Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome

Wataru Shimizu, Takashi Noda, Hiroshi Takaki, Noritoshi Nagaya, Kazuhiro Satomi, Takashi Kurita, Kazuhiro Suyama, Naohiko Aihara, Kenji Sunagawa, Shigeyuki Echigo, Yoshihiro Miyamoto, Yasunao Yoshimasa, Kazufumi Nakamura, Tohru Ohe, Jeffrey Towbin, Silvia G. Priori, Shiro Kamakura

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Objectives. The aim of this study was to test the hypothesis that epinephrine test may have diagnostic value for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome (LQTS). Background. A differential response of dynamic QT interval to epinephrine infusion between LQT1, LQT2, and LQT3 syndromes has been reported, indicating the potential diagnostic value of the epinephrine test for genotyping the three forms. Methods. The responses of 12-lead ECG parameters to epinephrine were retrospectively examined in 15 LQT1, 10 LQT2, 8 LQT3, and 10 healthy volunteers to select the best ECG criteria for separating the four groups. The epinephrine test then was prospectively conducted in 42 probands clinically affected with LQTS, their 67 family members, and 10 new volunteers. The best criteria were applied in a blinded fashion to prospectively separate a different group of 31 LQT1, 23 LQT2, 6 LQT3, and 30 Control patients (10 genotype-negative LQT1, 10 genotype-negative LQT2 family members, and 10 volunteers). Results. The sensitivity (pene trance) by ECG diagnostic criteria was lower in LQT1 (68%) than in LQT2 (83%) or LQT3 (83%) before epinephrine and was improved with steady-state epinephrine in LQT1 (87%) and LQT2 (91%) but not in LQT3 (83%), without the expense of specificity (100%). The sensitivity and specificity to differentiate LQT1 from LQT2 were 97% and 96%, those from LQT3 were 97% and 100%, and those from Control were 97% and 100%, respectively, when Δ mean corrected Q-Tend ≥35ms at steady state was used. The sensitivity and specificity to differentiate LQT2 from LQT3 or Control were 100% and 100%, respectively, when Δ mean corrected Q-Tend ≥80ms at peak was used. Conclusions. Epinephrine infusion is a powerful test to predict t he genotype of LQT1, LQT2, and LQT3 syndromes as well as to improve the clinical diagnosis of genotype-positive patients, especially those with LQT1 syndrome.

Original languageEnglish (US)
Pages (from-to)276-283
Number of pages8
JournalHeart Rhythm
Volume1
Issue number3
DOIs
StatePublished - Sep 1 2004
Externally publishedYes

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Long QT Syndrome
Epinephrine
Genotype
Electrocardiography
Volunteers
Sensitivity and Specificity
Healthy Volunteers

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Shimizu, W., Noda, T., Takaki, H., Nagaya, N., Satomi, K., Kurita, T., ... Kamakura, S. (2004). Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome. Heart Rhythm, 1(3), 276-283. https://doi.org/10.1016/j.hrthm.2004.04.021

Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome. / Shimizu, Wataru; Noda, Takashi; Takaki, Hiroshi; Nagaya, Noritoshi; Satomi, Kazuhiro; Kurita, Takashi; Suyama, Kazuhiro; Aihara, Naohiko; Sunagawa, Kenji; Echigo, Shigeyuki; Miyamoto, Yoshihiro; Yoshimasa, Yasunao; Nakamura, Kazufumi; Ohe, Tohru; Towbin, Jeffrey; Priori, Silvia G.; Kamakura, Shiro.

In: Heart Rhythm, Vol. 1, No. 3, 01.09.2004, p. 276-283.

Research output: Contribution to journalArticle

Shimizu, W, Noda, T, Takaki, H, Nagaya, N, Satomi, K, Kurita, T, Suyama, K, Aihara, N, Sunagawa, K, Echigo, S, Miyamoto, Y, Yoshimasa, Y, Nakamura, K, Ohe, T, Towbin, J, Priori, SG & Kamakura, S 2004, 'Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome', Heart Rhythm, vol. 1, no. 3, pp. 276-283. https://doi.org/10.1016/j.hrthm.2004.04.021
Shimizu, Wataru ; Noda, Takashi ; Takaki, Hiroshi ; Nagaya, Noritoshi ; Satomi, Kazuhiro ; Kurita, Takashi ; Suyama, Kazuhiro ; Aihara, Naohiko ; Sunagawa, Kenji ; Echigo, Shigeyuki ; Miyamoto, Yoshihiro ; Yoshimasa, Yasunao ; Nakamura, Kazufumi ; Ohe, Tohru ; Towbin, Jeffrey ; Priori, Silvia G. ; Kamakura, Shiro. / Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome. In: Heart Rhythm. 2004 ; Vol. 1, No. 3. pp. 276-283.
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abstract = "Objectives. The aim of this study was to test the hypothesis that epinephrine test may have diagnostic value for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome (LQTS). Background. A differential response of dynamic QT interval to epinephrine infusion between LQT1, LQT2, and LQT3 syndromes has been reported, indicating the potential diagnostic value of the epinephrine test for genotyping the three forms. Methods. The responses of 12-lead ECG parameters to epinephrine were retrospectively examined in 15 LQT1, 10 LQT2, 8 LQT3, and 10 healthy volunteers to select the best ECG criteria for separating the four groups. The epinephrine test then was prospectively conducted in 42 probands clinically affected with LQTS, their 67 family members, and 10 new volunteers. The best criteria were applied in a blinded fashion to prospectively separate a different group of 31 LQT1, 23 LQT2, 6 LQT3, and 30 Control patients (10 genotype-negative LQT1, 10 genotype-negative LQT2 family members, and 10 volunteers). Results. The sensitivity (pene trance) by ECG diagnostic criteria was lower in LQT1 (68{\%}) than in LQT2 (83{\%}) or LQT3 (83{\%}) before epinephrine and was improved with steady-state epinephrine in LQT1 (87{\%}) and LQT2 (91{\%}) but not in LQT3 (83{\%}), without the expense of specificity (100{\%}). The sensitivity and specificity to differentiate LQT1 from LQT2 were 97{\%} and 96{\%}, those from LQT3 were 97{\%} and 100{\%}, and those from Control were 97{\%} and 100{\%}, respectively, when Δ mean corrected Q-Tend ≥35ms at steady state was used. The sensitivity and specificity to differentiate LQT2 from LQT3 or Control were 100{\%} and 100{\%}, respectively, when Δ mean corrected Q-Tend ≥80ms at peak was used. Conclusions. Epinephrine infusion is a powerful test to predict t he genotype of LQT1, LQT2, and LQT3 syndromes as well as to improve the clinical diagnosis of genotype-positive patients, especially those with LQT1 syndrome.",
author = "Wataru Shimizu and Takashi Noda and Hiroshi Takaki and Noritoshi Nagaya and Kazuhiro Satomi and Takashi Kurita and Kazuhiro Suyama and Naohiko Aihara and Kenji Sunagawa and Shigeyuki Echigo and Yoshihiro Miyamoto and Yasunao Yoshimasa and Kazufumi Nakamura and Tohru Ohe and Jeffrey Towbin and Priori, {Silvia G.} and Shiro Kamakura",
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T1 - Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome

AU - Shimizu, Wataru

AU - Noda, Takashi

AU - Takaki, Hiroshi

AU - Nagaya, Noritoshi

AU - Satomi, Kazuhiro

AU - Kurita, Takashi

AU - Suyama, Kazuhiro

AU - Aihara, Naohiko

AU - Sunagawa, Kenji

AU - Echigo, Shigeyuki

AU - Miyamoto, Yoshihiro

AU - Yoshimasa, Yasunao

AU - Nakamura, Kazufumi

AU - Ohe, Tohru

AU - Towbin, Jeffrey

AU - Priori, Silvia G.

AU - Kamakura, Shiro

PY - 2004/9/1

Y1 - 2004/9/1

N2 - Objectives. The aim of this study was to test the hypothesis that epinephrine test may have diagnostic value for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome (LQTS). Background. A differential response of dynamic QT interval to epinephrine infusion between LQT1, LQT2, and LQT3 syndromes has been reported, indicating the potential diagnostic value of the epinephrine test for genotyping the three forms. Methods. The responses of 12-lead ECG parameters to epinephrine were retrospectively examined in 15 LQT1, 10 LQT2, 8 LQT3, and 10 healthy volunteers to select the best ECG criteria for separating the four groups. The epinephrine test then was prospectively conducted in 42 probands clinically affected with LQTS, their 67 family members, and 10 new volunteers. The best criteria were applied in a blinded fashion to prospectively separate a different group of 31 LQT1, 23 LQT2, 6 LQT3, and 30 Control patients (10 genotype-negative LQT1, 10 genotype-negative LQT2 family members, and 10 volunteers). Results. The sensitivity (pene trance) by ECG diagnostic criteria was lower in LQT1 (68%) than in LQT2 (83%) or LQT3 (83%) before epinephrine and was improved with steady-state epinephrine in LQT1 (87%) and LQT2 (91%) but not in LQT3 (83%), without the expense of specificity (100%). The sensitivity and specificity to differentiate LQT1 from LQT2 were 97% and 96%, those from LQT3 were 97% and 100%, and those from Control were 97% and 100%, respectively, when Δ mean corrected Q-Tend ≥35ms at steady state was used. The sensitivity and specificity to differentiate LQT2 from LQT3 or Control were 100% and 100%, respectively, when Δ mean corrected Q-Tend ≥80ms at peak was used. Conclusions. Epinephrine infusion is a powerful test to predict t he genotype of LQT1, LQT2, and LQT3 syndromes as well as to improve the clinical diagnosis of genotype-positive patients, especially those with LQT1 syndrome.

AB - Objectives. The aim of this study was to test the hypothesis that epinephrine test may have diagnostic value for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome (LQTS). Background. A differential response of dynamic QT interval to epinephrine infusion between LQT1, LQT2, and LQT3 syndromes has been reported, indicating the potential diagnostic value of the epinephrine test for genotyping the three forms. Methods. The responses of 12-lead ECG parameters to epinephrine were retrospectively examined in 15 LQT1, 10 LQT2, 8 LQT3, and 10 healthy volunteers to select the best ECG criteria for separating the four groups. The epinephrine test then was prospectively conducted in 42 probands clinically affected with LQTS, their 67 family members, and 10 new volunteers. The best criteria were applied in a blinded fashion to prospectively separate a different group of 31 LQT1, 23 LQT2, 6 LQT3, and 30 Control patients (10 genotype-negative LQT1, 10 genotype-negative LQT2 family members, and 10 volunteers). Results. The sensitivity (pene trance) by ECG diagnostic criteria was lower in LQT1 (68%) than in LQT2 (83%) or LQT3 (83%) before epinephrine and was improved with steady-state epinephrine in LQT1 (87%) and LQT2 (91%) but not in LQT3 (83%), without the expense of specificity (100%). The sensitivity and specificity to differentiate LQT1 from LQT2 were 97% and 96%, those from LQT3 were 97% and 100%, and those from Control were 97% and 100%, respectively, when Δ mean corrected Q-Tend ≥35ms at steady state was used. The sensitivity and specificity to differentiate LQT2 from LQT3 or Control were 100% and 100%, respectively, when Δ mean corrected Q-Tend ≥80ms at peak was used. Conclusions. Epinephrine infusion is a powerful test to predict t he genotype of LQT1, LQT2, and LQT3 syndromes as well as to improve the clinical diagnosis of genotype-positive patients, especially those with LQT1 syndrome.

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