The effect of ferric carboxymaltose treatment on the Tp-e interval and the Tp-e/QT and Tp-e/QTc ratios in heart failure patients with iron deficiency

Abstract

Aim In heart failure (HF) patients with iron deficiency, cardiac electrical irregularity is a cause of arrhythmias. The aim of our study was to evaluate the effect of ferric carboxymaltose (FCM) treatment on T wave peak to end (Tp-e) interval and the Tp-e / QT and Tp-e / corrected QT (QTc) ratios that reflect the transmural dispersion of repolarization in HF patients with iron deficiency.Material and methods Forty HF patients with iron deficiency that were treated with FCM were included in our single center, observational study. Repolarization parameters on electrocardiograms recorded before and 12 wks after FCM treatment were compared. Additionally, these parameters were compared with ventricular repolarization parameters of 40 healthy age and gender matched individuals and with another group of 40 HF patients without iron deficiency.Results In the HF patients with iron deficiency, the Tp-e interval and the Tp-e / QT and Tp-e / QTc ratios before FCM treatment were 103.7±19.1 ms, 0.25± 0.04, 0.23±0.04, respectively. These values were higher compared to the healthy the group and HF group without iron deficiency (p<0.001). In the HF patients with iron deficiency, the Tp-e interval and the Tp-e / QT and Tp-e / QTc ratios after FCM treatment were lower compared to pre-treatment and similar to the HF patients without iron deficiency (89.4±18.6 ms, 0.22±0.04, 0.20±0.04, respectively; p<0.001).Conclusion FCM treatment of HF patients with iron deficiency corrects prolonged Tp-e interval and high Tp-e / QT and Tp-e / QTc ratios, which are risk factors for ventricular arrhythmias.

Effect of sacubutril/valsartan on Tp-e, QT, QTc, Tp-e/QTc parameters in heart failure with reduced ejection fraction

“…When SGLT2 inhibitors were added to HF treatment, the ventricular repolarization markers QT, QTc, QTd, Tp-e, and Tpe/QTc were observed to improve positively in the first month 18 . In another study, an improvement in the Tp-e interval and Tp-e / QT and Tp-e / QTc ratios was observed in the third month with intravenous iron treatment in HF patients with iron deficiency 24 . While QTc, Tp-e, and Tp-e/QTc had positive effects, a decrease in NT-proBNP and improvement in symptoms were detected in patients who were switched from ramipril to ARNI, in the first month 23 .…”