Utility of corrected QT interval in orthostatic intolerance

We performed this study to determine whether electrocardiographic corrected QT (QTc) interval predicts alterations in sympathovagal balance during orthostatic intolerance (OI). We reviewed 1,368 patients presenting with symptoms suggestive of OI who underwent electrocardiography and composite autono...

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Bibliographic Details
Published in:PloS one 2014-09, Vol.9 (9), p.e106417-e106417
Main Authors: Kim, Jung Bin, Hong, Soonwoong, Park, Jin-Woo, Cho, Dong-Hyuk, Park, Ki-Jong, Kim, Byung-Jo
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis
Autonomic nervous system
Axons - physiology
Balance
Bioindicators
Biology and Life Sciences
Biomarkers
Breathing
Cardiac arrhythmia
Cardiovascular disease
Comorbidity
Correlation analysis
Demography
Dispersion
EKG
Electrocardiography
Fainting
Female
Heart rate
Heart Rate - physiology
Humans
Hypertension
Hypotension
Hypotension, Orthostatic - diagnostic imaging
Hypotension, Orthostatic - physiopathology
Intolerance
Male
Medical records
Medicine
Medicine and Health Sciences
Middle Aged
Nervous system
Neurology
Orthostatic Intolerance - diagnostic imaging
Orthostatic Intolerance - physiopathology
Pathogenesis
Patients
Posture
Quality
Reflex
Respiration
Sweat
Syncope
Tachycardia
Ultrasonography
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Summary:We performed this study to determine whether electrocardiographic corrected QT (QTc) interval predicts alterations in sympathovagal balance during orthostatic intolerance (OI). We reviewed 1,368 patients presenting with symptoms suggestive of OI who underwent electrocardiography and composite autonomic function tests (AFTs). Patients with a positive response to the head-up tilt test were classified into orthostatic hypotension (OH), neurocardiogenic syncope (NCS), or postural orthostatic tachycardia syndrome (POTS) groups. A total of 275 patients (159 OH, 54 NCS, and 62 POTS) were included in the final analysis. Between-group comparisons of OI symptom grade, QTc interval, QTc dispersion, and each AFT measure were performed. QTc interval and dispersion were correlated with AFT measures. OH Patients had the most severe OI symptom grade and NCS patients the mildest. Patients with OH showed the longest QTc interval (448.8±33.6 msec), QTc dispersion (59.5±30.3 msec) and the lowest values in heart rate response to deep breathing (HRDB) (10.3±6.0 beats/min) and Valsalva ratio (1.3±0.2). Patients with POTS showed the shortest QTc interval (421.7±28.6 msec), the highest HRDB values (24.5±9.2 beats/min), Valsalva ratio (1.8±0.3), and proximal and distal leg sweat volumes in the quantitative sudomotor axon reflex test. QTc interval correlated negatively with HRDB (r = -0.443, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0106417