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Master Thesis

Apport de la mesure de la fenêtre électromécanique dans le syndrome du QT long congénital

Abstract : Congenital long QT syndrome (LQTS) is a channelopathy affecting 1/2000 patients and purveyor of sudden death. Screening for this heart disease is based on the measurement of the corrected QT interval (QTC) on the electrocardiogram. However, QTC measurement is sometimes contentious, and may be misleading in patients with concealed long QT syndrome (with normal range QTC). The adrenaline challenge was developed to respond to these complex situations and increase the sensitivity of LQTS diagnosis. We carried out a first retrospective study, on 79 patients, to evaluate the intra-and inter-observer reproducibility of this test, by 2 blind reading by 3 different operators. Our results showed a low concordance of the interpretation of the test between the different observers (kappa at 0.31). The adrenaline test is therefore poorly reproducible and appears unreliable to diagnose LQTS patients. We continued our scientific approach in order to evaluate a new diagnostic method: the measurement of the electro-mechanical window by phonocardiogramme. We conducted a second, prospective, controlled study of 31 LQTS-genotyped patients and 21 healthy subjects. Our results show that this test is not only feasible, simple and reproducible, but also superior to the measurement of QTc and the adrenaline test in terms of diagnostic sensitivity. The conclusions of this pilot study will allow us to broaden our research to a greater number of patients, and to study the prognostic value of this test.
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Submitted on : Monday, December 16, 2019 - 5:00:23 PM
Last modification on : Friday, October 23, 2020 - 4:34:50 PM
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  • HAL Id : dumas-02414655, version 1



Maxime Churet. Apport de la mesure de la fenêtre électromécanique dans le syndrome du QT long congénital. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02414655⟩



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