Sökning: onr:"swepub:oai:DiVA.org:umu-62152" > Not all beta-blocke...
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000 | 04244naa a2200565 4500 | |
001 | oai:DiVA.org:umu-62152 | |
003 | SwePub | |
008 | 121210s2012 | |||||||||||000 ||eng| | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-621522 URI |
024 | 7 | a https://doi.org/10.1016/j.jacc.2012.07.0462 DOI |
040 | a (SwePub)umu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Chockalingam, Priya4 aut |
245 | 1 0 | a Not all beta-blockers are equal in the management of Long QT Syndrome types 1 and 2 :b higher recurrence of events under metoprolol |
264 | 1 | b Elsevier BV,c 2012 |
338 | a print2 rdacarrier | |
520 | a Objectives The purpose of this study was to compare the efficacy of beta-blockers in congenital long QT syndrome (LQTS). Background Beta-blockers are the mainstay in managing LQTS. Studies comparing the efficacy of commonly used beta-blockers are lacking, and clinicians generally assume they are equally effective.Methods Electrocardiographic and clinical parameters of 382 LQT1/LQT2 patients initiated on propranolol (n = 134), metoprolol (n = 147), and nadolol (n = 101) were analyzed, excluding patients <1 year of age at beta-blocker initiation. Symptoms before therapy and the first breakthrough cardiac events (BCEs) were documented.Results Patients (56% female, 27% symptomatic, heart rate 76 +/- 16 beats/min, QTc 472 +/- 46 ms) were started on beta-blocker therapy at a median age of 14 years (interquartile range: 8 to 32 years). The QTc shortening with propranolol was significantly greater than with other beta-blockers in the total cohort and in the subset with QTc >480 ms. None of the asymptomatic patients had BCEs. Among symptomatic patients (n = 101), 15 had BCEs (all syncopes). The QTc shortening was significantly less pronounced among patients with BCEs. There was a greater risk of BCEs for symptomatic patients initiated on metoprolol compared to users of the other 2 beta-blockers combined, after adjustment for genotype (odds ratio: 3.95, 95% confidence interval: 1.2 to 13.1, p = 0.025). Kaplan-Meier analysis showed a significantly lower event-free survival for symptomatic patients receiving metoprolol compared to propranolol/nadolol.Conclusions Propranolol has a significantly better QTc shortening effect compared to metoprolol and nadolol, especially in patients with prolonged QTc. Propranolol and nadolol are equally effective, whereas symptomatic patients started on metoprolol are at a significantly higher risk for BCEs. Metoprolol should not be used for symptomatic LQT1 and LQT2 patients.(J Am Coll Cardiol 2012;60:2092-9) (C) 2012 by the American College of Cardiology Foundation | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng |
653 | a breakthrough cardiac events | |
653 | a congenital long QT syndrome | |
653 | a metoprolol | |
653 | a nadolol | |
653 | a propranolol | |
700 | 1 | a Crotti, Lia4 aut |
700 | 1 | a Girardengo, Giulia4 aut |
700 | 1 | a Johnson, Jonathan N4 aut |
700 | 1 | a Harris, Katy M4 aut |
700 | 1 | a van der Heijden, Jeroen F4 aut |
700 | 1 | a Hauer, Richard NW4 aut |
700 | 1 | a Beckmann, Britt M4 aut |
700 | 1 | a Spazzolini, Carla4 aut |
700 | 1 | a Rordorf, Roberto4 aut |
700 | 1 | a Rydberg, Annikau Umeå universitet,Pediatrik4 aut0 (Swepub:umu)anry0014 |
700 | 1 | a Clur, Sally-Ann B4 aut |
700 | 1 | a Fischer, Markus4 aut |
700 | 1 | a van den Heuvel, Freek4 aut |
700 | 1 | a Kaeaeb, Stefan4 aut |
700 | 1 | a Blom, Nico A4 aut |
700 | 1 | a Ackerman, Michael J4 aut |
700 | 1 | a Schwartz, Peter J4 aut |
700 | 1 | a Wilde, Arthur AM4 aut |
710 | 2 | a Umeå universitetb Pediatrik4 org |
773 | 0 | t Journal of the American College of Cardiologyd : Elsevier BVg 60:20, s. 2092-2099q 60:20<2092-2099x 0735-1097x 1558-3597 |
856 | 4 | u https://doi.org/10.1016/j.jacc.2012.07.046 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-62152 |
856 | 4 8 | u https://doi.org/10.1016/j.jacc.2012.07.046 |
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