Prolongation of the Corrected QT Complex – A Cause of Sudden Cardiac Death in the Mountain Environment?

Windsor, Jeremy S.; Rodway, George W.; Mukherjee, Rahul; Firth, Paul G.; Shattock, Michael J.; Montgomery, Hugh

doi:10.1136/jramc-157-01-11

Cited by 3 publications

(1 citation statement)

References 44 publications

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“…Prolonged QTc interval was reported to be an independent contributing factor of cardiovascular disease and predicts death in apparently healthy individuals and in patients with electrolyte abnormalities, sinus node dysfunction, atrioventricular block and angina 29. Prolongation of the QTc interval might also predispose patients to a life-threatening ventricular arrhythmia, such as torsade de pointes and ventricular fibrillation 30. In the present study, multivariable analysis showed that the QTc interval was negatively associated with ZPP after adjusting for gender, age, alcohol intake, smoking status and education.…”

Section: Discussionmentioning

confidence: 99%

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

Xie

Zhang

et al. 2019

Occup Environ Med

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ObjectivesA significant number of researches have evidenced that occupational lead (Pb) exposure increased risks of cardiovascular disease. However, evidences about the potential effects of Pb on the cardiac conduction system are sparse and inconclusive. Besides, ryanodine receptors (RyRs) induced dysfunction of cardiac excitation contraction coupling which is considered to be one of the mechanisms in cardiovascular diseases. Therefore, we examined the association between occupational Pb exposure and ECG conduction abnormalities, as well as RyRs in Pb-induced ECG abnormalities.MethodsWe investigated 529 Pb smelter workers, and measured blood lead (BPb), zinc protoporphyrin (ZPP), ECG outcomes and RyR expression levels. Based on BPb levels, the workers were divided into three groups: the BPb not elevated group, the BPb elevated group and the Pb poisoning group. Descriptive and multivariable analyses were performed.ResultsCompared with the BPb not elevated group, the Pb poisoning group had a higher incidence of high QRS voltage, and a lower level of RyR1 gene expression (p<0.05). Further unconditional multivariable logistic regression analyses showed that high QRS voltage was positively related to BPb (OR=1.045, 95% CI 1.014 to 1.078) and inversely associated with RyR1 expression (OR=0.042, 95% CI 0.002 to 0.980) after adjusting for potential confounders. In addition, multiple linear regression analyses showed that the QTc interval was positively associated with ZPP (β=0.299, 95% CI 0.130 to 0.468) after adjusting for potential confounders.ConclusionsOur study provided evidences that occupational exposure to Pb may be associated with worse ECG outcomes (high QRS voltage), which might be related to decreased levels of RyR1.

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Section: Discussionmentioning

confidence: 99%

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

Xie

Zhang

et al. 2019

Occup Environ Med

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Markers of cardiovascular risk and their reversibility with acute oxygen therapy in Kyrgyz highlanders with high altitude pulmonary hypertension

et al. 2021

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Physiological Changes to the Cardiovascular System at High Altitude and Its Effects on Cardiovascular Disease

Riley

Gavin

2017

High Altitude Medicine & Biology

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Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.

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Prolongation of the Corrected QT Complex – A Cause of Sudden Cardiac Death in the Mountain Environment?

Cited by 3 publications

References 44 publications

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

Markers of cardiovascular risk and their reversibility with acute oxygen therapy in Kyrgyz highlanders with high altitude pulmonary hypertension

Physiological Changes to the Cardiovascular System at High Altitude and Its Effects on Cardiovascular Disease

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