Giovanni Targher1, Filippo Valbusa2, Stafano Bonapace3, Lorenzo Bertolini4, Luciano Zenari4, Isabella Pichiri5, Alessandro Mantovani5, Giacomo Zoppini5, Enzo Bonora5, Enrico Barbieri3, Christopher D Byrne6. 1. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy. Electronic address: giovanni.targher@univr.it. 2. Division of General Medicine, "Sacro Cuore" Hospital of Negrar, Verona, Italy. 3. Division of Cardiology, "Sacro Cuore" Hospital of Negrar, Verona, Italy. 4. Diabetes Unit, "Sacro Cuore" Hospital of Negrar, Verona, Italy. 5. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy. 6. Nutrition and Metabolism, Faculty of Medicine, University of Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, UK.
Abstract
BACKGROUND AND AIMS: The relationship between nonalcoholic fatty liver disease (NAFLD) and prolonged heart rate-corrected QT (QTc) interval, a risk factor for ventricular arrhythmias and sudden cardiac death, is currently unknown. We therefore examined the relationship between NAFLD and QTc interval in patients with type 2 diabetes. METHODS AND RESULTS: We studied a random sample of 400 outpatients with type 2 diabetes. Computerized electrocardiograms were performed for analysis and quantification of QTc interval. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Mean QTc interval and the proportion of those with increased QTc interval (defined as either QTc interval above the median, i.e. ≥416 ms, or QTc interval >440 ms) increased steadily with the presence and ultrasonographic severity of NAFLD. NAFLD was associated with increased QTc interval (odds ratio [OR] 2.16, 95% CI 1.4-3.4, p < 0.001). Adjustments for age, sex, smoking, alcohol consumption, BMI, hypertension, electrocardiographic left ventricular hypertrophy, diabetes-related variables and comorbid conditions did not attenuate the association between NAFLD and increased QTc interval (adjusted-OR 2.26, 95% CI 1.4-3.7, p < 0.001). Of note, the exclusion of those with established coronary heart disease or peripheral artery disease from analysis did not appreciably weaken this association. CONCLUSION: This is the first study to demonstrate that the presence and severity of NAFLD on ultrasound is strongly associated with increased QTc interval in patients with type 2 diabetes even after adjusting for multiple established risk factors and potential confounders.
BACKGROUND AND AIMS: The relationship between nonalcoholic fatty liver disease (NAFLD) and prolonged heart rate-corrected QT (QTc) interval, a risk factor for ventricular arrhythmias and sudden cardiac death, is currently unknown. We therefore examined the relationship between NAFLD and QTc interval in patients with type 2 diabetes. METHODS AND RESULTS: We studied a random sample of 400 outpatients with type 2 diabetes. Computerized electrocardiograms were performed for analysis and quantification of QTc interval. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Mean QTc interval and the proportion of those with increased QTc interval (defined as either QTc interval above the median, i.e. ≥416 ms, or QTc interval >440 ms) increased steadily with the presence and ultrasonographic severity of NAFLD. NAFLD was associated with increased QTc interval (odds ratio [OR] 2.16, 95% CI 1.4-3.4, p < 0.001). Adjustments for age, sex, smoking, alcohol consumption, BMI, hypertension, electrocardiographic left ventricular hypertrophy, diabetes-related variables and comorbid conditions did not attenuate the association between NAFLD and increased QTc interval (adjusted-OR 2.26, 95% CI 1.4-3.7, p < 0.001). Of note, the exclusion of those with established coronary heart disease or peripheral artery disease from analysis did not appreciably weaken this association. CONCLUSION: This is the first study to demonstrate that the presence and severity of NAFLD on ultrasound is strongly associated with increased QTc interval in patients with type 2 diabetes even after adjusting for multiple established risk factors and potential confounders.
Authors: Kiran Haresh Kumar Patel; Xinyang Li; Xiao Xu; Lin Sun; Maddalena Ardissino; Prakash P Punjabi; Sanjay Purkayastha; Nicholas S Peters; James S Ware; Fu Siong Ng Journal: Front Cardiovasc Med Date: 2022-06-29
Authors: Christoph Mahlke; Diego Hernando; Christina Jahn; Antonio Cigliano; Till Ittermann; Anne Mössler; Marie-Luise Kromrey; Grazyna Domaska; Scott B Reeder; Jens-Peter Kühn Journal: J Magn Reson Imaging Date: 2016-05-19 Impact factor: 4.813