Christiansen, Michael

Ellervik, Christina

Graff, Claus

Henriksen, Lise

Kanters, Jørgen K.

Kvetny, Jan

Nielsen, Jimmi

Petri, Anne Sofie

    Aalborg UniversitetThe QT interval increases with decreasing plasma potassium in the Danish generalpopulationKanters, Jørgen K.; Graff, Claus; Henriksen, Lise; Petri, Anne Sofie; Christiansen, Michael;Nielsen, Jimmi; Kvetny, Jan; Ellervik, ChristinaPublication date:2015Document VersionPeer reviewed versionLink to publication from Aalborg UniversityCitation for published version (APA):Kanters, J. K., Graff, C., Henriksen, L., Petri, A. S., Christiansen, M., Nielsen, J., ... Ellervik, C. (2015). The QTinterval increases with decreasing plasma potassium in the Danish general population. Poster session presentedat Annual Conference of The International Society for Computerized Electrocardiology, ISCE , San Jose, CA,United States.General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright ownersand it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.            ? Users may download and print one copy of any publication from the public portal for the purpose of private study or research.            ? You may not further distribute the material or use it for any profit-making activity or commercial gain            ? You may freely distribute the URL identifying the publication in the public portal ?Take down policyIf you believe that this document breaches copyright please contact us at vbn@aub.aau.dk providing details, and we will remove access tothe work immediately and investigate your claim.Downloaded from vbn.aau.dk on: April 29, 2017The QT interval increases with decreasing plasma potassium in the Danish general population Jørgen K. Kanters1,7, Claus Graff2, Lise Henriksen1, Anne Sofie Petri1, Michael Christiansen3, Jimmi Nielsen4, Jan Kvetny5, Christina Ellervik6  1Laboratory of Experimental Cardiology, University of Copenhagen, Denmark, 2Department of Health Science and Technology, Aalborg University, Denmark, 3Statens Seruminstitut, Copenhagen, Denmark, 4Department of Clinical Medicine, Aalborg Psychiatric Hospital, Aalborg, Denmark, 5Dept. of Clinical Biochemistry, Naestved Sygehus, Denmark, 6Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA, USA, 7Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark.   Mean±SD  Full Cohort Assumed Non-Healthy  Assumed Healthy Demographics     n  8779 3438 5341 age y 56.45±13.53 64.11±11.62* 51.52±12.32 male % 45.8% 47.1% (p=0.052) 45.0% ECG parameters     QTcF ms 416.5±20.4 420.5±21.8* 413.9±19.0 QTcB ms 420.9±24.5 427.7±25.2* 416.4±22.9 RR ms 956.0±163.9 918.6±159.8* 980.2±162.0 Clinical Chemistry     Se-Potassium mM 3.883±0.297 3.894±0.342* 3.876±0.264 Se-Sodium mM 140.70±2.24 140.52±2.52* 140.82±2.03 Creatinine µM 77.39±19.42 80.94±25.45* 75.14±13.83  It is a well-known fact that during hypokalemia, the corrected QT interval prolongs and the T-waves flattens and may even get humps, During hyperkalemia the corrected QT interval shortens and T-waves get higher amplitudes and become more peaked. However the magnitude of these repolarization changes during physiological variations of Se-K is unknown.  Subjects were enrolled from the Danish General Suburban Population Study (GESUS). GESUS is a cross-sectional study of the adult suburban general population in Naestved municipality (70 km south of Copenhagen) initiated in January 2010. The Full Cohort of participants having an electrocardiogram (ECG) recorded consisted of 9914 subjects. The (assumed) Healthy group excluded participants with self-reported history of myocardial infarction/angina pectoris, history of cerebrovascular incident, diabetes mellitus, Hba1c>42, estimated glomerular filtration rate lower than gender- and age-adjusted 5% percentile, intake of any cardiac medicamentation including diuretics, diabetes or insulin injections, consisted of 6314 patients.  ECGs were recorded on a digital ECG recorder (MAC5000, GE-Medical Systems, Milwaukee, WI, USA), at a sampling rate of 500 Hz. Each 10-second ECG was used to form a median beat in the recorded leads using MUSE/Interval Editor software (GE Health care, Milwaukee, WI, USA), where representative beat waveforms were constructed for each lead after baseline removal and then superimposed to construct a superlead. QT measurements were made automatically using the 12SL-algorithm (12SL, GE-Medical Systems, Milwaukee, WI, USA). QT intervals were corrected for heart rate with Fridericia’s formula (QTcF =(QT/RR )1/3).   Methods Conclusion Results  QTcF (ms) Univariate  95% CI Multivariate  95% CI age (y) 0.21* [0.17; 0.25] 0.26* [0.21; 0.30] gender (M vs. F) -7.4* [-8.4;-6.4] -6.7* [-7.7; -5.7] Se-Potassium (mM) -8.4* [-10.3;-6.4] -8.3* [-10.2;-6.3] Se-Sodium (mM) 0.12 [-0.12; 0.38]   Creatinine (µM) -0.17 [-0.21; -0.14]        Intercept   436* [429; 443]      T-wave Amplitude V5 (µV)     age (y) -1.8* [-2.2; -1.4] -2.3* [-2.7; -1.9] gender (M vs. F) 100* [90;110] 83* [95; 120] Se-Potassium (mM) 103* [85;123] 83* [77;115] Se-Sodium (mM) -0.09 [-2.6; 1.2]   Creatinine (µM) 2.0* [1.6; 2.4] -0.9* [-1.4;-0.5]      Intercept   161* [85; 236] • T-wave amplitude decreases 103 µV per mM decrease in potassium  • QTcF interval increases with 8.4 ms per mM decrease in potassium  • Since FDA has a threshold of concern of QTc=5 ms, it seems necessary to take plasma levels of potassium into account when analyzing data in studies with drug-induced repolarization changes Demographics of the Assumed healthy GESUS population. *p<0.05 vs. Healthy Univariate and Multivariate linear regression of QTcF and T-wave amplitude in lead V5 (Assumed healthy GESUS population). *p<0.05  

The QT interval increases with decreasing plasma potassium in the Danish general population

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The QT interval increases with decreasing plasma potassium in the Danish general population

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