Sympathetic stimulation produces a greater increase in both transmural and spatial dispersion of repolarization in LQT1 than LQT2 forms of congenital long QT syndrome
Sympathetic stimulation produces a greater increase in both transmural and spatial dispersion of repolarization in LQT1 than LQT2 forms of congenital long QT syndrome
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DOI：
10.1016/s0735-1097(00)01200-6
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发表时间：
2001-03-01
影响因子：
24
通讯作者：
Shimizu, W
中科院分区：
文献类型：
--
作者：
Tanabe, Y;Inagaki, M;Shimizu, W
本研究比较了交感神经刺激对先天性长QT综合征（LQTS）的LQT 1型和LQT 2型之间跨壁和空间复极离散度的影响。实验研究表明，在心电图（ECG）的T峰和Tend（Tp-e）之间的间隔反映跨室壁的复极跨壁dispersion。方法我们记录了87导联体表心电图肾上腺素输注（0.1 μ g/kg/min）之前和之后在13 LQT 1，6 LQT 2，和7个对照患者。在87导联心电图上自动测量Q-Tend（QT-e）、Q-T peak（QT-p）和Tp-e，用Bazett法校正（QTc-e、QTc-p、Tcp-e），取87导联和24导联心电图的平均值，反映左室游离壁电位。以QTc-e和QTc-p的最大值与最小值之间的间隔作为复极化空间离散度的指标，计算87个导联和24个导联的QTc-e和QTc-p的离散度。导致LQT 1和LQT 2的平均Tcp-e显著增加，但对照组患者没有。LQT 1中肾上腺素诱导的平均QTc-e和Tcp-e增加大于LQT 2，并且当从24导联获得平均数据时比从87导联获得平均数据时更明显。肾上腺素可增加最大QTc-e，但不增加最小QTc-e，导致LQT 1和LQT 2患者的QTc-eD显著增加，但对照组患者无此现象。QTc-eD的增加在LQT 1比在LQT 2 patients.CONCLUSIONS我们的数据表明，交感神经刺激产生更大的增加在LQT 1比LQT 2综合征的跨壁和空间离散复极，这可能解释了为什么LQT 1患者更敏感的交感神经刺激。CT Am Coil Cardiol 2001;37：911-9）（C）美国心脏病学会2001年。
OBJECTIVES The study compared the influence of sympathetic stimulation on transmural and spatial dispersion of repolarization between LQT1 and LQT2 forms of congenital long QT syndrome (LQTS).BACKGROUND Cardiac events are more associated with sympathetic stimulation in LQT1 than in LQT2 or LQT3 syndrome. Experimental studies have suggested that the interval between T peak and Tend (Tp-e) in the electrocardiogram (ECG) reflects transmural dispersion of repolarization across the ventricular wall.METHODS We recorded 87-lead body-surface ECGs before and after epinephrine infusion (0.1 mug/kg/min) in 13 LQT1, 6 LQT2, and 7 control patients. The Q-Tend (QT-e), Q-T peak (QT-p), and Tp-e were measured automatically from 87-lead ECGs, corrected by Bazett's method (QTc-e, QTc-p, Tcp-e), and averaged among all 87-leads and among 24-leads, which reflect the potential from the left ventricular free wall. As an index of spatial dispersion of repolarization, the dispersion of QTc-e (QTc-eD) and QTc-F (QTc-pD) were obtained among 87-leads and among 24-leads, and were defined as the interval between the maximum and the minimum of the QTc-e and the QTc-p, respectively.RESULTS Epinephrine significantly increased the mean QTc-e but not the mean QTc-p, resulting in a significant increase in the mean Tcp-e in both LQT1 and LQT2, but not in control patients. The epinephrine-induced increases in the mean QTc-e and Tcp-e were larger in LQT1 than in LQT2, and were more pronounced when the averaged data were obtained from 24-leads than from 87-leads. Epinephrine increased the maximum QTc-e but not the minimum QTc-e, producing a significant increase in the QTc-eD in both LQT1 and LQT2 patients, but not in control patients. The increase in the QTc-eD was larger in LQT1 than in LQT2 patients.CONCLUSIONS Our data suggest that sympathetic stimulation produces a greater increase in both transmural and spatial dispersion of repolarization in LQT1 than in LQT2 syndrome, and this may explain why LQT1 patients are more sensitive to sympathetic stimulation. CT Am Coil Cardiol 2001;37:911-9) (C) 2001 by the American College of Cardiology.