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Analysis of 24-h Rhythm in Ventricular Repolarization Identifies QT Diurnality As a Novel Clinical Parameter Associated with Previous Ventricular Arrhythmias in Heart Failure Patients
- Source :
- Frontiers in Physiology, Frontiers in Physiology, Vol 8 (2017), Frontiers in Physiology [E], 8(AUG). Frontiers Research Foundation
- Publication Year :
- 2017
-
Abstract
- Introduction: Cardiac repolarization abnormalities are among the major causes of ventricular arrhythmias and sudden cardiac death. In humans, cardiac repolarization duration has a 24-h rhythm. Animal studies show that this rhythm is regulated by 24-h rhythms in ion channel function and that disruption of this rhythm leads to ventricular arrhythmias. We hypothesized that 24-h rhythms in QT duration can be used as a predictor for sudden cardiac death and are associated with ventricular arrhythmias. Secondly, we assessed a possible mechanistic explanation by studying the putative role of hERG channel dysfunction.Materials and Methods: In 2 retrospective studies, measures of the 24-h variation in the QT and QTc intervals (QT and QTc diurnality, QTd and QTcd, respectively) have been derived from Holter analyses and compared between groups: 1) 39 post-infarct patients with systolic heart failure (CHF: EF < 35%), of which 14 with, and 25 without a history of ventricular arrhythmias and 2) five patients with proven (LQTS2) and 16 with potential (Sotalol-induced) hERG channel dysfunction vs. 22 controls.Results: QTd was two-fold higher in CHF patients with a history of ventricular arrhythmias (38 ± 15 ms) compared to CHF patients without VT (16 ± 9 ms, p = 0.001). QTd was significantly increased in LQT2 patients (43 ± 24 ms) or those treated with Sotalol (30 ± 10 ms) compared to controls (21 ± 8 ms, p < 0.05 for both).Discussion: QT diurnality presents a novel clinical parameter of repolarization that can be derived from Holter registrations and may be useful for identification of patients at risk for ventricular arrhythmias.
- Subjects :
- medicine.medical_specialty
Physiology
hERG
Repolarization
Rhythm
030204 cardiovascular system & hematology
QT interval
rhythm
lcsh:Physiology
sudden cardiac death
Sudden cardiac death
03 medical and health sciences
0302 clinical medicine
Internal medicine
Physiology (medical)
medicine
Journal Article
Diurnality
030212 general & internal medicine
Circadian rhythm
cardiovascular diseases
Original Research
ventricular arrhythmia
repolarization
biology
lcsh:QP1-981
business.industry
Sotalol
Circadian
QT
medicine.disease
circadian
Anesthesia
Heart failure
biology.protein
Cardiology
Ventricular arrhythmia
cardiovascular system
business
medicine.drug
Subjects
Details
- ISSN :
- 1664042X
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Frontiers in physiology
- Accession number :
- edsair.doi.dedup.....eb2a9c719fab6b07ae396042fad686ec