Prolonged Tp–e Interval and Tp–e/QT Ratio in Children with Mitral Valve Prolapse

Abstract

Although it is considered to be a benign condition, previous studies have shown that a subset of patients with mitral valve prolapse (MVP) may be at risk of ventricular arrhythmia and sudden cardiac death (SCD). Previous studies have suggested that the interval between the peak and the end of the T wave (Tp-e) can be used as a marker for the transmural dispersion of repolarization. Increased Tp-e interval and Tp-e/QT ratio are associated with ventricular arrhythmias and SCD. The aim of this study was to assess alterations in ventricular repolarization by using the Tp-e interval and Tp-e/QT ratio in children with MVP and to investigate their relationships with the degree of valvular regurgitation. This study prospectively investigated 110 children with MVP and 107 age- and sex-matched healthy control subjects. Tp-e interval, Tp-e/QT ratio, and QT and QTc dispersions were measured from a 12-lead electrocardiogram and compared between groups. QT and QTc dispersions, Tp-e interval, and Tp-e/QTc ratio were found to be significantly higher in patients with MVP. A positive correlation was found between Tp-e/QTc ratio and increase in the degree of mitral regurgitation (MR) (p < 0.05; r = 0.2). However, the degree of MR was not associated with QT, QTc, or Tp-e intervals; QT, QTc, or Tp-e dispersions; or Tp-e/QT ratio (all p values >0.05). Individuals with MVP may be more prone to ventricular arrhythmias due to prolonged QTd, QTcd, and Tp-e interval and increased Tp-e/QT and Tp-e/QTc ratios. Therefore, due to their longer life expectancy, children with MVP should be followed up on regarding life-threatening arrhythmias.

Mi̇tral Kapak Prolapsusu Olan Çocuklarda Kardi̇yak Otonomi̇k Di̇sfonksi̇yonun Ve Ari̇tmi̇ Ri̇ski̇ni̇n Değerlendi̇ri̇lmesi̇

“…28 Demirol et al also observed significantly higher values for the Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in MVP patients as compared to controls in a study involving 110 MVP patients and 107 controls in children. 21 Our study discovered that the Tp-e interval and Tp-e/QTc ratio were significantly higher in MVP patients in comparison to the control group. This differs from other studies because patients with ST-T segment changes on the ECG were excluded.…”

“…19,20 Similarly, pediatric patients with MVP have been found to have significantly higher QTc dispersion compared to healthy controls. 7,21 In our study, we excluded individuals with pathological findings such as frequent VEA, bundle branch block, and ST-T changes from the analysis and only evaluated subclinical cases. Despite this, we discovered that the MVP group's QTc dispersion was considerably higher than that of the healthy peers (p<0.05).…”

Effects of Mitral Valve Prolapse on Heart Rate Variability and the Autonomic Nervous System in Children

“…Demiro M et al 15 observed that QT dispersion and QTC dispersion were significantly higher in patients with MVP. Still, they reported no significant differences between the groups in terms of QT and QTc.…”

Evaluation of the Effects of Adolescent Obesity on Electrocardiography and Pulmonary Function Tests

“…QTc intervali normal olan hastalarda bile ventriküler aritmileri ve ani ölümü öngören Tp-e intervalinin obezlerde ventriküler aritmiler için invaziv olmayan EKG tarama yöntemi olarak kullanılabileceğini belirten çalışmalar mevcuttur (26). Tp-e/QT oranının da ventriküler aritmi ve ani ölüm riski açısından kullanılan bir diğer duyarlı parametre olabileceği bildirilmiştir (26,27). Çocukluk çağında, Tp-e intervalini ani ölüm riskiyle ilişkili olarak değerlendiren, kardiyak mortalite üzerine etkilerini net olarak açıklayan bir çalışmaya tarafımızca rastlanmamıştır.…”