Published online before print September 29, 2003, doi: 10.1161/01.CIR.0000095027.28753.9D
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;108:1985.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Prognostic Significance of Corrected QT and Corrected JT Interval for Incident Coronary Heart Disease in a General Population Sample Stratified by Presence or Absence of Wide QRS Complex
The ARIC Study With 13 Years of Follow-Up
From the Division of Epidemiology, University of Minnesota, Minneapolis, Minn.
Correspondence to Richard S. Crow, MD, University of Minnesota, Division of Epidemiology, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454. E-mail crow{at}epi.umn.edu
Received February 26, 2003; de novo received April 28, 2003; revision received July 15, 2003; accepted July 29, 2003.
Background— Heart rate-corrected QT interval (QTc) is the traditional method of assessing the duration of repolarization. Prolonged heart rate-corrected QT interval is associated with higher risk of mortality in patients with coronary heart disease (CHD) and in the general population. However, the QTc is typically not evaluated when QRS duration is 
120 ms, because increased QRS duration (QRSd) contributes to QT interval prolongation. In these circumstances, the JT interval has been proposed as a more valid way to assess ventricular repolarization.
Methods and Results— To allow for variation in heart rate, corrected JT interval (JTc) was defined as QTc-QRSd. Using data from the Atherosclerosis Risk in Communities Study, JTc and QTc were compared for their prognostic associations with incident CHD events among 14 696 men and women who were CHD-free at baseline, having either normal conduction or wide QRS complex. Among individuals with normal QRS duration, logistic regression adjusted for age, hypertensive status, diabetes, race, systolic blood pressure, smoking, HDL and LDL cholesterol, R-R interval, and menopausal status in women showed QTc and JTc were nonpredictive of future coronary events in men but significant in women. In individuals with wide QRS complex (QRSd 120 ms), similar analyses showed JTc had a significant prognostic advantage compared with QTc in men but not in women, among whom only 11 events occurred.
Conclusions— The JTc is a simple measurement that is a significant independent predictor of incident CHD events in men with wide QRS complex.
Key Words: electrocardiography • prognosis • bundle-branch block
This article has been cited by other articles:
 |
|
 |
|
  M. S. Hazari, N. Haykal-Coates, D. W. Winsett, D. L. Costa, and A. K. Farraj A Single Exposure to Particulate or Gaseous Air Pollution Increases the Risk of Aconitine-Induced Cardiac Arrhythmia in Hypertensive Rats Toxicol. Sci., December 1, 2009; 112(2): 532 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. L. Akylbekova, R. S. Crow, W. D. Johnson, S. G. Buxbaum, S. Njemanze, E. Fox, D. F. Sarpong, H. A. Taylor, and C. Newton-Cheh Clinical Correlates and Heritability of QT Interval Duration in Blacks: The Jackson Heart Study Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 427 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Rautaharju, B. Surawicz, and L. S. Gettes AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV: The ST Segment, T and U Waves, and the QT Interval A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology J. Am. Coll. Cardiol., March 17, 2009; 53(11): 982 - 991. [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Rautaharju, B. Surawicz, and L. S. Gettes AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV: The ST Segment, T and U Waves, and the QT Interval: A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: Endorsed by the International Society for Computerized Electrocardiology Circulation, March 17, 2009; 119(10): e241 - e250. [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Khan, K. M. Goode, J. G.F. Cleland, A. S. Rigby, N. Freemantle, J. Eastaugh, A. L. Clark, R. de Silva, M. J. Calvert, K. Swedberg, et al. Prevalence of ECG abnormalities in an international survey of patients with suspected or confirmed heart failure at death or discharge Eur J Heart Fail, May 1, 2007; 9(5): 491 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Kestenbaum, K. D. Rudser, M. G. Shlipak, L. F. Fried, A. B. Newman, R. Katz, M. J. Sarnak, S. Seliger, C. Stehman-Breen, R. Prineas, et al. Kidney Function, Electrocardiographic Findings, and Cardiovascular Events among Older Adults Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 501 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schillaci, M. Pirro, T. Ronti, F. Gemelli, G. Pucci, S. Innocente, C. Porcellati, and E. Mannarino Prognostic Impact of Prolonged Ventricular Repolarization in Hypertension. Arch Intern Med, April 24, 2006; 166(8): 909 - 913. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Nilsson, P. Hedberg, T. Jonasson, I. Lonnberg, and J. Ohrvik QTc interval and survival in 75-year-old men and women from the general population. Europace, April 1, 2006; 8(4): 233 - 240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G A Suarez, V M Clark, J E Norell, T E Kottke, M J Callahan, P C O'Brien, P A Low, and P J Dyck Sudden cardiac death in diabetes mellitus: risk factors in the Rochester diabetic neuropathy study J. Neurol. Neurosurg. Psychiatry, February 1, 2005; 76(2): 240 - 245. [Abstract] [Full Text] [PDF]
|
|