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Bari, V.* ; Valencia, J.F.* ; Vallverdú, M.* ; Girardengo, G.* ; Marchi, A.* ; Bassani, T.* ; Caminal, P.* ; Cerutti, S.* ; George, A.L.* ; Brink, P.A.* ; Crotti, L. ; Schwartz, P.J.* ; Porta, A.*

Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1.

PLoS ONE 9:e93808 (2014)
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The study assesses complexity of the cardiac control directed to the sinus node and to ventricles in long QT syndrome type 1 (LQT1) patients with KCNQ1-A341V mutation. Complexity was assessed via refined multiscale entropy (RMSE) computed over the beat-to-beat variability series of heart period (HP) and QT interval. HP and QT interval were approximated respectively as the temporal distance between two consecutive R-wave peaks and between the R-wave apex and T-wave end. Both measures were automatically taken from 24-hour electrocardiographic Holter traces recorded during daily activities in non mutation carriers (NMCs, n = 14) and mutation carriers (MCs, n = 34) belonging to a South African LQT1 founder population. The MC group was divided into asymptomatic (ASYMP, n = 11) and symptomatic (SYMP, n = 23) patients according to the symptom severity. Analyses were carried out during daytime (DAY, from 2PM to 6PM) and nighttime (NIGHT, from 12PM to 4AM) off and on beta-adrenergic blockade (BBoff and BBon). We found that the complexity of the HP variability at short time scale was under vagal control, being significantly increased during NIGHT and BBon both in ASYMP and SYMP groups, while the complexity of both HP and QT variability at long time scales was under sympathetic control, being smaller during NIGHT and BBon in SYMP subjects. Complexity indexes at long time scales in ASYMP individuals were smaller than those in SYMP ones regardless of therapy (i.e. BBoff or BBon), thus suggesting that a reduced complexity of the sympathetic regulation is protective in ASYMP individuals. RMSE analysis of HP and QT interval variability derived from routine 24-hour electrocardiographic Holter recordings might provide additional insights into the physiology of the cardiac control and might be fruitfully exploited to improve risk stratification in LQT1 population.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Heart-rate-variability; Autonomic Nervous-system; Power Spectrum Analysis; Interval Variability; Up Tilt; Repolarization Lability; Risk Stratification; Period Variability; Nonlinear Measures; Sample Entropy
Language english
Publication Year 2014
HGF-reported in Year 2014
ISSN (print) / ISBN 1932-6203
Journal PLoS ONE
Quellenangaben Volume: 9, Issue: 4, Pages: , Article Number: e93808 Supplement: ,
Publisher Public Library of Science (PLoS)
Publishing Place Lawrence, Kan.
Reviewing status Peer reviewed
Institute(s) Institute of Human Genetics (IHG)
POF-Topic(s) 30501 - Systemic Analysis of Genetic and Environmental Factors that Impact Health
Research field(s) Genetics and Epidemiology
PSP Element(s) G-500700-001
PubMed ID 24705789
DOI 10.1371/journal.pone.0093808
WOS ID WOS:000334107500067
Scopus ID 84899099532
Erfassungsdatum 2014-04-09
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