Evaluation of the relationship between the level of addiction and exhaled carbon monoxide levels with QT dispersion in smokers.

Gamze Keskin,Okcan Basat,Sibel Tunç Karaman

doi:10.18332/tid/133053

Abstract

INTRODUCTIONSmoking 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.METHODSThis 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.RESULTSThe 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).CONCLUSIONSIt 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.

Highlights

While carbon monoxide (CO) poses a risk for cardiovascular system diseases by worsening hypoxia, another critical component of a cigarette, nicotine, increases the release of catecholamine, activates the sympathetic nervous system and closes the potassium channels located in the ventricular myocardium, and prolongs and delays repolarization[4,5]
In the present study, the relationship between smoking and some ECG changes pertaining to increased cardiac arrhythmia risk was investigated, and it was shown that as the level of addiction, the number of cigarettes consumed, exhaled CO levels, and BMI increased, the QT dispersion, which is essential for determining the risk of ventricular arrhythmia, increased
We found a significant relationship between the value of CO measured from expiratory air and QT dispersion and concluded that it was not high enough to cause intoxication, regardless of the measurement technique, CO increased the risk of ventricular arrhythmia

Summary

Introduction

While CO poses a risk for cardiovascular system diseases by worsening hypoxia, another critical component of a cigarette, nicotine, increases the release of catecholamine, activates the sympathetic nervous system and closes the potassium channels located in the ventricular myocardium, and prolongs and delays repolarization[4,5]. QT dispersion (QTd) (the difference between the maximum and minimum QT interval) is an measured electrocardiographic marker and indicates ventricular electrical instability and variable myocardial repolarization[6,7,8]. It is considered an important indicator of the severe risk of ventricular arrhythmia[6]. In addition to the increase in a wide variety of cardiovascular diseases, QTd may increase in non-cardiovascular diseases such as diabetes mellitus, rheumatological diseases, and vitamin D deficiency[11,12,13]

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