The Association of Prolonged QT Interval on Electrocardiography and Chronic Lead Exposure

Chen, Chien‐Chou; Yen, Hsueh‐Wei; Lo, Yi-Hao; Chu, Yu-Hui; Chiu, Yu-Wen; Chuang, Hung‐Yi

doi:10.1097/jom.0b013e318291787a

Cited by 14 publications

(21 citation statements)

References 32 publications

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“…Although many studies have documented that lead exposure is associated with ischemic heart disease, HT, and cerebrovascular accident, cardiac conduction tissue can also be affected leading to conduction abnormalities and arrhythmias. In a study from Taiwan, Chen et al found that workers exposed to lead occupationally had significantly shorter PR interval and longer QTc interval compared with controls. Furthermore, no significant relationship of blood lead level was observed with PR interval, whereas there was a significant relationship with QTc.…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive Electrocardiographic Analysis of Lead Exposed Workers: An Arrhythmic Risk Assessment Study

Karakulak

Yılmaz

Tutkun

et al. 2016

Ann Noninvasive Electrocardiol

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Section: Discussionmentioning

confidence: 99%

“…However, there are a few relevant studies investigating the effects of lead on the cardiac conduction system. In these studies, the relationship between lead exposure and electrocardiographic parameters such as QT interval, QRS duration and conduction disturbances have been investigated …”

mentioning

confidence: 99%

Comprehensive Electrocardiographic Analysis of Lead Exposed Workers: An Arrhythmic Risk Assessment Study

Karakulak

Yılmaz

Tutkun

et al. 2016

Ann Noninvasive Electrocardiol

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show abstract

“…Cardiovascular diseases are the leading cause of mortality both in the United States and around the world [ 1 ]. Exposure to lead potentially accelerates the development of several cardiovascular diseases or disorders such as coronary heart disease, peripheral arterial disease, left ventricular hypertrophy, and cardiac arrhythmias in acute and chronic exposure [ 2 , 3 , 4 , 5 ]. Indeed, lead is a risk factor for hypertension in adults, and a positive association of lead exposure with elevated blood pressure has also been identified in the literature [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular-Related Outcomes in U.S. Adults Exposed to Lead

Obeng-Gyasi

Armijos

Weigel

et al. 2018

IJERPH

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Cardiovascular-related clinical markers were evaluated in this cross-sectional study of United States adults (aged ≥ 20) exposed to lead via the National Health and Nutrition Examination Survey 2007–2008 and the 2009–2010 datasets. In four quartiles of exposure—0–2 μg/dL, 2–5 μg/dL, 5–10 μg/dL, and 10 μg/dL and over, clinical and anthropometric markers were evaluated—to examine how the markers manifested in the quartiles. Associations were determined via linear regression. Finally, clinical makers, and how they manifested between exposed and less-exposed occupations, were explored in addition to how duration of exposure altered these clinical markers. In regression analysis, Diastolic Blood Pressure (DBP) and high-density lipoprotein (HDL) cholesterol, were significantly associated with blood lead level (BLL). In the occupational analysis, Systolic Blood Pressure (SBP), DBP, C-reactive protein (CRP), triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, showed differences between populations in the exposed and less-exposed occupations. Regarding Agriculture, Forestry & Fishing, the duration of exposure altered SBP, CRP, and LDL cholesterol. With mining, the duration of exposure altered SBP, DBP, triglycerides, and HDL cholesterol, whereas in construction, the duration in occupation altered SBP, triglycerides, and CRP. In conclusion, lead exposure has a profound effect on the cardiovascular system, with potentially adverse outcomes existing at all exposure levels.

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“…QTc interval is referred to as the period of ‘electrical systole’ of the ventricles 10. This duration prolongs when the heart rate shortens.…”

Section: Discussionmentioning

confidence: 99%

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

Xie

Zhang

et al. 2019

Occup Environ Med

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ObjectivesA significant number of researches have evidenced that occupational lead (Pb) exposure increased risks of cardiovascular disease. However, evidences about the potential effects of Pb on the cardiac conduction system are sparse and inconclusive. Besides, ryanodine receptors (RyRs) induced dysfunction of cardiac excitation contraction coupling which is considered to be one of the mechanisms in cardiovascular diseases. Therefore, we examined the association between occupational Pb exposure and ECG conduction abnormalities, as well as RyRs in Pb-induced ECG abnormalities.MethodsWe investigated 529 Pb smelter workers, and measured blood lead (BPb), zinc protoporphyrin (ZPP), ECG outcomes and RyR expression levels. Based on BPb levels, the workers were divided into three groups: the BPb not elevated group, the BPb elevated group and the Pb poisoning group. Descriptive and multivariable analyses were performed.ResultsCompared with the BPb not elevated group, the Pb poisoning group had a higher incidence of high QRS voltage, and a lower level of RyR1 gene expression (p<0.05). Further unconditional multivariable logistic regression analyses showed that high QRS voltage was positively related to BPb (OR=1.045, 95% CI 1.014 to 1.078) and inversely associated with RyR1 expression (OR=0.042, 95% CI 0.002 to 0.980) after adjusting for potential confounders. In addition, multiple linear regression analyses showed that the QTc interval was positively associated with ZPP (β=0.299, 95% CI 0.130 to 0.468) after adjusting for potential confounders.ConclusionsOur study provided evidences that occupational exposure to Pb may be associated with worse ECG outcomes (high QRS voltage), which might be related to decreased levels of RyR1.

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The Association of Prolonged QT Interval on Electrocardiography and Chronic Lead Exposure

Abstract: The data suggest that lead exposure is positively associated with prolonged QTc interval.

Cited by 14 publications

References 32 publications

Comprehensive Electrocardiographic Analysis of Lead Exposed Workers: An Arrhythmic Risk Assessment Study

Comprehensive Electrocardiographic Analysis of Lead Exposed Workers: An Arrhythmic Risk Assessment Study

Cardiovascular-Related Outcomes in U.S. Adults Exposed to Lead

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

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