| Increased QT dispersion in patients with vasospastic angina. | |
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MedLine Citation:
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PMID: 9714094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The risk factors for ventricular arrhythmias in patients with coronary vasospasm have not been identified. We evaluated QT dispersion in patients with vasospastic angina and its relation to susceptibility to ventricular arrhythmias during myocardial ischemia and reperfusion. METHODS AND RESULTS: We assessed the corrected QT (QTc) dispersion before induction of coronary artery spasm by intracoronary injection of acetylcholine (baseline) and 30 minutes after administration of isosorbide dinitrate in 50 patients with vasospastic angina and 50 patients with atypical chest pain. The baseline QTc dispersion was significantly greater in patients with vasospastic angina than in patients with atypical chest pain (mean+/-SD: 69+/-24 versus 44+/-19 ms, 95% confidence interval of mean difference [CI]: 16 to 33 ms; P<0.001). QTc dispersion decreased significantly, to 48+/-15 ms (CI: 15 to 26 ms; P<0.001 versus baseline), after administration of isosorbide dinitrate in patients with vasospastic angina but did not change significantly in patients with atypical chest pain (mean+/-SD: 41+/-17 ms, CI: -3 to 9 ms). During the provocation test, 24 of 50 patients with vasospastic angina experienced ventricular arrhythmias. The baseline QTc dispersion was significantly greater in patients with than without ventricular arrhythmias (mean+/-SD: 77+/-23 versus 61+/-19 ms, CI: 4 to 26 ms; P<0.05). CONCLUSIONS: Patients with vasospastic angina exhibited an increased baseline QTc dispersion compared with patients with atypical chest pain, which suggests that inhomogeneity of repolarization and susceptibility to ventricular arrhythmias are increased in patients with vasospastic angina, even when asymptomatic. The association between increased QTc dispersion and ventricular arrhythmias during the provocation test suggests that measurement of QT dispersion may help predict which patients with vasospastic angina are at high risk for ventricular arrhythmias during ischemia. |
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Authors:
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M Suzuki; M Nishizaki; M Arita; T Ashikaga; N Yamawake; T Kakuta; F Numano; M Hiraoka |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Circulation Volume: 98 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Aug |
Date Detail:
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Created Date: 1998-09-08 Completed Date: 1998-09-08 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 435-40 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetylcholine
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diagnostic use Aged Analysis of Variance Angina Pectoris / complications, diagnosis* Arrhythmias, Cardiac / diagnosis, etiology Chest Pain / complications, diagnosis Chi-Square Distribution Confidence Intervals Coronary Angiography / methods Coronary Vasospasm / complications, diagnosis* Electrocardiography, Ambulatory* / methods, statistics & numerical data Female Humans Isosorbide Dinitrate / diagnostic use Male Middle Aged Reproducibility of Results Vasodilator Agents / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 51-84-3/Acetylcholine; 87-33-2/Isosorbide Dinitrate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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