Maria Lukács Krogager1, Kristian Kragholm2, Regitze Kuhr Skals3, Rikke Nørmark Mortensen3, Christoffer Polcwiartek2, Claus Graff4, Jonas Bille Nielsen5, Jørgen K Kanters6, Anders Gaarsdal Holst7, Peter Søgaard8, Adrian Pietersen9, Christian Torp-Pedersen10, Steen Møller Hansen3. 1. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. Electronic address: maria.rogager@rn.dk. 2. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark. 3. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark. 4. Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. 5. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, USA. 6. Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark. 7. Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark. 8. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Heart Centre and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark. 9. Department of Cardiology, Nordsjællandshospital Hillerød, 3400 Hillerød, Denmark. 10. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Abstract
AIMS: Potassium disturbances are common and associated with increased morbidity and mortality, even in patients without prior cardiovascular disease. We examined six electrocardiographic (ECG) measures and their association to serum potassium levels. METHODS AND RESULTS: From the Copenhagen General Practitioners' Laboratory, we identified 163,547 individuals aged ≥16 years with a first available ECG and a concomitant serum potassium measurement during 2001-2011. Restricted cubic splines curves showed a non-linear relationship between potassium and the Fridericia corrected QT (QTcF) interval, T-wave amplitude, morphology combination score (MCS), PR interval, P-wave amplitude and duration. Therefore, potassium was stratified in two intervals K: 2.0-4.1 mmol/L and 4.2-6.0 mmol/L for further analyses. Within the low potassium range, we observed: QTcF was 12.8 ms longer for each mmol/L decrease in potassium (p < 0.0001); T-wave amplitude was 43.1 μV lower for each mmol/L decrease in potassium (p < 0.0001); and MCS was 0.13 higher per mmol/L decrease in potassium (p < 0.001). Moreover, P-wave duration and PR interval were prolonged by 2.7 and 4.6 ms for each mmol/L decrease in potassium (p < 0.0001), respectively. Within the lowest potassium range (2.0-4.1 mmol/L) P-wave amplitude was 3.5 μV higher for each mmol/L decrease in potassium (p < 0.0001). Within the high potassium range associations with the above-mentioned ECG parameters were much weaker.
AIMS: Potassium disturbances are common and associated with increased morbidity and mortality, even in patients without prior cardiovascular disease. We examined six electrocardiographic (ECG) measures and their association to serum potassium levels. METHODS AND RESULTS: From the Copenhagen General Practitioners' Laboratory, we identified 163,547 individuals aged ≥16 years with a first available ECG and a concomitant serum potassium measurement during 2001-2011. Restricted cubic splines curves showed a non-linear relationship between potassium and the Fridericia corrected QT (QTcF) interval, T-wave amplitude, morphology combination score (MCS), PR interval, P-wave amplitude and duration. Therefore, potassium was stratified in two intervals K: 2.0-4.1 mmol/L and 4.2-6.0 mmol/L for further analyses. Within the low potassium range, we observed: QTcF was 12.8 ms longer for each mmol/L decrease in potassium (p < 0.0001); T-wave amplitude was 43.1 μV lower for each mmol/L decrease in potassium (p < 0.0001); and MCS was 0.13 higher per mmol/L decrease in potassium (p < 0.001). Moreover, P-wave duration and PR interval were prolonged by 2.7 and 4.6 ms for each mmol/L decrease in potassium (p < 0.0001), respectively. Within the lowest potassium range (2.0-4.1 mmol/L) P-wave amplitude was 3.5 μV higher for each mmol/L decrease in potassium (p < 0.0001). Within the high potassium range associations with the above-mentioned ECG parameters were much weaker.
Authors: Flavio Palmieri; Pedro Gomis; Dina Ferreira; José Esteban Ruiz; Beatriz Bergasa; Alba Martín-Yebra; Hassaan A Bukhari; Esther Pueyo; Juan Pablo Martínez; Julia Ramírez; Pablo Laguna Journal: Sci Rep Date: 2021-02-16 Impact factor: 4.379
Authors: Flavio Palmieri; Pedro Gomis; José Esteban Ruiz; Dina Ferreira; Alba Martín-Yebra; Esther Pueyo; Juan Pablo Martínez; Julia Ramírez; Pablo Laguna Journal: Sensors (Basel) Date: 2021-04-12 Impact factor: 3.576