cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2024-4039cardiovascular-4039Research ArticleМЕТОДЫ ИССЛЕДОВАНИЯRESEARCH METHODSАссоциация трансмуральной дисперсии реполяризации желудочков (интервал Tрeak-Tеnd) с компонентами метаболического синдрома (в рамках ЭССЕ-РФ3)Association of transmural dispersion of ventricular repolarization (Tpeak-Tend interval) with components of metabolic syndrome: data from the ESSE-RF3https://orcid.org/0000-0001-5316-4664ГарбузоваЕ. В.GarbuzovaE. V.

Гарбузова Евгения Витальевна — к.м.н, н.с. лаборатории генетических и средовых детерминант жизненного цикла человека

Новосибирск

Novosibirsk

stryukova.j@mail.ruhttps://orcid.org/0000-0003-3502-7599КузнецовА. А.KuznetsovA. A.

Кузнецов Александр Александрович — д.м.н., в.н.с. лаборатории молекулярно-генетических исследований терапевтических заболеваний

Новосибирск

Novosibirsk

kuznetsoviimed@gmail.comhttps://orcid.org/0000-0002-1432-0473НестерецА. М.NesteretsA. M.

Нестерец Алина Михайловна — к.м.н., м.н.с. лаборатории генетических и средовых детерминант жизненного цикла человека

Новосибирск

Novosibirsk

alinvaleeva1994@gmail.comhttps://orcid.org/0000-0001-7875-1566ХудяковаА. Д.KhudyakovaA. D.

Худякова Алёна Дмитриевна — к.м.н., зав. лабораторией генетических и средовых детерминант жизненного цикла человека

 Новосибирск

Novosibirsk

alene.elene@gmail.comhttps://orcid.org/0000-0002-0436-2549ШрамкоВ. С.ShramkoV. S.

Шрамко Виктория Сергеевна — к.м.н., н.c. лаборатории клинических, биохимических, гормональных исследований терапевтических заболеваний

Новосибирск

Novosibirsk

nosova@211.ruhttps://orcid.org/0000-0002-9332-0622ИмаеваА. Э.ImaevaA. E.

Имаева Асия Эмвяровна — д.м.н., в.н.с. отдела эпидемиологии хронических неинфекционных заболеваний

Москва

Moscow

AImaeva@gnicpm.ruhttps://orcid.org/0000-0002-0240-3941МуромцеваГ. А.MuromtsevaG. A.

Муромцева Галина Аркадьевна — к.б.н., в.н.с. отдела эпидемиологии хронических неинфекционных заболеваний

Москва

Moscow

gmuromtseva@yahoo.comhttps://orcid.org/0000-0001-8011-2798БалановаЮ. А.BalanovaYu. A.

Баланова Юлия Андреевна — д.м.н., в.н.с. отдела эпидемиологии хронических неинфекционных заболеваний

Москва

Moscow

jbalanova@gnicpm.ruhttps://orcid.org/0000-0002-4030-6130СимоноваГ. И.SimonovaG. I.

Симонова Галина Ильинична — д.м.н., профессор, г.н.с. лаборатории этиопатогенеза и клиники внутренних заболеваний

Новосибирск

Novosibirsk

g.simonova2019@gmail.comНаучно-исследовательский институт терапии и профилактической медицины — филиал ФГБНУ "Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук" (НИИТПМ — филиал ИЦиГ СО РАН)Research Institute of Internal and Preventive Medicine — branch of the Institute of Cytology and GeneticsФГБУ "Национальный медицинский исследовательский центр терапии и профилактической медицины" Минздрава РоссииNational Medical Research Center for Therapy and Preventive Medicine20240108202423840394039Copyright © Гарбузова Е.В., Кузнецов А.А., Нестерец А.М., Худякова А.Д., Шрамко В.С., Имаева А.Э., Муромцева Г.А., Баланова Ю.А., Симонова Г.И., 20242024Гарбузова Е.В., Кузнецов А.А., Нестерец А.М., Худякова А.Д., Шрамко В.С., Имаева А.Э., Муромцева Г.А., Баланова Ю.А., Симонова Г.И.Garbuzova E.V., Kuznetsov A.A., Nesterets A.M., Khudyakova A.D., Shramko V.S., Imaeva A.E., Muromtseva G.A., Balanova Y.A., Simonova G.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/4039Цель

Цель. Изучение ассоциаций интервала Tрeak-Теnd (Tp-Te) с компонентами метаболического синдрома (МС) на выборке жителей г. Новосибирска.

Материал и методы

Материал и методы. В исследование вошло 1042 человека — жителей г. Новосибирска (510 (48,9%) мужчины) в возрасте 35-74 лет. В программу обследования входили сбор демографических и социальных данных, антропометрия, измерение артериального давления (АД), запись электрокардиограммы (ЭКГ). МС определяли согласно критериям 2013г. Интервал Tp-Te от пика, как максимального позитивного или негативного отклонения зубца T, до окончания зубца T, измеряли мануально в отведении V5; в исследовании использовали корригированный интервал Tp-Te (cTp-Te).

Результаты

Результаты. cTp-Te обратно ассоциирован с женским полом (В 3,390, 95% доверительный интервал (ДИ): (-5,516-2,504), р=0,001). Интервал cTp-Te ассоциирован с уровнем АД ≥140/90 мм рт.ст. (В 3,154, 95% ДИ: (1,614-4,688), р=0,001), уровнем холестерина липопротеинов низкой плотности (ХС ЛНП) >3,0 ммоль/л (В 1,818, 95% ДИ: (0,409-3,544), р=0,030), независимо от других компонентов МС, пола и возраста. Интервал cTp-Te был выше у лиц с АД ≥140/90 мм рт.ст. по сравнению с лицами с АД <140/90 мм рт.ст. (69,08 95% ДИ: 67,59-70,66 vs 65,93 95% ДИ: 64,60-67,24; р=0,001), и у лиц с ХС ЛНП>3,0 ммоль/л (68,41 95% ДИ: 67,11-69,63 vs 66,60 95% ДИ: 65,02-68,23; р=0,023), по сравнению с лицами с ХС ЛНП <3,0 ммоль/л.

Заключение

Заключение. Интервал сTр-Те, рассматриваемый как индикатор трансмуральной дисперсии-реполяризации желудочков, короче у женщин, чем у мужчин и связан с артериальной гипертензией и атерогенной дислипидемией вне зависимости от других компонентов МС.

Aim

Aim. To study the associations of the Tpeak-Tend interval (TpTe) with components of metabolic syndrome (MS) in a sample of Novosibirsk residents.

Material and methods

Material and methods. The study included 1042 residents of Novosibirsk (510 (48,9%) men) aged 35-74 years. The examination included the collection of demographic and social data, anthropometry, blood pressure (BP) measurement, and electrocardiography (ECG). MS was determined according to the 2013 criteria. The TpTe interval from the peak, as the maximum positive or negative T wave deviation, to the end of the T wave, was measured manually in lead V5. The corrected TpTe (cTpTe) interval was used in the study.

Results

Results. The cTpTe is inversely associated with female sex (B 3,390, 95% confidence interval (CI): (-5,516-2,504), p=0,001). The cTpTe interval is associated with a blood pressure (BP) ≥140/90 mm Hg (B 3,154, 95% CI: (1,614-4,688), p=0,001), low-density lipoprotein cholesterol (LDL-C) >3,0 mmol/l (B 1,818, 95% CI: (0,409-3,544), p=0,030), regardless of other MS components, sex and age. The cTpTe interval was higher in individuals with BP ≥140/90 mm Hg compared with individuals with BP <140/90 mm Hg (69,08 95% CI: 67,59-70,66 vs 65,93 95% CI: 64,60-67,24; p=0,001), and in persons with LDL-C >3,0 mmol/l (68,41 95% CI: 67,11-69,63 vs 66,60 95% CI: 65,02-68,23; p=0,023), compared with individuals with LDL-C <3,0 mmol/l.

Conclusion

Conclusion. The cTpTe interval, considered as an indicator of transmural dispersion of ventricular repolarization, is shorter in women than in men and is associated with hypertension and atherogenic dyslipidemia, regardless of other MS components.

интервал Tрeak-Теndкомпоненты метаболического синдромаартериальная гипертензияатерогенная дислипидемияTpeak-Tend intervalmetabolic syndrome componentshypertensionatherogenic dyslipidemiaРабота была выполнена в рамках исследования ЭССЕ-РФ3 и бюджетной темы № 122031700115-7 (FWNR-2022-0013)The study was carried out within the ESSERF3 study and budget topic № 122031700115-7 (FWNR-2022-0013)ReferencesZabel M, Portnoy S, Franz MR. Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol. 1995;25(3):746-52. doi:10.1016/0735-1097(94)00446-W.Zabel M, Portnoy S, Franz MR. Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol. 1995;25(3):746-52. doi:10.1016/0735-1097(94)00446-W.Antzelevitch C, Sicouri S, Di Diego JM, et al. Does Tpeak-Tend provide an index of transmural dispersion of repolarization? Heart Rhythm. 2007;4(8):1114-9. doi:10.1016/j.hrthm.2007.05.028.Antzelevitch C, Sicouri S, Di Diego JM, et al. Does Tpeak-Tend provide an index of transmural dispersion of repolarization? Heart Rhythm. 2007;4(8):1114-9. doi:10.1016/j.hrthm.2007.05.028.Yan GX, Antzelevitch C.Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998;98(18):1928-36. doi:10.1161/01.cir.98.18.1928.Yan GX, Antzelevitch C.Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998;98(18):1928-36. doi:10.1161/01.cir.98.18.1928.Opthof T, Coronel R, Wilms-Schopman FJ, et al. Dispersion of repolarization in canine ventricle and the electrocardiographic T wave: Tp-e interval does not reflect transmural dispersion. Heart Rhythm. 2007;4(3):341-8. doi:10.1016/j.hrthm.2006.11.022.Opthof T, Coronel R, Wilms-Schopman FJ, et al. Dispersion of repolarization in canine ventricle and the electrocardiographic T wave: Tp-e interval does not reflect transmural dispersion. Heart Rhythm. 2007;4(3):341-8. doi:10.1016/j.hrthm.2006.11.022.Xia Y, Liang Y, Kongstad O, et al. Tpeak-Tend interval as an index of global dispersion of ventricular repolarization: evaluations using monophasic action potential mapping of the epi- and endocardium in swine. J Interv Card Electrophysiol. 2005;14(2):79-87. doi:10.1007/s10840-005-4592-4.Xia Y, Liang Y, Kongstad O, et al. Tpeak-Tend interval as an index of global dispersion of ventricular repolarization: evaluations using monophasic action potential mapping of the epi- and endocardium in swine. J Interv Card Electrophysiol. 2005;14(2):79-87. doi:10.1007/s10840-005-4592-4.Kors JA, Ritsema van Eck HJ, van Herpen G.The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008; 41(6):575-80. doi:10.1016/j.jelectrocard.2008.07.030.Kors JA, Ritsema van Eck HJ, van Herpen G.The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008; 41(6):575-80. doi:10.1016/j.jelectrocard.2008.07.030.Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged Tpeakto-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011; 4(4):441-7. doi:10.1161/CIRCEP.110.960658.Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged Tpeakto-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011; 4(4):441-7. doi:10.1161/CIRCEP.110.960658.Bachmann TN, Skov MW, Rasmussen PV, et al. Electrocardiographic Tpeak-Tend interval and risk of cardiovascular morbidity and mortality: Results from the Copenhagen ECG study. Heart Rhythm. 2016;13(4):915-24. doi:10.1016/j.hrthm.2015.12.027.Bachmann TN, Skov MW, Rasmussen PV, et al. Electrocardiographic Tpeak-Tend interval and risk of cardiovascular morbidity and mortality: Results from the Copenhagen ECG study. Heart Rhythm. 2016;13(4):915-24. doi:10.1016/j.hrthm.2015.12.027.Tse G, Gong M, Wong WT, et al. The Tpeak — Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis. Heart Rhythm. 2017;14(8):1131-7. doi:10.1016/j.hrthm.2017.05.031.Tse G, Gong M, Wong WT, et al. The Tpeak — Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis. Heart Rhythm. 2017;14(8):1131-7. doi:10.1016/j.hrthm.2017.05.031.Braun CC, Zink MD, Gozdowsky S, et al. A Longer Tpeak-Tend Interval Is Associated with a Higher Risk of Death: A MetaAnalysis. J Clin Med. 2023;12(3):992. doi:10.3390/jcm12030992.Braun CC, Zink MD, Gozdowsky S, et al. A Longer Tpeak-Tend Interval Is Associated with a Higher Risk of Death: A MetaAnalysis. J Clin Med. 2023;12(3):992. doi:10.3390/jcm12030992.Karaagac K, Emul A, Tenekecioglu E, et al. The Effects of Metabolic Syndrome on TpTe Interval and TpTe/QT Ratio in Patients with Normal Coronary Arteries. Eurasian J Med. 2014;46(3): 182-6. doi:10.5152/eajm.2014.48.Karaagac K, Emul A, Tenekecioglu E, et al. The Effects of Metabolic Syndrome on TpTe Interval and TpTe/QT Ratio in Patients with Normal Coronary Arteries. Eurasian J Med. 2014;46(3): 182-6. doi:10.5152/eajm.2014.48.Драпкина О. М., Шальнова С. А., Имаева А. Э. и др. Эпидемиология сердечно-сосудистых заболеваний и их факторов риска в регионах Российской Федерации. Третье исследование (ЭССЕ-РФ-3). Обоснование и дизайн исследования. Кардиоваскулярная терапия и профилактика. 2022;21(5): 3246. doi:10.15829/1728-8800-2022-3246.Drapkina OM, Shalnova SA, Imaeva AE, et al. Epidemiology of Cardiovascular Diseases in Regions of Russian Federation. Third survey (ESSE-RF-3). Rationale and study design. Cardiovascular Therapy and Prevention. 2022;21(5):3246. (In Russ.) doi:10.15829/1728-8800-2022-3246.Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):976-81. doi:10.1016/j.jacc.2008.12.013.Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):976-81. doi:10.1016/j.jacc.2008.12.013.Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias: Lipid Modification to Reduce Cardiovascular Risk. Eur Heart J. 2020;41:111-88. doi:10.1093/eurheartj/ehz455.Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias: Lipid Modification to Reduce Cardiovascular Risk. Eur Heart J. 2020;41:111-88. doi:10.1093/eurheartj/ehz455.Мычка В.Б., Верткин А.Л., Вардаев Л.И. и др. Консенсус экспертов по междисциплинарному подходу к ведению, диагностике и лечению больных с метаболическим синдромом. Кардиоваскулярная терапия и профилактика. 2013;12(6):41-82.Mychka VB, Vertkin AL, Vardaev LI, et al. Experts’ consensus on the interdisciplinary approach towards the management, diagnostics, and treatment of patients with metabolic syndrome. Cardiovascular Therapy and Prevention. 2013;12(6):41-82. (In Russ.)Rosenthal TM, Masvidal D, Abi Samra FM, et al. Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention. Europace. 2018;20(4):698-705. doi:10.1093/europace/euw430.Rosenthal TM, Masvidal D, Abi Samra FM, et al. Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention. Europace. 2018;20(4):698-705. doi:10.1093/europace/euw430.Haarmark C, Hansen PR, Vedel-Larsen E, et al. The prognostic value of the Tpeak-Tend interval in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. J Electrocardiol. 2009;42(6):555-60. doi:10.1016/j.jelectrocard.2009.06.009.Haarmark C, Hansen PR, Vedel-Larsen E, et al. The prognostic value of the Tpeak-Tend interval in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. J Electrocardiol. 2009;42(6):555-60. doi:10.1016/j.jelectrocard.2009.06.009.Lepeschkin E, Surawicz B.The measurement of the Q-T interval of the electrocardiogram. Circulation. 1952;6(3):378-88. doi:10.1161/01.cir.6.3.378.Lepeschkin E, Surawicz B.The measurement of the Q-T interval of the electrocardiogram. Circulation. 1952;6(3):378-88. doi:10.1161/01.cir.6.3.378.Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):982-91. doi:10.1016/j.jacc.2008.12.014.Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):982-91. doi:10.1016/j.jacc.2008.12.014.Bazett HS. An analysis of time relations of electrocardiograms. Heart. 1920;7:353-67.Bazett HS. An analysis of time relations of electrocardiograms. Heart. 1920;7:353-67.Chua KC, Rusinaru C, Reinier K, et al. Tpeak-to-Tend interval corrected for heart rate: A more precise measure of increased sudden death risk? Heart Rhythm. 2016;13(11):2181-5. doi:10.1016/j.hrthm.2016.08.022.Chua KC, Rusinaru C, Reinier K, et al. Tpeak-to-Tend interval corrected for heart rate: A more precise measure of increased sudden death risk? Heart Rhythm. 2016;13(11):2181-5. doi:10.1016/j.hrthm.2016.08.022.Покровская М.С., Борисова А.Л., Метельская В.А. и др. Роль биобанкирования в организации крупномасштабных эпидемиологических исследований. Кардиоваскулярная терапия и профилактика. 2021;20(5):2958. doi:10.15829/1728-8800-2021-2958.Pokrovskaya MS, Borisova AL, Metelskaya VA, et al. Role of biobanking in managing large-scale epidemiological studies. Cardiovascular Therapy and Prevention. 2021;20(5):2958. (In Russ.) doi:10.15829/1728-8800-2021-2958.Linde C, Bongiorni MG, Birgersdotter-Green U, et al. Sex differences in cardiac arrhythmia: a consensus document of the European Heart Rhythm Association, endorsed by the Heart Rhythm Society and Asia Pacific Heart Rhythm Society. Europace. 2018;20:1565-1565ao. doi:10.1093/europace/euy067.Linde C, Bongiorni MG, Birgersdotter-Green U, et al. Sex differences in cardiac arrhythmia: a consensus document of the European Heart Rhythm Association, endorsed by the Heart Rhythm Society and Asia Pacific Heart Rhythm Society. Europace. 2018;20:1565-1565ao. doi:10.1093/europace/euy067.Hnatkova K, Toman O, Šišáková M, et al. Sex and race differences in J-Tend, J-Tpeak, and Tр-Те intervals. Sci Rep. 2019; 9(1):19880. doi:10.1038/s41598-019-56328-8.Hnatkova K, Toman O, Šišáková M, et al. Sex and race differences in J-Tend, J-Tpeak, and Tр-Те intervals. Sci Rep. 2019; 9(1):19880. doi:10.1038/s41598-019-56328-8.Smetana P, Batchvarov VN, Hnatkova K, et al. Sex differences in repolarization homogeneity and its circadian pattern. Am J Physiol Heart Circ Physiol. 2002;282:H1889-97. doi:10.1152/ajpheart.00962.2001.Smetana P, Batchvarov VN, Hnatkova K, et al. Sex differences in repolarization homogeneity and its circadian pattern. Am J Physiol Heart Circ Physiol. 2002;282:H1889-97. doi:10.1152/ajpheart.00962.2001.Ferrucci A, Canichella F, Battistoni A, et al. A Novel Electrocardiographic T-Wave Measurement (Tp-Te Interval) as a Predictor of Heart Abnormalities in Hypertension: A New Opportunity for First-Line Electrocardiographic Evaluation. J Clin Hypertens (Greenwich). 2015;17(6):441-9. doi:10.1111/jch.12522.Ferrucci A, Canichella F, Battistoni A, et al. A Novel Electrocardiographic T-Wave Measurement (Tp-Te Interval) as a Predictor of Heart Abnormalities in Hypertension: A New Opportunity for First-Line Electrocardiographic Evaluation. J Clin Hypertens (Greenwich). 2015;17(6):441-9. doi:10.1111/jch.12522.Porthan K, Virolainen J, Hiltunen TP, et al. Relationship of electrocardiographic repolarization measures to echocardiographic left ventricular mass in men with hypertension. J Hypertens. 2007;25(9):1951-7. doi:10.1097/HJH.0b013e328263088b.Porthan K, Virolainen J, Hiltunen TP, et al. Relationship of electrocardiographic repolarization measures to echocardiographic left ventricular mass in men with hypertension. J Hypertens. 2007;25(9):1951-7. doi:10.1097/HJH.0b013e328263088b.Sauer A, Wilcox JE, Andrei AC, et al. Diastolic electromechanical coupling: association of the ECG T-peak to T-end interval with echocardiographic markers of diastolic dysfunction. Circ Arrhythm Electrophysiol. 2012;5(3):537-43. doi:10.1161/CIRCEP.111.969717.Sauer A, Wilcox JE, Andrei AC, et al. Diastolic electromechanical coupling: association of the ECG T-peak to T-end interval with echocardiographic markers of diastolic dysfunction. Circ Arrhythm Electrophysiol. 2012;5(3):537-43. doi:10.1161/CIRCEP.111.969717.Karaagac K, Tenekecioglu E, Yontar OC, et al. Effect of nondipper and dipper blood pressure patterns on Tp-Te interval and Tp-Te/QT ratio in patients with metabolic syndrome. Int J Clin Exp Med. 2014;7(5):1397-403.Karaagac K, Tenekecioglu E, Yontar OC, et al. Effect of nondipper and dipper blood pressure patterns on Tp-Te interval and Tp-Te/QT ratio in patients with metabolic syndrome. Int J Clin Exp Med. 2014;7(5):1397-403.Ciobanu A, Gheorghe GS, Ababei M, et al. Dispersion of ventricular repolarization in relation to cardiovascular risk factors in hypertension. J Med Life. 2014;7(4):545-50.Ciobanu A, Gheorghe GS, Ababei M, et al. Dispersion of ventricular repolarization in relation to cardiovascular risk factors in hypertension. J Med Life. 2014;7(4):545-50.Ciobanu A, Tse G, Liu T, et al. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol. 2017; 14(12):717-24. doi:10.11909/j.issn.1671-5411.2017.12.001.Ciobanu A, Tse G, Liu T, et al. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol. 2017; 14(12):717-24. doi:10.11909/j.issn.1671-5411.2017.12.001.Mozos I. The link between ventricular repolarization variables and arterial function. J Electrocardiol. 2015;48(2):145-9. doi:10.1016/j.jelectrocard.2014.11.008.Mozos I. The link between ventricular repolarization variables and arterial function. J Electrocardiol. 2015;48(2):145-9. doi:10.1016/j.jelectrocard.2014.11.008.Bombelli M, Maloberti A, Raina L, et al. Prognostic relevance of electrocardiographic Tр-Те interval in the general and in the hypertensive population: data from the Pressioni Arteriose Monitorate E Loro Associazioni study. J Hypertens. 2016;34(9):1823-30. doi:10.1097/HJH.0000000000001005.Bombelli M, Maloberti A, Raina L, et al. Prognostic relevance of electrocardiographic Tр-Те interval in the general and in the hypertensive population: data from the Pressioni Arteriose Monitorate E Loro Associazioni study. J Hypertens. 2016;34(9):1823-30. doi:10.1097/HJH.0000000000001005.Küçükosmanoğlu M, Kılıç S, Saraçoğlu E, et al. Effect of Statin Therapy in Tpe-Interval and Tpe/Qtc Ratio in Patients with Familial Hypercholesterolemia. Eur J Ther. 2023:26(3):165-71. doi:10.5152/eurjther.2020.19018.Küçükosmanoğlu M, Kılıç S, Saraçoğlu E, et al. Effect of Statin Therapy in Tpe-Interval and Tpe/Qtc Ratio in Patients with Familial Hypercholesterolemia. Eur J Ther. 2023:26(3):165-71. doi:10.5152/eurjther.2020.19018.Liu YB, Lee YT, Pak HN, et al. Effects of simvastatin on cardiac neural and electrophysiologic remodeling in rabbits with hypercholesterolemia. Heart Rhythm. 2009;6(1):69-75. doi:10.1016/j.hrthm.2008.10.004.Liu YB, Lee YT, Pak HN, et al. Effects of simvastatin on cardiac neural and electrophysiologic remodeling in rabbits with hypercholesterolemia. Heart Rhythm. 2009;6(1):69-75. doi:10.1016/j.hrthm.2008.10.004.Liu YB, Wu CC, Lu LS, et al. Sympathetic nerve sprouting, electrical remodeling, and increased vulnerability to ventricular fibrillation in hypercholesterolemic rabbits. Circ Res. 2003; 92(10):1145-52. doi:10.1161/01.RES.0000072999.51484.92.Liu YB, Wu CC, Lu LS, et al. Sympathetic nerve sprouting, electrical remodeling, and increased vulnerability to ventricular fibrillation in hypercholesterolemic rabbits. Circ Res. 2003; 92(10):1145-52. doi:10.1161/01.RES.0000072999.51484.92.Luo TY, Wu CC, Liu YB, et al. Dietary cholesterol affects sympathetic nerve function in rabbit hearts. J Biomed Sci. 2004; 11(3):339-45. doi:10.1007/BF02254438.Luo TY, Wu CC, Liu YB, et al. Dietary cholesterol affects sympathetic nerve function in rabbit hearts. J Biomed Sci. 2004; 11(3):339-45. doi:10.1007/BF02254438.

The authors declare that there are no conflicts of interest present.