title: Influence of meals on variations of ST segment elevation in patients with Brugada syndrome.
abstract: 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.
authors: Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan. nisizaki@yhb.att.ne.jp
authors: Mitsuhiro
authors: M
authors: Nishizaki
authors: Harumizu
authors: H
authors: Sakurada
authors: Yuka
authors: Y
authors: Mizusawa
authors: Saori
authors: S
authors: Niki
authors: Tatsuya
authors: T
authors: Hayashi
authors: Yasuaki
authors: Y
authors: Tanaka
authors: Shingo
authors: S
authors: Maeda
authors: Hiroyuki
authors: H
authors: Fujii
authors: Takashi
authors: T
authors: Ashikaga
authors: Noriyoshi
authors: N
authors: Yamawake
authors: Mitsuaki
authors: M
authors: Isobe
authors: Masayasu
authors: M
authors: Hiraoka
mesh_terms: 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*