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Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1

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)...

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Autores principales: Bari, Vlasta, Valencia, José F., Vallverdú, Montserrat, Girardengo, Giulia, Marchi, Andrea, Bassani, Tito, Caminal, Pere, Cerutti, Sergio, George, Alfred L., Brink, Paul A., Crotti, Lia, Schwartz, Peter J., Porta, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976293/
https://www.ncbi.nlm.nih.gov/pubmed/24705789
http://dx.doi.org/10.1371/journal.pone.0093808
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author Bari, Vlasta
Valencia, José F.
Vallverdú, Montserrat
Girardengo, Giulia
Marchi, Andrea
Bassani, Tito
Caminal, Pere
Cerutti, Sergio
George, Alfred L.
Brink, Paul A.
Crotti, Lia
Schwartz, Peter J.
Porta, Alberto
author_facet Bari, Vlasta
Valencia, José F.
Vallverdú, Montserrat
Girardengo, Giulia
Marchi, Andrea
Bassani, Tito
Caminal, Pere
Cerutti, Sergio
George, Alfred L.
Brink, Paul A.
Crotti, Lia
Schwartz, Peter J.
Porta, Alberto
author_sort Bari, Vlasta
collection PubMed
description 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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spelling pubmed-39762932014-04-08 Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1 Bari, Vlasta Valencia, José F. Vallverdú, Montserrat Girardengo, Giulia Marchi, Andrea Bassani, Tito Caminal, Pere Cerutti, Sergio George, Alfred L. Brink, Paul A. Crotti, Lia Schwartz, Peter J. Porta, Alberto PLoS One Research Article 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. Public Library of Science 2014-04-04 /pmc/articles/PMC3976293/ /pubmed/24705789 http://dx.doi.org/10.1371/journal.pone.0093808 Text en © 2014 Bari et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bari, Vlasta
Valencia, José F.
Vallverdú, Montserrat
Girardengo, Giulia
Marchi, Andrea
Bassani, Tito
Caminal, Pere
Cerutti, Sergio
George, Alfred L.
Brink, Paul A.
Crotti, Lia
Schwartz, Peter J.
Porta, Alberto
Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title_full Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title_fullStr Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title_full_unstemmed Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title_short Multiscale Complexity Analysis of the Cardiac Control Identifies Asymptomatic and Symptomatic Patients in Long QT Syndrome Type 1
title_sort multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long qt syndrome type 1
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976293/
https://www.ncbi.nlm.nih.gov/pubmed/24705789
http://dx.doi.org/10.1371/journal.pone.0093808
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