The relationship between serum potassium concentrations and electrocardiographic characteristics in 163,547 individuals from primary care.

Maria Lukács Krogager, Kristian Kragholm, Regitze Kuhr Skals, Rikke Nørmark Mortensen, Christoffer Polcwiartek, Claus Graff, Jonas Bille Nielsen, Jørgen K Kanters, Anders Gaarsdal Holst, Peter Søgaard, Adrian Pietersen, Christian Torp-Pedersen, Steen Møller Hansen

Journal: Journal of electrocardiology 2021;57():104-111

PMID: 31629993

Full Text on Elsevier Science View on PubMed

Abstract

AIMS

Potassium disturbances are common and associated with increased morbidity and mortality, even in patients without prior cardiovascular disease. We examined six electrocardiographic (ECG) measures and their association to serum potassium levels.

METHODS AND RESULTS

From the Copenhagen General Practitioners' Laboratory, we identified 163,547 individuals aged ≥16 years with a first available ECG and a concomitant serum potassium measurement during 2001-2011. Restricted cubic splines curves showed a non-linear relationship between potassium and the Fridericia corrected QT (QTcF) interval, T-wave amplitude, morphology combination score (MCS), PR interval, P-wave amplitude and duration. Therefore, potassium was stratified in two intervals K: 2.0-4.1 mmol/L and 4.2-6.0 mmol/L for further analyses. Within the low potassium range, we observed: QTcF was 12.8 ms longer for each mmol/L decrease in potassium (p < 0.0001); T-wave amplitude was 43.1 μV lower for each mmol/L decrease in potassium (p < 0.0001); and MCS was 0.13 higher per mmol/L decrease in potassium (p < 0.001). Moreover, P-wave duration and PR interval were prolonged by 2.7 and 4.6 ms for each mmol/L decrease in potassium (p < 0.0001), respectively. Within the lowest potassium range (2.0-4.1 mmol/L) P-wave amplitude was 3.5 μV higher for each mmol/L decrease in potassium (p < 0.0001). Within the high potassium range associations with the above-mentioned ECG parameters were much weaker.

Address: Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. Electronic address: [email protected].; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark.; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, USA.; Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark.; Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Heart Centre and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark.; Department of Cardiology, Nordsjællandshospital Hillerød, 3400 Hillerød, Denmark.; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

DOI: 10.1016/j.jelectrocard.2019.09.005

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MeSH Terms: Arrhythmias, Cardiac, Electrocardiography, Humans, Potassium, Primary Health Care