Is the QT Interval an Indicator of Autonomic State?

Murakawa, Yuji; Yamashita, Takeshi; Ajiki, Kohsuke; Suzuki, Jun–ichi; Hayami, Noriyuki; Fukui, Ei-ichi; Kasaoka, Yuji; Omata, Masao; Nagai, Ryozo

doi:10.1536/jhj.41.713

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…We noted no association between HF power of HRV and QTc interval and this is consistent with previous reports [34,40]. Recent work from Dewland et al has suggested that HRV and HRR yields information concerning distinct and independent aspects of cardiac parasympathetic regulation [13].…”

Section: Discussionsupporting

confidence: 93%

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Heart rate recovery after exercise is associated with resting QTc interval in young men

2007

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Heart rate recovery (HRR) after exercise and spectral decomposition of heart rate variability (HRV), measures of autonomic nervous system function, are predictors of cardiovascular morbidity/mortality. QT interval, an index of ventricular depolarization and repolarization attained from surface ECG, is also associated with morbidity/mortality and is strongly influenced by autonomic tone. The purpose of this study was to assess the association between HRR after exercise, resting HRV and resting rate corrected QT interval in young healthy men. HRR was assessed in 37 men (23.3 +/- 0.6 years) 1 minute after a graded exercise test. Resting QT interval was derived from ECG recordings and rate corrected using five formulae (Bazett, Fridericia, Hodges, Framingham, and the nomogram method of Karjalainen). Resting HRV was spectrally decomposed using an autoregressive approach. A negative correlation was detected for QTc interval and HRR for each method (r = -0.36 to -0.48, P < 0.05). There was no correlation between high frequency power of HRV (a marker of parasympathetic modulation) and QTc interval. There was a negative relationship between absolute LF power (a marker of both sympathetic and parasympathetic modulation) and QTc interval for Karjalainen, Framingham, and Bazett correction methods (r = -0.33 to -0.47, P < 0.05). Resting LF power of HRV and HRR after exercise are inversely associated with resting QTc interval in young healthy men, supporting a relationship between cardiac autonomic nervous system function and ventricular depolarization and repolarization.

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Section: Discussionsupporting

confidence: 93%

“…As such, the use of both noninvasive techniques may provide information on the relationship between QT interval and an integrated ANS that pharmacological dissection and ANS segregation cannot [34]. The purpose of this study was to examine the association between resting QT interval and noninvasive measures of cardiac autonomic function.…”

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confidence: 99%

Heart rate recovery after exercise is associated with resting QTc interval in young men

2007

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“…The irregularity of the ventricular rhythm is considered to be caused by varying degrees of penetration of the atrial impulses into the AVN, which is mainly dependent on vagal tone during usual activity. 17,18 Therefore, our results would imply that AF patients with increased vagal tone have good exercise capacity. …”

Section: Discussionmentioning

confidence: 70%

Relation Between Variability of Ventricular Response Intervals and Exercise Capacity in Patients With Non-Valvular Atrial Fibrillation

Matsumoto

Yamashita

Fukuda

et al. 2004

Circ J

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trial fibrillation (AF) is the most common arrhythmia, with a prevalence of 0.4-0.5% for the overall population, and is associated with increased mortality and morbidity. 1 With regard to treatment, the heart rate control strategy is as effective as the rhythm control strategy, 2,3 but the target heart rate in this strategy is as yet unclear, although the heart rate during AF may be related to the prognosis and/or the quality of the patient's life. A heart rate less than 90 beats/min at rest and 115 beats/min during moderate exercise has been recommended, 4 but is based on clinical experience.In patients with sinus rhythm, heart rate variability has been used to evaluate the vagal and sympathetic influences on the heart and to identify patients at risk for a cardiovascular event or death. [5][6][7][8][9][10][11][12] In patients with AF, recent studies have reported that reduced variability of the ventricular response interval (VRI) during AF might predict an adverse prognosis. 13,14 VRI variability is known to be dependent on the increased parasympathetic tone in AF, as well as in sinus rhythm, 15 which may be related to an active life of AF patients. On the basis of these facts, we hypothesized that analysis of VRI variability during AF might be useful as an assessment of exercise capacity as a representative of quality of life in AF patients. To test this hypothesis, we examined whether or not VRI variability is related to exercise capacity in AF patients. If it holds true, it could be a new maker for the management of AF patients. Methods Study PatientsThirty-one patients with persistent AF for more than 6 months were included (29 men, 2 women; age 60±7.4 years; left ventricular ejection fraction (LVEF): 61.2±6.5%, left atrial dimension: 44.9±7.0 mm). None of the patients had structural heart disease or had been prescribed any drugs for the control of heart rate, including antiarrhythmic agents. VRI Variability and Exercise ToleranceTwenty-four-h ambulatory electrocardiographic (ECG) recording was performed during the patients' usual daily activities and the VRI variability was analyzed by the time domain method. Two parameters were adopted as the expression of total and 5 min-term VRI variability: the standard deviation of all the R-R intervals (SDNN) and of the 5-min mean R-R interval (SDANN). To evaluate the exercise capacity of the patients, Bruce's multi-stage maximal treadmill protocol was performed with 3-min periods to allow achievement of a steady state before workload was increased. Exercise was continued until the patients complained of shortness of breath, the endpoint of exercise in the present study. We determined the relation between the VRI variability during 24-h ambulatory ECG monitoring and exercise capacity in the treadmill exercise testing. Statistical AnalysisAll values are expressed as mean ± SD. Data were ana- Background Reduced variability of the ventricular response interval (VRI) has been reported to predict adverse prognosis in patients with atrial fibrillation (AF). To examine whe...

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“…In the other study by Curione et al [28], QTc interval and QTcdisp values were both considerably prolonged in IBD patients compared with individuals in the control group. The literatures suggested that sympathetic activity changes could be the reason for QT and QTc interval alterations and increased QT dispersion and QTc dispersion of ventricular repolarisation [29, 30]. In contrast to these studies, Dogan et al did not find any significant difference in QTdisp values between 69 IBD patients and controls [27].…”

Section: Discussionmentioning

confidence: 99%

Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission

Bornaun

Yılmaz

Kutluk

et al. 2017

BioMed Research International

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Objectives. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with unclear underlying aetiologies. Severe cardiac arrhythmias have been emphasised in a few studies on adult IBD patients. This study aimed to investigate the alteration of the P-wave and QT interval dispersion parameters to assess the risk of atrial conduction and ventricular repolarisation abnormalities in pediatric IBD patients. Patients and Methods. Thirty-six IBD patients in remission (UC: 20, CD: 16) aged 3–18 years and 36 age- and sex-matched control patients were enrolled in the study. Twelve-lead electrocardiograms were used to determine durations of P-wave, QT, and corrected QT (QTc) interval dispersion. Transthoracic echocardiograms and 24-hour rhythm Holter recordings were obtained for both groups. Results. The P-wave dispersion, QT dispersion, and QTc interval dispersion (Pdisp, QTdisp, and QTcdisp) were significantly longer in the patient group. The mean values of Pminimum, Pmaximum, and QTcminimum were significantly different between the two groups. The echocardiography and Holter monitoring results were not significantly different between the groups. Furthermore, no differences in these parameters were detected between the CD and UC groups. Conclusion. Results suggest that paediatric IBD patients may carry potential risks for serious atrial and ventricular arrhythmias over time even during remission.

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Is the QT Interval an Indicator of Autonomic State?

Cited by 10 publications

References 23 publications

Heart rate recovery after exercise is associated with resting QTc interval in young men

Heart rate recovery after exercise is associated with resting QTc interval in young men

Relation Between Variability of Ventricular Response Intervals and Exercise Capacity in Patients With Non-Valvular Atrial Fibrillation

Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission

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