Inflammation and prolonged QT time: results from the Cardiovascular Disease, Living and Ageing in Halle (CARLA) study.
BACKGROUND
Previous research found an association of CRP with QT time in population based samples. Even more, there is evidence of a substantial involvement of the tumor necrosis factor-alpha system in the pathophysiology of cardiac arrhythmia, while the role of Interleukin 6 remains inconclusive.


OBJECTIVE
To determine the association between inflammation with an abnormally prolonged QT-time (APQT) in men and women of the elderly general population.


METHODS
Data descend from the baseline examination of the prospective, population-based Cardiovascular Disease, Living and Ageing in Halle (CARLA) Study. After exclusion of subjects with atrial fibrillation and missing ECG recording the final study cohort consisted of 919 men and 797 women. Blood parameters of inflammation were the soluble TNF-Receptor 1 (sTNF-R1), the high-sensitive C-reactive protein (hsCRP), and Interleukin 6 (IL-6). In accordance with major cardiologic societies we defined an APQT above a QT time of 460 ms in women and 450 ms in men. Effect sizes and the corresponding 95% confidence intervals (CI) were estimated by performing multiple linear and logistic regression analyses including the analysis of sex differences by interaction terms.


RESULTS
After covariate adjustment we found an odds ratio (OR) of 1.89 (95% CI: 1.13, 3.17) per 1000 pg/mL increase of sTNF-R1 in women, and 0.74 (95% CI: 0.48, 1.15) in men. In the covariate adjusted linear regression sTNF-R1 was again positively associated with QT time in women (5.75 ms per 1000 pg/mL, 95% CI: 1.32, 10.18), but not in men. Taking possible confounders into account IL-6 and hsCRP were not significantly related to APQT in both sexes.


CONCLUSIONS
Our findings from cross-sectional analyses give evidence for an involvement of TNF-alpha in the pathology of APQT in women.
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Daniel
D
Medenwald
Department of Medical Informatics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Jan A
JA
Kors
Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Harald
H
Loppnow
Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany.
Joachim
J
Thiery
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Alexander
A
Kluttig
Department of Medical Informatics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Sebastian
S
Nuding
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Daniel
D
Tiller
German Cancer Research Centre, Division of Cancer Epidemiology, Heidelberg, Germany.
Karin H
KH
Greiser
Department of Medical Informatics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Karl
K
Werdan
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Johannes
J
Haerting
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006329:Heart Conduction System / Q000002:abnormalities* / Q000276:immunology / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology; D014505:Urban Population
C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D047888:Receptors, Tumor Necrosis Factor, Type I; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha