Acute reduction of ventricular volume decreases QT interval dispersion in elderly subjects with and without heart failure

Abstract

To evaluate the effects of acute reduction in ventricular volume (VV) on QT interval dispersion (QTd), 14 men with heart failure (HF; 74.5 ± 2 yr of age) and 11 healthy male control subjects (68 ± 2 yr of age) were studied. For 15 min, lower body negative pressure (LBNP) was applied at −15 and −40 mmHg to reduce venous return. At baseline and during LBNP application, QTd was measured with an 87-lead, body-surface-mapping device; chamber volumes were assessed by radioisotope ventriculography; blood pressure (BP) and heart rate (HR) were continuously monitored; and blood samples were obtained for assessment of norepinephrine (Nor) levels. At −15 mmHg, LNBP application induced a significant decrease in VV but did not change BP and HR in both groups. In addition, Nor levels increased significantly ( P ≤ 0.05) in the control group (from 286.7 ± 31.5 to 388.8 ± 41.2 pg/ml) and in HF patients (from 405.8 ± 56 to 477.6 ± 47 pg/ml), and QTd was significantly ( P ≤ 0.05) decreased in the control group (57.2 ± 3.8 vs. 49.1 ± 3.4 ms) and in HF patients (67.8 ± 6 vs. 63.7 ± 5.9 ms). No additional decreases in VV or QTd were produced by −40 mmHg LNBP, but Nor levels did increase in both groups and reach 475.5 ± 34 and 586.5 ± 60 pg/ml ( P < 0.05) in the control and HF groups, respectively; BP did not change, but HR also increased in both groups. In conclusion, an acute LBNP-induced reduction in VV caused a decrease in the QTd of elderly men regardless of the existence of HF. Because increased sympathetic activity with more intense LBNP was not accompanied by additional changes in QTd, altered QTd may be better related to changes in VV than to autonomic nervous system activity.