Document Detail


Increased QT dispersion in patients with vasospastic angina.
MedLine Citation:
PMID:  9714094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Suzuki; M Nishizaki; M Arita; T Ashikaga; N Yamawake; T Kakuta; F Numano; M Hiraoka
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  98     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-09-08     Completed Date:  1998-09-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  435-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / 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:
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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