Efficacy of T-Wave Alternans for the Prediction of Lethal Arrhythmic Events after Myocardial Infarction
Korean Circulation Journal
;
: 597-604, 2005.
Artículo
en Coreano
| WPRIM
| ID: wpr-189122
ABSTRACT
BACKGROUND AND OBJECTIVES:
The prevention of sudden death in patients with a myocardial infarction (MI) remains the therapeutic target. T-wave alternans is as a heart rate dependent measure of repolarization, which correlates with ventricular arrhythmia vulnerability. The goals of this study were to clarify whether microvolt-level T-wave alternans (mTWA) can predict lethal arrhythmic events, and compare their role with other risk indices in predicting lethal events following a MI. SUBJECTS ANDMETHODS:
The mTWA was analyzed in 78 MI patients, using a power-spectral method during bicycle exercise testing. Additionally, the left ventricular ejection fraction (EF), late potentials (LP) and heart rate variability were also measured.RESULTS:
The mTWA was positive in 16 patients (21%), negative in 36 (46%) and indeterminate in 21 (33%). Lethal arrhythmic events developed in 7 patients (3 sudden deaths, 3 ventricular tachycardia and 1 ventricular fibrillation), during a mean follow-up of 12+/-3 months. The event rate was significantly higher in patients with a positive mTWA (relative risk 12.0, 95% CI 1.2 to 118.1, p=0.01) or lower EF (<40%)(relative risk 11.0, CI 1.9 to 65.0, p=0.002). The mTWA test exhibited the highest sensitivity, relative risk and negative predictive value, but the lowest specificity; positive predictive values were observed compared with the EF or a combination of the two indices.CONCLUSION:
mTWA was closely related to the occurrence of lethal arrhythmic events in patients with a MI. Therefore, mTWA with a lower EF could be a useful screening test for the prediction of potentially lethal arrhythmic events following a MI.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Arritmias Cardíacas
/
Volumen Sistólico
/
Fibrilación Ventricular
/
Tamizaje Masivo
/
Estudios de Seguimiento
/
Sensibilidad y Especificidad
/
Muerte Súbita Cardíaca
/
Taquicardia Ventricular
/
Muerte Súbita
/
Prueba de Esfuerzo
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
/
Estudio de tamizaje
Límite:
Humanos
Idioma:
Coreano
Revista:
Korean Circulation Journal
Año:
2005
Tipo del documento:
Artículo
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