In pediatric structural heart disease with HF, QTc prolongation tied to ventricular dysfunction

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-06-20T10:00:08+05:30 | Updated On 20 Jun 2022 2:53 PM IST

Canada: In pediatric structural heart disease (SHD) with heart failure, each QTc and QRS prolongation are associated with ventricular dysfunction, a recent study in Pediatric Cardiology has stated.

Further, QTc prolongation is an indication of poor outcomes in cardiomyopathy (CM) and structural heart disease groups, leading to a higher death or transplantation risk. The progressive lengthening of QTc over time in pediatric patients with heart failure and reduced ejection fraction (HFrEF) may indicate an increased risk in this population.

Previous studies on adults have shown that depolarization and repolarization abnormalities are associated with worsening heart failure. However, in pediatric congenital heart disease, this relationship is not well understood. Elizabeth Stephenson, Department of Pediatrics, SickKids Hospital, Toronto, ON, Canada, and colleagues, therefore, aimed to evaluate the association between QTc and QRS duration to systolic function and outcome in children with HFrEF.

For this purpose, the researchers performed a retrospective, single-center, 14-year cohort study of HFrEF children. Clinical records, electrocardiograms, and echocardiograms were reviewed for every clinical encounter. Collection of diagnosis, outcomes, interventions, QRS and QTc duration, and systolic function was done. The association between depolarization and repolarization to cardiac function. The effects of age, and time since diagnosis were examined and measured and change in QTc and QRS duration on time to transplant/death.

136 cardiomyopathy (CM) and 47 structural heart disease (SHD) patients were enrolled.

Key findings of the study include:

Prolonged QRS and QTc were associated with systolic dysfunction. This association was significant in SHD group, but not CM group.
The progressive lengthening of QTc was significantly associated with transplant or death in the overall cohort (HR 1.02), SHD, (HR 1.020), and CM (HR 1.017).

The researchers concluded, "progressive lengthening of QTc over time in children with HFrEF may indicate an increased risk in this population."

Reference:

Mah, K., Chen, S., Chandhoke, G. et al. QTc and QRS Abnormalities are Associated with Outcome in Pediatric Heart Failure. Pediatr Cardiol (2022). https://doi.org/10.1007/s00246-022-02932-x

Pediatric Cardiologystructural heart diseaseheart failurereduced ejection fraction

Source : Pediatric Cardiology

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751