The relation between local repolarization and T-wave morphology in heart failure patients

Autor: Angelo Auricchio, Maria Luce Caputo, Daniel Sürder, Annekatrin Illner, Joris Wanten, Tiziano Moccetti, François Regoli, Francesco Maffessanti, Giulio Conte, Frits W. Prinzen, Rolf Krause, Mark Potse
Přispěvatelé: Center for Computational Medicine in Cardiology [Lugano], Università della Svizzera italiana = University of Italian Switzerland (USI), Maastricht University [Maastricht], Modélisation et calculs pour l'électrophysiologie cardiaque (CARMEN), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Cardiocentro Ticino [Lugano], Universität Zürich [Zürich] = University of Zurich (UZH), Otto-von-Guericke University [Magdeburg] (OVGU), Swiss National Science Foundation project 32003B_165802, Theo Rossi di Montelera Foundation, Metis Foundation Sergio Mantegazza, Fidinam Foundation, Horten Foundation, Biologic Delivery Systems, Biosense Webster, a Johnson & Johnson Company, Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-IHU-LIRYC, CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] (OVGU), RS: CARIM - R2.08 - Electro mechanics, Fysiologie, University of Zurich, Prinzen, Frits W
Jazyk: angličtina
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
medicine.medical_treatment
Repolarization
030204 cardiovascular system & hematology
ACTIVATION
Electrocardiography
0302 clinical medicine
Prospective Studies
Aged
80 and over
Left bundle branch block
ACTION-POTENTIAL DURATION
Depolarization
Middle Aged
MESH: Cardiac Electrophysiology
medicine.anatomical_structure
Cardiology
Female
CARDIAC RESYNCHRONIZATION THERAPY
VENTRICULAR REPOLARIZATION
Cardiology and Cardiovascular Medicine
CANINE
BUNDLE-BRANCH BLOCK
medicine.medical_specialty
Cardiac resynchronization therapy
GRADIENTS
610 Medicine & health
Heart failure
Electro-anatomic mapping
11171 Cardiocentro Ticino
2705 Cardiology and Cardiovascular Medicine
03 medical and health sciences
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Heart Conduction System
Internal medicine
medicine
Humans
MODULATION
Coronary sinus
Aged
ARRHYTHMIAS
Bundle branch block
business.industry
MEMORY
Stroke Volume
MESH: C14.280.434
medicine.disease
030104 developmental biology
Ventricle
T-wave
business
Zdroj: International Journal of Cardiology
International Journal of Cardiology, Elsevier, 2017, 241, pp.270-276. ⟨10.1016/j.ijcard.2017.02.056⟩
International journal of cardiology
International Journal of Cardiology, 2017, 241, pp.270-276. ⟨10.1016/j.ijcard.2017.02.056⟩
International Journal of Cardiology, 241, 270-276. Elsevier Ireland Ltd
ISSN: 1874-1754
0167-5273
Popis: Background: Both duration and morphology of the T-wave are regarded important parameters describing repolarization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time of depolarization (TD) and repolarization (TR). Little is known about T-wave morphology and TD-TR relations in patients with heart failure.Methods: Electro-anatomic maps were obtained in the left (LV) and right ventricle (RV) and in the coronary sinus (CS) in patients with heart failure with narrow (nQRS, n = 8) and wide QRS complex with (LBBB, n = 15) and without left bundle branch block (non-LBBB, n = 7). TD and TR were determined from the thus acquired electrograms.Results: In nQRS and non-LBBB patients, TD-TR relations had a slope between 0 and +1, indicating that repolarization followed the sequence of depolarization. In LBBB patients, repolarization occurred significantly earlier in the RV than in the LV, fitting with the idea that the discordant T-waves in LBBB are secondary to the abnormal depolarization sequence. However, the slopes of the TD-TR relations in the LV and CS were not significantly different from zero, indicating no major spatial gradient in LV repolarization, despite a considerable gradient in depolarization. Remarkable was also the large (similar to 100ms) transseptal gradient in repolarization. Values of the slopes of the TD-TR relation overlapped between the three patient groups, despite a difference in T-wave morphology between LBBB (all discordant) and nQRS patients (all flat/biphasic).Conclusions: Discordant T-waves in LBBB patients are explained by interventricular dispersion in repolarization. T-wave morphology is determined by more factors than the TD-TR relation alone. (C) 2017 The Authors. Published by Elsevier Ireland Ltd.
Databáze: OpenAIRE
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