Abstract:
BACKGROUND:Electromechanical (EM) coupling heterogeneity is significant in long QT syndrome (LQTS), particularly in symptomatic patients; EM window (EMW) has been proposed as an indicator of interaction and a better predictor of arrhythmia than QTc. HYPOTHESIS:To investigate the dynamic response of EMW to exercise in LQTS and its predictive value of arrhythmia. METHODS:Forty-seven LQTS carriers (45 ± 15 years, 20 with arrhythmic events), and 35 controls underwent exercise echocardiogram. EMW was measured as the time difference between aortic valve closure on Doppler and the end of QT interval on the superimposed electrocardiogram (ECG). Measurements were obtained at rest, peak exercise (PE) and 4 minutes into recovery. RESULTS:Patients did not differ in age, gender, heart rate, or left ventricular ejection fraction but had a negative resting EMW compared with controls (-42 ± 22 vs 17 ± 5 ms, P < 0.0001). EMW became more negative at PE (-89 ± 43 vs 16 ± 7 ms, P = 0.0001) and recovery (-65 ± 39 vs 16 ± 6 ms, P = 0.001) in patients, particularly the symptomatic, but remained unchanged in controls. PE EMW was a stronger predictor of arrhythmic events than QTc (AUC:0.765 vs 0.569, P < 0.001). B-blockers did not affect EMW at rest but was less negative at PE (BB: -66 ± 21 vs no-BB: -113 ± 25 ms, P < 0.001). LQT1 patients had worse PE EMW negativity than LQT2. CONCLUSION:LQTS patients have significantly negative EMW, which worsens with exercise. These changes are more pronounced in patients with documented arrhythmic events and decrease with B-blocker therapy. Thus, EMW assessment during exercise may help improve risk stratification and management of LQTS patients.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Charisopoulou D,Koulaouzidis G,Rydberg A,Michael HYdoi
10.1002/clc.23132subject
Has Abstractpub_date
2019-02-01 00:00:00pages
235-240issue
2eissn
0160-9289issn
1932-8737journal_volume
42pub_type
杂志文章abstract::Acute myocardial infarction can be stratified into electrocardiographic subsets based on the presence or absence of new Q waves. This stratification has important clinical and prognostic utility. Coronary angiography during acute non-Q-wave compared with Q-wave infarction shows much higher infarct-related artery paten...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
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abstract::In order to study left ventricular diastolic function, digitized M-mode echocardiograms of the free wall endocardium were analyzed. A population of 117 healthy individuals was compared with a group of 22 patients with myocardial hypertrophy due to aortic stenosis (AS), and a group of 21 with hypertrophic cardiomyopath...
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journal_title:Clinical cardiology
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pub_type: 历史文章,杂志文章
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