title: Diurnal modulation and sources of variation affecting ventricular repolarization in Warmblood horses.
abstract: OBJECTIVE
  Irregularities in cardiac repolarization are known to predispose for arrhythmias and sudden cardiac death in humans. The QT interval is a quantitative measurement of repolarization, and clinically, the QTc (QT interval corrected for heart rate) and Tpeak to Tend intervals (TpTe) are used as repolarization markers. To support the use of these markers in horses, we sought to describe the possible influence of the environment, time of day, day-to-day effects, T wave conformation, age, body weight (BW), and horse-to-horse variation on repolarization measurements.
  
  
  METHODS
  12 Warmblood geldings, age 10.8 ± 4.8 years.
  
  
  METHODS
  Holter ECGs were performed on days 0, 7 and 14. Measures of RR, QT, QTp, QTc and TpTe intervals and T wave conformation were obtained each hour during the recordings. An ANCOVA analysis was performed to estimate diurnal variation and the sources of variation affecting these intervals.
  
  
  RESULTS
  Differences between individual horses were the largest source of repolarization variability although the environment had a significant effect on repolarization as well. Diurnal variation affected both the RR interval and the repolarization markers. The QT, QTc and TpTe intervals were prolonged on day 0. Biphasic T waves shortened the TpTe interval approximately 10 ms. Age and BW did not appear to affect repolarization.
  
  
  CONCLUSIONS
  Equine repolarization markers exhibit significant variation. Factors affecting repolarization measurements include horse-to-horse variation, diurnal variation, the environment, and T wave conformation. These factors must be considered if markers of equine repolarization are used diagnostically.
authors.affiliation: Department of Veterinary Clinical and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 100, 1870 Frederiksberg C, Denmark. Electronic address: philip@sund.ku.dk.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Pedersen
authors.affiliation: Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
authors.forename: Sine B
authors.initials: SB
authors.lastname: Moeller
authors.affiliation: Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Flethøj
authors.affiliation: Laboratory of Experimental Cardiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Koebenhavn N, Denmark; Department of Cardiology, Herlev and Gentofte University Hospitals, Denmark.
authors.forename: Joergen K
authors.initials: JK
authors.lastname: Kanters
authors.affiliation: Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Buhl
authors.affiliation: Department of Veterinary Clinical and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 100, 1870 Frederiksberg C, Denmark.
authors.forename: Dan A
authors.initials: DA
authors.lastname: Klaerke
mesh_terms: D000818:Animals; D054537:Atrioventricular Block; D002940:Circadian Rhythm / Q000502:physiology*; D015716:Electrocardiography, Ambulatory / Q000662:veterinary*; D006736:Horses / Q000502:physiology*; D008297:Male; D010275:Parasympathetic Nervous System / Q000502:physiology; D012848:Sinoatrial Block; D016276:Ventricular Function / Q000502:physiology*
keywords: Biphasic; ECG; QT interval; T wave; T(p)T(e) interval