Cardiovascular medicine
Effects of cardiac sympathetic innervation on regional wall
motion abnormality in patients with long QT syndrome
H Yamanari, K Nakayama, H Morita, K Miyazi, K Fukushima, H Matsubara, T Emori, T Ohe
Department of
Cardiovascular Medicine, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Correspondence to: Dr Yamanari
Accepted 26 October 1999
AIM
To assess the spatial relation between regional
cardiac sympathetic innervation and regional ventricular repolarisation
indicated by ventricular wall motion abnormality in patients with
congenital long QT syndrome.
DESIGNRegional percentage uptake and washout rate of
123I metaiodobenzylguanidine (MIBG) were measured to assess
cardiac sympathetic innervation in septum, anterior wall, lateral wall,
and posterior wall. Left ventricular short axis images on
echocardiography were digitised to reconstruct digitised M mode
echocardiograms, from which left ventricular wall thickness curves were
obtained. The wall thickening time (ThT) was defined as the period in
which the instantaneous wall thickness exceeded 90% of the maximum
wall thickness. The ThT was measured from the ventricular wall
thickness curve at the same segments where regional percentage uptake
and washout rate of 123I MIBG were measured.
PATIENTSSeven patients with long QT syndrome.
RESULTSThe regional washout rate (mean (SD)) of
123I MIBG in patients with long QT syndrome was greater in
the segments with decreased percentage uptake of 123I MIBG
than in those without (17.4 (10.6)% v 9.7 (16.5)%, p < 0.03). ThT in segments both with and without decreased
percentage uptake of 123I MIBG was longer than in control
subjects (p < 0.0001). ThT was longer in the segments with decreased
percentage uptake of 123I MIBG than in those without (199 (70) ms v 150 (66) ms, p = 0.0018).
CONCLUSIONSActivation of regional cardiac sympathetic
terminals is likely to participate in additional regional prolongation
of ventricular repolarisation in patients with long QT syndrome.
Keywords: long QT syndrome; sympathetic innervation; regional wall motion
© 2000 by Heart
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