ORIGINAL ARTICLE Heterogeneity of Ventricular Repolarization in Newborns With Severe Aortic Coarctation Gerardo Nigro • Vincenzo Russo • Anna Rago • Andrea Antonio Papa • Nadia Della Cioppa • Federica Di Meo • Antonio Corcione • Giuseppe Caianiello • Maria Giovanna Russo • Raffaele Calabro ` Received: 24 June 2011 / Accepted: 13 September 2011 / Published online: 4 October 2011 Ó Springer Science+Business Media, LLC 2011 Abstract Sudden death is a possible occurrence for newborns younger than 1 year with severe aortic coarcta- tion (CoA) before surgical correction. Basic research and animal experiments have shown electrophysiologic chan- ges during mechanical ventricular pressure overload. The current study aimed to evaluate the effect of severe CoA on the heterogeneity of ventricular repolarization by examin- ing corrected QT and JT interval dispersion (respectively, QTc-D and JTc-D) and electrocardiographic parameters of spatial heterogeneity of ventricular repolarization in new- borns with no associated congenital cardiac malformations. The study enrolled 30 isolated severe CoA neonates (age, 45 ± 15 days; 17 males) with normal size and wall thickness of the left ventricle before surgical correction and 30 age- and sex-matched healthy newborns used as control subjects. Heart rate, QRS duration, maximum and mini- mum QT and JT intervals, and QTc-D and JTc-D mea- surements were performed. The healthy control group did not significantly differ from the CoA group in terms of heart rate, weight, height, and echocardiographic parame- ters. Compared with the healthy control group, the CoA group presented significantly increased values of QTc-D (109.7 ± 43.4 vs. 23 ± 15 ms; P= 0.03) and JTc-D (99.1 ± 43.3 vs. 65.8 ± 24.1 ms; P= 0.04). A statisti- cally significant correlation was found between the Dopp- ler peak pressure gradient across the coarctation site and the values of QTc-D (r = 0.48; P= 0.03) and JTc-D (r= 0.42; P= 0.04). Our study showed significantly increased QTc-D and JTc-D in isolated CoA newborns with normal left ventricular geometry. Keywords Congenital heart disease Á JTc dispersion Á Neonates Á QTc dispersion Á Sudden death Aortic coarctation (CoA), a relatively common defect that accounts for 5% to 8% of all congenital heart defects, may be defined as a constricted aortic segment that comprises localized medial thickening with some infolding of the medial and superimposed neointimal tissue [22]. A signifi- cant afterload is imposed by CoA on the left ventricle, resulting in early increased wall stress and late compensatory ventricular hypertrophy. Sudden cardiac death can occur for infants younger than 1 year with undiagnosed CoA [23]. Clinical and experimental studies have suggested that the QTc-D and the JTc-D can reflect the physiologic var- iability of regional and ventricular repolarization [28] and can provide a substrate for life-threatening ventricular arrhythmias in hypertrophic cardiomyopathy [4], chronic heart failure [2], myocardial ischemia [11, 20] and beta thalassemia major [24]. To our knowledge, no previous study has directly examined QTc-D and JTc-D in newborns affected by severe CoA. Newborns affected by severe CoA, without ventricular hypertrophy, may provide a unique clinical opportunity to evaluate the early effects of pressure G. Nigro Á V. Russo Á A. Rago Á A. A. Papa Á F. Di Meo Á M. G. Russo Á R. Calabro ` Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy V. Russo (&) Via della Resistenza no. 48, 80021 Afragola, Naples, Italy e-mail: v.p.russo@libero.it N. D. Cioppa Á A. Corcione Department of Anestesy and Rianimation, Monaldi Hospital, Naples, Italy G. Caianiello Pediatric Cardiac Surgery Unit, Monaldi Hospital, Naples, Italy 123 Pediatr Cardiol (2012) 33:302–306 DOI 10.1007/s00246-011-0132-4