Prolonged T


Journal

Congenital heart disease
ISSN: 1747-0803
Titre abrégé: Congenit Heart Dis
Pays: United States
ID NLM: 101256510

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 23 06 2019
revised: 05 09 2019
accepted: 11 09 2019
pubmed: 2 10 2019
medline: 1 7 2020
entrez: 2 10 2019
Statut: ppublish

Résumé

Adult congenital heart disease (ACHD) patients are at risk of sudden cardiac death (SCD). However, methods for risk stratification are not yet well-defined. The T From an international multicenter cohort of 25 790 ACHD patients, we identified all SCD cases. Cases were matched to controls by age, gender, congenital defect, and (surgical) intervention. TpTe was measured on a standard 12-lead ECG. The maximum TpTe of all ECG leads (TpTe-max), mean (TpTe-mean), and TpTe dispersion (maximum minus minimum) were obtained. Odds ratios (OR) for SCD cases vs controls were calculated using conditional logistic regression analysis. ECGs were available for 147 cases (median age at death 33.5 years (quartiles 26.2, 48.7), 66% male) and 267 controls. The mean TpTe-max was 97 ± 24 ms in cases vs 84 ± 17 ms in controls (P < .001); TpTe-mean was 70 ± 16 vs 63 ± 10 ms (P < .001); and dispersion was 51 ± 22 ms vs 41 ± 16 ms (P = .02), respectively. Assessing each ECG lead separately, TpTe in lead aVR predicted SCD most accurately. TpTe in lead aVR was 71 ± 23 ms in cases vs 61 ± 13 ms in controls (P < .001). After adjusting for impaired ventricular function, heart failure symptoms, and prolonged QRS duration, the OR of SCD of TpTe in lead aVR at an optimal cutoff of 80 ms was 5.8 (95% CI 2.7-12.4, P < .001). The TpTe interval is associated with SCD in ACHD patients. Particularly, TpTe in lead aVR can be used as an independent risk factor for SCD in ACHD patients and may, therefore, add precision to current risk prediction models.

Identifiants

pubmed: 31573144
doi: 10.1111/chd.12847
pmc: PMC7003836
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Pagination

952-957

Subventions

Organisme : ZonMw
ID : 016.146.310

Informations de copyright

© 2019 The Authors. Congenital Heart Disease published by Wiley Periodicals, Inc.

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Auteurs

Jim T Vehmeijer (JT)

Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

Zeliha Koyak (Z)

Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

A Suzanne Vink (AS)

Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

Werner Budts (W)

Department of Cardiology, Universitair Ziekenhuis Leuven, Leuven, Belgium.
Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.

Louise Harris (L)

Division of Cardiology, Peter Munk Cardiac Centre, Toronto Congenital Cardiac Centre for Adults, University of Toronto, Toronto, Ontario, Canada.

Candice K Silversides (CK)

Division of Cardiology, Peter Munk Cardiac Centre, Toronto Congenital Cardiac Centre for Adults, University of Toronto, Toronto, Ontario, Canada.

Erwin N Oechslin (EN)

Division of Cardiology, Peter Munk Cardiac Centre, Toronto Congenital Cardiac Centre for Adults, University of Toronto, Toronto, Ontario, Canada.

Aeilko H Zwinderman (AH)

Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

Barbara J M Mulder (BJM)

Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
Netherlands Heart Institute, Utrecht, the Netherlands.

Joris R de Groot (JR)

Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

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