Evaluation of the spatial aspects of T-wave complexity in the long-QT syndrome

Silvia G. Priori, David W. Mortara, Carlo Napolitano, Livia Diehl, Vincenzo Paganini, Francesco Cantù, Giacomo Cantù, Peter J. Schwartz

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Background: The duration of the QT interval is only a gross estimate of repolarization. Besides its limited accuracy and reproducibility, it does not provide information on the morphology of the T wave; thus, morphologic alterations such as notches can be only qualitatively described but not objectively quantified. Methods and Results: To measure the complexity of repolarization in the long-QT syndrome (LQTS) patients, we previously applied principal component analysis to body surface mapping and found it useful in distinguishing normal from abnormal repolarization patterns (sensitivity, 87%). In the present study, we applied principal component analysis to 12- lead Holter recordings. The index of complexity of repolarization that we have developed (CR(24h)) reflects the average 24-hour complexity of repolarization and is mathematically defined as the average ratio between the second and the first eigenvalue. We studied 36 LOTS patients and 40 control subjects. A mean of 22±1.3 ECG recordings at 1-hour intervals was used in each patient, and a total of 1655 recordings were analyzed. CR(24h) was significantly higher in LQTS than in control subjects (34±12% versus 13±3%; P20%) was present in 32 of 36 patients (88%). The negative predictive value of CR(24h) in LQTS was 88%, and the combination of prolonged QT and abnormal CR(24h) identified all LQTS patients from normal subjects, including 4 affected symptomatic individuals with a normal QT interval duration, suggesting that CR(24h) provides information independent of QT duration. Conclusions: Our data suggest that principal component analysis applied to 24-hour, 12-lead Holter recording adequately quantifies the complexity of ventricular repolarization and may become a useful noninvasive diagnostic tool in LQTS.

Original languageEnglish
Pages (from-to)3006-3012
Number of pages7
JournalCirculation
Volume96
Issue number9
Publication statusPublished - Nov 4 1997

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Long QT Syndrome
Principal Component Analysis
Body Surface Potential Mapping
Electrocardiography

Keywords

  • Death, sudden
  • Electrocardiography
  • Torsade de pointes

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of the spatial aspects of T-wave complexity in the long-QT syndrome. / Priori, Silvia G.; Mortara, David W.; Napolitano, Carlo; Diehl, Livia; Paganini, Vincenzo; Cantù, Francesco; Cantù, Giacomo; Schwartz, Peter J.

In: Circulation, Vol. 96, No. 9, 04.11.1997, p. 3006-3012.

Research output: Contribution to journalArticle

Priori, SG, Mortara, DW, Napolitano, C, Diehl, L, Paganini, V, Cantù, F, Cantù, G & Schwartz, PJ 1997, 'Evaluation of the spatial aspects of T-wave complexity in the long-QT syndrome', Circulation, vol. 96, no. 9, pp. 3006-3012.
Priori SG, Mortara DW, Napolitano C, Diehl L, Paganini V, Cantù F et al. Evaluation of the spatial aspects of T-wave complexity in the long-QT syndrome. Circulation. 1997 Nov 4;96(9):3006-3012.
Priori, Silvia G. ; Mortara, David W. ; Napolitano, Carlo ; Diehl, Livia ; Paganini, Vincenzo ; Cantù, Francesco ; Cantù, Giacomo ; Schwartz, Peter J. / Evaluation of the spatial aspects of T-wave complexity in the long-QT syndrome. In: Circulation. 1997 ; Vol. 96, No. 9. pp. 3006-3012.
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AU - Mortara, David W.

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AU - Diehl, Livia

AU - Paganini, Vincenzo

AU - Cantù, Francesco

AU - Cantù, Giacomo

AU - Schwartz, Peter J.

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