Sex and Rate Change Differences in QT/RR Hysteresis in Healthy Subjects

Andršová, Irena; Hnatkova, Katerina; Šišáková, Martina; Toman, Ondřej; Smetana, Peter; Huster, Katharina M.; Barthel, Petra; Novotný, Tomáš; Schmidt, Georg; Malik, Marek

doi:10.3389/fphys.2021.814542

Cited by 3 publications

(5 citation statements)

References 57 publications

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“…It was found that the rate of QT/RR hysteresis decreases with increasing age, while the duration of the individually corrected QTc interval increases with increasing age. In contrast to longer QTc intervals, the rate of QT/RR hysteresis was faster in women [145]. There are many causes of prolonged QT intervals, and acquired causes are more common than genetic causes [146].…”

Section: Qt Interval Duration (Ms) Under Individual Types Of Anesthes...mentioning

confidence: 84%

Rat Electrocardiography and General Anesthesia

Švorc¹

2023

Novel Pathogenesis and Treatments for Cardiovascular Disease

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General anesthesia is an established and well-known factor with a significant impact on cardiac parameters, which can be a problem in the final evaluation of changes in the individual electrophysiological myocardial parameters after various interventions. The present chapter provides a composite review of published data on electrocardiographic parameters (heart rate, PR interval, P wave duration, P wave amplitude, QRS complex, QT and QTc interval duration, and R wave and T wave amplitude) for in vivo rat experiments under general anesthesia from 130 articles, which were retrieved from a search of the Web of Science database, for articles published mainly between 2000 and 2021. ECG parameters reported as baseline or control values were summarized, and averages with ranges were calculated. It is important to be cautious in interpreting the results of such studies and discussions addressing the mechanisms underlying a given type of arrhythmia, it is important to acknowledge that initial ECG parameters may already be affected to some extent by general anesthesia as well as by sex and the time of day the experiments are performed. Although it is not an original research work, researchers working with rats in the laboratory, who routinely perform anesthesia, can use this as a reference to look into while analyzing their data.

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Section: Qt Interval Duration (Ms) Under Individual Types Of Anesthes...mentioning

confidence: 84%

Rat Electrocardiography and General Anesthesia

Švorc¹

2023

Novel Pathogenesis and Treatments for Cardiovascular Disease

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“…In other studies, autonomic blockades were used to assess QT hysteresis during exercise and recovery, providing evidence on the important role of autonomic nervous system effects on the QT-to-RR relationship [ 59 ]. Nevertheless, subsequent reports pointed out that the conclusions of those studies might be influenced by factors like the speed of HR change, which is also subjected to autonomic influence [ 69 ]. Here, we aimed to shed light on the role of β -adrenergic stimulation on the APD and QT adaptation lag after HR changes separately during exercise and recovery.…”

Section: Discussionmentioning

confidence: 99%

The role of β-adrenergic stimulation in QT interval adaptation to heart rate during stress test

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Cebollada²,

Mountris³

et al. 2023

PLoS ONE

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The adaptation lag of the QT interval after heart rate (HR) has been proposed as an arrhythmic risk marker. Most studies have quantified the QT adaptation lag in response to abrupt, step-like changes in HR induced by atrial pacing, in response to tilt test or during ambulatory recordings. Recent studies have introduced novel methods to quantify the QT adaptation lag to gradual, ramp-like HR changes in stress tests by evaluating the differences between the measured QT series and an estimated, memoryless QT series obtained from the instantaneous HR. These studies have observed the QT adaptation lag to progressively reduce when approaching the stress peak, with the underlying mechanisms being still unclear. This study analyzes the contribution of β-adrenergic stimulation to QT interval rate adaptation in response to gradual, ramp-like HR changes. We first quantify the QT adaptation lag in Coronary Artery Disease (CAD) patients undergoing stress test. To uncover the involved mechanisms, we use biophysically detailed computational models coupling descriptions of human ventricular electrophysiology and β-adrenergic signaling, from which we simulate ventricular action potentials and ECG signals. We characterize the adaptation of the simulated QT interval in response to the HR time series measured from each of the analyzed CAD patients. We show that, when the simulated ventricular tissue is subjected to a time-varying β-adrenergic stimulation pattern, with higher stimulation levels close to the stress peak, the simulated QT interval presents adaptation lags during exercise that are more similar to those measured from the patients than when subjected to constant β-adrenergic stimulation. During stress test recovery, constant and time-varying β-adrenergic stimulation patterns render similar adaptation lags, which are generally shorter than during exercise, in agreement with results from the patients. In conclusion, our findings support the role of time-varying β-adrenergic stimulation in contributing to QT interval adaptation to gradually increasing HR changes as those seen during the exercise phase of a stress test.

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“…The ECG recordings used in the study have been reported previously in studies that investigated very different electrophysiology factors ( Hnatkova et al, 2021 ; Andršová et al, 2022 ; Toman et al, 2022 ). For the purposes of the present investigation, we applied very different data processing methods.…”

Section: Methodsmentioning

confidence: 99%

“…The expressions of underlying heart rate based on a simple average of preceding RR intervals does not reflect gradual decrease of the influence of heart rate changes in more remote history. Therefore, exponential decay models were also used, in the same form as previously developed for the purposes of estimating QT/RR hysteresis ( Malik et al, 2008b ; Malik et al, 2016 ; Andršová et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

“…The age ranges of the study population were some 35 years wide and did not include any subjects over 60 years of age. Nevertheless, an obvious and statistically significant age relationship of heart rate variability, QT/RR hysteresis profiles, and of individually corrected QTc intervals was previously observed over similar or even narrower age ranges (Andršová et al, 2022;Toman et al, 2022). Finally, the data of the study were derived from ECG recordings obtained using Mason-Likar electrode positions.…”

Section: Limitationsmentioning

confidence: 99%

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Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate

et al. 2022

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Three-dimensional angle between the QRS complex and T wave vectors is a known powerful cardiovascular risk predictor. Nevertheless, several physiological properties of the angle are unknown or poorly understood. These include, among others, intra-subject profiles and stability of the angle relationship to heart rate, characteristics of angle/heart-rate hysteresis, and the changes of these characteristics with different modes of QRS-T angle calculation. These characteristics were investigated in long-term 12-lead Holter recordings of 523 healthy volunteers (259 females). Three different algorithmic methods for the angle computation were based on maximal vector magnitude of QRS and T wave loops, areas under the QRS complex and T wave curvatures in orthogonal leads, and weighted integration of all QRS and T wave vectors moving around the respective 3-dimensional loops. These methods were applied to orthogonal leads derived either by a uniform conversion matrix or by singular value decomposition (SVD) of the original 12-lead ECG, giving 6 possible ways of expressing the angle. Heart rate hysteresis was assessed using the exponential decay models. All these methods were used to measure the angle in 659,313 representative waveforms of individual 10-s ECG samples and in 7,350,733 individual beats contained in the same 10-s samples. With all measurement methods, the measured angles fitted second-degree polynomial regressions to the underlying heart rate. Independent of the measurement method, the angles were found significantly narrower in females (p < 0.00001) with the differences to males between 10o and 20o, suggesting that in future risk-assessment studies, different angle dichotomies are needed for both sexes. The integrative method combined with SVD leads showed the highest intra-subject reproducibility (p < 0.00001). No reproducible delay between heart rate changes and QRS-T angle changes was found. This was interpreted as a suggestion that the measurement of QRS-T angle might offer direct assessment of cardiac autonomic responsiveness at the ventricular level.

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Sex and Rate Change Differences in QT/RR Hysteresis in Healthy Subjects

Cited by 3 publications

References 57 publications

Rat Electrocardiography and General Anesthesia

Rat Electrocardiography and General Anesthesia

The role of β-adrenergic stimulation in QT interval adaptation to heart rate during stress test

Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate

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