Keskin Gamze, Karaman Sibel Tunç, Basat Okcan
Gaziosmanpaşa Training and Research Hospital, Department of Family Medicine, University of Health Sciences, Istanbul, Turkey.
Tob Induc Dis. 2021 Mar 31;19:22. doi: 10.18332/tid/133053. eCollection 2021.
Smoking increases the risk of arrhythmia. QT dispersion (QTd) is an important indicator for the determination of ventricular arrhythmia. In this study, we aimed to determine the arrhythmia risk by evaluating QTd in smokers and to assess the relationship between the level of nicotine addiction and carbon monoxide (CO) level in the expiratory air.
This study was designed as a single-center, cross-sectional study. Among the chronic smokers referred to the Smoking Cessation Clinic of a tertiary hospital between October 2019 and January 2020, all those who had no risk factors for cardiac arrhythmias, except smoking, were included in the study. Sociodemographic data and smoking characteristics of the participants were collected and exhaled CO levels were measured. QT intervals were measured in all leads by using a 12-lead standard electrocardiogram (ECG), and heart rate corrected QT (QTc) intervals, QT dispersion (QTd), and corrected QT dispersion (QTcd) were calculated.
The mean age of the 250 patients was 37.2±9.3 years and the majority of patients (65%) were male. The mean amount of smoking was 25.74±16.03 packs/year and the mean value of CO was 12.36±7.06 ppm. The mean QTd was 23.83±13.12 ms, and the mean QTcd was 26.63±15.02 ms. A statistically significant relationship was found between QTd and QTcd and level of addiction, consumption of sticks/day and packs/year, and exhaled CO values (all p<0.001).
It was found that as the level of addiction, cigarette use amount, exhaled CO levels, and BMI increased in smokers, QT dispersion and arrhythmia risk increased.
吸烟会增加心律失常的风险。QT离散度（QTd）是判定室性心律失常的一项重要指标。在本研究中，我们旨在通过评估吸烟者的QTd来确定心律失常风险，并评估尼古丁成瘾水平与呼出气中一氧化碳（CO）水平之间的关系。
本研究设计为单中心横断面研究。在2019年10月至2020年1月期间转诊至某三级医院戒烟门诊的慢性吸烟者中，纳入所有除吸烟外无心律失常危险因素的患者。收集参与者的社会人口学数据和吸烟特征，并测量呼出气中的CO水平。使用12导联标准心电图（ECG）测量所有导联的QT间期，并计算心率校正QT（QTc）间期、QT离散度（QTd）和校正QT离散度（QTcd）。
250例患者的平均年龄为37.2±9.3岁，大多数患者（65%）为男性。平均吸烟量为25.74±16.03包/年，CO的平均值为12.36±7.06 ppm。平均QTd为23.83±13.12 ms，平均QTcd为26.63±15.02 ms。发现QTd和QTcd与成瘾水平、每日吸烟支数和每年吸烟包数以及呼出气CO值之间存在统计学显著关系（所有p<0.001）。
研究发现，吸烟者的成瘾水平、吸烟量、呼出气CO水平和体重指数增加时，QT离散度和心律失常风险也会增加。
