Soliman⁶

Affiliations

¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: kapuaola@email.unc.edu.
² Department of Public Health Sciences, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston Salem, NC.
³ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁴ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
⁶ Department of Public Health Sciences, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston Salem, NC; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC.

PMID: 24792986
PMCID: PMC4025961
DOI: 10.1016/j.jelectrocard.2014.03.002

Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals

Kapuaola S Gellert et al. J Electrocardiol. 2014 May-Jun.

. 2014 May-Jun;47(3):356-61.

doi: 10.1016/j.jelectrocard.2014.03.002. Epub 2014 Mar 6.

Authors

Kapuaola S Gellert¹, Pentti Rautaharju², Michelle L Snyder³, Eric A Whitsel⁴, Kunihiro Matsushita⁵, Gerardo Heiss³, Elsayed Z Soliman⁶

Affiliations

¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: kapuaola@email.unc.edu.
² Department of Public Health Sciences, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston Salem, NC.
³ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁴ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
⁶ Department of Public Health Sciences, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston Salem, NC; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC.

PMID: 24792986
PMCID: PMC4025961
DOI: 10.1016/j.jelectrocard.2014.03.002

Abstract

Background: The electrocardiographic (ECG) Tpeak-Tend interval (TpTe) is associated with arrhythmias and sudden cardiac death. TpTe offers a supplementary measure for the QT interval (QT), yet its repeatability has not been established.

Purpose: Evaluate short-term repeatability of TpTe and QT.

Methods: Four ECGs were obtained on sixty participants. The sources of variation, intra-class correlation coefficient (ICC) - an index of reproducibility - and minimal detectable change (MDC) were estimated for TpTe and QT. The impact of repeated measurements on repeatability was estimated for a hypothetical clinical trial designed to detect drug-induced prolongation of TpTe and QT.

Results: We used heart rate-adjusted QT [(QT)a] but TpTe in the study group was rate-invariant. The ICC [95% confidence interval (CI)] was 0.77 (0.69, 0.85) for TpTe, 0.75 (0.65, 0.85) for QT and 0.60 (0.47, 0.73) for (QT)a. The MDC (ms) was 21, 32 and 26 for TpTe, QT and (QT)a respectively.

Conclusion: TpTe has excellent repeatability supporting its use as a supplement to QT in observational and clinical studies.

Keywords: Electrocardiogram; QT; Repeat variation T; TpTe interval.

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References

1. Zhang Y, Post WS, Blasco-Colmenares E, et al. Electrocardiographic QT interval and mortality: a meta-analysis. Epidemiology. 2011;22(5):660–70. doi: 10.1097/EDE.0b013e318225768b. - DOI - PMC - PubMed
1. Kanters JK, Haarmark C, Vedel-Larsen E, et al. T(peak)T(end) interval in long QT syndrome. J Electrocardiol. 2008;41(6):603–8. doi: 10.1016/j.jelectrocard.2008.07.024. - DOI - PubMed
1. Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4(4):441–7. doi: 10.1161/CIRCEP.110.960658. - DOI - PMC - PubMed
1. Castro Hevia J, Antzelevitch C, Tornes Barzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828–34. doi: 10.1016/j.jacc.2005.12.049. - DOI - PMC - PubMed
1. Antzelevitch C. T peak-Tend interval as an index of transmural dispersion of repolarization. Eur J Clin Invest. 2001;31(7):555–7. - PubMed

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[1] Zhang Y, Post WS, Blasco-Colmenares E, et al. Electrocardiographic QT interval and mortality: a meta-analysis. Epidemiology. 2011;22(5):660–70. doi: 10.1097/EDE.0b013e318225768b. - DOI - PMC - PubMed

[2] Zhang Y, Post WS, Blasco-Colmenares E, et al. Electrocardiographic QT interval and mortality: a meta-analysis. Epidemiology. 2011;22(5):660–70. doi: 10.1097/EDE.0b013e318225768b. - DOI - PMC - PubMed

[3] Kanters JK, Haarmark C, Vedel-Larsen E, et al. T(peak)T(end) interval in long QT syndrome. J Electrocardiol. 2008;41(6):603–8. doi: 10.1016/j.jelectrocard.2008.07.024. - DOI - PubMed

[4] Kanters JK, Haarmark C, Vedel-Larsen E, et al. T(peak)T(end) interval in long QT syndrome. J Electrocardiol. 2008;41(6):603–8. doi: 10.1016/j.jelectrocard.2008.07.024. - DOI - PubMed

[5] Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4(4):441–7. doi: 10.1161/CIRCEP.110.960658. - DOI - PMC - PubMed

[6] Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4(4):441–7. doi: 10.1161/CIRCEP.110.960658. - DOI - PMC - PubMed

[7] Castro Hevia J, Antzelevitch C, Tornes Barzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828–34. doi: 10.1016/j.jacc.2005.12.049. - DOI - PMC - PubMed

[8] Castro Hevia J, Antzelevitch C, Tornes Barzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828–34. doi: 10.1016/j.jacc.2005.12.049. - DOI - PMC - PubMed

[9] Antzelevitch C. T peak-Tend interval as an index of transmural dispersion of repolarization. Eur J Clin Invest. 2001;31(7):555–7. - PubMed

[10] Antzelevitch C. T peak-Tend interval as an index of transmural dispersion of repolarization. Eur J Clin Invest. 2001;31(7):555–7. - PubMed

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Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals

Affiliations

Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals

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Affiliations

Abstract

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