Left Ventricular Contraction Duration Is the Most Powerful Predictor of Cardiac Events in LQTS: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Study Selection
2.3. Outcome Variables
2.4. Data Extraction
2.5. Quality Assessment
2.6. Statistical Analysis
3. Results
3.1. Search Results and Trial Flow
3.2. Characteristics of Included Studies
3.3. Electrical Abnormalities in LQTS vs. Controls
3.4. LV Mechanical Abnormalities in LQTS Patients vs. Controls
3.5. LV Mechanical Abnormalities in Asymptomatic vs. Symptomatic LQTS Patients
3.6. LV Mechanical Abnormalities in Asymptomatic LQTS Patients vs. Controls
3.7. EM Abnormalities in LQT1 vs. LQT2
3.8. Electrical and Mechanical Predictors of Cardiac Events in LQTS Patients
3.9. Risk of Bias Assessment
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Study (Year) | Study Design | Long QT Mutation | Inclusion Criteria | Exclusion Criteria | Electrical Abnormalities | Echocardiographic Abnormalities | Type of Long QT |
---|---|---|---|---|---|---|---|
Priori et al., 1994 | Observational | Y—RWS | RWS Patients | Follow-up patients after institution of therapy of at least 1 year | QT, QTC, RR, | NR | RWS |
relative QT dispersion, | |||||||
relative QTC dispersion | |||||||
Nakayama et al., 1998 | Observational—Prospective | NR | NR | NR | QT, QTC, QT | ThT | NR |
dispersion | |||||||
Savoye et al., 2003 | Observational | NR | Screened after identifying symptomatic LQTS patients in family | Age ≥ 16, patients with pacemaker, valvular or myocardial disease | RR, QTC | LVDd, EF, E/A | LQT1 |
LQT2 | |||||||
Leren et al., 2015 | Cross-sectional | Y—DM and SM | LQTS mutation-positive subjects were included from our outpatient clinic. | Concomitant cardiac disease of other origin. | QTC, HR | EF%, EDV, GLS, MD, CD, EMW, e’, E deceleration time, IVRT, LAVI, E/A, E/e’ | LQT1 |
LQT2 | |||||||
Patients with a diagnosis of hypertension or taking antihypertensive medication or with diabetes mellitus were excluded from diastolic measurements. | LQT3 | ||||||
Only subjects with a pathogenic mutation were included. | |||||||
Haugaa et al., 2009 | Observational | Y—SM and DM | Patients with previous cardiac | NR | QTC, RR | EF, CD by velocity, CD by strain, time to aortic valve closure, peak ejection velocity, PEV, Onset E’ wave, E/, E deceleration time | A and S |
Haugaa et al., 2010 | Observational | Y—Hom and Het | Genotyped patients | Asymptomatic patients younger than 18 years old | HR, QTC, QTC dispersion | EF, Global strain, CD longitudinal, CD circumferential, MD longitudinal, MD circumferential | A and S; |
LQT1 | |||||||
LQT2 | |||||||
LQT3 | |||||||
LQT5 | |||||||
Haugaa et al., 2013 | Observational—Retrospective Study | Y | Patients evaluated in Mayo’s LQT Clinic between August 1998 till December 2008 | 24 patients who did not accept to participate | HR, QTC, | EF, Left atrial volume indexed, E, e/, E/e’, E deceleration time | A and S; |
LQT1 | |||||||
LQT2 | |||||||
LQT3 | |||||||
LQT4 | |||||||
LQT5 | |||||||
LQT7 | |||||||
Hummel et al., 2013 | Observational | Y—SCN5a mutation 1795insD | Genotyped asymptomatic patients | NR | NR | LV end-diastolic dimension, LV mass, LA volume, EF, E, A-wave, E/A, DT, IVRT, e’ | A |
LQT3 | |||||||
ter Bekke et al., 2015 | Observational | Y—SM and DM—Hom and Het | Genotyped patients | NR | RR, QT, QTC | EF, EMW, QAoC | A and S |
LQT1 | |||||||
LQT2 | |||||||
LQT3 | |||||||
LQT6 | |||||||
Robyns et al., 2017 | Cross-sectional | Y | Patients with LQTS mutation and their genotype-negative family members who had both resting ECG and Holter recordings available were included | One patient with LQTS was excluded due to QT-RR correlation below 0.5 | ECG RR, ECG QTC, ECG QT, Holter T-wave amplitude, Holter QT-RR slope, Holter mean QT, Holter number of templates, Holter RR | NR | NR |
Children younger than 8 years were excluded because of high heart rates | |||||||
Vink et al., 2018 | Cross-sectional | Y | Children under 18 years old | Children above 18 years old | RR, QTC, QT | CD | NR |
Charisopoulou et al., 2019 | Observational—Retrospective Study | Y | RR, HR, QTC | EF, e’, a’, E/A, FT, ET, IVRT | LQT1 | ||
LQT2 |
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Abdelsayed, M.; Bytyçi, I.; Rydberg, A.; Henein, M.Y. Left Ventricular Contraction Duration Is the Most Powerful Predictor of Cardiac Events in LQTS: A Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 2820. https://doi.org/10.3390/jcm9092820
Abdelsayed M, Bytyçi I, Rydberg A, Henein MY. Left Ventricular Contraction Duration Is the Most Powerful Predictor of Cardiac Events in LQTS: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020; 9(9):2820. https://doi.org/10.3390/jcm9092820
Chicago/Turabian StyleAbdelsayed, Mena, Ibadete Bytyçi, Annika Rydberg, and Michael Y. Henein. 2020. "Left Ventricular Contraction Duration Is the Most Powerful Predictor of Cardiac Events in LQTS: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 9, no. 9: 2820. https://doi.org/10.3390/jcm9092820