Association of non-invasive electrocardiographic risk factors with left ventricular systolic function in post-myocardial infarction patients with mildly reduced or preserved ejection fraction: Insights from the PRESERVE-EF study.
late potentials
left ventricular ejection fraction
non-invasive risk factors
non-sustained ventricular tachycardia
risk stratification
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:
09 2022
09 2022
Historique:
revised:
09
02
2022
received:
13
01
2022
accepted:
10
02
2022
pubmed:
8
7
2022
medline:
21
9
2022
entrez:
7
7
2022
Statut:
ppublish
Résumé
Electrocardiographic non-invasive risk factors (NIRFs) have an important role in the arrhythmic risk stratification of post-myocardial infarction (post-MI) patients with preserved or mildly reduced left ventricular ejection fraction (LVEF). However, their specific relation to left ventricular systolic function remains unclear. We aimed to evaluate the association between NIRFs and LVEF in the patients included in the PRESERVE-EF trial. We studied 575 post-MI ischemia-free patients with LVEF≥40% (mean age: 57.0 ± 10.4 years, 86.2% men). The following NIRFs were evaluated: premature ventricular complexes, non-sustained ventricular tachycardia (NSVT), late potentials (LPs), prolonged QTc, increased T-wave alternans, reduced heart rate variability, and abnormal deceleration capacity with abnormal turbulence. There was a statistically significant relationship between LPs (Chi-squared = 4.975; p < .05), nsVT (Chi-squared = 5.749, p < .05), PVCs (r= -.136; p < .01), and the LVEF. The multivariate linear regression analysis showed that LPs (p = .001) and NSVT (p < .001) were significant predictors of the LVEF. The results of the multivariate logistic regression analysis indicated that LPs (OR: 1.76; 95% CI: 1.02-3.05; p = .004) and NSVT (OR: 2.44; 95% CI: 1.18-5.04; p = .001) were independent predictors of the mildly reduced LVEF: 40%-49% versus the preserved LVEF: ≥50%. Late potentials and NSVT are independently related to reduced LVEF while they are independent predictors of mildly reduced LVEF versus the preserved LVEF. These findings may have important implications for the arrhythmic risk stratification of post-MI patients with mildly reduced or preserved LVEF.
Sections du résumé
BACKGROUND
Electrocardiographic non-invasive risk factors (NIRFs) have an important role in the arrhythmic risk stratification of post-myocardial infarction (post-MI) patients with preserved or mildly reduced left ventricular ejection fraction (LVEF). However, their specific relation to left ventricular systolic function remains unclear. We aimed to evaluate the association between NIRFs and LVEF in the patients included in the PRESERVE-EF trial.
METHODS
We studied 575 post-MI ischemia-free patients with LVEF≥40% (mean age: 57.0 ± 10.4 years, 86.2% men). The following NIRFs were evaluated: premature ventricular complexes, non-sustained ventricular tachycardia (NSVT), late potentials (LPs), prolonged QTc, increased T-wave alternans, reduced heart rate variability, and abnormal deceleration capacity with abnormal turbulence.
RESULTS
There was a statistically significant relationship between LPs (Chi-squared = 4.975; p < .05), nsVT (Chi-squared = 5.749, p < .05), PVCs (r= -.136; p < .01), and the LVEF. The multivariate linear regression analysis showed that LPs (p = .001) and NSVT (p < .001) were significant predictors of the LVEF. The results of the multivariate logistic regression analysis indicated that LPs (OR: 1.76; 95% CI: 1.02-3.05; p = .004) and NSVT (OR: 2.44; 95% CI: 1.18-5.04; p = .001) were independent predictors of the mildly reduced LVEF: 40%-49% versus the preserved LVEF: ≥50%.
CONCLUSION
Late potentials and NSVT are independently related to reduced LVEF while they are independent predictors of mildly reduced LVEF versus the preserved LVEF. These findings may have important implications for the arrhythmic risk stratification of post-MI patients with mildly reduced or preserved LVEF.
Identifiants
pubmed: 35795926
doi: 10.1111/anec.12946
pmc: PMC9484020
doi:
Substances chimiques
Lipopolysaccharides
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12946Subventions
Organisme : Medtronic Hellas S.A.
Organisme : General Electric Healthcare
Informations de copyright
© 2022 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.
Références
J Am Coll Cardiol. 2017 Feb 7;69(5):556-569
pubmed: 28153111
Ann Noninvasive Electrocardiol. 2022 Mar;27(2):e12908
pubmed: 34873786
J Arrhythm. 2020 Aug 02;36(5):890-898
pubmed: 33024466
Ann Noninvasive Electrocardiol. 2022 Sep;27(5):e12946
pubmed: 35795926
Hellenic J Cardiol. 2014 Sep-Oct;55(5):361-8
pubmed: 25243434
Eur J Heart Fail. 2008 Oct;10(10):1007-14
pubmed: 18692437
Ital Heart J. 2005 Sep;6(9):721-7
pubmed: 16212073
Ann Noninvasive Electrocardiol. 2017 Mar;22(2):
pubmed: 28252256
Diagnostics (Basel). 2020 Jul 31;10(8):
pubmed: 32751773
Eur Heart J. 2003 Jul;24(13):1204-9
pubmed: 12831814
Circ Res. 2015 Jun 5;116(12):1907-18
pubmed: 26044247
Europace. 2013 Jun;15(6):813-9
pubmed: 23365069
Pacing Clin Electrophysiol. 2014 Apr;37(4):447-53
pubmed: 24215211
Am J Cardiol. 1987 May 1;59(12):1071-4
pubmed: 3578046
Card Electrophysiol Clin. 2009 Dec;1(1):105-116
pubmed: 28770777
Ann Noninvasive Electrocardiol. 2021 Jan;26(1):e12803
pubmed: 32969113
J Clin Med. 2021 Apr 22;10(9):
pubmed: 33922111
Eur Heart J. 2005 Apr;26(8):762-9
pubmed: 15778204
Ann Noninvasive Electrocardiol. 2020 Jan;25(1):e12701
pubmed: 31605453
J Arrhythm. 2018 May 28;34(3):222-229
pubmed: 29951136
Hellenic J Cardiol. 2017 Nov - Dec;58(6):443-445
pubmed: 28351656
Eur Heart J. 2019 Sep 14;40(35):2940-2949
pubmed: 31049557
J Am Coll Cardiol. 2006 Mar 21;47(6):1161-6
pubmed: 16545646