Evaluation of the Tp−Te Interval, Tp-e/QTc ratio and QT Dispersion in Patients with Turner Syndrome

Abstract

Objective:To evaluate ventricular repolarization parameters using the interval from the peak to the end of the T wave (Tp–Te), together with QT and corrected QT (QTc) intervals, QT dispersion (QTd), and Tp-Te/QTc ratio in patients with Turner syndrome (pwTS) and to compare the results with those from healthy controls.Methods:In total, 38 patients previously diagnosed with Turner syndrome (TS) and 35 healthy girls (controls) were included in our cross-sectional study. Twelve-lead electrocardiography (ECG) and echocardiography after a 30-min rest were performed. The QT, QTc, QTd, Tp-Te interval, and Tp-Te/QTc ratio were determined.Results:No differences in age or sex were observed between the groups. QT intervals were similar in both groups [pwTS: 354.76±25.33 ms, controls (C): 353.29±17.51 ms, p=0.775]. pwTS had significantly longer QTc and QTd than controls (411.87±22.66 ms vs. 392.06±13.21 ms, p<0.001 and 40.31±2.02 ms vs. 37.54±1.83 ms, p<0.001, respectively). Similarly, the Tp-Te interval and Tp-Te/QTc ratio were significantly longer in pwTS than in controls (71.89±3.39 ms vs. 65.34±2.88 ms, p<0.001 and 0.17±0.01 vs. 0.16±0.01, p=0.01).Conclusion:As pwTS have longer QTc, QTd, Tp–Te interval, and Tp-Te/QTc ratio, an annual follow-up with ECG can provide awareness and even prevent sudden death in them. Also avoiding the use of drugs that makes repolarization anomaly and having knowledge about the side effects of these drugs are essential in pwTS.

Sexual Dimorphisms, Anti-Hormonal Therapy and Cardiac Arrhythmias

“…Several studies have analyzed the QTc interval in patients with TS and POI, though with many limitations [ 59 , 60 ]. These studies were from a small number of patients with only limited data on HRT and most without hormonal evaluation.…”

“…Moreover, QTc was frequently calculated with Bazett’s formula that does not take into account the higher heart rate in TS as with the use of Hodge’s formula, which is the preferred QTc correction in these patients [ 56 ]. In a recent cross-sectional study, Atici et al demonstrated that 38 patients with TS had significantly longer QTc than 35 controls (respectively, QTc 411.9 ± 22.7 vs. 392.1 ± 13.2 ms, p < 0.001), with the major limitation being the lack of data on karyotype or hormonal treatment [ 60 ]. This lengthening of the QTc interval had already been highlighted by Bondy et al as early as 2006 [ 61 ].…”

Features of electrocardiographic changes in non-coronarogenic syndromes in patients with COVID-19

“…В первую очередь, это показатели реполяризации желудочков: удлинение интервала QT, который зависит от вариабельности реполяризации желудочков и, возможно, дисперсия интервала QT (QTd). Показано, что увеличения значений QT и QTd ассоциированы с повышенным риском аритмической смерти [43]. Также довольно ценным в аспекте прогнозирования внезапной сердечной смерти является определение показателя микровольтной альтернации зубца Т [44,45].…”

Cardiac abnormalities in girls with Turner syndrome: ECG abnormalities, myocardial strain imaging, and karyotype–phenotype associations

“…Besides cardiovascular malformations, electrocardiogram (ECG) abnormalities, mainly QTc prolongation, have been reported (Atici et al, 2018 ; Bondy, Ceniceros, et al, 2006 ; Bondy, Van, et al, 2006 ; Dalla Pozza et al, 2006 ; Dalla Pozza et al, 2009 ; Sozen et al, 2008 ; Trolle et al, 2013 ). We recently found no increased prevalence of QTc prolongation using Hodges formula in a large cohort of girls ( n = 101) and women ( n = 251) with TS, as was confirmed by Harrahill et al in 112 women with TS (Harrahill et al, 2020 ; Noordman et al, 2020 ).…”