Variability of Myocardial Repolarization in Pediatric Patients with a Ventricular Septal Defect

Hidetoshi Uchida, Miki Nishio, Yumi Omeki, Yuka Takeuchi, Rina Nagata, Shota Oikawa, Arisa Nagatani, Yoshihiko Eryu, Tadayoshi Hata, Tetsushi Yoshikawa

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Abstract

In patients with a ventricular septal defect, left-to-right shunting increases the left ventricular preload. This pathological change affects myocardial depolarization and repolarization and has the potential to evoke arrhythmogenic substrates. We examined the effect of ventricular septal defects on myocardial repolarization by investigating the variability in the repolarization interval. This retrospective study included 19 patients (mean age, 1.8 ± 2.1 years) who underwent surgical closure (mean left-to-right shunt ratio, 2.60 ± 0.55) and 26 age-matched healthy controls from 2008 to 2015. Using preoperative electrocardiograms, we studied two electrocardiographic parameters (heart rate-corrected repolarization and variability of repolarization) and four repolarization intervals (QT, JT, J point to T peak [JTp], and T peak to T end [Tp-e] intervals). The variability index (VI) was calculated from the logarithm of the ratio of the repolarization parameter variance to heart rate variance. The various measures were compared between the patients and controls, and significant differences were found in the corrected QT, JTp, and Tp-e intervals (p < 0.05). The VI of the four intervals also showed significant differences (patients vs. controls: QTVI, −0.55 ± 0.61 vs. −1.10 ± 0.53; JTVI, −0.33 ± 0.60 vs. −0.86 ± 0.57; JTpVI, −0.15 ± 0.78 vs. −0.73 ± 0.56; Tp-eVI, 0.75 ± 0.70 vs. 0.11 ± 0.73, respectively; p < 0.05). No correlation was found between the QTVI and corrected QT interval using linear regression analysis. These repolarization characteristics provide not only electrophysiological indices but also a new index with which to assess the pathophysiology of congenital heart disease.

Original languageEnglish
Pages (from-to)1458-1464
Number of pages7
JournalPediatric Cardiology
Volume37
Issue number8
DOIs
Publication statusPublished - 01-12-2016

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Ventricular Heart Septal Defects
Pediatrics
Heart Rate
Linear Models
Heart Diseases
Electrocardiography
Retrospective Studies
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Uchida, Hidetoshi ; Nishio, Miki ; Omeki, Yumi ; Takeuchi, Yuka ; Nagata, Rina ; Oikawa, Shota ; Nagatani, Arisa ; Eryu, Yoshihiko ; Hata, Tadayoshi ; Yoshikawa, Tetsushi. / Variability of Myocardial Repolarization in Pediatric Patients with a Ventricular Septal Defect. In: Pediatric Cardiology. 2016 ; Vol. 37, No. 8. pp. 1458-1464.
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abstract = "In patients with a ventricular septal defect, left-to-right shunting increases the left ventricular preload. This pathological change affects myocardial depolarization and repolarization and has the potential to evoke arrhythmogenic substrates. We examined the effect of ventricular septal defects on myocardial repolarization by investigating the variability in the repolarization interval. This retrospective study included 19 patients (mean age, 1.8 ± 2.1 years) who underwent surgical closure (mean left-to-right shunt ratio, 2.60 ± 0.55) and 26 age-matched healthy controls from 2008 to 2015. Using preoperative electrocardiograms, we studied two electrocardiographic parameters (heart rate-corrected repolarization and variability of repolarization) and four repolarization intervals (QT, JT, J point to T peak [JTp], and T peak to T end [Tp-e] intervals). The variability index (VI) was calculated from the logarithm of the ratio of the repolarization parameter variance to heart rate variance. The various measures were compared between the patients and controls, and significant differences were found in the corrected QT, JTp, and Tp-e intervals (p < 0.05). The VI of the four intervals also showed significant differences (patients vs. controls: QTVI, −0.55 ± 0.61 vs. −1.10 ± 0.53; JTVI, −0.33 ± 0.60 vs. −0.86 ± 0.57; JTpVI, −0.15 ± 0.78 vs. −0.73 ± 0.56; Tp-eVI, 0.75 ± 0.70 vs. 0.11 ± 0.73, respectively; p < 0.05). No correlation was found between the QTVI and corrected QT interval using linear regression analysis. These repolarization characteristics provide not only electrophysiological indices but also a new index with which to assess the pathophysiology of congenital heart disease.",
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Uchida, H, Nishio, M, Omeki, Y, Takeuchi, Y, Nagata, R, Oikawa, S, Nagatani, A, Eryu, Y, Hata, T & Yoshikawa, T 2016, 'Variability of Myocardial Repolarization in Pediatric Patients with a Ventricular Septal Defect', Pediatric Cardiology, vol. 37, no. 8, pp. 1458-1464. https://doi.org/10.1007/s00246-016-1457-9

Variability of Myocardial Repolarization in Pediatric Patients with a Ventricular Septal Defect. / Uchida, Hidetoshi; Nishio, Miki; Omeki, Yumi; Takeuchi, Yuka; Nagata, Rina; Oikawa, Shota; Nagatani, Arisa; Eryu, Yoshihiko; Hata, Tadayoshi; Yoshikawa, Tetsushi.

In: Pediatric Cardiology, Vol. 37, No. 8, 01.12.2016, p. 1458-1464.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Variability of Myocardial Repolarization in Pediatric Patients with a Ventricular Septal Defect

AU - Uchida, Hidetoshi

AU - Nishio, Miki

AU - Omeki, Yumi

AU - Takeuchi, Yuka

AU - Nagata, Rina

AU - Oikawa, Shota

AU - Nagatani, Arisa

AU - Eryu, Yoshihiko

AU - Hata, Tadayoshi

AU - Yoshikawa, Tetsushi

PY - 2016/12/1

Y1 - 2016/12/1

N2 - In patients with a ventricular septal defect, left-to-right shunting increases the left ventricular preload. This pathological change affects myocardial depolarization and repolarization and has the potential to evoke arrhythmogenic substrates. We examined the effect of ventricular septal defects on myocardial repolarization by investigating the variability in the repolarization interval. This retrospective study included 19 patients (mean age, 1.8 ± 2.1 years) who underwent surgical closure (mean left-to-right shunt ratio, 2.60 ± 0.55) and 26 age-matched healthy controls from 2008 to 2015. Using preoperative electrocardiograms, we studied two electrocardiographic parameters (heart rate-corrected repolarization and variability of repolarization) and four repolarization intervals (QT, JT, J point to T peak [JTp], and T peak to T end [Tp-e] intervals). The variability index (VI) was calculated from the logarithm of the ratio of the repolarization parameter variance to heart rate variance. The various measures were compared between the patients and controls, and significant differences were found in the corrected QT, JTp, and Tp-e intervals (p < 0.05). The VI of the four intervals also showed significant differences (patients vs. controls: QTVI, −0.55 ± 0.61 vs. −1.10 ± 0.53; JTVI, −0.33 ± 0.60 vs. −0.86 ± 0.57; JTpVI, −0.15 ± 0.78 vs. −0.73 ± 0.56; Tp-eVI, 0.75 ± 0.70 vs. 0.11 ± 0.73, respectively; p < 0.05). No correlation was found between the QTVI and corrected QT interval using linear regression analysis. These repolarization characteristics provide not only electrophysiological indices but also a new index with which to assess the pathophysiology of congenital heart disease.

AB - In patients with a ventricular septal defect, left-to-right shunting increases the left ventricular preload. This pathological change affects myocardial depolarization and repolarization and has the potential to evoke arrhythmogenic substrates. We examined the effect of ventricular septal defects on myocardial repolarization by investigating the variability in the repolarization interval. This retrospective study included 19 patients (mean age, 1.8 ± 2.1 years) who underwent surgical closure (mean left-to-right shunt ratio, 2.60 ± 0.55) and 26 age-matched healthy controls from 2008 to 2015. Using preoperative electrocardiograms, we studied two electrocardiographic parameters (heart rate-corrected repolarization and variability of repolarization) and four repolarization intervals (QT, JT, J point to T peak [JTp], and T peak to T end [Tp-e] intervals). The variability index (VI) was calculated from the logarithm of the ratio of the repolarization parameter variance to heart rate variance. The various measures were compared between the patients and controls, and significant differences were found in the corrected QT, JTp, and Tp-e intervals (p < 0.05). The VI of the four intervals also showed significant differences (patients vs. controls: QTVI, −0.55 ± 0.61 vs. −1.10 ± 0.53; JTVI, −0.33 ± 0.60 vs. −0.86 ± 0.57; JTpVI, −0.15 ± 0.78 vs. −0.73 ± 0.56; Tp-eVI, 0.75 ± 0.70 vs. 0.11 ± 0.73, respectively; p < 0.05). No correlation was found between the QTVI and corrected QT interval using linear regression analysis. These repolarization characteristics provide not only electrophysiological indices but also a new index with which to assess the pathophysiology of congenital heart disease.

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