Fibrosis and wall thickness affect ventricular repolarization dynamics in hypertrophic cardiomyopathy

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Jalanko , M , Väänänen , H , Tarkiainen , M , Sipola , P , Jääskeläinen , P , Lauerma , K , Laitinen , T , Laitinen , T , Laine , M , Heliö , T , Kuusisto , J & Viitasalo , M 2018 , ' Fibrosis and wall thickness affect ventricular repolarization dynamics in hypertrophic cardiomyopathy ' , Annals of Noninvasive Electrocardiology , vol. 23 , no. 6 , 12582 . https://doi.org/10.1111/anec.12582

Title: Fibrosis and wall thickness affect ventricular repolarization dynamics in hypertrophic cardiomyopathy
Author: Jalanko, Mikko; Väänänen, Heikki; Tarkiainen, Mika; Sipola, Petri; Jääskeläinen, Pertti; Lauerma, Kirsi; Laitinen, Tiina; Laitinen, Tomi; Laine, Mika; Heliö, Tiina; Kuusisto, Johanna; Viitasalo, Matti
Other contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Kardiologian yksikkö
University of Helsinki, Department of Medicine
University of Helsinki, Kardiologian yksikkö







Date: 2018-11
Language: eng
Number of pages: 10
Belongs to series: Annals of Noninvasive Electrocardiology
ISSN: 1082-720X
DOI: https://doi.org/10.1111/anec.12582
URI: http://hdl.handle.net/10138/307722
Abstract: Background Hypertrophic cardiomyopathy (HCM) is characterized by ventricular repolarization abnormalities and risk of ventricular arrhythmias. Our aim was to study the association between the phenotype and ventricular repolarization dynamics in HCM patients. Methods Results HCM patients with either the MYBPC3-Q1061X or TPM1-D175N mutation (n = 46) and control subjects without mutation and hypertrophy (n = 35) were studied with 24-hr ambulatory ECG recordings by measuring time intervals of rate-adapted QT (QTe), maximal QT, and T-wave apex to wave end (TPE) intervals and the QTe/RR slope. Findings were correlated to specified echocardiographic and cardiac magnetic resonance imaging (CMRI) findings. Rate-adapted QTe interval was progressively longer in HCM patients with decreasing heart rates compared to control subjects (p = 0.020). The degree of hypertrophy correlated with measured QTe values. HCM patients with maximal wall thickness higher than the mean (20.6 mm) had longer maximum QTe and median TPE intervals compared to control subjects and HCM patients with milder hypertrophy (p p = 0.014, respectively). HCM patients with late gadolinium enhancement (LGE) on CMRI had steeper QTe/RR slopes compared to HCM patients without LGE and control subjects (p = 0.044 and p = 0.001, respectively). LGE was an independent predictor of QTe/RR slope (p = 0.023, B = 0.043). Conclusion Dynamics of ventricular repolarization in HCM are affected by hypertrophy and fibrosis. LGE may confer an independent effect on QT dynamics which may increase the arrhythmogenic potential in HCM.
Subject: SUDDEN CARDIAC DEATH
HIGH-RISK PATIENTS
PROGNOSTIC VALUE
QT DYNAMICITY
MAGNETIC-RESONANCE
CIRCADIAN PATTERNS
INTERVAL
PROLONGATION
DISPERSION
TACHYARRHYTHMIAS
3121 General medicine, internal medicine and other clinical medicine
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