Augmented Oscillations in QT Interval Duration Predict Mortality Post Myocardial Infarction Independent of Heart Rate.
autoregressive model
cardiovascular disease
myocardial infarction
repolarization variability
risk stratification
sudden death
Journal
Frontiers in physiology
ISSN: 1664-042X
Titre abrégé: Front Physiol
Pays: Switzerland
ID NLM: 101549006
Informations de publication
Date de publication:
2020
2020
Historique:
received:
30
06
2020
accepted:
16
10
2020
entrez:
26
11
2020
pubmed:
27
11
2020
medline:
27
11
2020
Statut:
epublish
Résumé
This study seeks to decompose QT variability (QTV) into physiological sources and assess their role for risk stratification in patients post myocardial infarction (MI). We hypothesize that the magnitude of QTV that cannot be explained by heart rate or respiration carries important prognostic information. Elevated beat-to-beat QTV is predictive of cardiac mortality, but the underlying mechanisms, and hence its interpretation, remain opaque. We decomposed the QTV of 895 patients post MI into contributions by heart rate, respiration, and unexplained sources. Cox proportional hazard analysis demonstrates that augmented oscillations in QTV and their level of dissociation from heart rate are associated with a higher 5-year mortality rate (18.4% vs. 4.7%, Augmented oscillations in QTV and discordance from heart rate, possibly indicative of excessive sympathetic outflow to the ventricular myocardium, predict high risk in patients post MI independent from established risk markers. www.ClinicalTrials.gov, identifier NCT00196274.
Sections du résumé
OBJECTIVE
OBJECTIVE
This study seeks to decompose QT variability (QTV) into physiological sources and assess their role for risk stratification in patients post myocardial infarction (MI). We hypothesize that the magnitude of QTV that cannot be explained by heart rate or respiration carries important prognostic information.
BACKGROUND
BACKGROUND
Elevated beat-to-beat QTV is predictive of cardiac mortality, but the underlying mechanisms, and hence its interpretation, remain opaque.
METHODS
METHODS
We decomposed the QTV of 895 patients post MI into contributions by heart rate, respiration, and unexplained sources.
RESULTS
RESULTS
Cox proportional hazard analysis demonstrates that augmented oscillations in QTV and their level of dissociation from heart rate are associated with a higher 5-year mortality rate (18.4% vs. 4.7%,
CONCLUSION
CONCLUSIONS
Augmented oscillations in QTV and discordance from heart rate, possibly indicative of excessive sympathetic outflow to the ventricular myocardium, predict high risk in patients post MI independent from established risk markers.
CLINICAL TRIAL REGISTRATION
BACKGROUND
www.ClinicalTrials.gov, identifier NCT00196274.
Identifiants
pubmed: 33240101
doi: 10.3389/fphys.2020.578173
pmc: PMC7680963
doi:
Banques de données
ClinicalTrials.gov
['NCT00196274']
Types de publication
Journal Article
Langues
eng
Pagination
578173Informations de copyright
Copyright © 2020 El-Hamad, Bonabi, Müller, Steger, Schmidt and Baumert.
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