The Relationship between Thyroid Hormone Levels and Corrected QT Interval and QT Dispersion in Non-Diabetic Hemodialysis Patients

Heo-Yeong  Kim; Ji Soo  Kim; Seung Eun  Suh; Yu Kyung  Hyun; Kyeong  Mi Park; Hyung-Jong  Kim

doi:10.4236/ojneph.2014.41003

Heo-Yeong Kim, Ji Soo Kim, Seung Eun Suh, Yu Kyung Hyun, Kyeong Mi Park, Hyung-Jong Kim^*

Abstract: Background: Cardiovascular disease and sudden cardiac death are common in hemodialysis patients. These cardiac complications are often associated with prolonged QTc interval (QTc) and QTc dispersion (QTcd). Subclinical hypothyroidism (SH) can alter autonomic modulation of heart rate and cause increased inhomogeneity of ventricular recovery time. We aimed to evaluate the relationship between thyroid hormone levels and QTc and QTcd in non-diabetic hemodialysis patients. Methods: We enrolled 29 non-diabetic hemodialysis patients without thyroid disease. After each hemodialysis session, a 12-lead ECG was recorded. Before each hemodialysis session, routine laboratory tests and measurement of thyroid hormone levels were performed. Patients were divided into 2 groups according to QTc (group 1 QTc < 430 ms, group 2 QTc ≥ 430 ms). We examined the relationship between QTc or QTcd and thyroid hormone in the respective groups and then compared the results from the 2 groups. Results: The mean age was 54.06 ± 14.72 years and the means of QTc and QTcd were 433.82 ± 22.03 ms, 59.10 ± 28.29 ms, respectively. Homocysteine levels were significant higher in group 2 than group 1 (p < 0.05) and QTcd was comparable between groups. In group 1, QTc and QTcd were not significant correlated with TSH, T3, fT4 and biochemical parameters. In group 2, QTc was significant positively correlated with TSH (p < 0.05) and QTcd was not significant correlated with thyroid hormone levels. Conclusion: The results of this study showed that TSH is associated with prolonged QTc interval and hyperhomocysteinemia in non-diabetic hemodialysis patients. Moreover, we suggest that SH may be associated with prolonged QTc in non-diabetic hemodialysis patients. However, further studies are required to elucidate the role of the L-thyroxine doses and TSH target levels in hemodialysis patients.

Keywords: Thyroid Hormone; Hemodialysis; Cardiovascular Disease

Cite this paper: H. Kim, J. Kim, S. Suh, Y. Hyun, K. Mi Park and H. Kim, "The Relationship between Thyroid Hormone Levels and Corrected QT Interval and QT Dispersion in Non-Diabetic Hemodialysis Patients," Open Journal of Nephrology, Vol. 4 No. 1, 2014, pp. 13-19. doi: 10.4236/ojneph.2014.41003.

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