School-based routine screenings of electrocardiograms for the diagnosis of long QT syndrome

被引:7
作者
Fukuyama, Megumi [1 ]
Horie, Minoru [1 ]
Aoki, Hisaaki [2 ]
Ozawa, Junichi [3 ]
Kato, Koichi [1 ]
Sawayama, Yuichi [1 ]
Tanaka-Mizuno, Sachiko [4 ]
Makiyama, Takeru [5 ]
Yoshinaga, Masao [6 ]
Nakagawa, Yoshihisa [1 ]
Ohno, Seiko [7 ]
机构
[1] Shiga Univ Med Sci, Dept Cardiovasc Med, Otsu, Shiga, Japan
[2] Osaka Womens & Childrens Hosp, Dept Pediat Cardiol, Osaka, Japan
[3] Niigata Univ, Dept Pediat, Grad Sch Med & Dent Sci, Niigata, Japan
[4] Shiga Univ Med Sci, Dept Med Stat, Otsu, Shiga, Japan
[5] Kyoto Univ, Dept Cardiovasc Med, Grad Sch Med, Kyoto, Japan
[6] Natl Hosp Org Kagoshima Med Ctr, Dept Pediat, Kagoshima, Japan
[7] Natl Cerebral & Cardiovasc Ctr, Dept Biosci & Genet, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan
来源
EUROPACE | 2022年 / 24卷 / 09期
关键词
Long QT syndrome; Genetic testing; School-based electrocardiogram screening; Arrhythmia; MANAGEMENT; ADOLESCENTS; ARRHYTHMIA; MUTATIONS; GENETICS; CHILDREN;
D O I
10.1093/europace/euab320
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims School-based routine screenings of electrocardiograms (ECGs) have been performed upon admission to primary school (PS), junior high school (JHS), and high school (HS) in Japan. Though ECGs with prolonged QT intervals are occasionally found, the role of regular ECG screening tests in identifying long QT syndrome (LQTS) remains to be determined. We investigated the usefulness of the ECG screenings by comparing the results of genetic tests between students who showed QT-prolongation in the screenings and patients with LQTS. Methods and results We genetically screened 341 students (106 PS, 173 JHS, and 62 HS). Of these, 230 subjects showed QT-prolongation during regular screenings (S-S group), and the other 111 patients were clinically consulted with suspected LQTS by paediatricians (C-C group). Genotype-phenotype relationships were compared between the two groups. The positive rates in the genetic tests were comparable among the two groups; however, symptomatic subjects were significantly fewer in the S-S group than the C-C group (3% vs. 70%). Compared to the genotype-negative subjects, the positive subjects showed significantly longer QTc (P < 0.0001) and more frequently presented LQTS risk scores with >= 3.5 points (P < 0.0001). Lethal arrhythmic events (LAE) occurred only in the C-C group; 18 subjects experienced LAE and 83% of them were found to carry variant(s) in the LQTS-related genes. Conclusion The school-based ECG screenings are effective in identifying young patients with LQTS who require genetic analysis. If individuals are screened at a younger age, we can identify patients at risk earlier and provide preventative treatments.
引用
收藏
页码:1496 / 1503
页数:8
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