Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population

Zhi-Dan Li; Xiao-Juan Bai; Lu-Lu Han; Wen Han; Xue-Feng Sun; Xiang-Mei Chen

doi:10.12998/wjcc.v7.i8.940

Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population

World J Clin Cases. 2019 Apr 26;7(8):940-950. doi: 10.12998/wjcc.v7.i8.940.

Authors

Zhi-Dan Li¹, Xiao-Juan Bai², Lu-Lu Han¹, Wen Han¹, Xue-Feng Sun³, Xiang-Mei Chen³

Affiliations

¹ Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
² Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China. xiaojuan_bai@126.com.
³ Department of Kidney, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.

Abstract

Background: Diastolic electromechanical couple, a well-described phenomenon in symptomatic heart failure, has not been well studied in healthy people. We hypothesized that ventricular repolarization variables, such as the QT interval, Tpeak-to-Tend (Tpe) interval and Tpe/QT ratio, are associated with cardiac diastolic function in the healthy Chinese population.

Aim: To assess the relationship between ventricular repolarization variables and cardiac diastolic function in apparently healthy Chinese individuals.

Methods: This was a community-based cross-sectional study conducted in Shenyang, China. A total of 414 healthy subjects aged 35-91 years were enrolled. All subjects underwent standard 12-lead electrocardiography (ECG) and comprehensive echocardiography. ECG enabled the measurement of QT and Tpe intervals and Tpe/QT ratio. echocardiographic parameters, such as the ratio of mitral early diastolic inflow velocity (E) and late diastolic inflow velocity (A), E-wave deceleration time, left atrial volume (LAV) and LAV index, were measured to assess diastolic function. E/A < 0.75 was considered to indicate reduced diastolic function. ECG and echocardiography results were analyzed separately and in a blinded fashion. Correlation and regression analyses were applied to determine associations.

Results: Ventricular repolarization variables, such as the QTc interval (393.59 ± 26.74 vs 403.86 ± 33.56; P < 0.001), Tpe interval (72.68 ± 12.41 vs 77.26 ± 17.86; P < 0.01), Tpe_c interval (76.36 ± 13.53 vs 83.32 ± 21.25; P < 0.001) and Tpe/QT ratio (0.19 ± 0.03 vs 0.20 ± 0.04; P < 0.01), were significantly different between the normal diastolic function group and the reduced diastolic function group. Significant associations were found between repolarization variables and diastolic function. After adjusting for all other possible confounders, the QTc and Tpe_c intervals were significantly associated with the E/A ratio (P = 0.008; P = 0.010). In men, the QTc interval was associated with abnormal diastolic function, and compared to the third QTc tertile, in the second QTc tertile, the odds ratio was 0.257 (95%CI: 0.102-0.649; P = 0.004).

Conclusion: Repolarization variables are associated with cardiac diastolic function even in healthy people. Moderate levels of the QTc interval exert a protective effect on diastolic dysfunction in men.

Keywords: Diastolic dysfunction; Electrocardiography; QT interval; Tpeak-to-Tend interval; Ventricular repolarization.