Cervical Rib and Subclavian Thrombosis

Abstract

<h3>OBJECTIVE</h3> To investigate whether QT dispersion is a reliable index of the severity of aortic stenosis and left ventricular hypertrophy in the setting of aortic stenosis. <h3>DESIGN</h3> A retrospective analysis of the results of echocardiography and electrocardiography before and after aortic valve replacement. <h3>SETTING</h3> Tertiary centre. <h3>PATIENTS</h3> 36 men (30 white and six black) with symptomatic aortic stenosis requiring valve replacement. <h3>RESULTS</h3> All patients had significant aortic stenosis (mean (SD) aortic valve area 0.68 (0.18) cm²) and evidence of left ventricular hypertrophy (left ventricular mass index (LVMI): 267 (90) g/m²). Before aortic valve replacement, QT dispersion was correlated with mean aortic valve area and LVMI (<i>r</i> = 0.697, p &lt; 0.001, and <i>r</i> = 0.59, p &lt; 2.4 × 10⁻⁶, respectively). QT dispersion and QT corrected for heart rate dispersion decreased from 133 (54) to 71 (33) ms and from 151 (64) to 94 (76) ms, respectively (p &lt; 0.001 for both). LVMI regressed after aortic valve replacement to 190 (79) g/m², p &lt; 0.01. <h3>CONCLUSIONS</h3> QT dispersion is increased in association with LVMI in patients with significant symptomatic aortic stenosis. Aortic valve replacement reduces QT dispersion and LVMI. QT dispersion could be a useful indicator of risk and risk reduction in patients with significant symptomatic aortic stenosis.