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Kandzia T, Markiewicz-Łoskot G, Binkiewicz P. Tpeak-Tend Interval during Pregnancy and Postpartum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12638. [PMID: 36231942 PMCID: PMC9566342 DOI: 10.3390/ijerph191912638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pregnancy is a condition in which new cardiac arrhythmias can occur or prior undiagnosed arrhythmias may provide symptoms. The occurrence of severe ventricular arrhythmias and polymorphic ventricular tachycardia that may lead to fainting or sudden cardiac death is promoted by the prolongation of the QTc interval. The post-partum adaptation period is the most arrhythmogenic. TpTe (Tpeak-Tend interval) is a novel marker of arrhythmogenesis by many considered a more sensitive marker than QTc. OBJECTIVE The aim of our work was to determine the TpTe interval (Tpeak-Tend) in women in the first, second and third trimester of pregnancy and the post-partum period. MATERIALS AND METHODS The study group consisted of 128 women in pregnancy or postpartum and a control group of 32 non-pregnant women. A standard 12-lead ECG (electrocardiograph) recording with evaluation of the duration of TpTe and QTc was performed in all patients. RESULTS In comparison to the non-pregnant women, higher values of QTc and TpTe were observed starting in the first trimester with highest values observed in the postpartum period. Mean duration of TpTe interval during pregnancy (81.59 ± 5.92 ms) and in the whole study group (pregnancy + postpartum) (85.46 ± 6.45 ms) was significantly longer (p < 0.001) compared to the TpTe interval in the control group (74.06 ± 6.14 ms). During pregnancy and postpartum, the increase in the TpTe interval in comparison to the increase in the QTc parameter (31.10% vs. 4.18%) was significantly higher (p < 0.001). CONCLUSIONS The study showed an increase in the duration of the TpTe interval and QTc parameter during pregnancy and postpartum with the highest values in the postpartum period. TpTe interval increase was significantly higher compared to QTc increase during pregnancy and postpartum. Changes of TpTe interval were not associated with any clinical outcome or measure of arrythmia burden. Further studies are needed in order to see the clinical significance of these ECG findings, in particular for larger groups of patients with automatic measurement in correlation with echocardiography.
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Affiliation(s)
- Tomasz Kandzia
- Department of Nursing and Social Medical Problems, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Grażyna Markiewicz-Łoskot
- Department of Nursing and Social Medical Problems, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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Castro-Torres Y, Carmona-Puerta R, Chávez-González E, González-Rodríguez EF. Tpeak-Tend, Tpeak-Tend dispersion and Tpeak-Tend/QT in children and its relationship with clinical variables. Colomb Med (Cali) 2019; 50:252-260. [PMID: 32476691 PMCID: PMC7232943 DOI: 10.25100/cm.v50i4.4199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim To characterize the Tpeak-Tend, the Tpeak-Tend dispersion and Tpeak-Tend/QT in children and its relationship with clinical variables. Methods Cross-sectional study in 126 children between 9 and 12 years of the Camilo Cienfuegos School in Santa Clara, Cuba. Clinical and anthropometric variables were obtained to determine their relationship with electrocardiographic parameters: Tpeak-Tend V5, Tpeak-Tend dispersion and Tpeak-Tend/QT ratio V5. In addition, laboratory tests were conducted. Results Age and systolic blood pressure are associated with an increased probability of having values of Tpeak-Tend/QT V5 ≥75 percentile for both sexes (OR: 1.72, CI 95%: 1.02-2.91; p= 0.043), (OR: 1.08, CI 95%: 1.01-1.16; p= 0.017) respectively. The body mass index and systolic blood pressure are linearly and significantly correlated with the Tpeak-Tend/QT V5 (r= 0.224; p= 0.012) and (r= 0.220; p= 0.014) respectively. Conclusions The age of the patients and the systolic blood pressure figures are factors that increase the probability of having values of the Tpeak-Tend/QT V5 ≥75 percentile. There was a significant linear correlation between the Tpeak-Tend/QT V5 with the body mass index and the systolic blood pressure.
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Affiliation(s)
- Yaniel Castro-Torres
- Hospital Universitario Celestino Hernández Robau, Servicio de Cardiología. Santa Clara , Villa Clara. Cuba
| | - Raimundo Carmona-Puerta
- Cardiocentro Ernesto Che Guevara, Servicio de Electrofisiología y Estimulación Cardiaca. Santa Clara, Villa Clara. Cuba
| | - Elibet Chávez-González
- Cardiocentro Ernesto Che Guevara, Servicio de Electrofisiología y Estimulación Cardiaca. Santa Clara, Villa Clara. Cuba
| | - Emilio Francisco González-Rodríguez
- Universidad Central Marta Abreu de las Villas, Facultad de Ingeniería Eléctrica, Centro de Desarrollo Electrónico. Santa Clara, Villa Clara. Cuba
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Jansweijer JA, van Spaendonck-Zwarts KY, Tanck MWT, van Tintelen JP, Christiaans I, van der Smagt JJ, Vermeer AMC, Bos JM, Moss AJ, Swan H, Priori SG, Rydberg A, Tfelt-Hansen J, Ackerman MJ, Olivotto I, Charron P, Gimeno JR, van den Berg MP, Wilde AAM, Pinto YM. Heritability in genetic heart disease: the role of genetic background. Open Heart 2019; 6:e000929. [PMID: 31245010 PMCID: PMC6546190 DOI: 10.1136/openhrt-2018-000929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/17/2019] [Accepted: 02/03/2019] [Indexed: 11/22/2022] Open
Abstract
Background Mutations in genes encoding ion channels or sarcomeric proteins are an important cause of hereditary cardiac disease. However, the severity of the resultant disease varies considerably even among those with an identical mutation. Such clinical variation is often thought to be explained largely by differences in genetic background or 'modifier genes'. We aimed to test the prediction that identical genetic backgrounds result in largely similar clinical expression of a cardiac disease causing mutation, by studying the clinical expression of mutations causing cardiac disease in monozygotic twins. Methods We compared first available clinical information on 46 monozygotic twin pairs and 59 control pairs that had either a hereditary cardiomyopathy or channelopathy. Results Despite limited power of this study, we found significant heritability for corrected QT interval (QTc) in long QT syndrome (LQTS). We could not detect significant heritability for structural traits, but found a significant environmental effect on thickness of the interventricular septum in hypertrophic cardiomyopathy. Conclusions Our study confirms previously found robust heritability for electrical traits like QTc in LQTS, and adds information on low or lacking heritability for structural traits in heritable cardiomyopathies. This may steer the search for genetic modifiers in heritable cardiac disease.
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Affiliation(s)
- Joeri A Jansweijer
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Michael W T Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - J Peter van Tintelen
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Clinical Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Imke Christiaans
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Jasper J van der Smagt
- Department of Medical Genetics, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Alexa M C Vermeer
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - J Martijn Bos
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Arthur J Moss
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, New York, USA
| | - Heikki Swan
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Sylvia G Priori
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Annika Rydberg
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael J Ackerman
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Iacopo Olivotto
- Department of Cardiology, Careggi University Hospital, Florence, Italy
| | - Philippe Charron
- Department of Clinical Genetics, Hopital Ambroise-Pare, Boulogne-Billancourt, France
| | - Juan R Gimeno
- Department of Cardiology, Universitary Hospital Virgen Arrixaca, El Palmar, Murcia, Spain
| | | | - Arthur AM Wilde
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Centre of Excellence in Research of Hereditary Disorders, Princess Al-Jawhara Al-Brahim, Jeddah, Saudi Arabia
| | - Yigal M Pinto
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Hodkinson EC, Neijts M, Sadrieh A, Imtiaz MS, Baumert M, Subbiah RN, Hayward CS, Boomsma D, Willemsen G, Vandenberg JI, Hill AP, De Geus E. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs. Front Physiol 2016; 7:154. [PMID: 27199769 PMCID: PMC4850154 DOI: 10.3389/fphys.2016.00154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/11/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction: The resting ECG is the most commonly used tool to assess cardiac electrophysiology. Previous studies have estimated heritability of ECG parameters based on these snapshots of the cardiac electrical activity. In this study we set out to determine whether analysis of heart rate specific data from Holter ECGs allows more complete assessment of the heritability of ECG parameters. Methods and Results: Holter ECGs were recorded from 221 twin pairs and analyzed using a multi-parameter beat binning approach. Heart rate dependent estimates of heritability for QRS duration, QT interval, Tpeak–Tend and Theight were calculated using structural equation modeling. QRS duration is largely determined by environmental factors whereas repolarization is primarily genetically determined. Heritability estimates of both QT interval and Theight were significantly higher when measured from Holter compared to resting ECGs and the heritability estimate of each was heart rate dependent. Analysis of the genetic contribution to correlation between repolarization parameters demonstrated that covariance of individual ECG parameters at different heart rates overlap but at each specific heart rate there was relatively little overlap in the genetic determinants of the different repolarization parameters. Conclusions: Here we present the first study of heritability of repolarization parameters measured from Holter ECGs. Our data demonstrate that higher heritability can be estimated from the Holter than the resting ECG and reveals rate dependence in the genetic—environmental determinants of the ECG that has not previously been tractable. Future applications include deeper dissection of the ECG of participants with inherited cardiac electrical disease.
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Affiliation(s)
- Emily C Hodkinson
- Molecular Cardiology and Biophysics, Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South WalesSydney, NSW, Australia
| | - Melanie Neijts
- Department of Biological Psychology, EMGO+ Institute, VU University and VU Medical Center Amsterdam, Netherlands
| | - Arash Sadrieh
- Molecular Cardiology and Biophysics, Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South WalesSydney, NSW, Australia
| | - Mohammad S Imtiaz
- Molecular Cardiology and Biophysics, Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South WalesSydney, NSW, Australia
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, University of Adelaide Adelaide, SA, Australia
| | - Rajesh N Subbiah
- St Vincent's Clinical School, University of New South Wales Sydney, NSW, Australia
| | | | - Dorret Boomsma
- Department of Biological Psychology, EMGO+ Institute, VU University and VU Medical Center Amsterdam, Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology, EMGO+ Institute, VU University and VU Medical Center Amsterdam, Netherlands
| | - Jamie I Vandenberg
- Molecular Cardiology and Biophysics, Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South WalesSydney, NSW, Australia
| | - Adam P Hill
- Molecular Cardiology and Biophysics, Victor Chang Cardiac Research InstituteDarlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South WalesSydney, NSW, Australia
| | - Eco De Geus
- Department of Biological Psychology, EMGO+ Institute, VU University and VU Medical Center Amsterdam, Netherlands
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Viskin S, Havakuk O, Antzelevitch C, Rosso R. Malignant early repolarization: It’s the T-wave, stupid…. Heart Rhythm 2016; 13:903-4. [DOI: 10.1016/j.hrthm.2015.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Indexed: 01/01/2023]
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The T-peak–T-end Interval as a Marker of Repolarization Abnormality: A Comparison with the QT Interval for Five Different Drugs. Clin Drug Investig 2015; 35:717-24. [DOI: 10.1007/s40261-015-0328-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Heritabilities, proportions of heritabilities explained by GWAS findings, and implications of cross-phenotype effects on PR interval. Hum Genet 2015; 134:1211-9. [PMID: 26385552 PMCID: PMC4628620 DOI: 10.1007/s00439-015-1595-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/21/2015] [Indexed: 12/04/2022]
Abstract
Electrocardiogram (ECG) measurements are a powerful tool for evaluating cardiac function and are widely used for the diagnosis and prediction of a variety of conditions, including myocardial infarction, cardiac arrhythmias, and sudden cardiac death. Recently, genome-wide association studies (GWASs) identified a large number of genes related to ECG parameter variability, specifically for the QT, QRS, and PR intervals. The aims of this study were to establish the heritability of ECG traits, including indices of left ventricular hypertrophy, and to directly assess the proportion of those heritabilities explained by GWAS variants. These analyses were conducted in a large, Dutch family-based cohort study, the Erasmus Rucphen Family study using variance component methods implemented in the SOLAR (Sequential Oligogenic Linkage Analysis Routines) software package. Heritability estimates ranged from 34 % for QRS and Cornell voltage product to 49 % for 12-lead sum. Trait-specific GWAS findings for each trait explained a fraction of their heritability (17 % for QRS, 4 % for QT, 2 % for PR, 3 % for Sokolow–Lyon index, and 4 % for 12-lead sum). The inclusion of all ECG-associated single nucleotide polymorphisms explained an additional 6 % of the heritability of PR. In conclusion, this study shows that, although GWAS explain a portion of ECG trait variability, a large amount of heritability remains to be explained. In addition, larger GWAS for PR are likely to detect loci already identified, particularly those observed for QRS and 12-lead sum.
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Abstract
OBJECTIVES Sertindole is a nonsedating atypical antipsychotic drug with low propensity to cause extrapyramidal side effects but it has been associated with a 20 ms QTc prolongation and increased risk of cardiac events. It is uncertain whether this drug-induced increase in cardiac risk might also be revealed by dynamic measures of the QT interval such as the ratio of QT variability to heart rate variability (variability ratio [VR]). The aim of this study was to investigate the effect of sertindole on QT dynamics. METHODS QTc and the VR were assessed in an observational study using 24-hour Holter monitoring at baseline and after 3 weeks of treatment with sertindole 16 mg. The VR was calculated by dividing the standard deviation of QT intervals with the standard deviation of heart rates. Outcome measures were compared using paired t-test. RESULTS A total of 18 patients participated in the study, two were excluded from further analysis due to low amplitude of the T-wave. When patients were shifted to sertindole, the VR increased from 0.192 (SD 0.045) to 0.223 (SD 0.061), p = 0.02. The QTcF interval increased from 388 (SD 16) to 403 ms (SD 14), p = 0.002. There was no difference in heart rate 78 bpm (SD 8) versus 80 bpm (SD 10), p = 0.3 or heart rate variability (SDNN) 127 (SD 40) versus 115 ms (SD 45), p = 0.4. CONCLUSION Sertindole was associated with 19 ms QTc prolongation and an increased ratio of QT variability to heart rate variability. Both measures may contribute to the increased cardiovascular mortality found with sertindole.
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Affiliation(s)
- Jimmi Nielsen
- Clinical Department of medicine, Centre for Schizophrenia, Aalborg Psychiatric Hospital, Brandevej 5, 9220 Aalborg Ø, Denmark, UK
| | - Fan Wang
- Laboratory of Experimental Cardiology, Danish National Foundation Centre of Arrhythmias, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark, UK
| | - Claus Graff
- Medical Informatics Group (MI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark, UK
| | - Jørgen K Kanters
- Laboratory of Experimental Cardiology, Danish National Foundation Centre of Arrhythmias, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark, UK
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Rautaharju PM, Zhang ZM, Haisty WK, Kucharska-Newton AM, Rosamond WD, Soliman EZ. Electrocardiographic repolarization-related predictors of coronary heart disease and sudden cardiac deaths in men and women with cardiovascular disease in the Atherosclerosis Risk in Communities (ARIC) study. J Electrocardiol 2015; 48:101-11. [DOI: 10.1016/j.jelectrocard.2014.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Indexed: 11/28/2022]
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Sadrieh A, Mann SA, Subbiah RN, Domanski L, Taylor JA, Vandenberg JI, Hill AP. Quantifying the origins of population variability in cardiac electrical activity through sensitivity analysis of the electrocardiogram. J Physiol 2013; 591:4207-22. [PMID: 23551947 DOI: 10.1113/jphysiol.2013.251710] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Altered function of ion channels in the heart can increase the risk of sudden arrhythmic death. Hundreds of genetic variants exist in these cardiac ion channel genes. The challenge is how to interpret the effects of multiple conductance perturbations on the complex multi-variable cardiac electrical system? In theory, sensitivity analysis can address this question. However, to date this approach has been restricted by computational overheads to analysis of isolated cells, which has limited extrapolation to physiologically relevant scales. The goal of this study was to extend existing sensitivity analyses to electrocardiogram (ECG) signals derived from multicellular systems and quantify the contribution of ionic conductances to emergent properties of the ECG. To achieve this, we have developed a highly parallelised simulation environment using unconventional high performance computing architectures to analyse the emergent electrical properties of a multicellular system. This has permitted the first systematic analysis of the molecular basis of the T wave amplitude, revealing important but distinct roles for delayed rectifier and inward rectifier K(+) currents. In addition to quantifying how interactions between multiple ion channels influence ECG parameters we show that these sensitivities are dynamic functions of heart rate. This study provides a significant advance in our understanding both of how individual ion conductances define ECG signals and of epistatic modification of cardiac electrical phenotypes. The parallelised simulation environment we have developed removes the computational roadblock that has limited this approach and so provides the framework for future analysis of more complex tissue and whole organ systems.
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Affiliation(s)
- Arash Sadrieh
- A. P. Hill: Victor Chang Cardiac Research Institute, 405, Liverpool Street, Darlinghurst, NSW 2010, Australia.
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Sex differences in cardiac autonomic regulation and in repolarisation electrocardiography. Pflugers Arch 2013; 465:699-717. [PMID: 23404618 DOI: 10.1007/s00424-013-1228-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 01/28/2013] [Indexed: 12/16/2022]
Abstract
The review summarises the present knowledge on the sex differences in cardiac autonomic regulations and in related aspects of electrocardiography with particular attention to myocardial repolarisation. Although some of the sex differences are far from fully established, multitude of observations show consistent differences between women and men. Despite more pronounced parasympathetic cardiac regulation, women have higher resting heart rate and lower baroreflex sensitivity. Of the electrocardiographic phenomena, women have longer QT interval duration, repolarisation sequence more synchronised with the inverse of the depolarisation sequence, and likely increased regional heterogeneity of myocardial repolarisation. Studies investigating the relationship of these sex disparities to hormonal differences led frequently to conflicting results. Although sex hormones seem to play a key role by influencing both autonomic tone and electrophysiological properties at the cellular level, neither the truly relevant hormones nor their detailed actions are known. Physiologic usefulness of the described sex differences is also unknown. The review suggests that new studies are needed to advance the understanding of the physiologic mechanisms responsible for these inequalities between women and men and provides key methodological suggestions that need to be followed in future research.
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A common variant near the KCNJ2 gene is associated with T-peak to T-end interval. Heart Rhythm 2012; 9:1099-103. [PMID: 22342860 DOI: 10.1016/j.hrthm.2012.02.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND T-peak to T-end (TPE) interval on the electrocardiogram is a measure of myocardial dispersion of repolarization and is associated with an increased risk of ventricular arrhythmias. The genetic factors affecting the TPE interval are largely unknown. OBJECTIVE To identify common genetic variants that affect the duration of the TPE interval in the general population. METHODS We performed a genome-wide association study on 1870 individuals of Finnish origin participating in the Health 2000 Study. The TPE interval was measured from T-peak to T-wave end in leads II, V(2), and V(5) on resting electrocardiograms, and the mean of these TPE intervals was adjusted for age, sex, and Cornell voltage-duration product. We sought replication for a genome-wide significant result in the 3745 subjects from the Framingham Heart Study. RESULTS We identified a locus on 17q24 that was associated with the TPE interval. The minor allele of the common variant rs7219669 was associated with a 1.8-ms shortening of the TPE interval (P = 1.1 × 10(-10)). The association was replicated in the Framingham Heart Study (-1.5 ms; P = 1.3 × 10(-4)). The overall effect estimate of rs7219669 in the 2 studies was -1.7 ms (P = 5.7 × 10(-14)). The common variant rs7219669 maps downstream of the KCNJ2 gene, in which rare mutations cause congenital long and short QT syndromes. CONCLUSION The common variant rs7219669 is associated with the TPE interval and is thus a candidate to modify repolarization-related arrhythmia susceptibility in individuals carrying the major allele of this polymorphism.
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