Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1

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dc.contributor.authorBari, Vlastaen_ZA
dc.contributor.authorValencia, Jose F.en_ZA
dc.contributor.authorVallverdu, Montserraten_ZA
dc.contributor.authorGirardengo, Giuliaen_ZA
dc.contributor.authorMarchi, Andreaen_ZA
dc.contributor.authorBassani, Titoen_ZA
dc.contributor.authorCaminal, Pereen_ZA
dc.contributor.authorCerutti, Sergioen_ZA
dc.contributor.authorGeorge, Alfred L.en_ZA
dc.contributor.authorBrink, Paul A.en_ZA
dc.contributor.authorCrotti, Liaen_ZA
dc.contributor.authorSchwartz, Peter J.en_ZA
dc.contributor.authorPorta, Albertoen_ZA
dc.date.accessioned2016-03-03T10:53:55Z
dc.date.available2016-03-03T10:53:55Z
dc.date.issued2014-04-04
dc.descriptionCITATION: Bari, V. et al. 2014. Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1. PLoS ONE, 9(4):e93808, doi:10.1371/journal.pone.0093808.
dc.descriptionThe original publication is available at http://journals.plos.org/plosone
dc.description.abstractThe 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.en_ZA
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093808
dc.description.versionPublisher's version
dc.format.extent10 pages
dc.identifier.citationBari, V. et al. 2014. Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1. PLoS ONE, 9(4):e93808, doi:10.1371/journal.pone.0093808.
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0093808
dc.identifier.urihttp://hdl.handle.net/10019.1/98251
dc.language.isoen_ZAen_ZA
dc.publisherPLoS
dc.rights.holderAuthors retain copyright
dc.subjectlong QT syndrome type 1en_ZA
dc.subjectLong QT syndromeen_ZA
dc.titleMultiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1en_ZA
dc.typeArticleen_ZA
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