Relationship between electrocardiographic and biochemical variables in coronary artery disease.
BACKGROUND
ECG (electrocardiogram) markers reflecting abnormal heart rate variability and abnormal repolarization as well as several biochemical markers reflecting inflammation, endothelial dysfunction, and procoagulation states were reported to show an association with increased cardiovascular mortality. ECG and biochemical markers could operate independently or they could interrelate in pathogenetic pathways of coronary disease. In this study, we aimed to explore the relationship between ECG and biochemical markers in a longitudinal study of coronary patients.


METHODS
A total of 499 observations from 52 patients with up to 12 repeated measurements were collected providing data on series of ECG (heart rate variability and repolarization) parameters and biochemical parameters. Generalized estimating equation models adjusting for repeated measurements were used for the analyses.


RESULTS
There was a significant association between ECG parameters reflecting abnormal repolarization (prolonged QT interval, lower T wave amplitude) and elevated levels of C-reactive protein and fibrinogen. Abnormal heart rate variability, increased sympathetic tone (low-frequency power) was associated with increased concentrations of soluble E-selectin, a marker of endothelial cell activation. There was no association between ECG markers and parameters reflecting increased procoagulation states.


CONCLUSIONS
These results indicate that there is an association between ECG parameters and blood markers reflecting endothelial function and inflammation in coronary artery disease patients. The pathophysiologic mechanisms of these associations remain to be elucidated.
Yue
Wei
W
Institute of Epidemiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany.
Schneider
Alexandra
A
Rückerl
Regina
R
Koenig
Wolfgang
W
Marder
Victor
V
Wang
Sheng
S
Wichmann
H-Erich
HE
Peters
Annette
A
Zareba
Wojciech
W
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003327:Coronary Disease / Q000097:blood* / Q000503:physiopathology*; D019040:E-Selectin / Q000097:blood; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D014841:von Willebrand Factor / Q000378:metabolism
D015415:Biomarkers; D019040:E-Selectin; D005338:Fibrin Fibrinogen Degradation Products; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein