Impact of presynaptic sympathetic imbalance in long-QT syndrome by positron emission tomography

Heart ◽  
2017 ◽  
Vol 104 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Sven Zumhagen ◽  
Alexis Vrachimis ◽  
Lars Stegger ◽  
Peter Kies ◽  
Christian Wenning ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Long Qt Syndrome ◽  
Clinical Symptoms ◽  
Retention Indices ◽  
Emission Tomography ◽  
Qtc Interval ◽  
Long Qt ◽  
Positron Emission ◽  
Qt Syndrome ◽  
The Impact

ObjectiveWe investigated the impact of cardiac presynaptic norepinephrine recycling in patients with long-QT syndrome (LQTS) using positron emission tomography (PET) with 11C-meta-hydroxyephedrine ([11C]mHED-PET).Methods[11C]mHED-PET was performed in 25 patients with LQTS (LQT1: n=14; LQT2: n=11) and 20 healthy controls and correlated with clinical parameters. [11C]mHED-PET images were analysed for global and regional retention indices (RI) and washout rates (WO) reflecting dynamic parameters of the tracer activity.ResultsGlobal and regional RI values were similar between patients with LQTS and controls. Although the global WO rates were similar between these groups, regional WO rates were on average higher in the lateral left ventricle (LV) wall in patients with LQTS (dose, mean ±SD; 0.08±0.14 vs 0.00%±0.09% min–1; p=0.033). In addition, patients with LQTS with a longer QTc interval showed a higher global WO rate. Clinical symptoms correlated with higher global WO rates. In the presence of normal global WO rates, asymptomatic LQTS patients showed higher global RI values.ConclusionThe increased regional WO rate of [11C]mHED in the lateral LV suggests an imbalance of presynaptic catecholamine reuptake and release, resulting in a higher synaptic catecholamine concentration, in particular in LQT1 patients. This might enhance β-adrenoceptor signalling and thereby aggravate inherited ion channel dysfunction and may facilitate occurrence of ventricular tachyarrhythmias. Detection of regional differences in LV sympathetic nervous function may modify disease expression and potentially serve as a non-invasive risk marker in congenital LQTS.Trial registration number2006-002767-41;Results.

Long QT syndrome masquerading as epilepsy

2018 ◽  
Vol 19 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Clare M Galtrey ◽  
Viva Levee ◽  
Jan Arevalo ◽  
Damian Wren
Keyword(s):  
Early Diagnosis ◽  
Long Qt Syndrome ◽  
Refractory Epilepsy ◽  
Near Miss ◽  
Long Qt ◽  
Her Family ◽  
Fatal Arrhythmia ◽  
Qt Syndrome ◽  
The Impact ◽  
Treatable Condition

The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. We provide practical pointers to increase the chance of early diagnosis and explore the impact of a late diagnosis for the patient and her family.

scholarly journals Paediatric/young versus adult patients with long QT syndrome

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001671
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Population Based ◽  
Public Hospitals ◽  
Qtc Interval ◽  
Onset Age ◽  
Long Qt ◽  
History Of ◽  
Qt Syndrome ◽  
Random Survival Forest

IntroductionLong QT syndrome (LQTS) is a less prevalent cardiac ion channelopathy than Brugada syndrome in Asia. The present study compared the outcomes between paediatric/young and adult LQTS patients.MethodsThis was a population-based retrospective cohort study of consecutive patients diagnosed with LQTS attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age=27±23 years old) were included. Arrhythmias other than VT/VF (HR 4.67, 95% CI (1.53 to 14.3), p=0.007), initial VT/VF (HR=3.25 (95% CI 1.29 to 8.16), p=0.012) and Schwartz score (HR=1.90 (95% CI 1.11 to 3.26), p=0.020) were predictive of the primary outcome for the overall cohort, while arrhythmias other than VT/VF (HR=5.41 (95% CI 1.36 to 21.4), p=0.016) and Schwartz score (HR=4.67 (95% CI 1.48 to 14.7), p=0.009) were predictive for the adult subgroup (>25 years old; n=58). A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic and arrhythmias other than VT/VF as the most important variables for risk prediction.ConclusionClinical and ECG presentation varies between the paediatric/young and adult LQTS population. Machine learning models achieved more accurate VT/VF prediction.

scholarly journals Paediatric/young versus adult patients with long QT syndrome or catecholaminergic polymorphic ventricular tachycardia

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Public Hospitals ◽  
Adult Patients ◽  
Polymorphic Ventricular Tachycardia ◽  
Qtc Interval ◽  
Long Qt ◽  
Old Patients ◽  
Qt Syndrome

AbstractIntroductionLong QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions.MethodsThis was a territory-wide retrospective cohort study of consecutive patients diagnosed with LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval=[1.53-14.3], p=0.007), initial VT/VF (HR=3.25 [1.29-8.16], p=0.012) and Schwartz score (HR=1.90 [1.11-3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36-21.4], p=0.016) and Schwartz score (HR=4.67 [1.48-14.7], p=0.009) were predictive for the adult subgroup (>25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT.ConclusionClinical and ECG presentation vary between the pediatric/young and adult LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction.

Post Evaluation of Tumor Cells Using Fused Positron Emission Tomography CT Imaging

2020 ◽  
Vol 17 (4) ◽  
pp. 1877-1879
Author(s):  
A. Allwyn Gnanadas ◽  
S. Sathishbabu ◽  
N. Shankar
Keyword(s):  
Positron Emission Tomography ◽  
Tumor Cells ◽  
Emission Tomography ◽  
Post Evaluation ◽  
Positron Emission ◽  
The Status ◽  
The Subject ◽  
The Impact ◽  
Post Assessment ◽  
Suitable Processing

Tumors, abnormally growing cells when identified in our body it is treated with appropriate medication. Anyway the impact of the medication on tumor cells is constantly disregarded. Ordinary tests however appear to be encouraging, the expense and the hazard included is gigantic. Post assessment along these lines should be exceptionally refined to create results fast and accurate. Fused imaging, a combination of PET scan and CT scan with suitable processing is utilized to gauge the volume of the tumor without influencing the subject under investigation.This strategy gives a promising post assessment results on the tumor cell that was under examination. The status of the tumor is also updated at regular intervals with simply imaging the subject at comfort.

Manifestation of Long QT syndrome with normal QTc interval under anesthesia: a case report

2011 ◽  
Vol 21 (12) ◽  
pp. 1265-1267 ◽  
Author(s):  
Banashree Mandal ◽  
Gurpreet Kaur ◽  
Yatindra K. Batra ◽  
Sachin Mahajan
Keyword(s):  
Case Report ◽  
Long Qt Syndrome ◽  
Qtc Interval ◽  
Long Qt ◽  
Qt Syndrome

Destination of Mental Disorders Through Biochemical and Neuropathological Analysis?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Falkai
Keyword(s):  
Positron Emission Tomography ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Clinical Symptoms ◽  
Emission Tomography ◽  
Imaging Findings ◽  
Severe Mental Disorders ◽  
Positron Emission ◽  
Dopamine Hypothesis

In the first half of the last century researchers believed that severe mental disorders like schizophrenia have a neuropathological basis. Up to now it has been difficult to prove any consistent core finding for this disorder. Reason for this might be that it is a network disorder and therefore regional specific findings will unlikely be found. Parallel to that describing the dopamine hypothesis of schizophrenia and the catechol amine deficit hypothesis of depression were very helpful for understanding the mechanisms of antipsychotics and antidepressants working in these disorders. Especially the introduction of the positron emission tomography has helped to link symptoms with the transmitter systems. However, none of these findings are specific for schizophrenia or depression. During the talk it will be discussed when the combination of core clinical symptoms, imaging findings and genetic variables are helpful for a future classification of psychiatric disorders.

Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer

2005 ◽  
Vol 23 (28) ◽  
pp. 6846-6853 ◽  
Author(s):  
Didier Lardinois ◽  
Walter Weder ◽  
Marina Roudas ◽  
Gustav K. von Schulthess ◽  
Michaela Tutic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Whole Body ◽  
Benign Tumors ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

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