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. 2018 Nov;18(5):353-360.
doi: 10.14744/AnatolJCardiol.2017.7876. Epub 2017 Oct 13.

Evaluation of Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with mitral valve stenosis before and after balloon valvuloplasty

Muhammet Dural  1 , Kadir Uğur Mert, Kemal İskenderov
Affiliations

Evaluation of Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with mitral valve stenosis before and after balloon valvuloplasty

Muhammet Dural et al. Anatol J Cardiol. 2018 Nov.

Abstract

Objective: Sympathetic activity increases in patients with mitral stenosis (MS). The association between prolonged Tpeak-Tend (Tp-e) interval and increased sympathetic activity has been demonstrated. This study aimed to evaluate Tp-e interval, Tp-e/QT ratio, and Tp-e/corrected QT interval (QTc) ratio in patients with MS before and after balloon valvuloplasty.

Methods: Thirty patients with severe MS and 30 sex-, body mass index-, and and age-matched healthy control subjects were enrolled. The severity of MS was defined following clinical, transthoracic, and transesophageal echocardiographic examinations. All patients underwent successful mitral balloon valvuloplasty. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured using 12-lead electrocardiogram. First, the abovementioned parameters were compared between patients with MS and healthy control subjects. Second, these parameters were compared before and after balloon valvuloplasty in patients with MS.

Results: The mean Tp-e interval was significantly prolonged in patients with MS compared with healthy control subjects (85.02±9.12 ms vs. 75.38±6.04 ms; p<0.001). In addition, Tp-e/QT ratio and Tp-e/QTc ratio were significantly higher in patients with MS than in healthy control subjects (0.217±0.025 vs. 0.196±0.02 and 0.203±0.02 vs. 0.184±0.019; p<0.001).The mean valve area significantly increased after balloon valvuloplasty compared with that before balloon valvuloplasty (1.83±0.32 cm2 vs. 1.18±0.15 cm2; p<0.001). Compared with those before balloon valvuloplasty, Tp-e interval (85.02±9.12 ms vs. 78.06±9.2 ms; p<0.001), Tp-e/QT ratio (0.217±0.02 vs. 0.201±0.02; p<0.001), and Tp-e/QTc ratio (0.203±0.02 vs. 0.184±0.02; p<0.001) decreased after balloon valvuloplasty.

Conclusion: We revealed that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio increased in patients with severe MS. Furthermore, balloon valvuloplasty had a favorable effect on parameters associated with myocardial repolarization.

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Figures

Figure 1
Figure 1
Mean Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly higher in patients with MS than in healthy control subjects. (MS, mitral stenosis; QTc, corrected QT interval; Tp-e, T-peak to T-end)
Figure 2
Figure 2
Mean Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly decreased after PMBV in patients with MS (PMBV, percutaneous mitral balloon valvuloplasty; QTc, corrected QT interval; Tp-e, T-peak to T-end)
Figure 3
Figure 3
Univariate analysis of variance between Tp-e and (a) LAD, (b) BMI, (c) sex, and (d) HT. Only LAD was associated with the Tp-e interval. (BMI, body mass index; HT, hypertension; LAD, left atrial diameter; Tp-e, T-peak to T-end)
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Alper Meranezlioğlu, from EFSAD’s collections
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