Document Detail


Rate-independent QT shortening during exercise in healthy subjects: terminal repolarization does not shorten with exercise.
MedLine Citation:
PMID:  18665873     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: QT interval for a given heart rate differs between exercise and recovery (QT hysteresis) due to slow QT adaptation to changes in heart rate. We hypothesized that QT hysteresis is evident within stages of exercise and investigated which component of the QT contributes to hysteresis.
METHODS AND RESULTS: Nineteen healthy volunteers performed a staged exercise test (four stages, 3 min each). Continuous telemetry was analyzed with software to compare QT intervals in a rate-independent fashion. QRST complexes during each minute were sorted by RR interval, and complexes in bins of 20 ms width were signal-averaged. QT and QTp (onset of QRS to peak T wave) were measured, and terminal QT calculated (peak to end of T wave, Tpe = QT - QTp). QT, QTp, and Tpe at the same heart rate were compared between the first and last minute of each stage. QT shortened from the first to last minute of exercise in each stage (Stage I: 358 +/- 30 to 346 +/- 25 ms, P < 0.001; Stage II: 342 +/- 27 to 331 +/- 24 ms, P = 0.003; Stage III: 329 +/- 21 to 322 +/- 18 ms, P = 0.03; Stage IV: 313 +/- 22 to 303 +/- 23 ms, P = 0.005). QTp also shortened in each stage, while Tpe was unchanged.
CONCLUSION: QT hysteresis occurs during exercise in normals, and the major determinant is shortening of the first component of the T wave. Terminal repolarization (peak to end of T wave), a surrogate for transmural dispersion of repolarization, does not shorten significantly with exercise.
Authors:
Prince J Kannankeril; Paul A Harris; Kris J Norris; Irfan Warsy; Phillip D Smith; Dan M Roden
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2008-07-28
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  19     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-03-16     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1284-8     Citation Subset:  IM    
Affiliation:
Oates Institute for Experimental Therapeutics, Clinical Research Center, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee 37232-9119, USA. prince.kannankeril@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Electrocardiography / methods*
Female
Heart Conduction System / physiology*
Heart Rate / physiology*
Humans
Male
Physical Exertion / physiology*
Reference Values
Young Adult
Grant Support
ID/Acronym/Agency:
HL076264/HL/NHLBI NIH HHS; HL65962/HL/NHLBI NIH HHS; K23 HL076264-01A2/HL/NHLBI NIH HHS; RR-00095/RR/NCRR NIH HHS; RR024975/RR/NCRR NIH HHS
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