Hilary F Armstrong1, Gina S Lovasi2, Elsayed Z Soliman3, Susan R Heckbert4, Bruce M Psaty5, John H M Austin6, Jerry A Krishnan7, Eric A Hoffman8, Craig Johnson9, Matthew J Budoff10, Karol E Watson11, R Graham Barr12. 1. Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States. Electronic address: Hfa2104@columbia.edu. 2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States. 3. Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Department of Internal Medicine-Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, United States. 4. Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, United States. 5. Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, United States; Group Health Research Institute, Group Health Cooperative, Seattle, WA, United States. 6. Department of Radiology, Columbia University Medical Center, New York, NY, United States. 7. Breathe Chicago Center, University of Illinois at Chicago, Chicago, IL, United States. 8. Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, United States. 9. Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, United States. 10. Los Angeles Biomedical Research Institute, Torrance, CA, United States. 11. UCLA School of Medicine, Los Angeles, CA, United States. 12. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
Abstract
BACKGROUND: The QT interval on electrocardiogram (ECG) reflects ventricular repolarization; a prolonged QT interval is associated with increased mortality risk. Prior studies suggest an association between chronic obstructive pulmonary disease (COPD) and prolonged QT interval. However, these studies were small and often enrolled hospital-based samples. We tested the hypotheses that lower lung function and increased percent emphysema on computed tomography (CT) are associated with a prolonged QT interval in a general population sample and additionally in those with COPD. METHODS: As part of the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, we assessed spirometry, full-lung CT scans, and ECGs in participants aged 45-84 years. The QT on ECGs was corrected for heart rate (QTc) using the Framingham formula. QTc values = 460 msec in women and ≥450 msec in men were considered abnormal (prolonged QTC). Multivariate regression models were used to examine the cross-sectional association between pulmonary measures and QTC. RESULTS: The mean age of the sample of 2585 participants was 69 years, and 47% were men. There was an inverse association between FEV1%, FVC%, FEV1/FVC%, emphysema, QTc duration and prolonged QTc. Gender was a significant interaction term, even among never smokers. Having severe COPD was also associated with QTc prolongation. CONCLUSIONS: Our analysis revealed a significant association between lower lung function and longer QTc in men but not in women in a population-based sample. Our findings suggest the possibility of gender differences in the risk of QTc-associated arrhythmias in a population-based sample.
BACKGROUND: The QT interval on electrocardiogram (ECG) reflects ventricular repolarization; a prolonged QT interval is associated with increased mortality risk. Prior studies suggest an association between chronic obstructive pulmonary disease (COPD) and prolonged QT interval. However, these studies were small and often enrolled hospital-based samples. We tested the hypotheses that lower lung function and increased percent emphysema on computed tomography (CT) are associated with a prolonged QT interval in a general population sample and additionally in those with COPD. METHODS: As part of the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, we assessed spirometry, full-lung CT scans, and ECGs in participants aged 45-84 years. The QT on ECGs was corrected for heart rate (QTc) using the Framingham formula. QTc values = 460 msec in women and ≥450 msec in men were considered abnormal (prolonged QTC). Multivariate regression models were used to examine the cross-sectional association between pulmonary measures and QTC. RESULTS: The mean age of the sample of 2585 participants was 69 years, and 47% were men. There was an inverse association between FEV1%, FVC%, FEV1/FVC%, emphysema, QTc duration and prolonged QTc. Gender was a significant interaction term, even among never smokers. Having severe COPD was also associated with QTc prolongation. CONCLUSIONS: Our analysis revealed a significant association between lower lung function and longer QTc in men but not in women in a population-based sample. Our findings suggest the possibility of gender differences in the risk of QTc-associated arrhythmias in a population-based sample.
Authors: Suellen M Curkendall; Stephan Lanes; Cynthia de Luise; Mary Rose Stang; Judith K Jones; Dewei She; Earl Goehring Journal: Eur J Epidemiol Date: 2006-11-15 Impact factor: 8.082
Authors: Stephen Sidney; Michael Sorel; Charles P Quesenberry; Cynthia DeLuise; Stephan Lanes; Mark D Eisner Journal: Chest Date: 2005-10 Impact factor: 9.410
Authors: R Graham Barr; David A Bluemke; Firas S Ahmed; J Jeffery Carr; Paul L Enright; Eric A Hoffman; Rui Jiang; Steven M Kawut; Richard A Kronmal; João A C Lima; Eyal Shahar; Lewis J Smith; Karol E Watson Journal: N Engl J Med Date: 2010-01-21 Impact factor: 91.245
Authors: Sara Giunti; Gabriella Gruden; Paolo Fornengo; Federica Barutta; Cristina Amione; Giuseppe Ghezzo; Paolo Cavallo-Perin; Graziella Bruno Journal: Diabetes Care Date: 2012-02-01 Impact factor: 19.112