Tp-e interval, Tp-e/QT and Tp-e/QTc ratio in hypertensive patients with primary aldosteronism

Clin Exp Hypertens. 2020;42(1):93-98. doi: 10.1080/10641963.2019.1632341. Epub 2019 Jun 15.

Abstract

Introduction: There is no study evaluating the Tp-e/QT and Tp-e/QTc ratios with T wave peak to end interval (Tp-e interval) used for evaluation of cardiac arrhythmia risk and ventricular repolarization changes in patients with primary aldosteronism (PA). We aimed to investigate whether there was a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with PA.Method: Thirty patients with newly diagnosed hypertension (HT) and PA and 30 patients with primary HT were included. Twelve-lead electrocardiography (ECG) was performed in all patients. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured in addition to routine measurements in ECG.Results: Sodium, potassium, and plasma renin activity (PRA) were significantly lower in patients with PA; systolic and diastolic blood pressure, plasma aldosterone, plasma aldosterone/PRA were significantly higher in patients with PA (p < .05 for each one). When ventricular repolarization parameters were examined; while QT and QTc interval were similar between two groups, Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were significantly higher in patients with PA (p < .05 for each one). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were positively correlated with the serum calcium, aldosterone, and aldosterone/PRA levels and negatively correlated with serum sodium, potassium, renin levels (p < .05 for each one). In linear regression analyses, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were independently associated with the aldosterone/PRA ratio.Conclusion: Tp-e interval, Tp-e/QT and Tp-e/QTc were increased in hypertensive patients with PA and were independently associated with aldosterone/PRA levels. This may be related to the changing neuroendocrine state in patients with PA.

Keywords: Primary aldosteronism; Tp-e interval; Tp-e/QT; Tp-e/QTc ratio; and ventricular repolarization; cardiac arrhythmia.

MeSH terms

  • Adult
  • Aldosterone / blood*
  • Blood Pressure
  • Calcium / blood
  • Cardiac Conduction System Disease
  • Electrocardiography
  • Female
  • Heart Ventricles / physiopathology*
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / physiopathology*
  • Hypertension / complications
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Potassium / blood
  • Renin / blood*
  • Sodium / blood

Substances

  • Aldosterone
  • Sodium
  • Renin
  • Potassium
  • Calcium