In Silico Cardiac Risk Assessment in Patients With Long QT Syndrome
| Autor: | Wojciech Zareba, J. Jeremy Rice, Arthur A.M. Wilde, Wataru Shimizu, Jørgen K. Kanters, Coeli M. Lopes, Pyotr G. Platonov, Ilan Goldenberg, Scott McNitt, Matthias Reumann, Yiping Gu, Ryan Hoefen, Christian Jons, Jin O-Uchi, Arthur J. Moss |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Long QT syndrome Hazard ratio medicine.disease QT interval Romano–Ward syndrome Sudden cardiac death Internal medicine Heart rate medicine Cardiology Repolarization Cardiology and Cardiovascular Medicine business Electrocardiography |
| Zdroj: | Journal of the American College of Cardiology. 60:2182-2191 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2012.07.053 |
| Popis: | Objectives The study was designed to assess the ability of computer-simulated electrocardiography parameters to predict clinical outcomes and to risk-stratify patients with long QT syndrome type 1 (LQT1). Background Although attempts have been made to correlate mutation-specific ion channel dysfunction with patient phenotype in long QT syndrome, these have been largely unsuccessful. Systems-level computational models can be used to predict consequences of complex changes in channel function to the overall heart rhythm. Methods A total of 633 LQT1-genotyped subjects with 34 mutations from multinational long QT syndrome registries were studied. Cellular electrophysiology function was determined for the mutations and introduced in a 1-dimensional transmural electrocardiography computer model. The mutation effect on transmural repolarization was determined for each mutation and related to the risk for cardiac events (syncope, aborted cardiac arrest, and sudden cardiac death) among patients. Results Multivariate analysis showed that mutation-specific transmural repolarization prolongation (TRP) was associated with an increased risk for cardiac events (35% per 10-ms increment [p = upper quartile hazard ratio: 2.80 [p = upper quartile hazard ratio: 2.24 [p = 0.002]) independently of patients' individual QT interval corrected for heart rate (QTc). Subgroup analysis showed that among patients with mild to moderate QTc duration ( |
| Databáze: | OpenAIRE |
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