Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 9, September, p. 1091–1099

doi: 10.17219/acem/117684

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Spotlights on some electrocardiographic paradigms: How should we evaluate normal reference values of Tp–Te interval, Tp–Te dispersion and Tp–Te/QT ratio?

Mücahid Yılmaz1,A,C,D,E,F, Hidayet Kayançiçek2,A,B,C,E,F, Nevzat Gözel3,B,C,E,F, Mehmet Nail Bilen1,A,B,E,F, Ertuğrul Kurtoğlu4,A,C,E,F, Özlem Seçen1,A,B,E,F, Pınar Öner5,A,C,E,F, Suat Demirkıran2,A,B,E,F, Ökkeş Uku1,A,B,C,E,F, Yusuf Çekici6,A,C,E,F, Orkun Eroglu7,A,C,E,F, Fikret Keleş1,A,B,E,F

1 Department of Cardiology, Elazığ Education and Research Hospital, Turkey

2 Department of Cardiology, Elazığ Medical Park Hospital, Istinye University, Turkey

3 Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey

4 Department of Cardiology, Malatya Education and Research Hospital, Turkey

5 Department of Microbiology, Elazığ Education and Research Hospital, Turkey

6 Department of Cardiology, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey

7 Department of Ear, Nose and Throat, Elazığ Education and Research Hospital, Turkey

Abstract

Background. Experimental and clinical studies evaluating the Tp–Te interval and Tp–Te/QT ratio have reported conflicting data. The overlap between normal Tp–Te/QT ratios (0.17 ±0.02–0.27 ±0.06 ms) and pathological values (0.20 ±0.03–0.30 ±0.06 ms) measured in earlier studies has raised questions about this ECG measurement technique.
Objectives. To analyze normal values of the Tp–Te interval, Tp–Te dispersion Tp–Te(d) and the Tp–Te/QT ratio based on electrocardiographic (ECG) assessment across sex and age groups in a healthy Turkish population.
Material and Methods. A total of 1,485 healthy participants (723 men) were enrolled into the study. The age of the participants ranged 17–75 years and they did not have either any cardiovascular/systemic disorders or risk factors for atherosclerosis which were detected with physical examination and laboratory tests. The Tp–Te interval, Tp–Te(d) and Tp–Te/QT ratio were determined from V1–V6 derivations.
Results. For the entire study, the median Tp–Te interval was 66.0 (64.0–70.0) ms, the Tp–Te(d) was 15.0 (10.0–20.0) ms, and the Tp–Te/QT ratio was 0.18 (0.17–0.19). The Pearson’s correlation test demonstrated that the Tp–Te/QT ratio significantly correlated with older age (r = 0.297; p < 0.0001), left ventricular (LV) end-diastolic diameter (LVEDD; r = 0.481; p < 0.0001), body mass index (BMI; r = 0.421; p < 0.0001), body surface area (BSA; r = 0.191; p < 0.0001), LV end-diastolic volume (LVEDV; r = 0.484; p < 0.0001), LVEDV index (r = 0.450; p < 0.0001), LV mass (r = 0.548; p < 0.0001), and LV mass index (r = 0.539; p < 0.0001).
Conclusion. The reference values for Tp–Te interval, Tp–Te(d) and Tp–Te/QT ratio are associated with age, BMI, BSA, LVEDV, LVEDV index, LV mass, and LV mass index. These structural elements should be considered when using these ECG parameters for assessing repolarization inhomogeneity. These findings may guide further studies assessing healthy and diseased populations.

Key words

Tp–Te interval, Tp–Te/QT ratio, Tp–Te dispersion, LV mass, LV mass index

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