Archives of the Turkish Society of Cardiology
QT dispersion in patients with rheumatic mitral stenosis and its relation with echocardiographic findings and serum NT-proBNP levels [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(3): 183-190 | DOI: 10.5543/tkda.2011.01230

QT dispersion in patients with rheumatic mitral stenosis and its relation with echocardiographic findings and serum NT-proBNP levels

Kadriye Orta Kilickesmez, Gulsum Bulut, Murat Baskurt, Ugur Coskun, Ahmet Yildiz, Serdar Kucukoğlu
Istanbul University Institute of Cardiology,department of Cardiology, Istanbul, Turkey


OBJECTIVES
We evaluated the value of QT interval dispersion in patients with rheumatic mitral stenosis (MS) in association with echocardiographic parameters and serum N-terminal pro brain natriuretic peptide (NT-proBNP) levels.

STUDY DESIGN
The study consisted of 46 patients (39 women, 7 men; mean age 46.9±9.7 years) with moderate-to-severe rheumatic MS. All patients underwent echocardiographic examination. Blood samples for NT-proBNP were collected immediately after ECG recording. QT interval and QRS complex were measured manually on standard 12-lead surface ECGs. Electrocardiographic and echocardiographic findings and serum NT-proBNP levels were compared with those of a control group consisting of 30 healthy subjects (26 women, 4 men; mean age 46.1±7.3 years).

RESULTS
Compared to controls, serum NT-proBNP levels were significantly higher in MS patients (284.6±206.5 vs. 70.2±9.3 pg/ml, p<0.001). The mean QT interval, QTc interval, and QT dispersion were significantly prolonged in MS patients compared to controls (378±25 vs. 349±21, 420±22 vs. 401±19, and 61±21 vs. 38±15 msec, respectively; p<0.005). QT and QTc dispersions were negatively correlated with mitral valve area (QT: r=-0.311, p=0.03; QTc: r=-0.327, p=0.02), and positively correlated with serum NT-proBNP level (QT: r=0.583, p<0.001; QTc: r=0.637, p<0.001). QTc dispersion was also an independent predictor of serum NT-proBNP level in regression analysis (β=0.330, p=0.03).

CONCLUSION
Our results indicate that QT dispersion is related to the echocardiographic degree of rheumatic mitral valve disease and serum NT-proBNP levels in rheumatic MS. Being a noninvasive, easy, and inexpensive method, QT dispersion may be used as a complementary tool to the clinical and echocardiographic evaluation of patients with rheumatic MS.

Keywords: Echocardiography, electrocardiography, mitral valve stenosis; natriuretic peptide, brain; rheumatic heart disease

How to cite this article
Kadriye Orta Kilickesmez, Gulsum Bulut, Murat Baskurt, Ugur Coskun, Ahmet Yildiz, Serdar Kucukoğlu. QT dispersion in patients with rheumatic mitral stenosis and its relation with echocardiographic findings and serum NT-proBNP levels. Turk Kardiyol Dern Ars. 2011; 39(3): 183-190

Corresponding Author: Kadriye Orta Kilickesmez, Türkiye
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