Background The prevalence of the metabolic syndrome in Korea is about 20%. The metabolic syndrome is known to increase the risk of cardiovascular disease. However, the relationship of this syndrome with electrocardiographic subclinical risk factors such as corrected QT (QTc) interval prolongation has not been evaluated extensively in Korea. In this perspective, we studied the relationship between metabolic syndrome and QTc interval prolongation among Korean adults. Methods: We analysed 1,560 Korean subjects (men, 873; women, 687; age, 30 to 75 years) at a health promotion center of a university hospital from November, 2006 to Jun, 2007. Subjects were evaluated for metabolic syndrome using a questionnaire, physical examination, blood pressure and blood test. QTc interval was measured from the standard 12-lead electrocardiogram. Results: In women, the odds ratios of QTc interval prolongation according the number 1, 2, 3 ≥ of diagnostic criteria of metabolic syndrome were 1.62 (1.07 to 2.45), 2.70 (1.59 to 4.59), 3.24 (1.65 to 6.32) compared to the number 0 (P for trend < 0.001). In men, the odds ratios according the number 2, 3 ≥ of them were 2.53 (1.56 to 4.11), 3.49 (2.05 to 5.93) (P for trend < 0.001). Conclusion: In Korean Adult, metabolic syndrome is significantly associated with QTc prolongation. As the number of diagnostic criteria of this syndrome increased, the ratio of QTc prolongation tends to be increased. This study suggest that the measurement of QTc interval of subjects with the diagnostic components of this syndrome can help predict cardiovascular risk of prolonged QTc.
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Background : Electrocardiographic QTc interval prolongation can cause serious arrhythmias such as ventricular tachycardia, ventricular fibrillation, torsade de pointes, and even sudden death. Many studies have been performed to clarify whether QTc interval prolongation is related to increasing body mass index (BMI) and abdominal obesity. However, there is no study about the relationship between abdominal obesity and QTc interval prolongation in Korea. We, therefore, studied the relationship between QTc interval prolongation and abdominal obesity among Korean adults.
Methods : The measurement of height, weight, and waist circumference, and standard 12-lead ECG was performed on 3,086 subjects at a health promotion center of a university hospital from March to April, 2003. We excluded: 37 subjects whose ECG or body measurement was not performed, 17 with a past history of cardiac disease or current cardiac medications which can influence QTc interval, 9 taking neuropsychiatric medications, 25 with abnormal serum concentration of potassium or calcium, 1 foreigner and 59 with underweight. First, we studied the correlation between BMI and waist circumference. Then, we analyzed the relationship between QTc interval prolongation and the index of obesity.
Results : A total of 2,938 subjects consisted of 2,411 men and 527 women. BMI and waist circumference were shown to have a significant correlation with QTc interval after age was adjusted in men (P＜0.01, P＜0.01). The odds ratio between QTc interval prolongation and the subjects of normal, overweight, and obesity by BMI were not significant in both men and women. In men with abdominal obesity, the odds ratio between QTc interval prolongation and abdominal obesity by waist circumference was 1.33 (0.99∼1.79).
Conclusion : In men, abdominal obesity was shown a positive correlation with QTc interval prolongation. But these results were not statistically significant.
Background : The purpose of this study was to examine the sensitivity and specificity of ECG as a tool for detecting echocardiographically defined LVH in a population-based sample and to examine the impact of a variety of factors that affect the sensitivity and specificity of ECG for detection of LVH.
Methods : A total of 1,130 subjects who received a thorough medical checkup for cardiologic department voluntarily were selected. The subjects were examined using M-mode echocardiography and standard 12-lead ECG. The x2 test was used to test for differences in sensitivity and specificity of ECG for echocardiographically defined LVH. Cochran-Mantel-Haenszel statistic was used to adjust for sex, age, and obesity and to test the association between cigarette smoking, amount of alcohol, exercise, hypertension, diabetes mellitus (DM) and sensitivity and specificity of ECG.
Results : Echocardiographic LVH was detected in 434 (38.4%) and electrocardiographic features of LVH were present in 146 (12.9%). ECG for diagnosis of LVH showed sensitivity of 20.0%, specificity of 91.5%, and diagnostic accuracy of 64.1%. Sensitivity of ECG for LVH was higher in persons with obesity (P=.04) or hypertension (P=.04). Specificity of ECG for LVH was lower in persons with hypertension (P=.003).
Conclusion : ECG has a low sensitivity and a high specificity for echocardiographically defined LVH. Attention must be paid to carefully interpret ECG for diagnosis of LVH in persons with obesity or hypertension, because the rate of false positives and negatives can be increased.
Background : Prolongation of the QTc interval is a risk factor for ventricular tachycardia, ventricular fibrillation, especially torsades de pointes, and sudden death. It is associated with increasing age, female sex, some of antiarrhythmic drugs, tricyclic antidepressants, and conditions such as hypokalemia, hypothermia, subarachnoid hemorrhage, congenital long QT syndrome. Earlier studies reported lengthening of the QTc interval with increasing body mass index (BMI) and intra-abdominal fat. But no such reports exist in Korea. Therefore, we determined the relationship between BMI and the QTc interval.
Methods : The study population consisted of 372 persons who undertook periodic health examination in a university hospital between September and December 1998. BMI and standard 12-lead electrocardiogram were measured in all subjects. Excluding 4 patients who ha arrhythmia where QTc interval could not be calculated, the QT interval was measured in the electrocardiogram of 368 subjects. The QT interval was measured in the leads that showed the longest interval for three consecutive beats and then were averaged. Correlation between the calculated QTc interval and BMI was examined. The QTc interval difference according to sex and obesity was also analyzed.
Results : Among 368 subjects, there were 197 men (54%) and 171 women (46%). The mean ages were 44.5 years for men and 47.6 for women, The BMI was 23.8±3.13 (mean±SD). Obese subjects with BMI above 27kg/m² totalled 61 917%), including 31 men and 30 women, The QTc interval was 399±25 msec (mean±SD), and the subjects showed prolonged QTc intervals of 24 (12 men and 12 women). There was a statistically significant correlation between BMI and QTc interval (r=0.135, P=0.0094), and the obese subjects were found to have a longer QTc interval than the nonobese controls. Women also had a longer QTc interval than men.
Conclusion : There was a significant correlation between BMI and QTc interval, and longer QTc interval was observed in obese patients. The QTc interval should be considered when analyzing electrocardiogram of obese patients.
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