Significance of QTc interval in chronic hypoparathyroidism and its correlates.
J Clin Endocrinol Metab
; 2024 May 17.
Article
en En
| MEDLINE
| ID: mdl-38758961
ABSTRACT
CONTEXT Hypocalcemia predisposes patients with chronic hypoparathyroidism (cHypoPT) to an increased risk of QTc prolongation and life-threatening arrhythmias. Information on clinical and biochemical correlates of QTc in cHypoPT is limited. DESIGN AND SETTING:
Observational cohort study at tertiary-care-center. SUBJECTS ANDMETHODS:
Eighty-eight non-surgical cHypoPT (mean age 44.1 ± 15.4 years, 45 males) were assessed for QTc interval and its possible correlates including arrhythmic symptoms (palpitation/giddiness/syncope), serum total-calcium, phosphate, 25(OH)D and iPTH.RESULTS:
The mean QTc in HypoPT cohort was 428 ± 34â ms with 13.6% having prolonged QTc. There was a significant inverse correlation between QTc interval and serum total-calcium measured on the same day (r = -0.43, p < 0.001). The mean serum total-calcium was significantly lower in patients with prolonged QTc (7.05 ± 1.94 vs. 8.49 ± 1.01â mg/dL, p = 0.02). 21.6% of cHypoPT patients had arrhythmic symptoms. They had significantly higher mean QTc (p = 0.02) and also tended to have lower mean serum total-calcium during follow-up (p = 0.06). In multivariable regression, female gender, higher current-age, higher BMI, and low serum total-calcium showed significant association with prolonged QTc. For every mg/dL decrease in serum total-calcium, QTc increased by 13â ms. Receiver-operating-characteristic analysis revealed serum total-calcium at cut-off of 8.3â mg/dL discriminated prolonged QTc with area-under-curve being 0.72 [95% CI 0.51,0.93].CONCLUSION:
One-fifth of cHypoPT had arrhythmic symptoms and a significant proportion had prolonged QTc. This highlights the need for close monitoring of cHypoPT patients for arrhythmic symptoms and QTc prolongation. The serum total-calcium should be maintained to at least 8.3â mg/dL to minimize the risk of potentially life-threatening arrhythmia in cHypoPT.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos