Association Between QT-Interval Components and Sudden Cardiac Death: The ARIC Study (Atherosclerosis Risk in Communities)
Several reports have demonstrated that prolongation of the QT interval is associated with sudden cardiac death (SCD). However, it is unknown whether any of the components within the QT interval are responsible for its association with SCD. We examined the association of the individual QT-interval co...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2017-10, Vol.10 (10) |
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| container_title | Circulation. Arrhythmia and electrophysiology |
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| creator | O'Neal, Wesley T Singleton, Matthew J Roberts, Jason D Tereshchenko, Larisa G Sotoodehnia, Nona Chen, Lin Y Marcus, Gregory M Soliman, Elsayed Z |
| description | Several reports have demonstrated that prolongation of the QT interval is associated with sudden cardiac death (SCD). However, it is unknown whether any of the components within the QT interval are responsible for its association with SCD.
We examined the association of the individual QT-interval components (R-wave onset to R-peak, R-peak to R-wave end, ST-segment, T-wave onset to T-peak, and T-peak to T-wave end) with SCD in 12 241 participants (54±5.7 years; 26% black; 55% women) from the ARIC study (Atherosclerosis Risk in Communities). The QT interval and its components were measured at baseline (1987-1989) from 12-lead ECGs. SCD cases were adjudicated by a group of physicians through December 31, 2012. During a median follow-up of 23.6 years, a total of 346 cases of SCD were identified. Although prolongation of the QT interval was associated with a 49% increased risk of SCD (hazard ratio, 1.49; 95% confidence interval, 1.01-2.18), only the T-wave onset to T-peak component (per 1-SD increase: hazard ratio, 1.19; 95% confidence interval, 1.06-1.34) was associated with SCD and not any of the other components in separate models. When all of the QT-interval components were included in the same model, T-wave onset to T-peak remained the strongest predictor of SCD (per 1-SD increase: hazard ratio, 1.21; 95% confidence interval, 1.06-1.37).
The risk of SCD with the QT interval is driven by prolongation of the T-wave onset to T-peak component. This suggests that shifting the focus from the overall QT interval to its individual components will refine SCD prediction in the community. |
| doi_str_mv | 10.1161/CIRCEP.117.005485 |
| format | Article |
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We examined the association of the individual QT-interval components (R-wave onset to R-peak, R-peak to R-wave end, ST-segment, T-wave onset to T-peak, and T-peak to T-wave end) with SCD in 12 241 participants (54±5.7 years; 26% black; 55% women) from the ARIC study (Atherosclerosis Risk in Communities). The QT interval and its components were measured at baseline (1987-1989) from 12-lead ECGs. SCD cases were adjudicated by a group of physicians through December 31, 2012. During a median follow-up of 23.6 years, a total of 346 cases of SCD were identified. Although prolongation of the QT interval was associated with a 49% increased risk of SCD (hazard ratio, 1.49; 95% confidence interval, 1.01-2.18), only the T-wave onset to T-peak component (per 1-SD increase: hazard ratio, 1.19; 95% confidence interval, 1.06-1.34) was associated with SCD and not any of the other components in separate models. When all of the QT-interval components were included in the same model, T-wave onset to T-peak remained the strongest predictor of SCD (per 1-SD increase: hazard ratio, 1.21; 95% confidence interval, 1.06-1.37).
The risk of SCD with the QT interval is driven by prolongation of the T-wave onset to T-peak component. This suggests that shifting the focus from the overall QT interval to its individual components will refine SCD prediction in the community.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.117.005485</identifier><identifier>PMID: 29030380</identifier><language>eng</language><publisher>United States</publisher><subject>Action Potentials ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - mortality ; Arrhythmias, Cardiac - physiopathology ; Death, Sudden, Cardiac - etiology ; Electrocardiography ; Female ; Heart Conduction System - physiopathology ; Heart Rate ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Time Factors ; United States</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2017-10, Vol.10 (10)</ispartof><rights>2017 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c253t-caeee52123981296ba6ce0f14b738575861af28f61dd1969806acbf1d436900d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29030380$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Neal, Wesley T</creatorcontrib><creatorcontrib>Singleton, Matthew J</creatorcontrib><creatorcontrib>Roberts, Jason D</creatorcontrib><creatorcontrib>Tereshchenko, Larisa G</creatorcontrib><creatorcontrib>Sotoodehnia, Nona</creatorcontrib><creatorcontrib>Chen, Lin Y</creatorcontrib><creatorcontrib>Marcus, Gregory M</creatorcontrib><creatorcontrib>Soliman, Elsayed Z</creatorcontrib><title>Association Between QT-Interval Components and Sudden Cardiac Death: The ARIC Study (Atherosclerosis Risk in Communities)</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>Several reports have demonstrated that prolongation of the QT interval is associated with sudden cardiac death (SCD). However, it is unknown whether any of the components within the QT interval are responsible for its association with SCD.
We examined the association of the individual QT-interval components (R-wave onset to R-peak, R-peak to R-wave end, ST-segment, T-wave onset to T-peak, and T-peak to T-wave end) with SCD in 12 241 participants (54±5.7 years; 26% black; 55% women) from the ARIC study (Atherosclerosis Risk in Communities). The QT interval and its components were measured at baseline (1987-1989) from 12-lead ECGs. SCD cases were adjudicated by a group of physicians through December 31, 2012. During a median follow-up of 23.6 years, a total of 346 cases of SCD were identified. Although prolongation of the QT interval was associated with a 49% increased risk of SCD (hazard ratio, 1.49; 95% confidence interval, 1.01-2.18), only the T-wave onset to T-peak component (per 1-SD increase: hazard ratio, 1.19; 95% confidence interval, 1.06-1.34) was associated with SCD and not any of the other components in separate models. When all of the QT-interval components were included in the same model, T-wave onset to T-peak remained the strongest predictor of SCD (per 1-SD increase: hazard ratio, 1.21; 95% confidence interval, 1.06-1.37).
The risk of SCD with the QT interval is driven by prolongation of the T-wave onset to T-peak component. This suggests that shifting the focus from the overall QT interval to its individual components will refine SCD prediction in the community.</description><subject>Action Potentials</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - mortality</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart Conduction System - physiopathology</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>United States</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kM1u2zAQhImgReI4fYBcAh6Tg1KuKFFkb67yUwMGmjjuWaDJFcxEolyRauC3jww7vezMYWaw-Ai5BHYLIOB7OV-W90-jL24ZyzOZn5AJqAwSzmT25dNDps7IeQivjAmQIE7JWaoYZ1yyCdnNQuiM09F1nv7E-I7o6fMqmfuI_T_d0LJrt51HHwPV3tKXwdoxUereOm3oHeq4-UFXG6Sz5bykL3GwO3o9ixvsu2Ca_XWBLl14o87vx9rBu-gw3FyQr7VuAn476pT8ebhflb-Sxe_HeTlbJCbNeUyMRsQ8hZQrCakSay0MshqydcFlXuRSgK5TWQuwFpRQkglt1jXYjAvFmOVTcn3Y3fbd3wFDrFoXDDaN9tgNoQKVQwZZLooxCoeoGd8OPdbVtnet7ncVsGpPvDoQH31RHYiPnavj_LBu0f5vfCLmH9EMe9w</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>O'Neal, Wesley T</creator><creator>Singleton, Matthew J</creator><creator>Roberts, Jason D</creator><creator>Tereshchenko, Larisa G</creator><creator>Sotoodehnia, Nona</creator><creator>Chen, Lin Y</creator><creator>Marcus, Gregory M</creator><creator>Soliman, Elsayed Z</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>Association Between QT-Interval Components and Sudden Cardiac Death: The ARIC Study (Atherosclerosis Risk in Communities)</title><author>O'Neal, Wesley T ; Singleton, Matthew J ; Roberts, Jason D ; Tereshchenko, Larisa G ; Sotoodehnia, Nona ; Chen, Lin Y ; Marcus, Gregory M ; Soliman, Elsayed Z</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c253t-caeee52123981296ba6ce0f14b738575861af28f61dd1969806acbf1d436900d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Action Potentials</topic><topic>Arrhythmias, Cardiac - complications</topic><topic>Arrhythmias, Cardiac - diagnosis</topic><topic>Arrhythmias, Cardiac - mortality</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart Conduction System - physiopathology</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Neal, Wesley T</creatorcontrib><creatorcontrib>Singleton, Matthew J</creatorcontrib><creatorcontrib>Roberts, Jason D</creatorcontrib><creatorcontrib>Tereshchenko, Larisa G</creatorcontrib><creatorcontrib>Sotoodehnia, Nona</creatorcontrib><creatorcontrib>Chen, Lin Y</creatorcontrib><creatorcontrib>Marcus, Gregory M</creatorcontrib><creatorcontrib>Soliman, Elsayed Z</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Neal, Wesley T</au><au>Singleton, Matthew J</au><au>Roberts, Jason D</au><au>Tereshchenko, Larisa G</au><au>Sotoodehnia, Nona</au><au>Chen, Lin Y</au><au>Marcus, Gregory M</au><au>Soliman, Elsayed Z</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between QT-Interval Components and Sudden Cardiac Death: The ARIC Study (Atherosclerosis Risk in Communities)</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2017-10</date><risdate>2017</risdate><volume>10</volume><issue>10</issue><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>Several reports have demonstrated that prolongation of the QT interval is associated with sudden cardiac death (SCD). However, it is unknown whether any of the components within the QT interval are responsible for its association with SCD.
We examined the association of the individual QT-interval components (R-wave onset to R-peak, R-peak to R-wave end, ST-segment, T-wave onset to T-peak, and T-peak to T-wave end) with SCD in 12 241 participants (54±5.7 years; 26% black; 55% women) from the ARIC study (Atherosclerosis Risk in Communities). The QT interval and its components were measured at baseline (1987-1989) from 12-lead ECGs. SCD cases were adjudicated by a group of physicians through December 31, 2012. During a median follow-up of 23.6 years, a total of 346 cases of SCD were identified. Although prolongation of the QT interval was associated with a 49% increased risk of SCD (hazard ratio, 1.49; 95% confidence interval, 1.01-2.18), only the T-wave onset to T-peak component (per 1-SD increase: hazard ratio, 1.19; 95% confidence interval, 1.06-1.34) was associated with SCD and not any of the other components in separate models. When all of the QT-interval components were included in the same model, T-wave onset to T-peak remained the strongest predictor of SCD (per 1-SD increase: hazard ratio, 1.21; 95% confidence interval, 1.06-1.37).
The risk of SCD with the QT interval is driven by prolongation of the T-wave onset to T-peak component. This suggests that shifting the focus from the overall QT interval to its individual components will refine SCD prediction in the community.</abstract><cop>United States</cop><pmid>29030380</pmid><doi>10.1161/CIRCEP.117.005485</doi></addata></record> |
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| subjects | Action Potentials Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - mortality Arrhythmias, Cardiac - physiopathology Death, Sudden, Cardiac - etiology Electrocardiography Female Heart Conduction System - physiopathology Heart Rate Humans Male Middle Aged Proportional Hazards Models Prospective Studies Risk Factors Time Factors United States |
| title | Association Between QT-Interval Components and Sudden Cardiac Death: The ARIC Study (Atherosclerosis Risk in Communities) |
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