Novel indexes of arrhythmogenesis in preeclampsia: QT dispersion, Tp-e interval, and Tp-e/QT ratio

Kırbaş, Ayşe; Kırbaş, Özgür; Dağlar, Korkut; İnal, Hasan Ali; Kurmuş, Özge; Kara, Özgür; Tımur, Hakan; Gencosmanoglu, Gulenay; Danışman, Nuri

doi:10.1016/j.preghy.2016.01.002

Cited by 16 publications

(21 citation statements)

References 27 publications

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“…In a study evaluating the risk of cardiac arrhythmia in a preeclampsia (PE) group, the maximum QT, QTc dispersion, Tp-e interval, and Tp-e/QTc ratio values were found to be significantly higher in the PE group than in the healthy pregnant group. 13 Another study examining the changes in atrial and ventricular repolarization markers during pregnancy found that P dispersion, maximum QTc interval, Tp-e interval and Tp-e/QT ratio were increased in late pregnancy, but still remained within the normal range. 14 Recently, Braschi et al demonstrated the increase in ventricular repolarization markers with increased age.…”

Section: Discussionmentioning

confidence: 99%

Assessment of increased risk of arrhythmia in advanced age pregnancies

Aslan¹,

Atıcı

2018

Pak J Med Sci

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Background and Objective:Cardiovascular deaths usually occur in older pregnancies and arrhythmia is the third most common cause. Our study aimed to determine whether the risk of arrhythmia increases in pregnancy with advanced age.Methods:In total, 280 pregnant women, of whom 98 were of advanced age and 182 were under 35 years of age were included in the study. The risk of arrhythmia was evaluated by calculating the electrocardiographic P-wave duration, QT interval, T peak-to-end interval, and the Tp-e/QT ratio.Results:Although there were no differences in the Tp-e interval and Tp-e/QTc ratio between the groups, the maximum QTc, minimum QTc, and QTc dispersion values were significantly higher in advanced-age pregnancies compared to the control group. In addition, the P dispersion was greater in advanced-age pregnancies. In correlation analysis, the increased dispersion of QTc and P were positively correlated with maternal age. Multiple linear regression analysis showed that QTc dispersion was independently associated with maternal age.Conclusion:Repolarization parameters increase in advanced-age pregnancies even though they remain in the normal range, which should lead to an investigation of whether this is a pathological condition.

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Section: Discussionmentioning

confidence: 99%

Assessment of increased risk of arrhythmia in advanced age pregnancies

Aslan¹,

Atıcı

2018

Pak J Med Sci

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“…, ; Kirbas et al . ). Invasive assessment of cardiovascular function in pregnancy is both impractical and inadvisable other than in exceptional clinical circumstances and scenarios.…”

Section: Cardiovascular and Renal Characteristics Of Preeclampsiamentioning

confidence: 97%

“…Electrocardiography studies in the latent and clinical phases of preeclampsia showed evidence of P-wave dispersion and delayed left atrial electromechanical coupling (Inci et al 2015), together with a prolonged QT-interval indicative of abnormal ventricular repolarisation (Raffaelli et al 2014). These ECG abnormalities also precede the onset of clinical symptoms of preeclampsia (Baumert et al 2010;Angeli et al 2011Angeli et al , 2015Kirbas et al 2016). Invasive assessment of cardiovascular function in pregnancy is both impractical and inadvisable other than in exceptional clinical circumstances and scenarios.…”

Section: Cardiovascular Function In Preeclampsiamentioning

confidence: 99%

Preeclampsia: a gestational cardiorenal syndrome

Gyselaers

Thilaganathan

2019

The Journal of Physiology

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It is generally accepted today that there are two different types of preeclampsia: an early‐onset or placental type and a late‐onset or maternal type. In the latent phase, the first one presents with a low output/high resistance circulation eventually leading in the late second or early third trimester to an intense and acutely aggravating systemic disorder with an important impact on maternal and neonatal mortality and morbidity; the other type presents initially as a high volume/low resistance circulation, gradually evolving to a state of circulatory decompensation usually in the later stages of pregnancy, with a less severe impact on maternal and neonatal outcome. For both processes, numerous dysfunctions of the heart, kidneys, arteries, veins and interconnecting systems are reported, most of them presenting earlier and more severely in early‐ than in late‐onset preeclampsia; however, some very specific dysfunctions exist for either type. Experimental, clinical and epidemiological observations before, during and after pregnancy are consistent with gestation‐induced worsening of subclinical pre‐existing chronic cardiovascular dysfunction in early‐onset preeclampsia, and thus sharing the pathophysiology of cardiorenal syndrome type II, and with acute volume overload decompensation of the maternal circulation in late‐onset preeclampsia, thus sharing the pathophysiology of cardiorenal syndrome type 1. Cardiorenal syndrome type V is consistent with the process of preeclampsia superimposed upon clinical cardiovascular and/or renal disease, alone or as part of a systemic disorder. This review focuses on the specific differences in haemodynamic dysfunctions between the two types of preeclampsia, with special emphasis on the interorgan interactions between heart and kidneys, introducing the theoretical concept that the pathophysiological processes of preeclampsia can be regarded as the gestational manifestations of cardiorenal syndromes.

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“…QT dispersion is the difference between QT maximum and QT minimum (in milliseconds) (45) Abnormal QT dispersion (QTd) QTd greater than the total of the mean QTd plus two standard deviations of the normotensive group (46) QTc maximum, minimum, dispersion, duration Similar to P wave above. QTc = QT interval corrected for heart rate using Bazett's formula: QT/ √ RR interval (11) Only Kirbas et al (12) uses Hodges formula instead to correct for heart rate: [QTc = QT + 1.75 (heart rate -60)]…”

Section: Comparing Ecg Wave Morphologymentioning

confidence: 99%

Assessment of Hypertension Using Clinical Electrocardiogram Features: A First-Ever Review

et al. 2020

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Hypertension affects an estimated 1.4 billion people and is a major cause of morbidity and mortality worldwide. Early diagnosis and intervention can potentially decrease cardiovascular events later in life. However, blood pressure (BP) measurements take time and require training for health care professionals. The measurements are also inconvenient for patients to access, numerous daily variables affect BP values, and only a few BP readings can be collected per session. This leads to an unmet need for an accurate, 24-h continuous, and portable BP measurement system. Electrocardiograms (ECGs) have been considered as an alternative way to measure BP and may meet this need. This review summarizes the literature published from January 1, 2010, to January 1, 2020, on the use of only ECG wave morphology to monitor BP or identify hypertension. From 35 articles analyzed (9 of those with no listed comorbidities and confounders), the P wave, QTc intervals and TpTe intervals may be promising for this purpose. Unfortunately, with the limited number of articles and the variety of participant populations, we are unable to make conclusions about the effectiveness of ECG-only BP monitoring. We provide 13 recommendations for future ECG-only BP monitoring studies and highlight the limited findings in pregnant and pediatric populations. With the advent of convenient and portable ECG signal recording in smart devices and wearables such as watches, understanding how to apply ECG-only findings to identify hypertension early is crucial to improving health outcomes worldwide.

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Novel indexes of arrhythmogenesis in preeclampsia: QT dispersion, Tp-e interval, and Tp-e/QT ratio

Cited by 16 publications

References 27 publications

Assessment of increased risk of arrhythmia in advanced age pregnancies

Assessment of increased risk of arrhythmia in advanced age pregnancies

Preeclampsia: a gestational cardiorenal syndrome

Assessment of Hypertension Using Clinical Electrocardiogram Features: A First-Ever Review

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