O alongamento do intervalo QT na cardite reumática aguda: um enigma

Saraiva, Lurildo R.; Santos, Cleusa Lapa; Aguiar, Inês Remígio de

doi:10.1590/s0066-782x2006001900025

Cited by 5 publications

(1 citation statement)

References 11 publications

(15 reference statements)

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“…Noteworthy, in murine models of the disease, a significant correlation between QTc duration and the degree of cardiac inflammation at the histological examination has been demonstrated ( 59 , 60 ). Finally, evidence also exists that QTc is often prolonged in a purely immune-mediated inflammatory heart disease such as acute rheumatic carditis ( 61 ), with some cases even complicating with TdP ( 62 , 63 ). In particular, an increased QTc has been found to be the most frequent ECG alteration in children with subclinical carditis (~30%) ( 19 ).…”

Section: Inflammation As a Cause Of Acquired Lqtsmentioning

confidence: 99%

Long QT Syndrome: An Emerging Role for Inflammation and Immunity

Lazzerini

Capecchi

Laghi‐Pasini

2015

Front. Cardiovasc. Med.

134

123

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The long QT syndrome (LQTS), classified as congenital or acquired, is a multi-factorial disorder of myocardial repolarization predisposing to life-threatening ventricular arrhythmias, particularly torsades de pointes. In the latest years, inflammation and immunity have been increasingly recognized as novel factors crucially involved in modulating ventricular repolarization. In the present paper, we critically review the available information on this topic, also analyzing putative mechanisms and potential interplays with the other etiologic factors, either acquired or inherited. Accumulating data indicate inflammatory activation as a potential cause of acquired LQTS. The putative underlying mechanisms are complex but essentially cytokine-mediated, including both direct actions on cardiomyocyte ion channels expression and function, and indirect effects resulting from an increased central nervous system sympathetic drive on the heart. Autoimmunity represents another recently arising cause of acquired LQTS. Indeed, increasing evidence demonstrates that autoantibodies may affect myocardial electric properties by directly cross-reacting with the cardiomyocyte and interfering with specific ion currents as a result of molecular mimicry mechanisms. Intriguingly, recent data suggest that inflammation and immunity may be also involved in modulating the clinical expression of congenital forms of LQTS, possibly triggering or enhancing electrical instability in patients who already are genetically predisposed to arrhythmias. In this view, targeting immuno-inflammatory pathways may in the future represent an attractive therapeutic approach in a number of LQTS patients, thus opening new exciting avenues in antiarrhythmic therapy.

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Section: Inflammation As a Cause Of Acquired Lqtsmentioning

confidence: 99%

Long QT Syndrome: An Emerging Role for Inflammation and Immunity

Lazzerini

Capecchi

Laghi‐Pasini

2015

Front. Cardiovasc. Med.

134

123

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The Role of Inflammation and Autoimmunity in Long QT Syndrome

Lazzerini

Laghi‐Pasini

El‐Sherif

et al. 2019

Cardiac Repolarization

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Rhythm and Conduction Analysis of Patients With Acute Rheumatic Fever

et al. 2012

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Various rhythm and conduction abnormalities can develop in acute rheumatic fever. This study investigated rhythm and conduction abnormalities in children with acute rheumatic fever using a standard 12-lead electrocardiogram and 24-h rhythm Holter recordings. This multicenter retrospective study, performed between August 2011 and March 2012, enrolled 73 consecutive children with acute rheumatic fever. Standard electrocardiography was used to measure PR and corrected QT intervals. Holter recordings were evaluated for all the patients, and 52 of the patients (71.2 %) had carditis that was either isolated or together with other major criteria. A positive correlation was detected between carditis and the mean PR interval on standard electrocardiography, but this was not significant (p > 0.05). Standard electrocardiography showed a significant positive correlation between PR and corrected QT intervals (p = 0.03; r = 0.55). Standard electrocardiography showed only three patients (4.2 %) with premature contractions, whereas 24-h electrocardiography showed 26 patients (35.6 %) with premature contractions. Carditis was positively correlated with premature contractions (p < 0.01; r = 0.57). One patient with junctional rhythm and one patient with left bundle block were detected by standard electrocardiography. Whereas some patients with carditis exhibited no arrhythmic evidence on standard electrocardiograms, complete atrioventricular block, supraventricular tachycardia, and Mobitz type 1 block were observed on 24-h Holter recordings. A positive correlation also was observed between the presence of premature contractions and serum levels of acute-phase reactants (p = 0.03; r = 0.62). These findings led to the conclusion that rhythm and conduction disorders in acute rheumatic fever are more common than previously thought.

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O alongamento do intervalo QT na cardite reumática aguda: um enigma

Cited by 5 publications

References 11 publications

Long QT Syndrome: An Emerging Role for Inflammation and Immunity

Long QT Syndrome: An Emerging Role for Inflammation and Immunity

The Role of Inflammation and Autoimmunity in Long QT Syndrome

Rhythm and Conduction Analysis of Patients With Acute Rheumatic Fever

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