Impaired repolarization parameters may predict fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy (from the CILICIA Registry)

Autor: Ezgi Gültekin Güner, Fatih Uzun, Serkan Aslan, Ahmet Yasar Cizgici, Mehmet Emin Kalkan, Ahmet Güner, Emrah Bayam, Ahmet Emir Ulutaş, Mehmet Celik, Macit Kalçık, Hicaz Zencirkiran Agus
Přispěvatelé: Kalçık, Macit
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Hypertrophic Cardiomyopathy
030204 cardiovascular system & hematology
Sudden Cardiac Death
QT interval
Sudden cardiac death
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Humans
Repolarization
In patient
Registries
cardiovascular diseases
030212 general & internal medicine
Frontal QRS-T Angle
Retrospective Studies
Tp-e/QTc Ratio
business.industry
Hypertrophic cardiomyopathy
Arrhythmias
Cardiac
Retrospective cohort study
Cardiomyopathy
Hypertrophic
Middle Aged
Implantable cardioverter-defibrillator
medicine.disease
Death
Sudden
Cardiac
Ventricular fibrillation
cardiovascular system
Cardiology
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Electrocardiology. 63:83-90
ISSN: 0022-0736
Popis: Background: Hypertrophic cardiomyopathy (HCM) is significantly associated with high risk of fatal ventricular arrhythmias (VAs). Increased frontal QRST angle (fQRSTa), Tpe interval, and Tp-e/QTc ratio are described as ventricular repolarization parameters which are related to arrhythmias. In this study, we aimed to investigate the predictive value of these repolarization parameters for fatal VAs in patients with HCM. Methods: A total of 127 HCM patients (mean age: 47.9 +/- 12.6 years; male:79) were enrolled in this retrospective study. All patients underwent transthoracic echocardiography. Moreover, the last electrocardiograms within 3 months prior to the fatal VA documentation were assessed. The primary outcome was the occurrence of fatal VAs including sustained ventricular tachycardia and ventricular fibrillation which were documented from implantable cardioverter defibrillator records. Results: There were documented fatal VAs in 37 (29.1%) patients during a mean follow-up time of 70.1 +/- 22.6 months. The prevalence of fatal VAs was significantly higher in patients with fQRSTa >= 140 degrees (67.4 vs. 7.4%; p < 0.001) and in patients with Tp-e/QTc ratio >= 0.19 (61.5 vs. 6.7%; p < 0.001) as compared to others. High Tp-e/QTc ratio (hazard ratio: 1.564; 95% confidence interval: 1.086-4.796; p = 0.032) and high fQRSTa (hazard ratio: 1.864; 95% confidence interval: 1.106-8.745; p = 0.002) were found to be independent predictors of fatal VAs in HCM patients. Conclusions: Wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio may be associated with fatal VAs in HCM patients. In addition to traditional risk factors, these simple ECG parameters may provide valuable information during evaluation of sudden cardiac death risk in HCM patients. (C) 2020 Elsevier Inc. All rights reserved. WOS:000600694400019 2-s2.0-85094805794 PubMed: 33142186
Databáze: OpenAIRE
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