Epicardial adipose tissue predicted prolonged QTc interval in patients with arterial hypertension

Introduction: It is important to identify those at higher risk for ventricular arrhythmia among hypertensive patients. Epicardial adipose tissue (EAT) leads to electromechanical changes in the heart by endocrine and paracrine effects with cytokines and mediators. Higher amount of EAT carries the risk of QT prolongation. Therefore, we investigated the association between EAT thickness and QTc interval in patients with arterial hypertension. Methods: A total of 230 patients who previously diagnosed with arterial hypertension between February 2019 to March 2020 were included in the study. Patients with atrial fibrillation, U-wave, atrioventricular block, left anterior or posterior fascicular block, right bundle branch block, left bundle branch block, and taking QT-prolonging medication were excluded. The corrected QT (QTc) interval was calculated with Bazzet's formula following the calculated QT interval in the semi-automatic application tool. EAT was measured at the point on the free wall of the right ventricle using transthoracic echocardiography. Results: The mean age was 62.1 ± 11.4 years and 95 (41.3%) of the patients were male. QTc was over 450 ms were considered as the prolonged interval. Both groups were similar in terms of age (p = .862), gender (p = .265) and other demographic characteristics. Left ventricle mass index (LVMI) (82.5 ± 29.5 vs 91.9 ± 32.6 g/1.7.m², p = .051) and EAT thickness (5.3 ± 2.3 vs 6.6 ± 2.6 mm, p = .001) were higher in the prolonged QTc group. Serum potassium (K) level was lesser in the prolonged QTc group (4.2 ± 0.39 vs 4.1 ± 0.4 mmol/mL, p = .005). Multivariate Cox regression analysis revealed that EAT thickness [OR = 1.227, 95% CI: 1.081-1.393, p = .002] and serum K level [OR = 0.348, 95% CI: 0.157-0.772, p = .009] predicted the prolonged QTc interval, independently. Conclusion: EAT thickness predicted prolonged QTc interval in patients with arterial hypertension. Patients with higher amount of EAT should be followed by closely monitoring to prevent arrhythmic events that may develop in the future. In addition, medications that have a potential effect on QTc interval prolongation may be carefully used in patients with higher EAT thickness.