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  3. Value of the "Standing Test" in the Diagnosis and Evaluation of Beta-blocker Therapy Response in Long QT Syndrome.

Value of the "Standing Test" in the Diagnosis and Evaluation of Beta-blocker Therapy Response in Long QT Syndrome.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Muñoz-Esparza C
  • Peñafiel-Verdú P
  • Sánchez-Muñoz JJ
  • García-Molina E
  • Sabater M
  • Navarro M
  • San-Román I
  • Pérez I
  • Santos JJ
  • Cabañas-Perianes V
  • Valdés M
  • Pascual D
  • García-Alberola A
  • Gimeno Blanes JR

Grupos

Abstract

INTRODUCTION AND OBJECTIVES: Patients with congenital long QT syndrome (LQTS) have an abnormal QT adaptation to sudden changes in heart rate provoked by standing. The present study sought to evaluate the standing test in a cohort of LQTS patients and to assess if this QT maladaptation phenomenon is ameliorated by beta-blocker therapy. METHODS: Electrographic assessments were performed at baseline and immediately after standing in 36 LQTS patients (6 LQT1 [17%], 20 LQT2 [56%], 3 LQT7 [8%], 7 unidentified-genotype patients [19%]) and 41 controls. The corrected QT interval (QTc) was measured at baseline (QTcsupine) and immediately after standing (QTcstanding); the QTc change from baseline (DeltaQTc) was calculated as QTcstanding - QTcsupine. The test was repeated in 26 patients receiving beta-blocker therapy. RESULTS: Both QTcstanding and DeltaQTc were significantly higher in the LQTS group than in controls (QTcstanding, 528 +/- 46ms vs 420 +/- 15ms, P < .0001; DeltaQTc, 78 +/- 40ms vs 8 +/- 13ms, P < .0001). No significant differences were noted between LQT1 and LQT2 patients. Typical ST-T wave patterns appeared after standing in LQTS patients. Receiver operating characteristic curves of QTcstanding and DeltaQTc showed a significant increase in diagnostic value compared with the QTcsupine (area under the curve for both, 0.99 vs 0.85; P < .001). Beta-blockers attenuated the response to standing in LQTS patients (QTcstanding, 440 +/- 32ms, P < .0001; DeltaQTc, 14 +/- 16ms, P < .0001). CONCLUSIONS: Evaluation of the QTc after the simple maneuver of standing shows a high diagnostic performance and could be important for monitoring the effects of beta-blocker therapy in LQTS patients.

Datos de la publicación

ISSN/ISSNe:
1885-5857, 1885-5857

REVISTA ESPANOLA DE CARDIOLOGIA  Elsevier Doyma

Tipo:
Article
Páginas:
907-914
PubMed:
28233664
Factor de Impacto:
0,181 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 8

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Keywords

  • Beta-blocker therapy; Corrected QT interval; Intervalo QT corregido; Long QT syndrome; Morfologia de la onda T; Standing test; Sindrome de QT largo; T wave morphology; Test de bipedestacion; Tratamiento con bloqueadores beta

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