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Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

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Journal of Geriatric Cardiology 2017年第12期14卷 717-724页

作者： Ana Ciobanu Gary Tse Tong Liu Maria V Deaconu Gabriela S Gheorghe Adriana M Iliesiu Ioan T Nanea Department of Internal Medicine and Cardiology Theodor Burghele Clinical Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sci- ences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease Department of Cardiology Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University Tianjin China

Objective To examine the relationship between Tpeak- Tend interval （Tpe） and Tpe/QT ratio with occurrence of ventricular premature beats （VPBs） and left ventricular remodeling in hypertension. Methods A total of 52 patients with mild to moderate essential hypertension were included, undergoing echocardiography and 24-hours Holter monitoring. Ventricular remodeling was assessed by left ventricular mass index （LVMI） using the Devereux formula and diastolic fimction by transmitral E and A wave velocities and E/A ratio. Tpe was measured in the precordial leads. The end of the T wave was set by the method of the tangent to the steepest descending slope of the T wave. Results Tpe and Tpe/QT in leads V2 （r = 0.33, P = 0.01; r = 0.27, P = 0.04 respectively） and V3 （r = 0.40, P = 0.002; r = 0.40, P = 0.003, respectively） correlated significantly with LVMI. A significant inverse relationship was observed between E/A ratio and QT （r = -0.33, P = 0.01）, Tpe in V3 （r = -0.39, P = 0.003） and Tpe/QT in V3 （r = -0.31, P = 0.02）. Tpe in V3, V5, mean Tpe and maximum Tpe with cut-offvalues of 60 ms, 59 ms, 62 ms and 71 ms, respectively, associated with the occurrence of ventricular premature beats. Conclusions The repolarization parameters Tpe interval and Tpe/QT ratio correlate with LVMI and indices of left ventricular diastolic function and show better predictive values than traditional parameters such as QT interval and QT dispersion. Lead V3 is the best lead for measuring Tpe and Tpe/QT. These ECG indices can therefore be used in clinical practice to monitor LV remodeling and predict occurrence of VPBs.

关键词： Hypertension repolarization Tpeak-Tend Ventricular remodeling

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Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population

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World Journal of Clinical Cases 2019年第8期7卷 940-950页

作者： Zhi-Dan Li Xiao-Juan Bai Lu-Lu Han Wen Han Xue-Feng Sun Xiang-Mei Chen Department of Gerontology and Geriatrics Shengjing Hospital of China Medical University Department of Kidney General Hospital of Chinese People's Liberation Army

BACKGROUND Diastolic electromechanical couple, a well-described phenomenon in symptomatic heart failure, has not been well studied in healthy people. We hypothesized that ventricular repolarization variables, such as the QT interval,Tpeak-to-Tend(Tpe) interval and Tpe/QT ratio, are associated with cardiac diastolic function in the healthy Chinese *** To assess the relationship between ventricular repolarization variables and cardiac diastolic function in apparently healthy Chinese *** This was a community-based cross-sectional study conducted in Shenyang,China. A total of 414 healthy subjects aged 35-91 years were enrolled. All subjects underwent standard 12-lead electrocardiography(ECG) and comprehensive echocardiography. ECG enabled the measurement of QT and Tpe intervals and Tpe/QT ratio. echocardiographic parameters, such as the ratio of mitral early diastolic inflow velocity(E) and late diastolic inflow velocity(A), E-wave deceleration time, left atrial volume(LAV) and LAV index, were measured to assess diastolic function. E/A repolarization variables, such as the QTc interval(393.59 ± 26.74 vs403.86 ± 33.56; P repolarization variables and diastolic *** adjusting for all other possible confounders, the QTc and Tpe_c intervals were significantly associated with the E/A ratio(P = 0.008; P = 0.010). In men, the QTc interval was associated with abnormal diastoli

关键词： QT interval Tpeak-to-Tend interval Diastolic dysfunction Ventricular repolarization Electrocardiography

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Effects of hypokalemia on transmural dispersion of ventricular repolarization in left ventricular myocardium

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Asian Pacific Journal of Tropical Medicine 2013年第6期6卷 485-488页

作者： Jiang-Hua Zhong Shi-Juan Lu Mo-Shui Chen Zi-Bin Chen Liu Wang Ping-Sheng Wu Department of Cardiology Affiliated South Hospital of South Medical University Department of Cardiology Haikou People's Hospital

Objective:To observe effects of hypokalemia on transmural heterogeneity of ventricular repolarization in left ventricular myocardium of rabbit,and explore the role of hypokalemia in malignant ventricular arrhythmia（MVA）.Methods:A total of 20 rabbits were randomly divided into control group and hypokalemic *** hearts in the control group were simply perfused with modified Tyrode’s solution,and were perfused with hypokalemic Tyrode’s solution in hypokalemic *** fibrillation threshold（VFT）,90%monophasic action potential repolarization duration(APD90) of subepicardial,midmyocardial and subendocardial myocardium,transmural dispersion of repolarization（TDR） and Cx43 protein expression in three layers of myocardium were measured in both ***:VFT in the control group and the hypokalemic group were（13.40±2.95） V,and（7.00±1.49） V,*** was a significant difference between two groups（P90 of three myocardial layers in the hypokalemic group were significantly prolonged than those in the control group（/’90in the hypokalemic group and the control group were（38.10±10\29） ms and（23.7015.68） ms,and TDR were（52.90r 14.55） ms and（36.10±12.44） ms,respectively.△APD90 and TDR in the hypokalemic group were significantly higher than those in the control group(P90 of midmyocardium was more significant in the hypokalemic ***43 protein expression of all three myocardial layers were decreased significantly in the hypokalemic group（P90 was significantly increased {Prepolarization in left ventricular myocardium of rabbit,and decrease VFT and can induce MVA more easily.

关键词： Hypokalemia Gap junction repolarization heterogeneity Midmyocardium

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Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice

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World Journal of Clinical Cases 2015年第8期3卷 705-720页

作者： Yaniel Castro-Torres Raimundo Carmona-Puerta Richard E Katholi Facultad de Medicina Universidad de Ciencias Médicas Dr.Serafín Ruiz de Zárate Ruiz Cardiocentro Ernesto Che Guevara Southern Illinois University School of Medicine and Prairie Cardiovascular Consultants

Malignant cardiac arrhythmias which result in sudden cardiac death may be present in individuals apparently healthy or be associated with other medical conditions. The way to predict their appearance represents a challenge for the medical community due to the tragic outcomes in most cases. In the last two decades some ventricular repolarization(VR) markers have been found to be useful to predict malignant cardiac arrhythmias in several clinical conditions. The corrected QT, QT dispersion, Tpeak-Tend, Tpeak-Tend dispersion and Tp-e/QT have been studied and implemented in clinical practice for this purpose. These markers are obtained from 12 lead surface electrocardiogram. In this review we discuss how these markers have demonstrated to be effective to predict malignant arrhythmias in medical conditions such as long and short QT syndromes, Brugada syndrome, early repolarization syndrome, acute myocardial ischemia, heart failure, hypertension, diabetes mellitus, obesity and highly trained athletes. Also the main pathophysiological mechanisms that explain the arrhythmogenic predisposition in these diseases and the basis for the VR markers are discussed. However, the same results have not been found in all conditions. Further studies are needed to reach a global consensus in order to incorporate these VR parameters in risk stratification of these patients.

关键词： Electrocardiographic predictor Ventricular repolarization markers Ventricular fibrillation Sudden cardiac death QT interval Corrected QT interval QT dispersion Tpeak-Tend interval Tpeak-Tend QT ratio

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Relationship between Ambient Fine Particles and Ventricular repolarization Changes and Heart Rate Variability of Elderly People with Heart Disease in Beijing, China

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Biomedical and Environmental Sciences 2013年第8期26卷 629-637页

作者： XU Mei Mei JIA Yu Ping LI Guo Xing LIU Li Qun MO Yun Zheng JIN Xiao Bin PAN Xiao Chuan Department of Occupational and Environmental Health School of Public Health Peking University Institute of Environmental Health Beijing Center for Disease Control and Prevention Institute of Epidemiology German Research Center for Environmental Health

Objective To explore the effects of particulate matters less than 2.5 μm in aerodynamic diameter （PM2.5） on heart repolarization/depolarization and heart rate variability （HRV）. Methods We conducted a panel study for elderly subjects with heart disease in Beijing from 2007 to 2008. PM2.5 was measured at a fixed station for 20 h continuously each day while electrocardiogram （ECG） indexes of 42 subjects were also recorded repeatedly. Meteorological data was obtained from the China Meteorological Data Sharing Service System. A mixed linear regression model was used to estimate the associations between PMz.s and the ECG indexes. The model was adjusted for age, body mass index, sex, day of the week and meteorology. Results Significant adverse effects of PM2.5 on ECG indexes reflecting HRV were observed statistically and the strongest effect of PM2.s on HRV was on lag i day in our study. However, there were no associations between PM2.5 and ECG indexes reflecting heart repolarization/depolarization. Additionally, the effects of PM2.5 on subjects with hypertension were larger than on the subjects without hypertension. Conclusion This study showed ambient PM2.5could affect cardiac autonomic function of the elderly people with heart disease, and subjects with hypertension appeared to be more susceptive to the autonomic dysfunction induced by PM2.5.

关键词： PM2.5 repolarization Heart rate variability Elderly Panel study

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Low-dose carvedilol reduces transmural heterogeneity of ventricular repolarization in congestive heart failure

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Acta Pharmacologica Sinica 2007年第8期28卷 1161-1165页

作者： Jiang-hua ZHONG~(2,3) Xiao-pan CHEN~2 Mei-ling YUN~2 Wei-jing LI~2 Yan-fang CHEN~3 Zhen YAO~(2,4) ~2Department of Cardiology Affiliated Hospital of Hainan Medical College,Haikou 570102,China ~3Department of Pharmacology and Toxicology Wright State University,Ohio 45435,USA Department of Cardiology Affiliated Hospital of Hainan Medical CollegeHaikou570102China Department of Pharmacology and Toxicology Wright State UniversityOhio 45435USA

Aim:To study the effects of carvedilol on the transmural heterogeneity of ven-tricular repolarization in rabbits with congestive heart failure(CHF).Methods:Rabbits were randomly divided into 3 groups:control,CHF and carvedilol treatedCHF *** action potential duration(MAPD)in the 3 myocardiallayers was simultaneously ***:All the rabbits in the CHF grouphad signs of severe *** with the control group,the mean bloodpressure and cardiac output were significantly decreased,while peripheral resis-tance was significantly increased in the CHF *** proved that the CHFmodel was successful created with adriamycin in this *** to thecontrol group,the ventricular fibrillation threshold(VFT)was remarkably decreasedand all MAPD of the 3 myocardial layers were extended in rabbits with ***,the extension of MAPD in the midmyocardium was more *** dispersion of repolarization(TDR)was significantly increased in ***-dose carvedilol(0.25 mg/kg,twice daily)had no effects on *** with low-dose carvedilol significantly increased ***-though the MAPD of the 3 myocardial layers were further prolonged in the carvediloltreated CHF group,the prolongation of MAPD in the midmyocardium was shorterthan those in the epicardium and *** with low-dose carvedilolsignificantly decreased TDR in ***:In the present study,the trans-mural heterogeneity of ventricular repolarization increased in the rabbits ***-dose carvedilol decreased the transmural heterogeneity of ventricularrepolarization in CHF,which may be related to its direct electropbysiological pro-perty rather than its effect on ventricular remodeling.

关键词： carvedilol congestive heart failure midmyocardium monophasic action potential duration repolarization

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Syncope and Early repolarization:A Benign or Dangerous ECG Finding?

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Cardiovascular Innovations and Applications 2016年第B02期1卷 179-186页

作者： Matthew McKillop,MD,FACC,FHRS William M.Miles,MD,FACC,FHRS Division of Cardiovascular Medicine University of FloridaGainesvilleFLUSA North Florida/South Georgia VA Medical Center GainesvilleFLUSA

Early repolarization is a well-described,common electrocardiographic *** was initially felt to be benign,but in the last twenty years a suggested a link between specific types of early repolarization and sudden cardiac death has *** association was has been termed the J wave syndrome and includes both the high risk early repolarization and Brugada ECG *** odds of early repolarization change being associated with poor outcomes are still exceedingly ***,the association of a fairly ubiquitous ECG finding with fatal or near fatal clinical outcomes has raised *** can we identify the truly high-risk patients?If a patient has a signifi cant clinical event with a concerning ECG repolarization pattern,what should be done next?The authors of this review present current information regarding the Early repolarization and Brugada Syndromes and how to proceed with diagnosis,management,and risk stratifi cation when early repolarization change is observed on ECG.

关键词： syncope early repolarization Brugada syndrome J wave syndrome genetic channelopathy

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Transmural dispersion of repolarization：a complementary index for cardiac inhomogeneity

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Journal of Geriatric Cardiology 2016年第1期13卷 99-100页

作者： Mehmet Dogan Omer Yiginer Gokhan Degirmencioglu Haluk Un Ankara Mevki Military Hospital Department of Cardiology Ankara Turkey Gulhane Military Medical Academy Haydarpasa Training Hospital Department of Cardiology Istanbul Turkey

We read the article written by Nuis, et al. The authors investigated the effects of transcatheter aortic valve implantation （TAVI） on corrected QT dispersion （cQTD） in severe aortic stenosis patients. They concluded that, 40% of patients had defective cQTD recovery at six months after the procedure and this was associated with increased late mortality risk. We would like to contribute to the study from a different methodological perspective.

关键词： QT dispersion repolarization Transcatheter aortic valve implantation

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Novel conduction-repolarization indices for the stratification of arrhythmic risk

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Journal of Geriatric Cardiology 2016年第9期13卷 811-812页

作者： Gary Tse Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China.

Sudden cardiac death （SCD） affects approximately 800,000 individuals per annum globally. It is most frequently due to cardiac tachy-arrhythmias, which include mono-morphic or polymorphic ventricular tachycardia （VT）, torsade de pointes and ventricular fibrillation （VF）. Risk stratification for SCD remains a challenging problem in clinical practice.

关键词： Conduction Depolarization QRS QT dispersion repolarization Transmural dispersion of repolarization Wavelength

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Variability in local action potential durations, dispersion of repolarization and wavelength restitution in aged wild-type and Scn5a^＋/- mouse hearts modeling human Brugada syndrome

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Journal of Geriatric Cardiology 2016年第11期13卷 930-931页

作者： Gary Tse Sheung Ting Wong Vivian Tse Jie Ming Yeo Department of Medicine and Therapeutics Faculty of Medicine Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of HongKong Hong Kong China Faculty of Medicine Imperial College London London UK Department of Physiology McGill University Quebec Canada

Brugada syndrome is a primary arrhythmia syndrome characterized by loss-of-function mutations in the SCN5A gene, which encodes for the cardiac Na^＋ channel. In affected individuals, the risk of developing malignant v... 详细信息

关键词： Brugada Conduction Monophasic action potential Mouse repolarization

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