Efficacy of T-Wave Alternans for the Prediction of Lethal Arrhythmic Events after Myocardial Infarction
Korean Circulation Journal
;
: 597-604, 2005.
Artigo
em 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:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Arritmias Cardíacas
/
Volume Sistólico
/
Fibrilação Ventricular
/
Programas de Rastreamento
/
Seguimentos
/
Sensibilidade e Especificidade
/
Morte Súbita Cardíaca
/
Taquicardia Ventricular
/
Morte Súbita
/
Teste de Esforço
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
/
Estudo de rastreamento
Limite:
Humanos
Idioma:
Coreano
Revista:
Korean Circulation Journal
Ano de publicação:
2005
Tipo de documento:
Artigo
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