scholarly journals Possibilities for predicting ventricular tachyarrhythmias in patients with heart failure with reduced ejection fraction based on surface electrocardiography. First results from a single-center prospective study

2021 ◽  
Vol 26 (12) ◽  
pp. 4661
Author(s):  
N. N. Ilov ◽  
O. N. Surikova ◽  
S. A. Boytsov ◽  
D. A. Zorin ◽  
A. A. Nechepurenko

According to current clinical guidelines, the risk of life-threatening ventricular tachyarrhythmias (VTAs) in patients with heart failure (HF) is determined by left ventricular ejection fraction (LVEF). The available clinical and experimental data indicate the imperfection of this one-factor approach, which specifies the need to search for new predictors of VTAs. In this prospective study, we performed a comparative analysis of surface electrocardiographic parameters in HF patients with LVEF ≤35% without syncope or sustained ventricular arrhythmias in history, who were implanted with cardioverter defibrillator as a primary prevention of sudden cardiac death. During the two-year follow-up, the primary endpoint (new-onset persistent VTA episode, or VTA/ventricular fibrillation that required electrotherapy) was recorded in 42 patients (25,5%). The secondary endpoint (an increase in LVEF by 5% or more of the initial level against the background of cardiac resynchronization therapy) was more often recorded in the group of patients without VTAs (41 (33%) vs 4 (9,5%), p=0,005). The studied cohort of patients was characterized by a left axis deviation (72%), LV hypertrophy signs (84%), impaired intra-atrial (P wave duration of 120 (101-120) ms) and intraventricular conduction (QRS duration of 140 (110-180) ms), ventricular electrical systole prolongation (QTcor — 465 (438-504) ms). Differences between the groups divided depending on reaching the primary endpoint in terms of the Cornell product, Cornell voltage index and ICEB, as well as the detection rate of complete left bundle branch block morphology had levels of significance close to critical (p=0,09; p=0,05; p=0,1; p=0,09, respectively). The multivariate predictive model included following factors: Cornell product, Tp-Te/ QRS, P wave duration (diagnostic efficiency of the model was 60%: sensitivity, 61,1%, specificity, 59,6%; p=0,007).

2009 ◽  
Vol 15 (6) ◽  
pp. S60
Author(s):  
Sapan N. Talati ◽  
Siva Mulpuru ◽  
Naresh Mori ◽  
Balendu C. Vasavada

2009 ◽  
Vol 32 (2) ◽  
pp. 239-244 ◽  
Author(s):  
YILMAZ GUNES ◽  
MUSTAFA TUNCER ◽  
UNAL GUNTEKIN ◽  
SERKAN AKDAG ◽  
HASAN ALI GUMRUKCUOGLU

2003 ◽  
Vol 37 (4) ◽  
pp. 193-198 ◽  
Author(s):  
Ulrik Dixen ◽  
Laura Wallevik ◽  
Maja S. Hansen ◽  
Anne Haghfelt ◽  
Katja F. Aqraou ◽  
...  

EP Europace ◽  
2003 ◽  
Vol 4 (Supplement_2) ◽  
pp. B130-B130
Author(s):  
T. Berger ◽  
F. Hintringer ◽  
O. Pachinger ◽  
F.X. Roithinger ◽  
F. Hanser ◽  
...  

Author(s):  
Akito Nakagawa ◽  
Yoshio Yasumura ◽  
Chikako Yoshida ◽  
Takahiro Okumura ◽  
Jun Tateishi ◽  
...  

Background: Recent accumulating evidence reveals that the right ventricular (RV)-pulmonary artery (PA) uncoupling is associated with poor outcome in patients with heart failure (HF), RV dysfunction, and pulmonary hypertension. However, the prognostic utility of RV-PA uncoupling in HF with preserved ejection fraction (HFpEF) remains elusive. In this study, we aim to investigate the associations of RV-PA uncoupling with outcomes of HFpEF inpatients. Methods: We prospectively studied 655 patients, registered in PURSUIT-HFpEF (The Prospective Multicenter Obervational Study of Patients with Heart Failure with Preserved Ejection Fraction), a multicenter observational study of Japanese HFpEF inpatients. We assigned registered patients based on the determined value of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio that can predict primary outcome as an indicator of RV-PA uncoupling. Results: Univariable Cox regression testing revealed that RV-PA uncoupling was associated with the primary endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio [HR] 1.77 [95% CI, 1.34–2.32], P <0.0001) and the secondary endpoints of all-cause death and HF rehospitalization (HR 2.75 [95% CI, 1.77–4.33], P <0.0001, HR 1.63 [95% CI, 1.18–2.26], P =0.0036, respectively). Multivariable analysis also showed that RV-PA uncoupling was significantly associated with primary endpoint and all-cause death independent of age, sex, atrial fibrillation, renal dysfunction, elevated E/e’, and elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide) (HR 1.38 [95% CI, 1.01–1.88], P =0.0413, HR 1.85 [95% CI, 1.14–3.01], P =0.0129, respectively). Conclusions: Prospective study of a hospitalized cohort revealed that RV-PA uncoupling was independently associated with adverse outcomes in acute decompensated patients with HFpEF. Registration: URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414 . Unique identifier: UMIN000021831.


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