Piotr Bienias1, Anna Łusakowska2, Michał Ciurzyński3, Zuzanna Rymarczyk3, Katarzyna Irzyk3, Michał Konwerski4, Kamil Ciąpała4, Paweł Kowalski4, Anna Kamińska2, Piotr Pruszczyk3. 1. Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland. pbienias@mp.pl. 2. Department of Neurology, Medical University of Warsaw, Warsaw, Poland. 3. Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland. 4. Students' Scientific Association by Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
Abstract
OBJECTIVE: The aim of this study was to evaluate cardiac autonomic nervous system function using Holter-derived and standard electrocardiographic parameters in patients with myotonic dystrophy (dystrophia myotonica, DM) and no clinically overt heart involvement. METHODS: Eighty-four DM patients without conditions potentially influencing cardiac autonomic function were enrolled in the study: 44 with DM type 1 and 40 with DM type 2 (mean age 34.9 ± 11.5 and 47.8 ± 13.5 years, respectively). Two corresponding control groups of aged-matched healthy subjects were selected for DM1 (n = 35) and for DM2 (n = 30). Standard electrocardiography for QT interval dispersion and 24-h Holter monitoring with time-domain heart rate variability and heart rate turbulence were performed. RESULTS: No significant differences in time-domain heart rate variability parameters between DM1 or DM2 subjects and controls were observed. However, heart rate turbulence parameters were significantly impaired in DM1 patients as compared to their controls: turbulence onset (p = 0.025), and turbulence slope (p = 0.018). Moreover, turbulence slope was also impaired in DM2 patients (p = 0.042). As compared to controls, we observed an increased QT dispersion, both in DM1 (p = 0.003) and also in DM2 patients (p < 0.0001). No relationship between disease duration or neurological status and time-domain heart rate variability, heart rate turbulence, and QT dispersion was observed. INTERPRETATION: Despite normal time-domain heart rate parameters, impaired heart rate turbulence and increased QT dispersion may suggest cardiac autonomic nervous system dysfunction in DM patients. The present study is the first one in which heart rate turbulence and QT dispersion assessment were examined both in DM1 and DM2 patients.
OBJECTIVE: The aim of this study was to evaluate cardiac autonomic nervous system function using Holter-derived and standard electrocardiographic parameters in patients with myotonic dystrophy (dystrophia myotonica, DM) and no clinically overt heart involvement. METHODS: Eighty-four DMpatients without conditions potentially influencing cardiac autonomic function were enrolled in the study: 44 with DM type 1 and 40 with DM type 2 (mean age 34.9 ± 11.5 and 47.8 ± 13.5 years, respectively). Two corresponding control groups of aged-matched healthy subjects were selected for DM1 (n = 35) and for DM2 (n = 30). Standard electrocardiography for QT interval dispersion and 24-h Holter monitoring with time-domain heart rate variability and heart rate turbulence were performed. RESULTS: No significant differences in time-domain heart rate variability parameters between DM1 or DM2 subjects and controls were observed. However, heart rate turbulence parameters were significantly impaired in DM1patients as compared to their controls: turbulence onset (p = 0.025), and turbulence slope (p = 0.018). Moreover, turbulence slope was also impaired in DM2patients (p = 0.042). As compared to controls, we observed an increased QT dispersion, both in DM1 (p = 0.003) and also in DM2patients (p < 0.0001). No relationship between disease duration or neurological status and time-domain heart rate variability, heart rate turbulence, and QT dispersion was observed. INTERPRETATION: Despite normal time-domain heart rate parameters, impaired heart rate turbulence and increased QT dispersion may suggest cardiac autonomic nervous system dysfunction in DMpatients. The present study is the first one in which heart rate turbulence and QT dispersion assessment were examined both in DM1 and DM2patients.
Entities:
Keywords:
Heart rate turbulence; Heart rate variability; Myotonic dystrophy type 1; Myotonic dystrophy type 2; QT dispersion
Authors: G Schmidt; M Malik; P Barthel; R Schneider; K Ulm; L Rolnitzky; A J Camm; J T Bigger; A Schömig Journal: Lancet Date: 1999-04-24 Impact factor: 79.321
Authors: Douglas P Zipes; A John Camm; Martin Borggrefe; Alfred E Buxton; Bernard Chaitman; Martin Fromer; Gabriel Gregoratos; George Klein; Arthur J Moss; Robert J Myerburg; Silvia G Priori; Miguel A Quinones; Dan M Roden; Michael J Silka; Cynthia Tracy; Jean-Jacques Blanc; Andrzej Budaj; Veronica Dean; Jaap W Deckers; Catherine Despres; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; Joao Morais; Ady Osterspey; Juan Luis Tamargo; José Luis Zamorano; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Elliott M Antman; Jeffrey L Anderson; Sharon A Hunt; Jonathan L Halperin; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: Eur Heart J Date: 2006-09 Impact factor: 29.983