Electromechanical coupling in patients with the short QT syndrome: Further insights into the mechanoelectrical hypothesis of the U wave
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Background Patients with a short QT syndrome (SQTS) are at risk of sudden cardiac death (SCD). It is not known whether abbreviation of cardiac repolarization alters mechanical function in SQTS. Controversies persist regarding whether the U wave is a purely electrical or mechanoelectrical phenomenon.Objective The present study uses echocardiographic measurements to discriminate between the hypotheses for the origin of the U wave.Methods Diagnostic work-up including echocardiography and electrocardiogram was performed in 5 SQTS patients (39 +/- 19 years old) from 2 unrelated families with a history of SCD and 5 age-matched and gender-matched control subjects.Results QT intervals were 268 +/- 18 ms (QTc 285 +/- 28 ms) in SQTS versus 386 +/- 20 ms (QTc 420 +/- 22 ms) in control subjects (P < .005). In SQTS patients, the end of the T wave preceded aortic valve closure by 111 +/- 30 ms versus -12 +/- 11 ms in control subjects (P < .005). The interval from aortic valve closure to the beginning of the U wave was 8 +/- 4 ms in patients and 15 +/- 11 ms in control subjects (P = .25). Thus, the inscription of the U wave in SQTS patients coincided with aortic valve closure and isovolumic relaxation, supporting the hypothesis that the U wave is related to mechanical stretch.Conclusion Our data show for the first time a significant dissociation between the ventricular repolarization and the end of mechanical systole in SQTS patients. Coincidence of the U wave with termination of mechanical systole provides support for the mechanoelectrical hypothesis for the origin of the U wave.
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In short QT syndrome patients, the inscription of the U wave coincided with aortic valve closure and isovolumic relaxation, supporting the hypothesis that the U wave is related to mechanical stretch.
“Electrocardiographic and echocardiographic correlations 34 showed that the inscription of the U wave in SQTS patients coincided with aortic valve closure and isovolumic relaxation, supporting the hypothesis that the U wave is related to mechanical stretch.”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [34]
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Adeniran, I. (2014) · Springer theses · doi:10.1007/978-3-319-07200-5_9
- Authors
- Schimpf, R., Antzelevitch, C., Haghi, D., Giustetto, C., Pizzuti, A., Gaita, F., Veltmann, C., Wolpert, C., & Borggrefe, M.
- Affiliations
- University Medical Centre Mannheim (DE)
- Masonic Medical Research Laboratory (US)
- University of Turin (IT)
- Corresponding author
- Schimpf, Rainer
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 5
- Issue
- 2
- Pages
- 241-245
- ISSN
- 1547-5271 (ISSN-L)
- PMC
- PMC2366900
- OpenAlex
- W1976022862
- Cited by
- 73
- References
- 29
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 4 · 2012: 3
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL047678)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- short QT syndrome, U wave, sudden cardiac death, aortic valve closure, ventricular repolarization, isovolumic relaxation, echocardiography, electrocardiogram
- MeSH terms
- Adult, Arrhythmias, Cardiac, Echocardiography, Electrocardiography, Female, Heart Conduction System, Heart Ventricles, Humans, Male, Risk Factors, Stroke Volume, Time Factors, Case-Control Studies, Death, Sudden, Cardiac
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