AIMS: Congenital or acquired QT prolongation is a risk factor for life-threatening arrhythmias. In patients with hypertrophic cardiomyopathy (HCM), the QT interval may be intrinsically prolonged. However, the prevalence, cause, and significance of QT prolongation among patients with HCM are unknown. METHODS AND RESULTS: After exclusion of patients on QT-prolonging drugs, a blinded, retrospective analysis of electrocardiograms, echocardiograms, and genotype status in 479 unrelated patients with HCM [201 females, age at diagnosis 41 ± 18 years, maximal left ventricular wall thickness (MLVWT) 22 ± 6 mm] from two independent centres was performed. The mean QTc was 440 ± 28 ms. The QTc exceeded 480 ms in 13% of patients. Age, gender, family history of HCM or sudden cardiac arrest, and genotype status had no association with QTc. Patients with a QTc over 480 ms were more symptomatic at diagnosis (P < 0.001), had a higher MLVWT (P = 0.03), were more obstructive (P < 0.001), and were more likely to have undergone septal reduction therapy (P = 0.02). There was a weak but significant direct linear relationship between QTc and peak outflow gradient (r(2) = 0.05, P < 0.0001). CONCLUSIONS: Compared with <1 in 200 otherwise healthy adults, QT prolongation (QTc > 480 ms) was present in 1 out of 8 patients with HCM. The QTc was partly reflective of the degree of cardiac hypertrophy and left ventricular outflow tract obstruction. Because of its pro-arrhythmic potential and its potential relevance to management and risk stratification, routine QTc assessment should be performed in patients with HCM, particularly when concomitant use of QT-prolonging medications is considered.
AIMS: Congenital or acquired QT prolongation is a risk factor for life-threatening arrhythmias. In patients with hypertrophic cardiomyopathy (HCM), the QT interval may be intrinsically prolonged. However, the prevalence, cause, and significance of QT prolongation among patients with HCM are unknown. METHODS AND RESULTS: After exclusion of patients on QT-prolonging drugs, a blinded, retrospective analysis of electrocardiograms, echocardiograms, and genotype status in 479 unrelated patients with HCM [201 females, age at diagnosis 41 ± 18 years, maximal left ventricular wall thickness (MLVWT) 22 ± 6 mm] from two independent centres was performed. The mean QTc was 440 ± 28 ms. The QTc exceeded 480 ms in 13% of patients. Age, gender, family history of HCM or sudden cardiac arrest, and genotype status had no association with QTc. Patients with a QTc over 480 ms were more symptomatic at diagnosis (P < 0.001), had a higher MLVWT (P = 0.03), were more obstructive (P < 0.001), and were more likely to have undergone septal reduction therapy (P = 0.02). There was a weak but significant direct linear relationship between QTc and peak outflow gradient (r(2) = 0.05, P < 0.0001). CONCLUSIONS: Compared with <1 in 200 otherwise healthy adults, QT prolongation (QTc > 480 ms) was present in 1 out of 8 patients with HCM. The QTc was partly reflective of the degree of cardiac hypertrophy and left ventricular outflow tract obstruction. Because of its pro-arrhythmic potential and its potential relevance to management and risk stratification, routine QTc assessment should be performed in patients with HCM, particularly when concomitant use of QT-prolonging medications is considered.
Authors: B J Maron; M J Leyhe; S A Casey; T E Gohman; C M Lawler; R S Crow; M S Maron; M Hodges Journal: Am J Cardiol Date: 2001-01-01 Impact factor: 2.778
Authors: Ilan Goldenberg; Arthur J Moss; Derick R Peterson; Scott McNitt; Wojciech Zareba; Mark L Andrews; Jennifer L Robinson; Emanuela H Locati; Michael J Ackerman; Jesaia Benhorin; Elizabeth S Kaufman; Carlo Napolitano; Silvia G Priori; Ming Qi; Peter J Schwartz; Jeffrey A Towbin; G Michael Vincent; Li Zhang Journal: Circulation Date: 2008-04-21 Impact factor: 29.690
Authors: Ilan Goldenberg; Arthur J Moss; James Bradley; Slava Polonsky; Derick R Peterson; Scott McNitt; Wojciech Zareba; Mark L Andrews; Jennifer L Robinson; Michael J Ackerman; Jesaia Benhorin; Elizabeth S Kaufman; Emanuela H Locati; Carlo Napolitano; Silvia G Priori; Ming Qi; Peter J Schwartz; Jeffrey A Towbin; G Michael Vincent; Li Zhang Journal: Circulation Date: 2008-04-21 Impact factor: 29.690
Authors: Paolo Spirito; Camillo Autore; Claudio Rapezzi; Paola Bernabò; Roberto Badagliacca; Martin S Maron; Sergio Bongioanni; Fabio Coccolo; N A Mark Estes; Caterina S Barillà; Elena Biagini; Giovanni Quarta; Maria Rosa Conte; Paolo Bruzzi; Barry J Maron Journal: Circulation Date: 2009-03-23 Impact factor: 29.690
Authors: Rocco Hueneke; Adam Adenwala; Rebecca L Mellor; Jonathan G Seidman; Christine E Seidman; Jeanne M Nerbonne Journal: J Mol Cell Cardiol Date: 2017-01-13 Impact factor: 5.000
Authors: Heather N Anderson; J Martijn Bos; Kristina H Haugaa; Bruce W Morlan; Robert F Tarrell; Pedro J Caraballo; Michael J Ackerman Journal: Pediatr Cardiol Date: 2015-04-07 Impact factor: 1.655
Authors: Wesley T O'Neal; Virginia J Howard; Dawn Kleindorfer; Brett Kissela; Suzanne E Judd; Leslie A McClure; Mary Cushman; George Howard; Elsayed Z Soliman Journal: Europace Date: 2015-10-20 Impact factor: 5.214
Authors: Mikko Jalanko; Heikki Väänänen; Mika Tarkiainen; Petri Sipola; Pertti Jääskeläinen; Kirsi Lauerma; Tiina Laitinen; Tomi Laitinen; Mika Laine; Tiina Heliö; Johanna Kuusisto; Matti Viitasalo Journal: Ann Noninvasive Electrocardiol Date: 2018-07-04 Impact factor: 1.468