TY - JOUR
T1 - T-wave amplitude variability and the risk of death in chagas disease
AU - Ribeiro, Antonio Luiz Pinho
AU - Rocha, Manoel Otàvio Da Costa
AU - Terranova, Paolo
AU - Cesarano, Marco
AU - Nunes, Maria Do Carmo Pereira
AU - Lombardi, Federico
PY - 2011/7
Y1 - 2011/7
N2 - T-Wave Amplitude Variability in Chagas Disease. Introduction: Measurement of beat-to-beat T-wave amplitude variability (TWV) has been described as a promising new technique for the stratification of arrhythmic risk in postmyocardial infarction and dilated cardiomyopathy patients. Chagas disease (ChD) can lead to a potentially lethal cardiopathy that can present with ventricular arrhythmias, heart blocks, heart failure, and sudden death. The aim of the study was to evaluate the prognostic value of TWV in ChD patients in addition to traditional prognostic predictors. Methods and Results: The study enrolled 113 ambulatory ChD patients (62 men; age: 42 ± 9 years) in sinus rhythm and without other systemic diseases, evaluated by a standard clinical protocol. We computed TWV in 10-minute ECG recordings obtained in controlled resting conditions. TWV was defined as the median values among 8 consecutive 50-ms T-wave segments and dichotomized as either ≤ or > 30 μV 2. The association of TWV and death was evaluated by Cox proportional-hazards analysis, considering other established predictors. During mean follow-up time of 106 ± 28 months, 14 patients died. A value of median TWV > 30 μV 2 predicts increased risk of death in a multivariate analysis (HR = 5.76, 95% CI 1.31-25.23, P = 0.014), in addition to depressed left ventricular function, presence of nonsustained ventricular tachycardia and QRS duration >133 ms. Conclusion: Repolarization variability, evaluated by TWV, is independently related to the risk of death in ChD. This noninvasive methodology could facilitate the identification of patients who may benefit from more aggressive therapeutic strategies.
AB - T-Wave Amplitude Variability in Chagas Disease. Introduction: Measurement of beat-to-beat T-wave amplitude variability (TWV) has been described as a promising new technique for the stratification of arrhythmic risk in postmyocardial infarction and dilated cardiomyopathy patients. Chagas disease (ChD) can lead to a potentially lethal cardiopathy that can present with ventricular arrhythmias, heart blocks, heart failure, and sudden death. The aim of the study was to evaluate the prognostic value of TWV in ChD patients in addition to traditional prognostic predictors. Methods and Results: The study enrolled 113 ambulatory ChD patients (62 men; age: 42 ± 9 years) in sinus rhythm and without other systemic diseases, evaluated by a standard clinical protocol. We computed TWV in 10-minute ECG recordings obtained in controlled resting conditions. TWV was defined as the median values among 8 consecutive 50-ms T-wave segments and dichotomized as either ≤ or > 30 μV 2. The association of TWV and death was evaluated by Cox proportional-hazards analysis, considering other established predictors. During mean follow-up time of 106 ± 28 months, 14 patients died. A value of median TWV > 30 μV 2 predicts increased risk of death in a multivariate analysis (HR = 5.76, 95% CI 1.31-25.23, P = 0.014), in addition to depressed left ventricular function, presence of nonsustained ventricular tachycardia and QRS duration >133 ms. Conclusion: Repolarization variability, evaluated by TWV, is independently related to the risk of death in ChD. This noninvasive methodology could facilitate the identification of patients who may benefit from more aggressive therapeutic strategies.
KW - autonomic nervous system
KW - Chagas disease
KW - heart rate variability
KW - prognosis
KW - QT interval
KW - ventricular repolarization
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U2 - 10.1111/j.1540-8167.2010.02000.x
DO - 10.1111/j.1540-8167.2010.02000.x
M3 - Article
C2 - 21235679
AN - SCOPUS:79960724366
VL - 22
SP - 799
EP - 805
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 7
ER -