scholarly journals Normal and abnormal QT interval duration and its changes in preadolescents and adolescents practicing sport

EP Europace ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. 1566-1574 ◽  
Author(s):  
Flavio D’Ascenzi ◽  
Francesca Anselmi ◽  
Francesca Graziano ◽  
Beatrice Berti ◽  
Andrea Franchini ◽  
...  
Keyword(s):  
Qt Interval ◽  
Qtc Interval ◽  
Interval Duration ◽  
Prospective Longitudinal Study ◽  
Repolarization Phase ◽  
Life Threatening ◽  
Qt Interval Duration ◽  
Electrocardiogram Ecg ◽  
Prospective Longitudinal

Abstract Aims Twelve-lead electrocardiogram (ECG) is an established tool in the evaluation of athletes, providing information about life-threatening cardiovascular diseases, such as long QT syndrome. However, the interpretation of ECG is sometimes challenging in children, particularly for the repolarization phase. The aim of this prospective, longitudinal study was to determinate the distribution of QT interval in children practicing sport and to evaluate changes in QT duration overtime. Methods and results A population of 1473 preadolescents practising sport (12.0 ± 1.8 years, 7–15 years) was analysed. Each athlete was evaluated at baseline, mid-term, and end of the study (mean follow-up: 3 ± 1 years). QT interval was corrected with Bazett (B) and Fridericia (F) formulae. At baseline QT interval corrected with the Bazett formula (QTcB) was 412 ± 25 ms and QT interval corrected with the Fridericia formula (QTcF) 387 ± 21 ms, with no changes during follow-up. Ten children (0.68%) had an abnormal QTc. In those with QTcB and QTcF ≥480 ms, QTc duration persisted abnormal during the follow-up and they were disqualified. Conversely, children with 460 ms < (QTcB) <480 ms had a normal QTc interval at the end of the study. These children had also a normal QTcF. Mean difference in the calculation of QT between the two formulae was 25 ± 11 ms (P < 0.0001). For resting heart rate (HR) ≥82 b.p.m., QTcF was independent from HR contrary to QTcB. Conclusion Normal QTc interval does not change over time in preadolescents. A minority of them has a QTc ≥480 ms; in these subjects, QTc interval remains prolonged. The use of Bazett and Fridericia correction formulae is not interchangeable and the Fridericia correction should be preferred in preadolescents with a resting HR ≥82 b.p.m.

4102QT interval duration, long QT pattern and changes over time in children practicing sport

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F D'Ascenzi ◽  
F Anselmi ◽  
F Graziano ◽  
B Berti ◽  
A Franchini ◽  
...  
Keyword(s):  
Qt Interval ◽  
Paediatric Population ◽  
P Value ◽  
Interval Duration ◽  
Long Qt ◽  
Prospective Longitudinal Study ◽  
Final Population ◽  
Prospective Longitudinal ◽  
Over Time

Abstract Background Twelve-lead electrocardiogram (ECG) is an established tool in the evaluation of adult athletes, providing information about life-threatening cardiovascular diseases such as long-QT syndrome. However, changes induced by development challenge the interpretation of ECG in the paediatric population, particularly for the repolarisation phase. The aim of this prospective, longitudinal study was to determinate the distribution of QT interval in children practicing sport and to evaluate changes in QT duration during preadolescence. Methods A final population of 1473 children practising sport (mean age: 12.0±1.8 years, interval 7–15 years) was analysed. Each athlete was evaluated at baseline, mid-term and end of the study with a mean follow-up of 3±1 years. QT interval was corrected with Bazett (B) and Fridericia (F) formulae. Results At baseline QTcB was 412±25ms and QTcF 387±21ms, with no changes during follow-up. Ten children (0.68%) had an abnormal QTc. In children with QTc ≥480ms confirmed both by Bazett and Fridericia formulae, QT duration persisted abnormal during the follow-up and children were disqualified. Conversely, children with borderline QTc intervals (>460 and <480ms) were not disqualified and we found a normalization of QT interval during the development. Mean difference in the calculation of QT between the two formulae was 25±11ms, p<0.0001. For HR values higher than 80 bpm, the QTcF resulted with low fluctuations around the mean was independent from HR values. Conversely, the QTcB revealed significant growing trend as the HR increased and showed higher variability than Fridericia correction. Dynamic changes in QT interval duration Baseline Mid-term FU Long-term FU p value Intervallo QT 343±25 345±24* 346±25* <0.0001 RR (ms) 599±111 711±111* 721±119*^ <0.0001 QTc Bazett (ms) 412±25 (371–449) 411±25 (367–449) 409±25 (367–446) 0.10 QTc Fredericia (ms) 387±21 (355–418) 387±20 (353–419) 387±20 (353–418) 0.59 FU, follow up; *p<0.0001 vs. baseline; §p<0.0001 vs. mid-term FU; ^p<0.05 vs. mid-term FU. Conclusions QT duration does not change over time in children with normal duration. A minority of children has a QT ≥480ms; in these subjects QT interval remains prolonged during the follow-up. Conversely, in children with borderline QT, mid-term follow-up is useful to identify a normalization during the growth. Clinicians should take into account that the use of Bazett and Fridericia correction formulae is not interchangeable and that Fridericia formula should be preferred when resting HR is higher than 80 bpm.

scholarly journals Postoperative QT Interval Prolongation in Patients Undergoing Noncardiac Surgery under General Anesthesia

2012 ◽  
Vol 117 (2) ◽  
pp. 321-328 ◽  
Author(s):  
Peter Nagele ◽  
Swatilika Pal ◽  
Frank Brown ◽  
Jane Blood ◽  
J. Philipp Miller ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Qt Interval ◽  
Serum Magnesium ◽  
Torsades De Pointes ◽  
Noncardiac Surgery ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Life Threatening ◽  
Qt Interval Duration

Background Abnormal cardiac repolarization, indicated by a prolongation of the QT interval, increases the risk for torsades de pointes, a potentially life-threatening arrhythmia. Many perioperatively administered drugs and conditions prolong the QT interval. Despite several reports of perioperative torsades de pointes, systematic evidence regarding perioperative QT interval prolongation is limited. Methods Serial postoperative 12-lead electrocardiograms were obtained from 469 adult patients undergoing major noncardiac surgery under general anesthesia. Heart rate corrected QT-interval duration (Fridericia formula) was the primary outcome. All perioperatively administered drugs were recorded. Emphasis was placed on absolute QTc prolongation greater than 500 ms and relative increases of 30 and 60 ms. Results At the end of surgery, 80% of the patients (345 of 429) experienced a significant QTc interval prolongation (ΔQTc 23 ± 26 ms (mean and SD), 95% CI 20-25 ms, P less than 0.001). Approximately 51% (219 of 429) had a QTc greater than 440 ms, and 4% (16 of 429) a QTc greater than 500 ms. In 39% (166 of 429), the ΔQTc was greater than 30 ms, in 8% (34 of 429) &gt;60 ms, and in greater than 0.5% (2 of 429) &gt;100 ms. No changes in ΔQTc occurred at subsequent time points. One patient developed torsades de pointes with a ΔQTc: 29 ms (0.4% incidence rate). Several drugs had a large effect on ΔQTc: isoflurane, methadone, ketorolac, cefoxitin, zosyn, unasyn, epinephrine, ephedrine, and calcium. Postoperative body temperature had a weak negative correlation with ΔQTc (r = -0.15, P = 0.02); serum magnesium, potassium, and calcium concentrations were not correlated. Conclusion Postoperative QT-interval prolongation is common. Several perioperatively administered drugs are associated with a substantial QT-interval prolongation. The exact cause and its clinical relevance are, however, unclear. Nevertheless, an association between postoperative QT prolongation and risk for torsades de pointes is likely.

scholarly journals QT Interval Variability Index and QT Interval Duration in Different Sleep Stages: Analysis of Polysomnographic Recordings in Nonapneic Male Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Moonika Viigimae ◽  
Deniss Karai ◽  
Peeter Pirn ◽  
Kristjan Pilt ◽  
Kalju Meigas ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Qt Interval ◽  
Sleep Stages ◽  
Qtc Interval ◽  
Interval Duration ◽  
Obstructive Sleep ◽  
Male Patients ◽  
Clinically Significant ◽  
Qt Interval Duration ◽  
Qt Interval Variability

The aim of the study was to determine whether different sleep stages, especially REM sleep, affect QT interval duration and variability in male patients without obstructive sleep apnea (OSA). Polysomnographic recordings of 30 patients were analyzed. Beat-to-beat QT interval variability was calculated using QTV index (QTVI) formula. For QTc interval calculation, in addition to Bazett’s formula, linear and parabolic heart rate correction formulas with two separateαvalues were used. QTVI and QTc values were calculated as means of 2 awake, 3 NREM, and 3 REM sleep episodes; the duration of each episode was 300 sec. Mean QTVI values were not statistically different between sleep stages. Therefore, elevated QTVI values found in patients with OSA cannot be interpreted as physiological sympathetic impact during REM sleep and should be considered as a risk factor for potentially life-threatening ventricular arrhythmias. The absence of difference of the mean QTc interval values between NREM and REM stages seems to confirm our conclusion that sympathetic surges during REM stage do not induce repolarization variability. In patients without notable structural and electrical remodeling of myocardium, physiological elevation in sympathetic activity during REM sleep remains subthreshold concerning clinically significant increase of myocardial electrical instability.

Prospective longitudinal study of depression and anosognosia in Alzheimer's disease

1997 ◽  
Vol 171 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Sergio E. Starkstein ◽  
Erán Chemerinski ◽  
Liliana Sabe ◽  
Gabriela Kuzis ◽  
Gustavo Petracca ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Major Depression ◽  
Cognitive Status ◽  
Initial Evaluation ◽  
Consecutive Series ◽  
Psychiatric Interview ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

BackgroundThe aim was to examine the longitudinal evolution of depression and anosognosia in patients with probable Alzheimer's disease (AD).MethodSixty-two of a consecutive series of 116 AD patients that were examined with a structured psychiatric interview had a follow-up evaluation between one and two years after the initial evaluation.ResultsAt the initial evaluation 19% of the 62 patients had major depression, 34% had dysthymia, and 47% were not depressed. After a mean follow-up of 16 months, 58% of patients with major depression at the initial evaluation were still depressed, whereas only 28% of patients with initial dysthymia and 21% of the non-depressed patients were depressed at follow-up. During the follow-up period, all three groups showed similar declines in cognitive status and activities of daily living. At the initial evaluation, 39% of the patients had anosognosia, and there was a significant increment of anosognosia during the follow-up period.ConclusionsWhile dysthymia in AD is a brief emotional disorder, major depression is a longer-lasting mood change. Anosognosia is another prevalent disorder among AD patients, and increases with the progression of the illness.

scholarly journals Coffee, Alcohol, Smoking, Physical Activity and QT Interval Duration: Results from the Third National Health and Nutrition Examination Survey

PLoS ONE ◽  
2011 ◽  
Vol 6 (2) ◽  
pp. e17584 ◽  
Author(s):  
Yiyi Zhang ◽  
Wendy S. Post ◽  
Darshan Dalal ◽  
Elena Blasco-Colmenares ◽  
Gordon F. Tomaselli ◽  
...  
Keyword(s):  
Physical Activity ◽  
National Health ◽  
Qt Interval ◽  
Nutrition Examination Survey ◽  
Interval Duration ◽  
The Third ◽  
Health And Nutrition ◽  
Qt Interval Duration

scholarly journals Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

2017 ◽  
Vol 35 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Michelle C. Janelsins ◽  
Charles E. Heckler ◽  
Luke J. Peppone ◽  
Charles Kamen ◽  
Karen M. Mustian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Reading Ability ◽  
Menopausal Status ◽  
Prospective Longitudinal Study ◽  
Cognitive Difficulties ◽  
Community Oncology ◽  
Prospective Longitudinal

Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and Methods Patients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. Results Of patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P < .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). Conclusion Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

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