title: Lung function, percent emphysema, and QT duration: The Multi-Ethnic Study of Atherosclerosis (MESA) lung study.
abstract: The QT interval on electrocardiogram (ECG) reflects ventricular repolarization; a prolonged QT interval is associated with increased mortality risk. Prior studies suggest an association between chronic obstructive pulmonary disease (COPD) and prolonged QT interval. However, these studies were small and often enrolled hospital-based samples. We tested the hypotheses that lower lung function and increased percent emphysema on computed tomography (CT) are associated with a prolonged QT interval in a general population sample and additionally in those with COPD.
  
  
  
  As part of the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, we assessed spirometry, full-lung CT scans, and ECGs in participants aged 45-84 years. The QT on ECGs was corrected for heart rate (QTc) using the Framingham formula. QTc values = 460 msec in women and ≥450 msec in men were considered abnormal (prolonged QTC). Multivariate regression models were used to examine the cross-sectional association between pulmonary measures and QTC.RESULTS: The mean age of the sample of 2585 participants was 69 years, and 47% were men. There was an inverse association between FEV1%, FVC%, FEV1/FVC%, emphysema, QTc duration and prolonged QTc. Gender was a significant interaction term, even among never smokers. Having severe COPD was also associated with QTc prolongation.
  
  
  
  Our analysis revealed a significant association between lower lung function and longer QTc in men but not in women in a population-based sample. Our findings suggest the possibility of gender differences in the risk of QTc-associated arrhythmias in a population-based sample.
authors.affiliation: Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States. Electronic address: Hfa2104@columbia.edu.
authors.forename: Hilary F
authors.initials: HF
authors.lastname: Armstrong
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
authors.forename: Gina S
authors.initials: GS
authors.lastname: Lovasi
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Department of Internal Medicine-Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.affiliation: Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, United States.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, United States; Group Health Research Institute, Group Health Cooperative, Seattle, WA, United States.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.affiliation: Department of Radiology, Columbia University Medical Center, New York, NY, United States.
authors.forename: John H M
authors.initials: JH
authors.lastname: Austin
authors.affiliation: Breathe Chicago Center, University of Illinois at Chicago, Chicago, IL, United States.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.affiliation: Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, United States.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Hoffman
authors.affiliation: Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, United States.
authors.forename: Craig
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Los Angeles Biomedical Research Institute, Torrance, CA, United States.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.affiliation: UCLA School of Medicine, Los Angeles, CA, United States.
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008133:Long QT Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013147:Spirometry / Q000379:methods; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D014797:Vital Capacity / Q000502:physiology
keywords: COPD; Emphysema; Lung function; QT duration; QT interval