Natural History and Risk Stratification

The increased availability of data collected among genotyped LQTS patients has allowed developing risk-stratification models based on the genetic substrate. Zareba et al. in 1998 provided the first gene-specific assessment of the natural history of the disease.[24] Such observations were further refined by Priori et al.[25] who also provided the first risk-stratification scheme based on the genotype. This study showed that the QT interval duration, the genotype, and the gender are significantly associated with the outcome. A QTc interval >500 msec determines a worse prognosis. However, LQT1 patients have a better prognosis vs. LQT2 and LQT3 with similar QT. Gender has no influence among LQT1 patients, whereas a higher risk was identified for LQT2 females and LQT3 males.[25]

Recent, still preliminary evidences suggested that risk stratification may be further refined when the position of a mutation on the predicted protein topology is taken into consideration. Among others, epidemiological findings from the International LQTS Registry[26] showed that LQT2 patients with mutation in the pore region are at greater risk of cardiac events (syncope and cardiac arrest) than patients with nonpore mutations.

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Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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