Abnormal transmural repolarization process in patients with Brugada syndrome

Mutsuko Sangawa, Hiroshi Morita, Takaaki Nakatsu, Nobuhiro Nishii, Daiji Miura, Aya Miura, Takeshi Tada, Masato Murakami, Shigeki Hiramatsu, Satoshi Nagase, Kazufumi Nakamura, Takefumi Oka, Shinji Toyonaga, Keiichi Mashima, Shozo Kusachi, Kazuhide Yamamoto, Tohru Ohe, Kengo F. Kusano

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Repolarization abnormality, especially during bradycardia, might be critical for initiation of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS), but the contribution of the rate-dependent repolarization dynamics to the occurrence of VF is still unknown. Objective: The aim of our study was to determine the differences in rate-dependent repolarization dynamics between BrS with and without spontaneous VF and between BrS with and without SCN5A mutation. Methods: The subjects were 37 BrS patients with VF (VF(+) group: 10 male subjects) and without VF (VF(-) group: 27 male subjects) and 20 control subjects. Genetic analysis of SCN5A was performed in all 37 BrS patients. The relationships between QT, QTp, Tp-e, and RR intervals were obtained from Holter recordings as first linear regression lines, and the slopes of QT/RR, QTp/RR, and Tp-e/RR linear regression lines as the sensitivity of rate-dependent repolarization dynamics were compared. Results: QT/RR and Tp-e/RR slopes showed loss of a rate-dependent property in the VF(+) group compared with those in the VF(-) and control groups. There was no significant difference in QTp/RR slope among the VF(+), VF(-) and control groups. The Tp-e interval had a negative correlation with the RR interval in the VF(+) group and a positive correlation with the RR interval in the VF(-) and control groups. There was no significant difference in QT/RR, QTp/RR, and Tp-e/RR slopes between BrS patients with SCN5A mutation and those without SCN5A mutation. Conclusions: Loss of rate-dependent QT dynamics may be associated with occurrence of VF in BrS.

Original languageEnglish
Pages (from-to)1163-1169
Number of pages7
JournalHeart Rhythm
Volume6
Issue number8
DOIs
Publication statusPublished - Aug 2009

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Brugada Syndrome
Ventricular Fibrillation
Control Groups
Mutation
Linear Models
Bradycardia

Keywords

  • Brugada syndrome
  • QT interval
  • SCN5A
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Abnormal transmural repolarization process in patients with Brugada syndrome. / Sangawa, Mutsuko; Morita, Hiroshi; Nakatsu, Takaaki; Nishii, Nobuhiro; Miura, Daiji; Miura, Aya; Tada, Takeshi; Murakami, Masato; Hiramatsu, Shigeki; Nagase, Satoshi; Nakamura, Kazufumi; Oka, Takefumi; Toyonaga, Shinji; Mashima, Keiichi; Kusachi, Shozo; Yamamoto, Kazuhide; Ohe, Tohru; Kusano, Kengo F.

In: Heart Rhythm, Vol. 6, No. 8, 08.2009, p. 1163-1169.

Research output: Contribution to journalArticle

Sangawa, M, Morita, H, Nakatsu, T, Nishii, N, Miura, D, Miura, A, Tada, T, Murakami, M, Hiramatsu, S, Nagase, S, Nakamura, K, Oka, T, Toyonaga, S, Mashima, K, Kusachi, S, Yamamoto, K, Ohe, T & Kusano, KF 2009, 'Abnormal transmural repolarization process in patients with Brugada syndrome', Heart Rhythm, vol. 6, no. 8, pp. 1163-1169. https://doi.org/10.1016/j.hrthm.2009.04.037
Sangawa, Mutsuko ; Morita, Hiroshi ; Nakatsu, Takaaki ; Nishii, Nobuhiro ; Miura, Daiji ; Miura, Aya ; Tada, Takeshi ; Murakami, Masato ; Hiramatsu, Shigeki ; Nagase, Satoshi ; Nakamura, Kazufumi ; Oka, Takefumi ; Toyonaga, Shinji ; Mashima, Keiichi ; Kusachi, Shozo ; Yamamoto, Kazuhide ; Ohe, Tohru ; Kusano, Kengo F. / Abnormal transmural repolarization process in patients with Brugada syndrome. In: Heart Rhythm. 2009 ; Vol. 6, No. 8. pp. 1163-1169.
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abstract = "Background: Repolarization abnormality, especially during bradycardia, might be critical for initiation of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS), but the contribution of the rate-dependent repolarization dynamics to the occurrence of VF is still unknown. Objective: The aim of our study was to determine the differences in rate-dependent repolarization dynamics between BrS with and without spontaneous VF and between BrS with and without SCN5A mutation. Methods: The subjects were 37 BrS patients with VF (VF(+) group: 10 male subjects) and without VF (VF(-) group: 27 male subjects) and 20 control subjects. Genetic analysis of SCN5A was performed in all 37 BrS patients. The relationships between QT, QTp, Tp-e, and RR intervals were obtained from Holter recordings as first linear regression lines, and the slopes of QT/RR, QTp/RR, and Tp-e/RR linear regression lines as the sensitivity of rate-dependent repolarization dynamics were compared. Results: QT/RR and Tp-e/RR slopes showed loss of a rate-dependent property in the VF(+) group compared with those in the VF(-) and control groups. There was no significant difference in QTp/RR slope among the VF(+), VF(-) and control groups. The Tp-e interval had a negative correlation with the RR interval in the VF(+) group and a positive correlation with the RR interval in the VF(-) and control groups. There was no significant difference in QT/RR, QTp/RR, and Tp-e/RR slopes between BrS patients with SCN5A mutation and those without SCN5A mutation. Conclusions: Loss of rate-dependent QT dynamics may be associated with occurrence of VF in BrS.",
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T1 - Abnormal transmural repolarization process in patients with Brugada syndrome

AU - Sangawa, Mutsuko

AU - Morita, Hiroshi

AU - Nakatsu, Takaaki

AU - Nishii, Nobuhiro

AU - Miura, Daiji

AU - Miura, Aya

AU - Tada, Takeshi

AU - Murakami, Masato

AU - Hiramatsu, Shigeki

AU - Nagase, Satoshi

AU - Nakamura, Kazufumi

AU - Oka, Takefumi

AU - Toyonaga, Shinji

AU - Mashima, Keiichi

AU - Kusachi, Shozo

AU - Yamamoto, Kazuhide

AU - Ohe, Tohru

AU - Kusano, Kengo F.

PY - 2009/8

Y1 - 2009/8

N2 - Background: Repolarization abnormality, especially during bradycardia, might be critical for initiation of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS), but the contribution of the rate-dependent repolarization dynamics to the occurrence of VF is still unknown. Objective: The aim of our study was to determine the differences in rate-dependent repolarization dynamics between BrS with and without spontaneous VF and between BrS with and without SCN5A mutation. Methods: The subjects were 37 BrS patients with VF (VF(+) group: 10 male subjects) and without VF (VF(-) group: 27 male subjects) and 20 control subjects. Genetic analysis of SCN5A was performed in all 37 BrS patients. The relationships between QT, QTp, Tp-e, and RR intervals were obtained from Holter recordings as first linear regression lines, and the slopes of QT/RR, QTp/RR, and Tp-e/RR linear regression lines as the sensitivity of rate-dependent repolarization dynamics were compared. Results: QT/RR and Tp-e/RR slopes showed loss of a rate-dependent property in the VF(+) group compared with those in the VF(-) and control groups. There was no significant difference in QTp/RR slope among the VF(+), VF(-) and control groups. The Tp-e interval had a negative correlation with the RR interval in the VF(+) group and a positive correlation with the RR interval in the VF(-) and control groups. There was no significant difference in QT/RR, QTp/RR, and Tp-e/RR slopes between BrS patients with SCN5A mutation and those without SCN5A mutation. Conclusions: Loss of rate-dependent QT dynamics may be associated with occurrence of VF in BrS.

AB - Background: Repolarization abnormality, especially during bradycardia, might be critical for initiation of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS), but the contribution of the rate-dependent repolarization dynamics to the occurrence of VF is still unknown. Objective: The aim of our study was to determine the differences in rate-dependent repolarization dynamics between BrS with and without spontaneous VF and between BrS with and without SCN5A mutation. Methods: The subjects were 37 BrS patients with VF (VF(+) group: 10 male subjects) and without VF (VF(-) group: 27 male subjects) and 20 control subjects. Genetic analysis of SCN5A was performed in all 37 BrS patients. The relationships between QT, QTp, Tp-e, and RR intervals were obtained from Holter recordings as first linear regression lines, and the slopes of QT/RR, QTp/RR, and Tp-e/RR linear regression lines as the sensitivity of rate-dependent repolarization dynamics were compared. Results: QT/RR and Tp-e/RR slopes showed loss of a rate-dependent property in the VF(+) group compared with those in the VF(-) and control groups. There was no significant difference in QTp/RR slope among the VF(+), VF(-) and control groups. The Tp-e interval had a negative correlation with the RR interval in the VF(+) group and a positive correlation with the RR interval in the VF(-) and control groups. There was no significant difference in QT/RR, QTp/RR, and Tp-e/RR slopes between BrS patients with SCN5A mutation and those without SCN5A mutation. Conclusions: Loss of rate-dependent QT dynamics may be associated with occurrence of VF in BrS.

KW - Brugada syndrome

KW - QT interval

KW - SCN5A

KW - Ventricular fibrillation

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