| Autor: |
Makino, Taro, Ichikawa, Tomohide, Amino, Mari, Nakamura, Mari, Koshikawa, Masayuki, Motoike, Yuji, Nomura, Yoshihiro, Harada, Masahide, Sobue, Yoshihiro, Watanabe, Eiichi, Kiyono, Ken, Yoshioka, Koichiro, Ikari, Yuji, Ozaki, Yukio, Izawa, Hideo |
| Zdroj: |
Annals of Noninvasive Electrocardiology; Nov2023, Vol. 28 Issue 6, p1-11, 11p |
| Abstrakt: |
Background: We aimed to investigate the association between ventricular repolarization instability and sustained ventricular tachycardia and ventricular fibrillation (VT/VF) occurring within 48 h (acute‐phase VT/VF) after the onset of acute coronary syndrome (ACS) and the prognostic role of repolarization instability and heart rate variability (HRV) after discharge from the hospital. Methods: We studied 572 ACS patients with a left ventricular ejection fraction >35%. The ventricular repolarization instability was assessed by the beat‐to‐beat T‐wave amplitude variability (TAV) using high‐resolution 24‐h Holter ECGs recorded at a median of 11 days from the date of admission. We calculated the HRV parameters including the deceleration capacity (DC) and non‐Gaussian index calculated on a 25 s timescale (λ25s). The DC and λ25s were dichotomized based on previous studies' thresholds. Results: Acute‐phase VT/VF developed in 43 (7.5%) patients. In‐hospital mortality was significantly higher among VT/VF patients (4.7% vs. 0.9%, p =.03). An adjusted logistic model showed that the maximum TAV (odds ratio 1.02, 95% confidence interval [CI] 1.00–1.29, p =.04) was associated with acute‐phase VT/VF. During a median follow‐up period of 2.1 years, 19 (3.3%) patients had cardiac deaths or resuscitated cardiac arrest. Acute‐phase VT/VF (p =.12) and TAV (p =.72) were not significant predictors of survival. An age and sex‐adjusted Cox model showed that the DC (p <.01), λ25s (p <.01), and emergency coronary intervention (p <.01) were independent predictors. Conclusion: T‐wave amplitude variability was associated with acute‐phase VT/VF, but the TAV was not predictive of survival post‐discharge. The DC, λ25s, and emergency coronary intervention were independent predictors of survival. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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