Evaluation of Tp-e interval and Tp-e/QT ratio in patients with rheumatoid arthritis.
OBJECTIVE
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 repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using the Tp-e interval and Tp-e/QT ratio in patients with rheumatoid arthritis (RA), and to assess the relation with inflammation.


METHODS
Ninety-six patients (72 females, 24 males; mean age 43.8±11.8 years) with RA and 50 controls (35 females, 15 males; mean age 44.2±11.1 years) were included. From the 12-lead electrocardiogram, Tp-e interval and Tp-e/QT ratio were measured. Blood samples were taken for erythrocyte sedimentation rate (ESR) and plasma levels of C-reactive protein (CRP). These parameters were compared between groups. The relationship between ventricular repolarization and inflammation was assessed by Pearson correlation coefficients.


RESULTS
Tp-e interval and Tp-e/QT ratio were increased in RA patients compared to the controls (72.6±8.2 vs 66.4±8.5 ms, 0.20±0.02 vs 0.18±0.02; p<0.001 and p<0.001, respectively). The Tp-e interval was significantly correlated with CRP, ESR, and disease activity score (DAS-28) (r=0.56, p<0.001, r=0.57, p<0.001, and r=0.29, p=0.02, respectively). The Tp-e/QT ratio was also correlated with CRP, ESR, and DAS-28 score (r=0.43, p<0.001, r=0.53, p<0.001, and r=0.25, p=0.03, respectively).


CONCLUSIONS
In RA patients, the increased frequency of ventricular arrhythmias may be explained by increased indexes of ventricular repolarization and their relationship with inflammation.
Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey. gurkandracar@hotmail.com.
Gu Rkan
GR
Acar
Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Murat
M
Akkoyun
Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Alper Bugra
AB
Nacar
Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Imran
I
Dirnak
Department of Rheumatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Gözde
G
Yıldırım Çetin
Department of Cardiology, Necip Fazıl State Hospital, Kahramanmaraş, Turkey.
Makbule
M
Nur Yıldırım
Department of Cardiology, Necip Fazıl State Hospital, Kahramanmaraş, Turkey.
Cemil
C
Zencir
Department of Cardiology, Necip Fazıl State Hospital, Kahramanmaraş, Turkey.
Kayıhan
K
Karaman
Department of Cardiology, Necip Fazıl State Hospital, Kahramanmaraş, Turkey.
Mustafa
M
Cetin
Department of Rheumatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Mehmet
M
Sayarlıoğlu
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D004562:Electrocardiography / Q000145:classification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D002097:C-Reactive Protein