Increased Short-Term Beat-To-Beat Variability of QT Interval in Patients with Acromegaly.
Cardiovascular diseases, including ventricular arrhythmias are responsible for increased mortality in patients with acromegaly. Acromegaly may cause repolarization abnormalities such as QT prolongation and impairment of repolarization reserve enhancing liability to arrhythmia. The aim of this study was to determine the short-term beat-to-beat QT variability in patients with acromegaly. Thirty acromegalic patients (23 women and 7 men, mean age±SD: 55.7±10.4 years) were compared with age- and sex-matched volunteers (mean age 51.3±7.6 years). Cardiac repolarization parameters including frequency corrected QT interval, PQ and QRS intervals, duration of terminal part of T waves (Tpeak-Tend) and short-term variability of QT interval were evaluated. All acromegalic patients and controls underwent transthoracic echocardiographic examination. Autonomic function was assessed by means of five standard cardiovascular reflex tests. Comparison of the two groups revealed no significant differences in the conventional ECG parameters of repolarization (QT: 401.1±30.6 ms vs 389.3±16.5 ms, corrected QT interval: 430.1±18.6 ms vs 425.6±17.3 ms, QT dispersion: 38.2±13.2 ms vs 36.6±10.2 ms; acromegaly vs control, respectively). However, short-term beat-to-beat QT variability was significantly increased in acromegalic patients (4.23±1.03 ms vs 3.02±0.80, P<0.0001). There were significant differences between the two groups in the echocardiographic dimensions (left ventricular end diastolic diameter: 52.6±5.4 mm vs 48.0±3.9 mm, left ventricular end systolic diameter: 32.3±5.2 mm vs 29.1±4.4 mm, interventricular septum: 11.1±2.2 mm vs 8.8±0.7 mm, posterior wall of left ventricle: 10.8±1.4 mm vs 8.9±0.7 mm, P<0.05, respectively). Short-term beat-to-beat QT variability was elevated in patients with acromegaly in spite of unchanged conventional parameters of ventricular repolarization. This enhanced temporal QT variability may be an early indicator of increased liability to arrhythmia.
Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Andrea
A
Orosz
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Éva
É
Csajbók
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Csilla
C
Czékus
2nd Department of Internal Medicine and Cardiology Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Henriette
H
Gavallér
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Sándor
S
Magony
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Zsuzsanna
Z
Valkusz
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Tamás T
TT
Várkonyi
2nd Department of Internal Medicine and Cardiology Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Attila
A
Nemes
Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.
István
I
Baczkó
2nd Department of Internal Medicine and Cardiology Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Tamás
T
Forster
1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Tibor
T
Wittmann
Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary; MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.
Julius Gy
JG
Papp
Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary; MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.
András
A
Varró
Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary; 1st Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
Csaba
C
Lengyel
D000172:Acromegaly / Q000150:complications / Q000503:physiopathology*; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014636:Valsalva Maneuver / Q000502:physiology