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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Genotype-specific QT correction for heart rate and the risk of life-threatening cardiac events in adolescents with congenital long-QT syndrome
Heart Rhythm, Volume 8, No. 8, Year 2011
Notification
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Description
Background: A prolonged QT interval corrected for heart rate (QTc) is a major risk factor in patients with long QT syndrome (LQTS). However, heart raterelated risk in this genetic disorder differs among genotypes. Objective: This study hypothesized that risk assessment in LQTS patients should incorporate genotype-specific QT correction for heart rate. Methods: The independent contribution of 4 repolarization measures (the absolute QT interval, and Bazett's, Fridericia's, and Framingham's correction formulas) to the risk of aborted cardiac arrest or sudden cardiac death during adolescence, before and after further adjustment for the RR interval, was assessed in 727 LQTS type 1 and 582 LQTS type 2 patients. Improved QT/RR correction was calculated using a Cox model, dividing the coefficient on log(RR) by that on log(QT). Results: Multivariate analysis demonstrated that in LQTS type 1 patients 100-ms increments in the absolute QT interval were associated with a 3.3-fold increase in the risk of life-threatening cardiac events (P =.020), and 100-ms decrements in the RR interval were associated with a further 1.9-fold increase in the risk (P =.007), whereas in LQTS type 2 patients, resting heart rate was not a significant risk factor (hazard ratio 1.11; P =.51; P value for heart rate × genotype interaction =.036). Accordingly, analysis of an improved QT correction formula showed that patients with the LQTS type 1 genotype required a greater degree of QT correction for heart rate (improved QTc = QT/RR 0.8) than LQTS type 2 patients (improved QTc = QT/RR 0.2). Conclusion: Our findings suggest that risk stratification for life-threatening cardiac events in LQTS patients can be improved by incorporating genotype-specific QT correction for heart rate. © 2011 Heart Rhythm Society.
Authors & Co-Authors
Barsheshet, Alon
United States, Rochester
University of Rochester
Peterson, Derick R.
United States, Rochester
University of Rochester
Moss, Arthur J.
United States, Rochester
University of Rochester
Schwartz, Peter J.
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Italy, Milan
Irccs Istituto Auxologico Italiano
Saudi Arabia, Riyadh
College of Medicine
Kaufman, Elizabeth S.
United States, Cleveland
Case Western Reserve University
McNitt, Scott
United States, Rochester
University of Rochester
Polonsky, Slava
United States, Rochester
University of Rochester
Buber, Jonathan
United States, Rochester
University of Rochester
Zareba, Wojciech
United States, Rochester
University of Rochester
Robinson, Jennifer L.
United States, Rochester
University of Rochester
Ackerman, Michael John
United States, Rochester
Mayo Clinic
Benhorin, Jesaia
Israel, Tel Aviv-yafo
Tel Aviv Sourasky Medical Center
Towbin, Jeffrey A.
United States, Cincinnati
Cincinnati Children's Hospital Medical Center
Vincent, G. Michael
United States, Salt Lake City
Lds Hospital
Zhang, Li
United States, Salt Lake City
Lds Hospital
Goldenberg, Ilan
United States, Rochester
University of Rochester
Statistics
Citations: 16
Authors: 16
Affiliations: 10
Identifiers
Doi:
10.1016/j.hrthm.2011.03.009
ISSN:
15475271
e-ISSN:
15563871
Research Areas
Environmental
Genetics And Genomics
Noncommunicable Diseases