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Abnormal ventricular repolarization in long QT syndrome carriers is related to short left ventricular filling time and attenuated stroke volume response during exercise
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK.ORCID iD: 0000-0001-6566-7867
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Molecular & Clinical Sciences Research Institute, St George University, London, UK.
2018 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 35, no 8, p. 1116-1123Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Long QT syndrome (LQTS) carriers are characterized by abnormal ventricular repolarization, prolonged systole, and mechanical dispersion. Prolonged left ventricular (LV) systole has been shown to result in disproportionate shortening of LV filling in other conditions. The aim of this study was to assess LV filling, diastolic function, and stroke volume (SV) response to dynamic exercise, in a group of LQTS carriers.

METHODS: Forty-seven LQTS carriers (45 ± 15 years, 20 symptomatic) and 35 healthy individuals underwent bicycle stress echocardiogram. Electrocardiographic and echocardiographic measurements were obtained at rest, peak exercise, and 4 minutes into recovery.

RESULTS: Long QT syndrome carriers and controls did not differ in age, gender, heart rate, QRS duration, or LV ejection fraction. At rest, LQTS carriers had longer QTc and shorter filling time (FT). At peak exercise, QTc increased and remained longer than controls at recovery. A negative correlation was found between QTc and FT (r = -.398, P = .001) with greater fall in FT in LQTS carriers than in controls at peak exercise (-23% ± 10 vs +2% ± 3, P < .0001). FT correlated with SV (r = +.27, P = .001), which increased more in controls than in LQTS carriers (+32% ± 4 vs +2% ± 1, P < .05). These differences were more pronounced in symptomatic LQTS carriers who had shorter FT and smaller SV at peak exercise and during recovery compared to asymptomatics (P < .05).

CONCLUSIONS: Long QT syndrome carriers have longer QTc, but also shorter FT. These disturbances worsen at peak exercise (particularly in symptomatics) compromising LV filling and SV, hence a potential pathomechanism for adverse events.

Place, publisher, year, edition, pages
2018. Vol. 35, no 8, p. 1116-1123
Keywords [en]
exercise echocardiography, left ventricular filling, long QT Syndrome
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-148429DOI: 10.1111/echo.13891ISI: 000440648000005PubMedID: 29648704OAI: oai:DiVA.org:umu-148429DiVA, id: diva2:1213757
Available from: 2018-06-05 Created: 2018-06-05 Last updated: 2019-03-11Bibliographically approved

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Charisopoulou, DafniKoulaouzidis, GeorgeRydberg, AnnikaHenein, Michael Y.

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