Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness

Abstract

BackgroundThe association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio.MethodsThe present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram.ResultsQTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001).ConclusionThe present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.

Is There any Relationship Between Myocardial Repolarization Parameters and the Frequency of Ventricular Premature Contractions?

“… 28 , 29 Recently, some myocardial repolarization markers, such as Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios, have been reported to be useful in predicting lethal ventricular arrhythmias in various clinical disorders without structural heart disease. 7 , 30 , 31 Tp-e interval is considered a new marker of increased risk of SCD. Yamaguchi et al.…”

The Relationship Between Epicardial Adipose Tissue Volume and Coronary Plaque Structure in Diabetics

“…Studies have shown an association between EAT thickness and the presence and extent of CAD [4]. Furthermore, the myocardial ischemia-related ventricular repolarization parameters Tp-e and Tp-e/QT are also increased in patients with thicker EAT [11]. A study by Park et al that evaluated the association between EAT thickness and plaque structure using virtual histology intravascular ultrasound (VH-IVUS) revealed that thin-cap fibroatheromas (TCFAs) and higher necrotic core burden are associated with EAT thickness [12].…”

Measurement of Epicardial Fat Thickness by Echocardiography Presents Challenges

“…They demonstrated some ventricular repolarization abnormalities on electrocardiography in patients with higher EFT thickness. We would like to thank Kaplan et al 1 for their great effort in this study, and share some of our thoughts.…”

“…It was with great interest that we read the paper by Kaplan et al 1 entitled ''Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness'' published on Arquivos Brasileiros de Cardiologia in December 2015. They aimed to investigate the relationship between epicardial adipose tissue (EFT) and ventricular repolarization.…”

“…2 Finally, EFT can change with supine or lateral positioning during echocardiography. 3 In the study by Kaplan et al, 1 the measurement of EFT was performed perpendicularly on the free wall of the right ventricle at the end diastole in the parasternal long-axis view in three cardiac cycles. We believe the measurement can be performed in the parasternal short-axis view, as well as parasternal long-axis view, and the mean value of the measurements may be calculated subsequently.…”