Subklinik Hipertiroidizm ile Ventriküler Repolarizasyon Belirteçleri Arasındaki İlişki

Year 2022, , 527 - 535, 29.09.2022

Emre Yılmaz , Kadem Arslan , Ercan Aydın

https://doi.org/10.31832/smj.1127603

Abstract

Amaç: Subklinik hipertiroidili (sHT) hastalarda ventriküler repolarizasyon belirteçleri ile repolarizasyon defektlerini ve aritmojenik yatkınlığı değerlendirmek.
Gereç ve Yöntemler: Asemptomatik endojen (sHT)’li hastalar ve benzer yaş ve demografik özelliklere sahip sağlıklı katılımcılar çalışmamıza dahil edildi. Laboratuvar testleri ve ekokardiyografik değerlendirmeler yapıldı. Elektrokardiyografide QT, QTc (Bazett formülü ile düzeltilmiş QT inteval) dispersiyonu, Tpeak-Tend (Tp-e) aralığı ve Tp-e/QT ve Tp-e/ QTc oranları gibi spesifik ventriküler repolarizasyon belirteçleri elle elde edildi.
Bulgular: Çalışmamıza toplam 90 katılımcı dahil edildi. sHT grubundaki 45 hasta için yaş ortalaması 59.04±13.28 yıl, 45 kontrol grubu için ortalama 57.13±15.87 yıl idi. PR, QT ve QTc dağılımlarının sHT grubunda anlamlı derecede yüksek olduğu bulundu (tümü için p<0.05). PR ve QT aralıkları gruplar arasında anlamlı farklılık göstermezken, QTc (p<0.05) sHT grubunda anlamlı olarak daha yüksekti. Tp-e , Tp-e/QT ve Tp-e/Qtc'nin de sHT grubunda kontrol grubuna göre daha yüksek seviyelerde olduğu bulundu (tümü için p<0.001). Tiroid uyarıcı hormon (TSH) ile Tp-e aralığı, QT, QTc dispersiyonu, Tp-e/QT ve Tp-e/QTc oranı arasında en yüksek korelasyon katsayısına sahip Tp-/QT ile istatistiksel olarak anlamlı negatif korelasyon saptandı (r: -0.298, p=0.004).
Sonuç: Sağlıklı bireylerle karşılaştırıldığında, Sht'li hastalar daha uzun Tp-e aralığına ve daha yüksek Tp-e / QT ve Tp-e / QTc oranlarına sahipti. TSH düzeyleri Tp-e aralığı ve Tp-e/QT ve Tp-e/QTc oranları ile negatif korelasyon gösterdi.

Keywords

Tp-e aralığı, Tp-e/QT oranı, subklinik hipertiroidizm, ventriküler repolarizasyon belirteçleri

Relationship between subclinical hyperthyroidism and ventricular repolarization markers

Abstract

Objective: To evaluate repolarization defects and arrhythmogenic predisposition through ventricular repolarization markers in patients with subclinical hyperthyroidism (sHT).
Materials and Methods: Patients with asymptomatic endogenous sHT and healthy participants with similar age and demographic characteristics were included in our study. Laboratory tests and echocardiographic evaluations were performed. Specific ventricular repolarization markers,such as QT, QTc (corrected QT inteval by Bazett formula) dispersion, Tpeak-Tend (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios were obtained with manually on electrocardiograpy.
Results: A total of 90 participants were included in our study. The mean age was 59.04±13.28 years for the 45 patients in the sHT group and mean 57.13±15.87 years for the 45 controls. The PR, QT and QTc dispersions were found to be significantly higher in the sHT group (p<0.05 for all). While the PR and QT intervals did not significantly differ between the groups, QTc (p<0.05) was significantly higher in the sHT group. Tp-e , Tp-e/QT,and Tp-e/QTc were also found to be at higher levels in the sHT group than in the control group (p<0.001 for all). A statistically significant negative correlation was detected between thyroid-stimulating hormone (TSH) and the Tp-e interval, QT, QTc dispersion, Tp-e/QT, and Tp-e/QTc ratio, with Tp-/QT having the highest correlation coefficient (r: -0.298, p=0.004).
Conclusion: Compared with healthy subjects, patients with sHT had a longer Tp-e interval and higher Tp-e/QT and Tp-e/QTc ratios. The TSH levels were negatively correlated with the Tp-e interval and Tp-e/QT and Tp-e/QTc ratios.

Keywords

Tp-e interval, Tp-e/QT ratio, subclinical hyperthyroidism, ventricular repolarization markers

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