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Herzschrittmacherther Elektrophysiol. 2018 Mar;29(1):43-47. doi: 10.1007/s00399-017-0544-9. Epub 2017 Dec 12.

Electromechanical heterogeneity in the heart : A key to long QT syndrome?

Author information

1
Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
2
Faculty of Medicine, University of Freiburg, Freiburg, Germany.
3
Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
4
Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. katja.odening@universitaets-herzzentrum.de.
5
Faculty of Medicine, University of Freiburg, Freiburg, Germany. katja.odening@universitaets-herzzentrum.de.
6
Institute for Experimental Cardiovascular Medicine, Heart Center, University of Freiburg, Freiburg, Germany. katja.odening@universitaets-herzzentrum.de.

Abstract

In the healthy heart, physiological heterogeneities in structure and in electrical and mechanical activity are crucial for normal, efficient excitation and pumping. Alterations of heterogeneity have been linked to arrhythmogenesis in various cardiac disorders such as long QT syndrome (LQTS). This inherited arrhythmia disorder is caused by mutations in different ion channel genes and is characterized by (heterogeneously) prolonged cardiac repolarization and increased risk for ventricular tachycardia, syncope and sudden cardiac death. Cardiac electrical and mechanical function are not independent of each other but interact in a bidirectional manner by electromechanical and mechano-electrical coupling. Therefore, changes in either process will affect the other. Recent experimental and clinical evidence suggests that LQTS, which is primarily considered an "electrical" disorder, also exhibits features of disturbed mechanical function and heterogeneity, which in turn appears to correlate with the risk of arrhythmia in the individual patient. In this review, we give a short overview of the current knowledge about physiological and pathological, long QT-related electrical and mechanical heterogeneity in the heart. Also, their respective roles for future risk prediction approaches in LQTS are discussed.

KEYWORDS:

Arrhythmogenesis; Electromechanical interaction; Heart diseases; Ion channels; Risk stratification

PMID:
29234865
DOI:
10.1007/s00399-017-0544-9
[Indexed for MEDLINE]

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