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. 2020 May;25(3):e12691.
doi: 10.1111/anec.12691. Epub 2019 Sep 11.

The relationship between systolic pulmonary arterial pressure and Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in patients with newly diagnosed chronic obstructive pulmonary disease

Ayhan Cosgun  1 , Huseyin Oren  2 , Mustafa Hamidullah Turkkani  3
Affiliations

The relationship between systolic pulmonary arterial pressure and Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in patients with newly diagnosed chronic obstructive pulmonary disease

Ayhan Cosgun et al. Ann Noninvasive Electrocardiol. 2020 May.

Abstract

Introduction: The risk of sudden cardiac death (SCD) and arrhythmias has been shown to be common in chronic obstructive pulmonary disease (COPD) subjects. We aimed to evaluate the markers of arrhythmia such as QT, QTc (corrected QT), Tp-e, and cTp-e (corrected Tp-e) intervals, Tp-e/QT ratio, and Tp-e/QTc ratio in newly diagnosed COPD subjects in both right and left precordial leads.

Materials and methods: The study group consisted of 74 subjects with obstructive respiratory function tests (RFTs). The control group consisted of 78 subjects who had nonobstructive RFTs. RFTs, electrocardiograms (ECG), and transthoracic echocardiograms (TTE) were performed, and QTR (QT interval in right precordial leads), QTL (QT interval in left precordial leads), Tp-eR (Tp-e interval in right precordial leads), and Tp-eL (Tp-e interval in left precordial leads) intervals; systolic pulmonary arterial pressure (sPAP); forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC); and peripheral oxygen saturation(POS) values were measured.

Results: Tp-eR interval 85.82 ± 5.34 millisecond (ms) versus 62.87 ± 3.55 ms (t = 31.29/p < .00001), cTp-eR interval 97.51 ± 7.18 ms versus 71.07 ± 4.58 ms (t = 27.20/p < .00001), Tp-eR/QTR ratio 0.234 ± 0.02 versus 0.164 ± 0.01 (t = 2.2/p = .014), and Tp-eR/QTcR ratio 0.201 ± 0.01 versus 0.141 ± 0.01 (t = 1.92/p = .028) were statistically significantly higher in COPD subjects. There was a strong negative correlation between RFT and sPAP (sPAP, 29.93 ± 5.1 mm Hg; and FEV1 /FVC, 63.78 ± 3.33%, r = -.85/p < .00001). There was a moderate positive correlation between sPAP and Tp-eR.

Conclusion: We found Tp-e and cTp-e intervals, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly higher in the COPD patients than in the control group. In addition, in the COPD group, heart rate variability (HRV) parameters were significantly lower on ECG.

Keywords: Tp-e interval; Tp-e/QT ratio; Tp-e/QTc ratio; chronic obstructive pulmonary disease; respiratory function test; systolic pulmonary arterial pressure.

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Conflict of interest statement

The authors declare that they have no conflict of interest. There is no source(s) of support in the form of grants, equipment, and drugs. All expenses are paid by the authors. The authors state that the manuscript has been read and approved by all the authors, that the requirements for authorship as stated earlier in this document have been met, and that each author believes that the manuscript represents honest work.

Figures

Figure 1
Figure 1
The linear regression graphic of sPAP and the values of Tp‐eR interval of the study group. sPAP, systolic pulmonary arterial pressure. R = .7469 and p < .00001
Figure 2
Figure 2
The linear regression graphic of sPAP and RFT of the study group. sPAP, systolic pulmonary arterial pressure. RFT, respiratory function test. r = −.8546, p < .00001
Figure 3
Figure 3
The linear regression graphic of Tp‐eR interval and RFT of the study group. RFT, respiratory function test; Tp‐e, T peak‐end interval R = −.6208, p < .00001
See this image and copyright information in PMC

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