QTc Interval is Associated with Atrial Fibrillation in Individuals with Metabolic Syndrome Phenotype

Abstract

Ming-Chuan Lee,1 Yu-Tsang Wang,2 Yu-Ju Li,1 Ching-Yi Tsai,1 Su-Te Chen,1 Wun-Jyun Jhuang,1,3 Meng-Chi Chang,1 Mei-Yu Chien,1 Hsiang-Chun Lee1,3– 5 1Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; 2Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; 3Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; 4Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; 5Institute/Center of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, 804, TaiwanCorrespondence: Hsiang-Chun Lee, Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan, Tel [phone]#2293, Fax [phone], Email [email protected]: Manifestations of metabolic syndrome (MetS) carry risks for atrial fibrillation (AF). The study determined whether any electrocardiographic parameter can reflect increased AF risk in individuals with MetS.Patients and Methods: From our University Hospital database, we examined the presence of AF and its correlation with MetS manifestations, renal function, lipid profiles, and electrocardiographic parameters (P wave duration, PR interval, QRS width, and QTc intervals). Between January 2008 and December 2015, data from 4479 adults (women 41.6% vs men 58.4%) were identified.Results: The overall prevalence of AF was 12.4%, without sex differences (women, 12.8% vs men, 12.1%). Patients with AF were older (age 73.9 ± 11.8 vs non-AF 67 ± 13.5 years), with lower lipid levels (TG, total cholesterol, and LDL-cholesterol, all p < 0.0001), and at lower eGFR level (64.1 ± 30.9 vs non-AF 68.8 ± 41.4 mL/min/1.73m2, p < 0.0001). Besides, sex differences were present in all electrocardiographic parameters (all p < 0.05). Hypertension had the highest odds ratio (1.33; p = 0.026) for AF. Comparing AF to non-AF, the QTc of quartiles was significantly different (p < 0.0089). The shortest and longest QTc quartiles had an increased incidence of AF.Conclusion: AF risk in patients with MetS phenotypes can be reflected by QTc quartiles.Keywords: atrial fibrillation, electrocardiography, metabolic syndrome, lipid, QTc interval

Keywords

• atrial fibrillation
• electrocardiography
• metabolic syndrome
• lipid
• qtc interval