Electro-mechanical dysfunction in long QT syndrome: Role for arrhythmogenic risk prediction and modulation by sex and sex hormones.

Lang, C N; Menza, M; Jochem, S; Franke, G; Perez Feliz, S; Brunner, M; Koren, G; Zehender, M; Bugger, H; Jung, Bernd; Foell, D; Bode, C; Odening, K E (2016). Electro-mechanical dysfunction in long QT syndrome: Role for arrhythmogenic risk prediction and modulation by sex and sex hormones. Progress in biophysics and molecular biology, 120(1-3), pp. 255-269. Elsevier Science 10.1016/j.pbiomolbio.2015.12.010

[img] Text
1-s2.0-S007961071500259X-main.pdf__tid=a0f1f448-e14d-11e6-b5c3-00000aacb360&acdnat=1485163601_276bf16cf083b3fc1954acdb71624cb2 - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (3MB) | Request a copy

Long QT syndrome (LQTS) is a congenital arrhythmogenic channelopathy characterized by impaired cardiac repolarization. Increasing evidence supports the notion that LQTS is not purely an "electrical" disease but rather an "electro-mechanical" disease with regionally heterogeneously impaired electrical and mechanical cardiac function. In the first part, this article reviews current knowledge on electro-mechanical (dys)function in LQTS, clinical consequences of the observed electro-mechanical dysfunction, and potential underlying mechanisms. Since several novel imaging techniques - Strain Echocardiography (SE) and Magnetic Resonance Tissue Phase Mapping (TPM) - are applied in clinical and experimental settings to assess the (regional) mechanical function, advantages of these non-invasive techniques and their feasibility in the clinical routine are particularly highlighted. The second part provides novel insights into sex differences and sex hormone effects on electro-mechanical cardiac function in a transgenic LQT2 rabbit model. Here we demonstrate that female LQT2 rabbits exhibit a prolonged time to diastolic peak - as marker for contraction duration and early relaxation - compared to males. Chronic estradiol-treatment enhances these differences in time to diastolic peak even more and additionally increases the risk for ventricular arrhythmia. Importantly, time to diastolic peak is particularly prolonged in rabbits exhibiting ventricular arrhythmia - regardless of hormone treatment - contrasting with a lack of differences in QT duration between symptomatic and asymptomatic LQT2 rabbits. This indicates the potential added value of the assessment of mechanical dysfunction in future risk stratification of LQTS patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Jung, Bernd

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0079-6107

Publisher:

Elsevier Science

Language:

English

Submitter:

Karin Hofmann

Date Deposited:

19 Apr 2017 15:58

Last Modified:

19 Apr 2017 15:58

Publisher DOI:

10.1016/j.pbiomolbio.2015.12.010

PubMed ID:

26718598

Uncontrolled Keywords:

Cardiac repolarization; Contraction duration; Diastolic relaxation; Long QT syndrome; Mechanical dysfunction; Sex hormones

BORIS DOI:

10.7892/boris.94111

URI:

https://boris.unibe.ch/id/eprint/94111

Actions (login required)

Edit item Edit item
Provide Feedback