Sotalol testing unmasks altered repolarization in patients with suspected acquired long-QT-syndrome -: a case-control pilot study using i.v. sotalol
Sotalol testing unmasks altered repolarization in patients with suspected acquired long-QT-syndrome -: a case-control pilot study using i.v. sotalol
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DOI：
10.1016/s0195-668x(02)00806-0
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发表时间：
2003-04-01
影响因子：
39.3
通讯作者：
Steinbeck, G
中科院分区：
文献类型：
--
作者：
Kääb, S;Hinterseer, M;Steinbeck, G
目的：本初步研究的目的是评价索他洛尔激发试验，以揭示由于获得性长QT综合征的关键特征心肌电特性改变引起的异常复极。个体患者的可靠诊断和风险分层由于涉及获得性QT延长的多种机制而变得复杂。所有成分的综合影响决定了对QT延长相关心律失常的易感性。方法连续20例患者在使用QT延长药物后发生尖端扭转型室性心动过速，静脉滴注左旋sotatot（2 mg/kg），24 h监护，通过测定QT间期和QTc间期来评估复极过程。结果进行了比较，年龄和性别匹配的controls.Results在基线时，对照组和研究人群之间的QT和QTc检测无差异。索他洛尔输注后，对照组的QTc从422 ± 17增加至450 ± 22 ms，研究人群的QTc从434 ± 20增加至541 ± 37 ms。尖端扭转型室性心动过速发生在三个20例患者（15%）在研究人群中，但没有在控制患者静脉索他洛尔testing.Conclusions暴露于索他洛尔成功地识别患者正常的QTc间期，但改变心肌复极。这可能有助于阐明获得性长QT综合征的诊断和发病机制。(C)2003年欧洲心脏病学会。由Elsevier Science Ltd.出版，版权所有。
Aims The aim of this pilot study was to evaluate provocative sotalol testing to unmask abnormal repolarization due to altered myocardial electrical properties as the key feature in acquired Long-QT-Syndrome. Reliable diagnosis and risk stratification for the individual patient are complicated by the multitude of mechanisms involved in acquired QT-prolongation. The combined influence of all components determines susceptibility to arrhythmias related to QT-prolongation.Methods Twenty consecutive patients who had experienced torsades de pointes in association with QT-prolonging drugs were tested with i.v. d,l-sotatot (2 mg/kg) with 24-h intensive care monitoring to evaluate the repolarization process by determining QT- and QTc-prolongations. Results were compared to age and sex matched controls.Results At baseline, no differences between control and study population with regard to QT and QTc were detected. After sotalol infusion, QTc increased from 422 17 to 450+/-22 ms in controls and from 434+/-20 to 541+/-37 ms in the study population. Torsades de pointes occurred in three out of 20 patients (15%) in the study population but in none of the control patients following i.v. sotalol testing.Conclusions Controlled exposure to sotalol successfully identifies patients with normal QTc intervals but altered myocardial repolarization. This may be useful for clarifying diagnosis and pathogenesis of acquired Long-QT-Syndrome. (C) 2003 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.