As QT variability increases and heart rate variability diminishes, the QT variability index (QTVI)-a non-invasive measure of beat-to-beat fluctuations in QT interval on a single ECG lead-shows a trend towards positive values. Increased QT variability is a risk factor for sudden death. Aging lengthens the QT interval and reduces RR-interval variability. In the present study we investigated the influence of aging and the autonomic nervous system on QT-interval variability in healthy subjects. We studied 143healthy subjects, and divided them into two age ranges (younger and older than 65 years). For each subject we measured two QTVIs: from the q wave to the end of the T wave (QTeVI) and to the apex of the T wave (QTaVI). Both indexes were calculated at baseline and after sympathetic stress. In 10 non-elderly subjects, both QTVIs were determined after β-adrenoreceptor blockade induced by intravenous infusion of propranolol or sotalol. The QTVI was higher in elderly than in younger subjects (P < 0.001). QTVIs obtained during sympathetic stress remained unchanged in the elderly, but became more negative in the younger group (P < 0.05). QTeVI and QTaVI at baseline were correlated positively with age (P < 0.01) and anxiety scores (P < 0.05), but inversely with the low-frequency spectral power of RR-interval variability (P < 0.001). QTVIs were higher in subjects with higher anxiety scores. In younger subjects, sotalol infusion increased both QTVIs significantly, whereas propranolol infusion did not. In conclusion, aging increases QT-interval variability. Whether this change is associated with an increased risk of sudden death remains unclear. The association of abnormal QT-interval variability with anxiety and with reduced low-frequency spectral power of heart rate variability merits specific investigation. In healthy non-elderly subjects, acute sympathetic stress (tilt) decreases the QTVI. β-Adrenoreceptor blockade inhibits this negative trend, thus showing its sympathetic origin. Because a negative trend in QTVI induced by sympathetic stress increases only in younger subjects, it could represent a protective mechanism that is lost with aging.
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October 2001
Research Article|
September 20 2001
Influence of age, the autonomic nervous system and anxiety on QT-interval variability
Gianfranco PICCIRILLO
;
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
Correspondence: Dr Gianfranco Piccirillo (e-mail piccirillog@uniroma1.it).
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Mauro CACCIAFESTA
;
Mauro CACCIAFESTA
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Marco LIONETTI
;
Marco LIONETTI
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Marialuce NOCCO
;
Marialuce NOCCO
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Vincenza DI GIUSEPPE
;
Vincenza DI GIUSEPPE
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Antonio MOISÈ
;
Antonio MOISÈ
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Camilla NASO
;
Camilla NASO
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Vincenzo MARIGLIANO
Vincenzo MARIGLIANO
1Dipartimento di Scienze dell'Invecchiamento, I Clinica Medica, Policlinico Umberto I, 00161 Rome, Italy
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Clin Sci (Lond) (2001) 101 (4): 429–438.
Article history
Received:
November 20 2000
Revision Received:
May 03 2001
Accepted:
June 21 2001
Citation
Gianfranco PICCIRILLO, Mauro CACCIAFESTA, Marco LIONETTI, Marialuce NOCCO, Vincenza DI GIUSEPPE, Antonio MOISÈ, Camilla NASO, Vincenzo MARIGLIANO; Influence of age, the autonomic nervous system and anxiety on QT-interval variability. Clin Sci (Lond) 1 October 2001; 101 (4): 429–438. doi: https://doi.org/10.1042/cs1010429
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