QT dispersion in young athletes Original Article

Yıl 2007, Cilt: 42 Sayı: 3, 117 - 120, 01.09.2007

Figen Akalın Burcu Topçu İlhan Odabaş Birol Çotuk Sami Mengütay

Öz

Aim: The risk of sudden death due to ventricular hypertrophy in athletes is controversial The relation of increased QT dispersion QTd with non homogeneous ventricular repolarization and arrhythmia in patients with hypertrophic cardiomyopathy is previously demonstrated We investigated if sports related ventricular hypertrophy causes such an abnormality in ventricular repolarization Material and Method: Twenty eight swimmers and 20 healthy children between 9 and 12 5 years of age were evaluated by history physical examination 12 lead electrocardiography and echocardiography Heart rate QT interval corrected QT QTc QTd and QTc dispersion QTcd values were compared Results: Echocardiographic measurements of swimmers were within the normal limits according to their weight However the interventricular nbsp; septal nbsp; thickness IVSd nbsp; left ventricular nbsp; posterior nbsp; wall nbsp; thickness LVPWd nbsp; left ventricular end diastolic diameter LVDd left ventricular mass were significantly increased in swimmers compared to the control group p lt;0 0001 0 009 0 046 lt;0 0001 respectively There was no statistical difference in terms of heart rate QT interval QTc QTd QTcd Conclusions: Absence of increased QT dispersion in athletes indicates that the ventricular repolarization is not heterogeneous and the arrhythmia risk is not higher than the normal population in this group Turk Arch Ped 2007; 42: 117 20 Key words: QT dispersion athletes heart sudden death arrhythmia

Anahtar Kelimeler

-

Sporcu çocuklarda QT dispersiyonu Orijinal Araştırma

Öz

Amaç: Sporcularda görülen ventrikül hipertrofisinin ani ölüm riski yaratıp yaratmayacağı tartışmalıdır Hipertrofik kardiyomiyopatili hastalarda QT dispersiyonunun QTd homojen olmayan ventrikül repolarizasyonu ve aritmi riski ile ilişkisi bilinmektedir Çalışmamızda spora bağlı hipertrofinin benzer bir repolarizasyon bozukluğuna yol açıp açmadığı araştırılmıştır Gereç ve Yöntem: Dokuz ile 12 5 yaşları arasında 28 yüzücü ve 20 sağlıklı çocuk; öykü fizik muayene ekokardiyografi ve 12 derivasyonlu elektrokardiyografi EKG ile değerlendirildi Kalp hızı QT intervali düzeltilmiş QT intervali QTc QTd ve QTc dispersiyonu QTcd nbsp; karşılaştırıldı Bulgular: Sporcularda ekokardiyografik ölçümler kilolarına göre normal sınırlarda olmakla birlikte; nbsp; interventriküler septum IVSd ve sol ventrikül arka duvar kalınlıkları LVPWd sol ventrikül diyastol sonu çapı LVDd sol ventrikül kitlesi LVMI kontrol grubuna göre anlamlı olarak artmış bulundu sırasıyla p lt;0 0001 0 009 0 046 lt;0 0001 idi Kalp hızı QT intervali QTc QTd ve QTcd yönünden istatistiksel anlamlı fark bulunmadı Çıkarımlar: Sporcularda QTd’nin artmamış olması heterojen bir repolarizasyonun bulunmadığını ve normal topluma göre artmış ventriküler aritmi riski taşımadıklarını düşündürmektedir Türk Ped Arş 2007; 42: 117 20 Anahtar kelimeler: QT dispersiyonu sporcu kalbi ani ölüm aritmi

Anahtar Kelimeler

-

Kaynakça

• Kulan K, Komşuoğlu B, Tuncer C, Kulan C. Significance of QT dispersion in ventricular arrythmias in mitral valve prolapse. Int J Cardiol 1998; 54: 241-7.
• Van de loo A, Arendts W, Hohnloser SH. Variability of QT dis- persion measurements in the surface electrocardiogram in patients with acute myocardial infarction and in normal sub- jects. Am J Cardiol 1994; 74: 1113-8.
• Pekdemir M, Karaca I, Çevik Y, Yanturali S, İlkay E. Diagnostic value of QT dispersion for acute coronary syndrome in patients presenting with chest pain and nondiagnostic initial electrocar- diogram. Mt Sinai J Med 2006; 73: 813-7.
• Akalın F, Ayabakan C, Güran Ö, et al. Kistik Fibrozisli hastalar- da QT dispersiyonu. Çocuk Sağlığı ve Hastalıkları Dergisi 2004; 47: 244-8
• Garson A. How to measure the QT interval-What is normal? Am J Cardiol 1993; 72: 14-6B.
• Maron BJ, Gohman TE, Aeppli D. Prevalence of sudden cardiac death during competitive sports activities in Minnesota high school athletes. J Am Coll Cardiol. 1998; 32: 1881-4.
• Corrado D, Pelliccia A, Bjornstad HH, Thiene G. Cardiovascular pre-participation screening of young competitive athletes: pro- posal for a common European protocol. Eur Heart J 2005; 20: 516-24.
• Haider AW, Larson MG, Benjamin EJ, Levy D. Increased left vent- ricular mass and hypertrophy are associated with increased risk for sudden death. J Am Coll Cardiol 1998; 32: 1454-9.
• Barr CS, Naas A, Freeman M, Lang CC, Struthers AD. QT dis- persion and sudden unexpected death in chronic heart failure. Lancet 1994; 343: 327-9.
• Sharma S, Whyte G, Elliott P, et al. Electrocardiographic chan- ges in 1000 highly trained junior elite athletes. Br J Sports Med 1999; 33: 319-24.
• Bjornstad H, Starstein L, Meen HD, Hals O. Ambulatory elect- rocardiographic findings in top athletes, athletic students and control subjects. Cardiol 1994; 84: 42-50.
• Bjornstad H, Starstein L, Meen HD, Hals O. Electrocardiograp- hic findings of repolarization in athletic students and control subjects. Cardiol 1994; 84: 51-60.
• Zoghi M, Gurgun C, Yavuzgil O, et al. QT dispersion in patients
• with different etiologies of left ventricular hypertrophy: the sig
• nificance of QT dispersion in endurance athletes. Int J Cardiol 2002; 84: 153-9.
• Halle M, Huonker M, Hohnloser SH, Alivertis M, Berg A, Keul J. QT dispersion in exercise-induced myocardial hypertrophy. Am Heart J 1999; 138: 309-12.
• Turley KR. Cardiovascular responses to exercise in children. Sports Med 1997; 24: 241-57.
• Stolt A, Karila T, Viitasalo M, Kujala UM, Karjalainen J. QT inter- val and QT dispersion in endurance athletes and in power ath- letes using large doses of anabolic steroids. Am J Cardiol 1999; 84: 364-6.