Nutrición Hospitalaria 03995 / http://dx.doi.org/10.20960/nh.03995
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Trabajo Original

The relationship between vitamin B12 levels and electrocardiographic ventricular repolarization markers


Emre Yılmaz, Devrim Kurt, Aslı Vural, Ertan Aydın, Sencer Çamcı, Ercan Aydın

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Background: it has been shown that vitamin B12 deficiency, which can cause hematological and neuropsychiatric disorders, may also be associated with cardiac autonomic dysfunction, heart rate variability, endothelial dysfunction, and a decrease in myocardial deformation. Aims: the aim of our study is to evaluate the relationship between vitamin B12 levels and electrocardiographic repolarization disorders, which are indicators of arrhythmogenic predisposition in healthy individuals. Methods: our study population consisted of 214 healthy adults. Considering the distribution of vitamin B12 levels and accepting 25 % and 75 % percentiles as the cut-off values, the participants were divided into 3 groups. Laboratory, echocardiography and electrocardiography (ECG) measurements were compared between three groups. ECG measurements were performed manually and Tpeak-Tend (Tp-e), Tp-e corrected (Tp-ec), QT and QT corrected (QTc) intervals were calculated. Results: the patients in Group 1 (vitamin B12 < 253 pg/ml) were found to have significantly higher QT and QTc dispersions, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios when compared to those in Group 2 (253 pg/ml < vitamin B12 > 436 pg/ml) and Group 3 (vitamin B12 > 436 pg/ml). On the other hand, a negative significant correlation was detected between vitamin B12 levels and Tp-e, Tp-e/QT, Tp-e/QTc ratios, QT and QTc dispersions. Conclusion: a low level of vitamin B12 in healthy individuals can be a significant indicator of arrhythmogenic susceptibility. A close follow-up of these subjects in terms of arrhythmogenic predisposition can be useful.

Palabras Clave: QT dispersion. Tpeak-Tend interval. Ventricular repolarization markers. Vitamin B12.



Aytemir K, Aksöyek S, Büyükasik Y, Haznedaroğlu I, Atalar E, Ozer N, Ovünç K et al. Assessment of autonomic nervous system functions in patients with vitamin B12 deficiency by power spectral analysis of heart rate variability. Pacing Clin Electrophysiol. 2000 ;23(6):975-8.
DOI: 10.1111/j.1540-8159.2000.tb00883.x
Beitzke M, Pfister P, Fortin J, Skrabal F. Autonomic dysfunction and hemodynamics in vitamin B12 deficiency. Auton Neurosci 2002; 97: 45-54.
DOI: 10.1016/S1566-0702(01)00393-9
Castro-Torres Y, Carmona-Puerta R, Katholi RE. Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice. World J Clin Cases. 2015 Aug 16;3(8):705-20.
DOI: 10.12998/wjcc.v3.i8.705
Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, Yan GX. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol. 2008 ;41(6):567-74.
DOI: 10.1016/j.jelectrocard.2008.07.016
Stabler SP. Screening the older population for cobalamin (vitamin B12) deficiency. Journal of the American Geriatrics Society. 1995; 43: 1290-7.
DOI: 10.1111/j.1532-5415.1995.tb07408.x
Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician, 2003; 67: 979–986
Stover PJ. Physiology of folate and vitamin B12 in health and disease. Nutr Rev. 2004;62(6):3-12; discussion S13.
DOI: 10.1301/nr.2004.jun.S3-S12
Woo KS, Kwok TC, Celermajer DS. Vegan diet, subnormal vitamin B-12 status and cardiovascular health. Nutrients. 2014 Aug 19;6(8):3259-73.
DOI: 10.3390/nu6083259
Celik SF, Celik E. Subclinical atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency. Niger J Clin Pract 2018;21: 1012-6.
Sucharita S, Thomas T, Sowmya S, Krishnamachari S, Kurpad AV, Vaz M. Subclinical Vitamin B12 Deficiency and Heart Rate Variability Across Life Cycle. Curr Aging Sci 2016;9:217-23.
DOI: 10.2174/1874609809666160211125218
Spallone V. Update on the Impact, Diagnosis and Management of Cardiovascular Autonomic Neuropathy in Diabetes: What Is Defined, What Is New, and What Is Unmet. Diabetes Metab J. 2019 ;43: 3-30.
DOI: 10.4093/dmj.2018.0259
Öner T, Guven B, Tavli V, Mese T, Yilmazer MM, Demirpence S. Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics 2014;133:138-42.
DOI: 10.1542/peds.2012-3427
13.Sadeghian S, Fallahi F, Salarifar M, Davoodi G, Mahmoodian M, Fallah N, et al. Homocysteine, vitamin B12 and folate levels in premature coronary artery disease. BMC Cardiovasc Disord 2006;6:38.
DOI: 10.1186/1471-2261-6-38
Herzlich BC, Lichstein E, Schulhoff N, et al. Relationship among homocyst(e)ine, vitamin B-12 and cardiac disease in the elderly: association between vitamin B-12 deficiency and decreased left ventricular ejection fraction. J Nutr 1996;126:1249-53.
DOI: 10.1093/jn/126.suppl_4.1249S
Kaya Z, Bicer A, Yalcin F, Er A, Camuzcuoglu A, Korkmaz N, et al. Impaired global and segmental myocardial deformation assessed by two-dimensional speckle tracking echocardiography in patients with vitamin B12 deficiency. Cardiol J. 2014;21: 60-6.
DOI: 10.5603/CJ.a2013.0059
Andersen DC, Kragholm K, Petersen LT, Graff C, Sørensen PL, Nielsen JB, et al. Association between vectorcardiographic QRS area and incident heart failure diagnosis and mortality among patients with left bundle branch block: A register-based cohort study. J Electrocardiol. 2021;69:30-35.
DOI: 10.1016/j.jelectrocard.2021.09.002
Wit AL, Peters NS. The role of gap junctions in the arrhythmias of ischemia and infarction. Heart Rhythm. 2012; 9: 308-11.
DOI: 10.1016/j.hrthm.2011.09.056
Piccirillo G, Moscucci F, Fabietti M, Di Iorio C, Mastropietri F, Sabatino T et al. Age, gender and drug therapy influences on Tpeak-tend interval and on electrical risk score. J Electrocardiol. 2020 ;59:88-92.
DOI: 10.1016/j.jelectrocard.2020.01.009
Yayla C, Bilgin M, Akboga MK, Gayretli Yayla K, Canpolat U, Dinc Asarcikli L, et al. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with aortic stenosis. Ann Noninvasive Electrocardiol. 2016;21:287–93.
DOI: 10.1111/anec.12298
Panikkath R, Reinier K, Uy-Evanado A, Teodorescu C, Hattenhauer J, Mariani R, et al. Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4:441–7.
DOI: 10.1161/CIRCEP.110.960658
21. Erikssen G, Liestøl K, Gullestad L, Haugaa KH, Bendz B, Amlie JP. The terminal part of the QT interval (T peak to T end): a predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol. 2012;17:85–94.
DOI: 10.1111/j.1542-474X.2012.00493.x
Antzelevitch C, Oliva A. Amplification of spatial dispersion of repolarization underlies sudden cardiac death associated with catecholaminergic polymorphic VT, long QT, short QT and Brugada syndromes. J Intern Med. 2006;259: 48–58.
DOI: 10.1111/j.1365-2796.2005.01587.x
Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. T(p–e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol. 2008;41:567–74.
DOI: 10.1016/j.jelectrocard.2008.07.016
Solak N,Canan Yolcu, Murat Elevli, Kamil Sahin. Evaluation of Relationship Between Tp-E Interval Values and QT Dispersion in Electrocardiogram in Children With B12 Vitamin Deficiency. Med Bull Haseki 2021; 59: 203-209
DOI: 10.4274/haseki.galenos.2021.7001
Tereshchenko LG, Soliman EZ, Davis BR, Oparil S. Risk stratification of sudden cardiac death in hypertension. J Electrocardiol. 2017 ;50: 798-801.
DOI: 10.1016/j.jelectrocard.2017.08.012
Wasfy MM, Hutter AM, Weiner RB. Sudden Cardiac Death in Athletes. Methodist Debakey Cardiovasc J. 2016; 12: 76-80.
DOI: 10.14797/mdcj-12-2-76

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