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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1
PLoS ONE, Volume 9, No. 4, Article e93808, Year 2014
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Description
The study assesses complexity of the cardiac control directed to the sinus node and to ventricles in long QT syndrome type 1 (LQT1) patients with KCNQ1-A341V mutation. Complexity was assessed via refined multiscale entropy (RMSE) computed over the beat-to-beat variability series of heart period (HP) and QT interval. HP and QT interval were approximated respectively as the temporal distance between two consecutive R-wave peaks and between the R-wave apex and T-wave end. Both measures were automatically taken from 24-hour electrocardiographic Holter traces recorded during daily activities in non mutation carriers (NMCs, n = 14) and mutation carriers (MCs, n = 34) belonging to a South African LQT1 founder population. The MC group was divided into asymptomatic (ASYMP, n = 11) and symptomatic (SYMP, n = 23) patients according to the symptom severity. Analyses were carried out during daytime (DAY, from 2PM to 6PM) and nighttime (NIGHT, from 12PM to 4AM) off and on beta-adrenergic blockade (BBoff and BBon). We found that the complexity of the HP variability at short time scale was under vagal control, being significantly increased during NIGHT and BBon both in ASYMP and SYMP groups, while the complexity of both HP and QT variability at long time scales was under sympathetic control, being smaller during NIGHT and BBon in SYMP subjects. Complexity indexes at long time scales in ASYMP individuals were smaller than those in SYMP ones regardless of therapy (i.e. BBoff or BBon), thus suggesting that a reduced complexity of the sympathetic regulation is protective in ASYMP individuals. RMSE analysis of HP and QT interval variability derived from routine 24-hour electrocardiographic Holter recordings might provide additional insights into the physiology of the cardiac control and might be fruitfully exploited to improve risk stratification in LQT1 population. © 2014 Bari et al.
Authors & Co-Authors
Bari, Vlasta
Italy, San Donato Milanese
Gruppo Ospedaliero San Donato
Italy, Milan
Politecnico Di Milano
Valencia, J. F.
Colombia, Cali
Universidad de San Buenaventura, Cali
Vallverdú, Montserrat
Spain, Barcelona
Universitat Politécnica de Catalunya
Girardengo, Giulia
Italy, Milan
Irccs Istituto Auxologico Italiano
Marchi, Andrea
Italy, Milan
Politecnico Di Milano
Italy, Rozzano
Humanitas Research Hospital
Bassani, Tito
Italy, Rozzano
Humanitas Research Hospital
Caminal, Peré
Spain, Barcelona
Universitat Politécnica de Catalunya
Cerutti, Sergio
Italy, Milan
Politecnico Di Milano
George, Alfred L.
United States, Nashville
Vanderbilt University
Brink, Paul A.
South Africa, Stellenbosch
Stellenbosch University
CROTTI, L.
Italy, Milan
Irccs Istituto Auxologico Italiano
Germany, Oberschleissheim
Helmholtz Center Munich German Research Center for Environmental Health
Schwartz, Peter J.
Italy, Milan
Irccs Istituto Auxologico Italiano
Porta, Alberto
Italy, Milan
Università Degli Studi Di Milano, Facoltà Di Medicina e Chirurgia
Italy, Milan
Irccs Istituto Ortopedico Galeazzi
Statistics
Citations: 42
Authors: 13
Affiliations: 11
Identifiers
Doi:
10.1371/journal.pone.0093808
e-ISSN:
19326203
Research Areas
Cancer
Noncommunicable Diseases
Study Design
Cross Sectional Study