Document Detail


Can the assessment of dynamic QT dispersion on exercise electrocardiogram predict sudden cardiac death in hypertrophic cardiomyopathy?
MedLine Citation:
PMID:  11139965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Premature sudden cardiac death (SD) is a critical event in the natural history of hypertrophic cardiomyopathy (HCM), and occurs during or just after physical exertion in approximately 60% of instances. Abnormalities in ventricular repolarization may not be present at rest in some patients but may become apparent under certain conditions. This study was performed to examine whether dynamic QT dispersion during exercise is associated with SD in HCM. Twenty-four HCM patients with catastrophic events (group I; 18 SD, 6 ventricular fibrillation) and 24 event-free survivors (group II) were studied. The two groups were pair-matched for age, gender, and maximum left ventricular wall thickness. QT intervals were manually measured from 12-lead exercise electrocardiogram (ECG) with a digitizing board. A custom-developed program was used to calculate QT and JT dispersion. The QT/RR relationship was evaluated by the slope of linear regression analysis. Before exercise, significant differences in heart rate and JT dispersion were found between group I and II. During exercise, heart rate increased and QT decreased significantly in both groups. QT and JT dispersion decreased in both groups, though the magnitude of reduction was greater in group I than in group II. No significant differences in QTc interval and QT or JT dispersion were found between the groups at any stages. At 3 minutes of recovery, heart rate had decreased but remained higher than before exercise, and all measurements of QT components remained shorter compared with those made before exercise in both groups. There was a strong correlation between QT and RR interval during exercise in all study patients (r = 0.95). No difference in the slope of QT against RR intervals was found between the groups (0.317 vs 0.319). In conclusion, exercise reduced QT dispersion in patients with HCM. The dynamic changes in QT dispersion examined by this method on exercise ECG did not make additional contributions in their risk stratification.
Authors:
G Yi; J Poloniecki; S Dickie; P M Elliott; M Malik; W J McKenna
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  23     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1953-6     Citation Subset:  IM    
Affiliation:
Dept. of Cardiological Sciences, St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, United Kingdom. Y.gang@sghms.ac.UK
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiomyopathy, Hypertrophic / diagnosis*,  epidemiology,  physiopathology*
Child
Death, Sudden, Cardiac / epidemiology*
Electrocardiography* / methods
Exercise Test
Female
Heart Rate
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Adjustment
Signal Processing, Computer-Assisted

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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