Thesis topic proposal
István Koncz
Early Repolarization Syndrome: novel therapeutic possibilities, new insights into the mechanisms


Institute: University of Szeged
theoretical medicine
Doctoral School of Multidisciplinary Medical Scienses

Thesis supervisor: István Koncz
Web address (URL): http://web.med.u-szeged.hu/phcol/
Location of studies (in Hungarian): Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged
Abbreviation of location of studies: ÁOK

Description of the research topic:

The early repolarization (ER) pattern on the ECG is characterized by ≥ 0.1 mV J-point elevation in 2 contiguous inferior
and/or lateral ECG leads. Multiple studies have linked ER with an increased risk of arrhythmogenic sudden death. The first
study to demonstrate an association between ER and ventricular arrhythmia came from Prof. Michel Haissaguerre et al in
2008. (Haissaguerre M et al. Sudden cardiac arrest associated with early repolarization. The New England J. of Medicine).
The most recent article from Haissaguerre group contains: „Koncz et al demonstrated that in a canine left ventricular wedge
preparation, increased vagal tone augments J-point elevation and precipitates phase2 reentry. Furthermore they
demonstrated that the inferior wall has a higher intrinsic Ito current which may account for the greater sensitivity of this
region for developing VF”. Our paper (Koncz I et al PMID: 24378566) was the first to present a comprehensive understanding
of the mechanisms underlying ER. Our paper was also cited as explaining the higher risk of VF and sudden cardiac death seen
in patients with inferior compared to lateral J waves (PMID: 25446046). Our aims are to define the role of Purkinje fibres in triggering
arrhythmias in ER syndrome, assess the role of the intracardiac nervous system in ERS, examine the effect of I)steroids II)hypokalaemia
and III)the combined effect of steroids and hypokalemia on the manifestation of ER pattern and the development of VT/VF, assess the
propensity for the development of VF in left ventricle with ER pattern and exposed to ischemia, to develop optimal approach to therapy.

Required language skills: English
Further requirements: 
TDK munka

Number of students who can be accepted: 1

Deadline for application: 2019-12-19

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