QTc, Tp-e Interval and Tp-e/QTc Ratio in Patients with Hypocalcemia-case Control Study

Abstract

Hypocalcemia is one of the common electrolyte disorders which can be encountered in the emergency department. It has a wide clinical range from asymptomatic cases to severe life-threatening cases 1 .One of the risk factors leading to prolonged QT interval is hypocalcemia 2 . When cardiac abnormalities related to hypocalcemia are examined, prolongation of QT interval is reported to be the most common 3 . Cases showing that prolonged QT interval associated with hypocalcemia causes fatal ventricular arrhythmias such as Torsades de Pointes are known 4,5 .There are multiple electrocardiography (ECG) measurements associated with ventricular repolarization and are associated with a risk of ventricular arrhythmia. These measurements are QT and QTc interval, QT and QTc dispersion and T wave peak and end interval (Tpe interval). Among these parameters, QT and QTc are indicative of ventricular depolarization in addition to repolarization. However, Tp-e is more predictive of ventricular repolarization and may be more meaningful especially in the evaluation of repolarization. The obtained Tp-e/QT and Tp-e/QTc ratios are related to ventricular transmural dispersion during repolarization 6 .

Biochemical disturbance in damage control resuscitation: mechanisms, management and prognostic utility

“…Monitoring plasma [iCa] during DCR is currently achieved by intermittent point-of-care analysis (PoC), which can prove challenging during higher intensity resuscitations as results can be outdated by the time they are available. An independent correlation between corrected QT interval (QTc) and [iCa] among hypocalcaemic patients has been demonstrated [38] and is supported by historical data that showed a correlation between QTc and peak transfusion rates [39]. This relationship was used as a novel means to guide calcium repletion in a case report of massive transfusion during liver transplantation [40 & ].…”