Normal Values of QT Variability in 10-s Electrocardiograms for all Ages
Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT var...
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| Vydáno v: | Frontiers in physiology Ročník 10; s. 1272 |
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04.10.2019
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| ISSN: | 1664-042X, 1664-042X |
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| Abstract | Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT variability were lacking, we set out to establish these in standard 10-s electrocardiograms (ECGs) covering both sexes and all ages. Methods: Ten-second, 12-lead ECGs were provided by five Dutch population studies (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study). ECGs were recorded digitally and processed by well-validated analysis software. We selected cardiologically healthy participants, 46% being women. Ages ranged from 11 days to 91 years. After quality control, 13,828 ECGs were available. We assessed three markers: standard deviation of QT intervals (SDqt), short-term QT variability (STVqt), and QT variability index (QTVI). Results: For SDqt and STVqt, the median and the lower limit of normal remained stable with age. The upper limit of normal declined until around age 45, and increased strongly in the elderly, notably so in women. This implies that a subset of the population, small enough not to have appreciable effect on the median, shows a high degree of QT variability with a possible risk of arrhythmias or worse, especially in women. Otherwise, sex differences were negligible in all three measurements. For QTVI, median, and normal limits decreased until age 20, and steadily went up afterwards except for the lower limit of normal, which flattens off after age 65. Conclusion: We report the first set of normal values for QT variability based on 10-s ECGs, for all ages and both sexes.Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT variability were lacking, we set out to establish these in standard 10-s electrocardiograms (ECGs) covering both sexes and all ages. Methods: Ten-second, 12-lead ECGs were provided by five Dutch population studies (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study). ECGs were recorded digitally and processed by well-validated analysis software. We selected cardiologically healthy participants, 46% being women. Ages ranged from 11 days to 91 years. After quality control, 13,828 ECGs were available. We assessed three markers: standard deviation of QT intervals (SDqt), short-term QT variability (STVqt), and QT variability index (QTVI). Results: For SDqt and STVqt, the median and the lower limit of normal remained stable with age. The upper limit of normal declined until around age 45, and increased strongly in the elderly, notably so in women. This implies that a subset of the population, small enough not to have appreciable effect on the median, shows a high degree of QT variability with a possible risk of arrhythmias or worse, especially in women. Otherwise, sex differences were negligible in all three measurements. For QTVI, median, and normal limits decreased until age 20, and steadily went up afterwards except for the lower limit of normal, which flattens off after age 65. Conclusion: We report the first set of normal values for QT variability based on 10-s ECGs, for all ages and both sexes. |
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| AbstractList | Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT variability were lacking, we set out to establish these in standard 10-s electrocardiograms (ECGs) covering both sexes and all ages. Methods: Ten-second, 12-lead ECGs were provided by five Dutch population studies (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study). ECGs were recorded digitally and processed by well-validated analysis software. We selected cardiologically healthy participants, 46% being women. Ages ranged from 11 days to 91 years. After quality control, 13,828 ECGs were available. We assessed three markers: standard deviation of QT intervals (SDqt), short-term QT variability (STVqt), and QT variability index (QTVI). Results: For SDqt and STVqt, the median and the lower limit of normal remained stable with age. The upper limit of normal declined until around age 45, and increased strongly in the elderly, notably so in women. This implies that a subset of the population, small enough not to have appreciable effect on the median, shows a high degree of QT variability with a possible risk of arrhythmias or worse, especially in women. Otherwise, sex differences were negligible in all three measurements. For QTVI, median, and normal limits decreased until age 20, and steadily went up afterwards except for the lower limit of normal, which flattens off after age 65. Conclusion: We report the first set of normal values for QT variability based on 10-s ECGs, for all ages and both sexes.Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT variability were lacking, we set out to establish these in standard 10-s electrocardiograms (ECGs) covering both sexes and all ages. Methods: Ten-second, 12-lead ECGs were provided by five Dutch population studies (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study). ECGs were recorded digitally and processed by well-validated analysis software. We selected cardiologically healthy participants, 46% being women. Ages ranged from 11 days to 91 years. After quality control, 13,828 ECGs were available. We assessed three markers: standard deviation of QT intervals (SDqt), short-term QT variability (STVqt), and QT variability index (QTVI). Results: For SDqt and STVqt, the median and the lower limit of normal remained stable with age. The upper limit of normal declined until around age 45, and increased strongly in the elderly, notably so in women. This implies that a subset of the population, small enough not to have appreciable effect on the median, shows a high degree of QT variability with a possible risk of arrhythmias or worse, especially in women. Otherwise, sex differences were negligible in all three measurements. For QTVI, median, and normal limits decreased until age 20, and steadily went up afterwards except for the lower limit of normal, which flattens off after age 65. Conclusion: We report the first set of normal values for QT variability based on 10-s ECGs, for all ages and both sexes. Aims: QT variability is a promising electrocardiographic marker. It has been studied as a screening tool for coronary artery disease and left ventricular hypertrophy, and increased QT variability is a known risk factor for sudden cardiac death. Considering that comprehensive normal values for QT variability were lacking, we set out to establish these in standard 10-s electrocardiograms (ECGs) covering both sexes and all ages. Methods: Ten-second, 12-lead ECGs were provided by five Dutch population studies (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study). ECGs were recorded digitally and processed by well-validated analysis software. We selected cardiologically healthy participants, 46% being women. Ages ranged from 11 days to 91 years. After quality control, 13,828 ECGs were available. We assessed three markers: standard deviation of QT intervals (SDqt), short-term QT variability (STVqt), and QT variability index (QTVI). Results: For SDqt and STVqt, the median and the lower limit of normal remained stable with age. The upper limit of normal declined until around age 45, and increased strongly in the elderly, notably so in women. This implies that a subset of the population, small enough not to have appreciable effect on the median, shows a high degree of QT variability with a possible risk of arrhythmias or worse, especially in women. Otherwise, sex differences were negligible in all three measurements. For QTVI, median, and normal limits decreased until age 20, and steadily went up afterwards except for the lower limit of normal, which flattens off after age 65. Conclusion: We report the first set of normal values for QT variability based on 10-s ECGs, for all ages and both sexes. |
| Author | Hillege, Hans Bots, Michiel L. Rijnbeek, Peter R. Stricker, Bruno H. van den Berg, Marten E. Kors, Jan A. Swenne, Cees A. van Herpen, Gerard |
| AuthorAffiliation | 3 Department of Cardiology, University Medical Center Groningen , Groningen , Netherlands 1 Department of Medical Informatics, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands 6 Department of Internal Medicine, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands 7 Inspectorate of Health Care , Utrecht , Netherlands 4 Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands 5 Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , Netherlands |
| AuthorAffiliation_xml | – name: 7 Inspectorate of Health Care , Utrecht , Netherlands – name: 6 Department of Internal Medicine, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands – name: 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , Netherlands – name: 3 Department of Cardiology, University Medical Center Groningen , Groningen , Netherlands – name: 1 Department of Medical Informatics, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands – name: 5 Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam , Rotterdam , Netherlands – name: 4 Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands |
| Author_xml | – sequence: 1 givenname: Marten E. surname: van den Berg fullname: van den Berg, Marten E. – sequence: 2 givenname: Jan A. surname: Kors fullname: Kors, Jan A. – sequence: 3 givenname: Gerard surname: van Herpen fullname: van Herpen, Gerard – sequence: 4 givenname: Michiel L. surname: Bots fullname: Bots, Michiel L. – sequence: 5 givenname: Hans surname: Hillege fullname: Hillege, Hans – sequence: 6 givenname: Cees A. surname: Swenne fullname: Swenne, Cees A. – sequence: 7 givenname: Bruno H. surname: Stricker fullname: Stricker, Bruno H. – sequence: 8 givenname: Peter R. surname: Rijnbeek fullname: Rijnbeek, Peter R. |
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| CitedBy_id | crossref_primary_10_3389_fphys_2022_863873 crossref_primary_10_3390_diagnostics10121096 crossref_primary_10_3389_fpsyt_2025_1606497 |
| Cites_doi | 10.1054/jelc.2002.37160 10.1161/01.CIR.96.5.1557 10.1007/s10654-004-5689-2 10.1371/journal.pone.0175087 10.1161/CIRCULATIONAHA.118.037702 10.1111/j.1540-8159.1999.tb06806.x 10.1093/eurheartj/ehl367 10.4236/ojs.2016.61003 10.1002/sim.4780111005 10.1088/0967-3334/34/11/1435 10.1055/s-0038-1634805 10.1016/j.jelectrocard.2014.06.003 10.1007/s002460010099 10.1007/s00246-004-0676-7 10.1053/euhj.2000.2399 10.1093/ndt/18.1.10 10.1016/j.jelectrocard.2008.07.006 10.1056/NEJM199112193252503 10.1016/j.trsl.2006.02.001 10.1136/heartjnl-2014-305671 10.1161/01.CIR.93.6.1170 10.1016/j.jacc.2004.06.063 10.1186/1471-2261-10-28 10.1093/europace/euv405 10.1007/BF00145007 10.1111/j.1542-474X.2010.00358.x 10.1111/j.1540-8159.2008.02278.x 10.1016/j.jelectrocard.2010.07.016 |
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| Copyright | Copyright © 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek. Copyright © 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek. 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek |
| Copyright_xml | – notice: Copyright © 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek. – notice: Copyright © 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek. 2019 van den Berg, Kors, van Herpen, Bots, Hillege, Swenne, Stricker and Rijnbeek |
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| Title | Normal Values of QT Variability in 10-s Electrocardiograms for all Ages |
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