Prognostic value of microvolt level T-wave alternans in patients at high risk of sudden cardiac death / 中华心血管病杂志
Chinese Journal of Cardiology
;
(12): 517-522, 2008.
Article
Dans Chinois
| WPRIM
| ID: wpr-243741
ABSTRACT
<p><b>OBJECTIVE</b>To explore the predict value of microvolt level T-wave alternans (MTWA) for malignant ventricular arrhythmia (MVA) and sudden cardiac death (SCD) in high risk patients.</p><p><b>METHODS</b>A total of 105 healthy subjects (control group) and 138 patients with history of VT or VF or patients with LVEF < or = 45% (SCD high risk group) were included in this study (mean age 52 years old). MTWA, LVEF, HRV, NSVT, QRS, QTc values and MACE data (death, causes of death, MVA, re-hospitalization, syncope) during follow up (12.0 +/- 1.3) months were obtained.</p><p><b>RESULTS</b>The normal reference value of MTWA was defined as < 37 microV. Positive rate in SCD high risk group was significantly higher than that in control group (45.7% vs. 4.8%, P < 0.01). There was no cardiovascular event report in control group. In SCD high risk group, there were 11 deaths (MTWA positive rate 81.8%) including 7 SCD (MTWA positive rate 85.7%), 17 MVA (MTWA positive rate 88.2%), 9 cases of syncope (MTWA positive rate 77.8%), 21 cases of re-hospitalization during the follow up (MTWA positive rate 85.7%). Logistic regression analysis revealed that positive MTWA, a history of myocardial infarction and LVDd > or = 60 mm were risk factors for all cause of death and positive MTWA was the only factor to predict SCD. The factors related to MVA in turn were positive MTWA, LVEF < or = 35%, a history of cardiopulmonary resuscitation and a history of syncope. Positive MTWA and LVEF < or = 35% are the independent risk factors for predicting MVA (P < 0.01). The sensitivity was 91% and specifity was 66% by combined use of positive MTWA and LVEF < or = 35% to predict MVA. MTWA positive rates were 68.3% and 87.5% respectively in 41 ICD patients and ICD patients with automatic shock during follow up.</p><p><b>CONCLUSION</b>Non-invasive MTWA measurement could be used as a screening tool to predict SCD or MVA in high risk patients.</p>
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Troubles du rythme cardiaque
/
Pronostic
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Fibrillation ventriculaire
/
Études cas-témoins
/
Valeur prédictive des tests
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Mort subite cardiaque
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Défibrillateurs implantables
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Appréciation des risques
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Techniques électrophysiologiques cardiaques
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Diagnostic
Type d'étude:
Etude diagnostique
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Etude d'étiologie
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Étude observationnelle
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Étude pronostique
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Facteurs de risque
Limites du sujet:
Adolescent
/
Adulte
/
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Chinois
Texte intégral:
Chinese Journal of Cardiology
Année:
2008
Type:
Article
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