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@article{Noordam:2019:10.1016/j.jacc.2019.03.519,
author = {Noordam, R and Young, WJ and Salman, R and Kanters, JK and van, den Berg ME and van, Heemst D and Lin, HJ and Barreto, SM and Biggs, ML and Biino, G and Catamo, E and Concas, MP and Ding, J and Evans, DS and Foco, L and Grarup, N and Lyytikainen, L-P and Mangino, M and Mei, H and van, der Most PJ and Mueller-Nurasyid, M and Nelson, CP and Qian, Y and Repetto, L and Said, MA and Shah, N and Schramm, K and Vidigal, PG and Weiss, S and Yao, J and Zilhao, NR and Brody, JA and Braund, PS and Brumat, M and Campana, E and Christofidou, P and Caulfield, MJ and De, Grandi A and Dominiczak, AF and Doney, ASF and Eiriksdottir, G and Ellervik, C and Giatti, L and Gogele, M and Graff, C and Guo, X and van, der Harst P and Joshi, PK and Kahonen, M and Kestenbaum, B and Lima-Costa, MF and Linneberg, A and Maan, AC and Meitinger, T and Padmanabhan, S and Pattaro, C and Peters, A and Petersmann, A and Sever, P and Sinner, MF and Shen, X and Stanton, A and Strauch, K and Soliman, EZ and Tarasov, KV and },
doi = {10.1016/j.jacc.2019.03.519},
journal = {Journal of the American College of Cardiology},
pages = {3118--3131},
title = {Effects of Calcium, Magnesium, and Potassium concentrations on ventricular repolarization in unselected individuals},
url = {http://dx.doi.org/10.1016/j.jacc.2019.03.519},
volume = {73},
year = {2019}
}

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TY  - JOUR
AB  - BackgroundSubclinical changes on the electrocardiogram are risk factors for cardiovascular mortality. Recognition and knowledge of electrolyte associations in cardiac electrophysiology are based on only in vitro models and observations in patients with severe medical conditions.ObjectivesThis study sought to investigate associations between serum electrolyte concentrations and changes in cardiac electrophysiology in the general population.MethodsSummary results collected from 153,014 individuals (54.4% women; mean age 55.1 ± 12.1 years) from 33 studies (of 5 ancestries) were meta-analyzed. Linear regression analyses examining associations between electrolyte concentrations (mmol/l of calcium, potassium, sodium, and magnesium), and electrocardiographic intervals (RR, QT, QRS, JT, and PR intervals) were performed. The study adjusted for potential confounders and also stratified by ancestry, sex, and use of antihypertensive drugs.ResultsLower calcium was associated with longer QT intervals (−11.5 ms; 99.75% confidence interval [CI]: −13.7 to −9.3) and JT duration, with sex-specific effects. In contrast, higher magnesium was associated with longer QT intervals (7.2 ms; 99.75% CI: 1.3 to 13.1) and JT. Lower potassium was associated with longer QT intervals (−2.8 ms; 99.75% CI: −3.5 to −2.0), JT, QRS, and PR durations, but all potassium associations were driven by use of antihypertensive drugs. No physiologically relevant associations were observed for sodium or RR intervals.ConclusionsThe study identified physiologically relevant associations between electrolytes and electrocardiographic intervals in a large-scale analysis combining cohorts from different settings. The results provide insights for further cardiac electrophysiology research and could potentially influence clinical practice, especially the association between calcium and QT duration, by which calcium levels at the bottom 2% of the population distribution led to cl
AU  - Noordam,R
AU  - Young,WJ
AU  - Salman,R
AU  - Kanters,JK
AU  - van,den Berg ME
AU  - van,Heemst D
AU  - Lin,HJ
AU  - Barreto,SM
AU  - Biggs,ML
AU  - Biino,G
AU  - Catamo,E
AU  - Concas,MP
AU  - Ding,J
AU  - Evans,DS
AU  - Foco,L
AU  - Grarup,N
AU  - Lyytikainen,L-P
AU  - Mangino,M
AU  - Mei,H
AU  - van,der Most PJ
AU  - Mueller-Nurasyid,M
AU  - Nelson,CP
AU  - Qian,Y
AU  - Repetto,L
AU  - Said,MA
AU  - Shah,N
AU  - Schramm,K
AU  - Vidigal,PG
AU  - Weiss,S
AU  - Yao,J
AU  - Zilhao,NR
AU  - Brody,JA
AU  - Braund,PS
AU  - Brumat,M
AU  - Campana,E
AU  - Christofidou,P
AU  - Caulfield,MJ
AU  - De,Grandi A
AU  - Dominiczak,AF
AU  - Doney,ASF
AU  - Eiriksdottir,G
AU  - Ellervik,C
AU  - Giatti,L
AU  - Gogele,M
AU  - Graff,C
AU  - Guo,X
AU  - van,der Harst P
AU  - Joshi,PK
AU  - Kahonen,M
AU  - Kestenbaum,B
AU  - Lima-Costa,MF
AU  - Linneberg,A
AU  - Maan,AC
AU  - Meitinger,T
AU  - Padmanabhan,S
AU  - Pattaro,C
AU  - Peters,A
AU  - Petersmann,A
AU  - Sever,P
AU  - Sinner,MF
AU  - Shen,X
AU  - Stanton,A
AU  - Strauch,K
AU  - Soliman,EZ
AU  - Tarasov,KV
AU  - Taylor,KD
AU  - Thio,CHL
AU  - Uitterlinden,AG
AU  - Vaccargiu,S
AU  - Waldenberger,M
AU  - Robino,A
AU  - Correa,A
AU  - Cucca,F
AU  - Cummings,SR
AU  - Doerr,M
AU  - Girotto,G
AU  - Gudnason,V
AU  - Hansen,T
AU  - Heckbert,SR
AU  - Juhl,CR
AU  - Kaeaeb,S
AU  - Lehtimaki,T
AU  - Liu,Y
AU  - Lotufo,PA
AU  - Palmer,CNA
AU  - Pirastu,M
AU  - Pramstaller,PP
AU  - Ribeiro,ALP
AU  - Rotter,JI
AU  - Samani,NJ
AU  - Snieder,H
AU  - Spector,TD
AU  - Stricker,BH
AU  - Verweij,N
AU  - Wilson,JF
AU  - Wilson,JG
AU  - Jukema,JW
AU  - Tinker,A
AU  - Newton-Cheh,CH
AU  - Sotoodehnia,N
AU  - Mook-Kanamori,DO
AU  - Munroe,PB
AU  - Warren,HR
DO  - 10.1016/j.jacc.2019.03.519
EP  - 3131
PY  - 2019///
SN  - 0735-1097
SP  - 3118
TI  - Effects of Calcium, Magnesium, and Potassium concentrations on ventricular repolarization in unselected individuals
T2  - Journal of the American College of Cardiology
UR  - http://dx.doi.org/10.1016/j.jacc.2019.03.519
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000471773400012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.sciencedirect.com/science/article/pii/S0735109719349939?via%3Dihub
UR  - http://hdl.handle.net/10044/1/72760
VL  - 73
ER  -

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