Autonomic and Cardiac Repolarization Lability in Long QT Syndrome Patients
| Autor: | Ahmed Selmi, Xiaojuan Xia, Wojciech Zareba, Matthew Wang, David S. Auerbach, Samuel Kashtan, Jean-Phillippe Couderc, Natalia DeMaria |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Autonomic function
Adult Male medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Long QT syndrome Logistic regression Cardiac repolarization Article 03 medical and health sciences Cellular and Molecular Neuroscience Young Adult 0302 clinical medicine Heart Rate Internal medicine medicine Heart rate variability Repolarization Humans cardiovascular diseases Qt variability Endocrine and Autonomic Systems business.industry Vagus Nerve Middle Aged medicine.disease Electrophysiological Phenomena Long QT Syndrome Autonomic Nervous System Diseases Cardiology Electrocardiography Ambulatory Female Neurology (clinical) business 030217 neurology & neurosurgery circulatory and respiratory physiology |
| Zdroj: | Auton Neurosci |
| Popis: | Objective Long QT-Syndrome (LQTS) patients are at risk of arrhythmias and seizures. We investigated whether autonomic and cardiac repolarization measures differed based on LQTS genotypes, and in LQTS patients with vs. without arrhythmias and seizures. Methods We used 24-h ECGs from LQTS1 (n = 87), LQTS2 (n = 50), and LQTS genotype negative patients (LQTS(−), n = 16). Patients were stratified by LQTS genotype, and arrhythmias/seizures. Heart rate variability (HRV) and QT variability index (QTVI) measures were compared between groups during specific physiological states (minimum, middle, & maximum sympathovagal balance, LF/HF). Results were further tested using logistic regression for each ECG measure, and all HRV measures in a single multivariate model. Results Across multiple physiological states, total autonomic (SDNN) and vagal (RMSSD, pNN50) function were lower and repolarization dynamics (QTVI) were elevated in LQTS(+), LQTS1, and LQTS2, compared to LQTS(−). Many measures remained significant in the regression models. Multivariate modeling demonstrated that SDNN, RMSSD, and pNN50 were independent markers of LQTS(+) vs. LQTS(−), and SDNN and pNN50 were markers for LQTS1 vs. LQTS(−). During sympathovagal balance (middle LF/HF), RMSSD and pNN50 distinguished LQTS1 vs. LQTS2. LQTS1 patients with arrhythmias had lower total (SDNN) and vagal (RMSSD and pNN50) autonomic function, and SDNN remained significant in the models. In contrast, ECG measures did not differ in LQTS2 patients with vs. without arrhythmias, and LQTS1 and LQTS2 with vs. without seizures. Conclusion Autonomic (HRV) and cardiac repolarization (QTVI) ECG measures differ based on LQTS genotype and history of arrhythmias in LQTS1. SDNN, RMSSD, and pNN50 were each independent markers for LQTS genotype. |
| Databáze: | OpenAIRE |
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