Electromechanical heterogeneity in the heart

Dressler, Frederick A.; Brado, Johannes; Odening, Katja E.

doi:10.1007/s00399-017-0544-9

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…In normal heart, physiological heterogeneities in structure, electrical and mechanical activity are crucial for normal, efficient excitation and pumping[ 3 ]. Due to multiple reasons (impaired function of outward K+ currents in cardiac myocytes, which may be caused by genetic defects or result from various acquired pathophysiological conditions, including electrical remodelling in cardiac disease, ion channel modulation by clinically used pharmacological agents, and systemic electrolyte disorders seen in heart failure, such as hypokalaemia), the level of RH could increase[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Dispersion of ventricular repolarization: Temporal and spatial

Arteyeva¹

2020

WJC

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Repolarization heterogeneity (RH) is an intrinsic property of ventricular myocardium and the reason for T-wave formation on electrocardiogram (ECG). Exceeding the physiologically based RH level is associated with appearance of life-threatening ventricular arrhythmias and sudden cardiac death. In this regard, an accurate and comprehensive evaluation of the degree of RH parameters is of importance for assessment of heart state and arrhythmic risk. This review is devoted to comprehensive consideration of RH phenomena in terms of electrophysiological processes underlying RH, cardiac electric field formation during ventricular repolarization, as well as clinical significance of RH and its reflection on ECG parameters. The formation of transmural, apicobasal, left-to-right and anterior-posterior gradients of action potential durations and end of repolarization times resulting from the heterogenous distribution of repolarizing ion currents and action potential morphology throughout the heart ventricles, and the different sensitivity of myocardial cells in different ventricular regions to the action of pharmacological agents, temperature, frequency of stimulation, etc ., are being discussed. The review is focused on the fact that RH has different aspects – temporal and spatial, global and local; ECG reflection of various RH aspects and their clinical significance are being discussed. Strategies for comprehensive assessment of ventricular RH using different ECG indices reflecting various RH aspects are presented.

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Section: Introductionmentioning

confidence: 99%

Dispersion of ventricular repolarization: Temporal and spatial

Arteyeva¹

2020

WJC

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“…The interplay between mechanical and electrical phenomena in the heart is also addressed in the context of long QT syndrome [9]. The authors emphasize the necessity for electrical (and mechanical)…”

Section: New Directions In Cardiac Cellular Electrophysiologymentioning

confidence: 99%

Advances in cardiac cellular electrophysiology – Relevance for clinical translation

Ravens

Goette

2018

Herzschr Elektrophys

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Prolonged left ventricular contraction duration in apical segments as a marker of arrhythmic risk in patients with long QT syndrome

et al. 2020

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Aims Long QT syndrome (LQTS) is an inherited cardiac ion channelopathy predisposing to life-threatening ventricular arrhythmias and sudden cardiac death. The aim of this study was to investigate left ventricular mechanical abnormalities in LQTS patients and establish a potential role of strain as a marker of arrhythmic risk. Methods and results We included 47 patients with genetically confirmed LQTS (22 LQT1, 20 LQT2, 3 LQT3, and 2 SCN3B) and 25 healthy controls. A history of cardiac events was present in 30 LQTS subjects. Tissue Doppler and speckle tracking echocardiography were performed and contraction duration was measured by radial and longitudinal strain. The radial strain characteristic was subdivided into two planes — the basal and the apical. Left ventricular ejection fraction and global longitudinal strain were normal in LQTS patients. Mean contraction duration was longer in LQTS patients compared with controls in regard to basal radial strain (491 ± 57 vs. 437 ± 55 ms, P < 0.001), apical radial strain (450 ± 53 vs. 407 ± 53 ms, P = 0.002), and longitudinal strain (445 ± 34 vs. 423 ± 43 ms, P = 0.02). Moreover, contraction duration obtained from apical radial strain analysis was longer in symptomatic compared with asymptomatic LQTS mutation carriers (462 ± 49 vs. 429 ± 55 ms, P = 0.024), as well as in subject with mutations other than LQT1 considered to be at higher risk (468 ± 50 vs. 429 ± 49 ms, P = 0.01). Conclusion Myocardial contraction duration is prolonged for both radial and longitudinal directions in LQTS patients. Regional left ventricular function analysis may contribute to risk stratification. Apical radial deformation seems to select subjects at higher risk of arrhythmic events.

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Electromechanical heterogeneity in the heart

Cited by 3 publications

References 32 publications

Dispersion of ventricular repolarization: Temporal and spatial

Dispersion of ventricular repolarization: Temporal and spatial

Advances in cardiac cellular electrophysiology – Relevance for clinical translation

Prolonged left ventricular contraction duration in apical segments as a marker of arrhythmic risk in patients with long QT syndrome

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