Diagnostic performance of QT interval variables from 24-h electrocardiography in the long QT syndrome
| Autor: | Pascale Guicheney, Nathalie Neyroud, S. Chevret, Philippe Coumel, P. Maison Blanche, Fabio Badilini, J. Fayn, Isabelle Denjoy, Ketty Schwartz, N. Menhabi, Claire Donger, Eric Dausse |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Genotype Heart disease Heart block Heart Ventricles Long QT syndrome Sensitivity and Specificity QT interval Statistics Nonparametric Heart Conduction System Heart Rate Internal medicine Heart rate medicine Humans cardiovascular diseases Child Aged Chi-Square Distribution medicine.diagnostic_test business.industry Chromosomes Human Pair 11 Middle Aged medicine.disease Circadian Rhythm Long QT Syndrome Logistic Models Case-Control Studies Anesthesia Ambulatory Electrocardiography Ambulatory Cardiology Population study Female Cardiology and Cardiovascular Medicine business Electrocardiography |
| Zdroj: | European Heart Journal. 19:158-165 |
| ISSN: | 0195-668X |
| DOI: | 10.1053/euhj.1997.0730 |
| Popis: | The long QT syndrome is mainly defined by QT interval prolongation (QTc0.44s). However, data obtained in genotyped patients showed that resting QTc measurement alone may be inaccurate for ascertaining the phenotype. The aim of this study was to evaluate the diagnostic performance of QT interval rate-dependence in untreated chromosome 11-linked patients.The study population consisted of 25 untreated long QT patients linked to chromosome 11 and 25 age- and gender-matched controls. QTc intervals were measured on 12-lead resting ECG recordings. From 24-h Holter recordings, the slope of the relationship between ventricular repolarization and heart rate was studied separately day and night to assess neural modulation. Mean heart rates and rate-dependences of QT and Q-maximum of T (QTm) intervals were compared between long QT patients and controls for both time periods.In both groups, the rate-dependences were modulated by day-night influences. When compared to controls, long QT patients showed a significant increase at night in QT/RR slopes (0.158 +/- 0.05 vs 0.117 +/- 0.03, P = 0.002) and QTm/RR slopes (0.163 +/- 0.05 vs 0.116 +/- 0.04, P = 0.0006). Multivariate analysis, adjusting QTc interval on age and gender, discriminated between long QT patients and controls with a 76% sensitivity and a 84% specificity. A 96% sensitivity and a 96% specificity were reached by taking into account the QTm/RR slope at night, the QTc interval and the mean heart rate during the day.QT interval variables obtained from 24-h ECG recordings improve long QT syndrome diagnosis by showing an increased nocturnal ventricular repolarization rate-dependence in genotyped chromosome 11-linked patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|