Relation between QT interval variability and cardiac sympathetic activity in hypertension

Mathias Baumert, Markus P. Schlaich, Eugene Nalivaiko, Elisabeth Lambert, Carolina Ika Sari, David M. Kaye, Murray D. Elser, Prashanthan Sanders, Gavin Lambert

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Elevated QT interval variability is a predictor of malignant ventricular arrhythmia, but the underlying mechanisms are incompletely understood. A recent study in dogs with pacing-induced heart failure suggests that QT variability is linked to cardiac sympathetic nerve activity. The aim of this study was to determine whether increased cardiac sympathetic activity is associated with increased beat-to-beat QT interval variability in patients with essential hypertension. We recorded resting norepinephrine (NE) spillover into the coronary sinus and single-lead, short-term, high-resolution, body-surface ECG in 23 patients with essential hypertension and 9 normotensive control subjects. To assess beat-to-beat QT interval variability, we calculated the overall QT variability (QTVN) as well as the QT variability index (QTVi). Cardiac NE spillover (12.2 ± 6.5 vs. 20.7 ± 14.7, P = 0.03) and QTVi (-1.75 ± 0.36 vs. -1.42 ± 0.50, P = 0.05) were significantly increased in hypertensive patients compared with normotensive subjects. QTVN was significantly correlated with cardiac NE spillover (r 2 = 0.31, P = 0.001), with RR variability (r 2 = 0.20, P = 0.008), and with systolic blood pressure (r 2 = 0.16, P = 0.02). Linear regression analysis identified the former two as independent predictors of QTVN. In conclusion, elevated repolarization lability is directly associated with sympathetic cardiac activation in patients with essential hypertension.

LanguageEnglish
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume300
Issue number4
DOIs
Publication statusPublished - 1 Apr 2011

Keywords

  • Norepinephrine spillover

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Baumert, Mathias ; Schlaich, Markus P. ; Nalivaiko, Eugene ; Lambert, Elisabeth ; Sari, Carolina Ika ; Kaye, David M. ; Elser, Murray D. ; Sanders, Prashanthan ; Lambert, Gavin. / Relation between QT interval variability and cardiac sympathetic activity in hypertension. In: American Journal of Physiology - Heart and Circulatory Physiology. 2011 ; Vol. 300, No. 4.
@article{b067fe92e4ab43a4bda538dfb37c73dc,
title = "Relation between QT interval variability and cardiac sympathetic activity in hypertension",
abstract = "Elevated QT interval variability is a predictor of malignant ventricular arrhythmia, but the underlying mechanisms are incompletely understood. A recent study in dogs with pacing-induced heart failure suggests that QT variability is linked to cardiac sympathetic nerve activity. The aim of this study was to determine whether increased cardiac sympathetic activity is associated with increased beat-to-beat QT interval variability in patients with essential hypertension. We recorded resting norepinephrine (NE) spillover into the coronary sinus and single-lead, short-term, high-resolution, body-surface ECG in 23 patients with essential hypertension and 9 normotensive control subjects. To assess beat-to-beat QT interval variability, we calculated the overall QT variability (QTVN) as well as the QT variability index (QTVi). Cardiac NE spillover (12.2 ± 6.5 vs. 20.7 ± 14.7, P = 0.03) and QTVi (-1.75 ± 0.36 vs. -1.42 ± 0.50, P = 0.05) were significantly increased in hypertensive patients compared with normotensive subjects. QTVN was significantly correlated with cardiac NE spillover (r 2 = 0.31, P = 0.001), with RR variability (r 2 = 0.20, P = 0.008), and with systolic blood pressure (r 2 = 0.16, P = 0.02). Linear regression analysis identified the former two as independent predictors of QTVN. In conclusion, elevated repolarization lability is directly associated with sympathetic cardiac activation in patients with essential hypertension.",
keywords = "Norepinephrine spillover",
author = "Mathias Baumert and Schlaich, {Markus P.} and Eugene Nalivaiko and Elisabeth Lambert and Sari, {Carolina Ika} and Kaye, {David M.} and Elser, {Murray D.} and Prashanthan Sanders and Gavin Lambert",
year = "2011",
month = "4",
day = "1",
doi = "10.1152/ajpheart.01184.2010",
language = "English",
volume = "300",
journal = "American Journal of Physiology - Heart and Circulatory Physiology",
issn = "0363-6135",
publisher = "American Physiological Society",
number = "4",

}

Baumert, M, Schlaich, MP, Nalivaiko, E, Lambert, E, Sari, CI, Kaye, DM, Elser, MD, Sanders, P & Lambert, G 2011, 'Relation between QT interval variability and cardiac sympathetic activity in hypertension', American Journal of Physiology - Heart and Circulatory Physiology, vol. 300, no. 4. https://doi.org/10.1152/ajpheart.01184.2010

Relation between QT interval variability and cardiac sympathetic activity in hypertension. / Baumert, Mathias; Schlaich, Markus P.; Nalivaiko, Eugene; Lambert, Elisabeth; Sari, Carolina Ika; Kaye, David M.; Elser, Murray D.; Sanders, Prashanthan; Lambert, Gavin.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 300, No. 4, 01.04.2011.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relation between QT interval variability and cardiac sympathetic activity in hypertension

AU - Baumert, Mathias

AU - Schlaich, Markus P.

AU - Nalivaiko, Eugene

AU - Lambert, Elisabeth

AU - Sari, Carolina Ika

AU - Kaye, David M.

AU - Elser, Murray D.

AU - Sanders, Prashanthan

AU - Lambert, Gavin

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Elevated QT interval variability is a predictor of malignant ventricular arrhythmia, but the underlying mechanisms are incompletely understood. A recent study in dogs with pacing-induced heart failure suggests that QT variability is linked to cardiac sympathetic nerve activity. The aim of this study was to determine whether increased cardiac sympathetic activity is associated with increased beat-to-beat QT interval variability in patients with essential hypertension. We recorded resting norepinephrine (NE) spillover into the coronary sinus and single-lead, short-term, high-resolution, body-surface ECG in 23 patients with essential hypertension and 9 normotensive control subjects. To assess beat-to-beat QT interval variability, we calculated the overall QT variability (QTVN) as well as the QT variability index (QTVi). Cardiac NE spillover (12.2 ± 6.5 vs. 20.7 ± 14.7, P = 0.03) and QTVi (-1.75 ± 0.36 vs. -1.42 ± 0.50, P = 0.05) were significantly increased in hypertensive patients compared with normotensive subjects. QTVN was significantly correlated with cardiac NE spillover (r 2 = 0.31, P = 0.001), with RR variability (r 2 = 0.20, P = 0.008), and with systolic blood pressure (r 2 = 0.16, P = 0.02). Linear regression analysis identified the former two as independent predictors of QTVN. In conclusion, elevated repolarization lability is directly associated with sympathetic cardiac activation in patients with essential hypertension.

AB - Elevated QT interval variability is a predictor of malignant ventricular arrhythmia, but the underlying mechanisms are incompletely understood. A recent study in dogs with pacing-induced heart failure suggests that QT variability is linked to cardiac sympathetic nerve activity. The aim of this study was to determine whether increased cardiac sympathetic activity is associated with increased beat-to-beat QT interval variability in patients with essential hypertension. We recorded resting norepinephrine (NE) spillover into the coronary sinus and single-lead, short-term, high-resolution, body-surface ECG in 23 patients with essential hypertension and 9 normotensive control subjects. To assess beat-to-beat QT interval variability, we calculated the overall QT variability (QTVN) as well as the QT variability index (QTVi). Cardiac NE spillover (12.2 ± 6.5 vs. 20.7 ± 14.7, P = 0.03) and QTVi (-1.75 ± 0.36 vs. -1.42 ± 0.50, P = 0.05) were significantly increased in hypertensive patients compared with normotensive subjects. QTVN was significantly correlated with cardiac NE spillover (r 2 = 0.31, P = 0.001), with RR variability (r 2 = 0.20, P = 0.008), and with systolic blood pressure (r 2 = 0.16, P = 0.02). Linear regression analysis identified the former two as independent predictors of QTVN. In conclusion, elevated repolarization lability is directly associated with sympathetic cardiac activation in patients with essential hypertension.

KW - Norepinephrine spillover

UR - http://www.scopus.com/inward/record.url?scp=79955070092&partnerID=8YFLogxK

U2 - 10.1152/ajpheart.01184.2010

DO - 10.1152/ajpheart.01184.2010

M3 - Article

VL - 300

JO - American Journal of Physiology - Heart and Circulatory Physiology

T2 - American Journal of Physiology - Heart and Circulatory Physiology

JF - American Journal of Physiology - Heart and Circulatory Physiology

SN - 0363-6135

IS - 4

ER -