Arrhythmogenic cardiomyopathy of the right ventricle. Predictive value of QT interval dispersion to assess arrhythmogenic risk and sudden death

Fagundes, Márcio; Maia, Ivan G.; Fo, Fernando E. S. Cruz; Alves, Pedro Nascimento; Boghossian, Silvia Helena Cardoso; Ribeiro, José Carlos; Sá, Roberto

doi:10.1590/s0066-782x2000000800004

Cited by 5 publications

(6 citation statements)

References 34 publications

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“… Turrini et al and Fagundes et al demonstrated that QTd and QTcd were prolonged in ARVD patients who had a history of ventricular arrthythmias or sudden death. It is known that QTc has been used as predictors of increased risk of ventricular arrhythmias and sudden death in several diseases. Previous study demonstrated that QTc was prolonged in symptomatic and asymptomatic ARVD patients when compared with control group.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy

Alızade

Yesi̇n

Yazıcıoğlu

et al. 2016

Noninvasive Electrocardiol

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Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.57, P = 0.02; r = -0.85, P = 0.02; r = -0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.61, P < 0.01; r = -0.67, P < 0.01; r = -0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp-e, Tp-e/QT, and Tp-e/QTc (r = - 0.64, P < 0.001, r = - 0.75, P < 0.01; r = -0,69, P < 0.01; respectively) CONCLUSION: In conclusion, we have presented strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in asymptomatic ARVD patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy

Alızade

Yesi̇n

Yazıcıoğlu

et al. 2016

Noninvasive Electrocardiol

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“…In LQTS, repolarization alternans on a surface ECG, in the form of T wave alternans, has been associated with life‐threatening arrhythmias (Schwartz & Malliani, 1975; Schwartz et al 1975; Zareba et al 1994; Fagundes et al 2000; Schwartz, 2006). In addition, in animal models of drug‐induced LQTS, transmural discordant alternans has been demonstrated (Chinushi et al 2003), suggesting discordant alternans (DA) may be involved in LQT related arrhythmias.…”

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confidence: 99%

Origin of complex behaviour of spatially discordant alternans in a transgenic rabbit model of type 2 long QT syndrome

Ziv

Morales

Song

et al. 2009

The Journal of Physiology

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Enhanced dispersion of repolarization has been proposed as an important mechanism in long QT related arrhythmias. Dispersion can be dynamic and can be augmented with the occurrence of spatially out-of-phase action potential duration (APD) alternans (discordant alternans; DA). We investigated the role of tissue heterogeneity in generating DA using a novel transgenic rabbit model of type 2 long QT syndrome (LQT2). Littermate control (LMC) and LQT2 rabbit hearts (n = 5 for each) were retrogradely perfused and action potentials were mapped from the epicardial surface using di-4-ANEPPS and a high speed CMOS camera. Spatial dispersion ( APD and slope of APD restitution) were both increased in LQT2 compared to LMC ( APD: 34 ± 7 ms vs. 23 ± 6 ms; slope:1.14 ± 0.23 vs. 0.59 ± 0.19). Onset of DA under a ramp stimulation protocol was seen at longer pacing cycle length (CL) in LQT2 compared to LMC hearts (206 ± 24 ms vs. 156 ± 5 ms). Nodal lines between regions with APD alternans out of phase from each other were correlated with conduction velocity (CV) alternation in LMC but not in LQT2 hearts. In LQT2 hearts, larger APD dispersion was associated with onset of DA at longer pacing CL. At shorter CLs, closer to ventricular fibrillation induction (VF), nodal lines in LQT2 (n = 2 out of 5) showed persistent complex beat-to-beat changes in nodal line formation of DA associated with competing contribution from CV restitution and tissue spatial heterogeneity, increasing vulnerability to conduction block. In conclusion, tissue heterogeneity plays a significant role in providing substrate for ventricular arrhythmia in LQT2 rabbits by facilitating DA onset and contributing to unstable nodal lines prone to reentry formation.

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“…In a Brazilian study 12 , the sudden death of 5 patients, among 26 studied, was correlated with right ventricular arrhythmogenic dysplasia, to the extension of QT interval, which constituted in an important predictive factor in that group of patients. QT interval corresponded to 62±17.8 in the risk group and to 51.9±12.8 in the other group.…”

Section: Discussionmentioning

confidence: 96%

Miocardiopatia preponderante de ventrículo direito por miocardite prévia ou por displasia arritmogênica?

Atik¹,

Rochitte²,

Ávila³

et al. 2005

Arq. Bras. Cardiol.

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A clinical case of a 10-year-old male patient is reported. His dilated and prevailing right ventricular myocardiopathy shows diagnostic difficulties between previous myocarditis etiology and arrhythmogenic dysplasia. As the elements are not pathognomonic of one or other cause, the increase of cardiac enzymes in subacute stage maybe tends to the supposition of previous myocarditis. Hence, the questioning that many cases labeled as arrhythmogenic dysplasia can truly correspond to the possibility of evolutional myocarditis. The controversial clinic management is disputable.

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Arrhythmogenic cardiomyopathy of the right ventricle. Predictive value of QT interval dispersion to assess arrhythmogenic risk and sudden death

Abstract: Objective -To determine in arrhythmogenic right

Cited by 5 publications

References 34 publications

Evaluation of Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy

Evaluation of Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy

Origin of complex behaviour of spatially discordant alternans in a transgenic rabbit model of type 2 long QT syndrome

Miocardiopatia preponderante de ventrículo direito por miocardite prévia ou por displasia arritmogênica?

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