Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy

Massimo Iacoviello, Cinzia Forleo, Pietro Guida, Roberta Romito, Antonio Sorgente, Sandro Sorrentino, Silvana Catucci, Filippo Mastropasqua, Mariavittoria Pitzalis

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Objectives: The purpose of this work was to evaluate whether ventricular repolarization dynamicity predicts major arrhythmic events in patients with idiopathic dilated cardiomyopathy (DCM). Background: Arrhythmic risk stratification in patients with DCM is still an open issue. Ventricular repolarization analysis should provide relevant information, but QT interval and QT dispersion failed in predicting arrhythmic risk. Methods: The following parameters were evaluated in 179 consecutive DCM patients without history of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) at enrollment: QRS duration, QT interval corrected for heart rate, and QT dispersion at electrocardiogram (ECG); left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter at echocardiogram; and nonsustained ventricular tachycardia (NSVT), heart rate variability (standard deviation of RR intervals), and ventricular repolarization dynamicity as measured by means of 24-h ECG monitoring, by calculating the slope of linear regression analysis of QT end and RR intervals (QTe-slope) and the value of mean QT end corrected for heart rate. Results: During a mean follow-up of 39 months, 9 patients died suddenly and 15 experienced VT and/or VF. At multivariate analysis, LVEF (p = 0.047), NSVT (p = 0.022), and QTe-slope (p = 0.034) were significantly associated with arrhythmic events. Among the patients with a low LVEF, NSVT and/or steeper QTe-slope identified a subgroup at highest arrhythmic risk. Conclusions: In patients with DCM, QT dynamicity is independently associated with the occurrence of major arrhythmic events and improves the predictive accuracy of stratifying arrhythmic risk of these patients.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalJournal of the American College of Cardiology
Volume50
Issue number3
DOIs
Publication statusPublished - Jul 17 2007

Fingerprint

Dilated Cardiomyopathy
Ventricular Tachycardia
Stroke Volume
Heart Rate
Ventricular Fibrillation
Electrocardiography
Linear Models
Multivariate Analysis
Regression Analysis

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy. / Iacoviello, Massimo; Forleo, Cinzia; Guida, Pietro; Romito, Roberta; Sorgente, Antonio; Sorrentino, Sandro; Catucci, Silvana; Mastropasqua, Filippo; Pitzalis, Mariavittoria.

In: Journal of the American College of Cardiology, Vol. 50, No. 3, 17.07.2007, p. 225-231.

Research output: Contribution to journalArticle

Iacoviello, Massimo ; Forleo, Cinzia ; Guida, Pietro ; Romito, Roberta ; Sorgente, Antonio ; Sorrentino, Sandro ; Catucci, Silvana ; Mastropasqua, Filippo ; Pitzalis, Mariavittoria. / Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy. In: Journal of the American College of Cardiology. 2007 ; Vol. 50, No. 3. pp. 225-231.
@article{135b2d4c2fb64d7eb3a040d951756bc2,
title = "Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy",
abstract = "Objectives: The purpose of this work was to evaluate whether ventricular repolarization dynamicity predicts major arrhythmic events in patients with idiopathic dilated cardiomyopathy (DCM). Background: Arrhythmic risk stratification in patients with DCM is still an open issue. Ventricular repolarization analysis should provide relevant information, but QT interval and QT dispersion failed in predicting arrhythmic risk. Methods: The following parameters were evaluated in 179 consecutive DCM patients without history of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) at enrollment: QRS duration, QT interval corrected for heart rate, and QT dispersion at electrocardiogram (ECG); left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter at echocardiogram; and nonsustained ventricular tachycardia (NSVT), heart rate variability (standard deviation of RR intervals), and ventricular repolarization dynamicity as measured by means of 24-h ECG monitoring, by calculating the slope of linear regression analysis of QT end and RR intervals (QTe-slope) and the value of mean QT end corrected for heart rate. Results: During a mean follow-up of 39 months, 9 patients died suddenly and 15 experienced VT and/or VF. At multivariate analysis, LVEF (p = 0.047), NSVT (p = 0.022), and QTe-slope (p = 0.034) were significantly associated with arrhythmic events. Among the patients with a low LVEF, NSVT and/or steeper QTe-slope identified a subgroup at highest arrhythmic risk. Conclusions: In patients with DCM, QT dynamicity is independently associated with the occurrence of major arrhythmic events and improves the predictive accuracy of stratifying arrhythmic risk of these patients.",
author = "Massimo Iacoviello and Cinzia Forleo and Pietro Guida and Roberta Romito and Antonio Sorgente and Sandro Sorrentino and Silvana Catucci and Filippo Mastropasqua and Mariavittoria Pitzalis",
year = "2007",
month = "7",
day = "17",
doi = "10.1016/j.jacc.2007.02.071",
language = "English",
volume = "50",
pages = "225--231",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy

AU - Iacoviello, Massimo

AU - Forleo, Cinzia

AU - Guida, Pietro

AU - Romito, Roberta

AU - Sorgente, Antonio

AU - Sorrentino, Sandro

AU - Catucci, Silvana

AU - Mastropasqua, Filippo

AU - Pitzalis, Mariavittoria

PY - 2007/7/17

Y1 - 2007/7/17

N2 - Objectives: The purpose of this work was to evaluate whether ventricular repolarization dynamicity predicts major arrhythmic events in patients with idiopathic dilated cardiomyopathy (DCM). Background: Arrhythmic risk stratification in patients with DCM is still an open issue. Ventricular repolarization analysis should provide relevant information, but QT interval and QT dispersion failed in predicting arrhythmic risk. Methods: The following parameters were evaluated in 179 consecutive DCM patients without history of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) at enrollment: QRS duration, QT interval corrected for heart rate, and QT dispersion at electrocardiogram (ECG); left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter at echocardiogram; and nonsustained ventricular tachycardia (NSVT), heart rate variability (standard deviation of RR intervals), and ventricular repolarization dynamicity as measured by means of 24-h ECG monitoring, by calculating the slope of linear regression analysis of QT end and RR intervals (QTe-slope) and the value of mean QT end corrected for heart rate. Results: During a mean follow-up of 39 months, 9 patients died suddenly and 15 experienced VT and/or VF. At multivariate analysis, LVEF (p = 0.047), NSVT (p = 0.022), and QTe-slope (p = 0.034) were significantly associated with arrhythmic events. Among the patients with a low LVEF, NSVT and/or steeper QTe-slope identified a subgroup at highest arrhythmic risk. Conclusions: In patients with DCM, QT dynamicity is independently associated with the occurrence of major arrhythmic events and improves the predictive accuracy of stratifying arrhythmic risk of these patients.

AB - Objectives: The purpose of this work was to evaluate whether ventricular repolarization dynamicity predicts major arrhythmic events in patients with idiopathic dilated cardiomyopathy (DCM). Background: Arrhythmic risk stratification in patients with DCM is still an open issue. Ventricular repolarization analysis should provide relevant information, but QT interval and QT dispersion failed in predicting arrhythmic risk. Methods: The following parameters were evaluated in 179 consecutive DCM patients without history of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) at enrollment: QRS duration, QT interval corrected for heart rate, and QT dispersion at electrocardiogram (ECG); left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter at echocardiogram; and nonsustained ventricular tachycardia (NSVT), heart rate variability (standard deviation of RR intervals), and ventricular repolarization dynamicity as measured by means of 24-h ECG monitoring, by calculating the slope of linear regression analysis of QT end and RR intervals (QTe-slope) and the value of mean QT end corrected for heart rate. Results: During a mean follow-up of 39 months, 9 patients died suddenly and 15 experienced VT and/or VF. At multivariate analysis, LVEF (p = 0.047), NSVT (p = 0.022), and QTe-slope (p = 0.034) were significantly associated with arrhythmic events. Among the patients with a low LVEF, NSVT and/or steeper QTe-slope identified a subgroup at highest arrhythmic risk. Conclusions: In patients with DCM, QT dynamicity is independently associated with the occurrence of major arrhythmic events and improves the predictive accuracy of stratifying arrhythmic risk of these patients.

UR - http://www.scopus.com/inward/record.url?scp=34447099598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447099598&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2007.02.071

DO - 10.1016/j.jacc.2007.02.071

M3 - Article

C2 - 17631214

AN - SCOPUS:34447099598

VL - 50

SP - 225

EP - 231

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -