Sudden death accounts for almost half of the high mortality in adult patients with
heart failure and is assumed to be associated with ventricular arrhythmias. Beta-blocking
agents result in improved ventricular function and reduce the risk of death in these
patients
1
,
2
and decrease QT and QT dispersion in adults with heart failure. This may account
for the decrease in mortality.
- Bristow M.R.
- Gilbert E.M.
- Abrahma W.T.
- Adams K.F.
- Fowler M.B.
- Hershberger R.E.
- Kubo S.H.
- Narahara K.A.
- Ingersoll H.
- Krueger S.
- Young S.
- Shusterman N.
Carvedilol produces dose-related improvements in left ventricular function and survival
in subjects with chronic heart failure. MOCHA Investigators.
Circulation. 1996; 94: 2807-2816
3
QT dispersion has been proposed as a measure of ventricular recovery and may provide
indirect evidence of the inhomogeneity of ventricular repolarization. Studies have
demonstrated a correlation between inhomogeneous myocardial repolarization and ventricular
arrhythmias.
4
Thus, QT dispersion has been proposed as a means to identify patients with heart
failure at risk of sudden death.
5
QT dispersion is increased in adults with chronic heart failure compared with controls,
3
and is reduced with β-blocking agents. A similar decrease has not been explored in
pediatric patients with heart failure. This study examines QT dispersion in pediatric
patients with heart failure and the effect of β-blocker therapy.To read this article in full you will need to make a payment
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References
- The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group.N Engl J Med. 1996; 334: 1349-1355
- Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. MOCHA Investigators.Circulation. 1996; 94: 2807-2816
- QT dispersion in patients with chronic heart failure.Heart. 1999; 81: 297-302
- Nonuniform recovery of excitability in the left ventricle.Circulation. 1988; 78: 1365-1372
- Repolarization dispersion and sudden cardiac death in patients with impaired left ventricular function.Eur Heart J. 1997; 18: 281-289
- Adjustment of QT dispersion assessed from 12 lead electrocardiograms for different numbers of analyzed electrocardiographic leads.Br Heart J. 1994; 72: 390-396
- Reduction in QT dispersion by sotalol following myocardial infection.Eur Heart J. 1991; 12: 423-427
- QT interval dispersion in chronic heart failure and left ventricular hypertrophy.Br Heart J. 1994; 71: 268-273
- Relation of left ventricular mass and QT dispersion in patients with systematic hypertension.Am J Cardiol. 1997; 79: 508-511
- Is QT dispersion associated with sudden cardiac death in patients with hypertrophic cardiomyopathy?.Ann Noninvasive Electrocardiol. 2001; 6: 209-215
- Acute ischaemia.Lancet. 1997; 349: 306-309
- QT dispersion and early arrhythmic risk during acute myocardial infarction.Angiology. 1999; 50: 209-215
- Circus movement in rabbit atrial muscle as a mechanism of tachycardia. II. The role of nonuniform recovery of excitability in the occurrence of unidirectional block, as studied with multiple microelectrodes.Circ Res. 1976; 39: 168-177
- Characteristics and possible mechanism of ventricular arrhythmia dependent on the dispersion of action potential durations.Circulation. 1983; 67: 1356-1367
- Assessment of QT dispersion in symptomatic patients with congenital long QT syndromes.Am J Cardiol. 1992; 69: 634-638
- Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease.Am J Cardiol. 1994; 74: 550-553
- QT dispersion in medicine.Quart J Med. 2000; 93: 425-431
- QT dispersion and sudden unexpected death in chronic heart failure.Lancet. 1994; 343: 327-329
- Measurement, interpretation and clinical potential of QT dispersion.J Am Coll Cardiol. 2000; 36: 1749-1766
- QT dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function.Circulation. 2001; 103: 831-835
Article info
Publication history
Accepted:
February 27,
2003
Received in revised form:
February 27,
2003
Received:
November 25,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
