Clinical determinants of the PR interval duration in Swiss middle‐aged adults: The CoLaus/PsyCoLaus study

Bay, Marylène; Vollenweider, Péter; Marques‐Vidal, Pedro; Bocchi, Federica; Pruvot, Étienne; Schläpfer, Jürg

doi:10.1002/clc.23356

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…With the results of our presented analysis, we confirm the prior notion that predominantly RR-interval, PR-interval, and QTc are indeed age-related [ 23 – 26 ]. All three measures show a highly significant association with telomere length as a marker of age in general.…”

Section: Discussionsupporting

confidence: 89%

Common electrocardiogram measures are not associated with telomere length

Falkenhausen

Freudling

Waldenberger

et al. 2022

Aging

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Aims: Aging is accompanied by telomere shortening. Increased telomere shortening is considered a marker of premature aging. Cardiac aging results in the development of cardiac pathologies. Electrocardiogram (ECG) measures reflect cardiac excitation, conduction, and repolarization. ECG measures also prolong with aging and are associated with cardiac pathologies including atrial fibrillation. As premature prolongation of ECG measures is observed, we hypothesized that such prolongation may be associated with telomere length. Methods and Results: We studied the large, community-based KORA F4 Study. Of 3,080 participants enrolled between 2006 and 2007 with detailed information on demographic, anthropometric, clinical, and ECG characteristics, 2,575 presented with available data on leukocyte telomere length. Telomere length was determined by real-time quantitative PCR and expressed relative to a single copy gene. We fitted multivariable adjusted linear regression models to associate the ECG measures RR-interval, PR-interval, QRS-duration, and heart rate corrected QTc with telomere length. In our cohort, the mean age was 54.9±12.9 years and 46.6% were men. Increased age was associated with shorter telomere length (p<0.01), and men had shorter telomere length than women (p<0.05). In unadjusted models, heart rate (p=0.023), PR-interval (p<0.01), and QTc-interval (p<0.01) were significantly associated with shorter telomere length. However, no significant associations remained after accounting for age, sex, and covariates. Conclusions: ECG measures are age-dependent, but not associated with shortened telomere length as a marker of biological aging. Further research is warranted to clarify if shortened telomeres are associated with clinical cardiac pathologies including atrial fibrillation.

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Section: Discussionsupporting

confidence: 89%

Common electrocardiogram measures are not associated with telomere length

Falkenhausen

Freudling

Waldenberger

et al. 2022

Aging

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“…Sympathetic stimulation shortens the PR interval and is well described during exercise and betaagonist exposure. 13,14 However, there are few published data on PR interval behavior during illness. Fever has been reported to be associated with PR interval shortening, and Karjalainen and Viitasalo 15 made the observation that ".even patients who demonstrated AV block during fever had shorter PR intervals than during the control period."…”

Section: Discussionmentioning

confidence: 99%

Behavior of the PR interval with increasing heart rate in patients with COVID-19

et al. 2020

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BACKGROUND Myriad manifestations of cardiovascular involvement have been described in patients with coronavirus disease 2019 (COVID-19), but there have been no reports of COVID-19 affecting the cardiac conduction system. The PR interval on the electrocardiogram (ECG) normally shortens with increasing heart rate (HR). The case of a patient with COVID-19 manifesting Mobitz type 1 atrioventricular (AV) block that normalized as the patient's condition improved prompted us to investigate PR interval behavior in patients with COVID-19.OBJECTIVE The purpose of this study was to characterize PR interval behavior in hospitalized patients with COVID-19 and to correlate that behavior with clinical outcomes.METHODS This study was a cross-sectional cohort analysis of confirmed COVID-19 cases (March 26, 2020, to April 25, 2020. We reviewed pre-COVID-19 and COVID-19 ECGs to characterize AV conduction by calculating the PR interval to HR (PR:HR) slope. Clinical endpoints were death or need for endotracheal intubation.RESULTS ECGs from 75 patients (246 pre-COVID-19 ECGs and 246 COVID-19 ECGs) were analyzed for PR:HR slope. Of these patients, 38 (50.7%) showed the expected PR interval shortening with increasing HR (negative PR:HR slope), whereas 37 (49.3%) showed either no change (8 with PR:HR slope 5 0) or paradoxical PR interval prolongation (29 with positive PR:HR slope) with increasing HR. Patients without PR interval shortening were more likely to die (11/37 [29.7%] vs 3/38 [7.9%]; P 5 .019) or require endotracheal intubation (16/37 [43.2%] vs 8/38 [21.1%]; P 5 .05) compared to patients with PR interval shortening.CONCLUSION Half of patients with COVID-19 showed abnormal PR interval behavior (paradoxical prolongation or lack of shortening) with increasing HR. This finding was associated with increased risk of death and need for endotracheal intubation.

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The prognostic predictive value of the components of the PR interval in hospitalized patients with heart failure

Huang

Zhao

et al. 2023

BMC Cardiovasc Disord

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Objective Previous reports on the epidemiology, influencing factors, and the prognostic value of the components of PR interval in hospitalized heart failure patients were limited. Methods This study retrospectively enrolled 1182 patients hospitalized with heart failure from 2014 to 2017. Multiple linear regression analysis was used to explore the association between the components of PR interval and the baseline parameters. The primary outcome was all-cause death or heart transplantation. Multivariable-adjusted Cox proportional hazard regression models were constructed to explore the predictive value of the components of PR interval for the primary outcome. Results In multiple linear regression analysis, higher height (for every 10 cm increase in height: regression coefficient 4.83, P < 0.001) as well as larger atrial and ventricular size were associated with larger P wave duration but not with PR segment. The primary outcome occurred in 310 patients after an average follow-up of 2.39 years. Cox regression analyses revealed that the increase in PR segment was an independent predictor of the primary outcome (every 10 ms increase: hazard ratio 1.041, 95% confidence interval [CI] 1.010–1.083, P = 0.023), whereas the P wave duration did not show significant correlation. When adding the PR segment to an initial prognostic prediction model, the likelihood ratio test and categorical net reclassification index (NRI) showed a significant improvement, but the increase in C-index was not significant. In subgroup analysis, increased PR segment was an independent predictor of the primary endpoint in patients taller than 170 cm (each 10 ms increase: hazard ratio 1.153, 95% CI 1.085–1.225, P < 0.001) but not the shorter group (P for interaction = 0.006). Conclusions In hospitalized patients with heart failure, longer PR segment was an independent predictor of the composite endpoint of all-cause death and heart transplantation, especially in the taller group, but it had limited significance in improving the prognostic risk stratification of this population.

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Clinical determinants of the PR interval duration in Swiss middle‐aged adults: The CoLaus/PsyCoLaus study

Cited by 3 publications

References 28 publications

Common electrocardiogram measures are not associated with telomere length

Common electrocardiogram measures are not associated with telomere length

Behavior of the PR interval with increasing heart rate in patients with COVID-19

The prognostic predictive value of the components of the PR interval in hospitalized patients with heart failure

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