Comparison of ECG T-wave Duration and Morphology Restitution Markers for Sudden Cardiac Death Prediction in Chronic Heart Failure

An index of T-wave morphology restitution, TMR, has previously shown to be a sudden cardiac death (SCD) predictor in a population of chronic heart failure (CHF) patients. The aim of this study is to compare the predictive value of TMR, T-wave width restitution (TWR), Tpeak-to-end (Tpe) morphology re...

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Detalhes bibliográficos
Autores: Ramírez, Julia, Orini, Michele, Pueyo, Esther, Laguna, Pablo
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Recursos:Universidad de Zaragoza
Repositorio:Zaguán. Repositorio Digital de la Universidad de Zaragoza
OAI Identifier:oai:zaguan.unizar.es:69683
Acesso em linha:http://zaguan.unizar.es/record/69683
Access Level:acceso abierto
Descrição
Resumo:An index of T-wave morphology restitution, TMR, has previously shown to be a sudden cardiac death (SCD) predictor in a population of chronic heart failure (CHF) patients. The aim of this study is to compare the predictive value of TMR, T-wave width restitution (TWR), Tpeak-to-end (Tpe) morphology restitution (TpeMR) and Tpe duration restitution (T peR) indices in the same CHF population. Holter ECG recordings from 651 CHF patients of the MUSIC study, including SCD victims and survivors, were analyzed. TMR was significantly correlated with T W R (¿=0.66), T peM R (¿=0.70) and T peR (¿=0.42). SCD victims showed significantly higher values of TMR, TWR and TpeMR than the rest of patients, with T M R being the index most strongly associated with SCD (p=0.002, p=0.006 and p=0.011, respectively). T peR values were only borderline significantly higher in SCD victims (p=0.061). Univariate Cox analysis showed that T M R was the restitution index with the strongest predictive value (hazard ratio (HR) of 1.466, p<0.001), followed by TWR (HR of 1.295, p=0.005), TpeR (HR of 1.297, p=0.004) and T peM R (HR of 1.164, p=0.020). In conclusion, considering the predictive value of the four Twave restitution indices, TMR is the preferred index for SCD risk stratification, followed by TpeMR. However, the marker TWR could also be used for SCD prediction when computational efficiency is an issue.