Evaluation of electrocardiographic ventricular repolarization parameters in extreme obesity.

BACKGROUND AND OBJECTIVES: The risk of sudden death and cardiac arrhythmia increases in morbidly obese patients. We aimed to evaluate the marker of arrhythmias such as Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios in extreme obesity. METHODS: The study included 41 extremely obese patients and 41 control subjects. QTmax, QTmin, QRS, JT and Tp-e intervals were measured od 12­lead electrocardiographies. In addition, Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc rates and QTc, cQTd and JTc intervals were calculated. RESULTS: Tp-e interval (79.2 ±â€¯9.7 ms (milisecond) vs. 68.6 ±â€¯8.1, p < 0.001), QTc interval (395.9 ±â€¯18.8 vs. 377.9 ±â€¯19.3 ms, p < 0.001), JTc interval (317.1 ±â€¯27.0 vs. 297.4 ±â€¯23.2 ms, p = 0.001), Tp-e/QT ratio (0.22 ±â€¯0.03vs. 0.19 ±â€¯0.02, p < 0.001), Tp-e/QTc ratio (0.20 ±â€¯0.26vs. 0.18 ±â€¯0.02, p = 0.001), Tp-e/JT ratio (0.29 ±â€¯0.04 vs. 0.25 ±â€¯0.03, p < 0.001), TPe/JTc ratio (0.25 ±â€¯0.04 vs. 0.23 ±â€¯0.03, p = 0.018), QTd (32.8 ±â€¯10 vs.15 ±â€¯6.4 ms, p < 0.001) and cQTd (70.0 ±â€¯30.1 vs. 31.3 ±â€¯22.4 ms, p < 0.001) were significantly higher in obese patients. CONCLUSION: Compared to healthy subjects potential ECG repolarization predictors were significantly increased in extremely obese patients.

Relation between serum total bilirubin levels and severity of coronary artery disease in patients with non-ST-segment elevation myocardial infarction.

We studied 403 consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI). This population was divided into tertiles according to the SYNTAX score (SXscore). The high SXscore group was defined as an SXscore ≥13, and the low SXscore group as an SXscore <13. The total bilirubin (sTB) and direct bilirubin levels of patients were significantly higher in the high SXscore group (P = .001 and P = .007, respectively). There was a correlation between sTB and SXscore (r = .495; P = .005). On multivariate linear regression analyses, age (ß = .100; P = .041), sTB levels (ß = .171; P = .005), low-density lipoprotein cholesterol (ß = .121; P = .014), and troponin-I (ß = .124; P = .011) remained independent correlates of high SXscore. The mean follow-up period was 18.2 months. All-cause mortality rate was higher in the high SXscore group but did not reach significance (P = .058). In conclusion, high sTB level is independently associated with severity of coronary artery disease in patients with NSTEMI. However, no association was found with long-term mortality.