ArticleJournal of the American College of Cardiology2019
Effects of Calcium, Magnesium, and Potassium Concentrations on Ventricular Repolarization in Unselected Individuals.
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Article in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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21citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 4% of its field
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Genome-Wide Interaction Analyses of Serum Calcium on Ventricular Repolarization Time in 125 393 Participants.Journal of the American Heart Association · 2024Pooled it
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- Effect of hyperglycaemia in combination with moxifloxacin on cardiac repolarization in male and female patients with type I diabetes.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Trial
- Genetically Determined Serum Calcium Levels and Markers of Ventricular Repolarization: A Mendelian Randomization Study in the UK Biobank.Circulation. Genomic and precision medicine · 2021Trial
- Clinical Relevance of Calcium Measures: QT-Based Comparison of Ionized, Total, and Albumin-Corrected Calcium.Kidney360 · 2026Observational
- Population prevalence and correlates of prolonged and shortened QTc intervals in a nationwide survey of adults in China: a report from Chinese arrhythmia epidemiology cross-sectional study.Frontiers in cardiovascular medicine · 2025Article
- Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation.Kidney international reports · 2024Article
- Serum electrolyte concentrations and risk of atrial fibrillation: an observational and mendelian randomization study.BMC genomics · 2024Observational
- Assessment and management of cardiovascular complications in eating disorders.Journal of eating disorders · 2023Review
- Differences in ventricular wall composition may explain inter-patient variability in the ECG response to variations in serum potassium and calcium.Frontiers in physiology · 2023Article
- Monitoring of Serum Potassium and Calcium Levels in End-Stage Renal Disease Patients by ECG Depolarization Morphology Analysis.Sensors (Basel, Switzerland) · 2022Article
- New clusters of serum electrolytes aid in stratification of diabetes and metabolic risk.Journal of diabetes · 2022Article
- L-shaped association of serum calcium with all-cause and CVD mortality in the US adults: A population-based prospective cohort study.Frontiers in nutrition · 2022Article
- Electrocardiogram findings at the initiation of hemodialysis and types of subsequent cardiovascular events.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Artificial intelligence for detecting electrolyte imbalance using electrocardiography.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Article
- Article
- Association Between Dynamic Change of QT Interval and Long-Term Cardiovascular Outcomes: A Prospective Cohort Study.Frontiers in cardiovascular medicine · 2021Article
- Insulin Resistance, Serum Calcium and Hypertension: A Cross-Sectional Study of a Multiracial Population, and a Similarity Assessment of Results from a Single-Race Population's Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Quantification and classification of potassium and calcium disorders with the electrocardiogram: What do clinical studies, modeling, and reconstruction tell us?APL bioengineering · 2020Review
- Article
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Authors and funding
103 authors at 20 institutions in 14 countries.
Raymond NoordamDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: r.noordam@lumc.nl.
William J YoungBarts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Reem SalmanClinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Jørgen K KantersLaboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Marten E van den BergDepartment of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Diana van HeemstDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
Henry J LinInstitute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Division of Medical Genetics, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Sandhi Maria BarretoFaculty of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Mary L BiggsCardiovascular Health Research Unit, Department of Medicine, and Department of Biostatistics, University of Washington, Seattle, Washington.
Ginevra BiinoInstitute of Molecular Genetics, National Research Council of Italy, Pavia, Italy.
Eulalia CatamoInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
Maria Pina ConcasInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
Jun DingTranslational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Daniel S EvansCalifornia Pacific Medical Center Research Institute, San Francisco, California.
Luisa FocoEurac Research, Institute for Biomedicine, affiliated to the University of Lübeck, Bolzano, Italy.
Niels GrarupNovo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Leo-Pekka LyytikäinenDepartment of Clinical Chemistry, Fimlab Laboratories, Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Massimo ManginoDepartment of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre at Guy's and St. Thomas' Foundation Trust, London, United Kingdom.
Hao MeiDepartment of Data Science, University of Mississippi Medical Center, Jackson, Mississippi.
Peter J van der MostDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Martina Müller-NurasyidInstitute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Christopher P NelsonCardiovascular Research Centre, Glenfield Hospital, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.
Yong QianTranslational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Linda RepettoCentre for Global Health Reasearch, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland.
M Abdullah SaidDepartment of Cardiology and Thorax Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Nabi ShahDivision of Molecular and Clinical Medicine, Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom; Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan.
Katharina SchrammInstitute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
Pedro G VidigalSchool of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Stefan WeissInterfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, partner site Greifswald, Greifswald, Germany.
Jie YaoInstitute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
Nuno R ZilhaoIcelandic Heart Association, Kópavogur, Iceland.
Jennifer A BrodyCardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington.
Peter S BraundCardiovascular Research Centre, Glenfield Hospital, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.
Marco BrumatDepartment of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Eric CampanaDepartment of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Paraskevi ChristofidouDepartment of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.
Mark J CaulfieldClinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.
Alessandro De GrandiEurac Research, Institute for Biomedicine, affiliated to the University of Lübeck, Bolzano, Italy.
Anna F DominiczakInstitute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Alex S F DoneyDivision of Molecular and Clinical Medicine, Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
Gudny EiriksdottirIcelandic Heart Association, Kópavogur, Iceland.
Christina EllervikDepartment of Production, Research and Innovation, Region Zealand, SorØ, Denmark; Harvard Medical School, Boston, Massachusetts; Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Luana GiattiFaculty of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Martin GögeleEurac Research, Institute for Biomedicine, affiliated to the University of Lübeck, Bolzano, Italy.
Claus GraffDepartment of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Xiuqing GuoInstitute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California.
Pim van der HarstDepartment of Cardiology and Thorax Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Peter K JoshiCentre for Global Health Reasearch, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland.
Mika KähönenDepartment of Clinical Physiology, Tampere University Hospital, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Bryan KestenbaumKidney Research Institute, University of Washington, Seattle, Washington.
Maria F Lima-CostaRene Rachou Reserch Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil.
Allan LinnebergDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Arie C MaanDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Thomas MeitingerDZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Institute of Human Genetics, Technische Universität München, Munich, Germany.
Sandosh PadmanabhanInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
Cristian PattaroEurac Research, Institute for Biomedicine, affiliated to the University of Lübeck, Bolzano, Italy.
Annette PetersDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research, Neuherberg, Germany.
Astrid PetersmannInstitute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
Peter SeverNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Mortiz F SinnerDepartment of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Xia ShenCentre for Global Health Reasearch, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Biostatistics Group, State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.
Alice StantonMolecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
Konstantin StrauchInstitute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany.
Elsayed Z SolimanDepartment of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina; Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Internal Medicine, Cardiology Section, Wake Forest School of Medicine, Winston Salem, North Carolina.
Kirill V TarasovLaboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Kent D TaylorInstitute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California.
Chris H L ThioDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
André G UitterlindenHuman Genotyping Facility, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Simona VaccargiuInstitute of Genetic and Biomedical Research, National Research Council of Italy, UOS of Sassari, Sassari, Italy.
Melanie WaldenbergerDZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
Antonietta RobinoInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
Adolfo CorreaDepartment of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
Francesco CuccaDepartment of Biomedical Sciences, University of Sassari, Sassari, Italy.
Steven R CummingsCalifornia Pacific Medical Center Research Institute, San Francisco, California.
Marcus DörrGerman Centre for Cardiovascular Research, partner site Greifswald, Greifswald, Germany; Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany.
Giorgia GirottoInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Vilmundur GudnasonIcelandic Heart Association, Kópavogur, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Torben HansenNovo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Susan R HeckbertCardiovascular Health Research Unit and the Department of Epidemiology, University of Washington, Seattle, Washington.
Christian R JuhlLaboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Stefan KääbDepartment of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Terho LehtimäkiDepartment of Clinical Chemistry, Fimlab Laboratories, Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Yongmei LiuDepartment of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina.
Paulo A LotufoMedical School and Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil.
Colin N A PalmerDivision of Molecular and Clinical Medicine, Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
Mario PirastuInstitute of Genetic and Biomedical Research, National Research Council of Italy, UOS of Sassari, Sassari, Italy.
Peter P PramstallerEurac Research, Institute for Biomedicine, affiliated to the University of Lübeck, Bolzano, Italy; Department of Neurology, General Central Hospital, Bolzano, Italy; Department of Neurology, University of Lübeck, Lübeck, Germany.
Antonio Luiz P RibeiroHospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Jerome I RotterInstitute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California.
Nilesh J SamaniCardiovascular Research Centre, Glenfield Hospital, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.
Harold SniederDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Tim D SpectorDepartment of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.
Bruno H StrickerDepartment of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Niek VerweijDepartment of Cardiology and Thorax Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
James F WilsonCentre for Global Health Reasearch, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland; MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
James G WilsonDepartment of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Andrew TinkerClinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.
Christopher H Newton-ChehCardiovascular Research Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts; Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Nona SotoodehniaCardiovascular Health Research Unit, Division of Cardiology, Departments of Medicine and Epidemiology, University of Washington, Seattle, Washington.
Dennis O Mook-KanamoriDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Patricia B MunroeClinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, United Kingdom. Electronic address: p.b.munroe@qmul.ac.uk.
Helen R WarrenClinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, United Kingdom.
Universidade Federal de Minas Gerais · BRGlenfield Hospital · GBHelmholtz Zentrum München · DEIRCCS Materno Infantile Burlo Garofolo · ITKing's College London · GBUniversity Medical Center Groningen · NLCalifornia Pacific Medical Center · USEurac Research · ITLeiden University Medical Center · NLNational Institutes of Health · USQueen Mary University of London · GBTampere University · FIUniversity of Copenhagen · DKBroad Institute · USErasmus MC · NLGerman Centre for Cardiovascular Research · DEIcelandic Heart Association · ISJackson Memorial Hospital · USNational Research Council · ITScience for Life Laboratory · SE
Funding
Tracking and Evaluation CoreU54GM115428 · NIGMS · UNIVERSITY OF MISSISSIPPI MED CTR · PI HALL, JOHN E · 2016 to 2025
$38.2MStatistical genetics of aging-related genomic and phenotypic changeZIAAG000693 · NIA · NATIONAL INSTITUTE ON AGING · PI DING, JUN · 2011 to 2025
$12.5MBritish Heart Foundation FS/12/21/29482British Heart Foundation FS/12/82/29736British Heart Foundation FS/16/30/32162British Heart Foundation RG/07/005/23633British Heart Foundation RG/15/15/31742British Heart Foundation SP/08/005/25115Department of HealthIntramural NIH HHS ZIA AG000693Medical Research Council G9521010Medical Research Council MC_EX_MR/M009203/1Medical Research Council MC_PC_14089Medical Research Council MC_UU_00007/10Medical Research Council MR/M009203/1Medical Research Council MR/R017468/1NIGMS NIH HHS U54 GM115428
Abstract
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 clinically relevant QT prolongation by >5 ms.
Indexed as
Cardiovascular DiseasesAsymptomatic DiseasesCalciumCorrelation of DataElectrocardiographyElectrophysiologic Techniques, CardiacFemaleHeart Conduction SystemHumansMagnesiumMaleMiddle AgedPotassiumRisk FactorsCalciumMagnesiumPotassiumcohort studieselectrocardiographic intervalselectrolytesepidemiologymeta-analysis
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