QT Dispersion and Left Ventricular Morphology in Patients with Hypertrophic Cardiomyopathy

Overview

Journal Heart

Date 2003 Jul 16

PMID 12860864

Citations 7

Authors

K Sakata

M Shimizu

H Ino

M Yamaguchi

H Terai

K Hayashi

M Kiyama

T Hayashi

M Inoue

H Mabuchi

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the relation between QT variables and disproportion of left ventricular wall hypertrophy in patients with hypertrophic cardiomyopathy.

Design: Retrospective analysis of the results of echocardiography and electrocardiography.

Setting: University hospital (tertiary referral centre).

Patients: 70 patients with hypertrophic cardiomyopathy were divided into four groups according to the distribution of left ventricular wall hypertrophy on cross sectional echocardiography: group A--hypertrophy confined to the interventricular septum; group B--hypertrophy confined to the interventricular septum and left ventricular anterior wall; group C--hypertrophy confined to the interventricular septum, left ventricular anterior wall, and lateral free wall; group D--hypertrophy involving all portions of the left ventricle.

Main Outcome Measures: QT intervals and QT dispersion in precordial six lead ECGs.

Results: There were no significant differences in the maximum left ventricular wall thickness among the four groups, and maximum and minimum QTc intervals also did not differ. QTc dispersion was increased significantly in groups A and B compared with groups C and D. Dispersions of the interval from the J point to the end of the T wave (JTc dispersions) in groups A and B were also increased significantly compared with groups C and D. By linear regression analysis, QTc and JTc dispersions correlated with the ratio of the interventricular septal thickness to left ventricular posterior wall thickness (p = 0.0152 and p = 0.0075, respectively).

Conclusions: QT dispersion may be affected by not only electrical inhomogeneity but also by morphological inhomogeneity of the left ventricle in patients with hypertrophic cardiomyopathy.

Citing Articles

Effects of ranolazine on the arrhythmic substrate in hypertrophic cardiomyopathy.

Coleman J, Doste R, Beltrami M, Argiro A, Coppini R, Olivotto I Front Pharmacol. 2024; 15:1379236.

PMID: 38659580 PMC: 11039821. DOI: 10.3389/fphar.2024.1379236.

Long QTc in hypertrophic cardiomyopathy: A consequence of structural myocardial damage or a distinct genetic disease?.

Cava F, Micolonghi C, Musumeci M, Petrucci S, Savio C, Fabiani M Front Cardiovasc Med. 2023; 10:1112759.

PMID: 37089884 PMC: 10113437. DOI: 10.3389/fcvm.2023.1112759.

Fibrosis and wall thickness affect ventricular repolarization dynamics in hypertrophic cardiomyopathy.

Jalanko M, Vaananen H, Tarkiainen M, Sipola P, Jaaskelainen P, Lauerma K Ann Noninvasive Electrocardiol. 2018; 23(6):e12582.

PMID: 29974557 PMC: 6931569. DOI: 10.1111/anec.12582.

Diffuse interstitial fibrosis assessed by cardiac magnetic resonance is associated with dispersion of ventricular repolarization in patients with hypertrophic cardiomyopathy.

Hurtado-de-Mendoza D, Corona-Villalobos C, Pozios I, Gonzales J, Soleimanifard Y, Sivalokanathan S J Arrhythm. 2017; 33(3):201-207.

PMID: 28607615 PMC: 5459419. DOI: 10.1016/j.joa.2016.10.005.

Prolonged QT dispersion in the infants of diabetic mothers.

Arslan D, Guvenc O, Cimen D, Ulu H, Oran B Pediatr Cardiol. 2014; 35(6):1052-6.

PMID: 24740627 DOI: 10.1007/s00246-014-0897-3.

References

Sahn D, DeMaria A, Kisslo J, Weyman A . Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978; 58(6):1072-83. DOI: 10.1161/01.cir.58.6.1072. View

Yi G, Elliott P, McKenna W, Prasad K, Sharma S, Guo X . QT dispersion and risk factors for sudden cardiac death in patients with hypertrophic cardiomyopathy. Am J Cardiol. 1999; 82(12):1514-9. DOI: 10.1016/s0002-9149(98)00696-1. View

Cowan J, Yusoff K, Moore M, AMOS P, Gold A, Bourke J . Importance of lead selection in QT interval measurement. Am J Cardiol. 1988; 61(1):83-7. DOI: 10.1016/0002-9149(88)91309-4. View

Spirito P, BELLONE P, Harris K, Bernabo P, Bruzzi P, Maron B . Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy. N Engl J Med. 2000; 342(24):1778-85. DOI: 10.1056/NEJM200006153422403. View

Maron B, Leyhe 3rd M, Casey S, Gohman T, Lawler C, Crow R . Assessment of QT dispersion as a prognostic marker for sudden death in a regional nonreferred hypertrophic cardiomyopathy cohort. Am J Cardiol. 2001; 87(1):114-5, A9. DOI: 10.1016/s0002-9149(00)01285-6. View

Day C, McComb J, CAMPBELL R . QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J. 1990; 63(6):342-4. PMC: 1024518. DOI: 10.1136/hrt.63.6.342. View

Day C, McComb J, CAMPBELL R . QT dispersion in sinus beats and ventricular extrasystoles in normal hearts. Br Heart J. 1992; 67(1):39-41. PMC: 1024698. DOI: 10.1136/hrt.67.1.39. View

Linker N, Colonna P, Kekwick C, Till J, Camm A, Ward D . Assessment of QT dispersion in symptomatic patients with congenital long QT syndromes. Am J Cardiol. 1992; 69(6):634-8. DOI: 10.1016/0002-9149(92)90155-r. View

Dritsas A, Sbarouni E, Gilligan D, Nihoyannopoulos P, Oakley C . QT-interval abnormalities in hypertrophic cardiomyopathy. Clin Cardiol. 1992; 15(10):739-42. DOI: 10.1002/clc.4960151010. View

10.

Buja G, Miorelli M, Turrini P, Melacini P, Nava A . Comparison of QT dispersion in hypertrophic cardiomyopathy between patients with and without ventricular arrhythmias and sudden death. Am J Cardiol. 1993; 72(12):973-6. DOI: 10.1016/0002-9149(93)91118-2. View

11.

Miorelli M, Buja G, Melacini P, Fasoli G, Nava A . QT-interval variability in hypertrophic cardiomyopathy patients with cardiac arrest. Int J Cardiol. 1994; 45(2):121-7. DOI: 10.1016/0167-5273(94)90267-4. View

12.

Perkiomaki J, Koistinen M, Huikuri H . Dispersion of QT interval in patients with and without susceptibility to ventricular tachyarrhythmias after previous myocardial infarction. J Am Coll Cardiol. 1995; 26(1):174-9. DOI: 10.1016/0735-1097(95)00122-g. View

13.

Mayet J, Shahi M, McGrath K, Poulter N, Sever P, Foale R . Left ventricular hypertrophy and QT dispersion in hypertension. Hypertension. 1996; 28(5):791-6. DOI: 10.1161/01.hyp.28.5.791. View

14.

Ichkhan K, Molnar J, Somberg J . Relation of left ventricular mass and QT dispersion in patients with systematic hypertension. Am J Cardiol. 1997; 79(4):508-11. DOI: 10.1016/s0002-9149(96)00797-7. View

15.

Zaidi M, Robert A, Fesler R, Derwael C, Brohet C . Dispersion of ventricular repolarization in hypertrophic cardiomyopathy. J Electrocardiol. 1996; 29 Suppl:89-94. DOI: 10.1016/s0022-0736(96)80026-4. View

16.

Tomiyama H, Doba N, Fu Y, Kushiro T, Hisaki R, Shinozaki Y . Left ventricular geometric patterns and QT dispersion in borderline and mild hypertension: their evolution and regression. Am J Hypertens. 1998; 11(3 Pt 1):286-92. DOI: 10.1016/s0895-7061(97)00460-3. View

17.

COUMEL P, Maison-Blanche P, Badilini F . Dispersion of ventricular repolarization: reality? Illusion? Significance?. Circulation. 1998; 97(25):2491-3. DOI: 10.1161/01.cir.97.25.2491. View

18.

Yetman A, Hamilton R, Benson L, McCrindle B . Long-term outcome and prognostic determinants in children with hypertrophic cardiomyopathy. J Am Coll Cardiol. 1998; 32(7):1943-50. DOI: 10.1016/s0735-1097(98)00493-8. View

19.

Maron B, Epstein S . Hypertrophic cardiomyopathy: a discussion of nomenclature. Am J Cardiol. 1979; 43(6):1242-4. DOI: 10.1016/0002-9149(79)90160-7. View