Importance of lead aVR on predicting adverse cardiac events in patients with noncompaction cardiomyopathy.
Adult
Cardiomyopathies
/ complications
Death, Sudden, Cardiac
Defibrillators, Implantable
Electrocardiography
/ methods
Female
Heart
/ physiopathology
Heart Failure
/ complications
Humans
Male
Retrospective Studies
Risk Assessment
Risk Factors
Tachycardia, Ventricular
/ complications
Ventricular Fibrillation
/ complications
T wave
electrocardiography
lead aVR
noncompaction cardiomyopathy
risk stratification
sudden cardiac death
Journal
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
ISSN: 1542-474X
Titre abrégé: Ann Noninvasive Electrocardiol
Pays: United States
ID NLM: 9607443
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
16
08
2019
revised:
15
09
2019
accepted:
17
09
2019
pubmed:
15
10
2019
medline:
29
6
2021
entrez:
15
10
2019
Statut:
ppublish
Résumé
Noncompaction cardiomyopathy (NCCM) is a relatively rare cardiac abnormality with high rates of mortality and morbidity. T-wave amplitudes during ventricular repolarization in lead aVR (TaVR) have been reported to be associated with the prognosis of various cardiovascular diseases. This study sought to investigate the prevalence and prognostic role of positive TaVR in patients with NCCM. We evaluated consecutive 161 patients with NCCM (65.8% men, mean age 42.5 ± 15.2 years old). Presentation electrocardiogram was assessed regarding classical parameters as well as T-wave amplitudes in lead aVR. The primary endpoint was defined as composite lethal arrhythmic events, including sudden cardiac death, ventricular fibrillation, or sustained ventricular tachycardia or appropriate implantable cardioverter-defibrillator shock. Heart failure requiring hospitalization, cardiovascular death, and all-cause mortality were also investigated as secondary endpoints. Patients with positive TaVR showed higher rates for arrhythmic events, hospitalization for heart failure, and death compared with patients without it. In multivariate Cox model, after adjusting for other known clinical and electrocardiographic risk factors, the positive TaVR was found to be a strong independent predictor of primary endpoint (HR: 4.8, 95% CI: 1.2-19.3; p = .025) and all-cause death (HR: 3.5, 95% CI: 1.0-12.1; p = .045). Our findings revealed that positive TaVR is significantly and independently associated with adverse outcomes in NCCM patients. This unique ECG criterion in the often ignored lead provides incremental information beyond what is available with other traditional risk factors.
Sections du résumé
BACKGROUND
Noncompaction cardiomyopathy (NCCM) is a relatively rare cardiac abnormality with high rates of mortality and morbidity. T-wave amplitudes during ventricular repolarization in lead aVR (TaVR) have been reported to be associated with the prognosis of various cardiovascular diseases. This study sought to investigate the prevalence and prognostic role of positive TaVR in patients with NCCM.
METHODS
We evaluated consecutive 161 patients with NCCM (65.8% men, mean age 42.5 ± 15.2 years old). Presentation electrocardiogram was assessed regarding classical parameters as well as T-wave amplitudes in lead aVR. The primary endpoint was defined as composite lethal arrhythmic events, including sudden cardiac death, ventricular fibrillation, or sustained ventricular tachycardia or appropriate implantable cardioverter-defibrillator shock. Heart failure requiring hospitalization, cardiovascular death, and all-cause mortality were also investigated as secondary endpoints.
RESULTS
Patients with positive TaVR showed higher rates for arrhythmic events, hospitalization for heart failure, and death compared with patients without it. In multivariate Cox model, after adjusting for other known clinical and electrocardiographic risk factors, the positive TaVR was found to be a strong independent predictor of primary endpoint (HR: 4.8, 95% CI: 1.2-19.3; p = .025) and all-cause death (HR: 3.5, 95% CI: 1.0-12.1; p = .045).
CONCLUSION
Our findings revealed that positive TaVR is significantly and independently associated with adverse outcomes in NCCM patients. This unique ECG criterion in the often ignored lead provides incremental information beyond what is available with other traditional risk factors.
Identifiants
pubmed: 31609051
doi: 10.1111/anec.12719
pmc: PMC7358825
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12719Informations de copyright
© 2019 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals, LLC.
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