Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome
Background: Electromechanical heterogeneities due to marked dispersion of ventricular repolarisation and mechanical function have been associated with symptoms in long QT syndrome (LQTS) patients; Aim: To examine the exercise response of longitudinal LV systolic and diastolic myocardial function and...
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| Format: | Article |
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/1/37 |
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| author | Dafni Charisopoulou George Koulaouzidis Lucy F. Law Annika Rydberg Michael Y. Henein |
| author_facet | Dafni Charisopoulou George Koulaouzidis Lucy F. Law Annika Rydberg Michael Y. Henein |
| author_sort | Dafni Charisopoulou |
| collection | DOAJ |
| description | Background: Electromechanical heterogeneities due to marked dispersion of ventricular repolarisation and mechanical function have been associated with symptoms in long QT syndrome (LQTS) patients; Aim: To examine the exercise response of longitudinal LV systolic and diastolic myocardial function and synchronicity in LQTS patients and its relationship with symptoms; Methods: Forty seven (age 45 ± 15 yrs, 25 female, 20 symptomatic) LQTS patients and 35 healthy individuals underwent an exercise test (Bruce protocol). ECG and echo parameters were recorded at rest, peak exercise (p.e.), and recovery; Results: LQTS patients had prolonged and markedly dispersed myocardial contraction, delayed early relaxation phase, and significantly decreased filling time at all exercise phases. Unlike controls, these electromechanical disturbances deteriorated further with exercise, during which additional decrease of the LV diastolic myocardial function and attenuated LV stroke volume were noted. Such abnormal responses to exercise were seen to a greater degree in symptomatic patients and in the LQT1 subgroup and improved with B-blocker therapy. Worsening myocardial contraction dispersion at p.e. was the strongest discriminator for previous clinical events, and its discriminating power excelled further by adding early relaxation delay; Conclusions: Electromechanical disturbances were shown to worsen during exercise in LQTS patients and were more pronounced in those with previous arrhythmic events. |
| first_indexed | 2024-03-10T13:47:23Z |
| format | Article |
| id | doaj.art-5aba8e5f57a449f79fe27dbaebd42fe6 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:47:23Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5aba8e5f57a449f79fe27dbaebd42fe62023-11-21T02:29:49ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-011013710.3390/jcm10010037Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT SyndromeDafni Charisopoulou0George Koulaouzidis1Lucy F. Law2Annika Rydberg3Michael Y. Henein4Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, SwedenInstitute of Public Health and Clinical Medicine, Umea University, 90187 Umea, SwedenDepartment of Clinical Sciences, Paediatrics, Umea University, 90187 Umea, SwedenDepartment of Clinical Sciences, Paediatrics, Umea University, 90187 Umea, SwedenInstitute of Public Health and Clinical Medicine, Umea University, 90187 Umea, SwedenBackground: Electromechanical heterogeneities due to marked dispersion of ventricular repolarisation and mechanical function have been associated with symptoms in long QT syndrome (LQTS) patients; Aim: To examine the exercise response of longitudinal LV systolic and diastolic myocardial function and synchronicity in LQTS patients and its relationship with symptoms; Methods: Forty seven (age 45 ± 15 yrs, 25 female, 20 symptomatic) LQTS patients and 35 healthy individuals underwent an exercise test (Bruce protocol). ECG and echo parameters were recorded at rest, peak exercise (p.e.), and recovery; Results: LQTS patients had prolonged and markedly dispersed myocardial contraction, delayed early relaxation phase, and significantly decreased filling time at all exercise phases. Unlike controls, these electromechanical disturbances deteriorated further with exercise, during which additional decrease of the LV diastolic myocardial function and attenuated LV stroke volume were noted. Such abnormal responses to exercise were seen to a greater degree in symptomatic patients and in the LQT1 subgroup and improved with B-blocker therapy. Worsening myocardial contraction dispersion at p.e. was the strongest discriminator for previous clinical events, and its discriminating power excelled further by adding early relaxation delay; Conclusions: Electromechanical disturbances were shown to worsen during exercise in LQTS patients and were more pronounced in those with previous arrhythmic events.https://www.mdpi.com/2077-0383/10/1/37long QT syndromeexercise stress echocardiogrammechanical dispersiondiastolic myocardial functionexercise |
| spellingShingle | Dafni Charisopoulou George Koulaouzidis Lucy F. Law Annika Rydberg Michael Y. Henein Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome Journal of Clinical Medicine long QT syndrome exercise stress echocardiogram mechanical dispersion diastolic myocardial function exercise |
| title | Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome |
| title_full | Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome |
| title_fullStr | Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome |
| title_full_unstemmed | Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome |
| title_short | Exercise Induced Worsening of Mechanical Heterogeneity and Diastolic Impairment in Long QT Syndrome |
| title_sort | exercise induced worsening of mechanical heterogeneity and diastolic impairment in long qt syndrome |
| topic | long QT syndrome exercise stress echocardiogram mechanical dispersion diastolic myocardial function exercise |
| url | https://www.mdpi.com/2077-0383/10/1/37 |
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