Evidence map›Paper›PMID 40448006›Full record

ArticleBMC cardiovascular disorders2025

The contribution of a short electrocardiographic diastolic interval to diastolic dysfunction and HFpEF.

A M L N van Ommen, L R Bear, C Carlos Sampedrano, N C Onland-Moret, M J Cramer, F H Rutten, E Dal Canto, I I Tulevski, G A Somsen, N K Sweitzer and 2 more

Abstract readMulticenter Study
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

A M L N van OmmenLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
L R Bear *Univ. Bordeaux, INSERM, CRCTB, IHU Liryc, Bordeaux, 1045, F-33000, France.
C Carlos Sampedrano *Univ. Bordeaux, INSERM, CRCTB, IHU Liryc, Bordeaux, 1045, F-33000, France.
N C Onland-MoretDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
M J CramerDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
F H RuttenDepartment of General Practice & Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
E Dal CantoLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
I I TulevskiCardiology Centers of the Netherlands, Amsterdam, The Netherlands.
G A SomsenCardiology Centers of the Netherlands, Amsterdam, The Netherlands.
N K SweitzerDepartment of Experimental Cardiology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
R CoronelDivision of Cardiovascular Medicine, Washington University in St. Louis, St. Louis, MO, USA.
H M den RuijterLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. h.m.denruijter-2@umcutrecht.nl.

Funding

Dutch Cardiovascular Alliance grant IMPRESS 2020B004Dutch Cardiovascular Alliance grant RECONNEXT 2020B008Leducq Network of Excellence grant RHYTHM 16CVD02
6 · The paper itself

Abstract

backgroundWomen are prone to develop heart failure with preserved ejection fraction (HFpEF) and have a longer QT interval compared to men at comparable heart rates, which results in shorter electrical and mechanical diastole. We hypothesize that a shorter electrical diastole increases HFpEF risk, independent of heart rate.

methodsIn 85,145 women and men visiting the Cardiology Centers of the Netherlands between 2007 and 2018, we calculated electrical diastolic intervals (TQ and TP) by subtracting the QT interval, or the sum of the QT- and PQ intervals, respectively, from the RR interval using 12-lead ECG recordings. Electrical diastolic intervals were compared between patients with prevalent left ventricular diastolic dysfunction (LVDD), HFpEF and controls. We validated the TQ interval's association with diastolic function using right atrial pacing and sotalol infusion in a pig model (n = 6).

resultsTQ intervals were approximately 30 ms shorter in women than men. Patients with LVDD or HFpEF had shorter TQ intervals compared to controls (LVDD: 479 ± 128ms, HFpEF: 485 ± 138ms and controls: 523 ± 137ms). Shorter TQ intervals increased the risk of prevalent LVDD/HFpEF (per SD decrease in TQ: OR = 1.37, 95%CI: 1.28, 1.45 and 1.16, 95%CI: 1.01, 1.35, respectively) in fully adjusted models in both sexes. After a median follow-up of 8 [IQR = 6-10] years, shorter TQ intervals were associated with a significant higher risk of death (HR = 1.13, 95%CI:1.02, 1.25) in patients with LVDD and HFpEF. In the subgroup with "delayed relaxation", beta-blocker use was associated with a significantly lower risk of death, which was not observed in those with "stiff" ventricles showing pseudonormalization or restrictive inflow patterns. Findings were independent of heart rate, and not exclusive to women. In pigs, paced at 100 bpm, sotalol infusion decreased the TQ interval, and TQ shortening was correlated to decreasing e'/a' ratio (r = 0.371, p = 0.018) and E/A ratio (r = 0.337, p = 0.030).

conclusionA short electrical diastole is associated with a higher risk of prevalent LVDD and HFpEF in both women and men at cardiovascular risk, independent of heart rate. Experimental shortening of the electrical diastole induced functional diastolic abnormalities in pigs. This overlooked mechanism of electrical diastolic shortening may contribute to the complex HFpEF syndrome, with beta-blockers potentially benefiting selected groups. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

ElectrocardiographyHeart FailureHeart RateStroke VolumeVentricular Dysfunction, LeftVentricular Function, LeftAction PotentialsAgedAged, 80 and overAnimalsCase-Control StudiesDiastoleDisease Models, AnimalFemaleHumansMaleSotalolAbnormal myocardial relaxationAnimal studyDiastolic timeHeart failure with preserved ejection fractionLeft ventricular diastolic dysfunctionSex-differences

Identifiers

PMID40448006
PMCPMC12123709

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.