Changes in Ventricular Repolarization Duration During Typical Daily Emotion in Patients With Long QT Syndrome
Changes in Ventricular Repolarization Duration During Typical Daily Emotion in Patients With Long QT Syndrome
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DOI：
10.1097/psy.0b013e318203310a
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发表时间：
2011-01-01
影响因子：
3.3
通讯作者：
Moss, Arthur J.
中科院分区：
文献类型：
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作者：
Lane, Richard D.;Zareba, Wojciech;Moss, Arthur J.
目的：强烈的情绪是心源性猝死的已知诱因。然而，典型的日常情绪对复极的影响还没有被研究。我们研究了QT间期是否作为典型的日常情绪的功能在情绪背景下的心脏事件的风险患者的变化。方法：我们研究了161例（n = 114名女性，平均年龄35岁）在日常活动中患有先天性长QT综合征的患者。连续3天，每天完成12小时的霍尔特记录。每天随机呼叫患者10次，并在前5分钟内对16种预先设定的情绪强度进行评级。QT间期和心搏间期的测量与情绪评分同步。结果如下：低唤醒积极情感与心率校正的QT间期显著增加相关（使用Fridericia的QTc）（p < .001），而高唤醒激活积极情感（p < .001）和激活消极情感（p < .01）与QTc显著降低相关。QTc随日常情绪变化的变化范围从5 ms增加到11 ms减少。高频心率变异性（迷走神经张力）与QTc呈正相关（p <0.001）。LQT2患者的每个积极情绪变量对QTc的影响大于LQT1患者（p <0.001）。结论：心室复极时程（QTc）随日常情绪变化而动态变化。这些变化相对较小，本身不构成风险。然而，在其他风险因素的背景下，它们可能导致脆弱人群的室性心律失常。
Objective: Intense emotions are known triggers of sudden cardiac death. However, the effect of typical daily emotion on repolarization has not been examined. We examined whether QT interval changes as a function of typical daily emotion in patients at risk for cardiac events in the context of emotion. Methods: We studied 161 patients (n = 114 females; mean age, 35 years) with the congenital form of the Long QT Syndrome during daily activities. Each day for 3 days, a 12-hour Holter recording was completed. Patients were paged ten times per day at random times and rated the intensity of 16 prespecified emotions during the preceding 5 minutes. Measurements of QT interval and interbeat intervals were synchronized with emotion ratings. Results: Low Arousal Positive Affect was associated with significant increases in QT interval corrected for heart rate (using Fridericia's QTc) (p < .001), whereas higher arousal Activated Positive Affect (p < .001) and Activated Negative Affect (p < .01) were associated with significant decreases in QTc. Changes in QTc as a function of daily emotion ranged from 5-ms increases to 11-ms decreases. High-frequency heart rate variability (vagal tone) was positively correlated with QTc (p < .001). The effects of each positive emotion variable on QTc were greater in LQT2 than LQT1 patients (p < .001). Conclusion: Ventricular repolarization duration (QTc) changes dynamically as a function of daily emotion. These changes are relatively small and do not constitute a risk in themselves. In the context of other risk factors, however, they may contribute to ventricular arrhythmias in vulnerable populations.