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(Circulation. 2004;109:2930-2932.)
© 2004 American Heart Association, Inc.

Focused Perspective

Stillbirths, Sudden Infant Deaths, and Long-QT Syndrome

Puzzle or Mosaic, the Pieces of the Jigsaw Are Being Fitted Together

Peter J. Schwartz, MD

From the Department of Cardiology, IRCCS Policlinico S. Matteo, Pavia, University of Pavia, Pavia, Italy.

Correspondence to Peter J. Schwartz, MD, Professor and Chairman, Department of Cardiology, Policlinico S. Matteo IRCCS, V.le Golgi, 19 27100 Pavia, Italy. E-mail PJQT@compuserve.com

Key Words: Focused Perspectives • long-QT syndrome • death, sudden • genetics • pediatrics

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Stillbirths contribute substantially to perinatal mortality in developed countries.¹ Their prevalence ranges between 4 and 6 per 1000 births.^1–3 Despite careful investigation, at least 25%,⁴ and possibly 50%,¹ remain unexplained. Another mysterious cause of early sudden death is represented by sudden infant death syndrome (SIDS),^5,6 which is still the leading cause of mortality during the first year of life. Finally, a relatively large number of sudden deaths in the young (infants, children, and teenagers) is due to long-QT syndrome (LQTS).^7–10 Are these entities completely unrelated or is there a link between them, such that the latter might be a contributor to the former? As a matter of fact, this specific hypothesis has already been proposed.^11,12 Its interest lies in the fact that, beyond the scientific and conceptual implications, if proven correct it could offer an opportunity to prevent those fetal or infant deaths sharing the same genetic and arrhythmogenic mechanism.

See p 3029

The value of scientific hypotheses lies in the possibility of testing them to be either dismissed or confirmed, thus advancing knowledge. The relatively small number, in absolute terms, of stillbirths and SIDS makes prospective studies difficult, albeit not impossible.¹³ Thus, to a large extent, the scientific community still has to rest on the evidence provided by well-documented case reports which sometimes can offer unexpected insights and can represent proof of concept. One such example is represented by the article by Miller et al¹⁴ in this issue of Circulation.

Their study was prompted by what initially appeared . . . [Full Text of this Article]

Related Article:

Recurrent Third-Trimester Fetal Loss and Maternal Mosaicism for Long-QT Syndrome

Todd E. Miller, Elicia Estrella, Robert J. Myerburg, Jocelyn Garcia de Viera, Niberto Moreno, Paolo Rusconi, Mary Ellen Ahearn, Lisa Baumbach, Paul Kurlansky, Grace Wolff, and Nanette H. Bishopric
Circulation 2004 109: 3029-3034. [Abstract] [Full Text]

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