Journal of Preventive Medicine and Public Health

  • 제39권6호
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  • Pages.455-461
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  • 2006
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
권호 표지

젊은 성인에서 교정 QT간격과 심혈관질환 위험요인의 관련성: 강화연구

Relationship between Corrected QT Interval and Cardiovascular Risk Factors in Young Healthy Adults: The Kangwha Study

  • 안성복 (연세대학교 의과대학 예방의학교실) ;
  • 김현창 (연세대학교 의과대학 예방의학교실) ;
  • 허남욱 (연세대학교 의과대학 예방의학교실) ;
  • 하경수 (연세대학교 의과대학 예방의학교실) ;
  • 장후선 (연세대학교 의과대학 예방의학교실) ;
  • 김진배 (연세대학교 의과대학 심장혈관병원 심장내과학교실) ;
  • 서일 (연세대학교 의과대학 예방의학교실)
  • Ahn, Song-Vogue (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyeon-Chang (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Hur, Nam-Wook (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Ha, Kyoung-Soo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Jang, Hoo-Sun (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Jin-Bae (Division of Cardiology, Cardiovascular Center, Yonsei University College of Medicine) ;
  • Suh, Il (Department of Preventive Medicine, Yonsei University College of Medicine)
  • 발행 : 2006.11.30
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초록

Objectives : Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people, The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. Methods : This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. Results : The mean QTc interval was significantly longer in women $(419{\pm}17ms)$ than in men $(405{\pm}17ms)$ (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. Conclusions : In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.

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참고문헌

  1. Schwartz PJ, Wolf S. QT interval prolongation as predictor of sudden death in patients with myocardial infarction. Circulation 1978; 57(6): 1074-1077 https://doi.org/10.1161/01.CIR.57.6.1074
  2. SC, Mallis GI, Brown EJ, Cohn PF. Documented sudden cardiac death in prolonged QT syndrome. Arch Intern Med 1984; 144(4): 833-835 https://doi.org/10.1001/archinte.144.4.833
  3. Moss AI, Schwartz PJ, Crampton RS, Tzivoni D, Locati EH, MacCluer J, Hall WJ, Weitkamp L, Vincent GM, Garson A Jr, Robinson JL, Benhorin J, Choi S. The long QT syndrome. prospective longitudinal study of 328 families. Circulation 1991; 84(3): 1136-1144 https://doi.org/10.1161/01.CIR.84.3.1136
  4. Jermendy G, Toth L, Voros P, Koltai MZ, Pogatsa G. Cardiac autonomic neuropathy and QT interval length. A follow-up study in diabetic patients. Acta Cardiol 1991; 46(2): 189-200
  5. Veglio M, Borra M, Stevens LK, Fuller JH, Perin PC. The relation between QTc interval prolongation and diabetic complications. The Eurodiab Iddm complication study group. Diobetdogia 1999;42(1): 68-75
  6. Schouten EG, Dekker JM, Meppelink P, Kok FJ, Vandenbroucke JP, Pool J. QT interval prolongation predicts cardiovascular mortality in an apparently healthy population. Circulation 1991;84(4): 1516-1523 https://doi.org/10.1161/01.CIR.84.4.1516
  7. Dekker JM, Schouten EG, Klootwijk P, Pool J, Kromhout D. Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen study. Circulation 1994; 90(2): 779-785 https://doi.org/10.1161/01.CIR.90.2.779
  8. De Bruyne MC, Hoes AW, Kors JA, Hofman A, van Bemmel JH, Grobbee DE. Prolonged QT interval predicts cardiac and all-cause mortality in the elderly. The Rotterdam study. Eur Heart J 1999; 20(4): 278-284 https://doi.org/10.1053/euhj.1998.1276
  9. Fauchier L, Maison-Blanche P, Forhan A, D'Hour A, Lepinay P, Tichet J, Vol S, Coumel P, Fauchier JP, Balkau B. Association between heart rate-corrected QT interval and coronary risk factors in 2,894 healthy subjects (the Desir study). Data from an epidemiological study on the insulin resistance syndrome. Am J Cardiol 2000; 86(5): 557-559 https://doi.org/10.1016/S0002-9149(00)01015-8
  10. Lefrandt JD, Diercks GF, van Boven AJ, Crijns HJ, van Gilst WH, Gans RO. High fasting glucose and QTc duration in a large healthy cohort. Diabetologia 2000; 43(10): 1332-1333
  11. Dekker JM, Feskens EJ, Schouten EG, Klootwijk P, Pool J, Kromhout D. QTc duration is associated with levels of insulin and glucose intolerance. The Zutphen elderly study. Diabetes 1996; 45(3): 376-380 https://doi.org/10.2337/diabetes.45.3.376
  12. Kazumi T, Kawaguchi A, Katoh J. Fasting serum insulin concentration are associated with QTc interval independent of serum leptin, percent body fat, and BMI. Diabetes Care 1999; 22(11): 1917-1918 https://doi.org/10.2337/diacare.22.11.1917
  13. Festa A, D'Agostino R Jr, Rautaharju P, O'Leary DH, Rewers M, Mykkanen L, Haffner SM. Is QT interval a marker of subclinical atherosclerosis in nondiabetic subjects? The insulin resistance atherosclerosis study (IRAS). Stroke 1999; 30(8): 1566-1571 https://doi.org/10.1161/01.STR.30.8.1566
  14. Strohmer B, Pichler M, Iglseder B, Paulweber B. Relationship of QT interval duration with carotid intima media thickness in a clinically healthy population undergoing cardiovascular risk screening. J Intern Med 2005; 257(3): 238-246 https://doi.org/10.1111/j.1365-2796.2004.01436.x
  15. Kannel WE, Dawber TR. Atherosclerosis as a pediatric problem. J Pediatr 1972; 80(4): 544-554 https://doi.org/10.1016/S0022-3476(72)80049-0
  16. Zieske AW, Malcom GT, Strong JP. Natural history and risk factors of atherosclerosis in children and youth: the PDAY study. Pediatr Pathol Mol Med 2002; 21(2): 213-237 https://doi.org/10.1080/15227950252852104
  17. Shin HS, Lee WY, Kim SW, Jung CH, Lee EJ, Sung KC, Kim BS, Kang JH, Lee MH, Park JR. Sex difference in the relationship between insulin resistance and QTc interval in Korean non-diabetic subjects. Korean J Med 2003; 64(6): 670-676 (Korean)
  18. Cho CG, Lim DS, Choi SC, Hong SW, Jang G, Kim DH, Kim CI, Park OK. The relationship between autonomic neuropathy and corrected QT interval in diabetic patients. Korean J Med 1991; 41(2): 223-230 (Korean)
  19. Cho CG, No HJ, Oh HJ, Yang BJ, Kim HY, Park BH. Prolonged QT interval and the BMI, systolic blood pressure and HDL-cholesterol in type 2 diabetic patients. J Kor Diabetes Assoc 2005; 29(3): 215-222 (Korean)
  20. Shin HS, Lee WY, Kim SW, Jung CH, Rhee EJ, Kim BJ, Sung KC, Kim BS, Kang JH, Lee MH, Park JR. Sex difference in the relationship between insulin resistance and corrected QT interval in non-diabetic subjects. Circ J 2005; 69(4): 409-413 https://doi.org/10.1253/circj.69.409
  21. Suh I KI, Nam CM, Lee SY, Oh HC, Kim CB, Park EC. The change of children's blood pressure and factors affecting the level of blood pressure in children. Korean J Prev Med 1989; 22(3): 303-312 (Korean)
  22. Suh I NC, Jee SH, Kim SI, Kim YO, Kim SS, Shim WH, Kim CB, Lee KH, Ha JW, Kang HG, Oh KW. Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents. Korean J Prev Med 1997; 30(2): 308-326 (Korean)
  23. Friedewald WT, Levy RI, Fredrickson DS. Estimation of concentration of low-density lipoprotein cholesterol in plarna without use of the preparative ultracentrifuge. Clin Chem 1972; 18(6): 499-502
  24. Bazett He. An analysis of the time-relations of electrocardiograms. Heart 1920; 7: 353-367
  25. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342(12): 836-843 https://doi.org/10.1056/NEJM200003233421202
  26. Algra A, Tijssen JG, Roelandt JR, Pool J, Lubsen J. QTc prolongation measured by standard 12-lead electrocardiography is an independent risk factor for sudden death due to cardiac arrest. Circulation 1991; 83(6): 1888-1894 https://doi.org/10.1161/01.CIR.83.6.1888
  27. Elming H, Holm E, Jun L, Torp-Pedersen C, Kober L, Kircshoff M, Malik M, Camm J. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19(9): 1391-1400 https://doi.org/10.1053/euhj.1998.1094
  28. Jackman WM, Friday KJ, Anderson JL, Aliot EM, Clark M, Lazzara R. The long QT syndromes: a critical review, new clinical observations and a unifying hypothesis. Prog Cardiovasc Dis 1988; 31(2): 115-172 https://doi.org/10.1016/0033-0620(88)90014-X
  29. Scherrer U, Sartori C. Insulin as a vascular and sympathoexcitatory hormone: implications for blood pressure regulation, insulin sensitivity, and cardiovascular morbidity. Circulation 1997; 96(11): 4104-4113 https://doi.org/10.1161/01.CIR.96.11.4104
  30. Leotta G, Maule S, Rabbia F, Del Colle S, Tredici M, Canade A, Verhovez A, Veglio F. Relationship between QT interval and cardiovascular risk factors in healthy young subjects. J Hum Hypertens 2005; 19(8): 623-627 https://doi.org/10.1038/sj.jhh.1001874
  31. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III) final report. Circulation 2002; 106(25): 3143-3421
  32. Rautaharju PM, Zhou SH, Wong S, Calhoun HP, Berenson GS, Prineas R, Davignon A. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol 1992; 8(7): 690-695
  33. Benton RE, Sale M, Flockhart DA, Woosley RL. Greater quinidine-induced QTc interval prolongation in women. Clin Pharmacol Ther 2000;67(4):413-418 https://doi.org/10.1067/mcp.2000.105761
  34. Boyle MB, MacLusky NJ, Naftolin F, Kaczmarek LK. Hormonal regulation of $K_+$ channel messenger RNA in rat myometrium during oestrus cycle and in pregnancy. Nature 1987;330(6146):373-375 https://doi.org/10.1038/330373a0
  35. Drici MD, Burklow TR, Haridasse V, Glazer RI, Woosley RL. Sex hormones prolong the QT interval and downregulate potassium channel expression in the rabbit heart. Circulation 1996; 94(6): 1471-1474 https://doi.org/10.1161/01.CIR.94.6.1471
  36. Altunkeser BB, Ozdemir K, Icli A, Celik C, Akyurek C, Gok H. Effects of long-term hormone replacement therapy on QT and corrected QT dispersion during resting and peak exercise electrocardiography in postmenopausal women. Jpn Heart J 2002; 43(4): 1-7 https://doi.org/10.1536/jhj.43.1
  37. Carnethon MR, Anthony MS, Cascio WE, Folsom AR, Rautaharju PM, Liao D, Evans GW, Heiss G. A prospective evaluation of the risk of QT prolongation with hormone replacement therapy: The atherosclerosis risk in communities study. Ann Epidemiol 2003; 13(7): 530-536 https://doi.org/10.1016/S1047-2797(03)00050-4
  38. Howard G, Burke GL, Szklo M, Tell GS, Eckfeldt J, Evans G, Heiss G. Active and passive smoking are associated with increased carotid wall thickness. The atherosclerosis risk in communities study. Arch Intern Med 1994; 154(11): 1277-1282 https://doi.org/10.1001/archinte.154.11.1277
  39. Ben-David J, Zipes DP. Differential response to right and left ansae subclaviae stimulation of early afterdepolarizations and ventricular tachycardia induced by cesium in dogs. Circulation 1988; 78(5): 1241-1250 https://doi.org/10.1161/01.CIR.78.5.1241
  40. Takahashi N, Nakagawa M, Saikawa T, Watanabe M, Ooie T, Yufu K, Shigematsu S, Hara M, Sakino H, Katsuragi I, Tanaka K, Yoshimatsu H. Regulation of QT indices mediated by autonomic nervous function in patients with type 2 diabetes. Int J Cardiol 2004; 96(3): 375-379 https://doi.org/10.1016/j.ijcard.2003.07.026