Prediction of sudden death from QTc interval prolongation in patients with chronic ischemic heart disease
| Autor: | Paolo Emilio Puddu, Martial G. Bourassa |
|---|---|
| Rok vydání: | 1986 |
| Předmět: |
Risk
medicine.medical_specialty complications etiology Myocardial Infarction Coronary Disease Disease Arrhythmias Sudden death QT interval Death Sudden Electrocardiography Cardiac complications Coronary Disease complications/physiopathology Death Sudden etiology Electrocardiography Humans Long QT Syndrome complications/physiopathology Myocardial Infarction complications/physiopathology Risk Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Risk factor Ejection fraction business.industry Atrial fibrillation Arrhythmias Cardiac complications/physiopathology medicine.disease Death Long QT Syndrome Anesthesia Cohort Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of electrocardiology. 19(3) |
| ISSN: | 0022-0736 |
| Popis: | Summary Although prolongation of QTc interval has been shown to increase the risk of sudden death after recent myocardial infarction, no data exist on the relationship between sudden death and QTc duration in patients with chronic ischemic heart disease. Furthermore, it is not known whether patients with long QTc intervals (≧440 units) have more prevalent coronary risk factors. Thus 141 nonsurvivors (128 with coronary death and 13 with non-coronary death) representing the follow-up deaths of a cohort of 1157 medically treated patients with ischemic heart disease over a four-year period were compared to 141 consecutive long-term survivors of the same cohort. Thirty-one patients were excluded because of drug interactions, bundle-branch block or atrial fibrillation. QTc duration was calculated on the ECG immediately prior to angiography in 62 patients with sudden death, 36 with intermediate death, 13 with noncoronary death and 140 long-term survivors with chronic ischemic heart disease. In addition, in 64 nonsurvivors (58%) in whom more than one yearly follow-up ECG was available, QTc was calculated in the last ECG preceding death (mean of four months before death). These data were compared to those obtained in 140 long-term survivors at the time of last ECG (mean 48 months after enrollment). At the time of angiography, mean QTc intervals were similar in patients who later died of ischemic heart disease and in long-term survivors (423±35 vs 421±25 units). No difference, in QTc duration was apparent among nonsurvivors with ischemic heart disease. All study patients were divided into normal and long QTc subgroups. No difference was observed in mean age, ECG signs of prior myocardial infarction, cardiothoracic ratio, therapy with propranolol or digitalis, mean ejection fraction and the number of diseased vessels between these subgroups. However, in the ECG preceding death, the incidence of QTc prolongation was higher in nonsurvivors with sudden death (61%) than in those with intermediate death (26%) or noncoronary death (0%) or in long-term survivors (p We conclude that QTc prolongation in patients with chronic ischemic heart disease is not related to coronary risk factors; nonsurvivors dying suddenly present a QTc prolongation during follow-up more frequently than either the other nonsurvivors or long-term survivors with ischemic heart disease; the QTc interval calculation may represent a simple method of monitoring patients with high risk of sudden death. |
| Databáze: | OpenAIRE |
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