Hara H, Niwano S, Hirasawa S, Sasaki T, Ikeda N, Izumi T. Evaluation of Exercise-Induced T Wave Changes in Patients with Idiopathic Dilated Cardiomyopathy Before and After Beta-Blocker Therapy.
J Cardiovasc Electrophysiol 2006;
17:865-70. [PMID:
16903965 DOI:
10.1111/j.1540-8167.2006.00521.x]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION
Ventricular repolarization abnormalities are thought to contribute to lethal ventricular arrhythmias in patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this study was to evaluate exercise-induced T wave changes in DCM patients before and after beta-blocker therapy to investigate repolarization abnormalities.
METHODS AND RESULTS
Treadmill exercise testing was performed in 20 DCM patients and 50 normal subjects. T wave amplitude (TA: baseline to T wave apex; mV) and recovery time (RT: QRS onset to the maximum dV/dt point of the T wave; msec) were measured before and 1 minute after peak exercise. TA was averaged in the right and left precordial leads (TA(V1-3), TA(V4-6)). RT was normalized to the maximum QT interval in the 12-lead ECG and expressed as the %RT (%RT). %RT was also averaged in the precordial leads (%RT(V1-3), %RT(V4-6)). After exercise, TA increased and %RT decreased in both groups. In DCM patients, TA(V1-3) was greater and TA(V4-6) was less than in normal subjects before and after exercise. There was no difference in %RT(V1-3) between the groups, but %RT(V4-6) was greater in DCM patients both before and after exercise. DCM patients repeated the same evaluation after 6 months of oral beta-blocker therapy. Compared with measurements before beta-blocker therapy, TA(V1-3) and %RT(V1-3) did not change. However, TA(V4-6) increased and %RT(V4-6) decreased significantly both before and after exercise.
CONCLUSION
DCM patients showed small TA and large %RT in the left precordial leads at rest as well as after exercise. Chronic beta-blocker therapy in DCM patients normalized these ventricular repolarization abnormalities.
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