Document Detail


Prevalence and clinical correlates of QT prolongation in patients with hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  21345853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Congenital or acquired QT prolongation is a risk factor for life-threatening arrhythmias. In patients with hypertrophic cardiomyopathy (HCM), the QT interval may be intrinsically prolonged. However, the prevalence, cause, and significance of QT prolongation among patients with HCM are unknown.
METHODS AND RESULTS: After exclusion of patients on QT-prolonging drugs, a blinded, retrospective analysis of electrocardiograms, echocardiograms, and genotype status in 479 unrelated patients with HCM [201 females, age at diagnosis 41 ± 18 years, maximal left ventricular wall thickness (MLVWT) 22 ± 6 mm] from two independent centres was performed. The mean QTc was 440 ± 28 ms. The QTc exceeded 480 ms in 13% of patients. Age, gender, family history of HCM or sudden cardiac arrest, and genotype status had no association with QTc. Patients with a QTc over 480 ms were more symptomatic at diagnosis (P < 0.001), had a higher MLVWT (P = 0.03), were more obstructive (P < 0.001), and were more likely to have undergone septal reduction therapy (P = 0.02). There was a weak but significant direct linear relationship between QTc and peak outflow gradient (r(2) = 0.05, P < 0.0001).
CONCLUSIONS: Compared with <1 in 200 otherwise healthy adults, QT prolongation (QTc > 480 ms) was present in 1 out of 8 patients with HCM. The QTc was partly reflective of the degree of cardiac hypertrophy and left ventricular outflow tract obstruction. Because of its pro-arrhythmic potential and its potential relevance to management and risk stratification, routine QTc assessment should be performed in patients with HCM, particularly when concomitant use of QT-prolonging medications is considered.
Authors:
Jonathan N Johnson; Camilla Grifoni; J Martijn Bos; Maha Saber-Ayad; Steve R Ommen; Stefano Nistri; Franco Cecchi; Iacopo Olivotto; Michael J Ackerman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-22
Journal Detail:
Title:  European heart journal     Volume:  32     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-04     Completed Date:  2012-01-05     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1114-20     Citation Subset:  IM    
Affiliation:
Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Hypertrophic / complications*,  therapy
Death, Sudden, Cardiac / etiology
Defibrillators, Implantable
Electric Countershock / instrumentation
Female
Genotype
Humans
Long QT Syndrome / etiology*,  therapy
Male
Middle Aged
Prognosis
Retrospective Studies
Ventricular Outflow Obstruction / etiology
Young Adult
Grant Support
ID/Acronym/Agency:
HD42569/HD/NICHD NIH HHS; HL094291/HL/NHLBI NIH HHS
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