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P wave dispersion and ventricular repolarization changes in children with familial hypercholesterolemia

Published online by Cambridge University Press:  09 November 2020

Nafiye E. Çakar  and
Ahmet İrdem
Nafiye E. Çakar*
Affiliation:
University of Health Sciences, Okmeydanı Training and Research Hospital, Department of Pediatric Metabolism, Istanbul, Turkey
Ahmet İrdem
Affiliation:
University of Health Sciences, Okmeydanı Training and Research Hospital, Department of Pediatric Cardiology, Istanbul, Turkey
*
Author for correspondence: Nafiye Emel Çakar, Okmeydanı Training and Research Hospital, Pediatric Metabolism Department, Kaptan Paşa Mahallesi, Darülaceze Cad. No:25, 34384 Okmeydanı, Istanbul, Turkey. Tel: +90 505 2702923. E-mail: [email protected]
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Abstract

Background:

Familial hypercholesterolemia is a genetic disease with plasma total cholesterol especially low-density lipoprotein-cholesterol elevation. In this study, we aimed to examine the changes in the electrocardiographies of children with familial hypercholesterolemia.

Materials and methods:

Electrocardiography of 85 patients with a diagnosis of familial hypercholesterolemia, followed up from the Pediatric Metabolism and Pediatric Cardiology outpatient clinic was examined. Electrocardiography of 83 children from the control group who did not have hypercholesterolemia in a similar gender and age range were examined. Heart rate, P wave, PR interval, P wave dispersion, QRS wave, QT interval, corrected QT (calculated with Bazett formula), Tpeak-end interval, QT dispersion, corrected QT dispersion, JT interval, corrected JT (calculated with Bazett formula) were statistically compared.

Results:

P wave, PR interval, and P wave dispersion values were significantly higher (p < 0.05) in the children with familial hypercholesterolemia. Corrected QT, QT dispersion, corrected QT dispersion, JT interval, corrected JT, Tpeak-end interval were significantly higher than the control group (p < 0.05) in children with familial hypercholesterolemia. These statistical differences in electrocardiography parameters support the risk of atrial and/or ventricular arrhythmia in children with familial hypercholesterolemia.

Conclusion:

We found that high total cholesterol and low-density lipoprotein-cholesterol variables are associated with an increased risk of cardiac atrial and/or ventricular arrhythmia. The findings suggest that total cholesterol and low-density lipoprotein-cholesterol variability can be used as a new marker for the risk of cardiac arrhythmia. In this case, decreasing total cholesterol and low-density lipoprotein-cholesterol variability below certain thresholds may decrease the risk of cardiac arrhythmia.

Keywords

hypercholesterolemiaarrhythmiaP wave dispersionventricular repolarisation
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1643 - 1648
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Maliachova, O, Stabouli, S. Familial hypercholesterolemia in children and adolescents: diagnosis and treatment. Curr Pharm Des. 2018; 24: 3672–3677.CrossRefGoogle ScholarPubMed
Gautschi, M, Pavlovic, M, Nuoffer, J-M. Fatal myocardial infarction at 4.5 years in a case of homozygous familial hypercholesterolaemia. JIMD Rep. 2012; 2: 45–50.CrossRefGoogle Scholar
Goonasekara, CL, Balse, E, Hatem, S, Steele, DF, Fedida, D. Cholesterol and cardiac arrhythmias. Expert Rev Cardiovasc Ther. 2010; 8: 965–979.CrossRefGoogle ScholarPubMed
Li, Z-Z, Du, X, Guo, X-Y, et al. Association between blood lipid profiles and atrial fibrillation: a case-control study. Med Sci Monit. 2018; 24: 3903–3908.CrossRefGoogle ScholarPubMed
Roh, E, Chung, HS, Lee, JS, et al. Total cholesterol variability and risk of atrial fibrillation: a nationwide population-based cohort study. PLoS ONE. 2019; 14: e0215687.CrossRefGoogle ScholarPubMed
Dilaveris, P, Batchvarov, V, Gialafos, J, Malik, M. Comparison of different methods for manual P wave duration measurement in 12-lead electrocardiograms. Pacing Clin Electrophysiol. 1999; 22: 1532–1538.CrossRefGoogle ScholarPubMed
Pérez-Riera, AR, de Abreu, LC, Barbosa-Barros, R, Grindler, J, Fernandes-Cardoso, A, Baranchuk, A. P-wave dispersion: an update. Indian Pacing Electrophysiol J. 2016; 16: 126–133.CrossRefGoogle ScholarPubMed
Van der Bijl, P, Heradien, M, Doubell, A, Brink, P. QTc prolongation prior to angiography predicts poor outcome and associates significantly with lower left ventricular ejection fractions and higher left ventricular end-diastolic pressures. Cardiovasc J Afr. 2012; 23: 541–545.CrossRefGoogle ScholarPubMed
Elming, H, Holm, E, Jun, L, et al. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J. 1998; 19: 1391–1400.CrossRefGoogle Scholar
Akpinar, M, Ocal, M, Irdem, A. Ventricular repolarization changes in children with breath holding spells. J Electrocardiol. 2019; 55: 116–119.CrossRefGoogle ScholarPubMed
Kors, JA, Ritsema van Eck, HJ, van Herpen, G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008; 41: 575–580.CrossRefGoogle ScholarPubMed
Yan, GX, Antzelevitch, C. Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998; 98: 1928–1936.CrossRefGoogle Scholar
Berul, CI, Sweeten, TL, Dubin, AM, Shah, MJ, Vetter, VL. Use of the rate-corrected JT interval for prediction of repolarization abnormalities in children. Am J Cardiol. 1994; 74: 1254–1257.CrossRefGoogle ScholarPubMed
Roguin, A. Henry Cuthbert Bazett (1885-1950)--the man behind the QT interval correction formula. Pacing Clin Electrophysiol. 2011; 34: 384–388.CrossRefGoogle ScholarPubMed
Malik, M, Batchvarov V. Measurement, Interpretation and clinical potential of QT dispersion. J Am Coll Cardiol. 2000; 36: 1749–1766.CrossRefGoogle ScholarPubMed
Castro Hevia, J, Antzelevitch, C, Tornés Bárzaga, F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006; 47: 1828–1834.CrossRefGoogle ScholarPubMed
Ference, BA, Ginsberg, HN, Graham, I, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017; 38: 2459–2472.CrossRefGoogle ScholarPubMed
Mochizuki, S, Okumura, M, Tanaka, F, et al. Ischemia-reperfusion arrhythmias and lipids: effect of human high- and low-density lipoproteins on reperfusion arrhythmias. Cardiovasc Drugs Ther. 1991; 5: 269–276.CrossRefGoogle ScholarPubMed
Imaizumi, S, Miura, S, Nakamura, K, et al. Antiarrhythmogenic effect of reconstituted high-density lipoprotein against ischemia/reperfusion in rats. J Am Coll Cardiol; 2008; 51: 1604–1612.CrossRefGoogle ScholarPubMed
Liu, YB, Wu, C, Lu, L, et al. Sympathetic nerve sprouting, electrical remodeling, and increased vulnerability to ventricular fibrillation in hypercholesterolemic rabbits. Circ Res. 2003; 92: 1145–1152.CrossRefGoogle ScholarPubMed
Annoura, M, Ogawa, M, Kumagai, K, Zhang, B, Saku, K, Arakawa, K. Cholesterol paradox in patients with paroxysmal atrial fibrillation. Cardiology 1999; 92: 21–27.CrossRefGoogle ScholarPubMed
Liu, YB, Wu, CC, Lee, CM, et al. Dyslipidemia is associated with ventricular tachyarrhythmia in patients with acute ST-segment elevation myocardial infarction. J Formos Med Assoc 2006; 105: 17–24.CrossRefGoogle ScholarPubMed
El-Gamal, A, Gallagher, D, Nawras, A, et al. Effects of Obesity on QT, RR, and QTc Intervals. Am J Cardiol 1995; 75: 956–959.CrossRefGoogle ScholarPubMed
Vrtovec, B, Okrajsek, R, Golicnik, A, Ferjan, M, Starc, V, Radovancevic, B. Atorvastatin therapy increases heart rate variability, decreases QT variability, and shortens QTc interval duration in patients with advanced chronic heart failure. J Card Fail 2005; 11: 684–690.CrossRefGoogle ScholarPubMed
Hovland, A, Mundal, LJ, Igland, J, et al. Increased risk of heart failure and atrial fibrillation in heterozygous familial hypercholesterolemia. Atherosclerosis. 2017; 266: 69–73.CrossRefGoogle ScholarPubMed