The role of β-adrenergic stimulation in QT interval adaptation to heart rate during stress test.

Autor: Pérez C; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; IIS Aragón, Zaragoza, Spain., Cebollada R; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; IIS Aragón, Zaragoza, Spain., Mountris KA; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; CIBER de Bioingeniería, Biomateriales, y Nanomedicina, Instituto de Salud Carlos III, Zaragoza, Spain., Martínez JP; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; CIBER de Bioingeniería, Biomateriales, y Nanomedicina, Instituto de Salud Carlos III, Zaragoza, Spain., Laguna P; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; IIS Aragón, Zaragoza, Spain.; CIBER de Bioingeniería, Biomateriales, y Nanomedicina, Instituto de Salud Carlos III, Zaragoza, Spain., Pueyo E; BSICoS Group, I3A, University of Zaragoza, Zaragoza, Spain.; IIS Aragón, Zaragoza, Spain.; CIBER de Bioingeniería, Biomateriales, y Nanomedicina, Instituto de Salud Carlos III, Zaragoza, Spain.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jan 26; Vol. 18 (1), pp. e0280901. Date of Electronic Publication: 2023 Jan 26 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0280901
Abstrakt: The adaptation lag of the QT interval after heart rate (HR) has been proposed as an arrhythmic risk marker. Most studies have quantified the QT adaptation lag in response to abrupt, step-like changes in HR induced by atrial pacing, in response to tilt test or during ambulatory recordings. Recent studies have introduced novel methods to quantify the QT adaptation lag to gradual, ramp-like HR changes in stress tests by evaluating the differences between the measured QT series and an estimated, memoryless QT series obtained from the instantaneous HR. These studies have observed the QT adaptation lag to progressively reduce when approaching the stress peak, with the underlying mechanisms being still unclear. This study analyzes the contribution of β-adrenergic stimulation to QT interval rate adaptation in response to gradual, ramp-like HR changes. We first quantify the QT adaptation lag in Coronary Artery Disease (CAD) patients undergoing stress test. To uncover the involved mechanisms, we use biophysically detailed computational models coupling descriptions of human ventricular electrophysiology and β-adrenergic signaling, from which we simulate ventricular action potentials and ECG signals. We characterize the adaptation of the simulated QT interval in response to the HR time series measured from each of the analyzed CAD patients. We show that, when the simulated ventricular tissue is subjected to a time-varying β-adrenergic stimulation pattern, with higher stimulation levels close to the stress peak, the simulated QT interval presents adaptation lags during exercise that are more similar to those measured from the patients than when subjected to constant β-adrenergic stimulation. During stress test recovery, constant and time-varying β-adrenergic stimulation patterns render similar adaptation lags, which are generally shorter than during exercise, in agreement with results from the patients. In conclusion, our findings support the role of time-varying β-adrenergic stimulation in contributing to QT interval adaptation to gradually increasing HR changes as those seen during the exercise phase of a stress test.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Pérez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje