Tp-e interval and Tp-e/QT ratio in patients with celiac disease

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"apellidos" => "Kayaçetin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Intervalo Tp-e y ratio Tp-e/QT en pacientes con celiaquía" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1137 "Ancho" => 2540 "Tamanyo" => 111515 ] ] "descripcion" => array:1 [ "en" => "(A) Correlation between Tp-e/QTc ratio and disease duration. (B) Correlation between Tp-e/QTc ratio and erythrocyte sedimentation rate." ] ] ] "textoCompleto" => "IntroductionCeliac disease (CD) is a chronic immune-mediated disease of the small intestine induced by gluten proteins present in wheat, barley, and rye, which is characterized by chronic malabsorption in susceptible individuals. CD appears in about 1% of the European and North American population.<a class="elsevierStyleCrossRefs" href="#bib0185">1,2</a> Cardiovascular complications are known as the one of the leading causes of the morbidity and mortality in CD.<a class="elsevierStyleCrossRef" href="#bib0195">3</a> Some studies have displayed increased risk of ischemic heart disease and impaired aortic functions in CD.<a class="elsevierStyleCrossRefs" href="#bib0195">3–6</a> Besides, subclinical cardiac involvement has been found in CD during the childhood.<a class="elsevierStyleCrossRef" href="#bib0215">7</a> Several studies have shown that CD is positively associated with idiopathic dilated cardiomyopathy.<a class="elsevierStyleCrossRefs" href="#bib0220">8,9</a>Left ventricular dysfunction is thought to have an important role in the development of arrhythmias.<a class="elsevierStyleCrossRef" href="#bib0230">10</a> Ventricular repolarization parameters can be evaluated for predicting ventricular arrhythmias, and measured in the electrocardiogram (ECG) by the QT interval QT interval, QT dispersion and T wave measurements.<a class="elsevierStyleCrossRefs" href="#bib0235">11,12</a> Recent studies have shown that the Tp-e interval (i.e., the interval between the peak and the end of the T wave) is a novel index of transmural dispersion of repolarization.<a class="elsevierStyleCrossRefs" href="#bib0245">13,14</a> Prolonged Tp-e interval may predict ventricular arrhythmias and mortality.<a class="elsevierStyleCrossRefs" href="#bib0255">15–17</a> It is known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with CD.<a class="elsevierStyleCrossRefs" href="#bib0205">5,18</a> The incidence of ventricular arrhythmia is more frequent in patients with these cardiac diseases than in the normal population.We aimed to evaluate the Tp-e interval and Tp-e/QT ratio in patients with CD. To our knowledge, no previous studies have investigated the Tp-e interval and Tp-e/QT ratio as markers of ventricular arrhythmogenesis in patients with CD.Patient and methodsThis cross-sectional study was conducted between January 2014 and June 2015, at a single center in collaboration with gastroenterology and cardiology clinics. Patients with coronary artery disease, valvular heart disease, wall motion abnormalities with left ventricular ejection fraction below 50%, hypertension, diabetes mellitus, kidney and hepatic disease, severe pulmonary disease, malignancy, atrial fibrillation, complete or incomplete bundle branch block, or paced rhythm were excluded. According to these criteria, three subjects were excluded from the study (one patient with coronary artery disease and other with atrial fibrillation among the CD group, and one from control group due to the presence of U wave on the ECG). Finally, a total of 38 consecutive patients with biopsy-proven CD and 38 age- and sex-matched control healthy subjects were included in the study. Baseline demographic and clinical characteristics were reviewed. All patients included in the study were in sinus rhythm and without cardiac symptoms. The study was in compliance with the principles outlined in the Declaration of Helsinki and approved by the local ethics committe (B.10.4.ISM.4.06.00.15-EPPK-619).Echocardiographic evaluation was performed by using a VIVID 7 Dimension Cardiovascular Ultrasound System (Vingmed-General Electric, Horten, Norway) with a 3.5MHz transducer. Echocardiographic examination was performed in the left lateral decubitus position. Parasternal long- and short-axis as well as apical views were used as standard imaging windows. Ejection fraction was calculated by using the modified Simpson method.<a class="elsevierStyleCrossRef" href="#bib0275">19</a> Left atrial diameter, end systolic and end diastolic dimensions were measured from parasternal long-axis view. All echocardiographic examinations were performed by an experienced cardiologist.The 12-lead ECG was recorded at a paper speed of 50mm/s (Hewlett Packard, Page-writer, USA) in the supine position. All of the ECGs were scanned and transferred to a personal computer to decrease error measurements, and then used for ×400% magnification by Adobe Photoshop software. ECG measurements of QT and Tp-e intervals were performed by two cardiologists who were blinded to the patient data. An average value of three readings was calculated for each lead. The Tp-e interval and QT interval was derived from a minimum of six measurements (at least three of them from precordial leads). The QT interval was measured from the beginning of the QRS complex to the end of the T wave and corrected for heart rate using the Bazett formula: cQT=QT√(R-R interval).<a class="elsevierStyleCrossRefs" href="#bib0280">20,21</a> The Tp-e interval was defined as the interval from the peak of T wave to the end of T wave. Measurements of the Tp-e interval were performed from precordial leads.<a class="elsevierStyleCrossRef" href="#bib0255">15</a> The Tp-e/QT ratio was calculated from these measurements.Peripheral venous blood samples were drawn from the antecubital vein after 12h of fasting in the morning. Blood samples were taken into standardized tubes containing dipotassium ethylenedinitre tetraacetic acid (EDTA) for complete blood count (CBC). Coulter Counter LH Series (Beckman coulter Inc., Hialeah, Florida) was used for CBC and C-reactive protein (CRP) analyses. Plasma level of CRP was measured using a turbidimetric immunoassay and erythrocyte sedimentation rate (ESR) was determined by the Westergren's method. Plasma levels of triglycerides, high-density lipoproteins, low-density lipoproteins, aspartate and alanine aminotransferases, glucose, and creatinine were evaluated by an automated chemistry analyzer (Abbott Aeroset, USA) using commercially available kits (Abbott, USA). Anti-gliadin-IgA, -IgG, and anti-tissue transglutaminase IgA, IgG levels were determined using Chorus ELISA kits on a CHORUS trio analyser (Diesse Diagnostica Senese SpA, Siena, Italy). An index higher than 12AU/ml was considered a positive result for anti-gliadin-IgA and anti-gliadin-IgG, and an index higher than 10U/ml as positive for anti-tissue transglutaminase IgA and IgG.Statistical analysisStatistical analysis was performed with SPSS 20.0 Statistical Package Program for Windows (SPSS Inc., Chicago, IL, USA). In order to test normality of distribution, the Kolmogorov-Smirnov test was used. Quantitative variables with a normal distribution were specified as means±standard deviation. Quantitative variables with a non-normal distribution were specified as medians (interquantile ranges). Categorical variables were shown as number and percentage values. Differences between groups were evaluated using the Student's t-test. Categorical variables were compared with the Chi-square test. Spearman correlation analysis was performed to examine the relationship between Tp-e/QTc and ESR, CRP and disease duration. A p value of <0.05 was accepted as statistically significant.ResultsBaseline clinical characteristics and laboratory parameters of the groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The mean age of the participants was 44.7±11.3, and 67.1% were female. There were no statistically significant differences between groups in terms of age, gender, smoking, alcohol consumption, body mass index and basal laboratory findings, except for ESR and CRP levels (p>0.05). ESR [11.0 (6.0–17.25) vs. 5.5 (5.0–7.25); p=0.032] and CRP [2.5 (1.1–3.8) vs. 0.8 (0.7–1.0); p=0.026] levels were higher in patients with CD. The median disease duration of CD was 5.0 (3.0–9.0) years. Antibody status of patients with CD is indicated in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The electrocardiographic and echocardiographic findings of the study groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Heart rate (77.0±14.3 vs. 80.2±16.6; p=0.364), QT interval (350.0±32.5 vs. 340.7±28.4; p=0.192) and QTc interval (393.8±26.7 vs. 387.3±34.9; p=0.370) were similar between CD and control groups. Also, there was no difference between groups in terms of left ventricular ejection fraction (60.5±2.7 vs. 61.4±3.0; p=0.257). Tp-e interval (64.2±11.0 vs. 44.5±6.0; p<0.001), Tp-e/QT ratio (0.18±0.02 vs. 0.13±0.02; p<0.001) and Tp-e/QTc ratio (0.16±0.02 vs. 0.11±0.01; p<0.001) were significantly higher in patients with CD than control subjects (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Interobserver and intraobserver coefficients of variation of Tp-e interval and QT ratio were 2.0% and 2.8%, respectively.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>There was a significant positive correlation between Tp-e/QTc ratio and disease duration in patients with CD (r=0.480, p=0.003) and also there was a significant positive correlation between Tp-e/QTc ratio and ESR (r=0.434, p<0.001) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). However, no correlation was found between Tp-e/QTc ratio and CRP (r=0.137, p=0.129).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>DiscussionIn this study, we found that the Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were prolonged in patients with CD as compared to control subjects. We showed the relationship between Tp-e interval, Tp-e/QT and Tp-e/QTc ratios and CD, and demonstrated that the Tp-e/QTc ratio was also correlated with the duration of CD and ESR.Cardiovascular diseases characterized by left ventricular dysfunction such as idiopathic congestive heart failure and myocarditis, have been described in association with CD.<a class="elsevierStyleCrossRefs" href="#bib0290">22,23</a> Specific antibodies for CD have been detected in nearly in 12% of patients with autoimmune myocarditis.<a class="elsevierStyleCrossRef" href="#bib0290">22</a> Cruione et al. showed that the incidence of CD was 5.8% in patients with dilated cardiomyopathy.<a class="elsevierStyleCrossRef" href="#bib0220">8</a> Polat et al., found subclinical systolic left ventricular dysfunction in children with CD, in whom serum IgA antiendomysial antibody reactivity was significant.<a class="elsevierStyleCrossRef" href="#bib0215">7</a> Prati et al. found that patients with end-stage heart failure were at increased risk for CD as compared to the general population.<a class="elsevierStyleCrossRef" href="#bib0300">24</a> Sarı et al. demonstrated the subclinical effect of CD on left ventricular systolic function by using strain echocardiography imaging.<a class="elsevierStyleCrossRef" href="#bib0305">25</a> Also, the risk of ischemic heart disease in CD is conflicting.<a class="elsevierStyleCrossRefs" href="#bib0200">4,5</a> Emilsson et al. showed that CD patients with myocardial infarction had a more favorable classical risk factor profile than controls with myocardial infarction.<a class="elsevierStyleCrossRef" href="#bib0310">26</a> Several studies have proposed that the pathophysiology of association between CD and myocardial dysfunction can be related to activation of metalloproteinase enzymes, autoimmunity and extramolecular epitope dissemination.<a class="elsevierStyleCrossRef" href="#bib0220">8</a> Intestinal absorption could be suppressed in patients with congestive heart failure or cardiomyopathy, and CD can change the absorption of essential nutrients, increase levels of plasma homocysteine because of the malabsorption of folic acid and vitamin B12 and lead to structural and functional abnormalities of cardiomyocytes that may aggravate or trigger the cardiomyopathy.<a class="elsevierStyleCrossRefs" href="#bib0315">27,28</a> In addition, Jansen et al. showed that common non-genetic factors such as single nucleotide polymorphisms can play an important role for explaining the coincidence of CD and the coronary artery disease.<a class="elsevierStyleCrossRef" href="#bib0325">29</a>Ventricular arrhythmias are more frequent in patients with left ventricular dysfunction than normal left ventricular function. The increase of ventricular repolarization dispersion is associated with malignant arrhythmias and has prognostic importance in terms of mortality and sudden cardiac death.<a class="elsevierStyleCrossRef" href="#bib0330">30</a> Prolonged QT interval is one of the markers of delayed heart repolarization on electrocardiography. Corazza et al. observed that 33% of CD patients had QT interval prolongation.<a class="elsevierStyleCrossRef" href="#bib0335">31</a> In recent studies, the Tp-e interval and Tp-e/QT ratio have been investigated as new indicators of increased dispersion of ventricular repolarization.<a class="elsevierStyleCrossRefs" href="#bib0340">32,33</a> Prolonged Tp-e interval was related with increased mortality in long QT syndrome, Brugada syndrome and patients with acute ST-segment elevation myocardial infarction.<a class="elsevierStyleCrossRef" href="#bib0340">32</a> Nevertheless, the Tp-e/QT ratio was not affected by the heart rate and body weight; so it has been suggested as a more sensitive marker than Tp-e or QT intervals.<a class="elsevierStyleCrossRef" href="#bib0340">32</a> Hence, Tp-e/QT ratio is a potentially important index of arrhythmogenesis, both under the conditions of short, normal and long QT interval, as well as in congenital and acquired channelopathies.<a class="elsevierStyleCrossRef" href="#bib0340">32</a> In our study, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were prolonged in patients with CD as compared to control subjects. It has been reported that the prevalence of impaired left ventricle function and ischemic cardiomyopathy was increased in patients with CD.<a class="elsevierStyleCrossRefs" href="#bib0200">4,34</a> According to the current evidence, it is reasonable to suggest that patients with CD might have an increased incidence of ventricular arrhythmia as compared to healthy subjects. Additionally, Tp-e/QTc ratio was also significantly increased in parallel to the duration of disease.Systemic inflammation might have a substantial impact on arrhythmogenesis through a variety of direct and indirect triggers.<a class="elsevierStyleCrossRef" href="#bib0355">35</a> Myocardial dysfunction has been regarded as a well-known trigger of arrhythmogenesis, possibly through different complex mechanisms including enhanced myocardial wall stress. Even so, inflammation-related arrhythmogenesis might occur in apparently normal hearts due to severe inflammatory states, such as sepsis, or in acute coronary syndromes.<a class="elsevierStyleCrossRef" href="#bib0360">36</a> Systemic inflammation is more likely to induce arrhythmias in arrhythmia-prone patients (i.e., those with clinical or subclinical structural heart disease) possibly by eliciting potential decreases in arrhythmogenic threshold in these patients.<a class="elsevierStyleCrossRef" href="#bib0360">36</a> As expected, Tp-e/QTc ratio was also significantly increased in parallel to the ESR level as a non-specific measure of inflammation in our study.Our study has some limitations. First, the sample size was small. Second, the study was from a single-center. Third, the study design was cross-sectional and, therefore, patient follow-up was lacking. Also, diastolic left ventricular functions were not evaluated. Advanced echocardiographic techniques such as strain, strain rate and speckle tracking could be more beneficial to detect early and subclinical structural abnormalities in patients with CD. The relationship between ventricular arrhythmias and Tp-e interval and Tp-e/QT ratio was not assessed. Therefore, long-term follow-up and large-scale prospective studies are needed to investigate the predictive value of the Tp-e interval and Tp-e/QT ratio in patients with CD.ConclusionsThis study demonstrated that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in patients with CD. It is possible that CD may have a negative effect on ventricular repolarization, which potentially can lead to increased risk of ventricular arrhythmias. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios are simple, easily accessible, inexpensive and non-invasive methods that can be a useful index for ventricular repolarization in patients with CD.FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article.Conflicts of interestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres933378" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec907724" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres933377" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec907725" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patient and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-03-16" "fechaAceptado" => "2017-09-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec907724" "palabras" => array:3 [ 0 => "Celiac disease" 1 => "Tp-e interval" 2 => "Tp-e/QT ratio" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec907725" "palabras" => array:3 [ 0 => "Celiaquía" 1 => "Intervalo Tp-e" 2 => "Ratio Tp-e/QT" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesCeliac disease is a chronic immune-mediated disease of the small intestine. It has been known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with celiac disease. The aim of the study was to assess Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Material and methodsThis study was conducted at a single center in collaboration with gastroenterology and cardiology clinics. Between January 2014 and June 2015, a total of 76 consecutive patients were enrolled (38 patients with celiac disease and 38 control subjects). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. ResultsTp-e interval (64.2±11.0 vs. 44.5±6.0; p<0.001), Tp-e/QT ratio (0.18±0.02 vs. 0.13±0.02; p<0.001) and Tp-e/QTc ratio (0.16±0.02 vs. 0.11±0.01; p<0.001) were significantly higher in patients with celiac disease than control subjects. There was a significant positive correlation between Tp-e/QTc ratio and disease duration in patients with celiac disease (r=0.480, p=0.003) and also there was a significant positive correlation between Tp-e/QTc ratio and erythrocyte sedimentation rate (r=0.434, p<0.001). ConclusionsOur study showed that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in patients with celiac disease. Whether these changes increase the risk of ventricular arrhythmia deserve further studies." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosLa enfermedad celíaca (EC) o celiaquía, es una enfermedad crónica del intestino delgado inmuno-mediada. Es bien sabido que la cardiomiopatía dilatada y la cardiopatía isquémica se han hecho frecuentes en los pacientes celíacos. El objetivo de este estudio fue evaluar el intervalo Tp-e y el ratio Tp-e/QT ratio en los pacientes con celiaquía. Material y métodosEste estudio se realizó en un único centro, en colaboración con los clínicos de gastroenterología y cardiología. Entre enero de 2014 y junio de 2015 se incluyeron a un total de 76 pacientes consecutivos (38 pacientes con celiaquía y 38 sujetos control). Se midieron el intervalo Tp-e y los ratios Tp-e/QT y Tp-e/QTc a partir del electrocardiograma de 12 derivaciones. ResultadosEl intervalo Tp-e (64,2±11 vs. 44,5±6; p<0,001), el ratio Tp-e/QT (0,18±0,02 vs. 0,13±0,02; p<0,001) y el ratio Tp-e/QTc (0,16±0,02 vs. 0,11±0,01; p<0,001) fueron significativamente superiores en los sujetos celíacos con respecto a los controles. Se observó una correlación significativa entre el ratio Tp-e/QTc y la duración de la enfermedad en los pacientes celíacos (r=0,48; p=0,003), y también una correlación positiva significativa entre el ratio Tp-e/QTc y la tasa de sedimentación eritrocitaria (r=0,434; p<0,001). ConclusionesNuestro estudio reflejó que el intervalo Tp-e y los ratios Tp-e/QT y Tp-e/QTc se incrementaron en los pacientes celíacos. El hecho de que dichos cambios incrementen o no el riesgo de arritmia ventricular justifica la realización de estudios futuros." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 897 "Ancho" => 3168 "Tamanyo" => 99562 ] ] "descripcion" => array:1 [ "en" => "(A) Comparison of Tp-e interval between study groups. (B) Comparison of Tp-e/QT ratio between study groups. (C) Comparison of Tp-e/QTc ratio between study groups." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1137 "Ancho" => 2540 "Tamanyo" => 111515 ] ] "descripcion" => array:1 [ "en" => "(A) Correlation between Tp-e/QTc ratio and disease duration. (B) Correlation between Tp-e/QTc ratio and erythrocyte sedimentation rate." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Data are given as mean±SD, median (interquantile range) or n (%). CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Celiac disease (n=38) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls (n=38) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42.9±13.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46.6±8.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.148 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 (65.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 (68.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.807 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (15.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (13.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.744 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alcohol, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body mass index, kg/m2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.7±5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.3±5.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.714 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin, g/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.7±1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.6±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.838 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.76±0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.82±0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.076 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sodium, mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">137.2±4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">137.7±4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.630 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Potassium, mmol/l \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.46±0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.48±0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.873 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Magnesium, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.98±0.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.98±0.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.937 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcium, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.45±0.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.40±0.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.699 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucose, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">96±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.667 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspartate aminotransferase, IU/l \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.7±9.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.9±8.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.124 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alanine aminotransferase, IU/l \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26.2±15.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29.5±8.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.371 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">172.5±37.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">189.8±42.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.101 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LDL cholesterol, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100.0±34.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">111.7±36.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.209 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HDL cholesterol, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50.6±11.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55.7±10.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.080 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglyceride, mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">106.6±47.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">114.4±47.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.527 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ESR, mm/h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.0 (6.0–17.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.5 (5.0–7.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.032 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CRP, mg/l \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.5 (1.1–3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 (0.7–1.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.026 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-gliadin Ig A, +/− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22/16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-gliadin Ig G, +/− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16/22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-tissue transglutaminase Ig A, +/− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20/18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-tissue transglutaminase Ig G, +/− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4/34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Disease duration, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.0 (3.0–9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1577480.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Basal characteristics and laboratory parameters of the study population." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Bpm: beats per minute; LVEDD: left ventricular end diastolic diameter; LVEF: left ventricular ejection fraction; LVESD: left ventricular end sistolic diameter; ms: milliseconds; QTc, corrected QT interval.Data are given as mean±SD." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Celiac disease (n=38) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls (n=38) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart rate, bpm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77.0±14.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.2±16.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.364 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tp-e interval, ms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64.2±11.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.5±6.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">QT interval, ms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">350.0±32.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">340.7±28.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.192 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">QTc interval, ms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">393.8±26.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">387.3±34.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.370 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tp-e/QT ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.18±0.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.13±0.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tp-e/QTc ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.16±0.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.11±0.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.5±2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.4±3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.257 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEDD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.0±2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47.0±3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.277 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVESD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.4±2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.7±2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.650 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Left atrium, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.0±2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.6±3.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.388 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1577479.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Electrocardiographic and echocardiographic characteristics of the study population." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib0185" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. 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Original article

Tp-e interval and Tp-e/QT ratio in patients with celiac disease

Intervalo Tp-e y ratio Tp-e/QT en pacientes con celiaquía

K. Demirtaşa, Ç. Yaylaa,

Autor para correspondencia

cagriyayla@gmail.com

Corresponding author.

, M. Yükselb, B. Açara, S. Ünala, A.G. Ertema, M. Kaplana, M.Y. Akpinarb, Z.M.Y. Kiliçb, E. Kayaçetinb

a Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey

b Türkiye Yüksek Ihtisas Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey

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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Correlation between Tp-e&#47;QTc ratio and disease duration&#46; &#40;B&#41; Correlation between Tp-e&#47;QTc ratio and erythrocyte sedimentation rate&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Celiac disease &#40;CD&#41; is a chronic immune-mediated disease of the small intestine induced by gluten proteins present in wheat&#44; barley&#44; and rye&#44; which is characterized by chronic malabsorption in susceptible individuals&#46; CD appears in about 1&#37; of the European and North American population&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a> Cardiovascular complications are known as the one of the leading causes of the morbidity and mortality in CD&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a> Some studies have displayed increased risk of ischemic heart disease and impaired aortic functions in CD&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">3&#8211;6</span></a> Besides&#44; subclinical cardiac involvement has been found in CD during the childhood&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> Several studies have shown that CD is positively associated with idiopathic dilated cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Left ventricular dysfunction is thought to have an important role in the development of arrhythmias&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a> Ventricular repolarization parameters can be evaluated for predicting ventricular arrhythmias&#44; and measured in the electrocardiogram &#40;ECG&#41; by the QT interval QT interval&#44; QT dispersion and T wave measurements&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;12</span></a> Recent studies have shown that the Tp-e interval &#40;i&#46;e&#46;&#44; the interval between the peak and the end of the T wave&#41; is a novel index of transmural dispersion of repolarization&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">13&#44;14</span></a> Prolonged Tp-e interval may predict ventricular arrhythmias and mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">15&#8211;17</span></a> It is known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with CD&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#44;18</span></a> The incidence of ventricular arrhythmia is more frequent in patients with these cardiac diseases than in the normal population&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We aimed to evaluate the Tp-e interval and Tp-e&#47;QT ratio in patients with CD&#46; To our knowledge&#44; no previous studies have investigated the Tp-e interval and Tp-e&#47;QT ratio as markers of ventricular arrhythmogenesis in patients with CD&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patient and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This cross-sectional study was conducted between January 2014 and June 2015&#44; at a single center in collaboration with gastroenterology and cardiology clinics&#46; Patients with coronary artery disease&#44; valvular heart disease&#44; wall motion abnormalities with left ventricular ejection fraction below 50&#37;&#44; hypertension&#44; diabetes mellitus&#44; kidney and hepatic disease&#44; severe pulmonary disease&#44; malignancy&#44; atrial fibrillation&#44; complete or incomplete bundle branch block&#44; or paced rhythm were excluded&#46; According to these criteria&#44; three subjects were excluded from the study &#40;one patient with coronary artery disease and other with atrial fibrillation among the CD group&#44; and one from control group due to the presence of U wave on the ECG&#41;&#46; Finally&#44; a total of 38 consecutive patients with biopsy-proven CD and 38 age- and sex-matched control healthy subjects were included in the study&#46; Baseline demographic and clinical characteristics were reviewed&#46; All patients included in the study were in sinus rhythm and without cardiac symptoms&#46; The study was in compliance with the principles outlined in the Declaration of Helsinki and approved by the local ethics committe &#40;B&#46;10&#46;4&#46;ISM&#46;4&#46;06&#46;00&#46;15-EPPK-619&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Echocardiographic evaluation was performed by using a VIVID 7 Dimension Cardiovascular Ultrasound System &#40;Vingmed-General Electric&#44; Horten&#44; Norway&#41; with a 3&#46;5<span class="elsevierStyleHsp" style=""></span>MHz transducer&#46; Echocardiographic examination was performed in the left lateral decubitus position&#46; Parasternal long- and short-axis as well as apical views were used as standard imaging windows&#46; Ejection fraction was calculated by using the modified Simpson method&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> Left atrial diameter&#44; end systolic and end diastolic dimensions were measured from parasternal long-axis view&#46; All echocardiographic examinations were performed by an experienced cardiologist&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The 12-lead ECG was recorded at a paper speed of 50<span class="elsevierStyleHsp" style=""></span>mm&#47;s &#40;Hewlett Packard&#44; Page-writer&#44; USA&#41; in the supine position&#46; All of the ECGs were scanned and transferred to a personal computer to decrease error measurements&#44; and then used for &#215;400&#37; magnification by Adobe Photoshop software&#46; ECG measurements of QT and Tp-e intervals were performed by two cardiologists who were blinded to the patient data&#46; An average value of three readings was calculated for each lead&#46; The Tp-e interval and QT interval was derived from a minimum of six measurements &#40;at least three of them from precordial leads&#41;&#46; The QT interval was measured from the beginning of the QRS complex to the end of the T wave and corrected for heart rate using the Bazett formula&#58; cQT<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>QT&#8730;&#40;R-R interval&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;21</span></a> The Tp-e interval was defined as the interval from the peak of T wave to the end of T wave&#46; Measurements of the Tp-e interval were performed from precordial leads&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a> The Tp-e&#47;QT ratio was calculated from these measurements&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Peripheral venous blood samples were drawn from the antecubital vein after 12<span class="elsevierStyleHsp" style=""></span>h of fasting in the morning&#46; Blood samples were taken into standardized tubes containing dipotassium ethylenedinitre tetraacetic acid &#40;EDTA&#41; for complete blood count &#40;CBC&#41;&#46; Coulter Counter LH Series &#40;Beckman coulter Inc&#46;&#44; Hialeah&#44; Florida&#41; was used for CBC and C-reactive protein &#40;CRP&#41; analyses&#46; Plasma level of CRP was measured using a turbidimetric immunoassay and erythrocyte sedimentation rate &#40;ESR&#41; was determined by the Westergren&#39;s method&#46; Plasma levels of triglycerides&#44; high-density lipoproteins&#44; low-density lipoproteins&#44; aspartate and alanine aminotransferases&#44; glucose&#44; and creatinine were evaluated by an automated chemistry analyzer &#40;Abbott Aeroset&#44; USA&#41; using commercially available kits &#40;Abbott&#44; USA&#41;&#46; Anti-gliadin-IgA&#44; -IgG&#44; and anti-tissue transglutaminase IgA&#44; IgG levels were determined using Chorus ELISA kits on a CHORUS trio analyser &#40;Diesse Diagnostica Senese SpA&#44; Siena&#44; Italy&#41;&#46; An index higher than 12<span class="elsevierStyleHsp" style=""></span>AU&#47;ml was considered a positive result for anti-gliadin-IgA and anti-gliadin-IgG&#44; and an index higher than 10<span class="elsevierStyleHsp" style=""></span>U&#47;ml as positive for anti-tissue transglutaminase IgA and IgG&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">Statistical analysis was performed with SPSS 20&#46;0 Statistical Package Program for Windows &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46; In order to test normality of distribution&#44; the Kolmogorov-Smirnov test was used&#46; Quantitative variables with a normal distribution were specified as means<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#46; Quantitative variables with a non-normal distribution were specified as medians &#40;interquantile ranges&#41;&#46; Categorical variables were shown as number and percentage values&#46; Differences between groups were evaluated using the Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46; Categorical variables were compared with the Chi-square test&#46; Spearman correlation analysis was performed to examine the relationship between Tp-e&#47;QTc and ESR&#44; CRP and disease duration&#46; A <span class="elsevierStyleItalic">p</span> value of &#60;0&#46;05 was accepted as statistically significant&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">Baseline clinical characteristics and laboratory parameters of the groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The mean age of the participants was 44&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3&#44; and 67&#46;1&#37; were female&#46; There were no statistically significant differences between groups in terms of age&#44; gender&#44; smoking&#44; alcohol consumption&#44; body mass index and basal laboratory findings&#44; except for ESR and CRP levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; ESR &#91;11&#46;0 &#40;6&#46;0&#8211;17&#46;25&#41; vs&#46; 5&#46;5 &#40;5&#46;0&#8211;7&#46;25&#41;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#93; and CRP &#91;2&#46;5 &#40;1&#46;1&#8211;3&#46;8&#41; vs&#46; 0&#46;8 &#40;0&#46;7&#8211;1&#46;0&#41;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;026&#93; levels were higher in patients with CD&#46; The median disease duration of CD was 5&#46;0 &#40;3&#46;0&#8211;9&#46;0&#41; years&#46; Antibody status of patients with CD is indicated in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The electrocardiographic and echocardiographic findings of the study groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; Heart rate &#40;77&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;3 vs&#46; 80&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;6&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;364&#41;&#44; QT interval &#40;350&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;5 vs&#46; 340&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#46;4&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;192&#41; and QTc interval &#40;393&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&#46;7 vs&#46; 387&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#46;9&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;370&#41; were similar between CD and control groups&#46; Also&#44; there was no difference between groups in terms of left ventricular ejection fraction &#40;60&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;7 vs&#46; 61&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;0&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;257&#41;&#46; Tp-e interval &#40;64&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;0 vs&#46; 44&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;0&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; Tp-e&#47;QT ratio &#40;0&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02 vs&#46; 0&#46;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and Tp-e&#47;QTc ratio &#40;0&#46;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02 vs&#46; 0&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; were significantly higher in patients with CD than control subjects &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Interobserver and intraobserver coefficients of variation of Tp-e interval and QT ratio were 2&#46;0&#37; and 2&#46;8&#37;&#44; respectively&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">There was a significant positive correlation between Tp-e&#47;QTc ratio and disease duration in patients with CD &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;480&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and also there was a significant positive correlation between Tp-e&#47;QTc ratio and ESR &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;434&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; However&#44; no correlation was found between Tp-e&#47;QTc ratio and CRP &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;137&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;129&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">In this study&#44; we found that the Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios were prolonged in patients with CD as compared to control subjects&#46; We showed the relationship between Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios and CD&#44; and demonstrated that the Tp-e&#47;QTc ratio was also correlated with the duration of CD and ESR&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Cardiovascular diseases characterized by left ventricular dysfunction such as idiopathic congestive heart failure and myocarditis&#44; have been described in association with CD&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a> Specific antibodies for CD have been detected in nearly in 12&#37; of patients with autoimmune myocarditis&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> Cruione et al&#46; showed that the incidence of CD was 5&#46;8&#37; in patients with dilated cardiomyopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a> Polat et al&#46;&#44; found subclinical systolic left ventricular dysfunction in children with CD&#44; in whom serum IgA antiendomysial antibody reactivity was significant&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> Prati et al&#46; found that patients with end-stage heart failure were at increased risk for CD as compared to the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> Sar&#305; et al&#46; demonstrated the subclinical effect of CD on left ventricular systolic function by using strain echocardiography imaging&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> Also&#44; the risk of ischemic heart disease in CD is conflicting&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">4&#44;5</span></a> Emilsson et al&#46; showed that CD patients with myocardial infarction had a more favorable classical risk factor profile than controls with myocardial infarction&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a> Several studies have proposed that the pathophysiology of association between CD and myocardial dysfunction can be related to activation of metalloproteinase enzymes&#44; autoimmunity and extramolecular epitope dissemination&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a> Intestinal absorption could be suppressed in patients with congestive heart failure or cardiomyopathy&#44; and CD can change the absorption of essential nutrients&#44; increase levels of plasma homocysteine because of the malabsorption of folic acid and vitamin B12 and lead to structural and functional abnormalities of cardiomyocytes that may aggravate or trigger the cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28</span></a> In addition&#44; Jansen et al&#46; showed that common non-genetic factors such as single nucleotide polymorphisms can play an important role for explaining the coincidence of CD and the coronary artery disease&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Ventricular arrhythmias are more frequent in patients with left ventricular dysfunction than normal left ventricular function&#46; The increase of ventricular repolarization dispersion is associated with malignant arrhythmias and has prognostic importance in terms of mortality and sudden cardiac death&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> Prolonged QT interval is one of the markers of delayed heart repolarization on electrocardiography&#46; Corazza et al&#46; observed that 33&#37; of CD patients had QT interval prolongation&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> In recent studies&#44; the Tp-e interval and Tp-e&#47;QT ratio have been investigated as new indicators of increased dispersion of ventricular repolarization&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#44;33</span></a> Prolonged Tp-e interval was related with increased mortality in long QT syndrome&#44; Brugada syndrome and patients with acute ST-segment elevation myocardial infarction&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> Nevertheless&#44; the Tp-e&#47;QT ratio was not affected by the heart rate and body weight&#59; so it has been suggested as a more sensitive marker than Tp-e or QT intervals&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> Hence&#44; Tp-e&#47;QT ratio is a potentially important index of arrhythmogenesis&#44; both under the conditions of short&#44; normal and long QT interval&#44; as well as in congenital and acquired channelopathies&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> In our study&#44; Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios were prolonged in patients with CD as compared to control subjects&#46; It has been reported that the prevalence of impaired left ventricle function and ischemic cardiomyopathy was increased in patients with CD&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">4&#44;34</span></a> According to the current evidence&#44; it is reasonable to suggest that patients with CD might have an increased incidence of ventricular arrhythmia as compared to healthy subjects&#46; Additionally&#44; Tp-e&#47;QTc ratio was also significantly increased in parallel to the duration of disease&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Systemic inflammation might have a substantial impact on arrhythmogenesis through a variety of direct and indirect triggers&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> Myocardial dysfunction has been regarded as a well-known trigger of arrhythmogenesis&#44; possibly through different complex mechanisms including enhanced myocardial wall stress&#46; Even so&#44; inflammation-related arrhythmogenesis might occur in apparently normal hearts due to severe inflammatory states&#44; such as sepsis&#44; or in acute coronary syndromes&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> Systemic inflammation is more likely to induce arrhythmias in arrhythmia-prone patients &#40;i&#46;e&#46;&#44; those with clinical or subclinical structural heart disease&#41; possibly by eliciting potential decreases in arrhythmogenic threshold in these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> As expected&#44; Tp-e&#47;QTc ratio was also significantly increased in parallel to the ESR level as a non-specific measure of inflammation in our study&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Our study has some limitations&#46; First&#44; the sample size was small&#46; Second&#44; the study was from a single-center&#46; Third&#44; the study design was cross-sectional and&#44; therefore&#44; patient follow-up was lacking&#46; Also&#44; diastolic left ventricular functions were not evaluated&#46; Advanced echocardiographic techniques such as strain&#44; strain rate and speckle tracking could be more beneficial to detect early and subclinical structural abnormalities in patients with CD&#46; The relationship between ventricular arrhythmias and Tp-e interval and Tp-e&#47;QT ratio was not assessed&#46; Therefore&#44; long-term follow-up and large-scale prospective studies are needed to investigate the predictive value of the Tp-e interval and Tp-e&#47;QT ratio in patients with CD&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study demonstrated that Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios were increased in patients with CD&#46; It is possible that CD may have a negative effect on ventricular repolarization&#44; which potentially can lead to increased risk of ventricular arrhythmias&#46; Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios are simple&#44; easily accessible&#44; inexpensive and non-invasive methods that can be a useful index for ventricular repolarization in patients with CD&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0090" class="elsevierStylePara elsevierViewall">The author&#40;s&#41; received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The author&#40;s&#41; declared no potential conflicts of interest with respect to the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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    "fechaRecibido" => "2017-03-16"
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    "PalabrasClave" => array:2 [
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          "clase" => "keyword"
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            0 => "Celiac disease"
            1 => "Tp-e interval"
            2 => "Tp-e&#47;QT ratio"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Celiaqu&#237;a"
            1 => "Intervalo Tp-e"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Celiac disease is a chronic immune-mediated disease of the small intestine&#46; It has been known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with celiac disease&#46; The aim of the study was to assess Tp-e interval and Tp-e&#47;QT ratio in patients with celiac disease&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study was conducted at a single center in collaboration with gastroenterology and cardiology clinics&#46; Between January 2014 and June 2015&#44; a total of 76 consecutive patients were enrolled &#40;38 patients with celiac disease and 38 control subjects&#41;&#46; Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratio were measured from the 12-lead electrocardiogram&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Tp-e interval &#40;64&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;0 vs&#46; 44&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;0&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; Tp-e&#47;QT ratio &#40;0&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02 vs&#46; 0&#46;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and Tp-e&#47;QTc ratio &#40;0&#46;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;02 vs&#46; 0&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; were significantly higher in patients with celiac disease than control subjects&#46; There was a significant positive correlation between Tp-e&#47;QTc ratio and disease duration in patients with celiac disease &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;480&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and also there was a significant positive correlation between Tp-e&#47;QTc ratio and erythrocyte sedimentation rate &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;434&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our study showed that Tp-e interval&#44; Tp-e&#47;QT and Tp-e&#47;QTc ratios were increased in patients with celiac disease&#46; Whether these changes increase the risk of ventricular arrhythmia deserve further studies&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
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          2 => array:2 [
            "identificador" => "abst0015"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La enfermedad cel&#237;aca &#40;EC&#41; o celiaqu&#237;a&#44; es una enfermedad cr&#243;nica del intestino delgado inmuno-mediada&#46; Es bien sabido que la cardiomiopat&#237;a dilatada y la cardiopat&#237;a isqu&#233;mica se han hecho frecuentes en los pacientes cel&#237;acos&#46; El objetivo de este estudio fue evaluar el intervalo Tp-e y el ratio Tp-e&#47;QT ratio en los pacientes con celiaqu&#237;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio se realiz&#243; en un &#250;nico centro&#44; en colaboraci&#243;n con los cl&#237;nicos de gastroenterolog&#237;a y cardiolog&#237;a&#46; Entre enero de 2014 y junio de 2015 se incluyeron a un total de 76 pacientes consecutivos &#40;38 pacientes con celiaqu&#237;a y 38 sujetos control&#41;&#46; Se midieron el intervalo Tp-e y los ratios Tp-e&#47;QT y Tp-e&#47;QTc a partir del electrocardiograma de 12 derivaciones&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El intervalo Tp-e &#40;64&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11 vs&#46; 44&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; el ratio Tp-e&#47;QT &#40;0&#44;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;02 vs&#46; 0&#44;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y el ratio Tp-e&#47;QTc &#40;0&#44;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;02 vs&#46; 0&#44;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; fueron significativamente superiores en los sujetos cel&#237;acos con respecto a los controles&#46; Se observ&#243; una correlaci&#243;n significativa entre el ratio Tp-e&#47;QTc y la duraci&#243;n de la enfermedad en los pacientes cel&#237;acos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;48&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; y tambi&#233;n una correlaci&#243;n positiva significativa entre el ratio Tp-e&#47;QTc y la tasa de sedimentaci&#243;n eritrocitaria &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;434&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio reflej&#243; que el intervalo Tp-e y los ratios Tp-e&#47;QT y Tp-e&#47;QTc se incrementaron en los pacientes cel&#237;acos&#46; El hecho de que dichos cambios incrementen o no el riesgo de arritmia ventricular justifica la realizaci&#243;n de estudios futuros&#46;</p></span>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Comparison of Tp-e interval between study groups&#46; &#40;B&#41; Comparison of Tp-e&#47;QT ratio between study groups&#46; &#40;C&#41; Comparison of Tp-e&#47;QTc ratio between study groups&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Correlation between Tp-e&#47;QTc ratio and disease duration&#46; &#40;B&#41; Correlation between Tp-e&#47;QTc ratio and erythrocyte sedimentation rate&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data are given as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#44; median &#40;interquantile range&#41; or <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&#46; CRP&#44; C-reactive protein&#59; ESR&#44; erythrocyte sedimentation rate&#59; HDL&#44; high-density lipoprotein&#59; LDL&#44; low-density lipoprotein&#46;</p>"
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&#44; years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;65&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;68&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;807&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alcohol&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body mass index&#44; kg&#47;m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;714&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin&#44; g&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sodium&#44; mEquiv&#46;&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;630&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Potassium&#44; mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;873&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Magnesium&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;937&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcium&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;45<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;40<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;699&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucose&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspartate aminotransferase&#44; IU&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alanine aminotransferase&#44; IU&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>37&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">189&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>42&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LDL cholesterol&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>36&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HDL cholesterol&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglyceride&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>47&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>47&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;527&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ESR&#44; mm&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;0 &#40;6&#46;0&#8211;17&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;5 &#40;5&#46;0&#8211;7&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CRP&#44; mg&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5 &#40;1&#46;1&#8211;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#40;0&#46;7&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-gliadin Ig A&#44; &#43;&#47;&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#47;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-gliadin Ig G&#44; &#43;&#47;&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#47;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-tissue transglutaminase Ig A&#44; &#43;&#47;&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#47;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-tissue transglutaminase Ig G&#44; &#43;&#47;&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Disease duration&#44; years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;0 &#40;3&#46;0&#8211;9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Bpm&#58; beats per minute&#59; LVEDD&#58; left ventricular end diastolic diameter&#59; LVEF&#58; left ventricular ejection fraction&#59; LVESD&#58; left ventricular end sistolic diameter&#59; ms&#58; milliseconds&#59; QTc&#44; corrected QT interval&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Data are given as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Celiac disease &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart rate&#44; bpm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;364&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tp-e interval&#44; ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">QT interval&#44; ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">350&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">340&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Electrocardiographic and echocardiographic characteristics of the study population&#46;</p>"
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Información del artículo

ISSN: 00142565
Idioma original: Inglés

DOI:10.1016/j.rce.2017.09.001

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