000061630 001__ 61630
000061630 005__ 20210507081944.0
000061630 0247_ $$2doi$$a10.1161/JAHA.116.005310
000061630 0248_ $$2sideral$$a99047
000061630 037__ $$aART-2017-99047
000061630 041__ $$aeng
000061630 100__ $$0(orcid)0000-0003-4130-5866$$aRamírez, J.$$uUniversidad de Zaragoza
000061630 245__ $$aT-wave morphology restitution predicts sudden cardiac death in patients with chronic heart failure
000061630 260__ $$c2017
000061630 5060_ $$aAccess copy available to the general public$$fUnrestricted
000061630 5203_ $$aBackground
Patients with chronic heart failure are at high risk of sudden cardiac death (SCD). Increased dispersion of repolarization restitution has been associated with SCD, and we hypothesize that this should be reflected in the morphology of the T‐wave and its variations with heart rate. The aim of this study is to propose an electrocardiogram (ECG)‐based index characterizing T‐wave morphology restitution (TMR), and to assess its association with SCD risk in a population of chronic heart failure patients.
Methods and Results
Holter ECGs from 651 ambulatory patients with chronic heart failure from the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study were available for the analysis. TMR was quantified by measuring the morphological variation of the T‐wave per RR increment using time‐warping metrics, and its predictive power was compared to that of clinical variables such as the left ventricular ejection fraction and other ECG‐derived indices, such as T‐wave alternans and heart rate variability. TMR was significantly higher in SCD victims than in the rest of patients (median 0.046 versus 0.039, P<0.001). When TMR was dichotomized at TMR=0.040, the SCD rate was significantly higher in the TMR≥0.040 group (P<0.001). Cox analysis revealed that TMR≥0.040 was strongly associated with SCD, with a hazard ratio of 3.27 (P<0.001), independently of clinical and ECG‐derived variables. No association was found between TMR and pump failure death.
Conclusions
This study shows that TMR is specifically associated with SCD in a population of chronic heart failure patients, and it is a better predictor than clinical and ECG‐derived variables.
000061630 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/TIN2013-41998-R$$9info:eu-repo/grantAgreement/ES/MINECO/TEC2013-42140-R$$9info:eu-repo/grantAgreement/ES/MINECO/DPI2016-75458-R$$9info:eu-repo/grantAgreement/ES/ISCIII/CIBER-BBN-MULTITOOLS2HEART$$9This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 638284-MODELAGE$$9info:eu-repo/grantAgreement/EC/H2020/638284/EU/Is your heart aging well? A systems biology approach to characterize cardiac aging from the cell to the body surface/MODELAGE$$9info:eu-repo/grantAgreement/ES/DGA/T96
000061630 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000061630 590__ $$a4.45$$b2017
000061630 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b36 / 128 = 0.281$$c2017$$dQ2$$eT1
000061630 592__ $$a2.674$$b2017
000061630 593__ $$aCardiology and Cardiovascular Medicine$$c2017$$dQ1
000061630 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000061630 700__ $$aOrini, M.
000061630 700__ $$aMincholé, A.
000061630 700__ $$aMonasterio, V.
000061630 700__ $$aCygankiewicz, I.
000061630 700__ $$ade Luna, A.B.
000061630 700__ $$0(orcid)0000-0002-7503-3339$$aMartínez, J.P.$$uUniversidad de Zaragoza
000061630 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo, E.$$uUniversidad de Zaragoza
000061630 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, P.$$uUniversidad de Zaragoza
000061630 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000061630 773__ $$g6, 5 (2017), e005310 [11 pp.]$$tJournal of the American Heart Association. Cardiovascular and cerebrovascular disease$$x2047-9980
000061630 8564_ $$s616054$$uhttps://zaguan.unizar.es/record/61630/files/texto_completo.pdf$$yVersión publicada
000061630 8564_ $$s121746$$uhttps://zaguan.unizar.es/record/61630/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000061630 909CO $$ooai:zaguan.unizar.es:61630$$particulos$$pdriver
000061630 951__ $$a2021-05-07-08:09:34
000061630 980__ $$aARTICLE