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QT dispersion increases with low glomerular filtration rate in patients with coronary artery disease

Murat Celik1, Uygarcagdas Yuksel2, Yalcin Gokoglan3

  • 1Murat Celik, Department of Cardiology, Gulhane Military Medical Academy, School of Medicine, Ankara, Turkey.

Pakistan Journal of Medical Sciences
|April 29, 2014
PubMed

Insights

Patients with lower estimated glomerular filtration rate (eGFR) have higher QT dispersion (QTd), a measure of heart electrical instability. This suggests QTd may help manage coronary artery disease (CAD) patients with poor kidney function.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Electrophysiology

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality worldwide.
  • Renal dysfunction is a common comorbidity in CAD patients, associated with adverse cardiovascular outcomes.
  • QT dispersion (QTd) reflects heterogeneity in ventricular repolarization and is a marker of arrhythmia risk.

Purpose of the Study:

  • To investigate the association between estimated glomerular filtration rate (eGFR) and QT dispersion (QTd) in patients with established CAD.
  • To determine if reduced eGFR is linked to increased QTd independently of CAD severity.

Main Methods:

  • Sixty patients with CAD were categorized into two groups based on eGFR: <60 ml/min/1.73m² (Group 1) and ≥60 ml/min/1.73m² (Group 2).
  • QTd was measured using the 12-lead electrocardiogram.
  • Statistical analyses, including ANCOVA, were performed to compare QTd between groups, adjusting for covariates like age, gender, and smoking status.

Main Results:

  • Baseline characteristics were comparable between groups, except for age, gender, and smoking history.
  • Patients with lower eGFR (Group 1) exhibited significantly higher QTd values compared to those with preserved eGFR (Group 2) (57.23 ± 40.65 ms vs. 31.23 ± 14.47 ms, p=0.002).
  • This significant difference in QTd persisted even after adjusting for age, gender, and smoking (p=0.038).

Conclusions:

  • Reduced kidney function, indicated by lower eGFR, is associated with increased QTd in patients with CAD.
  • The observed relationship between eGFR and QTd is independent of the angiographic severity of CAD.
  • QTd may serve as a valuable, non-invasive biomarker for risk stratification and management in CAD patients with impaired renal function.
Abstract

Keywords:
Coronary artery diseaseGlomerular filtration rateQT dispersion

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