The T-peak-to-T-end interval: a novel ECG marker for ventricular arrhythmia and appropriate ICD therapy in patients with hypertrophic cardiomyopathy
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The T-peak-to-T-end interval: a novel ECG marker for ventricular arrhythmia and appropriate ICD therapy in patients with hypertrophic cardiomyopathy. / Dinshaw, Leon; Münch, Julia; Dickow, Jannis; Lezius, Susanne; Willems, Stephan; Hoffmann, Boris A; Patten, Monica.
In: CLIN RES CARDIOL, Vol. 107, No. 2, 02.2018, p. 130-137.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - The T-peak-to-T-end interval: a novel ECG marker for ventricular arrhythmia and appropriate ICD therapy in patients with hypertrophic cardiomyopathy
AU - Dinshaw, Leon
AU - Münch, Julia
AU - Dickow, Jannis
AU - Lezius, Susanne
AU - Willems, Stephan
AU - Hoffmann, Boris A
AU - Patten, Monica
PY - 2018/2
Y1 - 2018/2
N2 - INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of sudden cardiac death (SCD) primarily due to ventricular arrhythmia (VA). In patients (pts.) with a high risk of SCD, the implantation of an intracardiac cardioverter defibrillator (ICD) is thus indicated. Previous studies suggest that a prolonged interval between the peak and the end of the T wave, T-peak to T-end (TpTe), is associated with an elevated risk of VA and SCD in various clinical settings. The aim of our study was to evaluate the association between TpTe and VA in HCM pts. with a previously implanted ICD.METHODS: In 40 HCM pts. (51.4 ± 16.4 years; 62.5% men), TpTe was measured using the baseline digital standard resting 12-lead ECG during sinus rhythm. VA was assessed by device follow-up.RESULTS: Within 41.8 ± 35.1 months, 7 (17.5%) pts. had VA leading to appropriate therapy (AT), 7 pts. (17.5%) had non-sustained VA, and 26 pts. (65.0%) had no VA. The maximum TpTe was significantly prolonged in pts. with VA leading to AT compared to pts. without VA (101.3 ± 19.6 vs. 79.9 ± 15.3 ms; p = 0.004). Maximum TpTe was associated with an elevated risk of VA leading to AT (hazard ratio per 10 ms increase 1.63; 95% CI 1.04-2.54; p = 0.031) and pts. with a maximum TpTe ≤ 78 ms were without any VA leading to AT during follow-up. There was no correlation of maximum TpTe to other clinical parameters in our patient cohort.CONCLUSION: A prolonged TpTe is associated with VA and AT in HCM. Our findings suggest that TpTe can possibly serve as a marker for ventricular arrhythmogenesis in pts. with HCM and assessment of TpTe might, therefore, optimize SCD risk stratification.
AB - INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of sudden cardiac death (SCD) primarily due to ventricular arrhythmia (VA). In patients (pts.) with a high risk of SCD, the implantation of an intracardiac cardioverter defibrillator (ICD) is thus indicated. Previous studies suggest that a prolonged interval between the peak and the end of the T wave, T-peak to T-end (TpTe), is associated with an elevated risk of VA and SCD in various clinical settings. The aim of our study was to evaluate the association between TpTe and VA in HCM pts. with a previously implanted ICD.METHODS: In 40 HCM pts. (51.4 ± 16.4 years; 62.5% men), TpTe was measured using the baseline digital standard resting 12-lead ECG during sinus rhythm. VA was assessed by device follow-up.RESULTS: Within 41.8 ± 35.1 months, 7 (17.5%) pts. had VA leading to appropriate therapy (AT), 7 pts. (17.5%) had non-sustained VA, and 26 pts. (65.0%) had no VA. The maximum TpTe was significantly prolonged in pts. with VA leading to AT compared to pts. without VA (101.3 ± 19.6 vs. 79.9 ± 15.3 ms; p = 0.004). Maximum TpTe was associated with an elevated risk of VA leading to AT (hazard ratio per 10 ms increase 1.63; 95% CI 1.04-2.54; p = 0.031) and pts. with a maximum TpTe ≤ 78 ms were without any VA leading to AT during follow-up. There was no correlation of maximum TpTe to other clinical parameters in our patient cohort.CONCLUSION: A prolonged TpTe is associated with VA and AT in HCM. Our findings suggest that TpTe can possibly serve as a marker for ventricular arrhythmogenesis in pts. with HCM and assessment of TpTe might, therefore, optimize SCD risk stratification.
KW - Action Potentials
KW - Adult
KW - Aged
KW - Arrhythmias, Cardiac
KW - Cardiomyopathy, Hypertrophic
KW - Death, Sudden, Cardiac
KW - Defibrillators, Implantable
KW - Disease-Free Survival
KW - Echocardiography
KW - Electric Countershock
KW - Electrocardiography
KW - Female
KW - Heart Conduction System
KW - Heart Rate
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Risk Factors
KW - Signal Processing, Computer-Assisted
KW - Time Factors
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1007/s00392-017-1164-4
DO - 10.1007/s00392-017-1164-4
M3 - SCORING: Journal article
C2 - 28965260
VL - 107
SP - 130
EP - 137
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 2
ER -