Heart rate turbulence and deceleration capacity for risk prediction of serious arrhythmic events in Marfan syndrome
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Heart rate turbulence and deceleration capacity for risk prediction of serious arrhythmic events in Marfan syndrome. / Schaeffer, Benjamin N; Rybczynski, Meike; Sheikhzadeh, Sara; Akbulak, Ruken Ö; Moser, Julia; Jularic, Mario; Schreiber, Doreen; Daubmann, Anne; Willems, Stephan; von Kodolitsch, Yskert; Hoffmann, Boris A.
In: CLIN RES CARDIOL, 02.06.2015.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Heart rate turbulence and deceleration capacity for risk prediction of serious arrhythmic events in Marfan syndrome
AU - Schaeffer, Benjamin N
AU - Rybczynski, Meike
AU - Sheikhzadeh, Sara
AU - Akbulak, Ruken Ö
AU - Moser, Julia
AU - Jularic, Mario
AU - Schreiber, Doreen
AU - Daubmann, Anne
AU - Willems, Stephan
AU - von Kodolitsch, Yskert
AU - Hoffmann, Boris A
PY - 2015/6/2
Y1 - 2015/6/2
N2 - OBJECTIVE: Marfan syndrome (MFS) is associated with a substantial risk for ventricular arrhythmia and sudden cardiac death (SCD). We used heart rate turbulence (HRT) and deceleration capacity (DC), to evaluate the risk stratification for these patients.METHODS: We enrolled 102 patients [45 male (44.1 %), age 40.5 ± 14.6 years] with MFS. Blood samples were obtained to determine N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Transthoracic echocardiography studies were conducted to evaluate heart function parameters and a 24-h holter ECG was performed. An analysis of two HRT parameters, turbulence onset (TO) and turbulence slope (TS), and DC was performed. Therefore, optimal cut-off values were calculated. Primary endpoint was the combination of SCD, ventricular arrhythmia and arrhythmogenic syncope. Secondary endpoint was total mortality.RESULTS: During a follow-up of 1145 ± 491 days, 12 (11.7 %) patients reached the primary and 8 (7.8 %) patients the secondary endpoint. Patients reaching the primary were significantly older, had a higher burden of premature ventricular complexes and NT-proBNP levels and lower values of LVEF, DC and HRT TS. Multivariate analysis identified NT-proBNP (HR 1.25, 95 % CI 1.01-1.56, p = .04) and the abnormal HRT (abnormal TS and/or TO (HR 7.04, 95 % CI 1.07-46.27, p = .04) as independent risk predictor of arrhythmogenic events.CONCLUSION: Patients with Marfan syndrome are at risk for severe ventricular arrhythmias and SCD. Abnormal HRT parameters and NT-proBNP values are independent risk factors for arrhythmogenic events and SCD. The assessment of these tools may help predicting SCD patients with MFS.
AB - OBJECTIVE: Marfan syndrome (MFS) is associated with a substantial risk for ventricular arrhythmia and sudden cardiac death (SCD). We used heart rate turbulence (HRT) and deceleration capacity (DC), to evaluate the risk stratification for these patients.METHODS: We enrolled 102 patients [45 male (44.1 %), age 40.5 ± 14.6 years] with MFS. Blood samples were obtained to determine N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Transthoracic echocardiography studies were conducted to evaluate heart function parameters and a 24-h holter ECG was performed. An analysis of two HRT parameters, turbulence onset (TO) and turbulence slope (TS), and DC was performed. Therefore, optimal cut-off values were calculated. Primary endpoint was the combination of SCD, ventricular arrhythmia and arrhythmogenic syncope. Secondary endpoint was total mortality.RESULTS: During a follow-up of 1145 ± 491 days, 12 (11.7 %) patients reached the primary and 8 (7.8 %) patients the secondary endpoint. Patients reaching the primary were significantly older, had a higher burden of premature ventricular complexes and NT-proBNP levels and lower values of LVEF, DC and HRT TS. Multivariate analysis identified NT-proBNP (HR 1.25, 95 % CI 1.01-1.56, p = .04) and the abnormal HRT (abnormal TS and/or TO (HR 7.04, 95 % CI 1.07-46.27, p = .04) as independent risk predictor of arrhythmogenic events.CONCLUSION: Patients with Marfan syndrome are at risk for severe ventricular arrhythmias and SCD. Abnormal HRT parameters and NT-proBNP values are independent risk factors for arrhythmogenic events and SCD. The assessment of these tools may help predicting SCD patients with MFS.
U2 - 10.1007/s00392-015-0873-9
DO - 10.1007/s00392-015-0873-9
M3 - SCORING: Journal article
C2 - 26033711
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
ER -