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Type: Journal article
Title: Relation between QT interval variability and cardiac sympathetic activity in hypertension
Author: Baumert, M.
Schlaich, M.
Nalivaiko, E.
Lambert, E.
Sari, C.
Kaye, D.
Elser, M.
Sanders, P.
Lambert, G.
Citation: American Journal of Physiology: Heart and Circulatory Physiology, 2011; 300(4):H1412-H1417
Publisher: Amer Physiological Soc
Issue Date: 2011
ISSN: 0363-6135
Statement of
Mathias Baumert, Markus P. Schlaich, Eugene Nalivaiko, Elisabeth Lambert, Carolina Ika Sari, David M. Kaye, Murray D. Elser, Prashanthan Sanders and Gavin Lambert
Abstract: Elevated QT interval variability is a predictor of malignant ventricular arrhythmia, but the underlying mechanisms are incompletely understood. A recent study in dogs with pacing-induced heart failure suggests that QT variability is linked to cardiac sympathetic nerve activity. The aim of this study was to determine whether increased cardiac sympathetic activity is associated with increased beat-to-beat QT interval variability in patients with essential hypertension. We recorded resting norepinephrine (NE) spillover into the coronary sinus and single-lead, short-term, high-resolution, body-surface ECG in 23 patients with essential hypertension and 9 normotensive control subjects. To assess beat-to-beat QT interval variability, we calculated the overall QT variability (QTVN) as well as the QT variability index (QTVi). Cardiac NE spillover (12.2 ± 6.5 vs. 20.7 ± 14.7, P = 0.03) and QTVi (-1.75 ± 0.36 vs. -1.42 ± 0.50, P = 0.05) were significantly increased in hypertensive patients compared with normotensive subjects. QTVN was significantly correlated with cardiac NE spillover (r(2) = 0.31, P = 0.001), with RR variability (r(2) = 0.20, P = 0.008), and with systolic blood pressure (r(2) = 0.16, P = 0.02). Linear regression analysis identified the former two as independent predictors of QTVN. In conclusion, elevated repolarization lability is directly associated with sympathetic cardiac activation in patients with essential hypertension.
Keywords: norepinephrine spillover
DOI: 10.1152/ajpheart.01184.2010
Grant ID: ARC
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