Exercise-induced changes in the QT interval duration and dispersion in patients with sudden cardiac death after myocardial infarction

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

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Faculty Opinions recommendation of Common variants at ten loci modulate the QT interval duration in the QTSCD Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1161025.621483 ◽

2009 ◽

Author(s):

Pascale Guicheney ◽

Nathalie Neyroud

Keyword(s):

Qt Interval ◽

Interval Duration ◽

Common Variants ◽

Qt Interval Duration

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Faculty Opinions recommendation of Polymorphisms in the NOS1AP gene modulate QT interval duration and risk of arrhythmias in the long QT syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4361959.4187057 ◽

2010 ◽

Author(s):

I Eli Ovsyshcher ◽

Guy Amit

Keyword(s):

Long Qt Syndrome ◽

Qt Interval ◽

Interval Duration ◽

Long Qt ◽

Qt Syndrome ◽

Qt Interval Duration

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Faculty Opinions recommendation of Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726155351.793515453 ◽

2016 ◽

Author(s):

Luis Ruilope ◽

Enrique Morales

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Systematic Review ◽

Sudden Cardiac Death ◽

Randomized Controlled Trials ◽

Cardiac Death ◽

Meta Analysis ◽

Controlled Trials ◽

Aldosterone Antagonists ◽

Randomized Controlled

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Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death

Diagnostics ◽

10.3390/diagnostics11040614 ◽

2021 ◽

Vol 11 (4) ◽

pp. 614

Author(s):

Diana Hernández-Romero ◽

María del Rocío Valverde-Vázquez ◽

Juan Pedro Hernández del Rincón ◽

José A. Noguera-Velasco ◽

María D. Pérez-Cárceles ◽

...

Keyword(s):

Myocardial Infarction ◽

Sudden Cardiac Death ◽

Cardiac Troponin ◽

Cardiac Death ◽

Troponin I ◽

Sampling Site ◽

Pericardial Fluid ◽

Cardiac Troponin I ◽

Control Group ◽

Complementary Method

In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies.

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