The Effect of Lower and Higher Calorie Meal on the Parameters of Ventricular Repolarization in Healthy Subjects

  • ErdoÄŸan Sökmen Kirsehir Ahi Evran Education and Research Hospital, Department of Cardiology, Ahi Evran University, Kirsehir, Turkey
  • Hacı Mehmet Çalışkan Kirsehir Ahi Evran Education and Research Hospital, Department of Emergency Medicine, Ahi Evran University, Kirsehir, Turkey
  • Mustafa Çelik Kirsehir Ahi Evran Education and Research Hospital, Department of Cardiology, Ahi Evran University, Kirsehir, Turkey
  • Serkan Sivri Kirsehir Ahi Evran Education and Research Hospital, Department of Cardiology, Ahi Evran University, Kirsehir, Turkey
  • Yalçın BoduroÄŸlu Kirsehir Ahi Evran Education and Research Hospital, Department of Cardiology, Ahi Evran University, Kirsehir, Turkey
  • Sinan Cemgil Özbek Kirsehir Ahi Evran Education and Research Hospital, Department of Cardiology, Ahi Evran University, Kirsehir, Turkey
Keywords: meal consumption, ventricular repolarization, high calorie intake


BACKGROUND: Cardiovascular modulation following meal consumption has been known. Little and conflicting data is present regarding electrocardiographic QT and QTc intervals after a meal, and status of ventricular repolarization following meal is not known comprehensively.

AIM: To inquire the electrocardiographic status of ventricular repolarisation thoroughly after lower and higher calorie meal consumption in a comparative manner.

METHODS: A group of 61 healthy individuals were studied before and after lunch. They were divided into two groups according to the calorie consumed (higher calorie and lower calorie; median 1580 and 900 kcals, respectively). Calorie consumed was estimated using dietary guidelines. Data was collected from 12-lead ECG both in a fasted state and 2nd postprandial hour for each participant. Parameters of ventricular repolarization, namely, JTp, Tp-e, QT, QTc intervals and their ratios, as well as RR intervals, were compared between fasted and postprandial states for every participant.

RESULTS: Tp-e and QTc intervals, and Tp-e/QTc ratio do not significantly change after both higher- and lower-calorie meals. JTp and QT intervals significantly shorten in both groups, regardless of the calorie consumed. While JTp shows a positive correlation with RR interval both before and after a meal in lower calorie intake group, no correlation was found with RR interval after a meal in higher calorie group. Logistic regression analysis revealed that higher calorie intake during a meal is a predictor for greater shortening in JTp and QT, compared to lower calorie meal.

CONCLUSION: Our study may guide future studies on ventricular repolarisation, particularly those conducted on various disease conditions or drug effect of cardiac electrophysiology.


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Moneta GL, Taylor DC, Helton WS, et al. Duplex ultrasound measurement of postprandial intestinal blood flow: effect of meal composition. Gastroenterology. 1988; 95(5):1294-1301.

Kelbaek H, Munck O, Christensen NJ, Godtfredsen J. Central haemodynamic changes after a meal. Br Heart J. 1989; 61(6):506-509. PMid:2757863 PMCid:PMC1216707

Hlebowicz J, Lindstedt S, Bjorgell O, Dencker M. Relationship between postprandial changes in cardiac left ventricular function, glucose and insulin concentrations, gastric emptying, and satiety in healthy subjects. Nutr J. 2011; 10:26. PMid:21429209 PMCid:PMC3075212

Sidery MB, Macdonald IA. The effect of meal size on the cardiovascular responses to food ingestion. Br J Nutr. 1994; 71(6):835-848.

Gastaldelli A, Emdin M, Conforti F, Camastra S, et al. Insulin prolongs the QTc interval in humans. Am J Physiol Regul Integr Comp Physiol. 2000; 279(6):R2022-2025. PMid:11080065

Dekker JM, Feskens EJ, Schouten EG, et al. QTc duration is associated with levels of insulin and glucose intolerance. The Zutphen Elderly Study. Diabetes. 1996; 45(3):376-380. PMid:8593946

Keren A, Tzivoni D, Gavish D, et al. Etiology, warning signs and therapy of torsade de pointes. A study of 10 patients. Circulation. 1981; 64(6):1167-1174. PMid:7296791

Algra A, Tijssen JG, Roelandt JR, et al. QTc prolongation measured by standard 12-lead electrocardiography is an independent risk factor for sudden death due to cardiac arrest. Circulation. 1991; 83(6):1888-1894. PMid:2040041

Wheelan K, Mukharji J, Rude RE, et al. Sudden death and its relation to QT-interval prolongation after acute myocardial infarction: two-year follow-up. Am J Cardiol. 1986; 57(10):745-750.

Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008; 41(6):575-580. PMid:18954608

Sokmen E, Ozbek SC, Celik M, et al. Changes in the parameters of ventricular repolarization during preapnea, apnea, and postapnea periods in patients with obstructive sleep apnea. Pacing Clin Electrophysiol. 2018. PMid:29726590

Castro-Torres Y, Carmona-Puerta R, Katholi RE. Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice. World J Clin Cases. 2015; 3(8):705-720. PMid:26301231 PMCid:PMC4539410

Panikkath R, Reinier K, Uy-Evanado A, 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(4):441-447. PMid:21593198 PMCid:PMC3157547

Sciot B, Vandenberk B, Huijghebaert S, et al. Influence of food intake on the QT and QT/RR relation. J Electrocardiol. 2016; 49(5):720-727. PMid:27421698

Nagy D, DeMeersman R, Gallagher D, et al. QTc interval (cardiac repolarization): lengthening after meals. Obes Res. 1997; 5(6):531-537. PMid:9449136

Hnatkova K, Kowalski D, Keirns JJ, et al. QTc changes after meal intake: sex differences and correlates. J Electrocardiol. 2014; 47(6):856-862. PMid:25173631

Taubel J, Wong AH, Naseem A, et al. Shortening of the QT interval after food can be used to demonstrate assay sensitivity in thorough QT studies. J Clin Pharmacol. 2012; 52(10):1558-1565. PMid:22067197

Widerlov E, Jostell KG, Claesson L, et al. Influence of food intake on electrocardiograms of healthy male volunteers. Eur J Clin Pharmacol. 1999; 55(9):619-624. PMid:10638388

Cirincione B, Sager PT, Mager DE. Influence of Meals and Glycemic Changes on QT Interval Dynamics. J Clin Pharmacol. 2017; 57(8):966-976. PMid:28543601 PMCid:PMC5518218

Harris JA, Benedict FG. A Biometric Study of Human Basal Metabolism. Proc Natl Acad Sci U S A. 1918; 4(12):370-373.

Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982; 36(5):936-942. PMid:7137077

Turkey Dietary Guidelines. Ministry of Health of Turkey Publication No: 1046, Ankara, 2016.

Zabel M, Lichtlen PR, Haverich A, Franz MR. Comparison of ECG variables of dispersion of ventricular repolarization with direct myocardial repolarization measurements in the human heart. J Cardiovasc Electrophysiol. 1998; 9(12):1279-1284. PMid:9869527

Cowan JC, Yusoff K, Moore M, et al. Importance of lead selection in QT interval measurement. Am J Cardiol. 1988; 61(1):83-87.

Alvarado-Serrano C, Ramos-Castro J, Pallà s-Areny R. Do ventricular repolarization interval ratios depend on heart rate and should they be rate-corrected? In Engineering in Medicine and Biology Society, 2003. Proceedings of the 25th Annual International Conference of the IEEE. 2003; 1:59-61. IEEE.

Charbit B, Samain E, Merckx P, Funck-Brentano C. QT interval measurement: evaluation of automatic QTc measurement and new simple method to calculate and interpret corrected QT interval. Anesthesiology. 2006; 104(2):255-260. PMid:16436843

Salles GF, Cardoso CR, Leocadio SM, Muxfeldt ES. Recent ventricular repolarization markers in resistant hypertension: are they different from the traditional QT interval? Am J Hypertens. 2008; 21(1):47-53. PMid:18091743

Bazett HC. An analysis of the time relations of electrocardiograms. Heart. 1920; 7:353-70.

Hnatkova K, Johannesen L, Vicente J, Malik M. Heart rate dependency of JT interval sections. J Electrocardiol. 2017; 50(6):814-824. PMid:28912074

Zareba W, McNitt S, Polonsky S, Couderc JP. JT interval: What does this interval mean?J Electrocardiol. 2017; 50(6):748-751. PMid:28942950

Waaler BA, Eriksen M, Toska K.The effect of meal size on postprandial increase in cardiac output. Acta Physiol Scand. 1991; 142(1):33-39. PMid:1877363

Taubel J, Lorch U, Ferber G, et al.Insulin at normal physiological levels does not prolong QT(c) interval in thorough QT studies performed in healthy volunteers. Br J Clin Pharmacol. 2013; 75(2):392-403. PMid:22775199 PMCid:PMC3579254

Fridericia LS.The duration of systole in an electrocardiogram in normal humans and in patients with heart disease. 1920. Ann Noninvasive Electrocardiol. 2003; 8(4):343-351. PMid:14516292

Goldenberg I, Moss AJ, Zareba W. QT interval: how to measure it and what is "normal". J Cardiovasc Electrophysiol. 2006; 17(3):333-336. PMid:16643414

How to Cite
Sökmen E, ÇalışkanHM, Çelik M, Sivri S, Boduroğlu Y, Özbek SC. The Effect of Lower and Higher Calorie Meal on the Parameters of Ventricular Repolarization in Healthy Subjects. Open Access Maced J Med Sci [Internet]. 2019Jan.21 [cited 2021Jan.25];7(3):329-35. Available from:
B - Clinical Sciences