.: ORİJİNAL ARAŞTIRMA
P Wave and QT Dispersion in Patients with Subclinical Hypothyroidism: Case-control Research
Subklinik Hipotiroidide P Dalga ve QT Dispersiyonunun İncelenmesi: Vaka-kontrol Araştırması
Turkiye Klinikleri J Cardiovasc Sci. 2021;33(2):85-90
doi: 10.5336/cardiosci.2021-83346
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Thyroid hormones have important effects on cardiovascular system. The aim of the present study was to assess QT and P wave dispersion (PWD) in subclinic hypothyroid patients. Material and Methods: A total of 125 subjects were enrolled in the study. The study group consisted of 60 subclinical hypothyroid patients, and the control group included 66 age and sex matched individuals. All subjects underwent two-dimensional echocardiographic and electrocardiographic examination. QT dispersion (QTD), corrected QTD (QTDc) and PWD were calculated. Results: There were no differences between two groups with respect to age, gender, smoking habit, heart rate, systolic and diastolic blood pressure. Study group had higher values of Max QT, min QT, QTD, max QTc, minQTc, QTDc, P max, P min and PWD and thyroid stimulating hormone (TSH) level compared to control group. Serum TSH levels were positively correlated with max QT, min QT, QTD, max QTc, min QTc, QTDc, P max, P min and PWD intervals. According to multivariate logistic regression analysis, PWD (OR: 1.046, 95% CI: 1.03- 1.090, p=0.034) was an independent predictor for the presence of subclinical hypothyroidism. Receiver operating characteristic curve analysis demonstrated that PWD value of 49.5 ms predicted subclinical hypothyroidism with 66.7% sensitivity and 62.1% specificity (AUC: 0.674, 95% CI: 0.581-0.765, p=0.001). Conclusion: QTD, QTDc and PWD may be used in clinical practice to evaluate subclinical hypothyroid patients who are at risk of arrhythmias and paroxysmal atrial fibrillation.
Keywords: Hypothyroidism; elektrocardiography; arrhythmias
Objective: Thyroid hormones have important effects on cardiovascular system. The aim of the present study was to assess QT and P wave dispersion (PWD) in subclinic hypothyroid patients. Material and Methods: A total of 125 subjects were enrolled in the study. The study group consisted of 60 subclinical hypothyroid patients, and the control group included 66 age and sex matched individuals. All subjects underwent two-dimensional echocardiographic and electrocardiographic examination. QT dispersion (QTD), corrected QTD (QTDc) and PWD were calculated. Results: There were no differences between two groups with respect to age, gender, smoking habit, heart rate, systolic and diastolic blood pressure. Study group had higher values of Max QT, min QT, QTD, max QTc, minQTc, QTDc, P max, P min and PWD and thyroid stimulating hormone (TSH) level compared to control group. Serum TSH levels were positively correlated with max QT, min QT, QTD, max QTc, min QTc, QTDc, P max, P min and PWD intervals. According to multivariate logistic regression analysis, PWD (OR: 1.046, 95% CI: 1.03- 1.090, p=0.034) was an independent predictor for the presence of subclinical hypothyroidism. Receiver operating characteristic curve analysis demonstrated that PWD value of 49.5 ms predicted subclinical hypothyroidism with 66.7% sensitivity and 62.1% specificity (AUC: 0.674, 95% CI: 0.581-0.765, p=0.001). Conclusion: QTD, QTDc and PWD may be used in clinical practice to evaluate subclinical hypothyroid patients who are at risk of arrhythmias and paroxysmal atrial fibrillation.
Keywords: Hypothyroidism; elektrocardiography; arrhythmias
ÖZET
Amaç: Tiroid hormonu kardiyovasküler sistem üzerinde önemli etkilere sahiptir. Bu çalışmanın amacı, subklinik hipotiroidi hastalarında P dalga ve QT dispersiyonunu analiz etmektir. Gereç ve Yöntemler: Çalışmaya toplam 125 kişi alındı. Çalışma grubu 60 subklinik hipotiroidi hastası, kontrol grubu ise 66 yaş ve cinsiyete göre eşleştirilmiş bireyden oluştu. Çalışmaya alınan tüm bireylere 2-boyutlu ekokardiyografik inceleme, elektrokardiyogram yapıldı. QT dispersiyonu (QTD), düzeltilmiş QTD (QTDd) ve P dalga disepersiyonu (PDD) ölçüldü. Bulgular: Her 2 grup arasında yaş, cinsiyet, sigara içiciliği, sistolik kan basıncı, diyastolik kan basıncı ve kalp hızı bakımından fark bulunmadı. Maksimum QT, minimum QT, QTD, maksimum QTd, minimum QTd, QTDd, P maksimum, P minimum, PDD ve tiroid stimule edici hormon (TSH) çalışma grubunda anlamlı olarak yüksek bulundu. Serum tiroid uyarıcı hormon değeri ile elektrokardiyografik parametreler arasında istatistiksel olarak anlamlı korelasyon saptandı. Multivaryant lojistik regresyon analizine göre PDD subklinik hipotirodi varlığı için bağımsız bir prediktör idi (OR: 1,046, %95 CI: 1,03-1,090, p=0,034). PDD'nin 49,5 ms değeri subklinik hipotiroidiyi %66,7 duyarlılık ve %62,1 özgüllük ile predikte etti (AUC: 0,674, %95 CI: 0,581-0,765, p=0,001). Sonuç: QTD, QTDd, PDD subklinik hipotiroidi hastalarında uzamıştır ve bu parametreler aritmi ve paroksizmal atriyal fibrilasyon tahmini için kullanılabilirler.
Anahtar Kelimeler: Hipotiroidi; elektrokardiogram; aritmi
Amaç: Tiroid hormonu kardiyovasküler sistem üzerinde önemli etkilere sahiptir. Bu çalışmanın amacı, subklinik hipotiroidi hastalarında P dalga ve QT dispersiyonunu analiz etmektir. Gereç ve Yöntemler: Çalışmaya toplam 125 kişi alındı. Çalışma grubu 60 subklinik hipotiroidi hastası, kontrol grubu ise 66 yaş ve cinsiyete göre eşleştirilmiş bireyden oluştu. Çalışmaya alınan tüm bireylere 2-boyutlu ekokardiyografik inceleme, elektrokardiyogram yapıldı. QT dispersiyonu (QTD), düzeltilmiş QTD (QTDd) ve P dalga disepersiyonu (PDD) ölçüldü. Bulgular: Her 2 grup arasında yaş, cinsiyet, sigara içiciliği, sistolik kan basıncı, diyastolik kan basıncı ve kalp hızı bakımından fark bulunmadı. Maksimum QT, minimum QT, QTD, maksimum QTd, minimum QTd, QTDd, P maksimum, P minimum, PDD ve tiroid stimule edici hormon (TSH) çalışma grubunda anlamlı olarak yüksek bulundu. Serum tiroid uyarıcı hormon değeri ile elektrokardiyografik parametreler arasında istatistiksel olarak anlamlı korelasyon saptandı. Multivaryant lojistik regresyon analizine göre PDD subklinik hipotirodi varlığı için bağımsız bir prediktör idi (OR: 1,046, %95 CI: 1,03-1,090, p=0,034). PDD'nin 49,5 ms değeri subklinik hipotiroidiyi %66,7 duyarlılık ve %62,1 özgüllük ile predikte etti (AUC: 0,674, %95 CI: 0,581-0,765, p=0,001). Sonuç: QTD, QTDd, PDD subklinik hipotiroidi hastalarında uzamıştır ve bu parametreler aritmi ve paroksizmal atriyal fibrilasyon tahmini için kullanılabilirler.
Anahtar Kelimeler: Hipotiroidi; elektrokardiogram; aritmi
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