Document Detail


QT dispersion in patients with chronic heart failure: beta blockers are associated with a reduction in QT dispersion.
MedLine Citation:
PMID:  10026356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare QT dispersion in patients with impaired left ventricular systolic function and in matched control patients with normal left ventricular systolic function. DESIGN: A retrospective, case-control study with controls matched 4:1 for age, sex, previous myocardial infarction, and diuretic and beta blocker treatment. SETTING: A regional cardiology centre and a university teaching hospital. PATIENTS: 25 patients with impaired left ventricular systolic function and 100 patients with normal left ventricular systolic function. MAIN OUTCOME MEASURES: QT and QTc dispersion measured by three methods: the difference between maximum and minimum QT and QTc intervals, the standard deviation of QT and QTc intervals, and the "lead adjusted" QT and QTc dispersion. RESULTS: All measures of QT/QTc dispersion were closely interrelated (r values 0.86 to 0.99; all p < 0.001). All measures of QT and QTc dispersion were significantly increased in the patients with impaired left ventricular systolic function v controls (p < 0.001): 71.9 (6.5) (mean (SEM)) v 46.9 (1.7) ms for QT dispersion, and 83.6 (7.6) v 54.3 (2.1) ms(-1-2) for QTc dispersion. All six dispersion parameters were reduced in patients taking beta blockers (p < 0.05), regardless of whether left ventricular function was normal or impaired-by 9.4 (4.6) ms for QT dispersion (p < 0.05) and by 13.8 (6. 5) ms(-1-2) for QTc dispersion (p = 0.01). CONCLUSIONS: QT and QTc dispersion are increased in patients with systolic heart failure in comparison with matched controls, regardless of the method of measurement and independently of possible confounding factors. beta Blockers are associated with a reduction in both QT and QTc dispersion, raising the possibility that a reduction in dispersion of ventricular repolarisation may be an important antiarrhythmic mechanism of beta blockade.
Authors:
C E Bonnar; A P Davie; L Caruana; L Fenn; S A Ogston; J J McMurray; A D Struthers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  81     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-03     Completed Date:  1999-06-03     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  297-302     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Pharmacology and Therapeutics, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. c.e.bonnar@clinpharm.dundee.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Aged
Case-Control Studies
Diuretics / therapeutic use
Echocardiography, Doppler, Color
Electrocardiography
Female
Heart Failure / drug therapy,  physiopathology*,  ultrasonography
Humans
Male
Middle Aged
Regression Analysis
Retrospective Studies
Ventricular Dysfunction, Left / drug therapy*,  physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Diuretics
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