Prolonged QT dispersion in inflammatory bowel disease
Elif Yorulmaz1, Aslıhan Sezgin, Hatice Yorulmaz
1Department of Gastroenterology, Goztepe Training and Research Hospital, 34470 Istanbul, Turkey.
Insights
Inflammatory bowel disease (IBD) patients exhibit prolonged QT dispersion, a potential risk factor for arrhythmias. Routine monitoring should include insulin resistance assessment and electrocardiograms for early detection.
Area of Science:
- Cardiology
- Gastroenterology
- Metabolic Syndrome
Background:
- Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is associated with various extraintestinal manifestations.
- Cardiac involvement in IBD is increasingly recognized, necessitating investigation into potential risk factors for arrhythmias.
Purpose of the Study:
- To determine the prevalence of prolonged corrected QT dispersion (QTcd) in patients with IBD.
- To identify factors associated with prolonged QTcd in IBD patients, particularly insulin resistance (IR).
Main Methods:
- Electrocardiography was used to measure QTcd in 63 UC patients, 41 CD patients, and 47 healthy controls.
- Homeostasis model assessment (HOMA) was employed to assess insulin resistance (IR), with HOMA > 2.5 indicating high IR.
- Statistical analyses were performed to compare QTcd, insulin, HOMA, blood pressure, and age between IBD subgroups and controls.
Main Results:
- Prolonged QTcd was observed in 12.2% of UC patients and 14.5% of CD patients, significantly higher than in controls (P < 0.05).
- IBD patients with prolonged QTcd showed significantly higher insulin and HOMA values, indicating increased insulin resistance (P < 0.05).
- Increased systolic arterial pressure and older age were significantly associated with prolonged QTcd in UC patients (P < 0.01 and P < 0.05, respectively).
Conclusions:
- Patients with IBD demonstrate a higher frequency of prolonged QTcd compared to healthy individuals.
- Insulin resistance, assessed by HOMA and insulin levels, is a significant factor associated with prolonged QTcd in IBD.
- Routine cardiovascular monitoring, including ECG and IR assessment, is recommended for IBD patients to mitigate arrhythmia risk.
Aim:
To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease (IBD).
Methods:
This study included 63 ulcerative colitis (UC) and 41 Crohn's disease (CD) patients. Forty-seven healthy patients were included as the control group. Heart rate was calculated using electrocardiography, corrected QT dispersion (QTcd) and the Bazett's formula. Homeostasis model assessment (HOMA) was used to determine insulin resistance (IR). HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.
Results:
Prolonged QTcd was found in 12.2% of UC patients, and in 14.5% of CD patients compared with the control group (P < 0.05). A significant difference was found between the insulin values (CD: 10.95 ± 6.10 vs 6.44 ± 3.28, P < 0.05; UC: 10.88 ± 7.19 vs 7.20 ± 4.54, P < 0.05) and HOMA (CD: 2.56 ± 1.43 vs 1.42 ± 0.75, P < 0.05; UC: 2.94 ± 1.88 vs 1.90 ± 1.09, P < 0.05) in UC and CD patients with and without prolonged QTcd. Disease behavior types were determined in CD patients with prolonged QTcd. Increased systolic arterial pressure (125 ± 13.81 vs 114.09 ± 8.73, P < 0.01) and age (48.67 ± 13.93 vs 39.57 ± 11.58, P < 0.05) in UC patients were significantly associated with prolonged QTcd.
Conclusion:
Our data show that IBD patients have prolonged QTcd in relation to controls. The routine follow-up of IBD patients should include determination of HOMA, insulin values and electrocardiogram examination.
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