ABSTRACT
OBJECTIVE: The aim of this study was to investigate the relation of QT dispersion to left ventricular (LV) systolic and diastolic function in patients undergoing anthracycline therapy. METHODS: We used echocardiography to evaluate LV systolic and diastolic function and electrocardiography to evaluate QT dispersion and corrected QT dispersion (QTcD) in patients with hematological diseases, who received anthracycline therapy. PATIENTS: Seventy-two patients with hematological diseases who were receiving anthracycline treatment were enrolled in the present study. RESULTS: LV end-diastolic diameter or LV end-systolic diameter had a significant positive correlation to QTcD (r = 0.35, p < 0.01, r = 0.43, p < 0.01). Also left ventricular ejection fraction of (LVEF) or fractional shortening had a significant negative correlation to QTcD (r = -0.46, p < 0.001, r = -0.27, p = 0.02). The highest QTcD group had a significantly larger LV end-diastolic diameter or LV end-systolic diameter than the lowest QTcD [48.5 +/- 5.7 vs. 44.4 +/- 4.5 (mm), p < 0.001, 34.1 +/- 6.4 vs. 28.8 +/- 4.3 (mm), p < 0.001] and the highest QTcD group had a significantly lower LVEF than the lowest QTcD [57.5 +/- 8.0 vs. 65.5 +/- 6.4 (%), p < 0.001]. On the other hand, none of the diastolic function markers were significantly correlated with QTcD. CONCLUSION: We concluded that increased QTcD is correlated with LV dilation and systolic dysfunction induced by anthracycline therapy, and does not reflect a dispersion of ventricular repolarization or asynchronous motion.
Subject(s)
Anthracyclines/adverse effects , Echocardiography, Doppler , Electrocardiography , Heart Conduction System/drug effects , Long QT Syndrome/chemically induced , Adolescent , Adult , Aged , Analysis of Variance , Anthracyclines/therapeutic use , Automation , Case-Control Studies , Diastole/drug effects , Dose-Response Relationship, Drug , Female , Heart Conduction System/physiopathology , Heart Function Tests , Hematologic Neoplasms/drug therapy , Hematologic Neoplasms/pathology , Humans , Male , Middle Aged , Probability , Reference Values , Sensitivity and Specificity , Systole/drug effectsABSTRACT
BACKGROUND: Endothelial dysfunction leads to atherosclerosis and the hypothesis of the present study was that the systemic circulatory response during exercise would be a manifestation of endothelial dysfunction. METHODS AND RESULTS: The circulatory response to exercise of 1,214 apparently healthy people (946 men, mean age 51.2 +/- 10.3; 268 women, mean age 52.7 +/- 10.1) was investigated, as well as the number of coronary risk factors. Systemic vascular resistance (SVR) was calculated from heart rate, blood pressure and oxygen uptake at rest and at maximal exercise during a ramp protocol using a bicycle ergometer. SVRs at rest (1,751-2,001 (dynes.s.cm(-5)) in women and 1,528-1,564 in men) did not significantly differ among the groups by number of coronary risk factors. At maximal exercise, however, they were lower in the group with fewer risk factors; that is, among women 929 (dynes.s.cm (-5)) with no risk factor to 1,305 with 5 risk factors; among men 793 with 1 risk factor to 1,170 with 6 risk factors. CONCLUSIONS: Those with more coronary risk factors showed a lower but lengthier reduction in SVR during exercise. This weak circulatory response to exercise is a manifestation of deteriorated circulatory function in coronary high-risk subjects.
Subject(s)
Coronary Circulation/physiology , Coronary Disease/physiopathology , Endothelium, Vascular/physiopathology , Exercise Tolerance/physiology , Exercise/physiology , Adaptation, Physiological , Adult , Arteriosclerosis/epidemiology , Arteriosclerosis/physiopathology , Blood Pressure , Body Mass Index , Coronary Disease/epidemiology , Exercise Test , Female , Heart Rate , Humans , Japan/epidemiology , Male , Middle Aged , Ophthalmoscopy , Oxygen Consumption , Risk Factors , Vascular ResistanceABSTRACT
Of 2,722 people (1.876 men, mean age: 51.3+/-10.3 years; 846 women, mean age: 51.4+/-11.1) who underwent the fitness check program at Aichi Prefectural Center for Health Care, the concentration of C-reactive protein (CRP) and the white blood cell count (WBC) were investigated in relation to the number of coronary risk factors, maximum oxygen uptake (VO2max) quartiles and physical fitness score. CRP was measured by conventional latex immunoturbidimetric assay. Both CRP and WBC were higher in those who had more risk factors. In men the lowest mean CRP was 0.07 mg/dl in those with only one risk factor (RF1) and the highest was 0.29 mg/dl in RF6 (p<0.0001). The lowest mean WBC was 4,868/mm3 in RF1 and the highest was 7,096/mm3 in RF6 (p<0.0001). In women the lowest mean CRP was 0.073 mg/dl in those with no risk factors (RF0) and the highest was 0.22mg/dl in RF5 (p=0.0379). The lowest mean WBC was 5,065/mm3 in RF1, and the highest was 6,792/mm3 in RF4 (p=0.0001). A similar relationship was noticed when the groups were analyzed by VO2max quartile or fitness score. CRP and WBC both showed a stepwise increase or decrease in men, but was generally in order in women in accordance with the number of risk factors, VO2max level or fitness score. In apparently healthy Japanese subjects, elevated inflammatory indices (ie, higher CRP and WBC) were associated with more coronary risk factors and poorer physical fitness. Therefore, high-risk coronary subjects might be screened by conventional measurement of CRP.
