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Cardio-ankle brachial index is associated with prolonged Tp-e interval in patients with arterial hypertension
Savaş Özer1, Nurcemal Şentürk1, Ercan Aydın1
1Trabzon Kanuni Training and Research Hospital Cardiology Clinic, Trabzon, Turkey.
Insights
Elevated cardio-ankle vascular index (CAVI), a marker of arterial stiffness, is linked to longer Tp-e intervals in hypertensive patients. This suggests a higher risk for cardiac arrhythmias, necessitating close monitoring.
Area of Science:
- Cardiology
- Vascular Medicine
- Electrocardiography
Background:
- The cardio-ankle vascular index (CAVI) is a validated indicator of arterial stiffness.
- Elevated CAVI is associated with increased cardiovascular mortality and risk of cardiac arrhythmias.
- The Tp-e interval on ECG is a marker of ventricular repolarization and potential arrhythmia risk.
Purpose of the Study:
- To investigate the relationship between the Tp-e interval and CAVI in hypertensive patients.
- To determine if arterial stiffness, as measured by CAVI, correlates with specific ECG markers of repolarization.
Main Methods:
- The study included hypertensive patients under controlled blood pressure.
- CAVI was measured using the VaSera VS-1000 system.
- Patients were categorized into CAVI<9 and CAVI≥9 groups.
- 12-lead ECG was used to measure Tp-e interval, QT, QTc, and Tp-e/QT and Tp-e/QTc ratios.
Main Results:
- Patients with CAVI≥9 exhibited significantly prolonged Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios compared to the CAVI<9 group.
- The Tp-e interval demonstrated high predictive value for identifying patients with CAVI≥9 (AUC=0.862).
- Both left and right CAVI showed significant negative correlations with the Tp-e interval.
Conclusions:
- Elevated CAVI is positively associated with prolonged Tp-e interval in hypertensive individuals.
- The findings suggest that increased arterial stiffness may contribute to altered ventricular repolarization.
- Close monitoring of patients with elevated CAVI is recommended to prevent cardiac arrhythmias.
Aim:
The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and elevated CAVI values have been reported to be associated with an increased risk of cardiovascular mortality and cardiac arrhythmia. This study aimed to evaluate the relationship between Tp-e interval and CAVI, which is associated with cardiac arrhythmia on electrocardiography (ECG).
Method:
The study included patients with hypertension whose blood pressure values were taken under control with optimal medical treatment. Arterial stiffness and CAVI were measured using the vascular scanning system VaSera VS-1000. The patients were divided into two groups as CAVI<9 and CAVI≥9. Ventricular repolarization markers QT and QTc intervals, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured using 12‑lead ECG.
Results:
Tp-e interval (78.7 ± 10.3 vs. 63.6 ± 9.1, p < 0.001), Tp-e/QT ratio (0.018 ± 0.02 vs. 0.015 ± 0.02, p < 0.001), and Tp-e/QTc ratio (0.17 ± 0.02 vs. 0.14 ± 0.04, p = 0.025) were statistically significantly higher in the CAVI≥9 group compared to the CAVI<9 group. In the prediction of patients in the CAVI≥9 group, Tp-e interval had an area under the curve value of 0.862 (0.784-0.940, p < 0.001) at the cut-off point of >72.5 msec, indicating a statistically significant result. Left CAVI and right CAVI were found to be significantly correlated with Tp-e interval (r = -0.650, p < 0.001 and r = -0.663, p < 0.001, respectively).
Conclusion:
We found that elevated CAVI values were associated and positively correlated with prolonged Tp-e interval values in patients with hypertension. Patients with elevated CAVI values should be followed up closely to prevent cardiac arrhythmic events.
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