Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy.

Autor:	Dural M; Department of Cardiology, Eskişehir Osmangazi University Faculty of Medicine, Odunpazarı, Eskişehir 26040, Turkey.; Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, Maastricht 6202, The Netherlands., Ghossein MA; Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands., Gerrits W; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Daniels F; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Meine M; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Maass AH; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Rienstra M; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Prinzen FW; Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands., Vernooy K; Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, Maastricht 6202, The Netherlands., van Stipdonk AMW; Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, Maastricht 6202, The Netherlands.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2023 Dec 28; Vol. 26 (1).
DOI:	10.1093/europace/euad370
Abstrakt:	Aims: Data on repolarization parameters in cardiac resynchronization therapy (CRT) are scarce. We investigated the association of baseline T-wave area, with both clinical and echocardiographic outcomes of CRT in a large, multi-centre cohort of CRT recipients. Also, we evaluated the association between the baseline T-wave area and QRS area. Methods and Results: In this retrospective study, 1355 consecutive CRT recipients were evaluated. Pre-implantation T-wave and QRS area were calculated from vectorcardiograms. Echocardiographic response was defined as a reduction of ≥15% in left ventricular end-systolic volume between 3 and 12 months after implantation. The clinical outcome was a combination of all-cause mortality, heart transplantation, and left ventricular assist device implantation. Left ventricular end-systolic volume reduction was largest in patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs compared with QRS area ≥ 109 μVs and T-wave area < 66 μVs (P = 0.004), QRS area < 109 μVs and T-wave area ≥ 66 μVs (P < 0.001) and QRS area < 109 μVs and T-wave area < 66 μVs (P < 0.001). Event-free survival rate was higher in the subgroup of patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs (n = 616, P < 0.001) and QRS area ≥ 109 μVs and T-wave area < 66 μVs (n = 100, P < 0.001) than the other subgroups. In the multivariate analysis, T-wave area remained associated with echocardiographic response (P = 0.008), but not with the clinical outcome (P = 0.143), when QRS area was included in the model. Conclusion: Baseline T-wave area has a significant association with both clinical and echocardiographic outcomes after CRT. The association of T-wave area with echocardiographic response is independent from QRS area; the association with clinical outcome, however, is not. Competing Interests: Conflict of interest: F.D. reports having a research contract in the UMCG. A.H.M. reports consultancy for Boston Scientific and Medtronic with all fees going to the department. M.R. reports grant support from Dutch Heart Foundation (CVON-RACE V, RED-CVD, DECISION), grant support from ZonMW/Ministry of Health (DigiTwin), EU H2020 (EHRA-PATHS), and consultancy fees to the institution from Bayer and InCarda. F.W.P. reports research contracts with Medtronic, Boston Scientific, Abbott, MicroPort CRM, Biotronik, EBR Systems, and Biosense Webster. K.V. reports financial support to hospital for consultancy with Medtronic, Abbott, Boston Scientific, and Biosense Webster. All remaining authors have declared no conflicts of interest. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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