Krogager Maria Lukács, Kragholm Kristian, Skals Regitze Kuhr, Mortensen Rikke Nørmark, Polcwiartek Christoffer, Graff Claus, Nielsen Jonas Bille, Kanters Jørgen K, Holst Anders Gaarsdal, Søgaard Peter, Pietersen Adrian, Torp-Pedersen Christian, Hansen Steen Møller
Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
J Electrocardiol. 2019 Nov-Dec;57:104-111. doi: 10.1016/j.jelectrocard.2019.09.005. Epub 2019 Sep 4.
Potassium disturbances are common and associated with increased morbidity and mortality, even in patients without prior cardiovascular disease. We examined six electrocardiographic (ECG) measures and their association to serum potassium levels.
From the Copenhagen General Practitioners' Laboratory, we identified 163,547 individuals aged ≥16 years with a first available ECG and a concomitant serum potassium measurement during 2001-2011. Restricted cubic splines curves showed a non-linear relationship between potassium and the Fridericia corrected QT (QTcF) interval, T-wave amplitude, morphology combination score (MCS), PR interval, P-wave amplitude and duration. Therefore, potassium was stratified in two intervals K: 2.0-4.1 mmol/L and 4.2-6.0 mmol/L for further analyses. Within the low potassium range, we observed: QTcF was 12.8 ms longer for each mmol/L decrease in potassium (p < 0.0001); T-wave amplitude was 43.1 μV lower for each mmol/L decrease in potassium (p < 0.0001); and MCS was 0.13 higher per mmol/L decrease in potassium (p < 0.001). Moreover, P-wave duration and PR interval were prolonged by 2.7 and 4.6 ms for each mmol/L decrease in potassium (p < 0.0001), respectively. Within the lowest potassium range (2.0-4.1 mmol/L) P-wave amplitude was 3.5 μV higher for each mmol/L decrease in potassium (p < 0.0001). Within the high potassium range associations with the above-mentioned ECG parameters were much weaker.
钾紊乱很常见，且与发病率和死亡率增加相关，即使在无既往心血管疾病的患者中也是如此。我们研究了六种心电图（ECG）测量指标及其与血清钾水平的关联。
从哥本哈根全科医生实验室，我们确定了2001年至2011年期间年龄≥16岁且有首次可用心电图及同步血清钾测量值的163547名个体。受限立方样条曲线显示钾与弗里德里西亚校正QT（QTcF）间期、T波振幅、形态组合评分（MCS）、PR间期、P波振幅和持续时间之间呈非线性关系。因此，将钾分为两个区间K：2.0 - 4.1 mmol/L和4.2 - 6.0 mmol/L进行进一步分析。在低钾范围内，我们观察到：钾每降低1 mmol/L，QTcF延长12.8 ms（p < 0.0001）；钾每降低1 mmol/L，T波振幅降低43.1 μV（p < 0.0001）；钾每降低1 mmol/L，MCS升高0.13（p < 0.001）。此外，钾每降低1 mmol/L，P波持续时间和PR间期分别延长2.7和4.6 ms（p < 0.0001）。在最低钾范围（2.0 - 4.1 mmol/L）内，钾每降低1 mmol/L，P波振幅升高3.5 μV（p < 0.0001）。在高钾范围内，与上述心电图参数的关联要弱得多。
