Influence of meals on variations of ST segment elevation in patients with Brugada syndrome.
BACKGROUND
Glucose-induced insulin secretion is one of the contributing factors to fluctuation of ST segment elevation in Brugada syndrome.


OBJECTIVE
The purpose of this study was to explore the influence of meals on variations of ST elevation in Brugada syndrome.


METHODS
We assessed changes of ST segment elevation in lead V1-3 on ECG before and after taking meals, at midnight, and at 3:00 a.m. in 20 patients with Brugada syndrome. Plasma glucose, insulin, and K(+) concentrations were measured. Variations of ST elevation were defined as morphological changes and/or augmentation of ST segment level by >1.0 mm.


RESULTS
Variations of ST segment morphology or elevation level after meals were observed in 15 of 20 patients (75%). ST elevation was augmented most markedly after dinner (3.3 +/- 1.7 mm) and decreased both at midnight (2.6 +/- 1.3 mm: P < 0.01 vs after dinner) and at 3:00 a.m. (2.4 +/- 1.2 mm: P < 0.01 vs after dinner). Morphologic changes and elevation levels of ST segment were associated with changes in glucose-induced insulin levels after meals, being highest after dinner (47 +/- 33 microU/mL) and decreasing significantly at midnight (7 +/- 4 microU/mL) and at 3:00 a.m. (5 +/- 2 microU/mL). There were no correlations between ST elevation and changes in serum K(+) level or heart rate.


CONCLUSIONS
The present findings suggest that variations of ST elevation are frequently associated with meals. Aggravation of ST elevation is most prominent in the evening to night after dinner rather than the period between midnight and early morning. This information may help to predict event times at high risk for life-threatening arrhythmias in Brugada syndrome.
Nishizaki
Mitsuhiro
M
Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan. nisizaki@yhb.att.ne.jp
Sakurada
Harumizu
H
Mizusawa
Yuka
Y
Niki
Saori
S
Hayashi
Tatsuya
T
Tanaka
Yasuaki
Y
Maeda
Shingo
S
Fujii
Hiroyuki
H
Ashikaga
Takashi
T
Yamawake
Noriyoshi
N
Isobe
Mitsuaki
M
Hiraoka
Masayasu
M
D000328:Adult; D000368:Aged; D053840:Brugada Syndrome / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014693:Ventricular Fibrillation / Q000503:physiopathology*