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Síndrome del intervalo QT largo después de los 40 años
Ilan Goldenberg1, Arthur J Moss, James Bradley
1Cardiology Division of the Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. Ilan.Goldenberg@heart.rochester.edu
Circulation
|April 23, 2008
Resumen
Los pacientes con síndrome congénito de QT largo (SQTL) mayores de 40 años aún enfrentan riesgos significativos de eventos cardíacos. Factores como el género, el síncope reciente y el genotipo LQT3 influyen en los resultados en esta población mayor.
Área de la Ciencia:
- Cardiología Cardiología.
- Genética La genética.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- Las investigaciones anteriores sobre el síndrome congénito de QT largo (SQTL) se centraron principalmente en individuos más jóvenes.
- La trayectoria clínica del LQTS en las poblaciones mayores sigue siendo poco estudiada.
Objetivo del estudio:
- Investigar el riesgo de eventos cardíacos potencialmente mortales en pacientes con LQTS de entre 41 y 75 años.
- Identificar los factores que influyen en el riesgo de eventos cardíacos en pacientes de LQTS mayores.
Principales métodos:
- Análisis de 2759 sujetos del Registro Internacional LQTS, categorizados por el intervalo QT corregido (QTc).
- Evaluación del riesgo de paro cardíaco abortado o muerte en diferentes rangos de edad (41-60 y 61-75).
- Evaluación de las diferencias de género, la historia clínica (sincope) y las mutaciones genéticas (genotipo LQT3) como factores de riesgo.
Principales resultados:
- Los pacientes con LQTS de 41 a 60 años tenían un riesgo significativamente mayor (HR 2.65) de eventos cardíacos en comparación con los individuos no afectados.
- El riesgo disminuyó en el grupo de edad 61-75 (HR 1.23), pero se mantuvo elevado.
- Las mujeres afectadas tenían tasas de eventos más altas (26%) que las mujeres limítrofes (16%) y no afectadas (12%); las tasas de hombres fueron similares en todos los grupos.
- El síncope reciente (HR 9.92) y el genotipo LQT3 (HR 4.76) fueron predictores significativos de eventos adversos.
Conclusiones:
- Los pacientes con síndrome congénito de QT largo mayores de 40 años siguen teniendo un riesgo sustancial de eventos cardíacos potencialmente mortales.
- La manifestación de LQTS en adultos mayores está determinada por factores relacionados con la edad, incluyendo el género, la historia clínica y mutaciones genéticas específicas.
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