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Evaluation of Tp-e interval and Tp-e/QT ratio in patients with chronic hepatitis B
1Department of Infectious Disease, Şevket Yılmaz Education and Research Hospital, Bursa, Turkey.
Insights
Chronic hepatitis B (CHB) patients show increased ventricular repolarization abnormalities, indicated by elevated Tp-e interval and Tp-e/QT ratio. These findings suggest a potential link between CHB, inflammation, and cardiac arrhythmia risk.
Area of Science:
- Cardiology
- Hepatology
- Electrophysiology
Background:
- Chronic hepatitis B (CHB) is a viral inflammatory liver disease.
- Altered ventricular repolarization and impaired autonomic function are noted in CHB.
- The Tp-e interval and Tp-e/QT ratio may reflect transmural dispersion of repolarization and arrhythmia risk.
Purpose of the Study:
- To evaluate ventricular repolarization using Tp-e interval and Tp-e/QT ratio in CHB patients.
- To assess the relationship between these repolarization parameters and inflammation in CHB.
- To compare cardiac repolarization metrics between CHB patients and healthy controls.
Main Methods:
- Fifty-five CHB patients and 50 controls were enrolled.
- 12-lead electrocardiograms were used to measure Tp-e interval, corrected Tp-e (cTp-e), Tp-e/QT ratio, QT dispersion (QTd), and corrected QTd.
- Statistical analysis compared these parameters between the CHB group and the control group.
Main Results:
- CHB patients exhibited significantly increased QTd and corrected QTd compared to controls.
- The cTp-e interval and Tp-e/QT ratio were significantly higher in CHB patients.
- These findings indicate prolonged ventricular repolarization and increased dispersion in CHB patients.
Conclusions:
- Ventricular repolarization is impaired in patients with chronic hepatitis B.
- Elevated Tp-e interval and Tp-e/QT ratio in CHB patients suggest increased risk for ventricular arrhythmias.
- Further research is warranted to explore the link between CHB, inflammation, and cardiac electrophysiological changes.
Abstract:
Chronic hepatitis B (CHB) is a chronic inflammatory viral disorder. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarisation and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. Impaired autonomic function has been described in patients with CHB. The aim of this study was to evaluate ventricular repolarisation by using Tp-e interval and Tp-e/QT ratio in patients with CHB, and to assess the relation with inflammation. Fifty-five patients with CHB and 50 controls were included. Tp-e interval and Tp-e/QT ratio were measured from the 12-lead electrocardiogram, and Tp-e interval corrected for heart rate. These parameters were compared between groups. In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in CHB patients compared to the controls (38.3 ± 10.9 vs. 28.5 ± 7.3 milliseconds and 39.5 ± 11.2 vs. 29.6 ± 7.6 milliseconds, P=0.01 and P<0.001, respectively). cTp-e interval and Tp-e/QT ratio were also significantly higher in CHB patients (85.3 ± 8.2 vs. 74.5 ± 7.4 milliseconds and 0.24 ± 0.02 vs. 0.18 ± 0.02, all P-value < 0.001). Our study revealed that Tp-e interval and Tp-e/QT ratio were increased in CHB patients.
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01:03Prediction Intervals
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y.