Clinical Value of a Special Treadmill Exercise Testing Protocol as an Auxiliary Diagnosis Tool for Patients With Long QT Syndrome
10.3969/j.issn.1000-3614.2025.07.004
- VernacularTitle:基于运动平板试验辅助诊断长QT综合征的检查方案探索
- Author:
Fang LIU
1
;
Lumian CHEN
1
;
Guoying LU
1
;
Yao ZHANG
1
;
Jia HE
1
;
Yi ZHANG
1
;
Jingjing YANG
1
;
Xiaolei SHI
1
;
Mingyang GUAN
1
;
Huaibing CHENG
1
;
Xiaohan FAN
1
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 功能检测科,北京 100037
- Publication Type:Journal Article
- Keywords:
long QT syndrome;
treadmill exercise testing;
QT interval;
QT interval correction
- From:
Chinese Circulation Journal
2025;40(7):659-665
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:QT interval prolongation during treadmill test exercise is one of the clinical feature of patients with long QT syndrome(LQTS).This study aimed to explore the feasibility and efficacy of treadmill exercise testing as an auxiliary diagnosis tool for LQTS in clinical practice.Methods:We enrolled normal healthy individuals,common cardiovascular disease patients,and clinically diagnosed or suspected LQTS patients,who underwent treadmill exercise test from July 2023 to July 2024 at Fuwai Hospital.A special treadmill exercise testing procedure was designed to record the QT interval correction(QTc)intervals of the twelve lead electrocardiogram at 6 time points when performing the exercise tablet,including supine,sitting,standing,peak exercise,and recovery at 1-minute and 4-minute.The differences in QTc intervals among healthy group,cardiovascular diseases group,and suspected LQTS group were compared.Results:A total of 80 cases were consecutively enrolled,including 37 normal healthy controls,25 patients with common cardiovascular disease,and 18 patients with suspected LQTS.The QTc intervals at 6 points did not differ significantly between normal healthy controls and patients with cardiovascular disease,with QTc intervals less than 480 ms at all measurement.For patients with suspected LQTS,67.7%(12/18)of these patients presented a QTc interval≥480 ms at the 4-minute during recovery period.Among them,5 cases were confirmed to have pathogenic gene mutations of LQTS by genetic testing(including 1 case with a lying electrocardiogram QTc interval of 489 ms diagnosed with LQTS 1 type and a QTc interval of 636 ms during the 4-minute recovery period after exercise);5 clinically diagnosed patients(negative or undetectable in genetic testing)with a Schwartz score≥4,and the remaining 2 patients had a Schwartz score of 3.The remaining 5/18 patients,include 2 patients with clinical Schwartz scores≥4 and 3 patients with clinical suspicion(Schwartz scores 2-3)had a 4 min QTc interval of 445-480 ms during exercise recovery.Another patient with clinical suspicion(Schwartz score 3)had a 4 min QTc interval of<445 ms during exercise recovery and a negative genetic test at a later stage.Receiver operating characteristic curve analysis showed a sensitivity of 83.3%and specificity of 98.4%for QTc interval≥482 ms during the 4-minute recovery period of exercise as the LQTS diagnostic cutoff.Conclusions:This study results suggest that this special treadmill exercise testing protocol is effective in identifying LQTS and has strong feasibility and generalizability for clinical practice.
